The Good Days and the Bad: What Makes the Difference With Alzheimer's Patients?
My father and I recently braced my father's brother and his wife about what to expect during their first visit with Mom in two years. We told them that she is really weak, often doesn't know who people are, and lives in her own alternate reality. After lunch, Dad escorted Uncle Bob and Aunt Betty to the nursing home. I decided not to go, having learned that too many people around tends to put Mom on "overload" and can cause an emotional outburst. So I headed home to wait for the group's return, anticipating that I was going to have to interpret some of Mom's behaviors for them.
About an hour later, Uncle Bob's vehicle pulled into the driveway and the trio emerged and headed towards my front door. Upon their entrance, I tried to gauge the reactions in their face; what I saw was a sense of disbelief. "How was she?" I asked. My dad's response: "She was great!" Turns out Mom recognized both Aunt Betty and Uncle Bob, and addressed them both by name. She even carried on a very coherent conversation. How could this be?
Flashback to about 1-1/2 years ago when my friends, Bob and Anna, first visited Mom when she was in the nursing home. Same thing happened - to the point that my friends seriously questioned whether Mom really needed to be in a secure unit (and based on Mom's performance that day, I agreed).
After Bob and Anna's visit, I shared what had happened with another friend, Pam, whose husband has a disease similar to early onset dementia. Pam said she had noticed the same thing happens with her husband.She described him like an athlete who tries to marshall his or her energy in order to have a "peak" performance when it most matters.
So how could Mom know how to focus her energies? During the week prior to Bob and Anna's visit, I regulary told Mom about the upcoming visit. I also listed this event on the dry erase board in her room which, at that point, served as her daily compass. Mom's mental capacity was strong enough that she was able to focus her attention on being ready for their visit.
Mom's mental capacity had deteriorated by the time of Uncle Bob and Aunt Betty's visit. Yet, there was a similarity in that there was an early warning system. Dad had mentioned to Mom earlier in the week that they were coming. But probably more importantly, Dad called the nursing home on the morning of the visit to ask them to prepare Mom for special visitors. In addition to dressing Mom up for the visit, I'm sure the nursing home staff shared with Mom that she was going to have special visitors. That cued Mom into conserving her mental energy for the visit. And this factor, when combined with the fact that Mom has known Uncle Bob and Aunt Betty for over 50 years (so they are people who populate her long-term memory), Mom was able to be "on" for her visitors.
These events showed me yet again that it's difficult to predict how Alzheimer's affects loved ones on a daily basis. So what happens in the days following these "peak" performances? I'll write about that in my next sharepost. Stay tuned...