Sabat Flips the Script on Alzheimer's, Dementia

A younger woman helps an older woman with an arts and crafts task
The cover of psychology Professor Emeritus Steven Sabat's new book, which approaches Alzheimer's and dementia by exploring the subjective experience of those affected rather than the clinical dimensions of the disease.

February 2, 2018 — Steven Sabat, a Professor Emeritus in the Department of Psychology, taught on the Hilltop for 40 years before retiring from the classroom. He’s still teaching now, but to a new audience: His latest book on Alzheimer’s disease and dementia was published this week by Oxford University Press.

Alzheimer’s Disease and Dementia: What Everyone Needs to Know is the latest in an Oxford series that engages experts from a variety of fields to write easily accessible guides to their areas of expertise. Sabat — who has researched people with Alzheimer’s disease for 36 years and written extensively on the topic — was approached to write the installation on Alzheimer’s and dementia in 2016.

“The book took seven months to write, but the learning has been going on for three and a half decades!” he quipped.

REFRAMING THE DIALOGUE

The opening chapters of Sabat’s book answer basic questions including the neurological roots of dementia, which diseases can cause it, and what drugs have been used in its treatment.     

But unlike most modern books on the topic, Alzheimer’s Disease and Dementia does not stop with a focus on cutting-edge pharmacological research in search of medical treatments or cures.

Instead, it focuses primarily on reframing the dialogue around people who experience these symptoms — looking at those with Alzheimer’s and dementia as people rather than just as patients, and emphasizing their significant remaining social and cognitive strengths that can be engaged by their care partners to the advantage of all concerned.

“Just because you have certain kinds of difficulties, doesn’t mean you cease to be a person,” Sabat said. “People diagnosed with dementia have more in common with people who don’t than we generally assume. We have to remember the commonalities that we share.”

SIGNAL-DETECTION THEORY

Sabat describes treatment of people with Alzheimer’s and dementia as a classic example of signal-detection theory, the psychological phenomenon of information being interpreted in ways shaped by pre-existing ideas. If you expect to see pathology, for example, it’s hard not to see a person’s every action as being pathological.

“If a person lives in a nursing home and walks about in a common area, she’s described as ‘wandering,’” Sabat said. “But what makes her a wanderer? She’s not allowed to take a walk? We start with a disease-based storyline about someone, and every neutral thing they do is then labeled as a pathology to fit the storyline.”

The book is designed to be accessible to a broad audience, with a focus on relatives and caregivers of people with Alzheimer’s and dementia. But Sabat hopes that medical practitioners also take his book’s lessons to heart.

“Professionals can learn from this, too,” Sabat said. “Sometimes we construct illness even when it’s not there, and this is meant as a corrective.”

LESSONS FROM GEORGETOWN

Alzheimer’s Disease and Dementia’s humanist, narrative-based approach to understanding disease comes as little surprise to those who knew Sabat from Georgetown lecture halls, where his psychology classes often featured compelling stories, philosophical observations and life lessons.

Sabat, who taught a section of General Psychology every semester of his career, called back to his teaching years in order to write a book for all audiences.

“My years at Georgetown prepared me to do this — I spent all that time teaching undergraduates, who are not necessarily all that well versed in what I’m talking about,” he said. “Did I get bored? No, because for the people in the class, it was always their first time, and I had to make it good for them!”

For Sabat, the book presents an opportunity to continue living out the Georgetown ideal of “men and women for others” even after leaving his everyday role on the Hilltop.

“When you’re in an environment where the raison d’etre is the betterment of others for the good of society, you take that with you,” he said.

— Patrick Curran