Gratitude #6

Many years ago, my mother was brought to a neurologist because we suspected something wasn’t quite right. She seemed a little forgetful, but more importantly, we suspected she was making things up to cover up her memory loss. She also seemed “simple”, as opposed to being complex. Life was pared down, simplified, broken down to concrete, discrete ideas.

I am grateful to the neurologist for his kindness and the gentle way he explained the diagnosis. How he encouraged us to enrol her in daycare, so that her days would be richer. How he listened when we described her response to the medications he put her on.

He accompanied us on the path over the years as Mom gradually got worse. He was realistic but never made us feel hopeless.

Over the years since the diagnosis, I think we coped quite well. Yet yesterday was the first time Mom looked at me blankly when I asked her a question as though trying to remember who I was. Such a long pause. Then I asked her if she knew who she was. She smiled and started to tell me but couldn’t say her own name.

Is this it? That stage of dementia that every recognises and identifies as dementia?

I don’t know, but I do know I am grateful for the many years we have enjoyed since being given the diagnosis.

Shrinking world

She forgot herself, her old job, what she used to do.

Did I really work?

Did I do all that?

She forgot her relatives, confused her siblings with her children.

She forgot her in-laws, knowing they were still familiar.

She forgot her children, forgetting she is a mother.

She forgot her husband, perhaps not surprising, he’s been gone many years.

She forgot her grandchildren, doesn’t recognize them.

She remembers how to eat, how to go to bed, how to rise in the morning.

She remembers how to wash herself, though she confuses the shampoo with the body wash.

She remembers numbers, but just barely gets up to ten.

She remembers to smile and she smiles often, everyday.

Dementia Artefacts

Mom lives in the present and is happy and contented on the whole. I think she lives fully in the present moment, with no worries of the future and no grudges of the past. She remembers little of her past anyway and not remembering doesn’t bother her.

Some others with dementia may suffer from memory tricks where the past is bright and clear, and the present foggy and confused. Such persons seem to be living in the past. They may talk about long dead persons as though they were still alive, and want to “go home” to another home which no longer exists. They are restless and disoriented.

To address disorientation, sometimes caregivers put out artefacts to trigger memories, conversation or even just to provide a familiar welcoming setting. Replicas of homes and items are recreated or purchased and displayed with fanfare. Personally I don’t think it works that well, because no recreation hits the mark for everyone, since everyone has a different past! National Museums Liverpool must be commended for curating items that suits a persons particular past, into a memory stimulating suitcase full of selected items. Do look them up.

Here I’ve cobbled together some examples of dementia care scenes in Singapore:

Cupboard of Items
Bigger than a suitcase, and it doesn’t need to fit into a scene. A useful way to introduce lots of artefacts in a small space.

Rustic Scene 1
Though not everyone with dementia grew up in such surroundings, this is still a very peaceful scene.

Rustic Scene 2
Hope the monkey doesn’t disturb anyone!

Home Setting
What a home might have looked like in the 1960s give or take 15 years. Mom would feel distressed in a place like this, because she would think she was a guest, and know that this is not her home.