What about grieving and loss when we are working with individuals with dementia? Because the traditional methods of communication may no longer be effective, our strategies for communication need to be modified.

A patient with dementia who became a friend was buried today. The family is concerned because the mother, who also has dementia, has not shed a tear and seems not to be grieving. This is after over 60 years of marriage. That does not seem reasonable for there not be any tears or sadness. Yet, I suspect that the wife is grieving. She and I had a conversation about her husband’s impending death while helping to feed him breakfast a few days before his death. I think she understood how sick he was. I think she understood that he was dying. I think she understood that he would soon leave, but her message to me was she did not think it would end like this. They had been together so long, he had been the man of the house, and now she was feeding him.

This woman with dementia is not able to process death, loss and grief like those of us who are cognitively intact. She will grieve in her own way and at her own pace. It is for those of us who are the caregivers to walk this journey with her in her way. We will need to watch for overt signs and symptoms like sleeping changes, appetite changes, tearfulness, sad affect, more mental confusion or withdrawal. However, none of these may appear. She may not actually grieve outwardly at the loss of her spouse. Our way of comforting her and helping her may be as simple as being with her. Reminiscing about she and her husband’s life. Sitting and holding her hand and letting her know she is not alone.

Do not despair if the grieving is different than you would anticipate. The grief process is unique to each of us, and when dementia is involved, it is accomplished in less traditional ways. Watch for changes and respond to them. if you are still concerned about how your loved one is coping with grief, contact me for more information.