I wrote last week about a man I met on one of the wards – he is a retired Flight Lieutenant and he wears contact lenses. He is 86. This week, another patient was describing his appreciation of ELO. Yes, the Electric Light Orchestra. He is not as old, he has a wicked sense of humour and he hasn’t got contacts or specs.
When we talk about dementia, we automatically allow a picture to pop into our minds… an older man or woman, grey hair, forgetful.
It is this last point which I think is least understood; most assume ‘dementia = forgetfulness’ when in reality, there is far more to the disease than this.
Sure, the majority of those living with dementia will become forgetful; their ability to lay-down new memories – encode recent events into neural pathways diminishes, yet, often, and this goes for many, what is more surprising, relevant and difficult to acknowledge is the change to other aspects of who they are.
Mood, personality, behaviour, interests – these can all change; What was once considered funny can alter – the music or the people whose company they enjoyed can take-off in different directions.
That is not to say that everyone who has dementia has a personality change, after all, this is all about people, this is the quintessential person-centred disease. But, something to think-about.
I remember my parents’ 50th wedding anniversary. We were all back in Glasgow – one of the guests, a friend of the family who had existed in a love-hate relationship with my father since his first day at primary school, led the singing; here he was – H; word-perfect, his personality, talent and ebullience intact and shining out of every pore.
H had Alzheimer’s.
And today on the ward, I saw patients playing the Catch-Phrase game.
Another reflected how sad he was to have not attended the Remembrance Day ceremony in town – the first time he hadn’t been;
And it made me think; how much of who we are is memory – how much embedded behaviour, routine and reflex – how much of ourselves can we stand to lose before we are not ourselves, but another.
Our personhood always remains – we are always more the person we have been for 60, 70 or 80 years than the individual who has been plagiarised by dementia; we must always hold-on to the realisation that people are people both through people and through memory and emotion.