If someone mentions “dementia,” we often think “memory loss”: that “forgetfulness” which often begins with an inability to remember words, then expands to include remembering where one lives, how to drive, and the names of one’s family members. Standard definitions of dementia by major health information sources, however, suggest dementia involves, not necessarily a permanent loss of memory, but rather a loss of access to memory. The Mayo Clinic, for instance, defines dementia as “a group of symptoms affecting memory, thinking and social abilities.” The U.S. National Institute on Aging defines dementia as a “loss of cognitive functioning—thinking, remembering, and reasoning,” suggesting that dementia is less about loss of data than about loss of ability to process data.
According to Harvard Psychology Professor Daniel Schacter, the act of remembering is a synthetic process; rather than recalling memories that exist in our minds in perfect detail, we create our coherent recollections out of fragments, “much as a paleontologist is able to reconstruct a dinosaur from fragments of bone” (40). All of us, it seems, remember something by retrieving fragments and inferring the rest. Memories, as Wordsworth once put it, are “what we half create and half perceive.”
Canadian journalist Heather Menzies, describes her mother’s inability to find her way home as a loss, not of memory, but of power to synthesize memory.
Now that I’ve delved into it, I can understand what was going on. It’s not that Mum didn’t recognize the mailboxes. Some part of her did recognize them. Rather, she couldn’t place them in context. They were just free-floating signs to her, familiar and yet severed from the larger memory maps in her mind that would tell her why they were familiar, and how they related to getting from points A to B in the car. Now that landscape that had signified “close to home” was just more undifferentiated landscape: terra incognita. (41-2)
As Wordsworth might have put it, Menzies’s mother could half perceive, but she couldn’t half create.
For the caregiver, then, dealing with a person who is suddenly unable to find a way home, or who is struggling to find words to express a thought, it may be more helpful to view the situation not as loss of memory, strictly speaking, but rather as a loss of retrieval ability. Psychology professor Steven Sabat’s painstaking analysis of conversations with persons with Alzheimer’s Disease suggests this, when he distinguishes between a person’s “explicit recall memory,” which is impaired, from information held “in memory,” which is often more robust than we realize (44-45).
That may be why it took me so long, with my parents, to guess that something was wrong, and even afterwards to occasionally wonder if they were playing with my head. Sometimes they appeared to know things, and other times they didn’t seem to know anything at all. But more on that in another post.
REFERENCES:
Menzies, H. (2009). Enter mourning: A memoir on death, dementia & coming home. Key Porter.
Sabat, S. R. (2001). The experience of Alzheimer’s disease: Life through a tangled web. Blackwell.
Schacter, D. L. (1996). Searching for memory: The brain, the mind, and the past (1st ed.). BasicBooks.
