Study: Some Skills Can Blossom in Alzheimer Patients

Alzheimer's caregivers can take a cue from a case study reported in the May 27 issue of Neurology that showed that the disease and other forms of dementia can allow some unique skills to flourish even as it devastates others.

In the study, Dr. Bruce L. Miller, of the University of California at San Francisco, and his colleagues described the case of a 52-year-old high school art teacher whose disease forced her to quit her teaching job, but advanced her artistic career. As dementia progressed, the researchers noticed that her paintings became freer and more original.

"We typically don't think that something could be getting better, we only think about what's getting worse," said Miller. "Now I always ask if there's anything patients are doing very well, or better than before."

According to Alzheimer's experts, such a response won't halt or reverse the disease, but may still comfort the patient and aid in countering some of the combative behaviors and agitation that often arises among people who have the disease.

Robin Fenley, director of the Alzheimer's and Long-Term-Care Unit of the New York City Department for the Aging, said the study illustrates that it is important to determine what an Alzheimer's sufferer can do and what skills they retain. "And then give them tasks to encourage the types of activities that will keep those skills as sharp as possible for as long as they can," she said.

As a very simple example, Fenley suggests that if the person has been used to folding clothes, they be encouraged to continue this task. "Empower the person with Alzheimer's to do the things they can do," she added.

Memory coaching, in which specific daily tasks are taught and rehearsed, is another approach that caregivers can adopt to help people with Alzheimer's revive forgotten skills, according to Sunny Kenowsky, of New York University Medical Center.

"In the early stages, we can teach a patient to brush their teeth, exercise and do some of those things that they can no longer do," Kenowsky said. "In the middle stages, we can teach them to eat with a knife and fork, for example, or it can help with incontinence. And in the end stages we can help people with walking and learning to sit up independently."

According to the researchers, the earlier in the illness that such approaches are tried, the better the results. Unfortunately, they added the success of such approaches is only temporary.

Other sources: Neurology 2003;60:1707-1710, Fisher Center for Alzheimer's Research Foundation