Brian Can’t Stop Fact-Checking His Mother-in-Law

Summary

Science Vs // Proxy Crossover: “Brian Can’t Stop Fact-Checking His Mother-in-Law”

Date: February 19, 2026
Featured Hosts: Yowei Shaw (Proxy), Rose Rimler (Science Vs)
Main Guests: Brian Reed (journalist, caregiver), Dr. Claudia Dressel (psychologist & Acceptance and Commitment Therapy expert)

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Episode Overview

This special crossover episode from Science Vs shares an installment of the “Proxy” podcast, hosted by Yowei Shaw. The featured story follows journalist Brian Reed (best known for “S-Town” and “The Trojan Horse Affair”) as he confronts a deeply personal and challenging dilemma: he can’t stop fact-checking his mother-in-law, who is living with Alzheimer’s and experiencing significant memory loss. The episode explores Brian’s struggle, the emotional burden of dementia caregiving, and practical/psychological coping strategies, culminating in a conversation between Brian and psychologist Dr. Claudia Dressel, who specializes in supporting caregivers of people with neurocognitive disorders.

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Key Discussion Points & Insights

1. Introducing the Emotional Conundrum ([03:00]–[08:00])

• Brian’s Dilemma:
  Brian Reed opens up about the difficulty of interacting kindly and effectively with his mother-in-law, whose dementia is progressing. He finds himself compulsively fact-checking or correcting her during daily interactions, despite knowing it’s futile and sometimes hurtful.

• Example Scenarios:

  • She claims not to have seen Brian, though they did earlier that day.
  • Insists scaffolding on a building has ‘always been there’ when it hasn’t.
  • Repeatedly asks the same questions (e.g., when her daughter will be home), sometimes 15 times in a row.

Quote:

“I find myself wanting to correct her or fact check her when she says something that isn’t factual or aligned with the reality that I’m experiencing.”
— Brian Reed [06:11]

• Emotional Toll:
  Brian feels guilty and frustrated, recognizing that his impulse to correct is part of his journalistic wiring but is poisoning precious remaining time.

Quote:

"I don't want my mother-in-law to have this. It's like me swatting the disease away, but it ends up being directed at her rather than the kind of radical acceptance you need to have with a diagnosis like this."
— Brian Reed [14:28]

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2. Caregiving Realities and Brian’s Grief ([08:00]–[14:00])

• All-consuming Caregiving:
  The episode provides a detailed snapshot of Brian’s day, showing the unrelenting stress and emotion: shuttling between swim lessons, navigating repeated questions, and managing his young daughter’s meltdowns—all while feeling unseen and unsupported.

• Loss and Grief:
  Brian describes his mother-in-law as a “badass” and laments the loss of her faculties, calling out the deeper trigger of his emotional reactions as grief over who she was and is becoming.

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3. Setting Up the Proxy ([14:58]–[17:24])

• Recognizing Limitations:
  Despite therapy and support groups, Brian feels stuck, unable to overcome his frustration or better manage his emotional responses.

• Turning to Proxy:
  Yowei promises to find a “proxy” (someone with equivalent experience and expertise) to help Brian gain new perspective and strategies.

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4. Introducing Dr. Claudia Dressel & Acceptance and Commitment Therapy (ACT) ([18:38]–[21:46])

• Claudia’s Background:
  Associate Professor at Eastern Michigan University, Claudia shares how her early experiences working with overlooked seniors, including a “nonverbal” Alzheimer’s patient, inspired her to devote her career to supporting caregivers.

• Core Approach:
  Claudia’s therapeutic work focuses on improving communication and relationships within caregiving families, aiming for not just less problematic behavior but genuinely better shared experiences.

Quote:

“What I hope for is that when people live together that they can really make their life work together.”
— Dr. Claudia Dressel [21:20]

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5. Confronting the Emotional Realities ([21:46]–[28:54])

• Invalidation & Isolation:
  Brian shares how much of the caregiving advice he encounters feels “emotionally dishonest” or dismissive of the real toll ("It’s not a problem, just let them check the door 40 times a night"), fueling his sense of isolation.

Quote:

“It feels emotionally dishonest for what this experience is actually like.”
— Brian Reed [24:57]

• A Common Caregiver Struggle:
  Claudia validates Brian’s anger, asserting that many caregivers (especially men, less often socially permitted for women) feel similarly—but the topic is steeped in silence, shame, and unrealistic standards.

• Societal Denial:
  Claudia raises the point that society largely ignores the inevitability of cognitive decline, leaving families unprepared and then blaming them for “not coping.”

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6. Therapeutic Tools & Caregiver Mapping ([30:09]–[35:44])

• The Impact on Families:
  Caregiver distress not only affects their health but exacerbates the symptoms and outcomes for the person with dementia.

• Claudia’s Process:

  • In-depth, detective-like assessment of the whole family’s context, mapping out immutable factors (diamonds), modifiable issues (circles), and resulting effects (squares).
  • Aims to pinpoint what’s truly changeable, where the pressure points are, and how to minimize suffering.

Quote:

"Making a family map... shows all the invisible forces shaping the situation."
— Yowei Shah [31:58]

• Caregiver Burnout Research:
  Results using Claudia’s ACT-based methods show promise in reducing burnout and depression among dementia caregivers.

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7. Acceptance and Commitment: Practical Application ([35:44]–[43:21])

• Step 1: Emotional Acceptance
  Acknowledge feelings such as anger, frustration, or feeling “this is unfair” rather than denying or fighting them.

Quote:

“That kind of acknowledgment... might create some space and some relief. The more we argue with the feeling, the harder it is going to be to do what is effective.”
— Dr. Claudia Dressel [36:45]

• Step 2: Committing to What Matters
  Identify core values (e.g., making the most of remaining time, protecting your child’s well-being) and weigh which caregiving tasks are realistically sustainable.

  Claudia gives an example about refusing to take cupboard doors off for accessible coffee cups—sometimes rooted in feeling “this isn’t fair”—and how acceptance makes way for practical adaptation.

