Correcting a Person with Alzheimer's Disease - Right or Wrong?


Q. My grandmother has Alzheimer’s Disease, and will often say things that are just not true. Why do the care attendants not correct her when she is wrong? Wouldn’t this help her get better?

A. At a ‘common sense’ level, the suggested approach behind this question seems logical. However, it is not so simple. Alzheimer’s Disease (AD) is a progressive, organic brain disorder. Over time (2 – 20 years), serious changes take place in brain structure and function. Neurons (brain cells) die and synapses (connectors between cells) are also destroyed. Functionally, these processes result in loss of memory, ability to understand, do abstract thinking, make decisions and general confusion.

Confusion in AD is confusion as to TIME, PERSON and PLACE. AD patients and their families find themselves in a ‘new reality’. Nothing is as it was before. There’s no going back. The changes are progressive and irreversible. And so, caregivers are rightly trained to “go to the PATIENT’ REALITY”, and acknowledge THEIR world, as THEY are experiencing it. There is NO “right and wrong” in that world, and so, there is no point in ’correcting’ what AD patients may say, no matter how bizarre it may seem. In fact, attempting to do so can add to their confusion, make them more stressed and irritable and produce agitation.

Of course, all and any care for AD patients must always be tempered by the paramount considerations of their safety and security and must do everything possible to maintain their dignity, respecting all human and personal rights.

This section of our newsletter gives you an opportunity to send in questions and receive answers from one of Canada's leading and founding gerontologists! Following his retirement as a professor of gerontology at Simon Fraser University, Dr. John Crawford continues to share his expertise and wisdom by serving as the VP of Education for Age-Friendly Business. Take advantage of your access to this remarkable resource by e-mailing your questions to: drjohn@AgeFriendlyBusiness.com


Seniors and Gambling


The Losses & Costs of ‘Gaming’
Gambling has increasingly become a form of recreation for older adults. Some 68% of Canadian seniors gamble, and around 2.1% have moderate to severe gambling-related problems (Canadian Centre on Substance Abuse).

The legalization of gaming establishments, increased access, greater social acceptance and increases in disposable time and money have all rendered seniors more susceptible to the "roll of the dice." Seniors are targeted because of the tremendous market they represent for the gaming industry, and because they’re more likely to be tempted by incentive campaigns, such as cheap day-time transportation, free hotel stays, special promotions and free lunches.

Seniors gamble for a variety of reasons -- for fun, to make money, out of curiosity, or to escape from loneliness, depression, financial difficulties, declining health and emotional loss. The most common gambling activities among older adults include the purchase of lottery and scratch tickets, and playing video lottery terminals, slot machines and bingo.

Seniors are often more vulnerable to gambling addiction because of a number of life factors. For example, they may seek to mask the pain associated with losing a spouse, they may be lonely or depressed or they may be facing financial or health problems. These factors can predispose a senior to the hypnotic, anaesthetizing effect of gambling.

Gambling is also much more acceptable and accessible now than it was a few decades ago. No longer a shady, illegal activity conducted in back rooms, ‘gaming’ (as the government euphemistically calls it) is now a legitimate form of recreation and entertainment. Governments tout the benefits of gambling, but they too are addicted: lotteries pump dollars into government coffers for education, sports, health care. Casinos pay taxes that improve roads, support schools and promote tourism. No one ever has to go far to find another opportunity to gamble, whether it is a lottery, a casino or a horse-racing track. Internet gambling via poker sites is readily available; and as this trend becomes more widespread with the inclusion of other ‘gaming sports’, seniors can now gamble without leaving their lazy-boy.

While most people can enjoy gambling without consequences, the lure of quick money can have devastating financial effects on seniors because they have little or no opportunity to recuperate from their losses. In Alberta it was reported that VLTs and casino gambling are partly to blame for the huge 15% bankruptcy rate among seniors. Similar to substance addictions, gambling may start out innocently as a social engagement, but for some people can progress into a solitary activity, then into a habit, a secret, a loss of control and finally, an addiction crisis.

Among older gamblers who file for personal bankruptcy, most view their problem as a financial issue rather than one of addiction and therefore do not seek the help they need. Compulsive or pathological gambling extends beyond losing money -- the disorder interferes with normal life activities and responsibilities, threatens physical health, sabotages reputations, and leads to psychological distress, and often suicide. Though the reported percentage of seniors with gambling and substance abuse issues is low, many hide their problem due to shame of straying so far from their deep-seeded cultural values of hard work, frugality and moderation.

If you know of a senior who may have a gambling problem, I urge you to help them get help by calling the Problem Gambling Help Line at 1-888-347-8888. To learn more about the dangers of gambling, visit www.GameOverVLTs.com/help.htm

Thanks to Age-Friendly Business for assistance with this article. Article by Alex Handyside, CPCA homecare@scotiacare.com, www.ScotiaCare.com