Sunday, June 21, 2009


And not for the first time, by any means. I have a warning: the below author was featured in Oprah's magazine. Newsweek recently ran a cover story on the likelihood that many of her guests are no more than charlatans or quacks.

"I'm Still Here: a Brilliant Approach to Understanding Someone Living with Alzheimer's" by John Zeisel, PhD. Penguin Group 262 pages $24.95

Zeisel posits that it's quite possible to have a good mutually-caring relationship with someone with this disease. He points out that certain portions of our brains continue to function normally -- art and/or music appreciation being two. We don't forget facial expressions or human touch.

Throughout the book, he stresses his theme "I'm still here" which, of course, I took to be positive and do-able. And then I got to thinking about it ... yes, physically, one is still "here" but when the mind has devolved into a much lesser part of us .. that IS change any way you cut it. Zeisel writes that changing just one half-step in music creates a different-sounding song -- and that is what happens to Alzheimer patients.

He lists three full pages of "what's left" -- sense memories such as smell, touch,. taste; body memories like riding a bicycle, putting a golf ball, dancing the fox trot. I would argue with him about "skill memories" such as cooking, knitting, bowling, sewing. Never leave a patient with Alzheimer's alone in the kitchen.

Conversely, complex sequence memories (brushing one's teeth, dressing, packing for a trip) are among the first to go. He writes that there are 51 separate activities just getting dressed! Clearly, he's thought about these things analytically.

Where he went off-track for me was the suggestion of museum tours with a small group of patients during off-hours or by special arrangement on days the museum/gallery is normally closed to the public. He advocates tickets to attractions such as ballet, opera, concerts and circuses! He also has said that patients grow nervous and agitated in crowds so I don't think these are good ideas. Art DVDs of museum tours, lives of artists, etc. might be a better idea.

One thing we do agree upon is this: Never approach a patient and ask, 'Do you know who I am?" Right away you've scared the poor bastard, forced him into a mental scramble trying to remember. It's far better to say, "Hi! I'm ______________ and we were neighbors on 62nd Street." Give them a reference frame.

If you can overlook the impractability of some of his suggestions, you may find some nuggets indeed.

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