With the recent exacerbations involving Ukraine, the nation is once again turning a fearful eye to the east, as the threat of war lingers in its shadow. Yet, in all the strife, the language of Russian and Ukrainian play a large role in the dissidence. For centuries, Ukraine’s seemingly endless battle for statehood reflected a dueling and bitter linguistic alchemy between Slavic languages. To better understand the current crisis, it is necessary to examine the history and complexities of language.


The Troubled History Of Ukraine

Ukraine has a profound history of being dominated by outside powers and a limited history of national independence. It was independent for a few years after World War I, and then for a short time in the 1600s. As we will see, in its struggle for sovereignty, language was always involved.


During the collapse of the Soviet Union in 1991, Ukraine became independent again and Ukrainian became the official state language. The country was under Russian dominance for many centuries, and it’s one reason why there are so many ethnic Russians living there. In Ukraine, One in three speak Russian as their native language, while the rest speak Ukrainian.

It is this language ratio that makes the subject of the Ukraine-Russia discussion divisive. Politically, much of the country sees Moscow as the culprit for Ukraine’s historical emancipation and something to resist, while the rest view Russia as a brother land, with sentiments of heritage to the former Soviet Union.


Interestingly, even its former name, “the Ukraine,” labeled it as a geographical region more than an independent country. Historians believe the name meant “the borderland,” or the country “in-between,” in the Slavic language.


After claiming independence in 1991, Ukraine was divided, and the current ideologies reflect that. Yet the division is defined by language, with around two-thirds of Ukrainians speaking Ukrainian, mostly in the west, while others to the east speak Russian. The language divide is only a blurry part, and it’s a moniker for a more complex ideological and political divide.


Catherine The Great And Stalin

To understand the significance of the current crisis, we must look at how the division started blurring back in the 1700s. Looking at history also clearly demonstrates how much languages impact the current situation.


It began when Russian leader Catherine the Great enforced making Ukraine more Russian by importing ethnic Russians and imposing laws requiring schools to teach Russian rather than the Ukrainian language. While this continued until the 1950s, like today, she also positioned Russian troops on the borders, and in the 1800s the Ukrainian language was banned.

In the 1930s, Soviet leader Joseph Stalin unleashed the Ukrainian famine that killed several million Ukrainians. He later repopulated the area with ethnic Russians. In the 1940s, he also relocated ethnic Tatars and again replaced them with Russians.


During this period, Russia’s focus was on Ukraine’s east, which had a bountiful amount of fossil fuels and metals, as well as fertile farmland. Even today, Ukraine’s linguistic dividing line remains the line between the rich farmland of the east and the forests of the west.

It is because of this history that many Ukrainians dislike Russia, yet there is still a significant population of families living in Ukraine that have deep connections to Russia and Soviet-era sentiment. It is this national and linguistic conundrum that took centuries to create, and that is a major component of the ongoing crisis.


The Shared History of Slavic Languages

For more than a thousand years of documented history, the Slavic language has often been a polarizing force in global politics. The Slavic languages consist of Ukrainian, Russian, Polish, Belorussian, Czech, and many others. While the Slavic languages are closely related to each other and often sound the same to non-native speakers, they are different in many ways.

The linguistic similarities of the Slavic languages in religion, culture, and especially politics, have traveled different roads in history, and the Ukrainian and Russian languages are constantly changing the Eastern European landscape.


Like many other languages, both Russian and Ukrainian have similar linguistic stories. These two languages are derived from the Indo-European family, or more specifically, the Eastern Slavic branch.


Historians believe these languages split around the 12th and 13th centuries, with Ukrainian, considered more influenced by Polish and Slovak languages, while Russian’s prominent influence was the Old Church Slavonic.


When Peter the Great tried to Westernize the Russian language, it helped further separate Russian from Ukrainian. Ukrainian was at one time banned from the Russian Empire altogether in what is now the eastern half of Ukraine.


Yet, the influence that Russia had on the Ukrainian language continued after the Soviets spread Russian throughout the country during the Soviet occupation.

As initiated by Catherine the Great, Russian became the predominant language taught in schools throughout the Soviet Union, and because of the Russian Orthographic Reform of 1917 and 1918. This helped meld some of the current characteristics of the two languages, and it also reveals the prevalence of Russian speakers in Ukraine today. Because of these similar origins, the distinct categories of politics and culture often clash.


