ALZHEIMER’S AND SELF ESTEEM

Self-esteem is a measure of how you feel about yourself.  Do you feel strong, competent, confident?  Or weak, incapable, insecure?  Does your life build your self-esteem up?  Or tear it down?

I think we all struggle with our feelings of self-esteem at some point in our lives.  Remember that awkward transitional phase of your life when you were in junior high?  I remember feeling alternatively too skinny, to heavy, not smart enough, too smart.  But, with the love and support of family and friends, it’s possible to come out the other side of that period, feeling more confident and in charge of your life.

That’s the thing about self-esteem.  It’s really about your own feelings of self-worth.  But those feelings are hugely impacted and often complicated by the messages you receive from other people.  Messages that can build you up, even when things go wrong…”Don’t worry, you’ll get the next job.”  Or tear you down…”What did you do in the interview that cost you the job offer?”.

Like all of us, Deena struggled with her feelings of self-esteem during different times in her life.  In truth, she was a strong, intelligent, compassionate woman with more natural insight into the world around her than most people.  And she was used to succeeding, through hard work and her life-long interest in learning. 

And then came her Alzheimer’s diagnosis.

The activities that she once excelled in, cooking, gardening, reading, connecting with people, became more difficult and finally impossible.  Her inability to follow a simple recipe left her frustrated and discouraged.  The change in routine from Deena being the head chef, with me as her trusty assistant, to me as the main cook was a blow to her self-image.

She had always prided herself on her appearance.  She wanted to wear cute clothes, have a good, fashionable hair style and loved it when the occasion called for make up and jewelry.  Every morning, before she came into the living room for the first time, she brushed her teeth, washed and moisturized her face, brushed and sprayed her hair and put on lipstick, even though she was still in her bathrobe.  The day she forgot her lipstick I knew that things had taken a significant turn.

So, when Deena’s disease started to rob her of the things that make her feel good about herself, I knew that I hard to work harder to fill that void.  I tried to be consciously aware of how my words and actions would build up her and worked really hard not to say or do anything that would make her feel any worse about herself than she already did.  I wanted Deena to feel loved and respected for the person she still was, even when her decline so clearly impacted her life.  

I worked hard at giving her positive messages:

  • “You look adorable in that outfit.”
  • “Honey, the tile that you chose for the floor throughout the house was the best decision we made during construction.”
  • “Your garden looks beautiful. Thanks for deadheading the flowers so we always have new blooms.”

And although I didn’t succeed every time, I tried to avoid negative messages:

  • “That pan doesn’t go in that drawer.”
  • “Those pants are too big.”
  • “Remember, I told you that already.”

At one point, Deena was in Physical Therapy in hopes of increasing her strength and decreasing her risk of falling.  By that point, her walk had really deteriorated to a shuffle.  The Physical Therapist, a woman that we both really liked, wanted Deena to pick up her feet when she walked, “heel toe”, “heel toe”, she would remind Deena during the therapy sessions.  Certainly, an appropriate Physical Therapy goal.

The therapist wanted me and our caregiver, Lorena, to also remind Deena to pick up her feet, “heel toe”, “heel toe”, each time we walked with her.  While it made sense to me that, during a 45-minute therapy session, Deena was constantly reminded to pick her feet up, I wasn’t willing to have Lorena and me constantly repeating “heel toe”, “heel toe” as we walked with her from the living room to the bathroom.  

I mean really, who wants to be reminded literally with every step they took that they were doing it wrong.  And no matter how much ‘reminding’ we did, Deena’s disease made her incapable of ever walking normally.  If she could have, she would have.  Deena deserved more respect than that and her already crumbling self-esteem couldn’t and shouldn’t have to absorb the constant negativity. 

So, I told the Physical Therapist that I had instructed Lorena that we weren’t going to follow the PT instructions.   Lorena and I made sure Deena used her walker and we were her biggest cheerleaders when she would inadvertently take 2 or 3 consecutive non-shuffling steps, but we were not going to be the walking style critics/nags/police.

For me, the bottom line was determining what was in Deena’s best interest.  Would she be better off maybe picking her feet up a little more frequently with our constant reminders, at the price of feeling increasingly worse about herself?  Or would love, support and appropriate precautions that kept her safe while making her feel more normal in something as simple as walking be better for her in the long run.  

I knew what side I came down on.  In the long run, no matter how much reminding I did, I couldn’t stop her walking from declining further.  That’s an unfortunate and natural part of the disease.  But I could help make her feel a little better about herself, a little more positive about her life by focusing on her self esteem and feelings.