How to Talk to Kids About Dementia-Related Psychosis
Young children will have questions, and you can be a resource for them.
Dementia can takea real toll on families. When a loved one begins losing treasured memories, forgetting names, and even mistaking the identities of close relatives, it is heartbreaking for everybody involved. And in cases of dementia-related psychosis—where hallucinations and delusions cause a patient to believe things that aren’t real—these episodes can be scary and confusing to witness.
“Seeing a family member’s behavior change in such a profound way has a direct impact on relationships,” says Angela Lunde, neurology associate and co-investigator of the Outreach, Recruitment and Engagement Core in the Mayo Clinic Alzheimer’s Disease Research Center in Rochester, MN. This is especially true for young children, who don’t necessarily understand dementia and how it affects someone’s brain. “For children, it can be hard to navigate seeing a grandparent in a way they haven’t seen before,” Lunde explains. “Unless a child has good guidance and understanding in terms of what can go wrong, I think oftentimes that relationship[孩子和痴呆症的人之间]can become strained.”
If it’s your parent (or older relative) with失智, and your child with all the questions, it can be a stressful situation for you to be sandwiched in the middle of. We asked three dementia experts to help guide you through the process of what to say—and how to say it.
对孩子们诚实。
经常看到他们祖父母的孩子们无疑会发现他们记忆和个性的变化。不要试图忽略那个现实或屏蔽他们真相。“成年人应该公开，诚实地回答问题，”莫妮卡·莫雷诺，芝加哥阿尔茨海默氏症协会的高级总监。此外，“没关系，不能拥有所有的答案。”
在回答她的问题时，请按照孩子的领导。“让孩子们在他们所知道的和他们想要分享的内容方面设置舞台，以及他们所看到的是如何让他们感受到的，”伦德说。告诉你的孩子，你们都在体验这些情绪，并通过作为一个家庭的挑战。
Suggestion:“我相信由于他的病，你已经注意到爷爷的行为的变化。我们都是一个家庭，我都在这里，如果你想谈谈。“
2. Explain clearly what dementia-related psychosis is (in age-appropriate terms).
“Tell your child the name of the disease,” Lunde says. “It’s important to let them know that grandma or grandpa has an illness that will not get better. They may look the same on the outside, but their brain is changing on the inside due to this illness.” To explain psychosis symptoms to children, you can tell them that their grandparent sometimes sees things that aren’t real, like an imaginary person or object.
Dementia-related psychosis can be especially confusing for children if they usually see their grandparent at their best. Melissa Armstrong, M.D., director of the Mangurian Clinical-Research Headquarters for Lewy Body Dementia at the University of Florida in Gainesville, explains that people with dementia can often get short bursts of energy and clarity在家庭聚会期间, seeming more like their old selves for a few hours in the presence of guests. “People with dementia can actually rally for a few days,” she says. “That’s both good and bad. It does mean that some of these events with families can go more smoothly.” But it also means that children may not fully understand why a grandparent is “on” one day and extremely forgetful or confused the next. Try to explain this to them as simply and clearly as you can.
Suggestion:“Grandma’s brain can sometimes play tricks on her. She might feel fine one day and very confused the next, so don’t be surprised if she forgets things. She might even forget your name or where you go to school, but that doesn’t mean she doesn’t care about you.”
3. Validate their feelings.
没有绕过It-Dementia相关的精神病对每个见证它的人引起强烈的情绪（它也可能对患者的可怕）。“If people have been married for 50 years and all of a sudden the husband is saying, ‘You’re cheating on me’ to the caregiving spouse, that is hugely painful for the spouse, caregiver, and the kids, too,” Dr. Armstrong says. She suggests reassuring young children and making sure they feel safe.
Suggestion:“Grandpa didn’t really mean what he just said—that’s the illness talking, but I know how scary that must have been for you. How are you feeling?”
4.提醒他们他们的祖父母爱他们。
It’s very easy for kids to take hallucinations and delusions personally, especially if their grandparent becomes angry or agitated. Try to help your child understand that this isn’t how their grandparent actually feels, but that the disease is making them confused. “I would probably tell them, ‘This disease that your grandma or grandpa has can play tricks on the mind, and grandma or grandpa may see or hear things that are not there, like people or animals. Even though we cannot see these people or animals, grandma or grandpa’s brain thinks they are real,’” Lunde suggests. That doesn’t mean that their grandparent no longer cares about them.
Suggestion:“Your grandma loves you very much, even when it seems like she doesn’t. Try to remember that she behaves this way because of her illness, not because of her true feelings.”
5.提供如何在此刻回应的简单建议。
您的孩子不应该觉得自己需要“修复”心理事件发生的情况。相反，告诉他，他总能要求你寻求帮助或在你回应时让他看看，所以他可以同样在未来做。
当你对你的家人中介想要敏感er’s feelings, you do not need to pretend you can see or hear the hallucinations along with the grandparent, says Lunde. Instead, “focus on being kind to their feelings—something even a young child can understand,” she says. For instance, if the hallucination is making Grandpa happy, your child might say, “Wow, that sounds wonderful, I’m glad you are happy.” If Grandma feels afraid, your child might respond, “That sounds scary. I’m here for you.” And if the person with dementia is becoming agitated, bring in other family members to diffuse the situation.
Suggestion:“If grandpa starts talking about things that aren’t real, you don’t have to pretend to see those things. Just tell him you hear him and care about him. I’m here if you need someone to help you out.”
6.继续谈论它，因为您所爱的人的症状进展。
The very nature of dementia is ever-changing, and your loved one may seem markedly different from one day to the next. Tell the kids that you are an open book to discuss any questions they have. “These should be ongoing conversations because dementia symptoms progress and change over time,” Lunde says. Check in with the child from time to time to see how they are feeling.
Suggestion:“每次拜访她时，奶奶似乎都不同。我们都在不同的日子里感到不同吗？有时候你很开心，有时候你很伤心。它现在对奶奶相似。“
7.鼓励你的孩子关注好。
在这个过程中会有很多悲伤，但也可以有快乐的时刻。“当我们考虑痴呆症时，我们考虑下降和能力丧失，”伦德说。“对于孩子们来说，我们能做的最好的事情之一是帮助他们看到一个祖父母或与整个痴呆症的亲戚。[他们]may have some decline and some changes, but at the same time, there are many things they can still do.” Maybe it’s as simple as a daily walk around the block or spending time with a beloved pet. These experiences can still be meaningful for children and give them a connection point with their grandparent, even if they have trouble communicating in detail.
Suggestion:“Grandpa has trouble talking right now, but he loves it when you come over and play the piano. Could you play a song for him next time you come visit, or take him for a walk around the neighborhood?”
- 痴呆症相关的精神病症状：National Institute on Aging. (n.d.). “Alzheimer’s and Hallucinations, Delusions, and Paranoia.”nia.nih.gov/health/alzheimers-and-hallucinations-delusions-dant-paranoia.