The Similarities of Ukrainian and Russian

Alphabet

While Ukrainian and Russian share a mostly analogous alphabet, they are still two different languages. This is true for English, German, and Dutch, as they have some of the same vowels and conjugations. There are some important differences between the Ukrainian and Russian alphabets:

· The Ukrainian alphabet has “Ґ ґ,” “Є є,” “Ї ї,” and “І і,” but the Russian alphabet does not.

· The Russian alphabet has “ы,” “Ё ё,” and “ъ,” but the Ukrainian alphabet does not.

While it’s very subtle, these differences become important when spoken, as the sounds are different in each language. If you consider that Italian and English only have five letter differences, you can better understand how Ukrainian, and Russian, are differentiated by sounds.

Vocabulary

Ukrainian and Russian have approximately 60 percent of the same vocabulary. When looking at the vocabulary, Ukrainian is more like Belarusian than Russian. Concerning vocabulary, Russian and Ukrainian have greater differences than most Romance languages, but they share common themes.

For communication in Ukrainian and Russian, the region of the country plays a large part in mutual intelligibility. Different regions all have different dialects, so a Ukrainian that lives close to Russia would understand Russian easier than someone located in the western half of Ukraine.


Writing

Ironically, the written form of both languages is understandable because they share the same alphabet. A Russian that has no exposure to Ukrainian could read a document written in Ukrainian and mostly understand it. In linguistic terms, they have an 80% commonality in their writing.


Grammar

While the writing between the two languages is similar, noticeable differences exist in some grammatical concepts.

· Ukrainian uses -mo ending for first-person plurals.

· Ukrainian uses ‘ as an alternative to the hard sign.


Pronunciation

While many changes have occurred in the phonological and phonetic systems of the Slavic language since its early origins in Indo-European, the most fascinating and important sound shifts occur between Common Slavonic and Old Russian. There was a loss of voiceless vowels known as jers, and the inclusion of "akan’je," which is heard in all Slavic languages.

To non-native speakers, spoken Russian and Ukrainian sound the same, yet they are a little different in pronunciation. While they are approximate in sound, native speakers, or speakers of a particular region, would be able to tell the difference. This is another hot point in certain areas of Ukraine, and this is especially true today.

· Ukrainian has numerous soft consonants.

· The Russian language doesn’t have a sound for “Г г.”

· Ukrainian pronounces the “o” as “o” whereas Russians pronounce it typically as an “a.”

· Ukrainian is a phonetic language. Its pronunciation often follows the spelling.

· The Ukrainian “И” and “Е” have different pronunciations contrasted to their Russian equivalents, “Ы” and “Э”.


While Ukrainian and Russian are alike, linguistically speaking, Ukrainian has a more viable connection to Polish than it does with Russian. Some Ukrainians don’t understand or speak Russian, yet because Ukraine is a former Soviet Territory, many Ukrainians grew up speaking or learning Russian. Today, around 60 percent of Ukrainians speak both languages, so it is an amalgam of sometimes conflicted dialogue.


The Geopolitical Issue of Language

The drama of the Ukrainian language is increasingly politicized, especially in the onslaught of Russia’s continued military action against Ukraine. After the independence of the Ukrainian language following the collapse of the Soviet Union, the language has struggled to be respected by much of the country and in many semblances of everyday life.


Since the 1990s, efforts to constrain and support the use of Ukrainian in addition to Russian have created geopolitical strife that remains present today. It also came to represent independent Ukraine’s post-Soviet identity issue.


The Ukrainian society, too, has an existing bias toward the predominant role Russia played in the country’s history. Yet, these sentiments are as divided as the national visage, with the country’s eastern and western sides supporting vastly different, stoic viewpoints.


The Language In Nation-Building

Language has always played a large role in Ukrainian nation-building, with an acute awareness of the linguistic divide between both Poles in western Ukraine, and the Russians in eastern and southern Ukraine. Both sides have fed the national-liberation movement and coddled ethnic convocation.


Ironically, the Ukrainian language became independent before Ukraine became a sovereign state. The “Law on Languages in the Ukrainian SSR” gave the Ukrainian language the predominant status of an official state language, yet it predated the creation of the post-Soviet Ukrainian state by more than two years. The communist parliament, the Ukrainian Soviet Socialist Republic, passed the bill in 1989 in a country that was, at the time, the Union of Soviet Socialist Republics (USSR).


Since then, the language predicament has involved discussions on the official status of using Ukrainian alongside Russian, and it brought heated debates in parliamentary elections.


The New Language Law

With the backdrop of the growing Ukrainian crisis, the Language Law passed in 2019 brought new optimism to many Ukrainians. The provision stipulated, among other things, that print media establishments registered in Ukraine must publish in Ukrainian.


