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Jun
24

When They No Longer Know You – Alzheimer’s

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I work with a lot of Alzheimer’s patients and their caregivers in NY. We are the Long Island Alzheier’s Foundation’s recommended physical therapists so we work with more Alzheimer’s patients than the average physical therapy clinic in NY. However, we have a more personalized approach to treating Alzheimer’s patients and working with their family. I see families who are affected by this disease almost on a daily basis; yet every day I seem to learn or see something new or inspiring. Many times I’m asked “Why bother with things like physical therapy?” and while it’s definitely a legitimate question the answer often surprises the families of those who have been diagnosed with Alzheimer’s or any type of dementia for that matter. The purpose of physical therapy for those with Alzheimer’s and dementia is to keep them physically healthy and strong. The disease itself can lead to a person literally foretting to do certain normal activities and literally just sit or sleep if they are not inspired to get up and move. These actions can lead to weaknesses in many joints, core strength, muscle weaknesses, and cause problems with balance. Working with a GO Physical Therapist enables the client to be given one on one attention right in the privacy of their own home to be evaluated and determine what their immediate needs are to maintain as much strength as possible in order to have quality of life. One of the facts of Alzheimer’s disease is that the mind will go; however, we never know how quickly. One of the things that upsets the loved ones of the person affected with Alzheimer’s the most is when they reach a point where they don’t always recognize people. This is exceptionally painful for those that are close to the patient, such as immediate family. However, I must point out to you that many times the eyes truly are the guide to the soul. You may sometimes look at your loved one and their eyes are far away; often, I believe that’s when their mind is more “far away” also. However, there are also moments when you will look at them and a sparkle will appear that only you know. That sparkle is quite often a moment PJswhen they do recognize you as you look at them. It’s important to let them know that you love them, to tell them often and to even remind them who you are. If you can, relate your name to something in particular that is relevant to the here and now. For example, I know one lady that always associated her granddaughter with her bedtime routine. She would ask each night, “Is Sarah coming to put on my pajamas?” and with regularity Sarah came each night to put on her pajamas. While Sarah was there she would talk to her grandmother about her husband Mark. Sarah found that saying their names together helped her grandmother associate who they were. As odd as it seemed you could hear Sarah saying things like “Sarah and Mark went to the farm today Gram. It reminded me of you when you lived on the farm Grandma.” When her grandmother’s nurse would care for her she would always use the two names together to explain things. For instance she would say, “Sarah puts my pajamas on. Sarah and Mark. Sarah and Mark.” The nurse would smile and say, “Yes, that’s right Sarah is your granddaughter and Mark is her husband.” This patient also remembered her children by saying their names in birth order very distinctively, “Robby, Sue, and Jim. Robby, Sue and Jim.” While at the same time any one of her children could visit and she may or may not realize who they were depending upon how she was that day. So why could she think like this? We have to remember that Alzheimer’s affects the brain and is a neurological disease. Sometimes it may take away their ability to say who a personAlzheimersBrain is but it doesn’t necessarily take away the inner knowledge of that person’s existence. Researchers feel that what may happen with Alzheimer’s patients is that they recognize them in some way yet don’t have the ability to connect them in their minds. This may also explain why at times they can quickly associate a face with a name, while other times they will either stare at a person with that lost look or even straight out ask “Who are you?” Many times they will sit with you and then after a period of time blurt out, “You’re my wife!” when you didn’t even realize that they didn’t know you. We think with a fully working brain that assumes because they welcome us and engage with us they know who we are; but, that’s not necessarily how their brain works. While I know this hurts, I think there is some comfort in knowing that your loved one may truly know you within their heart. More than that, they know that when you are there and doing loving things for them, smiling at them and making their day seem better they are happy. I think that is something families should strive for more than hearing their names from their loved ones. The heart often knows what the mind cannot say out loud and Alzheimer’s is a definite case where this seems very true. I know it hurts to feel as though the person you love with all of your heart doesn’t know you; I think that the truth is they may know more than we think but because of their inability to produce the proper neurological connection in their brain they simply cannot say it. In the meantime take each moment you have with your loved one and create your own memories with them. Even if it’s something as simple as a few moments in the garden smelling flowers, taking a brief walk or ride someplace beautiful, or spending time playing a game of cards or putting together a puzzle. The person whose mind cannot connect the dots fully is still the person you loved before the disease; it’s just that now they are changed. Create new memories, new laughter, new moments to join the memories of the past. I know it’s hard when the time comes that you hear those words or realize that your loved one doesn’t know you by face; but I truly feel they will always know you by the heart.

Dedicated To Your Health & Well-being (and safety),

Mike

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