Trip to the beach sparks memories in dementia patients
By MARION CALLAHAN, Bucks County Courier Times
Oct. 27, 2017
DOYLESTOWN, Pa. (AP) — The wheelchair only made it so far along Ocean City's sandy beach, but Odette Swan inhaled the salty air, fixed her gaze on the ocean and stood up, insisting she'd walk to get closer.
Guided by granddaughter Samantha Jonsson, Swan inched her way toward the ocean, stopping at one point to raise her arms, and as if she were conducting a symphony, moving them to the rhythm of the crashing waves. Then the 89-year-old woman - who sometimes forgets her name, how to get dressed and even what country she's in - couldn't stop recalling her life.
It was as if a window was opened and memories were flooding in. She talked of her childhood, growing up in a small coastal town in France and how her father was a fisherman. She talked of the days she spent collecting shells to make necklaces to sell to tourists. And she recalled swimming in the ocean, likening it to a feeling of flying.
"If I were young, I'd jump in and swim as far as I could," said Swan, as her voice cracked with emotion. She then dipped her hand in a plastic cup Jonsson filled with sand and ocean water, rubbing the mixture on her hands like it was lotion. It was as close as she would get to the ocean, but it was enough.
The journey that recent day to Ocean City, New Jersey, revived Swan's memories in ways that brought Jonsson to tears. But she knew that within hours, those memories would fade like the setting sun. Like about a dozen others from Doylestown Township's Pine Run Retirement Community on the bus trip that day, Swan suffers from dementia - a condition that affects more than 5.5 million Americans today.
Dementia, as defined by the Alzheimer's Association, is a general term for a decline in mental ability that's severe enough to interfere with daily life. While there are many different kinds of dementia, Alzheimer's is the most common. People with dementia struggle with short-term memory, and as the disease progresses, they have trouble with long-term memory and routine chores such as keeping track of belongings, paying bills, preparing meals, remembering appointments -- and over time, even recognizing loved ones.
There's no cure, but treatments and therapies can sometimes slow the progression -- and in some cases - help tap into patients' memories, doctors and therapists say. Sensory experiences, trips, music and interactions with children and animals can spark animated and emotional reactions for a short period of time.
That's where the trip to Ocean City came in for Swan.
Standing beside her grandmother in the sand, Jonsson said she felt goosebumps just watching her "light up."
"She remembers her childhood more than she remembers yesterday," said Jonsson. "Here, she feels connected to the water, people and me."
Dr. Anjan Chatterjee, chair of the Department of Neurology of Pennsylvania Hospital, wasn't surprised to hear a trip to the beach tapped into the early memories for some residents with dementia. He said Swan was likely experiencing sensations that triggered emotional memories. When people have dementia, Chatterjee said, the brain systems that control motor skills and the senses are "relatively preserved until late in the disease."
"What that means is that you can have people engaged in activities -- being at a beach or a garden or looking at art -- that still gives them pleasure, and they (experiences) can trigger those long-term memories," he said.
Chatterjee spoke of an Alzheimer's patient with a talent for ballroom dancing. The man's wife would take him to places where they once danced. "He couldn't communicate in a coherent way verbally," Chatterjee said. "Once on the floor dancing, it was though an important part of their relationship was recreated."
The common link between the walk on the beach and the dancing, he said, is that "none of those activities depend on having an intact short-term memory."
Chatterjee suggests families and caregivers focus on patients' recalling abilities -- not just disabilities. Producing art, nurturing a child or digging in a garden can bring out basic impulses that tend to be preserved longer in the brain than other abilities, he said.
On the fifth-floor memory care unit at Pine Run, a woman sat with a restful smile while she cradled and caressed a battery-operated lifelike cat. Props such as the cats and therapy baby dolls trigger that nurturing instinct and bring comfort to some residents, according to Emily Reinert, Pine Run's manager of life enrichment.
In a nearby room, other residents were rolling their shoulders and tapping their toes as they listened to Marvin Gaye's "How Sweet it is" during a chair exercise class. While some sang along, others struggled to stay awake.
Neuropsychologist Dr. Michelle Papka, director and founder of the Cognitive and Research Center of New Jersey, said growing research continues to show how therapies and healthy lifestyles can help prevent cognitive decline. Research has shown that diet, cardio exercise, proper sleep, stress reduction and cognitive and social stimulation are all key "healthy brain aging," she said.
At Pine Run, each resident has a memory box holding pictures, souvenirs, and other items that families believe hold special meaning. Sorting through her box one day, Swan picked up a doll in a dress that was the kind traditionally worn in her French Village. That prompted her to talk about her father and her own special dress.
What helps; what doesn't
Cooking and preparing food also can add familiarity to the lives of those with dementia.
"When cooking tools are handed to the residents ,it's amazing to see how their hands remember what to do; cracking an egg, stirring, sifting flour," Reinert said.
And with most activities, she said, music is playing.
Chatterjee said music has a unique effect on dementia patients. "Some people who can't verbalize what they want to say can sing a song," he said.
But families and caregivers shouldn't focus on patients recalling facts and names. Chatterjee said that can be counterproductive.
"I know it makes everyone feel good if they can remember names, but that's not always a good use of time; it's asking them to focus on what they can't always do," he said.
Glenn Masters, of Nockamixon, doesn't expect his mother, Dorothy Masters, to always remember his name. And he doesn't bother correcting her when she gets it wrong, since that would confuse or upset her.
"I just roll with it," said Masters, who joined his 86-year-old mother on the Pine Run trip to Ocean City. Being a caregiver for a loved one isn't easy, he said, recalling the day he had to break a window to get into her home to check on her. He found her in the bathtub wearing her nightgown -- she was unable to get out.
"Had I not discovered her, chances are she would have expired and that would have been horrific," he said. "She thought she was going to bed."
After that incident, Masters moved his mother into the memory care unit at Pine Run, where she gets around-the-clock care.
"It's heartbreaking to see the person slipping away and there's nothing you can do but give them the support they gave you when you were a helpless child," said Masters.
He said he treasures the trips to the beach, whether she remembers them later or not. On their last visit, her eyes were locked on the ocean. He, his mom and his daughter, Christine LaGuardia, watched dolphins springing out of the water and the waves lapping against the shore.
"I wonder what she's thinking when she's looking off into the distance," said Masters, watching his mother from just a few feet away. "She's not the person I grew up with, and I accept that. She no longer sees me as her son. Does that change our relationship? No."
For now, he said he'll focus on making moments -- not ones that she can remember -- but ones they can still enjoy together.
Information from: Bucks County Courier Times, http://www.buckscountycouriertimes.com