I think it is a common misconception of people not familiar with Alzheimer’s’s that the disease affects all parts of the mind (or memory) equally. Thus when people see an Alzheimer’s’s patient acting incompetent at one moment the assume the person is incompetent to that degree always and in all things.
I’ve already mentioned before how Grandpa has his good days and his bad days, so on one day he might seem a complete basket-case and the next day he might seem almost normal. But not only does he have good days and bad days, but even overall the disease affects different parts of his mind to different degrees. It is amazing (and perhaps bizarre) the juxtaposition between what he remembers and what he doesn’t. Grandpa is the one suffering from Alzheimer’s’s, but there are still some things he remember’s better than Grandma.
One thing he seems to be able to remember very well is old movie’s that he has seen. Some weeks ago Grandma was watching The Yearling and Grandpa decided he would go to bed. As I was putting him to bed he was telling me about how the first time when he had watched it he had thought it was pretty good but that over the years it had begun to strike him as childish.
Grandma has difficulty remembering what she has watched a long time ago. Late Saturday evening Grandma was flipping through channels looking for something to watch. She hollers out, “‘Grapes of Wrath’ is on. Is it any good?”
“I’ve read the book, Grandma,” I said from where I sat in front of my computer. “I haven’t seen the movie.”
“Was the book any good?” She says.
“It was worth reading once,” I said. “I don’t know as it would make a good movie.”
“I’ve seen it before,” Grandpa said. (The movie was some old black and white . . . I don’t know if there is some more recent version, but I’m sure Grandpa saw this years ago.)
“It’s rated three and a half stars,” Grandma said. “You want to watch it again?”
“No, not particularly. I’ve seen it enough times.”
So Grandma switched the channel and came to some movie made in 1991 that was called “Fried Green Tomatoes.”
“We’ve already seen that, too,” Grandpa said.
“Well, I don’t remember it,” Grandma said. Sometimes I think Grandma doesn’t believe that Grandpa actually does remember and has something of the opinion that “If I don’t remember it then surely you must be imagining that you do.”
Anyhow, she watched Fried Green Tomatoes and halfway through the movie she finally remembered that she had seen it before. I don’t know where what movies you have watched is stored in your mind, but it seems that part of Grandpa’s mind is still working better than Grandma’s.
****
Two little slice-of-life moments:
Saturday evening the sun had gone down and it was dark. Grandpa walked into our bedroom and saw I had left the blinds up so he proceeded to try and put them down. My hint that he was trying to do this was when, while working in the kitchen, I heard the sound of my bed springs squeaking and Grandpa climbed on my bed. I went into the bedroom and found Grandpa wrestling with the window latch.
“What are you trying to do?” I asked.
“Shut this window,” he said.
“Here, let me help,” I said. I took the pull cord and dropped the blinds.
“How did you do that?” Grandpa asked.
“I unlocked it up there by pulling the string.”
“Oh. Now shut the other window.”
“What?” I said.
“You shut that one,” he pointed at the window. “Now shut the other window,” he said, pointing at the back of my bed. My bed has a somewhat ornate white metal backing on it then runs along the wall.
“That’s not a window,” I said.
“It’s not?” Grandpa said.
“Nope,” I said. “I shut the one window. I can’t shut that because it isn’t a window.”
“Well, okay, if you say so,” Grandpa said.
I started to leave the room, but at this point Grandpa’s mind must have dropped back into gear because as he followed after me he laughed and said, “Next thing you know I’ll be having you tear up the sidewalk.” Which I took as his way of acknowledging that he had just asked me to do the pointless and impossible.
Grandpa’s mis-seeing of things is an interesting phenomena. People are inclined to think he is hallucinating, or, back in the day, that such a person was plain out of his mind. Certainly it can appear that way–Grandpa will talk to the empty couch, or think Grandma isn’t sitting in her chair when she is right in front of him. But I don’t think Grandpa hallucinate in the most strict sense. If you’ve ever read about how our mind handles the input from our eyes you know that our minds must interpret what our eyes are seeing. Perhaps you’ve occasionally seen something from a great distance or at an odd angle and you were sure that it was something only to discover as you drew closer that it was nothing of the sort. Or, as another example, you might see some small black thing on the floor and it is a spider and you scream and jump–it was a spider in that moment–only for you to take a second look and realize it is a bit of lint. Now imagine that the part of your brain which interprets what you see is damaged and it is a hundred times more difficult to inter-pert what you’re seeing. Then you’ll start thinking that a pillow and a blanket on the couch is someone sitting there.
