If and Alzheimer's patient can't answer simple questions, are they just having a bad day?

Anniegirl asked...

If and Alzheimer's patient cannot answer the questions, What day is it? What year is it? And what is the name of the President of the United States? About how far along are they and could they just be having a bad day?

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

This is an interesting question AnnieGirl and it sounds a bit as if you are hoping it is just a 'bad day'. Most likely it is a combination of the loss of short term memory and either the time of day or, like all of us, simply not being in 'a good place' at the time of the questioning. It is always fascinating to engage an Alzheimer (AD) patient in deep conversation about things they did as teenagers and yet not recalling what they had for breakfast this morning. This is short-term-memory vs. long-term-memory and the latter is preserved for most of the AD journey. The ability to store new information however, is slowly eroding and when new info has not found a place to be kept in the injured brain then it is not possible to recall that material. This is why your mom is not able to answer these seemingly simple questions - the infrmation hasn't been stored. You will find that mom may have more accurate responses on another day or earlier in the day when AD folks seem to be at their best.
It is difficult to determine what 'stage' she is in without more behavioral and cognitive information but if the doctor is asking these questions, I suspect she is most likely in the late part of the early stage. A rule of thumb for caregivers is to try to eliminate questions from your conversation. A beloved AD patient told me once: "Asking me questions doesn't make me better, it makes me sadder". When we question cognitively-impaired adults, we make them more aware of their losses; they feel as if we are testing them and they are already pretty sure they'll flunk the test. Try to interact with mom without asking her to remember something that just may not be possible for her to recall. Do remember to take care of you.