What should I do when my parent with Alzheimer's doesn't recognize members of the family?

A fellow caregiver asked...

It's hard to deal with the fact that my dad, who has Alzheimer's, keeps forgetting who his grandchildren are when we visit him. How should we react when he confuses my daughter with me, for example, and calls her by the wrong name?

Expert Answer

A social worker and geriatric consultant who specializes in dementia care, Joyce Simard is based in Land O' Lakes, Florida, and in Prague. She is a well-known speaker and has written two books, one focusing on end-of-life care and the other, entitled The Magic Tape Recorder, explaining aging, memory loss, and how children can be helpers to their elders.

Forgetting loved ones (often just temporarily) or confusing them with someone else is most typical in the middle to late stages of the disease. It's important to remember that this doesn't reflect your father's feelings about his grandchildren (or about anyone else in the family); it's just the nature of memory loss with Alzheimer's disease. Short-term memories -- as recent as a few minutes ago -- are usually the first to be lost. Gradually, other relatively recent memories also fade, while those from childhood and young adulthood -- when the "tape recorder" in the brain was turned on and working well -- tend to remain longest.

Name confusion often happens with younger grandchildren because they entered your parent's world late in his life, possibly when the disease process had already begun but was not yet suspected. Your parent's memories of you as a youngster are better preserved, and your child's resemblance to you when you were the same age can trigger those memories.

Keep your sense of humor, even if his remarks are disconcerting. And try casually introducing your child when you visit: "Look, here's your grandbaby Alice!" You can encourage an older child or teen to do the same: "Hi, Grandpa, it's me, your granddaughter Megan."

To an older child who's confused or unsettled by this phenomenon, you can explain, "Memories that your grandfather's brain recorded when he was younger stick in his mind better. So he remembers me as a young girl better than as a grown woman. And since you look a little like me, that's who he sometimes thinks you are. I know it's strange, but it's OK to go along with it. Your grandfather still loves you; he just can't help the way his memory is working now."