Responding Positively to Alzheimer's Patients

by Howard Gruetzner, M Ed. Director of Regional Aging Services

1. The person asks the same questions over and over.

Common response: The person is not listening or trying to remember; she wants attention or is trying to annoy you; she should be able to control this.

Alzheimer's interpretation: The person is suffering memory loss, which in turn creates a strong sense of insecurity and uncertainty. She may be asking the same questions repeatedly because she seeks reassurance and security, or perhaps you earlier answers seemed vague or unclear. She may sense you are avoiding the answer, which could heighten her sense of insecurity.

2. The person denies her memory problems and makes excuses for mistakes, blames others, or seems unaware of the problem.

Common response: The person is not being honest; she should face the problem and accept responsibility for her own mistakes; she is getting old and senile.

Alzheimer's Interpretation: Denial of memory problems is a very common response to Alzheimer's. Initially, denial is a necessary defense. It protects the person from frightening changes that are difficult to accept. If she makes excuses or blames others, she may be desperately trying to explain the memory impairment without directly confronting the problem.

3. The person tells ridiculous stories or says unusual things.

Common response: She is lying or being mean; she is going crazy or getting senile.

Alzheimer's Interpretation: Such stories are easy to take personally, but they are rarely malicious. As memory and reasoning abilities continue to decline, larger gaps are left in the person's perception of reality. It is harder for her to explain or understand what is happening because her grasp of logic is deteriorating.

Ridiculous stories and obvious untruths may be attempts to fill in the blank, to explain what she cannot understand.

If the person believes her own stories, the things she says may cause real agitation, anger, and fearfulness. If her stories place blame on others, she may be trying to defend her self-respect and integrity.

Some of the unusual things a person says may also represent difficulties in speech. Finding words to explain things or even name things correctly becomes difficult as the disease develops. The person may be able to manage only fragmentary ideas or statements.

4. The person's abilities fluctuate from day to day or hour to hour; she remembers some things but not others.

Common response: She remembers what she wants to; she is not trying to remember; she must be getting old and senile.

Alzheimer's Interpretation: It is normal for the memory of all Alzheimer's patients to fluctuate in this fashion. It is a mistake to believe that improved memory on a given day means the condition is improving, however. Material that is unpleasant or threatening may be more easily forgotten.