It’d been an exhausting day at the office and Mary just wants to go home, heat up some leftovers, and binge watch her favorite TV show. But she can’t. Instead, Mary visits her dad at his nursing home, just like she does every day. Of course, she loves him and wants to spend time with him, but every time it's the same confusing and frustrating routine. She tries to talk with him about her day or how he’s feeling, but he always floats back to two dreaded questions where they remain stuck for the remainder of her visit: “When am I going home? And where is Clara?”
The questions leave Mary feeling discouraged and sad. His home was in another state and was sold shortly after he moved into the nursing home. Tom’s doctor said it wouldn’t be safe for him to live alone. Tom’s wife Clara died a year ago, just before the big move. Mary keeps trying to tell him, but it doesn’t seem to make a difference. He just gets upset and then starts asking again.
If your clients are caring for someone with Alzheimer’s disease, they may feel frustrated at times, too. Communicating with someone with Alzheimer’s disease can be easier if we understand what is happening in their brain and how it affects memory and communication.
First, What’s Happening in the Brain
Alzheimer’s disease is caused by microscopic changes (plaques and tangles) that disrupt communication between brain cells and cause them to die. These changes typically emerge in the temporal lobes, which are the parts of the brain used for memory and communication.
In a healthy brain, the temporal lobes store new memories, much like putting a file away in a filing cabinet or saving a spreadsheet on a computer’s hard drive. But, in Alzheimer’s disease, the files aren’t saved and therefore can’t be recalled or used. The memory that Mary wants Tom to retrieve may not exist, because the disease has disrupted his ability to form new memories. It can be hard to predict what people with Alzheimer’s disease will and won’t remember, but we know that things that happened after a person develops the disease will be harder to remember than things that happened before.
The longer a person lives with Alzheimer’s disease, the more these changes spread in the brain, and the more they’ll forget. Recent memories are lost first, and older memories are affected as the disease progresses. This is why Tom’s behavior seems so strange to Mary but makes sense to him.