Image by Gerd Altmann 

The illness of a family member will overturn the entire structure of a relationship that has been woven together over the years. This disarray is even more profound when the illness is Alzheimer’s disease, against which we can fight but never win, and gives birth to a world of misunderstandings and questions.

All families live with their own unique experiences and possibilities. Relations inside the family change, conflicts can burst out of the past or burst up anew, or the family might find itself more tightly knit than ever. Life goes on, but we fear that, sooner or later, it will turn into the Stations of the Cross.

The moral suffering felt by the family is made more intense by their long history with the affected family member. Some of the patient’s behaviors are manageable, but others have the potential to surprise or destabilize the family milieu.

Understanding How Alzheimer's Develops

The moral discomfort can be mitigated by an understanding of how this disease develops. Alzheimer’s disease involves the patient and his or her whole family. It turns many situations that seemed settled upside down and brings back to the surface troubling situations that were thought to be resolved. It is impossible to imagine just how oppressive this can be as an everyday reality.

The intellectual, emotional, and relational life of patients doesn’t come to a stop at the onset of the disease, and they will react in accordance with the disorder’s intensity and their knowledge that their means to fight it are diminishing with time. The greatest value of an early diagnosis is that it allows everyone involved to get used to managing the situation before it has reached a critical point.

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When the context becomes more difficult, it is necessary to establish a way to handle matters that can head off destabilizing situations. In fact, lack of knowledge about the effect of the disease on our own psyche and that of other caregivers can breed many misunderstandings.

Alzheimer’s disease must be understood as an assemblage of cognitive impairments and emotional and relationship disruptions. It will change the way patients think, a change that is more or less profound depending on the stage of the disease. It alters how they relate to the world, to themselves, and to others.

Entering The Patient’s World

In its earliest stages, patients are lucid and autonomous. They can go out by themselves, take public transportation in familiar areas, drive a car, and continue to assume the bulk of their daily chores. They speak normally and can express their ideas and feelings. Their social behavior is normal—so normal that people who see them may doubt they are ill.

While life is almost totally normal over the course of these first years, some difficulties appear early and it is necessary to know them to prepare for them appropriately. Other difficulties that begin to gradually appear are going to shake the foundations of everyday life.

Communication permits constant interaction between the person speaking and the person listening: our speech, our attitude, the tone of our voice will modulate, consciously and unconsciously, based on the reactions we see in the person with whom we are talking. With Alzheimer’s patients, their feeling of identity will become increasingly dependent on the image we reflect back to them and which is reflected by the other people with whom they have contact. It is therefore imperative to make sure to maintain this representation as much as possible.

Don’t be surprised, for example, if their behavior sometimes reminds you of that of a child. However, it is very necessary to avoid infantilizing or overprotecting our loved ones with Alzheimer’s, as this will contribute to the decline of their feeling of who they are and their self-esteem. On the other hand, everything that can reinforce what made them who they are (reminders of events you’ve shared together, family photos, highlights of their personal qualities) should be made the chief focus of conversation.

Because our loved ones may have difficulty understanding the words or meanings of what we tell them, it is necessary to take some precautions when speaking to them so as to minimize misunderstandings. If they seem to find it hard to understand us, we can verify first that they are hearing us correctly, because hearing impairment is frequent among the aged and complicates their understanding of speech.

Each Person and Situation is Unique

Alzheimer’s disease is very different and unpredictable from one person and another. Patients may encounter some problems while being spared others. But generally speaking, the attitudes of the people around them have a direct and significant effect on them.

Increasing family members’ aptitude to interact with patients can extend their capacity to get home care and improve their quality of life. It is essential, on the other hand, to obtain as much information as we can about the problems connected to this disease. This can help us find solutions, better anticipate problems, and bolster our decisions.

As the disease progresses, exchanges with our loved ones will become increasingly laborious and force us to decipher what they wish to tell us. We will also have to learn how to speak to them so they understand us.

The Importance of Communication

Why should we continue to communicate with Alzheimer’s patients? It would be easy enough, once the diagnosis has been delivered, to simply conclude that these patients are no longer in possession of their faculties and any further communication will be useless. But these exchanges remain essential and healthy.

These victims of old age and disease remain our close family members even when illness has altered their intellect. Good communication makes good socialization possible and offers a gratifying compensation for the helper; it also postpones institutionalization.