• Allowing for Creative Solutions:
  Not every family member has to do every task. Claudia normalizes using outside help or redefining your caregiving role.

Quote:

“There’s a multitude of ways that you can actually show caring for somebody. And the question is, what is actually right for you? What is it that you would like to do and what is it that matters to you?”
— Dr. Claudia Dressel [42:28]

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8. Guilt, Precious Time, and Cognitive Defusion ([45:04]–[49:09])

• Lingering Self-Judgment:
  Brian worries he’s “polluting precious time with [his] shit,” i.e., spoiling limited opportunity with negative emotions or conflict.

Quote:

“I’m polluting this precious time with my shit.”
— Brian Reed [47:51]

• Claudia’s Cognitive Defusion Tool:
  She introduces a technique encouraging Brian to repeat self-defeating thoughts (like the above) in a cartoonish voice—literally, a Mickey Mouse impression—to help him see them as less powerful or serious.

Quote:

“The act of Brian hearing himself say this thought in the voice of a cartoon mouse can help him see it as ridiculous. Can help him stop self flagellating.”
— Yowei Shah [49:48]

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9. Final Reflections: Accepting What Can't Be Fixed ([50:03]–[52:26])

• Validation:
  Claudia acknowledges the reality: the situation is truly hard, and perhaps Brian is already doing all he can. The work is to recognize that, relieve self-judgment, and find the most sustainable, value-driven approach possible.

• Moving Forward:
  Claudia provides Brian and his wife with further resources; emphasizes that many caregivers need not soldier on alone. There are support systems and approaches (like ACT) that can help.

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Notable Quotes & Moments (with Timestamps)

• On Fact-Checking as a Reflex:

  “I feel like my brain has kind of just become wired in a way where I am just like attuned to these details and whether they're true or not... I can't turn that off.”
  — Brian Reed [07:24]

• On Feeling Like an Outsider:

  “It feels emotionally dishonest for what this experience is actually like.”
  — Brian Reed [24:57]

• On Societal Denial:

  “It’s almost as if there is the secret within our society that a lot of people will be affected by cognitive decline. Nobody really acknowledges it, nobody prepares you for it. But then when you find yourself in the situation, everybody says to you, well, if you just did X, Y and Z, then it would be okay.”
  — Dr. Claudia Dressel [27:30]

• On Precious Time:

  “I’m polluting this precious time with my shit.”
  — Brian Reed [47:51]

• On Cognitive Defusion:

  “The act of Brian hearing himself say this thought in the voice of a cartoon mouse... can help him see it as ridiculous.”
  — Yowei Shah [49:48]

• On Doing Enough:

  “And what if you were in a situation in which you actually are doing your best and have done everything you could and are doing whatever you can do?”
  — Dr. Claudia Dressel [50:20]

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Episode Structure & Timestamps

• [03:00] Brian introduces his struggle as a compulsive fact-checker and caregiver.
• [06:00–08:00] Daily examples of conflict; Brian’s emotional reactions.
• [09:46–11:47] Snapshot: a day in the life—overwhelm and exhaustion.
• [12:15–14:28] Brian’s memories and grief for his mother-in-law.
• [17:24–18:52] Introduction of Dr. Claudia Dressel.
• [21:14–28:54] Claudia’s approach; validation and recognition of isolation in caregivers.
• [30:09–35:44] Mapping out family stressors; Acceptance and Commitment Therapy principles.
• [36:45–43:21] Acceptance, boundary-setting, and sustainability of caregiving.
• [45:04–49:09] Addressing guilt, using cognitive diffusion strategies.
• [50:03–51:30] Final acknowledgments, validation of difficulty, and emphasizing acceptance.
• [51:47–52:26] Resources for caregivers; episode concludes.

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Tone & Language

The episode is intimate, honest, and emotionally raw—mixing dark humor (“I’m polluting this precious time with my shit” [47:51]) with clinical clarity, validation, and empathy. Both Brian and Claudia are forthright in expressing the pains and realities of caregiving, with no sugar-coating.

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Takeaway

The episode provides rare validation for caregivers of loved ones with dementia, demystifying the swirl of frustration, guilt, and grief. It highlights the importance of both acceptance (honestly facing hard emotions) and commitment (figuring out what truly matters, and what’s sustainable). Practical therapy approaches and community resources are discussed as means of coping, and listeners are invited to see themselves in Brian’s struggle rather than judging from the outside.

Transcript

[Rose Rimler]

Hi, I'm Rose Rimler and this is Science versus Today. We're sharing an episode from another show that we like. It's a podcast called Proxy. It's hosted by Yowei Shah, who you might remember from the podcast Invisibilia. In Proxy. Yohe kind of functions as an emotional investigative journalist. She starts with a guest who is going through something tough or confusing, something no one else they know can relate to. And and then she finds the perfect person for them to talk to, to act as a Proxy. She'll find someone who's been there who understands the problem and can hopefully help that person get less stuck. The episode we're sharing today is about something near and dear to us at Science fact checking. Yowei talks to a journalist who can't stop fact checking his mother in law. But in this situation it's particularly fraught because his mother in law is losing her memory. She has Alzheimer's. We like the way that this episode breaks down a situation that is tough and nuanced and we think that you guys will like it too. It's coming up after the break.

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[Yowei Shah]

This episode is brought to you by Claude from Anthropic. Some of the greatest innovations we have today came from someone just wanting to help people. The same is true for the scientists who founded Anthropic. They wanted to build an AI that's safe, harmless and benefits humanity. And one thing they just committed to no ads in Claude because once AI is optimized to keep you engaged and scrolling instead of helping you think, it stops being a tool and you become the product. See why problem solvers choose Claude as their thinking partner at Claude AI Scienceverses. Well, hello, Brian.

[Rose Rimler]

Hi.

[Yowei Shah]

When's the last time we were on the mic together?

[Brian Reed]

I don't think we were ever on the mic together. I mean, we were around mics together.

