Caring for a Loved One With Alzheimer's Disease

"Would you like me to tell you about our lunch specials? Our soup of the day is the roasted red pepper and it comes with-" "It's my birthday," my grandmother interjects. "A birthday, how exciting!" our waitress exclaims, but the rest of us look at each other and groan. Some of us muffle laughter. It's not my grandmother's birthday, but she doesn't know that. It's certainly a plausible explanation for why she is surrounded by family at a nice restaurant, but no, we explain, it is not her birthday. We apologize to the waitress and she continues taking our orders, even as my grandmother (Mimi, as I've always known her) insists that she is going to need some cake. Before Mimi's diagnosis, I had this false perception that Alzheimer's only affects memories of people and events, like short-term memory loss. I didn't realize that it's actually a form of dementia, in the sense that it causes general confusion and loss of comprehension. For example, sometimes Mimi recognizes that my mother is her daughter, but she doesn't know who I am. If I try and explain to her that since her daughter is my mother, that makes me her granddaughter, she can't grasp what I'm saying. Most of the time, she doesn't even know what the word 'grandmother' means. I don't pretend to be an expert on the disease, and I'm aware that not every patient's symptoms are identical, but I've learned a lot from observing my grandmother's Alzheimer's. It isn't something that happened overnight; she had been forgetting names and details for years before her official diagnosis. She no longer hides her memory loss, or tries to pretend she knows what's going on. Instead, she treats it lightheartedly, with an innocence that is almost childlike. One night as we were sitting together in a room full of immediate family, she leaned over to me and whispered, "I don't know who any of these people are." That included me, but it didn't stop her from confiding in me. I just laughed, and she did too. It might seem callous to laugh about what is a very complicated and devastating condition, but my grandmother has always inspired playful teasing in my family. Growing up during the Great Depression and world war, her childhood was not easy, and it shaped her life in many ways. She was never the kind of TV grandma who baked cookies or sang songs: she was practical and stubborn, sometimes to a fault. She was constantly preparing for the worst possible scenario, whether it was traffic on the highway or a rainy day at the beach. And her war-era frugality caused her to collect and accumulate everything, from old boxes to packets of salt to newspaper coupons she never used. This behavior frustrated my mother to no end, but I found it endearing. I miss my pre-Alzheimer's grandmother, and yet it's hard to deny that the disease has softened her demeanor. She smiles and laughs more, and is uncharacteristically vulnerable with her friends and family, regardless of how well she remembers them. If there is a silver lining to the disease, ours is that Mimi finally seems relaxed and carefree, even happy. There is a term for this -- "pleasant dementia," meaning that the patient is unaware but perhaps blissfully so. Obviously, it's not an ideal situation, but I know I'm lucky to have time left with my grandma, and I think she feels grateful to have me around too. People suffering from Alzheimer's and dementia are often the most in need of time and energy from their loved ones, despite the frustration that accompanies these interactions. A recent study found that Alzheimer's patients may mimic the emotions of their caregivers. This shows that even when it seems pointless, a nurturing and upbeat attitude towards an affected relative can reflect on and improve their quality of life. Alzheimer's can rob a person of many things, but it shouldn't take away family, love, or support.