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Question from a reader:

My mother, who was and is mentally ill, now also has dementia and forgets what I say, even though I’ve said over and over. How do you set boundaries with someone who has dementia? Does you have to go over the boundary repeatedly as if it was being newly set every time the infraction happens? 

Dear you:

I so get this one. And how emotionally draining it is.

My grandmother had dementia and I was her legal guardian for the last three years of her life. I transitioned from being a granddaughter who was both frustrated with, and fearful of, her grandmother, to being a woman who could have hard conversations with her grandmother in a loving way. It was an imperfect journey and it was well worth it for both our sakes. If I am honest, I never really liked her much when I was younger, but as I grew and changed I was able to feel love and compassion for her (and for myself).

She and I had the same basic conversations over and over again. Some of them were funny and I wrote them down and shared them on Facebook, to the delight of friends and family. Other conversations were hard. Sometimes she was mean and physically violent. Now I know she was simply afraid and trying to get her needs met. When she was that way, I removed myself from the situation.

In your case it’s important to be clear that healthy boundaries are about your actions and behavior, not hers, and they are a continual process (even with people who don’t have dementia). So, for example, let’s say that the infraction is her saying something that feels mean and hurtful to you. If she DIDN’T have dementia, your boundary might be something like this:

“Mom, I wish you wouldn’t speak to me that way. If you continue, I will leave (or hang up the phone).”

But because she DOES have dementia and won’t remember your request, you can simply leave (or hang up the phone). You can also let her caregivers know that you have this boundary.

And here’s what’s beautiful about that…when you’ve made the decision about what boundaries you are going to set, you no longer feel the emotional drain of having to repeat yourself over and over again, because you know what to DO.

What do you think?

Much, much love,

Karen

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