In and Out

A True Story

About 10 years ago my wife and I went to visit my father in California from Michigan where we resided. At that time, he was in his 80’s and had been observed and diagnosed as one manifesting symptoms of dementia.

We decided to take him out to eat and asked him where he would like to go. He said he would like a good hamburger. We asked him if he had a favorite place to go? He told us that he liked, “in and out” burgers. At that point, my wife and I looked at each other knowingly so as to say, “that is so cute, he sees the traffic directional signs at a burger joint instructing vehicles where to enter and exit and he thinks that is the name of the franchise.”  We assumed at his age and with his mental frailty, that he mistook those signs for the name of the franchise. And rather than embarrass him, we decided to say nothing and pretend he was making sense.

In the end, we took him to a local restaurant and enjoyed spending the rest of the day with him and thought nothing more of it.

Several days later when were traveling in California, my wife said, “Stop!”. I pulled the car over and asked what was the matter? She said, “Look behind us and across the street.”

And there it was, 

The signage was unmistakable. My father was correct and accurate in his description and we were the more feeble of mind.

In practice, it is easy to misjudge individuals based upon bias that we bring to the table. It is important to check ourselves when dealing with individuals who are reported to be suffering from dementia to evaluate them independently and objectively. Many of my clients suffer from hearing impairments that may affect their ability to understand or hear an inquiry properly that leads to an answer that doesn’t appear to make sense. A hearing impairment may mask itself as an inability to comprehend the meaning of my question. We have interviewed clients more than once who have severe hearing loss and who had been diagnosed as having dementia. During our assessment of the some of those individuals, we offer a headset amplifier and find that often they are competent and have been mis-diagnosed.

Similarly, a person who has suffered from a stroke can often experience cognitive deficiencies which resolve themselves fully or to a limited degree. This may mean that the affected individual’s part of the brain which affects speech or the ability to say the name might be interpreted as a cognitive deficiency. Yet, that person may be very capable of exercising good judgment and may regain that ability within a short period of time. Yet, once diagnosed as “incompetent”, it is a steep slope for the patient to climb to overcome the prejudice many individuals experience once labled as “incompetent.”

Make sure you do a critical and unbiased assessment. See what you can do to help your clients demonstrate their true abilities and you will be a better advocate.