Dementia Reveals the Swirling of Real and Unreal

I've just been spending time with a dear old friend who has dementia. Her condition is reflected in significant memory losses, some anxiety and paranoia, with some deeply emotional and personality magnifications, and occasional confusions about words. One of the aspects of her behavior that is startling and evocative, is her way of asking the simplest questions, the answers to which reveal the substrate of human relationships. She asks, "Whose house is this?" as she walks up the stairs in the house in which she has lived for many decades. She looks around her, discovering everything with delight and pleasure, but when told "This is your house," her face darkens in confusion. She meets my gaze and asks, "Really? How can that be?" Of course I can tell her the story of how this house came to be hers, but her questions ask something so much deeper. She often simply asks, "Where am I?" and for that the answer is also simple and deeply complex.

Much of the time she seeks a sense of safety, some reassurance within the boundaries she feels and sees, that she is protected and secure. This can be physical but is often much more than that. She seeks protection for her heart, and of the transitional spaces in which she now functions. Beautifully dressed for an occasion honoring her partner, surrounded by guests she has known for years, she will engage each person with charm and standing quite close, offer sotto voce intimations of shared secrets. "Only you know exactly how that happened!" she might say with an endearing smile and light touch on the arm, without giving any more of a reference. Each guest receives her gift of intimacy with grace and honor, to be brought in close, and treated with such trust. Substance has receded into the most essential materials with which we connect and sustain each other.

When tired or anxious, she grasps at a defense and holds firm, while some around her try to distract her and others speak directly to the underlying causes of the fear or anxiety. There are no more corrections, when people say, "No, you were not there that time," or "I didn't say that," "You never did learn to do that," or any other denials of her momentary realities. She will move on, taking each moment fully as it is, creating the network of supporting evidence she needs to convince her self, or others, in that moment. The purity with which she asks, "Would you like my cup?" or "Are you staying?" makes each moment so full of grace.

I can't help but wonder why we spend so much time trying to convince ourselves and others to agree about data and facts between us that may well be simply illusion. We put way too much meaning and false value in controlling and manipulating this fluid surface and its meanings. It seems so clear to me now that when my friend joyfully exclaims "That's my son!" there is really no longer any need for him to ask her, "So what's my name?" as if that is a test of her memory. She clasps his middle-aged face in her hands and says with a voice saturated with love and longing, "You were a beautiful baby boy." What more is there to say about anything, other than "I love you?"