FEATURES
|
ALZHEIMER'S VICTIMS GET HELP REMEMBERING
by Nancy Cook Lauer, FSU Communications Group
It begins with an inability to remember the names of people and objects important in your life. A lost word here, a forgotten fragment of information there.
As conversations become more and more difficult, the disease takes its victims first through embarrassment and frustration, then agitation, fearfulness and sometimes even aggression, until they finally give up trying to communicate entirely.
Alzheimer's disease strikes more than 10 percent of people over age 65 and more than 25 percent of those over age 85. About 4 million Americans now have the disease, according to the Alzheimer's Association and the National Institute on Aging. That figure is expected to be 10 million by the year 2020.
Alzheimer's hits hard and may be as frustrating for the caregiver as for the patient. But work by an FSU researcher is helping Alzheimer's victims reach into the darkest corners of their minds to retrieve those scraps of information that remain there.
"Some people believe that all that information is still there, but people just lose the ability to access it," said Michelle Bourgeois, a scholar in the FSU College of Communication and in the university's Pepper Institute on Aging and Public Policy.
Bourgeois is the principal investigator halfway through a four-year grant from the National Institute on Aging to study communication between nursing home caregivers and residents with Alzheimer's and other forms of dementia. Along with Louis Burgio, at the University of Alabama in Birmingham, Bourgeois is studying ways to improve communication between patients and staff in nursing homes.
Much of that communication strategy involves the use of memory aids in various sizes and shapes. Ranging from a memory book, similar to a photo album but with captions, to memory wallets and laminated cards strung together, the simple idea is having a surprisingly strong effect on memory retention.
The set of cards can be slipped into a clear pocket on a vest or apron, hung around the neck with a bright ribbon, hung around the wrist or attached to the arm of a wheelchair. It typically contains eight to 10 pages of photos and maps with family and biographic information. A few pages may be devoted to particular problem behaviors. A card may, for example, show a picture of the dining hall or food, with the words "Finishing all my food helps to keep me strong." Pages can be changed and updated as needed.
"There are a lot of problems that persons with dementia have," Bourgeois said. "All of it is related to their memory impairment. They don't remember why they eat. They don't recognize what food is."
It might seem odd that people who can't remember to eat still are able to read. But Bourgeois says reading becomes a rote task after so many years.
"We assume that reading is a higher-order cognitive function, but in fact it must be over-learned behavior," she said. "It seems to stay with them. And they do better with information that is relative to their personal situation."
In fact, Bourgeois' landmark research has found that patients not only remember more facts associated with each topic, but they keep remembering them, even 2 1/2 years later. Each phrase seemed to trigger more memories than were originally thought to remain. And the associated facts seemed to stay with the patients as well.
"That much later they can still access that exact same information," she said.
"For patients who had a memory book, their conversation was much more intact. It gets them to that part of the brain where that information is stored."
Reading also works better than listening as people age, because they're not processing the spoken word as well as they used to. They're reacting to the tone of voice, especially when people get frustrated with them for asking the same question over and over, or forgetting details.
So, for example, a patient can read "Ruth will pick me up at 3 o'clock." Now she doesn't have to keep asking the caregiver that question.
And the technique gets information to the patient in a neutral manner.
For example, a patient may keep asking when her deceased husband will be there.
Having a photo of her husband - or even of his headstone -with an inscription such as "This is my husband Henry, who died in 1972" is, paradoxically, comforting to the patient, who no longer has to keep waiting for Henry to arrive.
The books help the caregivers as well, by giving them a way to communicate with the dementia patient.
"It gives them something positive to do," Bourgeois said.