But Who Knows Where or When?

Did you know that there are different memory systems at work in our brains?  One of those systems is the declarative memory system. This is the memory system that affects short term memory, language, facts, recent episodes and executive function (the ability to make large and small decisions.)  This is why a person living with Alzheimer’s often cannot remember things that happened five minutes ago, or remember the names of loved ones, or struggles to make the simplest decisions. Just as the lyrics from the old song describes:

“It seems we stood and talked like this before. We looked at each other in the same way then, but I can’t remember where or when.

For someone living with Alzheimer’s, it is as though someone walks in every five minutes with a magic wand, waves the wand, and poof, everything that just happened to them in the last few minutes disappears. This disappearing act happens every few minutes, all day long. Can you imagine how frustrating, how frightening, how aggravating this must be?

It is often made even worse by well-meaning caregivers who insist that the person:

“Just ate dinner ten minutes ago, don’t you remember?”

“Just saw your daughter this morning, don’t you remember?”

“Just went outside for a walk, don’t you remember?”

The problem is, of course, that people with Alzheimer’s don’t remember these episodes that just happened. That magic wand wipes the slate clean again, and again, and again.

To make our lives and the lives of people living with Alzheimer’s a bit easier, we recommend that you lose the word “remember.” This is not an easy thing to do. In the course of a conversation, it is very natural to ask each other if we remember a person or event. But, for the person living with Alzheimer’s, asking them to remember is like asking them to jump up and fly around the room. It is an impossible request and we must be vigilant in avoiding direct requests for information recall. When people with Alzheimer’s are asked to remember something, this request can make them anxious or frustrated and may cause them to become very angry, depressed or withdrawn.

Declarative memory also affects language, and that is why people living with Alzheimer’s often struggle to remember names of people or names of common objects.

We all do a little of this ourselves in our daily lives. We’ve all had the experience where a word is right on the tip of our tongue but we cannot find it. Later, sometimes in the middle of the night, we’ll bolt up in bed and shout, “Calculus! He was good at calculus,” finally remembering that elusive word. This is very common, especially in our overloaded and frantic lives. But, for the person living with Alzheimer’s, the constant struggle for words can be exhausting and enraging.

Many times when we are working in a nursing home or an adult day center, we will hear family members or friends pleading with their loved one who has Alzheimer’s, “You remember, Mom. They lived next door to us for forty years! You have to remember them. She was your best friend!” Because of the impaired declarative memory, people with Alzheimer’s are often not able to remember names or faces of people they have known most of their lives. Trying to convince them otherwise is not going to help. We have to understand what they are dealing with; there are parts of their memory that are simply gone. 

As is often the case on the Alzheimer’s journey, just when we think we have a handle on understanding, something wild and unexpected happens. We may have worked hard to forget the word “remember,” when suddenly the person we love remembers us or some event from their lives. This may last only a few seconds, or a few minutes, but it is like the sunlight breaking through the clouds when it is happens. For a fleeting moment, we have the person we knew and loved with us again. Then, heartbreakingly, it is gone; the light goes out, the cloud descends.

To keep the ones we love in our life, it is important to understand that these fleeting moments of recognition or remembrance are causes for celebration, not despair. Rather than constantly mourning the loss of the person we knew and loved, we must learn to appreciate these brief encounters, these moments of connection. We must learn to see them as little gifts that flash brightly and leave just as suddenly as they come. If we can learn to enjoy this flash of connection, these little moments, we can have the people we love in our lives again, not, of course, as we used to have them in our lives, but still with us, one brief moment at a time. These moments of recognition, of connection, are like little jewels that are strung on the necklace of time.