Emotions and Dementia

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About twenty years ago, I attended an invitational Bible Quiz event for children. It was held at a church with a new facility. The sanctuary of the church was packed with participants and their parents. Sometime during the event, I left to find a restroom. While returning I heard much noise emanating from the gymnasium. Inquisitively, I entered at the same time as the host pastor to discover a group of unsupervised children being very noisy.

The pastor was instantly angry. His face turned red and he wanted to know why these children were in the gym especially since they weren’t supervised. We should have sent the children out and told them to return to their parents.

Instead, I volunteered to watch them. I don’t know why I volunteered because I’m not especially good with children. After all, I had no duct tape or any other means of restraining them. Somehow, I was able to quiet them to a reasonable level and the pastor was satisfied and left.

There I was with a bunch of unruly strangers’ children wondering how I got in this situation. With an adult present they were somewhat contained, but occasionally, I had to quiet them down. After a while some adult man wandered into the gym. I don’t know who he was or why he was there, but I offered some conversation. I commented, “They’ve been pretty loud”.

The stranger snapped back, “Well, they are just children”. Then he exited the gym leaving me with my mouth gaping open.

I couldn’t really believe his curt comment especially since I was volunteering to help. I felt unappreciated, and at the same time, angry. If he had stayed I might have said offered him the supervisor position.

You might wonder what this event has to do with dementia. Let me explain. I can’t remember the man’s appearance, and I’m not certain of our exact conversation. I don’t recall how many children were in the gym or how long I supervised them. In fact, I can’t even remember the name of the church or the town where it was located.

But I can remember how I FELT. In fact, just thinking about it makes my stomach tight and my breathing rate increase. I suppose my body is releasing adrenaline as I pound on my keyboard. The part of my brain that controls my emotions is the hypothalamus, but the region related to memory and navigation is the hippocampus.

The hippocampus somehow takes short term memory and converts it to long-term memory. Alzheimer’s disease often starts in the hippocampus, so the early signs of might be forgetfulness or getting lost.

But, the hypothalamus usually isn’t affected by Alzheimer’s disease until much later if ever. As a result, though a dementia patient may forget events of the past, they may still have an emotional response. We might not understand why a patient becomes irate at a seemingly minor stimulus. However, there is a good chance something triggered the old emotion even though they can’t explain why. The hippocampus can’t communicate with the hypothalamus to make the situation logical, but the emotions are very real.

When the loved-one becomes irate we can distract them. Some find soothing music helpful or taking a walk. A snack can also be an effective distraction. Once the person is calm, it is important to avoid the stimulus if we can identify it.

We caregivers deal with unusual and illogical situations. The apostle Paul gives good advice in his letter to the church in Rome.

Be joyful in hope, patient in affliction, faithful in prayer. Romans 12:12 NIV

© Copyright 2018 Ronald Milburn