It also stated that publications in other languages must also include a Ukrainian version that was equal in content, volume, and method of printing. Distribution centers had to have at least half of their contents in Ukrainian. The new state law also required Ukrainian to be used in most aspects of daily life.


Just as in the previous laws, the New Law focused on enhancing the status of the Ukrainian language throughout society, with broad measures to make certain media and public services helped promote it.


Most would agree that the Ukrainian government has every right to promote its state language and expand its national identity. Yet, most sociologists concur that it should implement a fair balance in its language policy to negate discrimination against linguistic minorities.


Yet the New Language Law seemed to be accepted in public opinion. A 2019 poll by the Democratic Initiatives Foundation and Razumkov Center revealed that 69% of Ukrainians approved of preserving Ukrainian as the country’s only official state language, yet agreed to maintain the freedom to use Russian in private life. As with any law related to language in Ukraine, amendments to the Language Law are on the political docket.

The Complications Of A State Language


To further complicate the language question, the national status of Ukraine as a sole state language convoluted the pro-Russian political forces in providing any sort of formal status to the Russian language. Politically, granting such status now involves a constitutional majority in the Parliament and the passing of a national referendum.


To counteract this, in 2021, the law “On the Principles of State Language Policy in Ukraine” attempted to expand the reach of the usage of the Russian language. The new law contained the phrase, “regional or minority language,” designed to give the Russian language semiofficial status in many regions of Ukraine.


This, of course, was implemented to prevent the spread of the Ukrainian language into civil service and nearly every other component of culture and politics. As a good example of the intricate wordplay both countries use as “provisions,” the law stated that the use of the regional or state language, which of course meant substituting Ukrainian with Russian, was allowed.


In many ways, instead of promoting multilingualism with an admitted knowledge of the state language, the law provisions imposed preconditions for linguistic segregation, marginalizing the position of the Ukrainian language. This subtle linguistic rancor is obvious in both countries, and it’s one of the issues that fuel the instability.


At the same time, provisions like this are detrimental to Ukraine’s people, the many ethnic monolingual Russians living in Ukraine are also affected. With the absence of practical incentives to allow the use of Ukrainian, the result is less Ukrainian-Russian bilingualism and a forced incentive to speak Russian. The social faults of this are numerous, as ethnic Russians eventually would be forced to avoid any sort of interaction with Ukrainians.


Despite the law’s intentions, because it recognizes Ukrainian as the state language, it resulted in an expansion of Russian into public use, at the expense of the Ukrainian government. Its implementation suggested that its benefits could only be enjoyed by the larger, dominant Russian language. Many years after its independence, traditional prejudices against the Ukrainian people still exist.


How Social Media Influences Language

Earlier in 2021, a Ukrainian Facebook user posted a picture of a McDonald’s electronic menu screen offering Ukrainian and English language options. The text on the screen suggested that the Russian language option had been removed. The post was seen by a Ukrainian pro-Kremlin social media star who insisted the menu language choices were divisive towards the Ukrainians who speak Russian.


Soon, Ukrainian media outlets brought the post to life, and call for boycotts and protests grew. The Ukrainian Embassy thanked McDonald’s for its support on the language issue, while the Russian Embassy accused the restaurant of excluding minority languages. As tempers rose, few seemed to care that McDonald’s made clear that there never was a Russian-language option on the company’s electronic menu.


While all of this seems benign, it underscores how language emotions are manipulated by the media, and how easy it is to destabilize a country, especially during a country in crisis. It also demonstrates the linguistic disparities created by decades of historic strife, and how these disparities remain a flashpoint.


Can Language Heal?

With the current dour political climate in Ukraine, it’s obvious that any attempts to beguile the standing Ukrainian language will be precarious. With the enormous weight of the history of Ukraine and Russia, it seems the fractured region has no fortitude. Any attempts to revise the Language Law now would be fruitless and could escalate things into a national crisis. Yet, the politicization of language does not reflect the daily reality of bilingual Ukraine, where both Ukrainian and Russian are spoken across the country.


This linguistic fluidity is so common that it’s not unusual to hear both languages spoken in a single conversation. Yet, in that conversation, two people are not just speaking to one another, but understanding words, feelings, and emotions. Language is powerful. Maybe those two people, seated in a cafe, speaking the same languages in the same country, can change a dichotomy.

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Updated: Apr 20


What 19th-century neuroanatomist Sir Charles Bell called the sixth sense is probably one you didn’t know you have.



