by David Herman
This is the fourth in my series of articles on Dementia to go along with my observance of World Alzheimer’s (Dementia) Month. I have, in past weeks, written about the various types of Dementia, Sundowning, and the effects of caffeine and marijuana on memory. For the final article, I want to present some thoughts on why we should continue to visit dementia patients, even when there is little memory left.
Our brain is composed of many parts that perform differing functions for us. Two of these parts, directly associated with memory, but different aspects of memory, are the Hippocampus and the Amygdala. A brief description of these, and how they differ, may be helpful. The hippocampus is associated mainly with memory, in particular long-term memory. It also plays an important role in spatial navigation. So you can see this portion of brain function is greatly affected by dementia. The amygdala is part of the limbic system of the brain, which is involved with emotions and other reactions to stimuli. It is highly involved with different emotional responses.
I will try and paint a verbal picture, so you can see how these can be severely affected, or not, by dementia. Picture, if you will, a person standing before you, and beside this person on each side is a bookcase. The one on the left is the hippocampus. It is a flimsy bookcase with many shelves, with most recent memories on the top shelf. These could be what the person had for breakfast, getting dressed this morning, etc. As you look down the bookcase, the memories are from further and further in the past, until the bottom shelf has childhood memories. When a person develops dementia, this bookcase is shaken and some books on the top tumble off the shelf. The shaking is most traumatic at the top of the bookcase, the recent memories. We notice that memory of recent events are lost. As the dementia progresses, other memories disappear until it seems the person is reverting to their childhood. It is important to note that this erosion of memory is different for each patient, and it also differs with the type of dementia the person is dealing with. The hippocampus is more susceptible to dementia.
The second bookcase is sturdily constructed and it represents the amygdala portion of our brain, which stores feelings and emotions, the things that make the person who he or she is, and why you love them. This sturdy bookcase is not shaken to the extent that the hippocampus one is shaken.
Let us say that, when the patient was a child, they had a teacher who inspired their students and they enjoyed the classes. The memory of the teacher and their classes are stored in the first flimsy bookcase, but the feelings that were instilled by the teaching are stored in the sturdy bookcase. The event, and the feelings from the event, are stored in separate parts of the brain. Now back to today, and you visit your loved one with dementia. Your visit is stored in the recent memory and it probably will disappear as soon as you walk out of the room. BUT the good feeling and love that they have always felt when with you will remain and, although they may not know why, they will be uplifted and feel better as a result of your visit.
I hope this explanation has provided some insight as to why you should continue to visit the people that you know and care for who are suffering from dementia; because there is more to the person than the dementia. This is not easy for some people, because it requires you to put the feelings of someone else ahead of your own. I am sorry to say that I think a lot of the problems today are as a result of people being unable, or unwilling, to think of others before themselves.