This mis-interpreting of visual cues is not the only source of Grandpa’s seeming hallucinatory actions. Sometimes Grandpa’s thoughts or memories leak out into the present so that he might be thinking about someone and that thought slips through into the category of present reality and he might think the person is there, or he remembers some time earlier in the day.
In the case of the “two windows” incident I think Grandpa saw the back of the bed where the cross bars from a “window” shape and it struck him like a window. Thus in that instant it became another window to close.
A little later that evening Grandpa decided he needed to straighten out Grandma’s chair while she was sleeping in it. I tried to dissuade him from it because Grandma absolutely hates to be disturbed while she is napping, and she was exhausted from going out shopping with Daryl that afternoon. However, even though he admitted it wasn’t a good idea to wake Grandma, somehow he had the urge to mess with the stuff of Grandma’s chair. He finally settled on the need to find something to weigh her blanket down with, and so started out be using his cane and then began to hunt around in the table beside the chair for some more heavy objects. I decided to not contest him too vigorously since it was nearly supper anyhow and Grandma would need to wake up soon anyhow. Grandpa was thwarted in his search for a properly heavy object to weigh down the blanket so he settled for using the TV remote, the cordless phone, and a Reader’s Digest along with his cane. He was about to move on to more activities with the chair but I suggested that he might have done enough.
I think he sensed my hint that he should stop. He paused and then said, “Well, I guess then I’m going to take a nap.”
****
Grandpa isn’t stupid. If some stranger saw him thinking the bed was a second window, or carting various objects over to weigh down the blanket around Grandma, or forgetting how to use the bathroom they might think him a driveling idiot incapable of any reasonable thought. But Grandpa does remember things, and he can think about things, and more than just all the old movies that he has watched.
I think part of the problem in some people’s thinking is that the saying of the “second childhood” is literally true. That is, you regress just as you grew up so that by the time you’re struggling to remember how to use the bathroom your mental functioning has obviously be reduced–across the board–to the level of a toddler who struggles to understand how to use the bathroom.
But that isn’t how it works. Grandpa can have the perspective of an adult from one perspective, and from another he can be reduced to the competence of a toddler. It can seem hard to believe that at one moment Grandpa can be talking to his brother Doug about world events and then go into the bathroom and not remember how to take a leak–but it is true. He doesn’t lose everything in a slow gradually decline–it’s like his mind is a puzzle and pieces keep falling out leaving black holes in the middle. Some places are clear, some places are now muddled, and some places are lost entirely.
Grandma has a tendency to treat Grandpa like a child, or at least shall we say in a demeaning manner. But while Grandpa doesn’t understand many things, and often loses his words, he still can pick up the attitude of people (and which is why Grandma’s attitude makes him hostile, though often he can’t adequately express his irritation). And also, he can sometimes pick up the subtler points in a conversation even if he can’t communicate clearly himself.
For example, I have a cousin who has just started going to college. He just finished his first semester and he flunked it. Grandma was talking about this with various people, and Grandpa was made aware of the fact. That was some days ago. You might think such information would have slipped from Grandpa’s mind, but no . . . that cousin stopped by Saturday after supper and Grandpa started to grill him about how he was doing at college. My cousin promptly started to spin the situation. I don’t know if he was outright lying (I don’t know anything first hand about the situation) but he was definitely trying to blow Grandpa off with the impression that everything was just fine. After all that all you need to give an ignorant old man, right?
Grandpa was having a hard enough time getting his mouth to work right, so he finally ended with an admonition to study hard and do a good job. But later he privately expressed disgust to me that my cousin would say, “Everything is fine, everything is great,” when, as Grandpa said, “That isn’t true at all.”
So be careful how little you think that Alzheimer’s’s patient doesn’t understand. Just because he can’t remember how to put his pants on doesn’t mean he has totally lost his mind. He can still understand more than you might think.
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