Penelope Maclachlan

“I think, therefore I am,”  said Descartes. We might paraphrase this and  say, “I remember, therefore I am.” Memories comprise who we are. Sometimes  we may wish we could forget certain occurrences – the rebuke from an angry parent, perhaps, or a scolding from a teacher. Yet we should not wish our memories away. They are our map or pathway through life until this very moment and beyond. 

Loss of memory is tragic, as sufferers from dementia and their loved ones will agree. Lost memories, as they escalate, dismantle the people who once knew us and whom we once knew. Lose the memories and we lose the person. 

Alzheimer’s, the commonest form of dementia, has a cluster of many symptoms, of which memory loss is just one.  Sufferers may experience depression, anxiety, agitation and disturbed sleep. Treating these disorders may improve their quality of life.  Changes in the brain and the shock of diagnosis can cause depression. (It differs from the depression which those free of Alzheimer’s may experience, sometimes accompanied by guilty feelings and suicidal thoughts.) Medication may help, but must be professionally prescribed. Buying mood-altering drugs online is dangerous. 

Anxiety and agitation, which caregivers often notice, are common in cases of Alzheimer’s. A woman reported that her  mother had settled in a nursing home, when one day a storm damaged the roof. The premises were in danger of flooding, and residents had to go elsewhere. The daughter found alternative accommodation   for her mother, who deteriorated after the move. She would not sit still, but paced along the corridors and up and down the stairs. Well-meant efforts to persuade her to relax and sit still made her irritable and rebellious. Again, medication may relieve some of the restlessness. Certain drugs, though, may increase the risk of dizziness, falls and worse – strokes, heart attacks and death.  Physicians strive to strike the best balance possible, but the perfect drug, with no side effects, does not exist. 

Sufferers may sleep badly at night. The answer is not sleeping pills, but physical activity during the day. The daughter reported that little physical activity was encouraged in one nursing home, and residents spent much of most days seated in a lounge in front of a television set staring blankly at a programme which they had not chosen and were not following.      
Alzheimer’s patients need physical and mental stimulation. As long as they are able to walk they should be encouraged to do so, ideally in quiet peaceful surroundings such as gardens or parks. Neighbours who encounter them during such outings should greet the patients. Whether or not there is recognition, such engagement is beneficial. Kindness touches the psyche long after the ability to reason is gone.

Other stimuli include photographs. Family members should organise them in an  album, 

and the images should include pictures of patients themselves at happy moments when they were young or younger. Many a middle-aged daughter or son may wince when a mother points at a photograph and ask where that pretty girl or good-looking boy has gone. She does not associate the adult at her side, who may have grey hair and a lined face, with the child who laughed and played. Rather than argue, and insist  the child has aged, it may be better to encourage the mother or father to talk about what they remember.   Old memories endure, even when patients have no idea of their present address or why they are there. Confusing generations is usual. The daughter of a friend from decades ago may be mistaken for her mother. A gesture, characteristic accent or choice of words echoes in the mind of the  listener, who may call the daughter by her mother’s name. Again, it is better to allow patients to reminisce  rather than constantly correct them.

Music, like kindness, touches parts that facts no longer reach. A former ballerina, confined to a wheelchair, heard music to which she had danced in her heyday, and repeated with her arms and hands the movements she had learned.  

To date there is no cure for Alzheimer’s, though we hope one will be found in future, through the dedication and intelligence of researchers.  Until then we must help keep alive the precious gift of memory. 


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