An interesting phenomenon

We take note of all the details of a disease and yet make no account of the marvels of health.
MARIA MONTESSORI

This is quoted in Zeigel's book 'I'm Still Here'. It came to mind when I was taking part in a discussion on an online forum about a common phenomenon (we know it's common as many carers have reported it) which occurs when a person with dementia is confronted with a professional or, less commonly, with someone they don't know, and puts on a 'public face' presenting themselves, quite convincingly. as 'fine', as a person who has no particular problems.

This is understandably frustrating to carers, particularly those who know that when they are alone again with the person they care for, they will have to endure aggression and, sometimes, physical violence. It's also frustrating if they have anticipated that when the professional sees the real problems, useful support will be forthcoming (of course, a positive outcome is by no means guaranteed even if the real problems are observed!).

I was interested in the fact that these brain-damaged people, whose behaviour is normally reckoned to be entirely beyond their control, are apparently capable of deciding on some level to be on their best behaviour, sometimes throughout a lengthy conversation. (It's very common for people, with and without dementia, to answer that they're fine when asked how they are, but we're talking about something much more elaborate).

Whilst recognising the frustration, I was surprised that people didn't seem to realise how remarkable this was. If a person can have this control in some situations, why not in others? Could we, perhaps, persuade them to behave differently in other situations?

Anyway, I was reminded very strongly of the Montessori quote when I read some of the discussion. 

Are people with dementia capable of new learning?

Yes!

Despite the fact that it's often stated that they aren't, my own experience tells me different. During the course of S's illness she has had to adapt to all sorts of changes. Sometimes, this has proved more difficult than at other times, but new learning has certainly taken place. Several years ago, we bought a motorhome. We have travelled over 30000 miles in it and have recently returned from a trip to Italy. S has had to learn all kinds of things as a result from, as an example, how to get into it (you have to climb up, rather than lower yourself into your seat as you do with most cars) to how to get onto the bed  -  from one end rather than the side.

But forget about S. It had already occurred to me that when people go into care homes it takes them a while to 'settle in' but after a time they nearly always do. What is settling in but new learning  -  new people, new procedures, new routines, new furniture, new toilets etc, etc, etc?

I was therefore heartened to see that John Zeisel in his book 'I'm Still Here' makes exactly the same point. His example involves a resident who gets angry when someone sits in 'her chair'. Other residents know it is her chair and know what her response will be. They have learnt, just as she has, that it is her chair.

Of course, there will come a point when new learning may be hard to see or non existent.

But there is all the difference in the world between treating someone as incapable of learning anything new, and treating them as potentially open to learning from new experiences, like most other human beings.

I read on an online forum, 'as is well known, people with Alzheimer's are incapable of new learning'. Like many of these well known 'facts', this is actually another of the all too prevalent and damaging myths about the condition