The Predicament of Dementia
Father Tadeusz Pacholczyk notes an unfortunate, but natural, reaction to dementia. Relating the story of a woman who could only connect with her afflicted mother by singing hymns, with the lesson being that “there’s always someone in there,” Pacholczyk goes on to lament our tendency to behave as if that’s not the case:
Sometimes we may view the situation more from our own vantage point, rather than the patient’s. In a report on care for the elderly, physicians Bernard Lo and Laurie Dornbrand put it this way: “Family members and health professionals sometimes project their own feelings onto the patient. Life situations that would be intolerable to young healthy people may be [made] acceptable to older debilitated patients.”
[Steven] Sabat notes how this raises the prospect of reducing the patient to a kind of object:
The dementia sufferer is not treated as a person; that is, as one who is an autonomous center of life. Instead, he or she is treated in some respects as a lump of dead matter, to be measured, pushed around, manipulated, drained, filled, dumped, etc.
Two thoughts: First, it’s possible to see a debilitating mental illness of late-life as a means of easing the process of death’s separation. To the loved one, the circumstances of the patient appear intolerable — perhaps more so than death itself — but if treated properly, the sufferer may not have to see the circumstance as one of suffering. In that way, the gradual loss of a connection to reality makes the final separation bearable.
Second, the particular affliction of dementia relates intriguingly to a metaphysical interpretation that I’ve come to see as broadly explanatory. Basically, we are all instantiations of the idea of us in every circumstance in which it would be logical for us to appear, given the constraints of physics and history; that is, if it were logically possible for you to be a millionaire movie star at this moment in time, an instance of you exists in that very role.
Our individual awareness of continuous time (another way of saying “our souls”) moves from one instance to the next with each passing moment, but according to the rules of reality. Your soul can’t, in other words, instantly leap into the version of you that’s a movie star, but you could take the steps — educational, social, economic — that lead you closer. This isn’t just a linear progression in a unique, circumscribed reality; it’s a transition of the very state of your being.
The experience of mental disorders, therefore, would be movement from one step to another with no logical coherence. To those of us living in a more ordered sequence of reality, that incoherence seems unreal.
So, it would be more correct, by this model, to say that the demented person is “over there,” rather than “in there” (lateral, rather than buried) although it remains no less possible to draw them back, perhaps so strongly and sustainedly as to effect what appears to be a miracle overcoming of biological logic.