[Yowei Shah]

This is Brian Reed, a man who hit podcasts Fall out of. You might have heard of his little show, s Town, or his other little show, the Trojan Horse Affair. Brian now makes the podcast question Everything, trying to make sense of what the heck is going on with journalism today. I met Brian when we worked together on my first big story back in 2013, an entire hour of this American Life. It was this really high stakes story about Eritrean refugees trying to get to Europe, but were then taken hostage by smugglers, often tortured in all sorts of horrific ways and forced to ask their families for huge amounts of ransom. I, as a reporter, felt way out of my depth, but I was lucky to have Brian as my producer, coaching me in interviews, helping me write scripts, making sure I didn't fuck up. He was patient. He made me feel safe. He also made working on a decidedly not fun story. Dan, dare I say fun at times. We'd spend all day cooped up in a hotel room listening to hostage calls. We'd huddle around a laptop speaker, our translator, telling us what was happening, occasionally breaking down in tears while Brian and I furiously typed, trying to get down everything he said. It would be hours and hours of this, but then Brian would force us to go out to a bar, buy a round of beers, get us talking about our lives, joking, laughing. In other words, Brian knew how to manage the vibes to make sure we didn't get stuck in the heavy. I didn't tell Brian any of this back then, but I cherish that time together. So when I ran into him at a conference last fall, I was excited to catch up. He was like, what's up with you? And I showed him a photo of myself pole dancing in a clean Xbox costume and told him about the show I was developing. And Brian, it turned out, had been struggling with a very specific problem, what some people might refer to as a niche emotional conundrum. Can we start there? What do you need help with, Brian?

[Brian Reed]

I need help figuring out how to better, more healthily and kindly interact with my mother in law who lives with me and my family. It's me and my wife, daughter and her in our house and she has dementia, she has Alzheimer's and I need help just figuring out how to be around, you know, the symptoms of that disease.

[Yowei Shah]

When you say you need help figuring out how to be, how are you being with her right now?

[Brian Reed]

The thing that is happening a lot is that I find myself wanting to correct her or fact check her when she says something that isn't factual or aligned with the reality that I'm experiencing.

[Yowei Shah]

What's an example of this?

[Brian Reed]

Just like a million daily examples. Like I'll come home and talk to my mother in law and she'll be like, oh, nice, I haven't seen you today. And it just hits me. It's like, well, that's not true. Like I saw her earlier, you know, oh my God. Or like the other day we were driving by some scaffolding in a building. She was talking about, like, yeah, the scaffolding's been up for years. And I'll just be like, that's just not true. You know, that's just not true.

[Yowei Shah]

As Brian told me this, I realized, oh, wait, I know that tone of voice this side of Brian. Like even in this interview, right after we said hello, the first thing he did was fact check me. When's the last time we were on the mic together?

[Brian Reed]

I don't think we were ever on the mic together. I mean, we were around mics together.

[Yowei Shah]

Brian says, yeah, you know what, Maybe it is a product of the work I'm doing as a journalist.

[Brian Reed]

Yeah, I feel like my brain has kind of just become wired in a way where I am just like attuned to these details and whether they're true or not. Even the idea of whether something's factual or not. Like, I don't think a lot of people think that way, but I do like the word factual comes into my head a fair amount. And so then I go home and find myself in this position where like my mother in law say something and I just, I can't turn that off. And I end up like, correcting her or butting heads with her over this disjointed reality. And she gets defensive or upset or hurt. Like she doesn't want to feel like a burden to me.

[Yowei Shah]

I say this with respect, but it sounds kind of like you're being an asshole.

[Brian Reed]

Yeah, no, I partly am, but yeah. No, you have to understand what it's like to live with someone with Alzheimer's. Like in your house.

[Yowei Shah]

Yeah, which I don't. To help me understand, Brian told me what just making dinner looks like. On a typical evening, Brian gets home from work, starts cooking. His daughter, who's 4, is buzzing around, taking dishes out, putting them on the floor, begging him for candy. And then his mother in law greets him in the kitchen, asks when his wife Solange, her daughter is coming home, to which Brian says 6:30. His mother in law goes back to the living room. Then a minute later, when's Solange coming home? 6:30, again and again. Could be 15 times in a row.

[Brian Reed]

What that is is like anxiety and paranoia, you know, from the disease, you know, when are they gonna be home? When are they gonna be home?

[Yowei Shah]

Yeah.

[Brian Reed]

And so you try to give them something to occupy them. So I'll ask for help setting the table, and that's like a question about every plate, or the plates will be brought out and then they'll be brought back in or something is put in the wrong place, you know, and sometimes I'll have actually had an expectation of like, oh, this will actually help me. Like I actually need help setting the table. And you kind of have to relinquish that. Like it's harder work basically to guide someone through it. And then in the course of doing that, I'll be like, oh, don't forget to grab the napkins. They'll be like, oh, where are the napkins? I'll be like, they're in the corner. And they're like, no, I've never done this before. You do it every night. That's not true. So it's like at the end of that kind of experience is when it'll happen.

[Yowei Shah]

Ryan told me, you know what? Actually, that doesn't even begin to capture it because that's just dinner to really help me wrap my head around how exhausting this is for him. Brian logged everything that happened one day after we spoke. The email is a catalog of one situation after another. Any of which on their own might be tolerable, but taken together without pause, feels like one of those Kafka esque dreams where you keep trying to reach your goal, but the obstacles keep mounting. Like Brian, his daughter and his mother in law drive to swim class. Brian is hoping to catch up with his daughter. But his mother in law interrupts, saying, I'm sorry, I've never asked where we're going. She asks the same question six times in just 20 minutes. Once they get to the pool, there's more. Ryan leaves his mother in law for just a few minutes to help his daughter change. And when he gets back, she's already wandered off, worried they left her. He manages to corral everyone to the car to run an errand, grab dinner. But then his daughter drops some glitter markers in a sewer, grateful, and loses her Shit. So now she's crying on the drive home. And through it all, his mother in law keeps asking him if Solange is back in town. Brian says, yes, she got home last night. They reach their street. She asks again, is Solange back in town? Brian is trying to parallel park. And she asks again, is Solange back in town? Later that night, the house is finally quiet, his mother in law in bed. Downstairs, Brian is up late writing a script behind on Deadline. And then suddenly she appears. He writes, she said she had a text message saying there was food for her in the kitchen. That's why she came up. She got very upset, started yelling. I looked at her phone. She was reading text messages from a year ago about groceries being delivered. Brian redirects her to bed. She'll soon be back.

