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28 Feb 2013

What Does Dementia Mean?

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By: Cindy Hasz, Geriatric Care Manager

what does dementia meanSAN DIEGO — A large percentage of the elderly are afflicted with it, but what is dementia?

The dictionary defines it as “a severe mental deficiency or impairment.” Literally, out from (de) the mind (mens). Most of us will think immediately of Alzheimer’s. But there are assorted varieties of dementia – the Parkinson’s-related type and the generic dementias associated with aging and “hardening of the arteries.”

What I find as I visit the various outposts of severe mental deficiencies in and around San Diego – facilities that specialize in Dementia Care – is that they are very special places full of very special people. They are in a sense, aboriginal places. Patients there are who they are – having lost the capacity to hide or misrepresent themselves. Most often they cannot remember who they are well enough to sustain the artifice of manners or deception.

Though I am often shocked to find people so unrestrained (lying on floors, walking around naked or relieving themselves on the nearest green plant), it is also strangely refreshing to observe the freedom of the primitive.

They dance with us easily, tell you that they love you or need you or hate you as the case may be. They do more than tell the truth – they simply are the truth. Each personality stands out in stark relief. Like frescoes one finds oneself alternately drawn to and disturbed by.

There’s the woman who swings her hips as she walks in a bold, teasing way while clutching a tattered stuffed animal tightly under her bony right arm, like her bottom half and top half belong to very different people.

There’s the man who mutters to himself shuffling along in his stained polyester and Sinatra type hat. A man with a quick smile who moves furniture and the tiny wraithe of a woman with pale blue eyes who holds serious conversations with her “sister” in the mirror.

Then there’s Jackie, who whistles when she’s feeling awkward, and Faye, the piano teacher, who though she can’t remember much else remembers every piece of music she ever learned. We sat together one day while she played song after song.

Beethoven’s “Moonlight Sonata,” Bach’s “Intentions” – written for his children. A march by Franz Schubert and Chopin’s Prelude in A. Her face had grown translucent by this time and a group had gathered round.

She played Paderewski’s Minuet in G and then Tchaikovsky’s 6th Symphony, “Pathetique.” The Polish Madame began to dance with a little man with very sad eyes. Ruby sat and scowled as Ruby always does and the rest of us listened rapt as frail fingers flew over ivory transforming the very unremarkable room into a palace. There was no mistaking the crumpled royalty assembled.

When she finished we didn’t want to leave. We’d been together in a shaft of light so brilliant and devastatingly sweet that we wanted it to go on forever. I thought of the words, “Blessed are the poor in spirit for theirs is the kingdom of God.”

Lo and behold, is the kingdom of God to be found in the outbacks of dementia? Verily, the poor of memory and challenged of intellect have greater riches to share with us than we imagine if we have the wisdom to open our hearts to them.

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