Alzheimer’s
The Stranger in the Mirror
PART 3
As to the disease causing behavior problems, I believe that it
depends upon your perspective. Alzheimer’s eventually causes a
person to wander, to forget, and to regress physically and
emotionally. The behavior is only a major problem if you forget
that it is disease-related.
If the person is wandering away from home, they will need to be
kept safe. It may be as simple as placing an obstruction at the
exits, painting the door the same color as the walls, or as
complicated as placing them in a more secure environment.
Roxanne Johnson, from Aging Consultants, Ltd. in Monroe,
Louisiana, talked about design at the Dementia Course in
Scotland. She discussed that environmental design can instigate
behavior problems, but design can also be used as a method of
preventing behavior problems.
Forgetting is not as much a problem to the person with
Alzheimer’s as it is to the family. Shortly after moving into
the nursing home, my mother called me into her bathroom to show
me something funny. I could not imagine what could be funny in
the bathroom. She pointed out that funny old lady (in the
mirror) that played with her and mocked her every move. She
giggled and laughed. With as much control as I could muster, I
said yes that was funny and then excused myself to go smoke a
cigarette. I had started back to smoking after having quit for
six months. I think that I inhaled about five cigarettes in ten
minutes as I paced the sidewalk and sobbed. Then I wiped my
face, blew my nose, and plastered on a smile. I went back to my
mother and told her how happy I was that she had found a
friend.
In that bathroom, she had moments of happiness. I could not
steal those moments from her. Regressing to earlier stages of
development causes a myriad of problems with mobility,
articulation, vision, body orientation, and all activities of
daily living.
My mother died 4 years ago. I was with her the day before she
died. I felt distressed that day because even singing her
favorite hymns did not connect with her at all. Just before I
left, she raised my left arm to her mouth. In those few seconds
as she raised my arm, I wondered whether she would bite me,
kiss me, lick me, spit on me, etc. It did not really matter. It
was a connection, albeit a small one. She continued to lift my
wrist to her mouth and then sucked on my watch. She died in her
sleep that night. Four days later, the day of her funeral, my
six-month-old grandson took my wrist to his mouth and sucked on
my watch. The nurse in me recognized the level to which my
mother had regressed. The daughter in me felt her presence in
her great-grandson and was very grateful again for that
connection. It felt as if my Mama was trying to tell me that
she was OK now.
In a world of unfamiliarity where even the reflection in the
mirror is a stranger, the person with Alzheimer’s needs someone
to care. They need gentle direction and a loving touch from
everyone they encounter to reassure them in a very strange
world. It is a world that makes no sense. It is a world going
backwards.
References
Fazio, S., Seman, D., Stansell, J. 1999, Rethinking Alzheimer’s
Care. Baltimore, Maryland.
Health Professions Press.
Harris, Phyllis Braudy. 2002, The Person with Alzheimer’s
Disease: Pathways to
Understanding the Experience. Baltimore and London: The John
Hopkins University Press
Johnson, Christopher., Johnson, Roxanne March/April 2000,
Alzheimer’s disease as a “trip back in time”.
American Journal of Alzheimer’s Disease: Volume 15, Number
2
Johnson, Roxanne. 2004, Speaker on Design and Dementia. New
Approaches to Dementia
Summer School. University of Stirling; Stirling, Scotland.
Reisberg, Barry. 1984. Functional Assessment Staging (FAST).
Psychopharmacology Bulletin. 1988:24: 653-659.
Alzheimer’s Association. “Statistics.” 1996
b-fountain@msn.com
by Brenda Fountain, BSN, RN
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