David Shenk Answers Your Questions About Alzheimer's

Nov. 20, 2007 — -- David Shenk is the author of "The Forgetting: Alzheimer's, Portrait of an Epidemic."

You submitted your questions about Alzheimer's disease. Read Shenk's answers below:

Question: I still don't understand the difference between dementia and Alzheimer's. Also, I have read that you should not argue with an Alzheimer's patient, but when my mother is confused, I feel that it sometimes seems to help when I "correct" her version of reality. Can I do anything to keep her grounded in reality?

-- Judy, Gadsden, AL

Shenk: Very important question. "Dementia" and "senile dementia" are generic terms that describe a set of symptoms - memory loss, confusion, aphasia, and so on. Every case of dementia is caused by one or another disease. Alzheimer's is one of those diseases, and is by far the most common cause of dementia. There are other diseases that cause dementia - multi-infarct dementia, fronto-temporal dementia, and others. But the important point here is that it is no longer acceptable for a doctor to leave a diagnosis at "just dementia." It's important to find a doctor who will work to find out which disease is causing the dementia.

This has to be handled on a case-by-case basis, but every caregiver I've spoken with about this has found that the easiest and most comforting thing to do is to let the patient be comfortable in his/her own reality. As you've suggested, you're never going to bring your mom back to your reality. She has a progressive brain disease and is now living through her own very different reality. If correcting her gently makes her happy, that might make sense some of the time. But generally, you want to be showing an understanding of what they are saying, and gently steering them to a conversation that they find comforting.