Saturday, January 24, 2009
Your Brain on Alzheimer's: The Chance for a Do-Over?
My father and his sister, my Aunt Helen, in the backyard of their home in Alabama, about 1925.
One of the interesting things about the Alzheimer's type dementia my father has, is that the range of his faculties are impacted in different ways. I think I've mentioned before that his vocabulary is undiminished and words and phrases like "formidable" and "halcyon" and "field expedient" (a military term) trip off his tongue as they always have and are used correctly and in context. He can still write a short, intelligent letter.
His reading comprehension, on the other hand, has gradually faded so that this man who used to enjoy the convoluted sentences of Ludwig von Mises, William Shirer, and William F. Buckley, among many others, now finds it difficult to focus on any kind of reading. He likes for me to take him to the library so he can find a book to read, but when we check one out for him, he doesn't read it. The idea of reading enjoyment is there, but the ability is going.
His personality is different too. He was quiet and reticent before, except with children, and with the onset of his disease he is far more social than I have ever known him to be. When I take him for coffee, he chats with people at nearby tables, especially the young. More than once when we've gone out for a walk he has suggested we knock on the doors of our neighbors to see if they'd like to come over and chat. Usually these people are at work, or at school, or out doing the many things people do in California, so I discourage him; but, the impulse intrigues me.
My father grew up in a small suburb of Birmingham, Alabama, called Homewood, where his father served as president of the city commission and a number of his relatives lived on nearby streets. He's told me more about his life there in the last year, than I ever knew before: for example, how he used to run through the backyards of his neighbors to get to his great aunt's house. She supplied the baked goods for the social hour at the First Presbyterian Church and she would always save him a piece of cake. One of his close friends growing up was George McHuchison, a cousin several times removed, who also lived nearby. There were lots of aunts and uncles within walking distance.
I've speculated that this new social impulse is a regression to the life he lived as a child. Unexpressed during his adult years with my more constrained mother, his love of social contact has reasserted itself with the onset of his disease.
My friend Anne, a social worker who facilitates Alzheimer support groups for families of dementia patients, says she thinks the meaning of the changes I see is more complex. Her theory is that Alzheimer's patients somehow know, deep inside their subconscious, that they have a chance to do a few things over: express love to someone that they couldn't express before, act out anger and frustration they've stored up for a lifetime, and share both criticism and praise they've always had to censor.
I don't know if Anne's theory is true or not. We do have an aunt in my family who was always a contentious person and who, when she contracted Alzheimer's disease, grew quiet and serene. Did she always want to be that way?
My father now has frightening incidents of agitation and anger. Has he been storing these up for a lifetime? When he isn't agitated, he is extremely loving to me, something I have missed from him all my life. He's told me I'm beautiful and smart and that he knows I can succeed at anything I try. He tells me he needs me. When I'm not there, he repeatedly asks my mother when I'm coming to visit, and when I am there he always asks to go with me when he sees I'm headed out the door.
What a strange mixed-blessing is this disease. Such a trial for all of us who love Dad, with soupçon of joy thrown in to make us able to bear it.