By Jane Verity © dementiacareinternational
Ranji was adamant that her neighbour was trying to kill her. She kept ringing the police, who had checked out the situation on several occasions only to find that Ranji was perfectly safe. Finally an assessment team was called in, which is how I came to meet her.
Being a strong believer in the meaningful symbolism behind such strong statements of people with dementia, I intuitively tried to understand what might lie behind Ranji’s fear that her neighbour was trying to kill her.
Her fear of being killed seemed reasonably straight forward, in that, symbolically Ranji feared something inside her or parts of her were being destroyed or perhaps she even feared for her future. But what could the neighbour represent? I needed to look beyond the words and go one step further. I needed more information to discover what her neighbour represented.
First, it was crucial to build Ranji’s trust in me using body language, my whole person and all my energy. I compassionately asked Ranji to tell me about her neighbour, adding questions to gather more content. Gradually, she told me that the police had come and shot her neighbour 10 times! I couldn’t help myself but responded that it sounded like her neighbour was superhuman! Ranji slowly bent forward and whispered: Yes… he is the Devil!
Here was the clue and the turning point. Ranji was adamant about something that did not appear real to me and, therefore, I knew that the Devil must represent something deeply symbolic for her. “The Devil is universally a symbol of evil. He is the opposite to what is considered good. His entire purpose is to deprive humans of the grace of God.”1
I asked Ranji if her fear that the devil was destroying her represented an inner fight between good and evil and if she was afraid that evil was going to win?
The answer emerged over two longer sessions where Ranji told me about her life. She had been brought up in a distant country with a very different culture and a strong belief in God. However, now in old age, she feared the fact that she had on a few occasions doubted God. The first time was when her daughter was raped and killed in front of her eyes; the second when her husband was taken away by soldiers never to be seen again.
Knowing of Ranji’s deep faith, I asked, ‘Do you fear that you are not going to go to heaven?’ Ranji’s response was a very clear, ‘Yes.’ As I was not familiar with Ranji’s religious persuasion, I needed to ask whether her God represented a gentle, forgiving God or a punishing God. She said her God was forgiving.
Once I was assured that her God was forgiving, I then asked if it would help to ease her pain and fear over having doubted God if she could see a representative from her religion to pass on forgiveness to her.
She had tears in her eyes when she said, ‘Yes.’
A visit was arranged and, from that day on, Ranji never again accused her neighbour of trying to kill her and she remained living independently in her own home.
Ranji’s behaviour was a deeply symbolic manifestation of her deepest fear and not hallucinations or delusions linked to dementia as first thought.
Many older people no longer have the mental or physical energy to suppress deeply buried emotional turmoils and tragedies and these can often re-emerge late in life. This means that no matter how much background information we have on a person it may still not give us the necessary clues. Often these experiences represent ‘skeletons in the closet’, which no-one may have any knowledge of. However, by looking into the symbolism behind their words you can often elicit the real meanings behind much of their pain and behaviour.