Learning and Dementia (Rant #537)

In the latest issue of Provider magazine, a new Dutch study is highlighted with the following cover teaser: “Alzheimer’s Finding Surprises Researchers”. So of course, I rushed to the article to find out what happened that was so shocking.

Turns out that people with Alzheimer’s can still learn! By testing the memorization of a way-finding route, the researchers found that markers along the route were learned and recognized by the subjects, even though many people living with Alzheimer’s have difficulty with visual-spatial skills.

Radboud University released a statement noting that “We must now dispose of the idea that Alzheimer’s patients are no longer capable of learning.”

What better statement to show how far we have traveled down the wrong road in our view of dementia!! Of course, people with dementia can still learn! We all know this–how can we have possibly convinced ourselves otherwise??

This article shows precisely how our deficit-based model has poisoned our view of people living with dementia, which subsequently affects our ability to care for them and provide true well-being. Tom Kitwood, father of the concept of ”positioning”, is no doubt rolling over in his grave. (Kitwood stated that once people are labeled with “dementia”, we automatically “position” people as being less capable than they are, and/or blame everything we see on the disease, rather than looking deeper and seeing the whole person.)

If we look at people living with dementia as whole people, we see that they learn all the time. I often illustrate this to my audiences by saying, ”If you think a person with advanced dementia cannot learn new things, try this experiment: Have 3-4 staff members take him to the shower room and force him to have a shower he doesn’t want. Then take him back there a few days later, and see if he has formed a new memory of what happened last time!”

The researchers go on to say that such automatic learning persists even though “conscious learning may well be long gone”, another reductionist view that is patently false. The brain is plastic, and a damaged brain still has plasticity.  How else could a person with dementia moving into a care home start calling his primary nurse or aide by name after living there for several weeks? There’s nothing ”unconscious” about that type of learning.

It’s time to adopt Dr. Richard Taylor’s view that “I am not dying of a fatal disease; I am living with a chronic disability.” Then, maybe we will stop selling people short and try to help find ways to enable them to succeed throughout their lives.

About Dr. Allen Power

G. Allen Power, MD is Eden Mentor at St. John’s Home in Rochester, NY, and Clinical Associate Professor of Medicine at the University of Rochester. He is a board certified internist and geriatrician, and is a Fellow of the American College of Physicians / American Society for Internal Medicine.
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8 Responses to Learning and Dementia (Rant #537)

  1. Great post, Al! and thank you for sharing this wonderful piece of research.

  2. This of course is not news to me, nor to anyone living with symptoms of dementia. I have met a few folks that over time have been convinced they can’t when they can, they could if want to but the fear of sure failure confirmed to them by people who should know better keeps them from even trying.

    The fact that this “finding” was announced as a surprise to researchers should forever shame these researchers into researching something other than the competencies of people living with the symptoms of dementia. It won’t. They will continue to be surprised until they too are living with the symptoms of dementia and are being told by younger researchers they can’t, when they know they can.

    And speaking of setrotypes, I thought everyone in Denmark was more aware of the realities of dementia than were obviously these researchers. I”ve held the “cold countries” up in my mind as sources of enlightenment. Apparently the Northern Lights flicker for many viewers when it comes to enlightening the shadows of ignorance created by the dark forces who use their self described darkness to scare others into purchasing light bulbs to support other’s researchers to cure this darkness they have created, defined, labeled.

    Richard

    Richard

  3. Judy Berry says:

    Kudos Al for highlighting this research! Those of us that have a long time ago refused to believe the myths out there and have taken the time needed to help people with dementia and their families focus on what they can do and learn they truly can. Sadly the people promoting the myths seem to turn a blind eye on research like this or things like the research that recently projected that as many as 50% are misdiagnosed with AD.
    I have a hard time understanding how anyone who has any significant contact with persons with dementia, (maybe researchers don’t??) would NOT see the whole person, with their feelings and emotions still in tact. All persons, whether they have the disability that comes with dementia or any other chronic illness, deserve to be recognized as the whole person they are and treated with dignity and respect and if we really want to help we need to

  4. Judy Berry says:

    We need to educate to change people’s current perspective on what REALLY happens as a person’s dementia disability progresses. Al I know both you, and Richard and some others including me are working hard at this!!! Thanks for the post and all you do!

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  6. Yes, I agree that the ability to learn is not what we associate with dementia. What is not clear to me is what difference it really makes. What can people suffering from dementia learn that can make their lives better and simplify the lives of their caregivers.

  7. Dave Sheehan says:

    “I am not a person dying of a fatal disease, I am a person living with a chronic disability!
    Hugs and yes, kisses to Richard, a lion who roars for those of us affected by Alz! It was so heartening for me to read…as I enter stage 2, whatever that means, that I can and will learn on the journey. It was a little like when I earlier “learned” that I would not lose my mind, just the old paths once connecting it! Thanks for the safety net this community provides for each, other and all!

  8. Ariel W says:

    I am an AGNG 200 student at the Erickson School of Aging. From what I have learned in class, I would have to agree that people with dementia only have a disability and have not lost the ability to learn. On the contrary, research has shown that a lot of dementia sufferers don’t even have bouts of forgetfulness. Research has also shown that people with dementia do not lose their intelligence. My grandfather, a longtime sufferer of dementia, wasn’t able to drive anymore, but he knew every corner and street from the walks that his nurse would take him on everyday. Just because these people have a disability doesn’t make them any less human than you or me.

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