Age disorientation, liminality and reality: The case of the Alzheimer's patient

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Abstract
“[Time] is a man‐made notion which we have projected into our environment for our own particular purposes” (Leach 1979:227). Although time is a structuring principle by which reality is ordered, it is difficult to understand. Time is measured and validated by clocks, calendars and sequence of events, but it can also be created and changed in memories, dreams, thoughts, reminiscences and speculations. It can be suspended, wasted and killed, but inevitably time determines reality. One who markedly alters time and reality so as not to be compatible with the surrounding social milieu is thought to be abnormal. As Alzheimer's victims Suffer from age and time disorientation, it is instructive to ask if such misrepresentations reveal a logic and insight into the patients’ perceptions of reality. Taking a cue from Turner (1969; 1974), the examination of the apparent abnormal behavior of self in chaos presented by the Alzheimer's patient, although seemingly superficial, reveals a complex phenomenon with a deeper structure of logic and organizing principles. The purpose of this paper is to present a discussion of the structure of reality fabricated by Alzheimer's patients who are afflicted with age and time disorientation and how this impacts on families. It is the contention of this author that this contradictory reality has a logic which is understandable if examined in light of the patient's past experiences. This explanatory approach offers a rationale and structure for an understanding of problematic behaviors, and using Turner's (1979) paradigm, it also shows a connection between the condition of the altered physiologic state and the emergence of a liminal state. Moreover, it examines the position of reality therapy used as a tool in the care of the Alzheimer's patient by comparing the reality of the patient's liminal time to that of the care giver's present‐time orientation.