[Brian Reed]

You know, like the famous book about Alzheimer's is the 36 hour day is what it's called. And that is right, like every day.

[Yowei Shah]

What makes it even more maddening is that Brian had always enjoyed spending time with his mother in law. Long before the diagnosis, Brian and his wife had actually been trying to convince her to move in with them. To help with childcare, sure, but also just to hang out more. In his words, she's a badass.

[Brian Reed]

She was a physician. Very interesting woman, you know, who was like the first in her family to go to college and became a doctor. And she would tell me about things she was reading that I was always like, oh, I didn't know you were like interested in Vietnamese history or just like, very voracious reader. See her of movies. Yeah. Really into art. My mother in law was incredibly intelligent and smart and funny, and she still is all those things, but she's losing those faculties, you know, and that's. There's grief there. So when she says something that's just not true, those things end up triggering the deeper feelings.

[Yowei Shah]

Brian says even with her Alzheimer's, his mother in law can still be really present at times, aware of what's happening. And so sometimes, even when he manages to bite his tongue and not correct her, his mother in law will see his thoughts on his face and she'll call him out on it.

[Brian Reed]

She'll say, like, hey, stop frowning like you have such a nice face. Is it gonna get stuck that way? Or like, there've been a couple times when we've been arguing and my mother in law says, like, let's just pause. She'll just like, grab my hand. Wow. You know, and she's someone who's taken care of people her whole life and she'll acknowledge that and be like, I've had to do this too. And I'm so appreciative for all that you do. And one of the things this disease makes you very aware of is that, you know, just the value of time. It's a progressive disease that goes in one direction. And I do feel really bad when I'm spending time kind of arguing over these things because it feels like it's poisoning the time we have.

[Yowei Shah]

Brian has been dealing with this for three years now. He goes to therapy, he gets help from a social worker, he reads books, he goes to support groups. But even so, he needs help figuring out how to not be so frustrated with his mother in law. He doesn't want to spoil the precious time he and his family have left with her. And this is why Brian came to us.

[Brian Reed]

I think ultimately it comes down to like a matter of acceptance too. You know, I think with every correction or fact check that I'm doing, it's just a little bit of like, I don't want this to be true. I don't want my mother in law to have this. You know, it's like me swatting the disease away, but it ends up being directed at her rather than the kind of radical acceptance you need to have with a diagnosis like this.

[Yowei Shah]

I'm really sorry that you are dealing with this, and I'm gonna. I'm gonna try to find a proxy that maybe can help.

[Brian Reed]

All right, let me know what you find. I'll be.

[Yowei Shah]

After the break. Somebody who gets it.

[Rose Rimler]

Hello, this is Jana calling in from Massachusetts. My two niche to podcast conundrum is what do you do when you've been making small talk with a neighbor for like two years, but you still don't know their name? And it's definitely too late to ask now, but I'm glad Proxy is investigating other niche emotional conundrums, which is why I recently became a member of Proxy's Patreon. Because yoe and the team make this show independently and depend on listeners like you and me. When you join the prox, when you join the Proxy Patreon, you get benefits, like hearing episodes without ads and exclusive Patreon episodes. What a bargain. Plus, you'll get a gold star for helping make the world's first emotional investigative journalism, which is important because feelings are everywhere and it's about time someone looked into it. To become a member, go to patreon.com ProxyPodcast that's patreon.com ProxyPodcast Can I get the Windows 95 startup sound.

[Claudia Dressel]

Oh, my God.

[Brian Reed]

I can't find the stop button.

[Yowei Shah]

The day of the proxy conversation.

[Brian Reed]

Hello? Hello?

[Yowei Shah]

Ryan. Seems surprisingly sunny on the video call.

[Brian Reed]

I just went on vacation. We went with just my wife and my daughter, so we were relieved of dementia caretaking duties for a week.

[Yowei Shah]

You seem refreshed. I couldn't help but notice Ryan was smiling more.

[Brian Reed]

Actually turned my phone off. I read two novels, which I can't remember the last time I did that.

[Yowei Shah]

Of course, now he was back to real life, back to all of life's problems. I just got a notification that the proxy's here.

[Brian Reed]

Okay. All right, let's do it.

[Claudia Dressel]

Okay.

[Yowei Shah]

You ready?

[Claudia Dressel]

Mm.

[Yowei Shah]

So, the proxy. As I was looking for a proxy for Brian, I thought about something. He told me how, on the surface, the problem was that he couldn't stop correcting his mother in law. But deeper down, it was probably his way of responding to the disease and the pain and terror it was inflicting. Ryan said he probably needed to just learn how to accept the situation. But how? He didn't know. So the proxy team started poking around the research on acceptance, and we discovered something that seemed almost too on the nose. Something called Acceptance and Commitment Therapy, or act, a type of cognitive behavioral therapy. I reached out to Stephen C. Hayes, the person who created act, and he was like, sure, I could talk, but you know, who would even be better? I know someone who uses this therapy specifically with caregivers of people with neurocognitive disorders. People just like Brian. This is how I found Claudia.

[Claudia Dressel]

Hi, Brian.

[Brian Reed]

Hi, Claudia. How are you? I don't know who you are or anything about you. Who are you?

[Claudia Dressel]

I'm here at Eastern Michigan University, where I'm an associate professor.

[Brian Reed]

Okay.

[Yowei Shah]

Claudia Dressel is a psychologist who helps people with the neurodegenerative disease and their caregivers figure out how to make life easier and healthier for everyone involved.

[Claudia Dressel]

I train people. I do research in that area. And for over 20 years, I have worked with families where one person has cognitive decline. I kind of want to tell my origin story here too.

[Brian Reed]

I'd love to hear that. Yeah.

