Flying Polar Bears

A nursing magazine told the story of Roland, a man with Alzheimer’s disease who lived at home with his son and his wife. One day, Roland’s daughter-in-law discovered him using his cane to beat off flying polar bears in his bedroom.

That’s right: hallucinations. Sometimes people with brain damage see or hear things nobody else does. Yet to this gentleman, those polar bears were real, they were flying, and he was in mortal danger.

The daughter-in-law had a choice. She could do a reality check and tell her 81-year-old father-in-law that he was wrong — no polar bears threatened him. Or she could play along and try to solve the problem creatively.

She chose to play along. She covered a can of air freshener with paper that said “Flying Polar Bear Spray.” Then she marched into Roland’s room and proceeded to chase those polar bears, spraying in all corners, until she got every last one of them.

Roland relaxed, fell asleep, and hasn’t seen a polar bear since.

And therein lies a dilemma for family members and caregivers everywhere who provide care to people who experience hallucinations, paranoia or whose illness separates them from reality. When do try to bring people back to your world, and when do you play along?

Each approach has its time and place. If you understand your family member and the way the disease affects the mind, you may know instinctively or through experience what works best. However, if you’re unsure about what to do to restore calm, try this test.

Try bringing your family member back to reality: once. Say, “It’s okay, Dad, I don’t see any polar bears,” or “Mom, this is your home now.” If the approach results in argument or upset, you’ll know the “reality” approach is not right.

Another test: if you ever catch yourself feeling angry or frustrated because your family member won’t agree with your way of thinking, stop and reorient. It may be time for a new approach.

Diseases that change the way people think have a way of prompting caregivers to change the way they think, too. Sometimes, insisting that the resident’s reality match your reality can do more damage and bring more grief.

Many hallucinations or false views of the world may be harmless, and you and the resident would be happier if you simply accepted them.And that calls for creativity, such as Flying Polar Bear Spray.

The “sidestep” is also an effective approach. If a resident continually asks to go home, or talks about people who are dead as though they were alive, resist the urge to set the record straight. Just sidestep and say, “Mom, you must really miss your lovely home on Sycamore Street,” or “Dad, you really miss mom, don’t you.” The sidestep can be tremendously reassuring, and fills many needs.

Can the creative or sidestep approach ever be harmful? Yes: if you see that they add confusion and distress instead of calm, or if they are not used with love, sincerity and respect for the person’s dignity.