When Ted struggles the most with his memory, I tell him he has Alzheimer's. He thanks me profusely. It might seem like rubbing salt in a wound to bring it up over and over again, but Ted forgets that he has a disease that is robbing him of his memories and of his ability to form new memories. When Ted is struggling the most, he often wonders what is wrong with him. He thinks he may be crazy. He worries that others will think he is stupid.
Because Ted often forgets that he has a brain disease, he becomes ashamed and tries to hide the fact that he may not know where he is, who I am, or what has happened yesterday or today. I cannot discern his current state of confusion by asking him what he remembers (as in, "Do you remember where you are?"). To do so either causes him great anxiety as he fears being exposed, or it insults him when he is having a lucid moment and knows full well where he is. I have learned to make assertions rather than ask questions. For example, when we are having breakfast, I may offer up observations such as "The weather here in Oregon is really nice. Barbara and I have loved living in this house for all these years." Simple statements of fact can offer him relief. They often bolster his ability to remember related information. He might reply,"Yes, I am really glad to be able to live with you". Or he might confess, " I was confused about where I was. Remind me how I got here." I stick to short declarative sentences. "You moved here when Juanita died". "Juanita and you lived in your own apartment at Stoneybrook just a few miles from here". Ted often visibly brightens has he gains some bearings and reconstructs an outline of his recent history.
Ted is an intelligent man. His ability to reason is still largely intact. But without memories, he has little information to work with. I offer him that information so that he can figure things out for himself to some degree. Once he is feeling more confident, he will often say "I will forget this again after a while". "I know, Ted, but I will remind you when you do. Feel free to ask me any time." Of course, Ted won't remember that I have made that particular statement. However, I can help him feel safe. I can give him reason to trust me. He will not recall the particulars, but he has an emotional memory that can serve to reassure him.
Each day I try to learn a little more about how to help Ted. It is a process. It is an opportunity to serve.