[Yowei Shah]

When Claudia was in grad school, she actually had no plans to work in dementia care. She wanted to teach psychology at a university. But then one day, a friend from school asked for a favor. Could Claudia come to a senior center and sit with a man who has Alzheimer's while she met with his caregiver?

[Claudia Dressel]

And she told me that I didn't need to do much, that the person with a neurodegenerative disease had basically stopped speaking. And I come from a little village in Germany. You hear my accent. And had always lived with my grandparents. And many of my peers also really had close ties with that grandparents. So I had seen older adults of all ability levels, really. And I thought, you know, I can do this. I can be in the senior center and sit with this person. And while we were sitting there, somebody switched on music and a boombox. They started line dancing. And suddenly I hear this voice next to me that says, this is all a bunch of crap. And so I thought, wow, you know, he can, he can speak. And I took him into a quiet area and he told me a lot about his life.

[Yowei Shah]

The man told Claudia about his kids, how he used to work at a department store. He talked a lot, if not always clearly, but she was able to figure out what he was saying.

[Claudia Dressel]

And I thought this was quite amazing because here was somebody who was described to me as non verbal and hardly speaking. And so ever since then, really, I've worked with people with cognitive impairment to try to find out how to best support them and their caregivers in terms of communication and relationships. The question is, what is so difficult about it and how can we remove the barriers and perhaps, if not making it necessarily easier, perhaps even make it more predictable?

[Brian Reed]

Is that the best you can hope for? Is it more predictable or is there some higher goal you can have?

[Claudia Dressel]

What I hope for is that when people live together that they can really make their life work together.

[Yowei Shah]

Claudia's goal is to not just stop problematic behaviors. She's focused on holistically helping both caregivers and the care recipient have a nicer time together. Ryan, of course, is nowhere near that. So I ask him to give the rundown of his situation, how he can't stop correcting his mother in law.

[Brian Reed]

And that was leading to just a ton of tension, upset, strife, how even.

[Yowei Shah]

When he does try to get help, some of the resources just make him angrier. He talked about watching this one webinar in a support group that particularly pissed him off. The webinar presented a bunch of scenarios of what someone with Alzheimer's might do and asked how the caregiver should respond.

[Brian Reed]

One of them was like, your loved one keeps going to the door and checking whether it's locked. Is this a problem or not?

[Yowei Shah]

This might be annoying, but it's not harmful to your husband or anyone else.

[Brian Reed]

And it was like just one thing after another, like that problem two. And I remember my experience, like in the group after watching this was just the tone, delivery and Presentation of that exercise of that like webinar was so at odds with my experience of this. It was just so, like calm. And this is not a problem. Let them check the door if it's locked and then just go up as the caregiver and make sure the door's locked and it's fine. This is not actually a problem. They can check the door if they want. You don't need to get up in arms about it.

[Yowei Shah]

It might be annoying, but it's not a serious problem for anyone.

[Brian Reed]

And in my head I'm just like, yeah, this happened to my house. I will spend an hour and a half of my evening doing that. Like, that's not, not a problem to me. I don't know. I don't know if that's just me being self centered, but I would not say that's not a problem. I would say it's not a problem if I'm willing to make like a huge sacrifice, even just like this influencer that I follow. Hold on, give me one second.

[Yowei Shah]

Ryan holds up his phone to show us a video from Instagram. The caregiver is looking into the camera with a knowing look on her face and hits the camera in time to the beat of the song with the caption, stop correcting them.

[Brian Reed]

And I'm just like, easier said than done. I don't know. Like, what are you talking about? Yeah, duh, I don't know. And so I actually commented on this. I was like, was this easy for you to acclimate to? I find this much easier said than done. And she wrote back, like, it's not easy, taken moment by moment. Yeah, but it doesn't, I don't know, it just doesn't match my experience of it, which is, this is fucking crazy, you saying the same thing 40 times. How can I live like this?

[Claudia Dressel]

I mean, this is your experience and there is no arguing with that experience. I think, Brian, you give voice to what a lot of people are feeling. And I know that a lot of people are also exasperated because they feel as if there is a competition to be kind of a good caregiver without having these kinds of feelings. I'm just curious with Brian, would it help if you found other people who also are angry?

[Brian Reed]

I can't say for sure, but it would certainly feel different. I can't remember a time where I've heard someone express their experience and I've been like, that's exactly how I feel.

[Claudia Dressel]

So you're feeling alone with this?

[Brian Reed]

Yeah. And I think, you know, and my wife and I are going through it together. But her experience of it is quite different. I mean, she's angry in her own ways, and in ways it's much more acute for her. I mean, she's incredibly close to her mom, which both makes the pain of it all that much worse. But she had an incredibly good relationship and they really do have that to rely on. We had a good relationship, my mother in law and I, but she's my mother in law. It's not the same, you know, and so our experience isn't the same. So I feel like I'm often like holding a lot of like, anger and frustration with the experience in the house. Yeah. I think I've vacillated feeling like I just must feel this differently than other people. And it feels very lonely. Or other times I do feel like I know other people are feeling this and nobody's being honest about this. And I feel like that's like the big fact check here, frankly. This is the webinar that's created to help caregivers. Like, this feels dishonest. It feels emotionally dishonest for what this experience is actually like.

[Claudia Dressel]

And noticing that different caregivers come from different kinds of perspectives. Right. So I think, to tell you quite the truth, I think that to some extent, at least, the expression is gendered, meaning more men are willing to talk about this being just really, really brutal and also infuriating. I think there is less acceptance, less welcoming for women who express similar kinds of things.

[Brian Reed]

Yeah, I think that's definitely true. But Claudia, you say they're out there. Other people feel this way. Or am I? Am I one of a kind?

[Claudia Dressel]

I am saying that they're out there, lots of them. I mean, I can quote some people who just say, you know, what do you got? We're totally. Either we are going to be the person who is giving the care or the person who is receiving the care, and that's what our life is going to look like. And nothing else can make that better.

[Brian Reed]

You got more.

[Claudia Dressel]

Those kinds of things. Lots of them, yeah. Lots of people who are very angry because it also doesn't seem to be fair. And so fairness also comes up as one of those things, as you expected your life to be just different.

