Different Dementias, Different Approaches: Part II

  • My dad suffered a closed head injury during WWII. He recovered from a coma, learned again to walk and talk, and he went on to live a reasonably normal life. His seventh decade, however, brought the injury back to haunt him. He was getting “fuzzy” mentally. Eventually, his balance became a problem, and it was determined that fluid was building up behind scar tissue, left from the injury, in his brain.

    It was decided to insert a shunt, to drain off the fluid. This is considered, under most circumstances, a safe, effective surgery. Dad was one of the unfortunate few who didn’t fair so well. He went into surgery pretty much himself, except for the waterlogged episodes. He came out a different man, firmly linked to a voice in his head we came to call Herman. Like my mother, he was given the catch-all diagnosis of organic brain disease.
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    Unlike my mother, my dad’s dementia was instant. Into surgery one man. Out of surgery, another. No one knew, from day to day, “who” he would be. Sometimes, he slept a great deal, almost to the point that we wondered if he’d ever come out of it. Sometimes he was agitated to the point of hysterics.

    Dad was like this for ten years, before he finally, physically, died. During that time, he changed, of course, but the main thing about caring for Dad was that I had to get into his world. It was the only way to bring him some peace.

    When he first had the surgery, psychiatric thought was fixated on redirection and distraction, for nearly everyone. “Bring him back to the real world,” I was told. Sorry folks, that just made him crazy. He was far beyond the real world.

    I became Dad’s “office manager” and took dictation, wrote letters to him from dignitaries, made degrees he thought he’d earned and generally helped him live in a fantasy world. I was, at first, criticized by some. The nursing home people, who knew him well, were fantastic, but his first psychiatrist was furious with me.

    Funny how things change. I refused to put my dad through hell by doing what I knew only frustrated him – the redirection and distraction routes. I joined him in fantasyland. I ignored criticism for years. Then, low and behold, a psychiatrist complimented me on how I handled Dad. He even chuckled over the wall of awards and degrees that plastered Dad’s walls. He said, “You instinctively knew what to do.” I needed to hear that, because even some who knew Dad thought my game of pretend was demeaning to such an intelligent man. They wanted to believe that he could be Dad again. Perhaps a little strange, but with the right techniques, still Dad. I knew that Dad was buried alive.

    Dad’s dementia was an adventure, that is for sure. He spent a great deal of time in mental hell. But I still remember how relieved I felt when I left him in peace, after seeing him frantic only an hour before – all because I got into his world. I “believed” what he told me. I carried out his “business.” He was able to accomplish the task that had bothered him so much, because I offered a solution – a fantasy, to be sure, but never-the-less, a solution. Dad’s peace was my reward.

  • Coming in the next blog is my uncle’s story. His dementia was caused by a stroke.
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Published On: October 05, 2006