What should I do when my parent with Alzheimer's doesn't recognize members of the family?
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?
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."
It is very important to start educating the family and friends at the early stage about things that will happen with a loved one. Keep the communication open and honest. Make picture books with family names and frames of family members around. Be proactive and when the car arrives say so and so is here to visit. My husband recognizes but does not know their names and it is OK. He is grandpa and probably the little ones don't know his name either. Keep it light or you might scare the kids.
My father's health care provider told us something during the early stages of his disease that we have often quoted to each other and anyone else who would listen. It sounded strange at the time but now, five years later, we have witnessed its truth. She said, "The brain forgets but the heart remembers." Dad lights up when any of us walk into the room, even when he doesn't remember why. At times, he has thought I was his wife, mother, sister, cousin, childhood neighbor, nurse, etc., etc. But every single time he sees me, Mom, my sister, my husband, or our kids, he visibly brightens. Compared to the love in his heart, his knowing exactly how we fit into his life is trivial. <3
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