In 1971, 19-year-old Ian Waterman awoke and discovered his body had disappeared. He could see his physical body, yet he was unable to move or feel it. Immobilized by a rare neurological illness caused by a rare autoimmune response, his immune system attacked the sensory neurons from his neck down. He was unable to feel any sensation below the neck, yet he was not paralyzed in the traditional sense. When his mother tried to help him stand, he collapsed to the floor because he could not control his limbs in gravity. Waterman lost the ability to sense proprioception, or where the body is in space. It is this “sixth sense” that many take for granted, and one that most don’t know they have.

Mind Over Matter

Waterman lost the basic ability to sense himself and the presence of his own body, and he began to feel that he did not exist. The information that Waterman lost is a complex system of neural pathways that subsist throughout the body, specifically in the joints, tendons, and muscles. Standing, balancing, performing coordinated movements, and maneuvering through crowds is all done using proprioception.


Refusing to live life in a wheelchair, Waterman, once a butcher by trade, where intricate movements were part of his skill, began to visualize his movements as though he were performing them. One day while lying on his back, he imagined the physical act of sitting up. He began to do this daily and started to see small movements, even though he still felt nothing. Finally, by using intent for the physical action, he was able to sit up.

Waterman taught himself how to regain his movements again by consciously controlling and visually tracking every action. The visual component was vital, and if the lights went out suddenly, he collapsed to the floor as though he were unplugged. If the lights were restored, he could move again and stand. Dr. Jonathan Cole, who practices at Poole Hospital, England, and Southampton University, was the first physician to recognize what Waterman had begun to do in his self-training protocol. He wrote about it in the book Pride and a Daily Marathon, which tells Waterman’s incredible story. “Before I met Jonathan, I often thought I might be mad,” says Waterman. “No one understood what was wrong or why life was such a struggle.”

The Importance of Proprioception

Waterman’s experience resonated in the medical field, as physicians were fascinated with Waterman’s ability to compensate for his loss. While others with the same condition often refused to learn to walk again, Waterman did not surrender. Yet his case also emphasizes the critical importance of proprioception and touch, according to psychologist Michael Turvey, PhD, who researches touch at the University of Connecticut. “The haptic senses underlie almost everything we do that involves movement,” he says. “At the same time, Waterman is able to do more than many theories of touch and movement would predict.” The case also presents a unique moment to test theories of movement and proprioception that would not be possible otherwise. Never have researchers been able to examine precisely how a complete lack of feedback from the outside world affects a living human.


Physiologists of the 19th century did not know specialized proprioceptors existed. They questioned the origin of ‘muscle sense,’ a term credited to the Scottish physician, scientist, and neural system researcher physiologist Charles Bell, who first distinguished motor from sensory nerves. Proprioception in the body is governed by mechanosensory neurons distributed throughout the body, also known as proprioceptors. This wasn’t always known; early physiologists assumed all awareness in body position is central and controlled by the brain only. In the late 19th century, neurophysiologist Charles Sherrington proved that a peripheral source of sensory receptors was located in muscles and tendons, and that the nervous system, including the brain, is a single interlinking network.

Sherrington created the term proprioception, which he defined as the feeling of stimuli that “are traceable to actions of the organism itself.” His sensory theory was based on what he called exteroception, or stimuli existing outside the body, and interception, the sensory signals from the internal organs. While other physiologists like Kuhne and Ruffini had defined proprioceptor organs, Sherrington was the first to apply sensory neurons' influence on innervating organs and muscles for posture and movement control.


Today, the study of sensorimotor control still centers around Sherrington’s initial model of the proprioceptive system, especially his focus on ‘reflex’ pathways that guide proprioceptive feedback into motor output. How do these receptors help suspend us in gravity? The body has three distinct types of sensors located in the joints, in the connections between muscles, and in the muscle fibers. Without them, after hip surgery for example, a patient would not be able to sense where her feet were in relation to the hip. This would make physical therapy impossible.

How He Got His Body Back

A muscle spindle includes four different nerve endings that spiral around a number of muscle fibers. The small sensor, only a centimeter long, is enveloped in cone-shaped fascia that divides it from the rest of the muscle. The proprioceptors connect the nueron’s varied signals with changes to a muscle. They also remember the position they were in previously when a muscle is motionless. For Waterman, all of these connections were lost. He had to think of movements and have vision to monitor their actions. His case was unique in that he was the first patient to lose his body and teach himself how to walk again. He relied only on the sense of sight and conscious orders to make his legs move.


