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Living With Alzheimer's >> Behavior Basics | 04.24.15

Disorientation: confusion with place and time  

We’ve all been lost at one time or another, and depending on the circumstances, the experience can range from annoying to terrifying. For people with dementia, the same is true, but with a crucial difference: they can become lost in familiar places or even become confused about the time of day or the year. This is the symptom known as disorientation.

Situations where disorientation can occur:

Away from home

Even commonly visited locations, such as a store or a friend’s house, can become a strange place for a person with dementia. You can practice orientation outside the home by pointing out familiar landmarks during walks, drives and other outings. However, visits outside the home should not be unsupervised. You can avoid potential orientation problems by inviting visitors to the person’s home, which is usually more familiar territory.

Within the home

Even a home that has been lived in for years can feel like a strange place to a person with dementia. That disorientation can bring on feelings of anxiety and insecurity, so it’s important to reassure the person that they are safe. Show them familiar objects, offer kind words of support and ask if they recognize any pictures, mementos or furniture.

If a person still insists they aren’t home, don’t try to argue with them. If they want to leave, take a short walk or a drive, and then point out familiar landmarks on the return trip. Constantly reinforce that they are safe and secure in your care.

Confusion with time

People with dementia can become lost in time as well as in space. They may confuse the time of day by treating morning as evening, or vice versa. They may repeatedly ask about the time. They may believe it is a different year, or even a different decade, and ask to see or contact long dead people.

If a person is convinced they are correct about the circumstances of the day and the year, sometimes it’s best to play along. That’s especially true if they believe a deceased loved one is still alive. Reminding them of the death would only cause them to relive the pain of the loss. Instead, you might ask them to share with you a happy memory about the person.

Social disorientation

Forgetting the rules of certain surroundings (a church, a restaurant, etc.) can lead to inappropriate behavior on the part of a person with dementia–and embarrassment for the caregiver. The social filters that are usually in place may no longer apply, which could mean loud, rude and obnoxious actions in public. In these cases, you have to depend on the understanding of those around you and make the best of the situation. Remember, the person with dementia is not responsible for this unseemly behavior. It is the disease that is to blame.

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