Love in the World of Alzheimer's

Love in the World of Alzheimer's
MONDAY, Dec. 10 (HealthDay News) -- Even when Alzheimer's disease robsthem of the life they once knew, some people can still find love among theruins.
And in most cases -- as highlighted by recent news on retired SupremeCourt Judge Sandra Day O'Connor -- the spouse or child of the Alzheimer'spatient grows to understand and accept the new relationship, expertssay.
O'Connor's Alzheimer's-stricken husband John, 77, has foundcompanionship with a woman in the nursing home where he now resides,according to recent news reports. The two spend time together, holdinghands, even when Justice O'Connor is nearby, the reports said.
This type of relationship was also the focus of the recent film AwayFrom Her, starring Julie Christie as a woman with Alzheimer's whogradually forgets her husband and forms a new bond with a fellow nursinghome resident. Her husband gradually comes to accept the relationship,understanding that it gives his wife comfort and stability amid theconfusion that Alzheimer's can bring.
Such an emotional journey is common for caregivers confronted with sucha situation, said Donna Schempp, program director of the nationaladvocacy group Family Caregiver Alliance, based in San Francisco.
Most spouses or children of people with Alzheimer's "have respondedvery positively" to these newfound relationships, which are not uncommon,she said. "Because if the person does not know who you are anymore, it'snot a rejection," Schempp explained.
"And in the end, we want the person that we care about to be happy,"she said. "Just behaviorally, and in other ways, they are going to bebetter if they are feeling cared about and nurtured, loved andappreciated."
Experts in Alzheimer's disease say many people are surprised to learnthat patients continue to have rich emotional lives.
"People still have their personhood at the core of who they are," saidDr. Peter Reed, senior director of programs at the Alzheimer'sAssociation. "So the effects [of the disease] do not diminish theindividual's need for social interaction, it doesn't diminish their needfor dignity and meaning in their life."
Alzheimer's typically causes an individual to forget all but those theysee near them regularly, he added. "So, people learn familiarity with thepeople around them," Reed said, and with that, "they become morecomfortable."
The persistence of emotional needs after declines in memory makes somesense on a neurological level, another expert said.
"The Alzheimer's pathology starts in the memory and learning areas ofthe brain and then spreads," said Dr. Gary Kennedy, director of geriatricpsychiatry at the Montefiore Medical Center in New York City. "Thedirection and extent of the spread varies tremendously from one person tothe next. For some, their thinking and memory are largely gone, but theiremotional expressiveness may be relatively intact."
Emotions may often be less guarded as Alzheimer's advances, with peopleshowing less reticence to express affection, he added. "In some instances,emotional expressiveness may be augmented by the illness -- in otherwords, inhibitions may be taken away," Kennedy said.
Sexuality can enter the mix as well, and that's where relationshipsbetween Alzheimer's-affected patients get more complicated, Schemppsaid.
Depending on a person' level of cognition, "there's a kind ofmoral-ethical issue as to when someone can be consensuallyinvolved," she noted. "Some nursing homes just categorically say no,other nursing homes work on it on a case-by-case basis. Some nursing homessay no because the families object, and some nursing homes say yes becausethe families are OK with it."
Schempp said that, in her experience, the adult children ofAlzheimer's patients typically have a tougher time accepting this new lovethan spouses do.
"It's harder for the children -- it's an abandonment, and they feelcommitted to both parents. How could my mother or father do this?" shesaid.
That's where educating yourself about the progression of the diseasereally becomes valuable, she said.
"In our experience, so many people know so little about dementia andyet they are caring for someone with dementia," Schempp said. "It justgoes back to the incredible need that we have for people to get informed.It takes a lot of information to really be able to navigate how you carefor someone with dementia."
In the end, allowing a loved one to find his or her own peace amid theravages of Alzheimer's may be the best course to take, Kennedy said.
"As Sandra Day O'Connor and others say, they are just thankful thatthere is a moment of happiness that comes into their loved one's life," hesaid.