The elderly woman was studying the magazine intently when Susan entered the Day Room. Pulling up a chair, she sat down, moving closer to her mother who looked up frowning.
“What are you doing here?”
“I came to see you, Mother. I’m Susan.”
“I don’t know you. Go away. Go away now.”
Susan stood up, moving back.
She wanted to cry, but the tears had gone long ago. There were good days and bad days, but there were a lot more bad ones lately. When she called her sister that night, she felt pretty discouraged. Pam was more upbeat, but then she lived two hours away. She didn’t see their mother very often.
Susan was chagrined when Pam changed the subject, asking if she had seen a recent movie with James Garner.
“I don’t have much time for movies,” Susan began but Pam interrupted.
“No, this was on televison, James Garner and Gena Rowlands. She had Alzheimer’s and was in a nursing home.”
Susan maintained a stubborn silence as Pam continued. “He visited every day, but she didn’t know him. Then one day he brought a notebook about stuff they used to do together.
“We don’t have a notebook,” Susan reminded Pam stiffly.
“But we have pictures… boxes of pictures. I wonder how she would react to them if you brought several to the home one day.”
Well, it couldn’t hurt, Susan reasoned. The next day she pulled down a box of photos from the attic and selected three from their childhood.
Her mother was in bed when she arrived at the home “She doesn’t want me to get her up, Miss Susan. I tried,” the nurses aide explained.
Susan approached the bed… “Mother,” she said softly. There was no response. “Mother, I’ve brought you a surprise.”
When her mother turned her head, Susan thrust a photo of her and Pam when they were toddlers. She had written “Susan and Pam at the pool” on a card with the picture. Her mother studied the picture, read the paper, then looked up at Susan. “You are beautiful a s ever,” she said, stroking the picture smiling.
The next day Susan brought more pictures, and the reaction was the same, and the next day and the next. Two weeks later the staff nurse approached her. “You know since you have been bringing those photo-graphs, your mother seems more aware. About this time of day it’s almost like she’s looking for you. I mentioned it to Dr. Lindsay, and he said that certain kinds of skills, like reading, are less afflicted than learning and memory processes.”
“I have studied Alzheimer’s a little,” Susan replied. “I know it strikes the hippocampus, the part of the brain that is critical for learning and remembering.”
The nurse nodded. “I’ve noticed that even when dementia is so advanced that patients can’t speak, they can read large words. I know because they smile as they read and touch a picture.”
Unfortunately for Susan’s mother and others also suffering from
Alzheimer’s disease, patients are often treated as though they are not the person they were. One of the most irritating problems for a caregiver is the individual’s repeatedly asking the same question. Doctors say spoken words literally go through one ear and out the other. Patients may understand, but they cannot store information.
One man reported that his mother would repeatedly ask,” Where are we going?” when he picked her up for her weekly visit to the doctor. One day he wrote on a card,” We are going to the doctor’s.” When she asked again, he would say, “The answer is on that card.” After that she would look out the window, then at the card, then out the window again.
A similar technique has been used to deal with anger or anxiety. When one patient refused to shower, the nurses aide gave him a card that read, “Showers make me feel clean and fresh.” The next time it was time to shower, she handed him the card, saying it was time for a shower. He looked at the card, then obediently followed her to the shower room.
Research and experience are changing the care Alzheimer’s patients receive. If caregivers are not stressed and in a hurry, if the patient is well cared for, better communication can enhance the life of family and patient alike.