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IKF Blog
Posted: Tuesday, January 14, 2020

Understanding the Behavior Behind Dementia

When someone you love has Alzheimer’s or dementia, the most difficult experience may occur in only a moment, but it will never be forgotten. Looking into the eyes of a spouse, parent, or life-long friend and realizing they no longer recognize who you are is heartbreaking.

Although it’s hard to accept, it’s also essential to remember the person you once knew is as helpless in this situation as you are. The disease is in control now. But understanding how this unfolds may help you better comprehend the behavior and not take it personally.

The progression of the disease

In the first stages of Alzheimer’s or dementia, memory challenges may be mild, although still frustrating and difficult. As the disease advances, memory loss becomes more severe. In the later stages, recognition of even close family members and relationships may be gone. A person may also forget the purpose of common items, such as a fork and knife or a set of keys. What causes this is the continued and progressive damage to their brain cells.

3 stages of memory loss disease

The rate at which the brain damage develops can vary with each person. Brain tissue of someone with Alzheimer’s will have fewer nerve cells and synapses, influencing the ability to deliver needed material to the cells, causing them to die. Along with significant tissue loss, the brain actually shrinks, affecting almost all of its functions.

Here is a short summary of the process:

1.  The brain’s wrinkled surface is called the cortex. It’s been mapped to certain functions such as processing sights, sounds and thoughts, as well as forming and storing memories. Signals that form memories and thoughts move through a nerve cell as an electrical charge. With Alzheimer’s, there’s a disruption in the way electrical charges travel within cells.

2. As the disease progresses, plaques or abnormal clusters of protein fragments build up between nerve cells. The dead and dying nerve cells contain tangles, which are made up of twisted strands of another protein. As the plaques clump together, they may block cell-to-cell signaling. When an individual reaches the mild to moderate stages, areas of the brain that are vital to memory, thinking and planning have developed more plaques and tangles, causing them to become confused and struggle to express or organize their thoughts.

3.  As the impairment advances and the plaques and tangles spread through the cortex, individuals will experience changes in their personality and have trouble with recognition. Eventually, most of the cortex is damaged and the ability to communicate, care for themselves or recognize loved ones will be lost.

(Source: alzheimer's association)

Suggestions for responding to behaviors

If you notice abrupt changes in your loved one’s behavior or mood, don’t automatically assume it’s a consequence of the disease. Some medical conditions can also be the cause so talk to a doctor or medical team to rule that out. But if the time has come when your loved one no longer recognizes you, here are a few recommendations for how best to respond.

1.  Remind the person gently who you are but without judgment or frustration. And remind yourself that it’s not their fault or choice not to remember you. It’s a result of the disease. It’s painful but taking it personal will only make things worse.

2.  Try not to show the hurt you feel from not being recognized. It’s not their intention or a reflection on how they once felt about you. Don’t become defensive, accuse them of not caring or torture yourself doubting your relationship. They have a progressive cognitive disease and have no control over what’s happening in their brain.  

3.  Meet your loved one where they are. Don’t try to get them to return back to the old life you shared together. If they’re talking about a past time, join the conversation with them there. Adding your own memories and stories can make for a pleasant visit.

4.  To help with the present recognition of who you and others are, or to explain the relationships, keep photographs, memory boxes or a simple bulletin board with pictures to help remind the person of who their visitors may be.

5.  Although your loved one may not recognize who, they still appreciate your compassion and kindness. Your visits or interactions are no less valuable or meaningful. Don’t underestimate the value of human engagement.

Ways to help yourself

As the disease progresses, reach out to the memory care community’s staff who understand this behavior and can help your family. A good support group can also be crucial to share this experience with those who have gone through this themselves. It’s also a great opportunity to learn what other caregivers have tried, as well as what worked and what didn’t.

But don’t pretend that the feeling of not being recognized isn’t significant. This is another loss that the disease has dealt in your life. Even though your loved one is not intentionally hurting you, it’s still painful. Taking the time to acknowledge and grieve this loss will actually help you move forward.

One of the bigger mistakes family or friends can make is to stop visiting because they think it no longer matters. But remind yourself that what is still important is the interaction between you and your loved one. Even though they may not be able to capture the memory of who you are and how much you mean to them, they do benefit from your visits and acts of kindness. And those pleasant feelings can last even after you leave.

Ingleside’s Memory Support Assisted Living

We know the behaviors of dementia and the frustration and heartache they can cause. But we can also help you better understand why this is happening, as well as support you and your loved one as you move through the stages of this disease. At Ingleside’s Memory Support Assisted Living, we care for both our residents and their families.

Call (240) 455-4582 if you have any questions or would like to schedule a personalized tour today.


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