In the Alzheimer’s unit
Last week I visited two elderly relatives who’ve recently moved to an assisted living facility not too far from me. They’re in their mid-eighties, and although they’ve been married for more than 50 years they live in separate wings of the place, because his problems are physical and she has Alzheimer’s.
These are people who were long known for their lively, upbeat personalities, always fun to be around. He’s still gamely trying to be cheery, despite some pain and enormous fatigue, plus his concern about what’s going on with his wife, but it’s a challenge he doesn’t always meet. He’s the one with the full awareness, after all, which is mainly a blessing but has its drawbacks when things are bleak.
But his wife has no such problems. Her mental state hasn’t deteriorated too much yet. She’s still, as they say, “well oriented”—at least in space, if not in time. She’s aware that he lives in a different building, but she thinks it’s a temporary thing, a sort of hospital, and that they’ll soon be reunited for good. He visits her a couple of times a week, and her ordinarily cheerful personality seems intact so far.
Both her parents died a couple of decades ago (her father of Alzheimer’s), but in her mind they remain alive and well, as do a host of other deceased relatives. No use trying to introduce some reality on that score: what would be the point of inducing fresh pain, over and over? So it’s best to play along when she asks after other aunts and uncles who are no longer alive. The answers that seem to make sense are “fine,” “about the same,” or “holding their own.” And after all, who’s to say that’s not the case?
If you adjust to the fact that in her mind it’s about two decades earlier, conversation can go fairly smoothly and the visit is even fun. It’s important to stave off the awareness that next visit she’ll probably be worse, and the next and the next. Since her body seems strong, the day may come when she knows no one, and even speech departs. It’s not a good thing to contemplate; best to keep it at bay.
During this visit there was even a moment of unintentional humor. Shown a recent photo of her only surviving aunt, who is now 95, she gave a gasp of shock.
“What happened to her? She looks terrible!”
“She got very old. She’s 95!” was the answer. But she didn’t accept it, because to her the passage of years stopped quite some time ago, and she tried to do the math and came up short. But it was easy enough to distract and soothe her by changing the subject, because her memory doesn’t hold things for long.
Will she remember my visit? Almost undoubtedly, no. But was she happy to see me? Almost undoubtedly, yes. And doesn’t that have its own value?
As I was reading this, my brain’s music channel started singing “Had an apartment in the city….” What a pleasant surprise to scroll down to that very song. Thank you, for invoking the song, and for saying “hello in there” to your relatives. Have a great weekend.
My Mother-in-law has been experiencing worsening dementia, which at the age of 95 is no big surprise. It’s the same with her- she has lost the last couple decades and usually doesn’t remember our recent visits, let alone what we spoke about two minutes earlier. Yet, she is still a wonderful spirit that loves and laughs despite her confusion and frustration. I’m thinking her true nature of kindness shows no matter what.
My heart goes out to you.
I think the deal is long term embedded memories are the strongest and the last to go and that’s why we see them seemingly revert to another time. My mom died from alzheimers. What was especially terrible was seeing her grieve over the loss of something but she really had no idea what it was.
Very moved by this. So much so that this is my first comment, though I visit everyday. Thank you for this post. My mom suffers from dementia. She is in great health, 89, and is always great “in the moment”. Most gut wrenching, painful day was to tell her my father had died. We had to tell her several times, and each and every time we would tell her, she’d totally break down in sobs and guttural moans….as if we were telling her for the very first time.
You have my heartfelt sympathy. It hurts so much to see people we have known to be the wise ones in the family, no longer so. It’s such a crazy mixed-up way to die.
In our family we don’t get dementia, or, at least, no worse as we age, and we regard dementia as highly under rated. There they sit, in bodies gone to Hell, with minds as sharp as ever, knowing exactly that they are dying by inches.
My mother has been alert and aware for all her years, eighty three tomorrow. For the past few days, however, she is in and out. We don’t expect her to last another week. For those of a praying sort, she is Julia LaVoye Adams.
God bless . . .
