Everything we know about the world, says Suzanne Faith Baybutt, a psychiatric nurse consultant, we know because of memory.

A person suffering memory loss is like a stranger in a foreign country. "You don't speak the language, or know the currency, or where you are," Baybutt says. Without memory, she adds, "you are living truly in the moment." But that's a very hard way to live -- and frightening to both the person who is living that way and those trying to care for him or her.

Memory impairment is the cardinal symptom of Alzheimer's disease, a progressive, degenerative disease of the brain that gradually destroys mental capabilities. It affects an estimated 4.5 million Americans, a number that has more than doubled since 1980.

Baybutt, who has worked in Alzheimer's care for 20 years, will lead a program called "Understanding Alzheimer's Disease: Becoming a Better Caregiver " from 7 to 8:30 p.m. Monday at the Plymouth library. Through specializing in the management of Alzheimer's and related dementias, Baybutt said she has learned that caregivers need education in how to care for a loved one with the disease.

Memory impairment through Alzheimer's or dementia is qualitatively different from, and much worse than, simple forgetting. In Alzheimer's, she said -- borrowing an image from computers -- the "file" where the information is stored is erased and you can't get it back. "If you've lost the file, lost the connection, you don't know what it is." The person with Alzheimer's "is always living with an undercurrent of anxiety, never really sure where they are, or who they are, in any moment of time."

Alzheimer's and dementia are not the same. Alzheimer's is a specific disease, while dementia is a wider term for a group of 70 medical conditions that produce similar symptoms. Memory loss is a consequence of both.

But it's a mistake to attribute all memory impairment to Alzheimer's, and one of Baybutt's first advisories for caregivers is to make sure they get a medical diagnosis. Some dementias are reversible. Some are associated with depression and are treatable with antidepressants. If the diagnosis is Alzheimer's, one sad consequence is inevitable: it does get worse.

Family caregivers face the challenge of learning new ways to communicate with loved ones suffering from memory loss, Baybutt said. They have to "undo all the usual patterns of communication and learn new patterns of communication," such as nonverbal language, "to help the person feel good" and avoid bringing on more anxiety in the sufferer by insisting on old patterns.

"This is the biggest problem," she said. "Family members continue to want their parent and spouse to live in our world. And they can't anymore."

The "horrendous behaviors" people are likely to hear about people with Alzheimer's have often been prompted by caregivers, she said.

source: http://www.boston.com/news

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