As Alzheimer’s disease progresses into its middle stage and later, word-finding skills diminish and meaningful verbal communication becomes increasingly impaired or even nonexistent. The thoughts, desires and emotions of a person with AD still remain, but how can a caregiver discern what they might be?
The answer may, in part, be located in the research and writings of Charles Darwin; specifically, in his book The Expression of the Emotions in Man and Animals, first published in 1872, and long regarded as a seminal work in psychology. Here, Darwin makes the case for the instinctual or inherited nature of the facial expressions and body language that accompany our simple or primary emotions—anger and fear, surprise and disgust, joy and sadness, and other more complex emotions, too. Darwin terms these facial expressions and body language “the language of the emotions,” and deems them a product of natural selection, a process of evolution.
For the most part, the simple emotions are generally easily detectable to an alert observer, but complex emotions—for instance, grief, indignation, helplessness, cheerfulness and perplexity—are more subtle, less well known.
The facial expressions and body language that accompany the simple and also the most important of the complex emotions are instinctual or innate, but a few, such as weeping and laughter, require repetition by an individual to achieve their fullest expression. Others, like the act of devotion, are first adopted by imitating other family members and later become habitual with practice and the passage of time. A person in a devotional or prayerful state of mind often lifts his or her eyes upwards or skywards, and presses the palms of their hands together.
Stephen Nash holds an MD from SUNY Buffalo and a Masters of Public Health in epidemiology from Emory University. He is the co-author of “Putting Evidence into Practice: Palliative Care,” a British Medical Journal report, and “Reclassification of Simvastatin to Over-the-Counter Status in the United Kingdom,” published in the American Journal of Cardiology.