Last night, after my mother called and could not remember why she made the call, she said, “My memory is really bad.” This is the first time she admitted to her memory loss since her stroke. However, she did make the call 15 minutes before Jeopardy and told me that is why she called, knowing I would be watching that program in a few minutes.
The strategic planning of when to call and what the other might be doing is part of the executive functioning of the brain and, as a clinician, it is a clue to me on the difference between someone with Alzheimer’s dementia and someone with a vascular dementia. Clients with Alzheimer’s disease would have just called at any time as they are often unaware of the needs or interests of others.
My response to Mom was to say, “Well, we are working on getting some of your other brain cells to recover.” That might not be a possibility and she might always have a severe short term memory problem – but as a family member and a professional, I never want to take away hope. Some might say that is not being honest and I that I should have just said, “You had a stroke so your memory is not going to get any better.” But, to tell you the truth, I have seen some people adapt and find ways that work for them that assist with their memory – such as writing themselves notes or consulting their calendars often.
If you get into “concrete reality” without considering the “emotional reality” in your responses, your family member could end up feeling bad and have a bruised self-esteem. Emotional assaults (even minor ones) are remembered longer. It isn’t the event or the words spoken that caused the bruise to the self-esteem, it is the feeling the person had at the time of the incident that stays with them.
When a person with any dementia leaves an interaction feeling dumb, inept, confused, scared or angry – that feeling could stay for days and cause behavioral issues that surprise family members or caregivers. It is up to us, family and professional caregivers to always be aware of how we speak and what the emotional impact might be on the other. If safety is at risk you must act quickly and not have the time to protect the self-esteem in the moment. We are all human and will make mistakes – if we do just move on and look for some positives.
In my mother’s case we just laughed and moved on in our conversation talking about pleasant things and activities. I left the door open for her to call me anytime – but she has to write down what she needs first and then dial my number.