Alzheimer’s/Caregivers Month: “Al” is Talking

“When I came in to visit Richard, he said, ‘What are you doing here?’” Sarah told me. “I was so hurt I just sat there for two hours while he rolled over and didn’t say anything else.”

“That wasn’t Richard, Sarah. That was Al talking,” I reassured her. “Richard is leaving you and Alzheimer’s, aka ‘Al,’ is replacing him.” As her sister-in-law and a psychologist, my heart broke for her. She was suffering the loss of her husband day after day.

If Al, or Alice, is crowding out the person you love, you, as the caregiver, can be hurt when the impostor is rude or misunderstood. In Richard’s case, his dry sense of humor and kidding nature no longer came with a smile and a slap on the back. His expressions were flat, his joking was no longer funny and his eyes had lost their sparkle. But, he was still trying to be Richard. He just couldn’t play the “hero part” any longer. He had been reduced to a character-roll in the movie of his own life.

For the caregiver, the important thing to remember is, your loved one is not intending to hurt or embarrass you. They don’t know their lines anymore and the script changes every day. The actor’s name has even been re-written, from Richard to Al and you don’t’ know Al. Just remember—your parent or spouse doesn’t know Al either.

You have become the memory, the detail-holder for the family. Keep a day-planner and/or journal to help you remember your treasured past, your daily appointment and activities, as well as your loved one’s memories. This will help you, as caregiver, relax and take the anxiety out of holding it all in short-term memory.

 As Richard slowly faded away, Sarah would take out an album or stack of pictures from her purse. She would say, “You remember Jason and Shelly. This is their picture from ten years ago and this is the new one we took last week.” Richard would smile at the old picture of family or friends and then study the new one. He seemed to be trying to make new memories. Sarah’s reminders happened several times a day, so Richard was able to be part of a family reunion or gathering and not just in the group.

If “Al” doesn’t recognize or respond to new information or the efforts you are putting into their care, you need not interpret that as a personal failing of your own. It’s not about you or your shortcomings as a caregiver. It is about Al or Alice. Like the movie, “The Invasion of the Body Snatchers,” Alzheimer’s has come in and is slowly pushing your loved one out of their own body. As you would with a precious baby, talk to your loved one like you always have, but don’t be hurt is they don’t respond in the way they have in the past. Remember, you are talking to the remnant of the person you knew. They are still inside and love your touch, the melodic sound of your voice, and the interesting people you talk to them about.

God teaches his people with repeated lessons. "For He says, 'Order on order, order on order, Line on line, line on line, A little here, a little there.” Isaiah 28:10.  Our loved ones are not learning new precepts like in Isaiah. They are being reminded of their life so they can hold on a little longer. Be patient. This is the blessing of your life for such a time as this.

When “Al” talks to you, respond to Richard and to Al, so that Al isn’t more confused than they were. The old memories belong to Richard; the new confusion is Al’s. Let Al know that you are not disappointed in him. He is loved too. When Al speaks, listen, but don’t expect him to sound like Richard. Richard has taken a divergent path and is on the long-way-home.

Doris Gaines Rapp, Ph.D.

Copyright 2014 Doris Gaines Rapp

Author/Psychologist

Contributor- Christmases Past

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