The art of aging. How difficult it is. Maybe those who get dementia are spared the knowledge that the end is near. But it is very difficult for those who love them. It’s wonderful when nursing home patients have relatives or friends that visit. My mother-in-law was in a nursing home for five years. To the end you could tell how happy she was to have company. It has to be a depressing thing to know that the little room and the boring routines are leading to the last act. Any contact with someone who takes your mind off such things has to be a blessing, even if you have dementia.
“Will she remember my visit? Almost undoubtedly, no. But was she happy to see me? Almost undoubtedly, yes. And doesn’t that have its own value?”
It has tremendous value.
You’re a good soul, Neo. I hope I am as fortunate in my visitors in times to come.
MaryinOh, how hard. I’m so sorry.
My father suffered from progressively worse dementia in the final years of his life. It wasn’t Alzheimer’s, but the assisted living facility where he ended up was a small one that specialized in patients with Alzheimer’s and related types of dementia. Fortunately he never forgot who the members of the family were, but his sense of time grew very jumbled and he could be very confused about things at times.
Unlike MaryinOH, we stopped trying to tell him or remind him about the deaths of people (or animals) in the distant or even recent past. This posed a minor problem because he confused another patient at the assisted living center with an old family friend. The family friend’s wife had died a few years before my father went into the assisted living center, but he couldn’t remember that, and he didn’t understand who the patient’s wife was. But no amount of trying to explain that the other patient wasn’t the family friend would work, and no matter that he was told about the death of the family friend’s wife, he’d never remember that, either. It was the same way with the family dog he’d ask about who had died years before. There was no use in telling him whenever he asked because he’d just get sad and upset about it.
Anyway, I’d echo what Parker and J.J. said about the value of your visit, even if your relative was a little uncertain about things.
This a hard thing to have. Hard thing to bear. A hard thing period.
I am a music therapist and I do sessions in Alzheimer’s units, among other things. I don’t change things for the residents in a big way, but for the hour I am there we have a rip-roaring time, and I think that’s important. Funny, though, last month we sang a lot of patriotic songs and talked about America and the flag. When I asked how many stars are on the flag, the answer was inevitably “48”.
My Mum is in a similar place now in New Zealand and when I visited in April I was able to do some music groups with the residents in her home. They were all most enthusiastic and grateful. On my next visits, they would all ask Mum, “now who is this?” Believe it or not, you get used to it after a while!
I wouldn’t be entirely sure she won’t remember– my granny had dementia, at the end, for several years. One time when my mom visited, towards the end, mom just couldn’t take it anymore– she cried on the way out, although she thought that she’d made it clear of where her mom could see.
Granny called mom’s little sister to tell her that there was something wrong, my mom was crying. (a REALLY rare thing)
It seems like a consistent pattern and lack of emotional shocks helps them adjust to a happy, less confused fog– at one point, after her husband died, granny didn’t recognize my aunt, but did recognize a neighbor of 50+ years. (Her favorite daughter, who was doing most of her care– they’d gone out to visit papa’s grave.)
I wish there was a way for your elderly relatives to stay together. No matter which way it goes, I know it’s got to be incredibly hard on her husband.
“Will she remember my visit? Almost undoubtedly, no. But was she happy to see me? Almost undoubtedly, yes. And doesn’t that have its own value?”
Neo, when my grandmother was in a nursing home with dementia, it drove me CRAZY that my out-of-town relatives would drive literally a stone’s throw from the nursing home on their way to vacation and never stop to visit. One cousin said, “What’s the point? She won’t remember I was there.” But HE would remember he was there, and didn’t he want those memories? And wasn’t it worth giving her a little joy, even if she forgot it five minutes after he left? I just didn’t get that attitude.
My Mom forgot she saw her youngest great grandson the day before, then she forgot she had a great grandson completely.
She is sharp enough and cognizant enough to understand her being placed in the assisted living home but resents it severerly and the fact she has alzheimers is just not to be believed.
Mom believes I used this as a way of getting rid of her so I would not have to take care of her.
When I go see her she asks me first thing, “Can I go home now? how long do I have to stay here, Do you mean I am going to live here forever?”
Then she grows angry and gets hostile and violent.
She gives me and My Brother up for adoption every visit to whom ever is nearest.
Nobody wants to adopt a 55 and 58 year old men LOL but she is determined to give us away.