Sometimes I share with families the story of a woman I knew who was in the early stages of Alzheimer’s disease. She lived in an assisted nursing facility, and family members would visit her whenever they could, which was often.
It sounds great, doesn’t it? But one day her nurses told her family that their loved one would sit by the front door every day, asking, “Are they coming today?” Because she couldn’t remember when they came last and because there was no established routine, she became ultra-anxious, scared and confused every day.
Establishing a routine – and other adjustments – are so important for patients and families living with a diagnosis of Alzheimer’s disease or another dementia. The ultimate goal? To help patients and families know how to interact with their loved ones so they can in turn help them function well and enjoy a good quality of life for as long as possible.
THE DIAGNOSIS OF Alzheimer’s has improved so much over the past decade. Today, we can use neuropsychological assessments to figure out exactly what’s happening in a patient’s brain, and track where his or her strengths and weaknesses are over time. This ongoing assessment involves testing (taking the form of puzzles, games and logic questions), which paints a picture of a person’s sensory perception, motor functions, attention, memory, auditory and visual processing, language, problem-solving, planning, organization, speed of processing and many other brain functions.
This picture then helps us define what families can do to help their loved ones. In the earliest stages, making as much of their day as automatic as possible can help reduce fear and anxiety. For example, establish a rigid daily routine: Every morning, they wake up, brush their teeth then walk to the kitchen to get a cup of coffee. Just like riding a bike, it’s not something they have to remember; it’s something that simply becomes automatic.
Patients who test showing a better visual memory than a verbal memory can benefit from a to-do list (as simple as an index card) to help them visually remember. Likewise, a calendar that stays in the same place on the refrigerator and includes all the medical and other appointments (which the family is meticulous about updating) also can be helpful.
LATER, IT CAN BE important to establish triggers to help improve memory. Linking a new memory to an old one can be an effective tactic, but you have to be deliberate in how you encode and how you retrieve. For example, if your father with Alzheimer’s is celebrating at your son’s 1-year-old Superman birthday party, make a point of asking him about your own 1-year birthday and how you celebrated. The next day, when you talk about your son’s party and he doesn’t remember, prompting him with, “Remember we talked about my birthday party, too?” can help trigger the new memory.
While a diagnosis of Alzheimer’s or other dementia is heartbreaking for any family, we do have tactics and tools designed to help families and patients live the best life they can, for as long as they can, beginning at the earliest stages and throughout the disease’s progression.
(The writer is a neuropsychologist and director of NeuroBehavioral Associates in Augusta. November is National Alzheimer’s Disease Awareness Month and National Caregiver Month.)