There is a phrase that is consistent across the fields of dementia, delirium and person-centred care, that is, if you have seen one person with dementia (or delirium, or pain), you have seen one person with dementia (or delirium, etc).
Statistics, data, evidence have little to do with the interpersonal one-to-one relationships with people experiencing the extremes of cognition or humanity.
This might suggest that consequently, there is little to be learned from individual experience – this is equally wrong. We interact, engage, care, support and treat people based upon a synthesis of our experiences and those of others.
This brings me to the dream state.
Recently, I have been involved in the care of a man who has dementia and the component of his self that has been mostly affected by the disease is short-term memory. Those who have read Oliver Sacks will be familiar with the patients he has described who lose the ability to lay-down short-term memory.
Sitting and talking with someone living this is remarkable.
The closest I can relate is perhaps the state of dreaming.
During our dreams, we can have vivid, full-colour, auditory, tactile, HD experiences – happy or sad, frightening or tranquil, as our eyes flicker during sleep, we recreate reality inside our heads.
Yet, upon waking, the memories rapidly fade and mostly within half an hour we have forgotten altogether the content of our dreams. And, once they are gone, recollection is mostly impossible.
What is it like to be living in an eternal dream state, a night without end?
For most the image is frightening. All of your personality, intelligence, and, sensitivity remains, your interests and competencies live-on, yet, your ability to build or construct life going forwards is insecure, like building on sand, the foundations disappear with the tide.
What to do?
I haven’t yet found an answer beyond our usual fall-back which is person-centred practices; listening, caring, engaging, and connecting.
Again, although certain aspects of memory are gone, others persist – the ability to integrate sound and touch, feeling, emotion.
Perhaps we need to move from an over-reliance on our logical, methodical 21st Century brains and revert to a simpler time where information overload was not synonymous with getting-buy.
Spend time listening. Examine and analyse behaviours.
Be present, gift your time and attention.