Different Dementias, Different Approaches: Part III

  • As I journey through the dementias I have experienced as a hands-on caregiver, I come to my uncle Wilkes. His wife was my mother’s older sister, who, while going into the hospital to visit my uncle after one of his many health crises, collapsed. She’d been very tired and weak, and we finally talked her into making an appointment with a doctor.

    The doctor suspected ovarian cancer. They opened her up during exploratory surgery, then closed her, saying she was full of cancer. In two weeks, she was gone. Self-neglect from caregiver stress? Hard to tell. She wasn’t much for doctors, anyway, and, if the cancer had, indeed, started in her ovaries, that is hard to detect in the early stages. Still, more concentration on her own health may have benefited her. We’ll never know.
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    Marian’s death was the beginning of a train of more strokes and other health problems for my uncle. He had home- health care for a year or so. Then another massive stroke, and he entered the nursing home (the same one my parents eventually entered – the new wing is jokingly called “the Bradley wing”). Each stroke affected him physically, of course, but also showed as aphasia – a language disorder caused by damage to portions of the brain, usually from stroke. For Wilkes, it showed in an inability so retrieve or say the right name for an object, even though he was thinking it. Aphasia is horribly frustrating for the sufferer, but is fairly common in stroke patients and those with multi-infarct dementia, which comes from blocked blood vessels in the brain.

    In “Minding Our Elders,” I describe an incident which stands out as key in Wilkes’ later life. He had always been very neat – an ex-military officer. He was quite rigid about his surroundings being just so. I was with him in his room at the nursing home, and he asked me to fix his magazines. The only thing I could see was his very neat pile of magazines on his bed stand. I sort of fiddled with them, and then asked if that was okay. He started getting frustrated and angry. He shouted, “No! Fix my magazines!”
    I touched different things and asked if that was what he wanted “fixed.” He looked ready to burst from the frustration. Finally, I opened his drawer, saw his razor and asked if his razor was what he wanted fixed. He shouted, “Yes! Fix my magazines!” I got his razor fixed.

    This kind of thought process, coupled with his sitting on the sun porch, screaming “Marian! Marian!” were hallmarks of his later years. Sometimes, distraction would work to get him involved in something outside of himself. That approach grew less and less effective as time went on.

    Lying in his deathbed, Uncle Wilkes kept reaching upwards, grabbing at the air and shouting “Marian! Marian!” I encouraged him to grab her hand. I knew Marian was waiting, and that death would end the immense frustration that had plagued him during his final, brain damaged, years. His death was my first attended death. It was a moving, spiritual moment. I saw Uncle Wilkes set free.

  • My sweet mother-in-law suffered another kind of dementia. I’ll finish the tale of my family dementia journeys in fourth and last blog of this series.
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Published On: October 12, 2006