When human beings loses their ability to communicate verbally, whether through stroke, Alzheimer's or some other disease, the frustration of not being able to articulate one's feelings can create anger and difficult behavior.
I saw my uncle struggle with aphasia after his last major stroke. This man, who had been a voracious reader, speaker and crossword puzzle whiz, could no longer put the right name on an object. He spent ten minutes one day hollering at me, as he wanted me to get his magazines fixed. When I put my hand on his neat stack of magazines, he got madder. "No! My magazines!" he hollered. After touching everything in site, I finally opened his bed stand drawer, picked up his razor and said, "Does your razor need to be fixed?" By then in a purple rage of frustration, he yelled, "Yes! My magazines!"
With Alzheimer's disease, failing communication can also frustrate an elder and bring out similar behavior. The inability to express oneself gets worse as the disease progresses. This is difficult for the person with dementia, the medical people and the caregiver because caregivers want to know what the person with dementia needs. It's also extremely hard during the later phases of the disease because the person is often unable to let others know if there is pain, and if there is pain, what kind of pain. A bad tooth could be making the person miserable, but all he can do is act angry. Caregivers are left to study body language.
My dad didn't have Alzheimer's, but surgery caused instant dementia. In his later years of dementia, it became a constant worry as we tried to figure out his pain. He couldn't articulate it. In the end, we fought with a doctor to get him on hospice care, as we who knew Dad could see by his body language he was in extreme pain, but the doctor was unconvinced. Eventually, we prevailed.
What brought this subject to mind is a recent study reported on in an article titled, "Memantine Benefits Functional Communication in Patients With Moderate Alzheimer's Disease..." This study was reported on at the 22nd European College of Neuropsychopharmacology Congress. Memantine is sold under the brand name Namenda, and is often prescribed for people with Alzheimer's disease, to take along with cholinesterase inhibitors such as Aricept.
According to this double-blind study, "Compared with patients on placebo... researchers found a statistically significant ... improvement... in patients treated with memantine."
Have you ever had laryngitis so severe you couldn't speak at all? Even if the inability to speak lasts only a short time, this can frustrate the most patient person. We are made to communicate.
Now imagine not being able to express your fears, your pain or even your love? This extremely human ability to communicate with language is one of our most precious gifts. Alzheimer's is one disease that strips away this precious gift. Since memantine has been shown, as least in this study, to improve communication for some people with Alzheimer's, it seems to me it's worth mentioning to the doctor. Many people already take it, as noted above.
But if your loved one doesn't take memantine, it may be time to look into it. As with all drugs there are side effects, and some people won't be able to tolerate the medicine. It won't benefit everyone. But this study indicates a step forward in the treatment of the symptoms of Alzheimer's. That's always good news.
Published On: September 21, 2009