Waterman has perfected his strategy to an astonishing degree. Since his movements require constant visual contact with the environment and space, he must “plan” his walks. Every movement is choreographed previously, including calculations of the force and direction, and the movements are monitored as he ambulates. He calls his slightly lumbering gait “controlled falling.” While most of his gestures are planned and monitored, research conducted by The University of Chicago’s David McNeill demonstrated some are not. McNeill’s research on Waterman showed the human brain orchestrates communicative motions in the absence of proprioception.


What McNeill discovered through experiments in voice and hand movement is that Waterman uses a thought-language-hand link to modulate some of his hand gestures. His gestures modulated with the speed of his speech. If he spoke slow, his gestures slowed too. Yet the speech-gesture synchrony was exactly preserved. Waterman’s case suggests that control of the hands and the relative motor neurons are possible directly from the thought-linguistic system. While Waterman had reworked his motion and control system, the thought-language-hand link system in the human brain survived his neuronopathy.

Despite his disability, Ian Waterman has taken his life very seriously, always attempting to do the best he can. While he doesn’t care about the science of his illness, he has helped change it with hours of lab experiments. “We choose our own paths,” he says.

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Updated: Apr 24

Frontotemporal dementia commonly afflicts people in the prime of their lives and gives them an entirely new persona.

Every act of memory is to some degree an act of imagination. – Oliver Sacks

This article is dedicated to my mother, Nancy Wren Cheatham. You are in our sunrises and sunsets.

If you enjoy this article, please donate to the Dementia Society.



On a Cape Cod summer weekend perhaps a decade ago, just like in previous years, the Cartolano family is set to perform their version of a talent show they call The Carto Show. It’s a pleasant seventy-four degrees, and the wind gusts from the water, swaying the juniper and scrub pines as the day fades. From the wooden deck stage, you can hear the seagulls cry and the roar of the surf. They most likely had a family barbecue that day, complete with ice cream and cake and coffee, though it’s difficult to recall now. Nina Cartolano’s mom, Rene, dressed in a nightgown as Lucille Ball, would perform Neal Diamond’s Sweet Caroline, crooning to the dog. It was heartfelt, funny entertainment, and the Cartolano’s treated it as such, said Nina, 32, who uses her comedy upbringing as a writer of sitcoms in New York.


I’ll Crush Your Fingers

For as long as she can remember, Nina’s mother would dress up in costumes and practice lines and even the choreography, just like a Broadway actress. The themes for 2014’s performance were all as varied as in past summers, including appearances by her father, Leo, as the Pillsbury Dough Boy in a bathing suit, and the family performing a rewritten Can’t Buy Me Love. Except this year was different, as one person remained aloof from the production, sitting peacefully in a lone chair in the audience. As everyone guffawed, Rene sat emotionless.


Around 2009, Nina’s mother began to change. While she was always known as a smart, witty, and attractive woman, she started overeating and would go into trance-like states. Always the first to laugh at the family’s relentless jokes, now she didn’t respond. A schoolteacher for decades, she began to snarl at kids and say things like, “I’ll break your fingers if you do that again.” It was a line that could have easily been a joke except it wasn’t.


Rene began to say other things as though she were someone else. She talked about sex to people she met on the street. Always one to compliment other women on clothes or shoes, now she’d tell them they were fat as they stood right in front of her. She began to eat all the time, and even steal and hide food. She gained twenty pounds. Sarcasm by others went unnoticed, where she used to respond with witty comebacks. It was as though Rene Cartolano had disappeared, and someone else had taken over. And someone had.


A Diagnosis

Confused and often embarrassed by the new Rene, the family spent months researching possible brain afflictions that could be causing her behavior. Finally, they got a diagnosis. While there are many types of dementia, Frontotemporal dementia (FTD) is the most common neurodegenerative disease diagnosed before age sixty. It is centralized in the frontal lobe of the brain, a region that is partially responsible for behavior and emotions. While a disease like Alzheimer’s usually affects older people, and is detected when memory issues begin to arise, FTD literally robs people of their personalities first, and like early-onset dementia, it occurs in early ages between 30 and 50. It’s estimated that 10-15% of people with dementia have this type, but don’t know it.


