Dementia

Every once in a while I will write a piece here for my blog and then save it as a draft for months, and this case years, before I rediscover it and finally decide to post it. This particular entry was written April 2011. 

Dementia is a subject that I don't think I've ever discussed on my blog. I probably have told a few amusing anecdotes from my experiences with residents with this condition, but I think I've shied away from talking about it outright. It's not really a pleasant topic. Even those who have it will try to pretend they don't. When told that they already did something they will often reply, "I did?...Oh...I think I remember that now." Nobody wants to admit that they're losing their mind. And out of politeness or maybe fear we try to pretend its not happening either.

Earlier this week a well meaning son of a current resident whose mother has short-term memory loss bought his mother a new laptop. She excitedly told anybody who would listen about this new acquisition. I cringe anytime a relative buys a new piece of technology for their family member. Selfishly I think of how this act of generosity will inconvenience me as I am left to explain over and over to them how to use it long after the family member has left. It seems like such a great idea for grandma to have 250 channels, but the reality is that it's just an overly complicated remote standing in her way of her watching Oprah and Judge Judy. But this story doesn't end that way. It's much more tragic than that.

The next day I was attending a meeting away from the community when I received a text message from the receptionist. "Are you coming back soon? Louise had her laptop stolen." When I returned I met with a distraught resident and her son. I don't think we'll ever know the real story. One of her versions (it keeps changing) is that she went to the bathroom to do her makeup, and when she came out it was gone. I have my suspicions that she might have carried it out and left it somewhere in a public place. I saw her with it outside at one point. No staff members were scheduled to go to her room that day, and nobody has seen it. I still hold on hope that it was left in the room of an equally confused resident who is still trying to figure out what it is. I listened as both son and mother went through all stages of grief in my office, and I assured them that we would have all the staff members keep an eye out for it.

Today my phone was ringing as I walked into my office in the morning.

"Hello, Shaun. Something awful has happened."
"Is this about your laptop?"
"Yes. How did you know?"
"You told me yesterday."
"What? It was missing yesterday!? What am I going to tell my son?"
"He already knows. You and he came to my office yesterday."
"I don't remember that."

And then this conversation takes a different turn than what usually happens. Unable to deny her fears she lets out a long stream of profanities followed by a fearful, "Shaun, I'm losing my mind. I don't remember that!"

It wasn't even 30 minutes later that Louise appears at my office door holding an empty laptop box.

"Shaun, something awful has happened!"'
"Yes. Your laptop is missing."
"How did you know?!"
"You called me this morning."

This time instead of expletives, she merely looks up at me with a look of confusion, fear, and panic which all culminates into a tearful question, "What is happening to me?" Her eyes pleading for answer, I decide to go with the direct approach. "Well...Louise...you have some trouble with short term memory." It's a horrible feeling when you realize that you have just made somebody confront their own dementia. Part of you wonders if it was the right thing to do. The other part takes comfort that given time they will forget and ease their way back into blissful ignorance. We go through what ends up being a loop.

"How am I going to tell my son?"
"He already knows?"
"How do you know?"
"You and he came to my office yesterday."
"It was missing yesterday? I thought we bought it yesterday."
"No. It was Wednesday. I remember you showed it to me out front by the gazebo."
"I showed it to you?"
"Yes. It's a pretty blue laptop."
"It was blue? Well that was my favorite color.Oh my son works so hard for his money. I don't think I'll tell him. I'll just buy a new one. How much does one cost?"
"About $300, but your son already knows."
"He does?"

The loop continues for several minutes as I contemplate how to break it. Finally she does by telling me how much she hates it here and that she's going to move. I don't fight it. I've learned. There's no sense arguing with somebody who won't remember. She leaves.

20 minutes later she's back with the same box.

"Shaun. Something awful has happened!"

It's frustrating. For me it's a repeat, but for her it's fresh every time. It's hard to be as present to her emotions the 3rd time as you were the 1st time, but I try to remember that every time is her first. There are times where this can work to your advantage. It reminds me of a story of my brother and sister-in-law. When they found out they were expecting their first child they called everybody on their list to let them know the good news. They had so much fun rejoicing with friends and family at this new that they were somewhat disappointed when they came to the end of their list. Excitedly they called Auntie Annie who had dementia who was just as excited and surprised as she was the first time. Unfortunately with Louise, each time she goes through this loop she grieves at the loss of her laptop, she frets at the prospect of telling her son, and she fears as she realizes she is losing her memory.

Louise and I repeat these conversations in brief 2 more times as I pass her in the hallway. In a public space she is quicker to confabulate to cover her loss. "Oh. I did tell you.? That's right. I remember." But a short while later she is in my office for a 4th time holding onto that same box with that same statement of "Something awful has happened." In some ways it feels like the movie Groundhog Day where Bill Murray is stuck repeating the same day over and over until he gets it just right. With each loop I learn how to maneuver the conversation. We start to breeze through the loop. "Your son knows. He was here yesterday. A laptop is about $300. We'll be on the lookout. I'll let you know if we find anything. Would you like a hug?" In our 3rd loop of that conversation I'm struck with the answer. I find that key that will let me out of my loop. "Louise, do you mind if I hold onto your box so that I can show it to the other staff members to help them identify it?" I quickly hide it under my desk. I am free.

An hour later Louise shows up again, but this time it's not about the laptop. "Shaun, I love it here. I can't stand my roommate, but I love it here." See. Don't argue with somebody who won't remember anyway.

UPDATE: About six months later we found her laptop. Afraid that somebody would steal it she hid it from would be thieves, and ultimately herself, at the bottom of her underwear drawer.