Senin, 06 Desember 2010

You can Get by with Dementia

I didn't really understand about the role of confabulation in dementia life until I became a nursing staff trainer in a 54-bed Alzheimer's Special Care Unit in Alameda, California.

I knew from those I'd looked after in their own homes, that memory issues caused people to slip from time zine to time zone. That made sense to me. After all, if you have serious short term memory issues, then you can't remember reliably what time zone you live in.

We make such a big deal about this, but having short-term memory issues means not knowing what year this is. That is totally a memory task. Duh!

In the Care Facility, I met people who really had wild fantasy lives. A woman listed as being a childless widow told me she had twenty children and was pregnant with her 21st. Another woman carried around a doll all day that was, she said, the Baby Jesus. Another told me quietly that she and her husband had bought this hospital about 15 years before.

There weren't many men living there but one of them had a dog. Pete. His dog was imaginery but he took it for a convincing walk several times a day.

"Damn," said Roo, "I'd swear I could see that damn dog," and we all turned to watch Pete walking his dog. It obviously pulled a lot, because he had to brace himself and hold tight to the leash. It looked like a large yellow lab, something like that, and it often stopped to pee and he could relax his pulling then. Pete was like one of those French Mime artists.

I've never met anyone outside a care unit who had such wildly inventive imaginary lives and I've always assumed it was because life in there was so bleak. People needed to invent something that satisfied them, like deprived children. So they had imaginary pregnancies, imaginary dogs -- why not?

These stories, like all dementia stories, were not lies. They couldn't be, because to make up a lie would mean you didn't have dementia. A dementia story is a way of seeking peace or a way of fighting fear.

Fear of the abyss which life can become once you get Alzheimer's dementia. Day to day life now -- gone. Your immediate family, gone. Hobbies, gone. Friends, gone. These may be actually gone or you may simply be experiencing as gone because you can't remember them. Either way, they can fall into the abyss.

Having ropes of invention save you from falling into the abyss. What you did yesterday. Who you saw today. Your mother still being alive. You being pregnant, all these are safety nets, ropes and rappelling devices to keep you sane.

People in American maximum security prisons where they are kept totally in solitary all become insane. They are factories for breaking people into fragments which can never be mended.

People with dementia can still have the capacity to save themselves from the abyss of loss and loneliness. Trying to argue them out of it is probably pointless. in that you won't win. And would also be tragic if you did manage to win. Because then that essential human beingness which makes up personhood would drop and away and let them fall into the abyss.

So, don't get mad. Those stories serve a healthy purpose. Enjoy them. Indulge them. Get over yourself. Have a bit of fun, why don't you?

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