Jul 8, 2014

What Dementia Can Never Take Away

In dementia, someone’s past becomes very much a part of their present. Long-term memory stays with people even when their short-term memory fails them.

Rachael Wonderlin
Alzheimer's Reading Room

Forget

Although I spend all day working at a memory care community, I sometimes find myself forgetting that the residents are cognitively impaired. It is not until I leave work for the day, or stop by the assisted living building next-door, that I realize how significant the memory loss is at my community.

After interacting all day with these residents, I stop seeing them as people with dementia: I just see them as people.

Each one of my residents is different, with a distinct personality that is still very much intact. 

My favorite examples of this are the residents who do not speak. While we have a few residents who are entirely (or nearly entirely) nonverbal, each one has very different traits. One loves to dance and is incredibly outgoing—she loves to be the center of attention. Another is more reserved: he smiles when spoken to and enjoys being involved, but prefers one-on-one time. Still another is more aggressive and commanding: she’ll motion to you and demand your presence.

In everyday social situations, there will always be ones that you get along with, ones you want to avoid, others you barely know, and still some that you have trouble communicating with. Memory care communities are just like this.

It’s always fascinated me when visitors seem apprehensive about meeting our residents. “They’re just people,” I’ve heard myself say.

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The most common concern I hear from family members of our residents is that people with dementia seem to lack a “filter.” This is definitely true.

Those with dementia do lose some ability to hold things back, or they may not recognize when it is inappropriate to say something. “Mom never used to curse like that!” a visitor will cry. It wasn’t that her mother didn’t know foul language; it was just that she used to bite her tongue before speaking. Now it’s all out in the open.

“Your pants are very tight,” a resident said to me last week. “You should go change them.” I held back some laughter and a little embarrassment, but I appreciated how forward she was. With dementia, what someone thinks is what you’ll hear.

Dementia can affect and alter many day-to-day behaviors. But it cannot strip from a person their core personality. It can’t take what makes you, you.

The most enjoyable part of memory care is getting to know my residents. I find out new things every day about each one of them. Their past lives fascinate me — it’s wild to think about how much more there is to a person than who you see sitting in front of you.

In dementia, someone’s past becomes very much a part of their present. Long-term memory stays with people even when their short-term memory fails them. What remains intact are life lessons, successes, failures, traumatic events, likes and dislikes.

It can be challenging to look at an individual and remember that there is much more to them than a person with cognitive deficits.

I’ve found that, in order to best serve my residents, it helps to remember that they have a past, a present, and a future like the rest of us.

Like an old, much-loved puzzle, pieces of the mind begin to get lost over time.

The person’s mind doesn't seem to fit together the same way that it used to, but that does not mean that it is worth giving up on.

Rachael Wonderlin has a Master’s of Science in Gerontology from the University of North Carolina at Greensboro. She works as a Memory Care Program Coordinator and Manager at Clare Bridge of Burlington in Burlington, NC. Rachael also writes on her own blog at Dementia By Day.

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Original content the Alzheimer's Reading Room