It’s a Wednesday morning in the Assisted Living Community that I managed. There’s nothing exceptionally challenging on my agenda on this day and “God is in his heaven and all appears to be right with the world.” As I head down to one of our main activity rooms, I’m called into one of the suites by one of my residents.
Marion was one of my younger, shall we say, higher functioning residents and one of the many I had a close relationship with. She said “Bob, I think I have a problem. There’s a chipmunk that comes out of this sprinkler head and then runs across the ceiling into that other sprinkler head.” As you would expect, my first thought was to insure her that we did not have rodents running around inside our building, her home, and leave it at that. I reconsidered that approach and then asked Marion if she would like, I could call maintenance immediately and have them deal with the problem. Surprisingly, she said “no, that’s OK, I think he’s kind of cute.”
Ellen was one of my more ”senior”seniors and one day she started coming into the office to complain about the man that was constantly stopping into her suite to use the bathroom. My staff and I investigated and it was determined that there was no man using her bathroom at any time. There were no men living on her floor, the few males we had on our staff, myself included, were rarely, on her floor and if any of us were and needed to use the facilities, we would never have gone into a residents suite. Once again, I recognized what I was dealing with and assured her that, as The Administrator, I would speak to the gentleman personally and that she would no longer have the problem. We never received another complaint.
While holding a formal, week long training of Police Officers, one of them brought up a challenging situation they had to deal with. Apparently a gentleman that lived alone in a senior housing community was convinced that there was a strange man coming through the woods in the back of his apartment. He was calling 911 on a regular basis and although the Department responded every time, there was no man to be found anywhere. After some careful thought, I suggested that they reach out to this man ,before the next 911 call and tell him that they are going to put an undercover officer in the parking lot by his building. I asked them to remind him that he probably won’t see them as they’ll be undercover but that way he won’t have to worry. If he comes back, they’ll catch him. The 911 calls stopped.
The one thing that these three stories have in common is those involved “joined the journey” of the parties involved. The number one thing these folks are looking to their support/care giving team for is to feel safe. If I had simply been dismissive of Marion’s concerns and the delusion, she may not have trusted me ever again. For the the older lady, that gentleman visitor was very real and to ignore that would not have helped her feel safe. And,likewise, the gentleman with the impression that some guy was coming out of the woods would never have been satisfied being told “there is no guy.” He was looking for a solution. That’s joining the journey. Once again I will remind you that you cannot reason with someone that has literally lost the ability to reason. Their world makes perfect sense to them and that’s part of the illness.
In all three examples, therapeutic fibbing proved to be a very effective way of dealing with the challenges . Be advised however it may not always work the first time. Especially when you’re working with hallucinations. Be patient and remember “job one” is to keep them in a “good place” feeling safe.
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