Dear Kerry,
My 7-year-old son sees my grandmother three or four times a year. She has been gradually declining as a result of Alzheimer’s. Over the holidays Zach saw several incidents where she was angry and irrational. Since then he has been worried about her and seems generally kind of tense. I don’t know how to talk to him about this.

-DP, Ontario

Dear DP,
I am so sorry to hear of the distress your whole family must be experiencing as your grandmother suffers the ravages of this illness. It is hard at any age, but kids find it especially confusing and worrying to see a beloved grownup unable to manage ordinary tasks. Sometimes it helps parents come to terms with things when they take on the task of explaining to their children, but none of it is easy.

The first thing to do is acknowledge to Zach what he saw. He may need you to put into words how scary and weird it might have seemed to him. Zach will be relieved to know that it’s all right to notice the changes, have reactions and to talk about them.

Most children Zach’s age have already been thinking about aging and death, but they have lots of fears, fantasies and worrying theories that can resurface when triggered by some real situation. Since it’s hard for them to imagine the whole span of time, they are scared that bad things will happen to themselves or to their parents in the present or near future. So the second issue is to clarify that your grandmother’s illness has come to her only now that she is very old and has lived her full life. Zach is not in danger of this happening, and you and his dad are fine now, too.

You might then explain that her behavior comes from changes in her brain that don’t happen to most people and that she couldn’t help either. As her illness gets worse, there will be more changes. She may have more trouble managing her feelings. You can also describe how her ways of remembering will be different. Maybe now it’s already hard for her to remember daily things from the present, but she may still remember old times and songs and stories from when she was little. If she is still well enough, you might create good memories for Zach to hold on to by singing together with his great-grandma.

Reading stories often gives a child a safe enough distance to experience his feelings without being overwhelmed. That is particularly true for young schoolchildren, who have just achieved mastery of their feelings and worry that it’s babyish to get upset. Amazon.com has a whole page of books about Alzheimer’s for children, and your local library may be an excellent source of advice and information. As more people have been affected by Alzheimer’s and other forms of dementia, resources for information and support have grown accordingly. There are excellent online discussions of ways to talk about these illnesses with children of different ages, for instance, at
http://alzheimers.about.com/lw/Health-Medicine/Childrens-Health/Talking-to-Children-about-Alzheimers-Disease.htm.

In the meantime, you may perhaps comfort Zach and yourself with the idea that, even when your grandma can no longer remember your names or recognize you, she will feel your love the way Zach can feel the sun on his face.

Kerry Kelly Novick is a local child, adolescent and adult psychoanalyst, affiliated with the Michigan Psychoanalytic Institute and the Michigan Psychoanalytic Council. She is a founder of Allen Creek Preschool and author, with Jack Novick, of “Emotional Muscle: Strong Parents, Strong Children,” available through http://www.buildemotionalmuscle.com and at amazon.com. She welcomes your email with comments and questions for future columns at kerrynovick@gmail.com. The ideas and opinions in this column are Kerry Kelly Novick’s and do not necessarily represent the views of Allen Creek Preschool, MPI or MPC.