The Troubled Brain

THE TROUBLED BRAIN - Installment 2

This installment of The Troubled Brain focuses on some observations from a caregiver's point of view. As a caregiver of someone who had Alzheimer's disease and someone who has experience with another person with aphasia, the "look" of the two brain injuries seem the same at first but after extended time with both are very different beasts.The Troubled BrainAlzheimher's disease is the crumbling of mental capacity which largely effects memory.Primary Progressive Aphasia is the crumbling of the area of the brain where communications skills reside.

The Troubled Brain and Signs of Alzheimher's (10 symptoms listed on Alz.org)

The Troubled Brain - Alz.org

  1. Memory loss that disrupts daily life
  2. Challenges in planning or problem-solving
  3. Difficulty completing familiar tasks at home, at work, or at leisure
  4. Confusion with time or place
  5. Trouble understanding visual images or spatial relationships
  6. New problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment
  9. Withdrawal from work or social activities
  10. Changes in mood or personality

What I noticed with my mom was a heightened sense of paranoia. All the symptoms listed above were present in her as well.

What I saw in Mom

The Troubled Brain - dementiaThere was the time when she asked me If I'd seen two electricians leave her home (this was before we moved her into our home). She'd said the electricians had come into her house, messed around in her bedroom. Then she said, they'd stolen checks from her checkbook.Before that, people were trying to steal her identity. They'd gotten her social security information because of a hacked database at Phoenix College. The hacked database actually happened but mom hadn't attended Phoenix College since the 60's. She'd not lived in Phoenix for over sixteen years.Then, after we moved mom to our home, she became aggressive. She was confused and scared. She called me names. She'd yell at me. At one point, she swung a fist at me. Albeit, possibly the slowest swing in recorded history but, nonetheless, you can imagine her level of aggression and anger to actually try to hit someone in anger.You can find more examples of what to expect from a person suffering from Alzheimer's in The Dementia Chronicles. There are twenty-five installments to The Dementia Chronicles.

The Troubled Brain and Signs of Primary Progressive Aphasia (Aphasia.org)

The Troubled Brain - national aphasia organizationPrimary Progressive Aphasia (PPA) is quite different from Alzheimer's and dementia. It is a neurological syndrome where language skills slowly and progressively become impaired. And it's different from more temporary forms of aphasia which might occur because of a stroke or brain injury.PPA is a neuro-degenerative disease. Alzheimer’s Disease and Frontotemporal Lobar Degeneration are also degenerative but with PPA the results effect and deteriorate brain tissue important for speech and language. And, although the first symptoms appear in problems with speech and language, other problems will occur, such as memory loss later. So, it has the ability, and caregivers should expect, PPA to turn into dementia at some point.

... THE TROUBLED BRAIN ...

The Troubled BrainWhat I noticed in my person suffering with aphasia was this stall in response time.Now, you might be thinking, "Well, I don't always respond the second someone asks me something or says something to me."Sure. I get that. But a person with PPA stalls for quite a few seconds, say, fifteen to thirty seconds. The stalling out seems to show an absence of recognition--one, that a question has even been posed and, two, a comment was spoken.At first, I would ask, "Did you hear me?" My person would almost act surprised, like I'd jarred her out of a trance. She would nod, and then tell me that she had answered me, but in her head.This behavior went on for a good year and ran parallel to a time when I was still taking care of mom. To me, a non-medical person, it looked a lot like dementia. Because of my concerns, we went to the doctor. The doc started her on drugs for memory loss--Aricept and Namenda. After another year of absolutely no improvement in the "stalling out," we went back to the doc.This time I asked for further testing. He ordered a full set of blood work, memory testing, and imaging diagnostics. The results showed her memory was sound. But the diagnosticians saw a "fuzzy" area in the left frontal lobe, the area where communication happens.After that, we scheduled appointments with a neurologist who did a bunch more tests on her. The neurologist referred us to a neuro-psychologist who ran a battery of tests that took nearly three hours. Between both medical pros, they agreed her issue was not Alzheimer's but PPA.

Treatment for PPA

The Troubled BrainImportant Point to Know Before I go on...One important detail you should know is that a person with PPA does not have decreased intelligence. This can be contrasted with people suffering from Alz or dementia.Okay. About treatment options. Well, there's really nothing anyone can do (at this point) to treat PPA. By it's very name, we know it's progressive. But you can manage PPA. There are activities to do to mitigate the disease. First, you might think to start your person in speech therapy. It helps and you get an idea of how to practice treatment at home. But, the effect wears off if going only weekly or bimonthly. The brain needs constant training and will relearn from aphasia-centered exercises if done more often. If not practiced more regularly than once a week, the brain soon regresses back to where it feels comfortable, in this sort of silent fugue state.My person and I do two things:

  1. We use a set of flash cards called More Descripto Cards for Adult Aphasia. We got them on Amazon.com. They come with sets of instruction for each of five different levels, A through E.
  2. We also do word association drills. I say, "Breakfast." My person responds, "Eggs." You see what I mean. We do this for no more than 10 minutes at a time.

Because I am fairly new to speech therapy, I'm sure I will learn more exercises but, right now, this is what we do. And, we practice no fewer than five times a week, for no more than an hour at a time in total. And, yes. I have seen improvement.Note! What I have observed however is that when my person gets tired, the fugue signs are exacerbated. So, up to bed she goes. Naps are awesome for people with brain injuries, naps and tons of water and healthy foods. Exercise too.

THE TROUBLED BRAIN - IN CLOSING

Caring for people with brain injuries can be laborious but also rewarding. When I slow down, calm down, and focus on my person instead of myself, the going is so much more effective. Reading the Bible helps too! I need all the help I can get. One thing I have yet to do is to find a support group. There are no support groups specific to Aphasia on our tiny island so my next steps are to find an online group.Anyway, I hope these posts will help you too. For me, I often visit Alz.org for Alzheimer's and dementia, and have added Aphasia.org to my regular stops on the internet for information. Maybe these sites will help you too. God bless you.


I also write fiction and have several published novels. In fact, THE DEER EFFECT won six book awards. You can find all of my books HERE.