"People still have their personhood at the core of who they are," said Dr. Peter Reed, senior director of programs at the Alzheimer's Association. "So the effects [of the disease] do not diminish the individual's need for social interaction, it doesn't diminish their need for dignity and meaning in their life."
Alzheimer's typically causes an individual to forget all but those they see near them regularly, he added. "So, people learn familiarity with the people around them," Reed said, and with that, "they become more comfortable."
The persistence of emotional needs after declines in memory makes some sense on a neurological level, another expert said.
"The Alzheimer's pathology starts in the memory and learning areas of the brain and then spreads," said Dr. Gary Kennedy, director of geriatric psychiatry at the Montefiore Medical Center in New York City. "The direction and extent of the spread varies tremendously from one person to the next. For some, their thinking and memory are largely gone, but their emotional expressiveness may be relatively intact."
Emotions may often be less guarded as Alzheimer's advances, with people showing less reticence to express affection, he added. "In some instances, emotional expressiveness may be augmented by the illness -- in other words, inhibitions may be taken away," Kennedy said.
Sexuality can enter the mix as well, and that's where relationships between Alzheimer's-affected patients get more complicated, Schempp said.
Depending on a person' level of cognition, "there's a kind of moral-ethical issue as to when someone can be consensually involved," she noted. "Some nursing homes just categorically say no, other nursing homes work on it on a case-by-case basis. Some nursing homes say no because the families object, and some nursing homes say yes because the families are OK with it."
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