You have to be clever to be an Alzheimer’s patient

January 4, 2008 by  
Filed under ALZHEIMER'S

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Most (but not all) Alzheimer’s patients are elderly. They have had many years to learn how to deal with all sorts of embarrassing and uncomfortable situations. Especially in the early stages of Alzheimer’s, they use their (immense) social skills to cover up their weaknesses. (But don’t we all.) These social skills make it possible for them to hide the symptoms of their disease, at first. I wonder how much Ronald Reagan did that when he was President. How many people even suspected that he had Alzheimer’s disease, before he announced it after he left office? As we’ve written before, stages of Alzheimer’s vary from person to person. The earliest stages are hard to detect.

For example, an elderly person may have a great sense of humor but a short memory for recent events. So they make jokes instead of simply making the embarrassing admission, “I don’t remember.” They entertain you, they have you rolling on the floor, and you may never understand that, inside their heads, there is a gap that troubles them very much. Humor doesn’t merely put an audience at ease, though it does that. It also puts the humorist at ease.

Or they may have a great store of wisdom, and when they can’t deal with their immediate circumstances because they can’t remember an important detail, they simply make a wise statement. It’s probably more valuable than what you were talking about, but it allows them to divert the conversation to something they can control, instead of making them feel out of control.

Or they may want to talk about the past instead of the present. They can remember the past better. Face it, they can remember the past better than you. After all, what do you remember from the 1920s? Zippo, nada, zilch, right? There’s probably a history professor somewhere you would buy a plane ticket just to talk with your loved one. So don’t start feeling superior about your command of last week’s memories. Your loved one may still have more memories than you.

A distant cousin of mine doesn’t have Alzheimer’s but she is 90 years old. Many of her old acquaintances are dead, so she tells me she’s found a discreet way to ask about them. Instead of “How is Joe?” “He’s dead, you fool” she simply asks, “Tell me about Joe.” That way, (she confided to me with a clever smile), the answer can be, “He’s still having trouble with his hip” or “Yes, we do miss him. It’s been almost two years.”

Understand, there’s nothing wrong with cleverness. There’s nothing wrong with humor or wisdom. They may cover up symptoms and delay an Alzheimer’s diagnosis, but once the diagnosis is settled, there’s no need to accuse the patient with, “You don’t even remember, do you?” Humor and wisdom are wonderful parts of conversation. Enjoy them, treasure them, while you have them.

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