The Internal Clock
A “sense of time” is formed by multiple memories which create an “internal clock“ that tells us when it’s time to get up, go to work, have lunch or go to bed. We do all these things because we’ve formed a memory in our “internal clock.”
Most of us take our “inner clock” for granted, yet our daily schedule is regulated almost entirely by a “sense of time” created by memories.
We know what day it is because we know what happened yesterday. We know what time it is because we just woke up and know we’ll be leaving for work soon. When someone with Alzheimer’s or Dementia is unable to remember yesterday, or last night, or 5 minutes ago, he doesn’t know what day it is. And, he will not have a “sense of time” to tell him what will happen a few moments from now or hours from now.
When you leave a person with Alzheimer’s or Dementia alone for an hour, they may believe you’ve been gone for days, weeks or even months because they don’t remember an hour ago, or a week ago or a month ago. Short-term memories from a recent past must be retained to have a “sense of timing” for what will happen next in the future.
When my Mom was in the nursing home, I visited her daily. Yet, Mom would complain that she hadn’t seen me in a year. Because the last time she remembered seeing me was the year before, her “sense of time” told her I hadn’t been there since that visit.
She had no memory of the daily visits since that time a year ago. All of her recent memory was gone, destroyed by Alzheimer’s. Since Alzheimer’s prevented the recording of new memories, Mom could only remember the visit from the previous year. Her “sense of time” was skewered. Her “internal clock” no longer working properly.
Missing short-term memories not only causes “loss of time” and the inability to read the hands on a clock, but also creates havoc with any sort of scheduling. Without knowing that you had breakfast a few hours ago, you will not know when it is time for lunch. If you don’t remember that you just woke up from a night’s sleep, you won’t know it’s time to take your medication, or shower, or brush your teeth, or get dressed.
All scheduling is affected by a “sense of time;” when to eat, when to sleep, when to wake up. Losing a “sense of time” causes great confusion and frustration for the person with Alzheimer’s or Dementia and fosters some of their odd behavior seen by the caregiver.
As the holidays near, I’m reminded of the last holiday season before my Mom was diagnosed with Alzheimer’s. The entire family was confounded by her odd, and seemingly rude, behavior on that special Holiday weekend. In hindsight, Mom’s “sense of time” was gone then, even before her diagnosis of Alzheimer’s several months later.
On that holiday, I was up early for the long drive to get Mom and bring her back to our house for the weekend. There would be grown Children, Grand-Children and Great-Grand-Children. The entire family was overjoyed that we’d all be together for this holiday, four generations. I had my digital camera ready to take photos and document this holiday with four generations of our family in-tact.
The first surprise came when I arrived at Mom’s house. She was in her gown and pretended no knowledge of a holiday weekend at all. I was slightly furious as I packed her bag while Mom showered and got dressed.
Then I drove back to my house feeling hurt that she could have forgotten our planned celebration. Then, less than an hour after our arrival, while I was still trying to schedule baking times for cakes, pies, dressing and dinner rolls, Mom entered the kitchen and whispered in my ear.
“Can you take me home now?” “What?” I frowned, still tasting the bitterness I’d felt earlier because she hadn’t showered, dressed or packed for her visit to our home when she knew I’d be arriving early.
“What do you mean? Did you forget something?” I could only assume that she’d forgotten something and wanted me to make another trip across town to her house. She was shaking her head.
“No. I didn’t forget anything. I want you to take me home?”
“Mom,” I put my arm around her. “You’re staying here for the weekend. Remember? All the kids are here…the grand-kids…”
She looked puzzled. “Oh no, I can’t stay for the whole weekend. I’ve already been here too long. I want to go home now. I want you to take me home right now.” She began tugging my arm as she headed for the door.
“Mom…” I tried to pull away. “You just got here. You haven’t been here an hour yet.”
“Oh come on–” she gave me a hard jerk and headed to the door. “I’ve been here all day, I’m tired, I can’t leave my place empty, someone might break-in. I’m going home.”
Suddenly my gentle, little Mom was gruff and demanding. I didn’t know what else to do but obey. My husband gave my Mom a ride home and I cried myself to sleep that night because she had missed all the planned festivities.
I didn’t know my Mom had Alzheimer’s yet. I hadn’t been forced to make any decisions for my Adult parent yet. I hadn’t learned to question my Mom’s behavior or disagree with her. I hadn’t learned to tell her, “No.” As I look back now, I can see that Mom had already lost her “sense of time” and yet, it would be many months before she was diagnosed. So that leaves me wishing I’d been kinder, or more understanding, or more aware.
So know the symptoms of Alzheimer’s and Dementia. Educate yourself about what happens as it progresses and be prepared to cope with behaviors that your loved one has never shown before. And most of all, Learn to love them anyway because they have no knowledge or understanding of the unconscious changes that are happening to them.