[Brian Reed]

Yeah.

[Claudia Dressel]

And you didn't have to think about how to adjust your life in these different ways that, like Brian said, are sometimes quite ridiculous. It's almost as if there is the secret within our society that a lot of people will be affected by cognitive decline. Nobody really acknowledges it, nobody prepares you for it. But then when you find yourself in the situation, everybody says to you, well, if you just did X, Y and Z, then it would be okay. And everything rebels against the if only because you know that that is not true. It's not like if only one thing, it's a whole rearrangement of your life that is happening. When you think about it, it's almost like a murder has been committed and there is kind of no corpse. And you are the one who is saying, can't anybody see just how incredibly fucked up this is?

[Brian Reed]

Right? And so then when I'm like not getting that acknowledgement, like the way that frustration is manifesting is like in my interactions with my mother in law. Taking it out there.

[Claudia Dressel]

Yes.

[Yowei Shah]

When we return, Claudia tells Brian about the tools he can use to help him stop venting at his mother in law.

[Brian Reed]

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[Yowei Shah]

So Brian is feeling lots of shitty emotions. He's feeling angry, he's feeling frustrated, sad. This turns out to be the way a lot of dementia caregivers feel. Way higher levels of depression, anxiety and stress than the rest of us. And because we're talking about nearly 12 million Americans who, like Brian, are providing unpaid care to a loved one in this way, that's a huge steaming pile of shitty feelings. Shitty feelings that are affecting everyone involved. Researchers have found that these stressed out caregivers tend to skip doctor's appointments, not take breaks, not exercise, not see friends. But here's the the more caregivers neglect their own well being and the more they become distressed, the worse the people they're caring for tend to do. They're more likely to have worse symptoms of dementia, more likely to end up in the hospital, even more likely to be abused. It's this terrible irony. The more a caregiver gives up of their life to care for the person they love, the more the care they're giving can suffer. So what to do with all these shitty feelings? And how can Brian stop taking out his frustration on his mother in law? Claudia says typically we feel a bad feeling and we want to get rid of it. Maybe go to yoga, start boxing. The point is to purge the bad feeling so you can Be a better caregiver who doesn't snap at your confused mother in law. But Claudia says that's just temporary because you can't really get rid of a feeling if you don't change the situation. And if you bat away the feeling without trying to understand it, like, no, no, no, no, no, no. Those are your clues. Claudia wants caregivers to sit with and feel all the feelings, even the bad ones, so together they can observe and trace the steps that led to them to try to solve the mystery of why they're stuck, why the entire family might be. When Claudia talked about her process, it really does sound like she's an emotional detective. She visits the homes of her clients. She'll interview the caregiver at great length, gathering all of their negative feelings, the expectations they're trapped by, the situations that make them upset and the ripples of that upset. And then she'll gather their positive feelings, their hopes, their dreams, the moments they feel most connected. She'll pull their medical records. She'll find out how much support they have, the things they're good at, the things they're bad at. Just an unbelievably detailed profile of the person and their context. And then she does that again with the person with Alzheimer's, then the wife, then the child. Meanwhile, Claudia is observing and recording all interactions on video to analyze later, to look for patterns. Then with the caregiver, she'll throw the most salient factors on a whiteboard. Kind of like a corkboard in a police precinct, but more touchy feely. No dead bodies. This is the family's map. It shows all the invisible forces shaping the situation. Claudia showed me one of these maps. It's broken up into different sections. There's one for the caregiver, let's call her Sally. Another for Sally's dad, who is dementia. One for Sally's mom, who has trouble getting around. In each of these sections, there are a bunch of different shapes filled with text. The diamonds are the things that can't be changed. Like for Sally, it says sudden death of husband. And then the circles, these represent the things that can be addressed. Maybe in therapy. For instance, Sally feeling like she's the only one, that everyone has to rely on her, when in fact there are other family members who could step up. Finally, the squares. These are the potential effects of this challenging situation. For example, that Sally is burned, burned out. Or that her mom feels guilty about not being able to care for her husband. Claudia and Sally will constantly return to this map, updating it and seeing what they can try to change to improve the situation. It's a lot of information and the process can take months, even years. I'm really only scratching the surface, but these are the first steps of acceptance and commitment therapy, Claudia's version of it. And Claudia says early studies of this therapy have been promising. They're showing it can actually help with dementia, caregiver burnout and depression.

[Brian Reed]

How long has this been around?

[Claudia Dressel]

It's been around since 1998.

[Brian Reed]

I just don't understand. How have I never heard of it? Like, I'm in these. I'm having meetings with people and social workers. I've just never, you know, I don't know.

[Claudia Dressel]

The reason you haven't heard of it is because it comes from clinical psychology. And sometimes the fields are so different that it takes a while for things that come from clinics, clinical psychology to go into this other context, which is the geropsychology context.

[Yowei Shah]

Oh, interesting.

[Brian Reed]

It's like Balkanized.

[Yowei Shah]

Claudia walks us through how act could help Brian. She says, a lot of the time caregivers can get stuck in a specific situation because there's some feeling they have that they don't pause to investigate, they're just reacting. And it can prevent them from implementing a possibly really obvious fix.

[Claudia Dressel]

Imagine somebody has a really hard time knowing where things go in the kitchen. That's a very typical one. And what I see caregivers do is they label. Often they label cupboards with post its.

[Brian Reed]

Yeah, we've done that.

[Claudia Dressel]

And it actually turns out that does not work. Yeah, most of the time those kinds of things, they don't work for the person because they might not benefit from any kind of reminders or queuing at all. So then the next step would be if you still want the person to be somewhat active in the kitchen, let's say they are supposed to get a cup and reheat their coffee still in the microwave in the morning. And a caregiver might say, well, I'm. Under no circumstances am I going to take off my cupboard door.

[Yowei Shah]

Not wanting to take off the cupboard door could sound like a small thing just setting a tiny boundary. But Claudia says behind it is this voice yelling, this is unfair. This is ridiculous. And so the first thing is to simply accept this is how I'm feeling.

