I remember the day I lost my Nana to another woman. I was visiting her apartment when I first noticed something was wrong. “Can I help, Nana?” I asked. As we sat on the edge of the bed, she told me about a woman who was imitating her every move, even putting on the same clothes just to torment her. “I tell her to go away,” said Nana, “but she just stares back at me. I don't know how to stop her.” I squeezed her hand, trying to comfort her like she'd done for me countless times. It was then that I looked up and saw her wardrobe mirror covered with cardboard.

Nana moved in with us as she battled Alzheimer's disease. During the next two years she forgot who I was, and I no longer recognized her. Gone were the happy childhood vacations I took with her, the birthday celebrations, her Saturday night phone calls. When she deteriorated to the point of needing constant care and attention, we placed her in a long-term care facility for patients with dementia.

Those final days in the hospital still haunt me. Where was her smile, her voice, her laugh? I find it difficult to think about this strange woman. This was not the Nana I'd grown up with. Unfortunately, every memory I had of her before the illness seemed vague and artificial—she was like a stranger then, too. Who was she really? When did the disease take her away from us? When did she stop being my Nana?

What is Alzheimer's?
Alzheimer's disease is the most common form of dementia. Symptoms often include a gradual loss of memory and language skills, problems with reasoning or judgment, disorientation, delusions, difficulty in learning and a decline in the ability to perform routine tasks. Alzheimer's advances at widely different rates and the duration of the illness may vary from three to 20 years. It affects the areas of the brain that control memory and thinking skills first, but as the disease progresses, cells die in other regions of the brain eventually causing death.

An estimated 238,000 Canadians over 65 have Alzheimer's. By the year 2031, this number is expected to triple. While research has progressed significantly over the past several years, the cause and cure for Alzheimer's remains unknown. “Over 52 percent of Canadians know someone with Alzheimer's disease and almost 25 percent have someone in their family who is affected,” says Steve Rudin, executive director, Alzheimer Society of Canada. Sadly, this means that family members will continue to face the pain of watching loved ones succumb to the disease.

Blame the Disease, Not the Person
As the Alzheimer's sufferer loses memories, the caregiver gains new and often painful ones. And if the illness lasts for many years, the more recent and vivid memories may overpower the old. A family's greatest challenge may be remembering who the person was before the illness took over.

So how can families preserve cherished memories of loved ones? Ilona Horgen, director of support services and education for the Alzheimer's Society of Canada, suggests reminiscent therapy, a process where patients are encouraged to share their recollections of life events. “It allows Alzheimer's patients and their families to talk about their lives, and what's important to them,” she says. “Done early, it can help sufferers articulate how they want to be remembered.”

This was not the Nana I'd grown up with. Unfortunately, every memory I had of her before the illness seemed vague
and artificial

Horgen encourages caregivers to continue participating in activities that the Alzheimer's sufferer enjoys. Go on a picnic, visit a shopping mall or eat at a favourite restaurant. It's a good opportunity for all parties to continue living out shared memories.

“Scrapbooks, photo albums, journaling and videos can be effective ways to preserve memories,” says Gail Clement, an Alzheimer's Society counsellor. These materials will help ensure that there will be positive symbols of the life you shared. And, says Horgen, “often the Alzheimer's sufferer will be able to work on it with you.”

Clement also suggests that caregivers never lose perspective. “Take time each day to reflect on the happier times you shared,” suggests Clement. “This will help balance your attitude toward caring for them.” Realize that your loved one will inevitably exhibit behavioural changes and memory loss. They will say or do things that may hurt, anger or sadden you. If you take their actions too personally, you will harbour resentment long after they're gone. And that's not a good way to remember them. So blame the disease, not the person.

Cultivate Positive Memories
The week after Nana died my family sat together in our living room and spoke, not of a frail woman, but of a strong matriarch. As my dad shared some old photos from Scotland, we gazed at the confidence Nana displayed at 19. Dad recalled how she never lost hope that Papa would return from the war. And he did, six months after the picture was taken, freed from a Japanese PoW internment camp.

My mother remembered the cooking classes she took from Nana just before marrying my dad. Nana wanted Mom to be prepared. There was Nana's way and the wrong way to cook. Thankfully my mom was a good student. She's since taught me Nana's recipes for scotch pies, mincemeat tarts and trifle, so Nana's culinary expertise lives on.

I recalled how I'd inherited her love of books and the outdoors. Each summer she and my Papa would take my brother and me to parks, zoos and museums. It was important to her that we learned about our world. She never pushed us, just created opportunities.

The more my family talked, the more I recalled my life with Nana before her illness, and how she always followed a God who would never forget her or stop loving her. The painful memories still creep up at times, but they no longer have the power to overwhelm me. Even in death, my Nana continues to encourage me to live simply, serve others and love genuinely. And memories of her give me the strength to make it possible.

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When a Loved One Is Diagnosed With Alzheimer's

1. Learn as much as you can. Find out how the disease can affect a person, what changes you can expect and how you can provide support to maintain the person's independence and
quality of life.

2. Recognize that the disease affects the person's abilities. Alzheimer's disease progresses over time. Learn about the changes the disease will cause so that you have realistic expectations. And be patient.

3. Don't lose sight of the person. No matter how the disease affects the individual, it is important to treat her with dignity. Although certain abilities will be lost, the person's feelings will remain, as will the need for companionship and belonging.

4. Explore treatment options. Currently there is no cure for Alzheimer's disease. But medications are available that may help with some of the symptoms. Discuss risks and benefits with a doctor.

5. Recognize your emotions. The diagnosis and the changes it will bring can cause you to have all kinds of feelings: anger, denial, embarrassment, frustration, fear, sadness and guilt. These emotions are normal among caregivers.

6. Plan for the future. Support the person in planning for the future. Decisions about work, health care and estate planning need to be made while the person is able to be involved in the decision-making process.

7. Recognize that caregiving can take its toll. Caregivers are often at risk for physical and emotional problems. Those who provide care should be aware of this and take steps to care for themselves.

8. Seek help. There are community agencies and services to help you with everyday household or caregiving tasks. Family and friends may also be willing to lend support.

9. Develop a support network. Find people you are comfortable with to share your feelings and emotions—a pastor, a friend, a support group. Contact someone at your local Alzheimer Society (www.alzheimers.ca) for more information.

John McAlister is senior editor for The Salvation Army's Editorial Department. From 2006-2008, he served in Zimbabwe with his wife, Rochelle. John and Rochelle have a baby boy named Kieran Tinashe.