Memory Loss or Dysfunction

I read a provocative quote the other day by Steven Sabat, Professor Emeritus of Psychology at Georgetown University, USA, that got me thinking maybe we have mislabelled the kind of memory impairment that comes with dementia in its many forms.

Prof Sabat said, “It is really memory dysfunction rather than loss and therefore what we do around people living with dementia, how we treat them, can enable them to function, can support them and build, rather than erode, their confidence.”

I find the analogy of road work helps provide an explanation.

Summer, as lovely as it is, can be a source of frustration when it comes to navigating my home city of Victoria, BC. It seems every road you take is blocked, narrowed, or somehow disrupted by road work.

You have to try to squeeze through; it takes an inordinate amount of time, and sometimes you can’t get through at all.

You need to take an alternate route.

This is not unlike the neural pathways in the brain experiencing dementia. Plaques and tangles build up around those pathways, choking them off.

Sometimes they block them completely, forcing the message to find an alternate route, until there is so much interference that memories can no longer be reached and function is lost.

Think about it! Memory loss is considered a hallmark of dementia — but that description doesn’t address those days when a person with dementia seems so lucid, clear or sharp, as they are often described by carers.

It can also explain why this lucidness can disappear as suddenly as it appears; why memories from the distant past are intact; or why engaging in art or music can help access memories believed to be lost.

Maybe it’s road work?

The crews come, they set up, they take down they move a block or two. Perhaps the memories don’t go up in a puff of smoke. Perhaps they could be better maintained knowing that they haven’t been lost but rather it is the dysfunction in the brain that gets in the way of memory recall or retention.

This brings me back to the concept of memory dysfunction rather than loss: if plaques and tangles are impeding access, then the memory isn’t really lost, is it? You just can’t reach it.

Similarly, it’s not that new memories can’t be formed: it’s that the road to where they need to be stored for recall later is blocked off.

As the disease progresses, proven tools and techniques such as patience while you wait for the person to find an open path to recall, or encouraging a different access route by stimulating the mind with art or music, will eventually stop working.

This also explains why dementia is so much more than memory loss and why it affects every aspect of life and function, and eventually leads to death.

When we label it as memory loss we trivialize the magnitude of the situation.

We all have memory loss from time to time, both young and old.

Where did I put my keys, my wallet, or my mobile phone?

Why did I come into this room?

What’s your name again?

This is memory loss, perhaps even dysfunction— but it is not dementia!

 

 Marjorie Moulton, Executive Director
We Rage We Weep Alzheimer Foundation
and Dementia Care Consultant drmmoulton@werageweweep.com
https://www.dementiaconsulting.ca