Moments of Clarity: Why Glimpses Through Dementia's Fog Can Surprise Us

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Question

Dear Candid Caregiver: My grandma has had mixed dementia, probably a combination of Alzheimer’s and vascular, for many years. She’s generally sweet and compliant, just wanting to stay comfortable in a world that she seems to have created for herself. The whole family tries to encourage her to tell stories, which she will sometimes do if she’s feeling up to it, but mostly she listens to the old-time music that we play for her or she naps. Grandma hasn’t recognized anyone in the family for a couple of years, but last week my mom and I had a shock. We were both helping Grandma get dressed after a sponge bath when she looked at Mom and called her by name. She asked how my dad — using his name — was. Then she looked at me, and using my name, told me that I’d grown up so nicely. While Mom and I were recovering enough to engage Grandma in some happy conversation, she slipped back into her personal reverie. That was it. We’re still shaking our heads. How common is this? — Stunned Granddaughter

Answer

Dear Stunned: First, let me congratulate you on being such a fine granddaughter. Your compassion would be laudable at any age but from your note, I’m assuming that you are still quite young. Your grandmother was right. You’ve grown up beautifully.

To address your question, while what I’ve always called “moments of clarity” don’t happen to everyone living with dementia, they aren’t all that unusual, either.

I experienced several of these glorious moments with my dad who developed dementia after he had brain surgery. Dad didn’t have memory issues but he had reality issues, so our interactions were not based on my view of facts as I saw them but facts as he saw them. However, on one particular morning, I entered his room as usual, expecting that I would need to take myself into his world during our daily communications.

Dad’s eyes were clear — almost normal. I was happy to see that but I didn’t realize the importance of this physical sign of clarity until he looked he looked directly at me and said, “Thank you for helping an old man’s fantasy.” He then wanted to kiss me. I was happy to give him a kiss, but I was dumbfounded by his statement. He was thanking me for jumping into his world. I realized that on some level he knew that we played a daily game and he was thanking me for sticking with him. This moment was a gift of a lifetime for me — one that I could hardly wait to share with my mom, and a moment in time that I’ll forever cherish.

Another example of one of these moments happened to Anna, a student who was in a class for gerontology students at a local university that uses my book as a text. As we chatted, she told the class that she, too, had a grandmother who no longer knew her name — hadn’t for years.

One day, though, when Anna walked into her grandma’s nursing home room, her grandma saw Anna and happily exclaimed, “Anna! How wonderful to see you!” Needless to say, Anna was first shocked, then thrilled. There were a few more coherent sentences exchanged before her grandma “slipped back,” as Anna put it. Like me, Anna will cherish that brief moment where she had a glimpse of her beloved grandmother, seeing her how she was rather than how she presented to the world.

I feel that these moments are an important reminder to those of us who struggle to reach people who live with Alzheimer’s and other types of dementia. The person we love is still there. Even though it often feels like we’ve lost their essence, we haven’t. They still have needs, desires, and the ability to love back. Even though their brains have changed, their essence hasn't.

I hope that you will be able to tuck that precious moment away to use when you need a smile, Stunned. Remind yourself that your grandma is still your grandma and that moment was her blessing to you.

See more helpful articles:

Dementia: Living with a Positive Outlook Despite the Diagnosis

Parsing Validation: Helping People Living with Dementia Maintain Self-Worth

9 Things To Consider Before Placing a Loved One in a Nursing Home