During the last few years of my Mom’s illness, there were times when visiting with her was very emotionally taxing for me and my siblings. Not being recognized by one’s own parent hurts. That pain discourages one from visiting, and it’s all too easy to rationalize not visiting by telling oneself “what’s the point – Mom won’t remember anyway?”
I was spared a lot of that process, since I lived near Mom and could visit her frequently. Mom always smiled when she saw me, so I knew there was some kind of recognition even if she couldn’t remember my name. That smile made it all worth it.
I’ve recently come across some research (via an NPR piece) that sheds light the ’emotional memory’ of demential patients, and how it lasts even when factual memory does not.
You can read the original study here. Here a few salient takeaways from the study’s lead author, Edmarie Guzmán-Vélez:
You know, all of these people that say it doesn’t matter if I don’t visit my grandma because she won’t remember -and it just shows it does matter. Our actions do matter.
So go spend time with your relative who suffers from dementia! You will make them happy, even if they can’t remember why.
As Ms Guzmán-Vélez says about her own study:
…it gives me that extra reward I guess to know that every thing that I do is impacting them. And it does make me try to be a better person with them or try to give them good experiences ’cause I know that will make them happy and that happiness will last for a long time.
I’ll second that from my own experience with Mom. The joy I felt knowing I’d brightened her day and made her happier went a very long way to erasing the pain I felt watching her illness inexorably diminish her.
Writing about Alzheimer’s isn’t often fun. Even good news, which is pleasant to bring to you, isn’t necessarily fun.
Today, however, I got lucky. I found out about an article in the BMJ Open online journal published in January by a group of Australian scientists. I got to read about “The SMILE Study”, which included “LaughterBosses” and “ElderClowns”. I kid you not.
The SMILE study (aka The Sydney Multisite Intervention of LaughterBosses and ElderClowns) was, by one measure, a failure. They wanted to find out if humor could alleviate depression in dementia patients. This they did not find.
More on that later, because what they did find is just as good. Humor does reduce patients’ agitation and anxiety. They found that their humor intervention could reduce the occurence of “two agitated behaviours” from daily to once a week.
From daily to once a week. Those readers among you who’ve spent time with a loved one with Alzheimer’s can tell you what a big deal this is. It’s big! For one thing, the results are just as good as what is achieved with Risperidone, a common anti-psychotic, but without the side effects! My Mom was taking that when she was at home – though thankfully at hasn’t been necessary since she moved to her care center. For another, let’s face it, it doesn’t just reduce agitation and anxiety, it makes people laugh and smile. Can Risperidone do that?
This is good news for everyone, but especially for people who are caring for someone with dementia. Make them laugh! Can it get more win-win than that?
To return to the question of depression, it wasn’t a complete failure. Here’s what the researchers write:
Depression, other forms of behavioural disturbances and self-rated quality-of-life all improved more in residents who experienced higher doses of engagement as a result of humour therapy, suggesting that humour therapy does change these outcomes, even though there was not a statistical advantage of intervention over control groups.
The conclusion is not, then, that humor cannot treat depression in dementia patients, but only that this study couldn’t prove that it can. Further study is most definitely warranted by these results.
But to get back to my original point, this was also fun. I mean, where else could read a sentence like “LaughterBosses were not tested for competency in delivering humour”? And reading “some suggest that the label ‘ElderClown’ might not be appropriate in describing the work of the professional performers” immediately called to mind an over-sensitive performer scoffing at term. “Sir, I am an actor!“
From France comes an interesting study linking retirement age and Alzheimer’s risk. Results from INSERM were presented at Alzheimer’s Association’s 2013 International Conference in Boston.
They found that delaying retirement by a year reduced the risk of dementia by 3.2%, and the effect is cumulative: the overall risk reduction was 14%. That’s a pretty significant impact!
Back in 2008, I was lucky to be present when the late Dr. C. Everett Koop gave an interview for the film I was editing at the time: New York Street Games. He was about 92 at the time, but still sharp as a tack. Off camera, he discussed the secret to his longevity: work. All his friends who had retired, he said, were dead. He made a point to keep on working. Clearly, he was on to something!
Now, my Mom’s Alzheimer’s came on strong 3 years ago, when she was about 84. She was still publishing papers into her late 70’s. I am certain that her diligence helped delay onset of symptoms. In hindsight, I can see lots of early signs that I hoped – wishfully – were just signs of ordinary aging.
It’s also likely that the progress of my Mom’s disease is an example of the benefit of ‘cognitive reserve‘: the idea that factors such as a life of challenging mental work, speaking several languages, having a wide circle of friends, an active social life, and intellectually challenging hobbies can offset the symptoms of Alzheimer’s, even when the physical damage to the brain is present. In other words, people with deep cognitive reserve can have the disease without the symptoms.
This suggests that we can significantly reduce our future health-care cost burdens by providing people with enough education that they’re at least bilingual, and that they can pursue careers as knowledge workers instead of WalMart greeters and McD’s burger flippers. Doing so would very likely have tremendous knock-on benefits such as increased innovation, job creation, more highly skilled workforce, etc.
So here’s my plea to all the ‘fiscal conservatives’ in Washington: save money by investing wisely! Education before weapons, please!