Dr. Suratana Posts Case Study on Elderly Dementia Patient, Offers 6 Care Tips: Patient Not Being Difficult, But Lost in Time
A Chiang Mai neurologist shares insights on dementia care, explaining how elderly patients lose their sense of time and place rather than deliberately being difficult, and recommends prioritizing emotional comfort over correcting memory los
On May 3, 2025, Associate Professor Dr. Suratana Tanpravet, a neurology and brain specialist from Chiang Mai University's Faculty of Medicine, posted a case study about an elderly dementia patient. A daughter brought her 85-year-old mother for examination, whose dementia had progressed significantly. Each morning, the mother would wake up saying, "Father is waiting for breakfast," even though her husband had passed away five years prior.
Dr. Suratana explained that she frequently encounters such cases. In Alzheimer's disease, short-term memory deteriorates first, gradually erasing memories chronologically backward from the present. However, long-term memories and significant emotional events often remain intact.
When the daughter asked what her mother experiences when looking at the world, Dr. Suratana noted that patients experience what's called "temporal disorientation"—like a ship without an anchor, drifting through time with no fixed coordinates on life's map. Beyond memory loss, patients lose their ability to orient themselves in time and space. They become confused about what day it is, what time, and where they are—like being trapped in a dark room.
When the mother arrived at the clinic, startled by the bright lights and unfamiliar surroundings, her daughter gently asked: "Mom, what day is it today? Where are we? Tell the doctor." The mother's eyes searched, trying desperately to grasp something in this strange world she'd never encountered.
"A good day, a..." the mother said, then stopped.
"Yes, Mom, a good day," Dr. Suratana responded reassuringly.
There's no need to insist it's Monday morning—just knowing it's a day to see a familiar, kind doctor is enough. When the mother pointed and said, "Doctor is kind," Dr. Suratana replied, "You remember the doctor is kind, and that makes the doctor happy." She emphasized repeatedly that this isn't the time to correct or demand perfect memory.
At Chivacare Nursing and Rehabilitation Center, staff recognize that dementia patients may forget dates and places, but they retain memories associated with happiness. By designing activities and environments to be pleasant and joyful, caregivers prioritize what matters most: happiness.
The hippocampus, a brain structure resembling a seahorse's tail, functions like a filing system that marks when events occurred and their relationship to our life timeline. When this system deteriorates, memories don't just disappear—they become unmoored from the patient's internal calendar. Patients may ask, "Haven't I eaten?" even after finishing a meal, or "What time is it?" moments after being told, or "My husband is waiting" though he passed long ago—not from inattention, but because their brains can no longer anchor themselves to time.
Caregivers often become stressed, repeating information endlessly. It's important to understand that confusion and memory loss stem from neurological damage, not stubbornness. For patients, however, what matters most is feeling secure and not abandoned.
