Fear & Reasoning
My husband and I woke to the sounds of a wrecker loading our neighbor’s truck at 2:44am one morning. Fear and panic overcame both of us as we sprang from the bed to see what in the world was happening. Were they being robbed? Had there been an accident? What was going on? Within just a few seconds my husband recalled an earlier conversation with our neighbor, and although it didn’t explain the timing, we were able to calmly figure things out. A quick walk over to talk with the neighbor, just to make sure, put our concerns to bed, so to speak.
This experience brought back memories of a consult with a family caring for their mom, who is living with dementia. News of the church shooting in Texas had scared her to the point they could no longer get her to go to church on Sunday. Fear of a similar incident happening in her own church caused great stress.
In another experience working with a resident living with dementia, “One afternoon I was startled by horrific screams coming from the room of Ms. S. As I ran from my office, I was met by staff from all over the facility running in the same direction. When we reached her room, Ms. S. was yelling for us to save her roommate because men were shooting her. We knew this wasn’t possible, but to Ms. S., it was real. Can you guess what was happening? There was a western playing on the TV. A simple channel change, and all was right on South Wing again!” (Excerpt from my article for Together in This “Fear is real, even when it’s not” – How to Acknowledge and Alleviate Fear in Dementia Care.)
Understanding the difference in the experience my husband and I had and the experiences of people living with dementia, falls squarely on understanding the brain and how it is affected by this disease.
According to “How the Brain Works”, put out by John Hopkins Medicine, the large part of the brain, the cerebrum, is divided in to two hemispheres, and four lobes, with the frontal lobe controlling “decision making and reasoning”.
When the frontal lobe of the brain is damaged by Alzheimer’s, the ability to reason and understand what is going on, then form a course of action, is impaired. When my husband recalled his conversation with the neighbor, we were able to put away our fears, check on our neighbor for good measure, then head back to bed. To a person living with dementia, who’s frontal lobe has been damaged, reasoning becomes impaired and being able to put aside fear and concern is no longer possible.
For a person living with dementia, news of a shooting that took place hundreds of miles away may seem to be happening right outside their window, while a shoot out on the TV may be so real, panic consumes the mind. With no ability to reason or solve the issue due to the damage to the brain, it is up to those of us providing care to step in, validate emotions, alleviate fears, and try to eliminate triggers that lead to the panic as best we can for the future.
To learn more about the brain, what each part does, and the affects of damage from Alzheimer’s, check out the Alzheimer’s Association’s “BRAIN TOUR”