Alzheimer's Patients and Their Need To Be Included: The Need To Be Loved:

Do Alzheimer’s patients have a need to be included? 

Of course, they do, just like everyone else.  Because Alzheimer’s patients can be in different stages of the devastating disease, it is important to be aware of the symptoms that occur in these stages. Their need to feel included can vary depending upon their level of awareness. 

The article, “About Alzheimer’s Disease: Symptoms”, identifies three different stages as “an early, pre-clinical stage with no symptoms; a middle stage of mild cognitive impairment (MCI); and a final stage of Alzheimer’s dementia.

At what point do Alzheimer’s patients lose their awareness of not being included?

There is no easy answer to that question, as every patient is different.

In the early stages of Alzheimer’s disease, patients will have awareness with respect to being included, rather than excluded by their family and friends. Exclusion by others could be devastating for them.    

In the mild Alzheimer’s disease stage, the changes in mood and personality are unpredictable. Alzheimer’s disease may make it difficult for them to relate to others, as well as for others to relate to them. Family and friends may try to include them, but depending upon the mood the patient is in, the attempt to include them may prove futile. This can be frustrating for everyone.

Family and friends will gradually begin to realize that including the Alzheimer’s patient in the same way as before, gradually becomes less and less feasible.

The patient may have good days where he or she has awareness with respect to being included, but it is just as likely that on other days, there is limited awareness. When there is awareness, there may be little or no response, but these patients still need to be included. Being included is an emotional need that everyone has. 

Remember that depression may be a factor and the patient may assume a non-caring attitude with respect to being included

In the moderate stages of Alzheimer’s disease, because of increasing memory loss coupled with confusion, as well as difficulty recognizing family members and friends, being included becomes increasingly difficult. When there are hallucinations, delusions and paranoia or bouts of radical, impulsive behavior, the patient may not have the awareness of being included. Family members and friend may hesitate to try to include them.

Being included is one way of demonstrating the reality that family and friends continue to love Alzheimer’s patients regardless of their illness. Being included may not be part of the patient’s immediate reality, as awareness may come and go at any stage, but it is equally important for family members and friends to know they have attempted to include Alzheimer’s patients, even though the response is not what they desired or expected.

With severe Alzheimer’s disease, there is limited awareness or communication from the patient with respect to being included or not being included among family members or friends. When there is awareness, the patient may not be able to communicate that reality, even though he or she may try to do so. At the same time, continuing concern, care and compassion on the part of family members and friends is important. Remember that communication occurs on many different levels.

Ongoing research into Alzheimer’s disease will continue in the future and it is highly likely that many new discoveries in terms of awareness will surface.