Why You Shouldn’t Start Statements with “At Least” in Dementialand (And Elsewhere)

I read something recently that made me think.

A woman who had been through a heartbreaking crisis that ended in the death of her infant suggested that people who try to console others should avoid statements that start with “At least…..”

This didn’t impact me at first–but then I thought about all the “At least” statements we throw around, trying to help but hurting.

When a woman has a miscarriage, we tell her at least she can have another baby.

When a married couple can’t get pregnant, we tell them at least they can still adopt.

When a person dies suddenly, we say at least they didn’t have to suffer.

When a person dies slowly, we say at least you had time to say goodbye.

When parents lose a child, we say at least they have other children.

These statements come from people who are well-meaning. They come from people who are trying to help…but they don’t help. They don’t help at all.

There are other (less dire) times that we hear statements like this. Last semester I was on a time-consuming, although rewarding, work committee that was somewhat stressful and required me to sacrifice a few weekends and many evenings. As some other committee members and I were sitting around at a hotel bar after a day of tiring meetings and venting about the experience, one of them said to me, “At least you don’t have kids.” Um. Thanks. (I guess not having children makes my time less valuable.)

Statements that start with “At least” are often made to those in Dementialand. Here are some comments that families have relayed to me or that I have overheard:

At least it’s not cancer. (Comparing who has the worst disease is seldom helpful to anyone.)

At least it’s not terminal. (Ummmmm….insensitive and also inaccurate.)

At least you have a great family. (One guy told me a friend said this to him and he responded, “Yeah, and I love the idea of putting them through this.”)

At least it’s not something physical. (This one typically comes from someone without a knowledge of dementia.)

At least it’s something that progresses slowly. (I find that the idea of the slow progression is one of the scariest pieces of dementia to some people.)

At least there’s a medicine you can take for that. (Yeah–but the medications don’t slow or stop the disease.)

At least you won’t know what’s happening when things get really bad. (REALLY?)

It’s true that things can always be worse, but attempting to point out how they could be worse to a person in the midst of crisis is not helpful. The next time you try to find the right words, make sure those words don’t start with “At least.”

Don’t focus on putting a silver lining on dementia. Maybe they’ll somehow find that silver lining  in the midst of the tsunami, but it’s not for you to put it there.

To support people, you gotta meet them where they are in the moment. And trying to throw a little glitter into the conversation sometimes puts you on a different planet than the one they are currently inhabiting.




2 thoughts on “Why You Shouldn’t Start Statements with “At Least” in Dementialand (And Elsewhere)

  1. So true. We always have the best of intentions, but unfortunately our ignorance can be very hurtful. Thanks for giving me this to think about! 🙂


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