Tag Archives: delusions

Dementia on TV

Social science research suggests that our views of reality are often shaped by what we see on television. Now that characters with dementia are popping up on TV, people who have no contact with the disease may view these fictions as portraits of the real thing. Do you think Hollywood is getting it right?

For a while I’ve been tracking two TV characters with distinct forms of dementia. Maw Maw, on the weekly comedy Raising Hope, is the great-grandmother of the Chance family. Cloris Leachman portrays Maw Maw as an endearing person with advanced Alzheimer’s. Her bizarre behavior can be both troubling and useful.  In some episodes, Maw Maw has incredibly lucid moments during which she can fix household appliances — in other shows she lapses into a comatose state or takes her clothes off in public places. There have been a few episodes where things went way over the top — like when Maw Maw attended a wake and stole the dress off a corpse. But every character on this show gets caught doing ridiculous things, so the person with dementia isn’t too much crazier than the other members of the family. For me, the best aspect of this show is the love displayed by all these fictitious creatures and the joy of life that animates their goofy household.

The Kane family, on Boss, enjoys none of this happiness. They have money and power, but they seethe with anger and shared disappointment. Along with the rest of Chicago, the Kanes live in thrall to their family patriarch, the city’s ruthless mayor who secretly suffers from Lewy Body dementia. In recent episodes, Kane’s disease has taken center stage. He’s been whiplashed by hallucinations and manic fits while trying to run an urban empire and keep his foes in check. Since Kane won’t relinquish the reins of power, he has embraced untested therapies to manage his symptoms. His “alternative” cure required injections of stem cells — followed by shock treatments. I haven’t seen the final episodes so I’m not sure if the procedures will improve Kane’s health — or just make him more of a tyrant. The most compelling element of the character is his constant struggle to deal with delusions and keep a grip on reality.

If you are a caregiver for someone with dementia, you might enjoy watching some episodes or just viewing clips of these programs online. If you don’t like the way the disease is portrayed, you can share your opinions on the shows’ websites. Our comments won’t transform the television industry. It revolves around short scripts that maximize melodrama. But we can still complain if we think their images give people an unfair picture of dementia. What are your thoughts?

Care and Feeding of a Delusion

Lots of people suffer from delusions. That guy in the jacked-up truck believes his morning rush is more pressing than yours, so he cuts you off without a signal. Charlie Sheen thought he was a warlock full of tiger blood, though he now seems less convinced. Dementia, however, produces powerful delusions that complicate caregiving in a million ways.

When considering the delusions that have troubled my mom, I’ve searched for patterns that could help me fight back. From what I can deduce, the recipe for a persistent delusion begins with a tiny shred of truth. She never has delusions about being rich or having a summer Christmas. Something unpleasant kicks it off. It could be as simple as a stranger speaking harshly or an appliance malfunction. Her disease embraces this bad moment. Instead of erasing the thought — as it has so many other memories — dementia embroiders a complex tapestry around it. Suddenly, instead of one unpleasant incident (which a healthy person might forget after dinner), the little scrap of unhappiness gets stitched into a vast pattern of disturbance that echoes without cease. After the mind has done so much work to grow a small fear into a giant, reality cannot win without a fight.

For a while my Mom believed that the occasional leak in our faucet meant that we were about to run out of water. She was afraid to use water, afraid we wouldn’t be able to take showers. Then she thought the toilet would overflow. Her fear of using the toilet pushed her to stop drinking water. The circle of magical thinking spiraled into a very dangerous practice of willful, self-dehydration. Fortunately this particular fear has now receded — but not without patient effort on my part.

Experts in the field warn that caregivers should not be confrontational when challenging a dementia patient’s way of seeing. The disease often limits their insight about their behavior. When you get pulled into an argument over the facts, you may end up expending your scarce energy without ever changing their actions. In the case of Mom’s water phobia, it took nearly a month of calm re-direction to defuse the power of her obsession. Whew!

Today I am thankful that her terrors have subsided. When she is calm and clear, she is a joy to be around. Her happiness is at least as infectious as her distress. I know we will face a slew of other strange suspicions in the future. I just hope Halloween won’t trigger any weird fears that can’t be erased by some candy.