How is it that most of us instantly recognize someone before they utter a sound? How can we can pick a certain individual out of a large group photo? Large
portions of our brain are dedicated to facial recognition and interpretation. What we see may trigger whole sets of emotions, memories, feelings, sounds
and even smells. A picture of my grandfather triggers the wonderful aroma of his ever present half-chewed-half-smoked cigar. I can't help but smile when
I see his face.
We automatically interpret others' facial expressions, but as people age or develop neurologic disorders like Alzheimer's or Parkinson's disease, they lose
their familiar range of facial expression. We look at or talk to our loved one and we no longer see what we saw before. People with Alzheimer's disease not
only lose verbal abilities, but also lose the ability to truly express their thoughts and emotions with their faces. In turn, we lose the ability interact
with them the way we did in the past.
So, how can we learn what lies behind their eyes? Has the light gone out? Dr. Potts insists, emphatically, "No." He
says, "We have to assure ourselves that our loved one is still with us, even though they don't always act like themselves. We do this by meeting them in
their present-day world. We have to be open to their new ways of communicating, and help them find novel avenues for this expression."
We tend to preserve a mental image of the person as they were prior to their illness, the way we've known them our whole lives. Think about when you
reunite with someone you haven't seen in 20 years. Before you meet with them, you have an image of them from 20 years ago frozen in your memory. You are
always at least a little surprised that, in reality, they have aged. You might recoil at the thought that they must be thinking the exact same thing. As
our parents age, we continue to see them as the people that we love and in the roles that they played in our lives in the past -- strong, supportive, and
On top of these innate feelings, we ground so much of our adult identity in our vocational accomplishments that without them, many of us lose all personal
identity. Of course, we don't want to be known only for our prior achievements. We want to be respected and admired for who we are now and what we
contribute to our friends, families, and society. Those with Alzheimer's are no different.
Dr. Potts insists that when illness strikes we must validate the person in the present and "learn to love and appreciate who they are in their
now." The person with Alzheimer's disease will not return to who they were so we must meet them and accept them in their new role. Dr. Potts tells family
members and health care professional that they must:
Discover who the people were by taking the time to learn their story.
Appreciate who they are now and see them as more than their illness.
Demonstrate for them their current worth.
Help them preserve their personhood and dignity.
Find channels for expression that bypass those blocked by their disease.
Help them "save face."