This patient had little memory of his past life and was clearlyabout his present circumstances. In that sense, he’d lost his “self,” knowledge of who he was and who he’d been. At the same time, he was still his “same old self,” in the sense that his personality hadn’t changed.
This brings us back to the distinction between “knowing what” declarative memory and “knowing how” procedural memory. Autobiographical memory is “knowing what,” and this is what’s largely lost in Alzheimer’s. However, personality is defined by psychologists as an individual’s typical ways of thinking, feeling, and behaving. In other words, personality resides in “knowing how” procedural memory, which is mostly spared.
From this observation, Francis and colleagues offer a word of advice. If you’re caring for a loved one with dementia, the best thing you can do is to keep every interaction as emotionally positive as possible. Smile with them, laugh with them, and give them hugs to elicit as many good feelings as you can.
Early-stage Alzheimer’s patients are frequently distressed because they’re aware of their memory loss and what the future holds in store for them. But by the later stages, they’ve mainly forgotten about their memory loss and are no longer distressed by it—unless they’re reminded of it.
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