Forget Memory Loss – What about the Person?

“Thinking that people diagnosed with dementia have something called “memory loss” is harmful for a number of reasons”.

That was the key message in Professor Steven Sabat’s talk at the Alzheimer’s Australia free lectures this week.

Prof Sabat is Professor Emeritus of Psychology from Georgetown University in the US,  and for the past 35 years has studied the cognitive and social abilities of people with Alzheimer’s disease.

So why does he believe that the idea that people with dementia have “memory loss” is damaging?

Firstly, if people with dementia or Alzheimer’s disease have “memory loss”, then they supposedly cannot make new memories and if they cannot make new memories, they cannot be affected for very long by what happens to them hear and now.

And if they cannot be affected by recent events, then there is this idea that “it doesn’t matter how we treat them” – which is not true.

Sadly, it’s not uncommon to see people say and do negative things under the pretense that “it’s ok, they won’t remember anyway”.

Recalling is not the same as remembering. Just because a person fails to recall something, it does not mean they do not remember.

For example, an elderly father being mad at his adult daughter for taking his car keys away – even if he can’t remember the fight or that his keys were taken, he still recalls his feelings of being ‘mad’ at her. How is that possible?

A person can still remember even if they cannot recall because they might still be able to recognise and implicit memories can still exist.

The Importance of Common Courtesy

It’s important to treat people living with dementia with common courtesy, and to know that they can make new memories – and that they can act on the basis of those memories.

For example: there is a common misconception we can talk about people with dementia in the room as if they are not even there. Simply because they won’t remember.

Based on this, those around them should continue to make good memories – don’t assume that they will not remember.

Do not put people in a position to fail

When conversing with a person with dementia, do not put them in a position to fail by asking questions about things that are relatively inconsequential to them and require then to use explicit recall – which Prof. Sabat calls the “weak suit” for many.

Asking things like “what day is it today?” or “ what did you have for breakfast?” can frustrate people when they struggle to answer. Try not to ask things that they may find hard to recall, requiring explicit memories, especially if it is out of context. Even people without dementia can find it hard if you suddenly ask them what today’s date is.  

As a loved one or carers, you need to assume that what you do and say can affect the person with dementia, and that they can make new memories even if shown implicitly.

Repeatedly Asking the Same Question

If the person with dementia repeats previously asked and answered questions, don’t say “I just told you that” or “what did I just tell you?” because they clearly aren’t recalling that fact.

Instead, you might say, “take a guess”. You might be surprised to see that they do remember the answer even if they can’t recall it when you ask directly.

Most of all, try to maintain a “non-anxious presence”. People can be very sensitive to heightened anxiety and that will not help them retrieve memories.

It’s worth remembering that people diagnosed with dementia can get very upset about being unable to recall things, and may try to cover them up – people with dementia still retain pride and self-respect.

Remember that having self respect is more important that being able to recall today’s date.

Maya Angelou once said “people may forget what you say, but they’ll always remember how you made them feel”.

People with dementia are still people and deserve common courtesy.

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