This afternoon, one of my loves frantically stopped me in the hallway as I passed her apartment: “Chris, can you help me? Please, please help me for a minute?!” She was visibly panicked as she reached for a notebook and pencil from her rollator. Shakily, she wrote down 4:45. “Supper is at 4:45. 11:45 is lunch.” She repeated and re-wrote, “4:45, 11:45.”
While this behavior was without a doubt concerning and definitely out of character, I can’t say that I was completely surprised; yesterday, I affectionately reminded her of my 3PM program, to which she replied, “I just have to get to supper first, then I’ll be there!” A little strange, but I assumed hoped she was having a late lunch and simply slipped and called it dinner. To my (and her) disappointment, she was shooed away by the wait staff – supper was not for another two hours. Oh, and to be clear, this nonna is not a dementia resident. 😦
With a lump in my throat and a heavy heart, I spent the next half hour drawing clock faces and timetables. She was able to without hesitation read me the time displayed on her watch, yet she had no idea what those numbers meant. She confidently (and accurately) explained which hand was for minutes and which for the hour, and repeated her seating times and the meals served at each. When it came to tying the two together, however – that clear number and its obscure meaning, she simply was not able. Understandably so, she was an overwhelming mixture of scared, upset, confused, and mortified.
It’s pretty widely understood that people with dementia have a warped sense of time; their reality orientation may be off by several years. In other words, they might think they’re decades younger than they actually are, in turn mistaking adult children for siblings or a frightening, unrecognizable mirror reflection for someone else’s. We also get that they lose sense of the passage of time, therefore experiencing a shorter attention span and not comprehending how long it’s been since some event occurred. Seemingly less implicit, however, is the fact that the ability to read a clock may be lost early in the course of the disease: Even when a person can look at the clock and say, “It is 3:15,” he may be unable to make sense of this information. Could you imagine? Obviously, my love was distraught today, and I don’t blame her one bit:
“Not being able to keep track of time can worry the forgetful person. Many of us, throughout our lives, are dependent on a regular time schedule. Not knowing the time can make a person worry that he will be late, be forgotten, miss the bus, overstay his welcome, miss lunch, or miss his ride home. The person who has dementia may not know just what he is worried about, but a general feeling of anxiety may [occur].”
There’s no one-size-fits-all when it comes to these difficult situations; everyone is unique and will respond differently to your approach. In our case this afternoon, I felt a new watch was a solid first step. It took just minutes to find one on Amazon with daily alarms and a large display. She’ll be alerted every mealtime and, given her current cognitive state, should hopefully make her way to the dining room with less anxiety and much more confidence. And if she arrives at 11:45 for lunch but calls it supper, I’ll *still* consider it a win and cheerfully escort her to her seat.