John, a sophomore on the varsity track team, suddenly began missing practice. His parents no longer attended school events. When walking home from school with friends, John became anxious if they started walking toward his door. He offered excuses for not inviting them into his home. Friends and teachers ultimately learned that John's grandfather had moved to the family home because he had Alzheimer's disease and could no longer live independently. Care of the grandfather demanded extensive family time. Additionally, John was uncomfortable with and embarrassed by his grandfather's unpredictable behavior.
Beth, who was eight, adored her grandmother, and frequently told stories about special times they shared. A teacher became concerned when Beth exhibited symptoms of childhood depression. The teacher observed that Beth seldom talked about her grandmother. He inquired about possible family changes or deaths; however these inquiries elicited no explanation for the change in Beth's demeanor. When the teacher asked students to interview a grandparent for a class assignment, Beth began to cry. She did not know how to explain that her grandmother was living but that she could not answer the questions. As a third grade student, Beth was frightened and confused by her grandmother, who no longer knew her name.
Approximately 4 million Americans are afflicted with Alzheimer's disease (Alzheimer's Association, 1996); 70% of these persons rely on family and friends for their primary care (Alzheimer's Association, 1996). Trends suggest that the prevalence of Alzheimer's disease will increase dramatically unless medical interventions can be discovered (Alzheimer's Association, 1996). From these statistics we can extrapolate that large numbers of American youth have grandparents who have Alzheimer's disease. Grandchildren of persons with Alzheimer's disease are often called upon to assume additional family responsibilities. At the same time, they must share parental nurturing and care with the grandparent (Arshonsky, Adelstein, & Stauber, 1988).
Students seldom approach a school counselor with, "My grandma has Alzheimer's and I'm confused." Indeed, this silent group of students and their families invite school counselors' sensitivity and assertive attention. Increased awareness of the challenges, experiences, and difficulties encountered by grandchildren of persons with Alzheimer's diseases will empower counselors to recognize their needs and respond with greater efficacy
This article is proffered to heighten school counselors' sensitivity to the unique challenges and losses students may encounter when their grandparents have Alzheimer's disease. It features basic information about the disease, suggestions for proactive and respondent interventions, and resources to assist counselors in these endeavors.
Alzheimer's disease was first diagnosed in 1907 by a German physician who recognized altered brain tissue in a deceased mentally ill woman (National Institute on Aging, 1995). Since that time, scientists have pursued causes and treatments for this complex disease that interferes with intellectual processes. While research has resulted in tentative medical interventions that temporarily reduce symptoms, neither conclusive identification of causes nor a cure is available (Alzheimer's Association, 1997a; National Institute on Aging, 1995).
Experts in the field suggest that "Alzheimer's patients' brains are dying" (Dementia Education and Training Program, 1995, p. 12). Alzheimer's disease destroys brain cells that contain intellectual functions such as memory, words, understanding, and emotions (Dementia Training Program, 1995). Thus, initial symptoms are usually related to forgetfulness and confusion (Alzheimer's Association, 1997a). The disease gradually manifests itself in (a) loss of memory, (b) diminished ability to communicate, (c) impairment of motor functions, (d) fluctuations in mood, (e) changes in personality, and (f) decreased judgment (Dementia Training Program, n. …