Alzheimer’s Disease (AZD) and Memory Loss

Symptom (s): “Why can’t mom remember who was at her house yesterday, but can relate in great detail what happened when she was a teenager?” We all have a Short Term Memory (STM), Middle-Term Memory (MTM) and a Long-Term Memory (LTM). Once new information is presented to us, it first enters the STM and from there the brain decides whether or not to store the information in the MTM part of the brain (I have a Dr. Appointment next week) or the LTM part of the brain (my brother’s new wife’s name is Julie) or we can just let the information go from the STM as unnecessary (a fly just flew by me).

Why: The part of the brain that is affected first in the person with AZD is called the hippocampus and its chief duty is to grab and hold onto new information while the brain decides where it wants it to go: MTM or LTM (Humans can only hold 7 bits of new information in our STM at a time, so this decision needs to be made quickly.) Unfortunately, no new information will “stick” in the AZD patient. The nerve endings in the hippocampus get covered with a protein plaque so that nerve cells cannot “pass along” information to the next cell. The result is that information goes, literally, “in one ear and out the other.” The person may suddenly stop using, say, the microwave, or the bathtub, or a cell phone because there are so many steps to using these things that they just can’t remember them at all. That’s very scary for them; embarrassing, too. Sometimes only part of the memory is damaged in as the disease progresses and the person will “make up” parts of or names to fill the “holes” in their memory. This is called “confabulating” and the caregiver must let the person give their flawed, inaccurate story. What’s it like for the person? When you get up and start out of the room, you will know you had been on the computer. A person with STMemory loss will have no idea of where they have just been, or where they are going or even that there is even a computer.

Caregiver Strategies: As with almost every facet of the behavior of the person afflicted by AZD, as a caregiver you must “choose your battles.” If the person cannot remember where their other blue sock is and puts on a red one instead, let it go (unless you are going out somewhere). Never argue with the person (Dad!? Don’t you remember?!). It puts them on the defensive, voices are raised, tempers flare, and the relationship suffers. More importantly, no, they really don’t remember. On the other hand, if they say “I think I’ll drive the car to the grocery store,” then intervention is required. Let their memory loss work in your favor. Distract them long enough and soon they will have forgotten all about the car. This is a technique that is helpful in all stages of AZD. Another good technique is to talk to the person about things that happened in their past, go over old photographs, play to their strength, their LTM. They will be more comfortable and so will you. Plus you may learn all kinds of neat stuff while they are reminiscing. R.