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Why I Pretend to See What My Mother Sees

The debate over responding to Alzheimer's hallucinations.

Key points

  • Hallucinations form part of my mother’s Alzheimer’s.
  • “Don’t argue, see what she sees,” a neurologist friend told me.
  • What she needs is reassurance. And I offer that; I can assuage some of the fear.
Source: dall.e/OpenAI

My mother asks, sounding fretful, “Who are those people at the window? Why are they staring at me?”

I look out into the garden, a sprinkler rotates lazily, the tops of trees tip slightly in the breeze. But I don’t see a soul; there’s nobody there.

“They’ll go soon, Mum, don’t worry, they’ll go soon.”

Hallucinations form part of my mother’s Alzheimer’s; fabrications stitching up the holes sheared wide by this disease.

A friend, a neurologist, taught me to do this: “Don’t argue, see what she sees,” she urged. I try to remember that.

My husband’s instinct taught him the same lesson.

“Those children...” Mum says, craning her neck as if to see better as she gazes across the lawn, “Who do you think that man is that's with them?”

My husband does not miss a beat. He looks up and in the direction she’s pointing, feigns focus on this fictive arrangement of invisible people.

And then he says, with conviction, as if he has recognised the gentleman my mother is gesturing towards, “Oh, that’s just their dad.”

Mum visibly relaxes, "Oh good," she says. "I was worried."

"Don’t be," says my husband gently, “I think he must be a very good dad, spending time with his kids like that, don’t you?”

"Yes," says Mum thoughtfully, "He must be."

And with that, her vision slowly dissolves; she does not mention the children again that day.

Cardiologist Sandeep Jauhar describes learning to lie to his father when he had to, to make the experience of Alzheimer’s less painful for them both, to defuse distress.

I understand what he means. But I don’t think it’s lying. I think it’s buying into the reality dementia conjures. Holding a person’s hand as they navigate a twilight world.

My husband reads none of the stuff I read on the illness, he does not unpick the science of dementia with my forensic habit (one sharpened by unhelpful comments from friends, "Let’s hope it’s not genetic").

How did you know, I ask him later, “How did you know to pretend you could see what she sees? How did you know what to say?”

He shrugs, “It’s common sense, isn’t it? And kinder: You take the fear out of it and at the same time turn it into a conversation.”

I think he must be a very good dad, spending time with his kids like that, don’t you?

When I ask my sister why we have adopted this sort of "emperor’s new clothes" pretence—seeing what is plainly not there—she says, “We have to make mum’s reality safe, whatever her reality is.”

My mother no longer has the means to get a grip on the realities of my—our—life.

Surely then, it’s our job to try to fathom something of hers, to endorse what she believes even when what she believes is far-fetched fiction and frightening.

Especially then.

"Do I need to hide?"

"Hide? From what, Mum? From who?"

"From the enemy," she answers, in a tone that suggests I must be mad if I don't already know this.

I could scoff. I could laugh. I could say, "Don’t be daft, mum; there are no enemies."

But that would only confuse her. In her world, those foes are real. She would grow agitated, "The enemy, the enemy," she would insist, anger and frustration giving way to desperation.

No. That would not work: I cannot magically erase what she is certain she sees.

What she needs is reassurance. And I offer that; I can assuage some of the fear. That I can do.

No mum. You don’t need to hide. I will keep you safe. I promise you: I will keep you safe from whatever enemies there are. Always.

“Oh. OK, then. That’s good to know.”

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