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Cecilia's Sobbing

Dementia can manifest in many ways. Sometimes the symptoms and behaviors are deceiving.

One of the first senior day care programs in Costa Rica was owned and operated by a visionary Geriatric psychologist. She created a senior center that offered physical rehabilitation, mental stimulation, and enhanced emotional well-being even to those in later stages of dementia. At the time, the country had minimal information about dementia.

Cecilia attended the center several days a week. Her communication skills rapidly declined, and worse yet, she continuously sobbed most of the day. Her family was beside themselves, thinking how terribly unhappy she was, and had stopped taking her on outings and to family gatherings. They hoped her participation at the center would help.

I was asked to see if the CCT picture communication therapy could help.

At first, her sobbing broke my heart, as all my attempts to comfort her were in vain. However, the crying stopped when I opened a magazine and started pointing out pictures. She focused on several of the ones I talked about and indicated she liked a picture of a bride. She watched as I cut it out and talked about it. I placed the image in her hand and asked if she wore a white dress at her wedding. Immediately she resumed weeping, yet to my amazement, in the middle of her sobs, she replied clearly, “Si Blanca”; (Yes, white). Her words intermingled with the weeping. Again, she stopped crying when we resumed paging through the magazine. Each time I asked a question about a picture, her reply was accompanied by sobbing unrelated to any sad emotions. Any attempts to verbally communicate would trigger the sobbing reaction involuntarily.

Cecilia's cognitive understanding of her environment was much more than she could communicate. She was aware of most of what was going on, and the involuntary sobs were part of the damage to her brain; they didn’t correlate to emotions.

Her family was updated, and Cecilia's home life changed considerably. Her children now listened to Cecilia's words, no longer affected by the weeping sounds. After informing the rest of the family, she was included in gatherings, and they even began taking her to her favorite restaurant. They got their mother back, and she again felt included in her family.

Dementia symptoms don’t always reflect what is actually happening. For instance, repeated words might seem senseless. However, these words often connect to something the person needs to express.

Continually saying they want to go home often expresses the need to feel safe and in familiar surroundings. Not necessarily wanting to go to an actual place they most likely have forgotten.

Compulsive actions like pulling things from the closet or drawers are often a need to find something lost. They don't know this; they just feel they have lost something. The lost item could just be themselves feeling lost. Wandering can mean the same.

Anger is often a manifestation of frustration or inability to communicate a need.

A sudden spike in confusion or out-of-control behavior is commonly a signal of a urinary infection or pain in some body area.

The underlying causes of many dementia symptoms are a mystery; the caregiver, like a detective, must decipher the clues as to what is truly happening with their loved one. This can be very exhausting.

This is why it is essential for anyone caring for a person with dementia to continuously educate themselves about this condition. The more knowledge you accumulate, the easier it can become to decipher those clues and create a more peaceful environment.

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