[Claudia Dressel]

That kind of acknowledgment that in itself might create some space and some relief. So the more we argue with the feeling, the harder it is going to be to do what is effective.

[Yowei Shah]

Next up, deciding whether it's necessary to act on feelings that come up. Like that one about the kitchen cupboard. Do these feelings help solve the problem or do they just make me more miserable?

[Claudia Dressel]

It makes sense that they come up and they're not very useful. Both things can be true at the same time.

[Brian Reed]

So I hear the acceptance part. What's the commitment part?

[Claudia Dressel]

The commitment part is really thinking about what would I really like to have happen and how can we help you go into the direction that will work for you and your family in the long term.

[Yowei Shah]

Claudia means over everything else, what's most important? Is it to enjoy the time you have left with your loved one who has Alzheimer's? Is it to give your kids a stress free home? And how do you work toward that without getting tangled in feelings like shame and resentment?

[Claudia Dressel]

For example, I've worked with families who have promised their father on his deathbed that they will take care of mom. And what they found out is that mom was much more impaired than they had bargained for. And they tried to have her live independently in her home and then take shifts. Those were five siblings and within a few weeks it all had fallen apart. It was really untenable. And so it's really the thinking about the ideal situation, the practicalities of caregiving, how they really intersect with your life. Thinking about the four year old because you are also a sandwich caregiver. And so the commitment part is the work of actually figuring out not only what you ideally would like in terms of your relationship, for example, with your mother in law, but also what practically you could do in terms of steps to move into that direction.

[Brian Reed]

So yeah, walk me through that. How does this apply? Because there's been a stretch recently of my mother in law, I guess, getting up in the middle of the night and opening her door and setting off the alarm. So we're being woken up two or three times a night and my wife's having to go down there and kind of settle her down. Generally my wife puts her mom to bed, but you know, sometimes her job, she has to work at night a lot or be out at night, so that time will kind of fall to me and kind of the, like we'd done problem solving. My this is credit to Solange, to my wife. Like she's figured out like, okay, if I really kind of make like a routine around bedtime, it's like clear that my mother in law's going to bed. She kind of tucks her in, turns the lights off in a certain way, shows her that the door's locked. That has seemed to make it better, that she's not getting up in the middle of the night and opening the door and setting off the alarm and waking us up over and over again. So I tried to implement that when I was home alone with her and I go to turn off the light and my mother in law is like, no, no, no, leave the light on. And I'm like, no, it's really important to kind of turn off the light so that we know it's bedtime. No, no, no, no, leave the light on. And just like, you know, fighting with me with it and like won't get ready for bed. Just leave the light on. And I know that if like this doesn't happen, like, we're probably gonna be up a bunch that night, you know, or she could walk out the door, like, I don't know, you know what I mean?

[Claudia Dressel]

Becomes urgent for you. Almost.

[Brian Reed]

Yeah. And so then I try to explain to her, like, listen, like, I'm doing this because the last few nights, like you've gotten up several times in the middle of the night and woken us up or the alarm company was called. And so we found that it helps like if you turn off the light. She's like, that didn't happen. I'm like, yes, it did happen. This is happening. It's happened like seven times in the last week. And I get activated like that. I'm like, you're denying this like incredibly present exhausting reality and I'm trying to stop it and you won't let me just, you won't just trust me that this will help us all, you know.

[Claudia Dressel]

And you'll find yourself explaining over and over again.

[Brian Reed]

Yeah. And I think the self talk there is just like, I'm already kind of frustrated in those situations because I'm like, we were up three times last night. I'm exhausted, you know, and like, it shouldn't be this way. Like, I don't want to do this. Like, I don't want to live this way. Like this requires a professional.

[Claudia Dressel]

So there might be a way that you can be effective while having these kinds of thoughts. But here we also want to make sure that if you're saying you shouldn't be doing this and it needs a professional, is it tenable or not? Would you like to give direct care? You are giving direct care. Bedtime routines, night awakenings, those are direct care routines. Many family caregivers don't give direct care because it's just too much. Caregiving has a lot of different kinds of aspects. You can be a caregiver who does direct care. You can be a Caregiver who checks in with people. You can be a caregiver who just monitors and supervises or manages. There's different ways of caregiving. There's a multitude of ways that you can actually show caring for somebody. And the question is, what is actually right for you? What is it that you would like to do and what is it that matters to you?

[Brian Reed]

Is another way of putting it, like, what am I actually built for?

[Claudia Dressel]

Well, I don't know if it's your constitution, but the question would be has more like to do with willingness. What can you see yourself do in the service of what matters to you?

[Yowei Shah]

Claudia says obviously Brian only has so many resources. There are other people involved he has to negotiate with. But she says it's important to get clear on which caregiving tasks you can actually see yourself doing in the long run. Because a lot of people see caregiving as all or nothing. When maybe there's a creative, more sustainable solution, you'd be surprised, she says, how many caregivers don't ask for help from other family members or don't take advantage of in home care, even when they get funding from community agencies?

[Claudia Dressel]

Taking myself as an example, I probably would not be a person. Even though my parents matter to me tremendously. I probably won't be the person to do their direct care and to assist them with instrumental activities of daily living because there's too much of a conflict there. I value being there for my parents and at the same time, my job matters to me a lot. And now I'm here, 4,000 miles away. It turns out that when you make a choice to do one thing, you often can't do all the other things. So how I can be there for them differs by my context. In the summers, I can spend time with them and I can be much more pragmatically involved and work remotely. So what can you actually do? What would you be willing to do in the service of what matters to you?

[Brian Reed]

Yeah, I don't think I ever totally pictured this. I didn't picture myself as a caregiver giving care. I pictured living with my mother in law and there'll be professionals who will help us with that.

[Claudia Dressel]

Right.

[Brian Reed]

You know, and we do, we do have an aide during the day sometimes. And that's also been very hard.

[Claudia Dressel]

Yes. You have somebody else in your home.

[Brian Reed]

Yeah. So it comes with its own costs.

[Claudia Dressel]

Yes.

[Brian Reed]

It's not like, oh my God, this is perfect.

