Book Review

I recently read an excellent book about a women with Alzheimer's disease. This novel hit me on so many levels, first because I have worked in nursing homes with Alzheimer's units for several years and seen this terrible disease manifest, and second because I have a dear friend who's mother has early onset Alzheimer's disease. After reading this, I wanted everyone, especially those I work with to read it too. I wrote the following book review that was distributed at my work and published in a local paper.

The novel Still Alice by Lisa Genova was real and was profound. It was so real that it both haunted me and made me grateful. The New York Times Bestseller is a novel chronicling a well-educated women with early-onset Alzheimer's Disease and it illustrates so touchingly how it might feel to be her. For anyone who has been touched by this disease, or like me who works with many adults afflicted by this disease, this is a must-read. Originally inspired by her grandmother's trial with Alzheimer's, the doctorate level Neuroscience trained author embarked on a journey into the mind of amyloid plaques and killed off neurons.

Alice Howland, the main character, was a professor at Harvard who prided herself on her renowned research, sought after ease with speaking at world-wide conferences, and inspiring daily lectures at the University. When she began to find that she was at a loss for the correct word to complete her thoughts in regular conversation, or that she had forgotten to return an important email, she wondered what might be plaguing her mind so unusually. Early on in the novel, Dr. Howland went for her daily run through her stomping ground of Harvard Yard and she became anxious and confused. After years of habitual, effortless strides, she did not know which direction would lead her home. This frightful experience that seemed to have no logical excuse brought her to seek the wisdom of her physician. And this visit unleashed the cascade of questioning that led to her diagnosis of exclusion... Alzheimer's.

When reading this novel, I felt so deeply for the character, for her humiliation, simplicity, and her innocence with uncertainty.I felt scared for my self and for my loved ones. When reading this novel, each line ran into the next, disease progression continued, and my eyes and mind bore into the life of Alice Howland.

A diagnosis of early onset Alzheimer's disease is terrifying and terminal, and when Alice was diagnosed in a place of sound mind, she was left with the picture of her future. Should she set up a ritualistic quiz for herself so as to monitor her cognition? And with these answers, make a decision about her life when it comes to a point when it is no longer a pleasure to live? Should she tell her family about the genetic relationship of the disease that may possibly affect her children? When will she stop recognizing her husband?

Amazingly, each and every line of the praise and comments touted on the covers and pages of the book mimic my full-bodied enthusiasm for sharing with everyone and anyone. These pages will not leave you untouched. This is a quick read for the compassionate, an informative journey for the inquisitive and a mindset changing story for the helpless, heartfelt reader who will only benefit from this new perspective of awareness that only Still Alice can deliver.

The old and the young

I have done a lot of work in Long Term Care with the elderly and many Alzheimer's patients and it is amazing how similar the elderly are to children. The elderly in particular that I am thinking of are those in various stages of dementia. Some of the similarities are comical, and some very sweet. I can readily compare the mind of elderly afflicted with dementia with the minds of children. If you do not delve into the person, you superficially see that there is a person, young or old, who does not fully understand, express what they feel or know what is going on around them. But if you give time to these people, you find there is so much inside. I have seen men wander without regard- whether down the hall or into the street, speak gibberish, kiss ladies they don't know and fall asleep in arm chairs, lunch rooms, or any one's bed. I have had many conversations with patients on the Alzheimer's unit where I worked that if they were written down into a dialog, you would probably guess that I was speaking with a toddler. Not to mention, they have lost control of their bowels and bladder, they need assistance eating, brushing teeth, changing cloths, bathing and sometimes walking about.

Sometimes my daughter collects things from around the house and puts them into trunks, cabinets, bags, purses or boxes which makes me laugh when I eventually find them. One lady on the Unit would take all the picture frames from other people's rooms and take them to her room and hide them in her drawers.
You begin to see a child's personality come through as they get older. Similarly, in the older adult you see parts of the personality that you already knew very well hang on as the older person's dementia worsens. One sweet woman didn't know her name, didn't know where her room was, forgot when she had eaten just as she stood up from the table, but part of her personality from her younger years was very apparent -she was always meticulous about cleaning and maintaining orderliness. If you looked in her room and her drawers, her cloths were all perfectly folded, down to her undergarments and socks, and her bed was perfectly made without a wrinkle everyday, by her. Both children and the demented elderly have pieces of their personality there, but not the whole picture.
There are so many stories I can think of - one more is another woman also with dementia who carried around a baby doll in her arms, which is not uncommon. My daughter loves baby dolls! - she feels like she is a little mama who can both imitate different things I do and nurture a little one herself. I remember, however, the daughter of this woman was very upset to see her mom with the baby doll because she remembered her mother growing up as being very cold and not very "touchy - feely" but now she has found comfort in being affectionate to a doll.

For me, it is infinitely interesting and rewarding to observe and interact with the elderly, especially those afflicted with Alzheimer's and Dementia. It is such an awful disease, especially for the family members and probably the patient in the early stages. But these people should never be disregarded and I give them the same time of day as other patients of sound mind. They are very special and almost return to innocence. I have heard that it is the child in all of us that is appealing - Many times in the elderly, this child takes a leading roll making them magical, simple and uniquely individual. Just like a child, they often have an imagination- they believe in it and it is OK for us to join them, just like we do with our kids.