After decades of new research, neuroscientists now have a better understanding of FTD, and the roles different parts of the brain play in how it shapes our personalities. Yet it remains one of the less known cognitive diseases. Dr. Bruce Miller, one the world's foremost researchers on frontotemporal dementia, is leading the science in FTD research. At his lab at the University of California, San Francisco, he and his team are doing revolutionary studies on the two main forms of FTD. In the speech variant, where speech is affected, patients struggle to find words, often pausing in mid-sentence as the words vacate the thoughts. In the behavioral variant, like Rene Cartolanos, personality, empathy, and judgement are attacked. People might start stealing things or do activities that are dangerous to themselves and others and not realize they are doing anything wrong.


Miller’s work shows regions in the brain that have atrophied from FTD and discovered that the amygdala, orbitofrontal cortex, superior temporal, and fusiform cortex regions show the most tissue damage. Also called the perception network, this region is responsible for responding to social cues, eye contact, facial expression, as well as body gestures. Sarcasm response –- something that Rene Cartolano stopped reacting to -- relies on all these cues, yet FTD also affects the affiliation and aversion networks, which motivates a person to want to have connections with others and experience rewarding emotions during social interactions. FTD patients also begin to trust strangers and possibly unsafe individuals, often giving out personal information, like bank account numbers.


Bolero As A Score For FTD

“We used to think dementias hit the brain diffusely,” Miller says. “Nothing was anatomically specific. That is wrong. We now realize that when specific, dominant circuits are injured or disintegrate, they may release or disinhibit activity in other areas. In other words, if one part of the brain is compromised, another part can remodel and become stronger.” He reminds us the composer Ravel also suffered from a brain disease with symptoms that were identical to FTD.


Perhaps there is no better musical score to represent FTD than Bolero. Ravel composed Bolero in 1928 when he was fifty-three, and when errors in his musical scores and spelling began to present. “Bolero is an exercise in compulsivity, structure and perseveration,” Miller said. It elevates with no key change until the 326th bar. Then it accelerates and implodes in a finale. It changes between two main hypnotic themes, repeating the themes eight times over 340 bars with layers of instruments. Yet the score soars methodically with two simple alternating staccato bass lines.


Miller says Ravel was probably in the early stages of FTD when he was working on Bolero. The disease would have altered circuits in his brain, changing the connections between the anterior and posterior regions, resulting in a deluge of creativity. Because circuits in the brain become reorganized in FTD, some patients develop incredible creative abilities. Miller has witnessed FTD patients suddenly become gifted painters, pianists, or engage in skills they never did before as their disease progressed.


A Loss Of Empathy

In FTD brain scans, a deep blue indicates a loss of tissue, and in some scans, almost the entire frontal lobes are blue. “When we see loss of tissue in that brain region, we know people have lost their interest in life, their drive. They do less, they care less about other people,” says Miller. That loss of empathy, Miller says, can trigger dangerous, impulsive, even illicit behavior. Then there are the stories of fathers left watching their children who suddenly lose the ability to care about them, or CEOs who start walking around their office with their pants down. To the patient, they are not aware that anything has changed, yet to the spouse, it’s as though a light switch was turned off. Miller says because so many cases of FTD are often misdiagnosed as a mental illness like schizophrenia, it can take years and many brain scans to get a correct diagnosis.


The Soul Of Humanity

Miller often says FTD attacks people at the very soul of their humanity. “This is profound as anything that can happen to a human being. It robs us of our very essence of our humanity, of who we are,” he says. It is a devastating financial burden for families, too, as the cost of caring for someone with FTD is astronomical. The outcome of FTD is always death. As FTD erodes the brain, it begins to cause organs to shut down. Swallowing becomes difficult and eventually impossible. Yet Miller is optimistic, leading the promising research both in his lab and by NIH- funded grants to scientists around the globe. “Suddenly we have interventions and research that are going on that give me great hope,” he says. “I'm hoping in the next five years that we will have very powerful therapies in certain variants of frontotemporal dementia that may stop it cold.”


Patients in memory care often ask to go home. Some believe they are still home, in the place they have always lived. Some ask for their dogs, some for their mothers or fathers or siblings who have long since died. For caregivers to explain constantly throughout the day that this is where they live now is not comforting to the dementia patient. To try and ease this distress, many memory care facilities have installed prop bus stops. When a patient asks to go home, the caregiver walks them to the bus stop, where they sit and wait for a bus that never arrives. Sometimes they wait for hours, sometimes they fall asleep. Eventually, as is the course of dementia, their thoughts fade like sunsets, and they forget what they are doing at the bus stop. They are gently led back to their rooms to prepare for sleep. Perhaps when they dream, they dream of a bus that finally came. When they wake in the morning, the first thing they will say is that they want to go home.


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