ALZHEIMERS – A Spiritual Perspective of ‘The Long Goodbye’

The day I went to visit my mother and found her sprinkling sugar on a plate of mashed potatoes as she told me she had made me my favourite custard tart for tea, was a turning point. I was forced to accept that the mild confusion and increasing memory loss of recent years had become something else. We had reached a point of no return. An independent woman who had shown great resilience throughout her life was now dependent upon us, her family and sadly it was no longer possible to ensure her safety in her own home.

In the months which followed I sought help from every available source, becoming increasingly aware that our remaining time together to share any meaningful conversation was slipping away. I resolved to use it well. Doris had overcome major challenges throughout her life, writing a fascinating autobiography to record her war time memories and nursing experiences.   We talked for hours as she repeated the well worn stories of her teenage years,  the ‘big band’ sounds of Glenn Miller and the weekly dances, the sound of sirens and the hurried rush through the streets to air raid shelters.  Tears rolled down her cheeks as she recalled the friends in khaki who never returned when the war ended; on one occasion she looked around the room and said; ‘It’s nice to see them again’ When I asked who she was referring to she gave the names of three soldiers, friends who had been lost. I remembered she had told me their story many years ago.  ‘They come now and again‘ she said ‘usually round Poppy Day’.  I had no doubt that she could see her old friends and thank fully did not feel the need to contradict her in an attempt to stop the ‘hallucination’.

Similarly, she frequently refers to visits from deceased parents, ‘my mother seems to come for no real reason, just to see me, but my dad comes when I’m feeling down, to cheer me up, I always feel better when he’s been.’  It would be easy to dismiss such stories as reminiscence, a way of reassuring oneself however I well remember experiences when I was nursing. Those who were about to pass from the world would frequently describe visits from deceased family members or old friends, because of my own paranormal experiences I always gave them the benefit of the doubt. Once on night duty a somewhat assertive senior nurse instructed me to ask the visitors in a side ward to leave saying ‘How on Earth did they get in at this time, it’s ten past ten?‘ I went to the room and found only the patient who informed me that her aunt and her grandmother had just been to see her and would be coming again at the same time next day.: Since the patient was herself elderly I knew her grandmother could not have visited her, I checked the entry door to the ward, it was secured as always on night shift. I realized the nocturnal visitors seen by the staff nurse were the patients deceased family members; on reflection I decided not to risk the ridicule of a skeptical retort and said nothing to the staff nurse. I was off duty next day but on my return found that my patient had passed at ten past ten the following night.

Alzheimers has been referred to as ‘the long goodbye’ because the decline of faculties and perception usually occurs over many years. Hallucination, defined as ‘seeing what is not there’ can  be  a significant symptom assisting an Alzheimers diagnosis, yet how are we to know for certain whether the person is hallucinating or  ‘seeing’ on another level. Those of us who have had the good fortune to experience ‘altered states of consciousness’ or psychic events may consider other realities.

Perhaps the most difficult aspect of care for those diagnosed with such  mental health problems is the uncertainty of how best to manage their care. The challenge is not to become complacent and above all to keep a sense of humour.  My moments of utter despair  have been mixed with moments of laughter, even hilarity, when far from being delusional, my mother proved to be extra ordinarily perceptive. During the time she was living with me, I had requested a home visit from the doctor, concerned that she was deteriorating, due to increasing signs of confusion. I was told a nurse would call within 48 hours, I went to make some arrangements with a neighbour, when I  returned my mother said ‘the nurse has been, and done my blood tests’. I  knew this was not possible, I had been gone only minutes and mother was in an upstairs room, the local nurses had never previously visited so would surely not have entered the house and spoken to her in my absence. I  assured her that  the nurse would be coming next day but she  remained adamant that her blood had been taken. I looked around, there was no card or notification, I again tried to reassure her. Exasperated she stuck out her arm and said ‘I’m not ****** crackers, I’ve had the blood test!’  There in the vein was a needle, left in situ by mistake………….. Had it not been for the needle I would have been convinced that she was confused or ‘confabulating’.

Confabulation is a real feature of Alzheimer’s, a term used to describe  seemingly real experiences of an  imaginative world, it is an attempt by the person to make sense of their environment in a meaningful way. I will always be grateful to the psychiatrist who visited my mother to assess her mental state and despite her seeming lucidity on that occasion, made a definitive diagnosis. He told me a story of one of his patients, an elderly bedridden lady who described being entertained by the pink mice who ran backwards and forwards and danced on the bed rail. He said ‘I don’t try to persuade her that they are not there, why should I, if they keep her entertained’. Some years later as I listen to my mother ‘confabulating’ describing how she took the bus into town yesterday to the market, listing the things she had bought, I am grateful for his wise words. Immobile, she has not left her home alone in over six years, why would I take from her the memory of what she once enjoyed.

Doris has proved to be a great teacher, drawing around her a group of caring holistic therapists who feel privileged for the opportunity to learn more about Alzheimer’s disease from her than they ever could from a manual. When I was struggling with the decision to place my mother in residential care she turned to look at me with a steady gaze  and said quietly ‘Don’t cry, it’s just part of the journey’. At the age of 91 she told us that she has decided to stay for a while longer to help us to understand and she did. Doris passed away two years later, we remain grateful and endeavour to pass on the reminder that consciousness remains intact at a higher level as the journey continues.

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Dementia and Alzheimers – The Soul Journey  

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