Words and pictures

Mom is officially enrolled in a new research project, her first in about two years. She participated in two drug clinical trials, one of which ended early for her when the nurses at the assisted living facility neglected to administer the experimental drug for more than two weeks – a bummer for the doctor running the study. But it’s water under the bridge now, the result of a misunderstanding. I later learned by reading a news article that the drug in the second trial was determined to not be helpful to Alzheimer’s patients. Sad news, but still important to know.

This new study is very different. I will assemble two memory posters that contain pictures of important people from Mom’s life, including Mom herself. One poster will have photos only. The second will include text that accompanies each picture – more than just names, but a little sentence describing the role the photographed person/people had in Mom’s life. The researcher, from Ohio State, aims to find out whether the added words contribute to dementia patients’ understanding of what they’re looking at. In Mom’s case, I really don’t know what to expect in terms of her comprehension. Even though she still talks pretty well, she doesn’t really seem to have much understanding of what is going on around her, and she certainly seems to have no solid memories from any part of her past.

I sat in on the researcher’s first meeting with Mom. I missed part of it while I ran to get Mom a jacket because she was cold in the Alz center conference room. When I got back, the researcher was asking Mom to read a sentence on a piece of paper and then follow the instructions implied in the sentence. “Close your eyes,” Mom read. But she could not comprehend that she should close her own eyes. The researcher showed Mom a drawing of two interlocked boxes and asked Mom to draw the same picture. Mom drew a single box. She asked Mom to describe what she saw in various pictures. “A house,” Mom said. “I don’t know her,” she said about the next one. “It’s a woman,” the researcher said. At one point, the researcher asked Mom to read something on the page in front of her and Mom said, “Goodbye.” That is not what the paper said. I think Mom was just about fed up with the questions. In fact, Mom was just a little disagreeable throughout. She has never liked the mental testing that has gone along with her illness. The researcher said that is common. She knows not to take anything personally.

The researcher then just tried to chat with Mom a little bit. She asked Mom if she had any children. “I don’t think so,” Mom said. She pointed to me and indicated she knows I belong to her, but she has not really understood our relationship for some time. “Did you go to college?” the researcher asked. “No, I don’t think I did,” Mom replied. “Did you meet a sweetheart at some point and get married?” “No,” Mom said. I was squirming with all the inaccuracies. Mom has a bachelor’s in social work. She was married for 11 years. I am one of her three children. But the researcher said Mom’s responses were not really important – she was just gauging whether Mom can converse and understand that questions she was being asked were intended to have a response of some kind. “Did you have any brothers or sisters?” “A sister and a brother,” Mom said. This might be the closest thing to correct. “You have a sister and a brother-in-law,” I said.

As part of the study, Mom will be asked to discuss the photos and captions, and then she will be distracted for a little while and then return to the photo discussion. The researcher asked if Mom had any hobbies. I misunderstood at the time that she was trying to come up with distraction exercises for this portion of the study. “She was a big reader,” I said, forlornly; the fact that she was such a big user of her brain makes me sad sometimes. “An intellectual, really, who just liked to discuss things.” But then I realized what she was getting at, and I apologized for getting off track. For the study, I suggested puzzles might work, or a discussion about cats of some kind. Maybe pictures of cats. And perhaps a coloring book.

A nice thing about this study is that Mom will be visited a few times by a young student who will tape-record her discussions with Mom about the posters. The tape recordings will be analyzed to determine differences in Mom’s comprehension of the pictures. Mom will enjoy the visits, I’m sure, as long as they don’t feel like tests.

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