Many family members and friends of individuals living with dementia are striving to wrap their heads around the concept of what is happening in the brain.
In the Caregiver education series I avoid those pictures where a cross section of the brain is envisioned like a shrinking head of a cauliflower: this powerful imagery is overwhelming.
In discussing the transmission of information through the brain cells and the subsequent changes in Alzheimer disease, I find the use of a rope is simple and impacting.
In my first lecture of a series, the audience is generally feeling a bit wary and anxious, so I try to find ways to inject humor and analogies into a difficult discussion to improve the learning experience.
When I produce the rope: about 10 feet in length, eyes widen. I love soliciting an intrigued audience member to join me. That bit of trepidation, and nervous laughter from a “captive” audience creates a memorable moment. This is exactly what I look for when discussing a disease that affects our ability to remember.
The participant is asked to hold their hands in front of them, arms outstretched, thumbs up, about 10 inches apart. As I wrap the rope in a loop from one hand to the other: essentially back and forth, I talk about brain cells.
I use the rope to explain that the brain cells are communicating through pathways relaying information throughout the brain. We talk about the smooth transmission of information along these pathways; the end result allows us to think, act and move with purpose. Everyone agrees that there are no interruptions to the flow as the rope travels back and forth between the hands. Essentially we are peering into cellular activity within a brain unaffected by disease.
To explain the changes in Alzheimer disease, I start to weave the rope between the smooth lines. As the rope is woven in and out randomly, those once perfectly straight lines are now affected by a mass of tangles.
In Alzheimer disease, the brain cells are affected by plaque formation. Thread like tangles weave into other cells affecting function.
Visually, the participants see how the smooth flow of the rope (information) is now interrupted. These changes or interruptions impact our ability to feel, think, remember, and interpret sensory information.
This simple visual cue creates that “aha” moment I am aiming to achieve.
This interactive presentation example is consistently recalled later in the series. The care partners retain the information and basic concepts.