stop watchA moment in time is brief and very specific. It may only be a matter of seconds or minutes.
Perhaps it’s a moment when you remember a childhood secret or the moment when the love of your life slipped your wedding band onto your finger. A moment when you see a beautiful fall tree that reminds you of a special spot where your family camped years ago.

Your Grandmother may have many moments like these to share with you and your family. And as her Alzheimer’s disease progresses, those long term memories may be all that she is able to talk about. And those memories, generally, will be clear and defined.

Yet your Grandmother will have fewer and fewer of these moments when she can remember what happened on a daily basis. What she had to eat for lunch or what TV program she watched last night, will not be part of her conversations. She might have had her birthday yesterday and the family gathered to celebrate her 87th, but she has no recollection of the festivities. It doesn’t mean that she didn’t have fun or love seeing everyone…she just doesn’t remember it all taking place.

On the other hand there are those moments when your Grandmother’s reality and your reality are the same. She knows who you are, where she is living and recognizes her grandchildren. And you’re wondering what is happening? Why is it that she didn’t know who you were last week, but does this week? Is she playing games or just trying to be difficult? Is she trying to manipulate you? Does she do that to your siblings or only you? All legitimate questions to ask.

So let’s take a look at the brain to figure out why Grandmother is so “fickle” in how she responds to the family.

We know that short term memory loss is a major problem with Alzheimer’s disease. That is because the hippocampus, which stores short term memories, malfunctions. It’s no longer working properly. If the battery in your car died, you would have no problem understanding that your car is not going to work properly. The same thing is true with Alzheimer’s disease. The hippocampus (or battery) has stopped working…therefore there is no way for your Grandmother to store information and experiences that have recently occurred. There is no place for that information to go. Another example…If an individual has surgery and is given anesthesia, that patient has no knowledge of what took place even though she was in the room where the doctors and nurses spoke and completed the surgery. There is no way for the patient to know what took place as her brain was not able to register what was happening around her.  It’s not quite the same thing, but perhaps the example will help you understand the point I am making.

Family members and caregivers (family and professional) need to understand this concept to be able to cope with the behaviors that Alzheimer’s patient’s exhibit. Whether its repetitive behaviors, repetitive speech, wandering away from home and getting lost, forgetting to take medications or taking too many meds, or forgetting/refusing to take a bath or shower, Grandmother does these things because she doesn’t remember that she has already done them or the world around her doesn’t look familiar.

There will be days when she can remember recent events because the hippocampus may be partially functioning. But as the disease progresses and the hippocampus continues to malfunction, those days will be few and far between.

We don’t expect very young children to remember everything that is happening around them and we must remember that this is also true for our loved ones. We can’t have unrealistic expectations. Having the ability to change our expectations comes from seeking knowledge and talking to people who now the disease best. We need to face the reality that every day will be different. We must learn to be patient and have compassion for our loved one who has no control over what is happening to her mind.

Not an easy task for any one of us, but a necessary one.

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