We can help patients make their way through this challenging situation by encouraging all kinds of communication in an atmosphere of warmth and kindness and avoiding situations doomed to fail. We can treat the affected family member like a true conversational partner by speaking to them, listening to them, dialoguing with them, and responding to the messages they have to give.

Understanding and Interpreting

Little by little, we will begin to have to interpret what the patients say to us, for they will have trouble finding words, and the words they use will not always correspond to what they want to tell us. They could use one word instead of another (“pass me the salt” instead of “bread”), mispronounce words (“natlin” for “napkin”), or give them an unusual or even opposite meaning (“no” for “yes”).

As incoherent as their words may appear, they have a meaning that we must decipher based on context, expressions, gestures, and regard. It is helpful to verify with our loved ones that we really understood what they meant to say by restating the phrase ourselves.

We must never show any signs of disapproval through words, facial expression (or body language), or attitude. We must never show impatience, even if we feel inside as if we have taken all we can take. We must not put any pressure on them, interrupt them, or jostle them when they are speaking.

When they are aphasic or their reason is stuttering, we must show even more receptiveness. When a heavy silence drags on, we can come to their help with expressions that help them pick up the thread: “Yes?” “Then what?” “Are you sure?” If they are struggling to express themselves, we can fill the void before irritation takes them over by improvising on what they are trying to say or by suggesting to them the sentence they are looking for.

We should not forget that our loved ones have just as much trouble understanding our messages as they do formulating their own. In certain situations, when they cannot express their thoughts through words, they will reveal them through behavior. This is why an apparently deviant form of behavior (agitation, aggressiveness) can become the sole possible means for patients in a given situation to respond to messages that seem muddled to them. 

Emotions Hold Memories

The souvenirs held in our episodic memory are indicated by an emotion. This is why we prioritize the use of photos, aromas, movies, and songs depending upon their ability to evoke an emotionally charged event. The aide who spends time with a patient on a daily basis and knows their personal history well is the person best able to find the inspiration for triggering an emotion.

These evocations are also the pretext to express, recount, sing, move, and mimic the gestures of the patient’s job, a favorite sport, and even dancing.

By helping our loved ones rememorize certain old memories, we encourage the emergence of others. We can tell them stories about their life to help them rediscover, through this conquest of identity through their own story, what is called narrative identity. We can speak with certainty here: the senses, the emotions, and stimulation of the sense of smell are the best therapies.

A care protocol for Alzheimer’s that is based on the pharmaceutical approach doesn’t work; its remedies are not only minimally effective but also have enormous negative side effects. Theater, music, painting, olfactory therapy—these and other sensorial experiences are key to preserving the cognitive reserve.

When establishing such an approach to care, it should be adapted as best it can to the needs of each patient. I recommend that you turn to qualified caregivers who can attempt to rebuild cerebral circuitry, mend ailing brains, calm fears and anxieties, restore pleasure, and recover self-esteem, while at the same time letting patients keep their dignity.

Copyright 2022. All Rights Reserved.
Adapted with permission of the publisher,
Healing Arts Press, an imprint of Inner Traditions Intl.

Article Source:

BOOK: Alzheimer's, Aromatherapy, and the Sense of Smell

Alzheimer's, Aromatherapy, and the Sense of Smell: Essential Oils to Prevent Cognitive Loss and Restore Memory
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book cover of Alzheimer's, Aromatherapy, and the Sense of Smell by Jean-Pierre Willem.Offering a hands-on and medication-free way to help those suffering from Alzheimer’s, this guide provides a way for Alzheimer’s patients and their families to recover the joy of living again.

Citing years of clinical evidence, Jean-Pierre Willem, M.D., shows how Alzheimer’s is critically bound with the sense of smell. Sharing the striking results seen in French hospitals and senior living homes where aromatherapy has been used as a therapy for Alzheimer’s for more than 10 years, Dr. Willem details how to use essential oils to stimulate memory, prevent cognitive loss, and counter the isolation, withdrawal, and depression these patients are likely to feel.

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willem jean pierreAbout the Author

Jean-Pierre Willem, M.D., is the founder of the French Barefoot Doctors movement, which brings traditional healing techniques back into clinical settings. The author of several books in French on natural healing for degenerative diseases, he lives in France.

Books by this Author (many in their original French language).