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Therapeutically Engaging Dementia Patients: Part 3 Using the World of Imagination

This post is the third and last installment of my series covering how to therapeutically engage dementia patients. In part 1, we explored the current models of treating the disease, and in part 2, we discussed engaging people with dementia through humor, music, meaningful activities and social interactions.

Another powerful, but often overlooked approach is the use of imagination. The idea is to tap into the capacity for creativity that is often dormant but not gone. My mother was masterful in doing this with my father. During her daily visits to him in the nursing home, she would typically begin the conversation with a simple question, “Who are you?” Although, in reality, the answer was “Henry Oppenheim”, a retired clinical psychologist, he would often answer with “Erich Von Stroheim”, an actor he remembered from his childhood in Germany. From there, they might explore his relationship with his imaginary mistress Kunigunde and their children or his powerful role as a military officer.

Here’s an example of one of their conversations:

Mom: Who are you?
Dad: Erich Von Stroheim
Mom: How shall I address you?
Dad: Sir.
Mom (saluting): Do you have orders for me?
Dad: Yes. Invade France.
Mom: What country do you represent?
Dad: The Soviet Union.
Mom: By what route shall I invade France?
Dad: The Polish Corridor
Mom: Who is in charge of France?
Dad: Marechal Petain (head of the Vichy government during World War II)
Mom: Will he be in charge or will you?
Dad: I will give him the honor of believing that he is in charge, but I will be.
Mom: How clever. That way you will avoid struggles. We are in Paris now. Where shall we go?
Dad: The Champs Elysee, le Rive Gauche, the Eiffel Tower and the Louvre.
Mom: If you want the French to like you, it would be good to sing to them in French.
Together they sing: The Marseillaise, Sur le Pont D’Avignon, Frere Jacque and Allouette.

My mother instinctively knew that in the world of imagination, my father could experience some sense of mastery, power and control whereas in reality, he had none. Therefore, she never corrected him when he took on different personas because that would have robbed him of the delight he took in doing so. Instead, she joined and guided him in a variety of virtual experiences that involved travel, exploration, fantasy and shared humor. Thus, rather than stagnate or diminish, their relationship continued to grow. The short film, “Hansl”, produced by my brother, Keith Oppenheim, demonstrates the myriad of ways that my mother connected with my father when he had dementia and is an inspirational tribute to their relationship. It can be found at this link: How This Wife Unlocked Her Husband’s Dementia – Next Avenue.