Variability

photo credit: I am what I have found by Lomo-Cam

Each day is new for all of us. We may be more or less energetic. More or less motivated. Sadder or happier. Because we have a memory, we can see the variation during recent days. Even so it can be hard to avoid thinking that we have always been in our current state. For example, when I am depressed, I find it harder to believe that I was happy in the past.

Imagine how much more difficult it would be to understand our ups and downs if we had no memory of them. The ability to put things in perspective is seriously impaired. If Ted feels weak today, then he believes he has always been weak. He will say that he has good days and bad days, because his reasoning still works. But he has no memory of what happened in the past few days.

Goal setting is difficult. During a recent spate of good days, Ted became excited about the prospect of visiting his son, Bruce, in Illinois. I was surprised that over a period of two or three days he seemed to remember the idea of a trip. He looked forward to it and became impatient to know when he could go. Then a couple of days ago, Bruce sent a card with words of encouragement. Bruce mentioned that he was happy to hear from Barbara that Ted was looking forward to a trip to Illinois. Ted suddenly became quite angry. "I'm not going anywhere! Whose idea was this? Why didn't you talk to me about it?" I had just left the house, so it was Barbara who had to maneuver through this minefield. "Daddy, the trip was your idea. We were trying to help make it happen." Ted thought that was absurd. I suppose just then he was tired and perhaps anxious at the prospect of traveling. Since he had no memory of discussing it some days earlier, he felt strongly that the trip was some plot being foisted on him.

Most arguments contain an element of "I said" vs "you said". Even between two people with excellent memories, recollections vary. Two of us may have heard the same statement and interpreted it differently. If one can find documentation such as an e-mail, they may hold it up as evidence that their version of the story is right. The other may read it and explain that they remember the e-mail, but that they also remember seeing quite a different meaning or tone in it.

Because Ted has virtually no memory, arguments are futile. He cannot support his side of the argument by citing things that happened in the past. During the stress of attempting to argue, he may forget that he cannot remember. His reason is in tact. His current emotions are available to him. So he is likely to insist that there is no way he could have said or done something that is incompatible with his current emotional state. If Barbara or I try to use logic, his ability to reason is there, but he has to fabricate his own idea of what has happened in the past. His emotions may make it very difficult for him to believe our version of recent events.

It is hard enough to reconcile differing views between two folks with memory. It is much more difficult with someone who has virtually no memory. Even when we are able to reach agreement, Ted will often forget in less than 10 minutes. He relapses to taking a position based on his current emotional state.

It is very dangerous to say, "Don't you remember?". It is a common phrase in most disagreements. It is devastating for Ted. He may despair when he is challenged with that phrase, or he may become angry and agitated.

I try to stay in safe territory with Ted. For example, I help him reminisce about the farm or the war. Lately, he is fabricating entirely new versions of even his most vivid memories. There is no point in trying to correct him. I can offer up words or phrases that may entice him down memory lane, but I cannot coerce him to walk where I would like him to.

The safe territory keeps getting smaller. There are fewer detailed memories that I can help him access. Even when Ted can remember events, he may forget the words need to describe those events. I give him a chance to grope for the right word, but once it is obvious he is stuck, I offer whatever seems most likely. Sometimes I hit right on the mark. Other times my suggestion merely confuses Ted and I scramble to redirect the conversation.

I have feared that I will tire of rehashing the same stories with Ted. Sometimes I have. But I am surprised to find that more often we have an exchange that I find interesting and even enlightening. It works best if I immerse myself in the story as it is told. I can consider how I might have handled a situation. I speculate on why Ted made certain decisions. It is also important to believe that I am performing a valuable service by fully giving my attention to Ted.

Despite the many difficulties occasioned by Ted's handicap, our relationship is deepening. My respect for Ted grows. I learn important lessons. I hope that will continue as the dementia progresses.