Tuesday, September 22, 2009

Old Age and Dementia

My grandfather passed away recently. Without dwelling on the topic, the last few years of his life were tragic, as the family watched our beloved father and grandfather slowly deteriorate from the great man that he was into a non-communicative state of minimal function and great suffering. The thought of it makes one think of where we are ultimately headed and generally does not engender warm fuzzy feelings.

This past Rosh HaShanah I had the privilege of pushing an older gentleman in his wheelchair to and from shul a number of times. This man apparently just recently, in the past month or two, began to demonstrate symptoms of dementia, to the obvious great distress of his family. I was aware of this from the outset, but not knowing him very well beforehand, was not really disturbed by this. On our first walk, I learned that he was born in Cracow in the 20s, was in a few concentration camps during the war, was transported to Frankfurt by U.S. troops upon liberation, where he found a small reconstructed Jewish community and he remained until 1951 when he immigrated to the states, met his wife, raised a family, etc. His only surviving relative was his father, whom he was reunited with 2 years after liberation. He apparently remained observant the entire time. I earned great respect for this man in our conversations, and I felt we both enjoyed these conversations, despite his asking me the same questions on almost every walk, and other similar blunders indicating the unfortunate deterioration of his mind.

Others who know him well remarked sadly how brilliant he was, his wife expressed her torment. But given the context of my introduction to him, I wasn't disturbed by the situation. I was viewing the present moment, not the past. It is what it is, and it is unfortunate, but he is still a man with feelings and many other distinctively human capacities, and I was glad to be able to transport him to shul, have some nice conversation with him, make him smile, feel good, etc. He was quite grateful as well and expressed so numerous times.

I later reflected on this experience as compared to how I related to my grandfather in his final years. Granted, my grandfather was more debilitated and probably suffering to a much greater extent. But reality is such that many of us will end our lives in a debilitated state, to some extent or another, we have resistance to accepting that, but we can't change it. I wished that I could have related to my grandfather in partial disregard of the giant of the man he used to be, only focusing on who he is now, his current existence. Perhaps I could have focused more on making him smile instead of the horror that consumed me in not even knowing if he knew who I was anymore.

I told my wife, if I ever go that way, please, don't even think about what I was and get distraught about my condition in relation to the past. Just focus on who I am at that moment. Make me laugh, smile, make my life a positive experience, give me an opportunity to give to others and remain human despite my existence as compared to my earlier self.




4 comments:

  1. Its very interesting. Usually, we struggle with anxiety about the future, which damages our experience of the present. But here, as you say, our experiences of the past can also damage the way we view the present. Like the Jews who returned to Eretz Israel after the first exile, and wept at the building of the Second Temple - they remembered the first Temple, and the Second Temple could not compare. Yet the young people danced, since this is all they ever knew...

    I think your point is very important, in so many contexts. Being able to detach ourselves from past sins and probable future sins, to experience holiness in the moment - its a great wisdom. I think psychologists call this "Mindfulness"...

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  2. I had some interesting reactions when reading your articale. On the one hand I relate to the experience of being able to appreciate someone more detached to you while at the same time being morbid about the decline of someone that is closer to you.
    However, whatever peace you may have gained in your experience that you eluded to by your comments to your wife escapes me. The thought of being betrayed by my own mind is one of scariest possible thoughts to me. Having seen the ravages of mental disease in two of my grandparents the thoughts that fill my mind are those of humbling fear.
    What would I want to happen to me on the onset of such a disease? How would the pity of those around me effect me while I still had the capacity to comprehend my deteriation? And of course the ciclecale nature of mind brings me back to the innate cruelty of such a system where someone is humbled and destroyed slowly before the eyes of those around them.
    I guess what I am trying to say is that I can understand the negative aspect of your experience. However, whatever peace you have gained eludes me and perhaps someday I will find myself in a place where I can begin to comprehend the sence of such suffering.

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  4. Solomon, thanks for the comment. You are seeking to comprehend the sense of suffering. I don't bother with that, I see no sense in trying to make sense of suffering; suffering makes no sense. Regardless though, suffering happens, and we must deal with it.

    Reflecting on the past, the decline compared to a previous state, is an intuitive response to this type of suffering. But it is counterproductive, it doesn't help one deal with the situation, it only makes it more difficult. I think it takes a concerted effort to isolate the situation to the present, and this makes it easier to deal with the situation more effectively, to continue to live and even enjoy life in such a state.

    As an analogy, imagine a mentally handicapped child being born to a family. This is clearly a difficult situation, but a healthy family will dedicate themselves to giving the kid a good and happy life, and will likely be generally cheerful around the child, despite the challenges. In contrast, think about the older person who degenerates from health to a mentally debilitated state. His family is less likely, I think, to deal with him in the cheerful manner of the family of the retarded child, because they reflect on the past and find the present depressing.

    The thought of losing my mind is no doubt frightening, but if I have my mind for most of my life, I hope I can accept losing it in my final years, if that turns out to be my fate. Being alive is more than just about having a mind that works properly. I've known some mentally handicapped people who seem to really enjoy life, even if their faculties are limited. If I have the misfortune to go that way in my old age, I hope my family can overlook their horror over what I am no longer, and instead treat my for what I am. A human being with limited mental faculties, but who can still be very much alive and even happy.

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