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Caring for people with Alzheimer's calls for creativity and compassion

Todd Stern M.Ed.
Todd Stern M.Ed.
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Try to imagine how frightening it would be if you couldn’t remember where you lived, didn’t know where you were, or how you were going to get home. Imagine wanting to say something but not remembering the words, or not being able to understand people when they talked to you- when every moment brings uncertainty because you can’t remember the moment before. This is the harsh reality experienced by those afflicted with Alzheimer Disease (AD)

AD is a neurological condition that impairs the brain’s functioning. Symptoms of the disease represent deficits of how a person remembers, thinks and feels. Problems with memory may be manifested by forgetting names, dates, whether a bill has been paid, whether the stove has been turned off, or something said over and over. Intellectual abilities are eventually lost.

For purposes of behavioral management, caregivers must remain sensitive to the feelings of those afflicted by the disease. We must try to understand their reality as opposed to bringing them back to ours. Difficult as this is, we must find creative and compassionate interventions to deal with problematic behaviors. For instance, an elderly person with AD. who wants to drive his car may react more positively to being told that his car is in the garage for repairs than that he lost his license and can’t drive anymore. Controversial as this is, we must look at the underlying motivation for telling the absolute truth.

In most cases, loving caregivers want to alleviate their loved ones’ confusion. They often feel guilty about lying to their relative, they feel they’re tricking them, being disrespectful or are not treating the person with dignity. But it must be noted that at a certain point in the disease, the affected person’s judgment is seriously impaired. The person with AD may not recognize his or her limitations. Reasoning with them may no longer be possible. More importantly, they may not remember that they lost their license, and confronting them may only worsen the situation.

Caring for someone with AD requires caregivers and family members to revise their expectations about their loved ones’ remaining abilities. Appropriate behavior must be defined by standards that acknowledge the effects of progressive damage to the brain. Half truths may be necessary. Persons with AD and related illnesses fail to understand the logic behind many actions as their illness progresses. In many cases, attempts to reason with them only makes matters worse. It is best to remember the motivation behind such actions.