Loss and Grief in Dementia

Section 4
CASE STUDY 3 | Joe
Joe is a 75-year-old man with a diagnosis of Alzheimer's disease. He has been living
with Alzheimers disease for seven years. Joe lives in his own home with his daughter
Emma. He has a homecare package, with staff coming into the home to assist him 3
times a day. Joe’s wife Mary died five years ago. You are a healthcare staff who regularly
works in the house in the morning times. The past few mornings, Joe appears to be
anxious and keeps asking for Mary. His daughter told you that she has tried a number
of approaches to dealing with his question – she has tried to tell him that Mary is dead
and also tried to avoid the topic and distract him. Joe asks you where Mary is and is
pacing up and down. How do you respond?
• Validate Joe’s emotions and tune into the emotion behind the words. Joe might
be missing Mary, feeling lonely, wondering why she is not around and be feeling fearful,
distressed, suspicious or concerned. Sometimes labelling emotions can be helpful to
a person who is struggling to say what they are feeling “You sound like you’re really
upset about Mary. Tell me what she was like/ what you miss about her” or “You sound
really lost/ frightened/ angry, let me help you”.
• There may be a practical thing you can do – Joe may be upset about something Mary
would have typically done. It may be helpful to say something like “What would Mary
do if she were here?” Often a person with dementia may give a very practical response
which you can do (e.g. help with dressing/ breakfast/ going out etc).
• Use the past tense when referring to the person “I heard that Mary used to make a
lovely chocolate cake, didn’t she?”
• Be responsive to Joe’s mood and respond accordingly. If he seems sad/ angry/ has
another change in his behaviour, provide support for those emotions.
• Be consistent – develop a response which best supports Joe and share which
approach seems to work best for Joe with Emma his daughter and other key people
who support Joe.
Understand connections: Accept that Joe might want to talk about Mary frequently or
infrequently. Follow his lead.
• Look for patterns in when Joe is asking for Mary– is it morning/ evening? Is it related
to a particular routine they did together? What works best to support Joe? Does it
seem more helpful to deflect his attention to another topic or to talk about Mary?
Utilise environmental cues: Use photos or other objects relating to Mary to support Joe
express his grief but also to reminisce about and remember his wife.
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Loss and Grief in Dementia