If time is a measure of life, then memory is the autopilot, the search engine, and the network for all of life’s journey.  Memory is a conundrum, a mystery not yet understood nor definable. The workings of memory have been widely studied, and the findings are remarkable. But at best we end up reading about memory and concluding that its functioning is still illusive. 

A lay person understands memory by gauging and feeling its results, in oneself or in others.  When memory is operative and functioning well,  it can enable us to “travel in time” to the most special times and places of our lives, past and imagined.*  Or if it is flawed, the trip in time is disturbed and detoured by washed out bridges and blocked tunnels, and the journey can become a nightmare.

In an earlier article I wrote about the “Alzheimer’s patient descent” in a piece titled “How Long Will the Suffering Last?”  I defined the elements of the descent as losses: memory, judgment, understanding, and control of bodily functions.  In that article, I explained that these passages are not clean breaks, marshaled in a straight line between life and death.  Indeed they are not.  But in my experience they have proven to be predictable – albeit jigsawed, overlapping, advancing and regressing, with undefinable boundaries, and at times fully blended in a milieu of mental fog. 

However, I believe that the loss of memory is not only the most identifiable and talked about symptom of Alzheimer’s, it is also the foundation and a nefarious player throughout the process.

The January 29, 2007 issue of TIME brilliantly presented insights into the workings of the human brain. Included was an insightful article by Michael D. Lemonick titled “The Flavor of Memories.”* It was somewhat technical, but familiar enough in its basic assumptions that a lay person could benefit from it.  The value of such findings will ultimately relate to treatments for persons with memory issues and insights for the caregiver dealing with the stresses of loss and caring. Lemonick notes that even though our memory of an event seems starkly clear, it may not be accurate.  Why?  Because each time we “retrieve and restore a memory . . . what goes back into our brains is like a new version of a text document, overprinting the old.”   

His second insight is credited to a neurologist, Dr. James McGaugh of the University of California: the stronger the emotion associated with an original experience, the stronger the memory of that event.  McGaugh adds, “The major purpose of memory is to predict the future.”

These two insights assumed, think of what the loss of memory means in the Alzheimer’s patient aside from the inconvenience and difficulty of day to day functioning:

·         He/she revisits a memory, but can’t recall its truth, so it becomes “a new document” with different facts, people, places or emotion replacing a part of the original.  What comes out is a strange and convoluted story that is very real to the Alzheimer’s patient, but foreign to us.

·         He/she revisits a memory accompanied by strong emotion, good or bad.  If it is a painful memory, in the Alzheimer’s patient it may also be blurred and confused.  So, the strong, uncertain memory creates a fight/flight response, and the loved one becomes hostile, paces, or is uncontrollably agitated.  

I will illustrate these ideas from my experience.  Shortly after their marriage, my parents went to the river, my father for a swim and my mother to enjoy wading around the river’s edge.  She was afraid of water. My father coaxed her to go with him into very deep water; then he left her alone as he swam around.  He underestimated the seriousness of her fear. She was terrified, and felt abandoned.  The fear never went away. As she aged and gradually became ill this memory may have become confused and distorted.  At first she resisted getting into the bathtub and finally, out of fear, refused.  Then, she had to be reassured and coaxed to step onto the bathroom floor, “because it was shiny and looked like water.” She now had residual negative associations from a memory with a script that had little resemblance to the original experience.  This, along with her lostness in time, produced unbearable anxiety. 

While these interpretations and illustrations are my own thoughts, the point is to understand that memory is a player in every response of our loved one.  If it is too weak to experience the past sensibly, or too barren to project the future, it leaves the loved one confused and frightened.  The article confirms that in some circumstances memory enhancers may be beneficial, but can be dangerous for the elderly.  Dr. McGaugh notes that for serious memory problems, “existing drugs are not yet powerful enough or nice enough.”

Then, what can we do in the face of such tricky behavior shapers?

• Be present to the loved one.

• Touch him/her reassuringly

• Speak softly, lovingly and simply.

• Offer diversionary activity.

• Slowly reintroduce objects/persons familiar to him/her.

*January 29,2007,  Time Magazine,“Time Travel in the Brain,” Daniel Gilbert and Randy Buckner, p.91 and “The Flavor of Memories,” Michael D. Lemonick, pp. 101-104