Every individual thinks differently on a daily basis, regardless of their cognitive abilities. Although, I cannot provide specifics in what individuals with Alzheimer’s disease think. I can provide you with information that will help understand how this disease affects the individual and thinking process.
Alzheimer’s disease is considered a progressive neurodegenerative illness, which means that the illness will cause more and more brain cells to become damaged over time. The result of this ongoing brain damage is a continual loss in the ability to think and function correctly. Our brains are very complex and amazing organs, with many different areas controlling different aspects of how we think, act, remember, function, and control our bodies. Alzheimer’s disease affects the whole brain in time, but not all at once.
Although I am not a physician, there are certain symptoms that are characteristic of Alzheimer’s disease and do not appear in every individual. These include a loss of short term memory (what they ate for breakfast or what was said 5 minutes ago), problems expressing thoughts or comprehending requests (trouble finding the right words or calling something by the wrong name), confusion or disorientation to time, place, or person. People with Alzheimer’s disease tend to experience confusion and disorientation, which can influence their perception of reality.
Alzheimer’s disease causes communication problems due to damaging the brain. One of the terms to describe this loss of language is Aphasia. Aphasia is an inability to express one’s inner thoughts and feelings through communication, as well as an inability to understand the communications of others. Similarly, the disease also prevents a person from accessing the vocabulary that they have developed throughout their life. With Alzheimer’s disease, a person can have problems giving information (expressive aphasia), receiving information (receptive aphasia), or both. In receptive aphasia, a person with dementia may be holding a magazine and may appear to be reading, but they may not be able to understand the words on the page. In expressive aphasia many words become inaccessible. They are unable to successfully share their thoughts and feelings most of the time. Overall, as the disease progresses, communication becomes more and more difficult. More words are lost, and there are fewer substitutions available.
In general, what a person is thinking of on a daily basis can depend greatly on the person’s progression in the disease process. Someone in the early stages, who is still aware of surroundings, etc., may be no different in thinking than someone without the disease. As the disease progresses, the person might be struggling in his/her thoughts to make sense of the surroundings, people caring for him/her and of “going home”—a common reaction to the need to feel comfort and safe. The important thing to remember is not so much what the person is thinking, but rather to make the person feel safe, secure and stimulated.
I think everybody gave you great answers. In our family's case, I was almost always constantly surprised by what Mom would say when I visited. One time she was sure that she was back at the fabric store that she and my father had run for about 25 years. Then another time, she thought she was in the middle of an airport (when in reality she was right by the nurse's station at the nursing home). Another time, Mom was sure that she almost had become "a crispy critter," stating that there had been a fire in the nursing home's courtyard. That wasn't the case; she had actually been watching the news where they were reporting wildfires in another part of the state.
So the lessons that I took from these visits was that she could indeed be living in the past. However, Mom also could "adopt" whatever scenario she was watching, whether it was something she saw on television or heard in her environment.
Take care and stay in touch!
Every person with dementia is different, just as we are all different. As his or her short-term memory worsens, the person tends to go later back in time. Therefore, a person with stage 5 dementia may feel as though he or she is about 20 years old and that's where the memories are. This is one explanation for people not recognizing themselves in a mirror - they don't know they are 70 or 80 years old. Their brain is telling them they are much younger.
The bottom line is that what a person is thinking will change, and will almost certainly start to focus on the past. However, when it comes to fear or pain, often they are in the moment.
Give comfort and do what you can to reassure the person of safety and love. Sometimes you can't do a whole lot more.
Hi LisaThis is a very interesting question. Thank you. When people cannot express themselves and are unable to efficiently communicate their needs and wishes we do wonder what they are thinking. As Carol points out, everyone is an individual and that does not change for people with dementia. There are many types of dementia that depend on cause (what type of disease they have) so the way people think can depend what type they have. Here is a link to more information on the different types of dementia. In the early stages of dementia, for instance, Alzheimer's disease, memory loss will affect thinking because you forget words, forget what they were doing so there will be increasing gaps. It increasingly difficult to carry out tasks. As you can imagine in the early stages of the disease it is distressing and can make you frightened. Not being able to think clearly means you get confused and this confusion increases as the disease progresses.Thoughts can be fleeting and jumbled up. That is why it is important to use more simple sentences to ask them what they think they want or how they feel.In some types of dementia, such as vascular dementia, memory can be variable. Sometimes they can think more clearly than at other times. Check out Leah's shareposts . She has vascular dementia and so will give you an insight into what it feels like, and her thoughts about it.This sharepost on How it feels to have Alzheimer's may also give you an insight into how they think.
Hope this helps