Why people with dementia do the odd things they do can seem like an unsolvable riddle. But with a basic understanding of how the brain operates, we see patterns that are less random than they may seem.
The human brain is a vast, four-pound wilderness that continues to defy thorough explanation. The brain is made up of one hundred billion cells – yes, that’s billion with a B, even for those of us who may have killed off a few over the course of time.
At a hundred billion in number, is it any wonder that brain cells have no trouble hiding answers as to how and why they operate? All is not lost though. From centuries of examination with lots of trial and error, there are a few things we do know on the subject.
Different regions of the brain are called lobes. You can break these down to quite a long list of sections. We are concerned with the six biggies: frontal lobe, temporal lobe, parietal lobe, occipital lobe, the cerebellum and the brain stem. Each lobe or region carries out distinct operations.
When disease hits the brain, we can guess where the damage is by which operations are affected. For example, vision changes could indicate damage in the occipital lobe, the area that controls vision. Personality changes point to both the frontal and/or the temporal lobes being diseased.
To understand some of the changes we see in the person with brain illness, we need an understanding of the functions of each region of the brain. Don’t panic that this is getting complicated. One advantage of having gotten a D in anatomy and physiology in college is I learn to adapt simple definitions and explanations. Sharper brains than mine have developed a diagram that helps us understand brain operations.
Another axiom on how dementia develops is that brain illness may start in any region, but it then marches through the rest of the brain. Alzheimer’s Disease (AD), for example, is believed to begin in a part of the midbrain that controls memory.
As the disease progresses, surrounding cells are damaged. Surrounding cells of each diseased area are damaged until the process reaches the parts of the brain that keep us alive. It may take a few years or a few decades for this process to come to completion. It may progress in a stairstep fashion with periods of plateau followed by “sudden” drops in function. Unfortunately, predicting a timeline is almost impossible to do accurately.
Part of the difficulty in treating brain illnesses that cause dementia is that with 100B cells, the brain can cover for a very long time before function starts to decline. So by the time we see changes in a person, their brain has been under assault for quite a long time with irreversible damage already done. Hence, we have the difficulty in stopping the disease rather than merely slowing it down.
Here’s an exercise that might help this information gel in your brain. Make a scribble list of changes you see in the person living with dementia. Then compare that list to the functions described in the brain diagram we are using. When you see a match between change and brain region function, you can guess that this is a region of the brain that is damaged and diseased.
I would love to hear how this simple exercise worked out for you. Did it make sense? Did it shine a light on some of the problems you see? Let me know in the comments if you will.
Wishing you peace, hope, and courage,