Tag Archives: Mood and Memory Loss

MUSIC AND MEMORY LOSS (AND STRENGTHENING?)

I have finally found an organized activity for Ralph that he not only will attend but actually seems to enjoy. The Ochsner brain clinic has started a research project on the value of music therapy for Alzheimer’s patients, and when a spot was offered, I jumped on it. 

Before our first session, Ralph was clearly nervous and bit leary, as he is of anything medical. I kept assuring him he would not be having cognitive tests or any shots, and he seemed to believe me, but he was more doubtful when I said he would have fun. I wasn’t sure myself.

It was awkward at first. We met Meredith in a typical, very small medical examination room that did not seem conducive to a creative musical experience. Meredith was young and blond, non-descript behind her mask, as we were. We made the usual small talk, and as usual, Ralph kept turning to me to answer questions for him while I sat slightly apart trying to keep quiet and make him answer for himself. Almost grudgingly he told Meredith he played guitar a little and that he was partial to Bob Dylan. I might have (definitely) interjected there, saying he’d played seriously as a kid and had interviewed major country and folk musicians as a journalist in his youth. She nodded mildly and I thought to myself She’s too young and tentative for this to work.

Then she pulled out her guitar and began to sing. CRAZY, the Patsy Cline classic written by Willie Nelson. It may seem an odd choice, given Meredith was singing to a man with what is labeled dementia, but who cares. It turned out that even masked Meredith, who got a degree at NYU, can really belt out a song. And how crazy was it, in a good way, when Ralph almost immediately began to sing along unprompted. He knew almost all the words. At the end she clapped. And so did he. 

She asked if he’d like to play her guitar. Hesitantly he started Blowing in the Wind, then gathered some steam and it was her turn to sing along. She pulled out more songs. She played the guitar but gave him drums to improvise with. They sang and sang. Of course he didn’t remember all the words, but who would. Meredith was genuinely enjoying Ralph. When she introduced some rhythm and memory exercises, I held my breath waiting for him to resist, but he went along like a trouper. And coincidently days later I heard a science report the the research shows statistical evidence that playing music helps cognitive function, particularly for those with Mild Cognitive Impairment or in the early stages of Alzheimer’s. Ralph’s diagnosis has held in early Alzheimer’s so he is the perfect candidate for this “therapy.”

At Meredith’s request, Ralph now takes his guitar him. As I push him to get ready each Friday morning,  I do have to remind him how much he enjoys the sessions and he looks at me grumbling I do? But once he’s there, he’s fine. Usually now I sit in the waiting room because I think letting him have this magical hour alone is probably better, but I did sit in again the other week just for fun because listening to the two of them harmonizing with the voices and instruments as Meredith guides him along is  like a mini concert.

Still, as lovely as this new experience has been, it is also bittersweet. Rick’s relationship to music has changed. Only 19 months ago when Ralph and his oldest son pulled out their guitars at Christmas, Ralph could play one song after another as if one song reminded him of another, some well known, some obscure. It was as if his cognitive impairment dropped away.  That is not exactly the case now. When I ask him to play at home, joking–Serenade me while I cook–he usually says he’s too tired. And if I push and he gets out the guitar, he clings to Blowing in the Wind. It is the one song he’s comfortable with now. Without Meredith sitting beside him, he struggles to find the chords and words. Meredith is giving him a playbook and I hope that will help because at the moment he doesn’t seem willing to try other songs on his own. The diminishment is almost more apparent. 

Almost, but Ralph’s joy each Friday hasn’t. 

Which raises a reality I think about a lot—that Ralph with his cognitive impairment seems happier than he ever was without it, and than I am living with him a lot of the time.

Mood Lasts Beyond Memory for Alzheimer’s Patients

The fact that forgotten events can continue to exert a profound influence on a patient’s emotional life highlights the need for caregivers to avoid causing negative feelings and to try to induce positive feelings.

This quote comes from a University of Iowa study on mood retention among Alzheimer’s patients, results I heard discussed a few days ago on NPR. The interviewer was thrilled with the information. And I know I should be too. After all, Ralph is still in a great mood ten days after we hosted the wedding because he knows he had a wonderful time even if  he can’t remember almost any of the details.

But what I actually thought as I listened to the earnestly enthusiastic young researcher was, “Oh great, now I have another reason to feel guilty.”

What I heard her telling me was that If feelings linger after the memory fades, I am “causing negative feelings” in Ralph more often than I want to admit. I see the way his face collapses when I am short with him after he asks me where I am going for the fifth time in half an hour. Or when I get annoyed that he has forgotten to take his pills or has not given me an important message from the electrician or has gone to bed before eight after spending the entire afternoon asleep on the couch. Less than a minute ago, he interrupted me as I was typing here at my desk with another question I had just answered, and I shouted down the stairs Not Now I’m Busy in a less than kind voice. Since Ralph’s diagnosis of MCI over a year ago, I have told myself not to feel bad about outbursts of impatience because he won’t remember. Evidently I was wrong: an essential non-cognitive part of him will remember.

Coincidentally, the blogger of “Not My Original Plan” –whom  I much admire for her realistic and committed optimism–writes in her most recent post about enjoying her mother’s lingering joy after the actual memory of an experience they have shared together fades.  I know I should follow her example and be glad that in some essential way his loss of memory has not robbed Ralph of his emotional life. And most of me is glad.

But to be honest, another considerable part of me liked thinking I had an escape hatch from responsibility:  I could let down my guard and be selfish or mean or emotionally lazy without it counting as long as Ralph wouldn’t remember.  That escape hatch is closed from now on, and I can’t help letting out a short sigh of “caregiver” fatigue.