If you’ve spent any time with someone suffering from Alzheimer’s, you know they talk in strange, often disconnected language. They misname things or refer to their children as if they were young. They ask to go home even as they are standing in the middle of their own living room. They become agitated and swear with the foulest of language—a big shock if they’ve been polite, sensible ladies or gentlemen all their lives. But should we call them delusional?
Delusions and hallucinations are symptoms of Alzheimer’s and other dementias.* Meaning, those with the disease don’t experience things as they really are.
Delusions are false beliefs. Even if you try to convince a person with Alzheimer’s that the cat can’t really ride a bicycle, she won’t change her belief. Sometimes these can be negative delusions, if they believe that someone is out to get them or they can’t eat their chicken because it’s being saved for someone else.
Hallucinations are incorrect perceptions of objects or events involving the senses. What seems real to the person experiencing them cannot be verified by anyone else. Most often, these experiences involve visual or auditory hallucinations and can also be positive or negative. Mom often thinks her mother or father will return home soon—despite their deaths years ago.
I accept this. I can say with certainty that Mom has delusional and hallucinatory episodes. But I object to calling her delusional. I feel like it’s labelling her as crazy.
Mom’s not crazy; she has Alzheimer’s. Her random conversations originate from several different sources, and once we understand this, we can better appreciate the non-sequiturs and the reliance on past experiences that makes her dialogue bizarre.
Mom often incorporates words she hears around her into her conversation. If I tell Daddy I found a letter in their mail box, Mom will start talking about the man who lost his letter. Or she’ll ask a question about someone who did something and put half of it away in the letter and the doctor outside (because one of us mentioned a doctor) gave her this ring (pointing to her ring) and what should she do.
I firmly believe Mom is trying to communicate with us. Part of this rambling is due to the fact that she can’t recall the precise words she needs to explain herself. She talks around her subject, trying to create meaning with the words that do come to mind. I understand. When I speak my second, less extensive language, in this case Hebrew, I often substitute words to make myself understood. If I don’t know how to say “divide,” but I do know the word for “half,” I can manage to say, “I’ll take this half,” instead of, “Let’s divide this cake between us.” (Yes, it’s always about cake.)
She also talks about people or events in her past, often with great clarity. She can still recognize herself in childhood photos and even as a young 20-year-old. These past moments are accessible in her tangled brain whereas her present memories are all blank. It makes sense that if she is trying to understand the emotional map of her current surroundings that she pulls from her distant memory emotional experiences that are somehow similar. For example, when we’re giggling together, Mom tells me I’m her best friend and she knows me from school. In her mind, she’s a young girl, the age where her strongest memories converge. It is too much to ask her to remember that she birthed me just 53 years ago.
I would also suggest that many of us have experienced delusions either when we are exhausted or pumped up on energy or drink or when experiencing loss. We know what it’s like to disconnect from reality, to believe something that isn’t true. Thankfully, though, we come back to ourselves, as opposed to someone with Alzheimer’s.
Despite not understanding the context of her present, Mom can and does experience a full range of emotions. The situation may not be clear, but the emotion is. We don’t necessarily know what makes her agitated or distressed, but these emotions flare in her as they flare in the rest of us. Sometimes she’s happy; sometimes she’s angry. She has an internal life that may be every bit as vibrant as our own.
I challenge anyone who thinks that someone with Alzheimer’s is crazy. Loving, unpleasant, annoying, caring, yes. Unable to hold significant, meaningful, coherent conversations, yes. Unable to understand reality, yes. But they can still bond and feel and react in a nuanced world of their own making. Perception is in the eye of the beholder and I am ready to enter Mom’s world to connect with her—to calm her when she’s upset and to embrace her when she’s content.
Sometimes the simplest recipes yield the most surprisingly beautiful results. Take this roasted cabbage recipe. The sliced cabbage emerges from the oven looking like elegant flowers. Would that our words flowed as elegantly.
Roasted Red Cabbage Wedges
The trick to this recipe is making sure to cut the cabbage from top to bottom, leaving the stem intact. That way the slices are sure to stay together.
1 medium red (or white) cabbage
1½ Tbsp olive oil
1 tsp crushed garlic
Salt and pepper to taste
Preheat oven to 420°. Slice cabbage vertically into ½” thick slices, making sure to keep the stem intact as this will keep the slices cohesive. Place on lined baking tray. Brush with garlic mixed into the olive oil and sprinkle with spices. Cook for 20-25 minutes until edges of cabbage crisp.
*The information here is derived from “Delusions and Hallucinations,” Alzheimer’s Society, Canada, http://alzheimer.ca/en/Home/Living-with-dementia/Understanding-behaviour/Delusions-and-hallucinations.