[Claudia Dressel]

Absolutely.

[Brian Reed]

But I mean, that's part of the acceptance part is just even like accepting this as part of my identity. And role in life as being like a caregiver for an elder with dementia.

[Claudia Dressel]

A lot of people start caregiving because of a sense of duty or obligation. And at the same time people are not prepared that caregiving can be longer than caregiving for a child. And so part of what we need to do is really kind of figure out how sustainable are things in the long run.

[Brian Reed]

Yeah, I mean I have not prepared for that. So. Yeah.

[Claudia Dressel]

How will relationships be actually? Okay, how can you maximize the relationship with your mother in law? Because it seems that kind of suffers from arguing. If you asked her, she probably wants to have great relationships with the three of you. The question is how to actually make that happen. So over the long term it works.

[Yowei Shah]

Brian, you are nodding when Claudia was speaking just now. I'm curious what has been going on through your head?

[Brian Reed]

I think like the first part of this conversation kind of just acknowledging, affirming that it's okay to feel angry and kind of letting me feel that, that actually like I felt that kind of very physically kind of a less pent up feeling. This doesn't feel that way. It's more kind of. We're talking about a process that I could see applying and it's trying to, I guess trying to find the relationship between the two because yeah, I do find this to just be like a very emotionally charged, fraught, just an experience that involves a lot of emotions.

[Claudia Dressel]

Is there a sadness about trying so hard and not making it work?

[Brian Reed]

Yeah, of course. And I feel guilt and grief and yeah, one thing this disease does is it certainly, or I'll speak for myself, it makes me very aware of how precious time is, you know, with this loved one who is declining. But we do get time with her. That's one of the great benefits of living with her. We get these small moments like when.

[Yowei Shah]

Brian's mother in law reads to his daughter or when the family takes an extra long walk in the neighborhood or sitting on the stoop together. Brian's personal favorite way to connect is to sing. Like some Donny Hathaway song will come on and Brian and his mother in law will end up singing together, sometimes dancing.

[Brian Reed]

And I both want that with her. I want to give it to my wife, to my daughter, to my mother in law. But then when that time is filled with this tension, these negative feelings, then I feel guilt about it, you know, Cause it's like, oh, I'm polluting this precious time with this shit. And then that's like a self talk that helped him too. It's like we shouldn't be having to spend the time having to figure out like manage an aid and figure out care.com and like how to, you know, like, you know, like all this stuff like we don't have time for. And it's not a nice use of this precious time. And then I feel resentful about that.

[Claudia Dressel]

If we were working together, I would actually put. I'm polluting this precious time with my shit. I would put that right now up on the whiteboard.

[Brian Reed]

Why?

[Claudia Dressel]

Because there is so much judgment of. You are the odd person out. Everybody can live with this arrangement and I'm the one who is just fucking it up. We would put that thought on the whiteboard to actually then actively start working on that one and thinking about how useful it is and diffusing it. So there's a process that is called cognitive diffusion.

[Yowei Shah]

What's that?

[Claudia Dressel]

This idea of taking away the strength of the words, the impact. Saying it in a Mickey Mouse voice.

[Yowei Shah]

You mean literally? Literally saying it in a Mickey Mouse voice.

[Claudia Dressel]

Literally saying it in a Mickey Mouse voice. Not believing yourself when you say it.

[Brian Reed]

Yeah.

[Yowei Shah]

I asked Claudia to send me a voice memo later to demonstrate.

[Claudia Dressel]

I'm poisoning this precious time with my shit.

[Yowei Shah]

Claudia says the act of Brian hearing himself say this thought in the voice of a cartoon mouse.

[Claudia Dressel]

I'm poisoning this precious time with my shit.

[Yowei Shah]

Can help him see it as ridiculous. Can help him stop self flagellating.

[Claudia Dressel]

Because it seems like you are really trying so hard and your conclusion is because you're still feeling badly about it, you're not trying hard enough.

[Brian Reed]

That sums it up. Yeah.

[Claudia Dressel]

I wish I could make this easier for you and I could take some of these things away. Could tell you, yeah, I can make this easier, but I can't. It is that hard.

[Brian Reed]

Yeah, it's so hard.

[Claudia Dressel]

And what if you were in a situation in which you actually are doing your best and have done everything you could and are doing whatever you can do?

[Brian Reed]

Yeah. I feel like that's. That's where I turn to acceptance. Because it's like, okay, this is just a terrible disease and a really difficult situation and somehow millions of people are going through it and still we don't have the proper approaches or supports. There are therapies out there that could help that nobody knows about. Yeah. What I'm taking from this is we should probably hire you. That's my takeaway here. Yeah, no, I really appreciate it. I would love to get more info, Claudia. Or if there are people we should reach out to here. I definitely. We're in the middle of this and have many years ahead of us probably in one way or another. So I'm certainly intrigued to learn more about this process.

[Claudia Dressel]

I think it's really important.

[Brian Reed]

Thank you.

[Claudia Dressel]

Oh, you're so welcome. Thank you for sharing. All the best to you and your family.

[Brian Reed]

I really appreciate that.

[Claudia Dressel]

Bye.

[Yowei Shah]

Thank you to Brian Reed for being today's guest. And thank you to Claudia Drossel for being today's Proxy. Claudia is a psychology professor at Eastern Michigan University, where she's the director of the center for the Advancement of neurobehavioral Health. After the Proxy conversation, Ryan and his wife did a consult with Claudia to see about working together, but you do not have to personally reach out to get resources. Claudia put together a list for caregivers, which we'll put in our show notes.

[Rose Rimler]

Hi, it's Rose here again. So that was an episode of Proxy with host Yowei Shaw. If that episode got you thinking, got you interested in Proxy, you might want to listen to the episode Amanda and the Nonstop Narrator next or Mike chooses the Wrong Life. And we also recommend checking out Brian Reed's podcast Question Everything on the show, Brian takes on big tech and spotlights journalists and regular people who are fighting back against lies, stifled speech and discontent. You can listen and subscribe to Proxy and Question Everything wherever you get your podcasts and we'll fact you soon.