I visited my 86-year-old mom today, at the assisted living place where she resides. Mom’s still mentally acute, untouched by senility, totally in touch with reality.
Which reality includes unremitting pain. Pain that haunts her even through a narcotic patch. Her leg and hip joints are frozen into near-immobility, she’s confined to a motorized wheelchair, her right arm is almost useless from an old rotator cuff tear, her fingers are gnarled with arthritis, her ribcage is slowly collapsing, tightening on her lungs, as her spine compresses more and more.
She knows full well all her suffering will never be relieved, can only get worse. She sleeps poorly because she’s in constant physical misery, and she’s always tired. She tries to maintain a cheerful frame of mind, but the cruel truth of her existence torments her.
To lose one’s mind to senile dementia is a horrifying prospect. But might it not be merciful in cases such as my mother’s? No, I don’t want to lose what I have left of her into that blank oblivion, but sometimes I wonder whether it’s crueller for her to know so completely just how dreaful her existence is.
It’s impossible to say for sure, I think, but to me it would seem more like insult being added to injury - to have my physical health slip away, then start losing my mental faculties.
I’d tend to agree with that view of it. But it raises another question: What of the reverse situation – where the mental slide begins before the physical? If the person had been lost in senile dementia before the worst of the physical suffering developed, would that be worse, better, or irrelevant?
I guess my mother had the worst of both worlds. She was in a lot of pain, she was losing her mind, and she knew it. Her death was swift however.
I would have to say that senility is the greater burden. This is based mostly on my belief that a person should have the final say on the decisions that affect her life, including when and how to end it. I realize that is a hypothetical right in most of America.
That would be my grandfather. He started to get small symptoms of dementia (forgetting names, birthdays and the like) when I was…10? Anyways, I think he was 79 or 80 at the time, but yet in perfect physical health (well, as perfect as one can be for being 80.)
By the time I was 15 his car was gone (thankfully we took it away before anything bad happened,) he was getting meals on wheels, and every night either my mother or my uncle would check up on him, get him dinner, and so forth. Mind you, we lived 45 minutes from his house, my uncle thirty. This was not an easy thing to do.
By the time I was 18 we had to put him in assisted living care. It was a very nice facility designed especially for people with alzeheimers and dementia. He was there for about two years until he passed away from complictions that arose after he got pnuemonia.
It was very hard to deal with this growing up. To see a loved one slip away and being able to do nothing about it is hard. You can’t communicate with them, they are unable to tell you how they feel, etc…Is it better or worse than being in physical pain? Hard to say. From their standpoint, I’m sure better. As far as we can tell, they aren’t usually aware that their mind isn’t all there. Wheras in the other case, they are in constant pain and can feel it all the time. But from our standpoint, it’s still very hard to watch someone go through that. And when he died, it wasn’t like he suffered through years of pain/cancer and we can at least say it was a blessing, or something to that effect, cause we know that maybe he could have lived another five or ten years had he just not gotten that pnuemonia.
Currently, my father’s mother is now in an assisted living facility for her dementia. She, unfortunately, also has physical problems. She has a bad hip and arm. And the big problem with having dementia and being physically injured/hurt is that they can’t always communicate the pain. Just thid past thanksgiving we had her over for dinner. She fell down, partially onto her hip, and partially onto her arm. We say her down, gave her some advil, and kept an eye on her. Five minutes later, she didn’t remember she had fallen, and said she felt fine. Well, by the time dinenr was over, she couldn’t even walk from the dining room to ther living room. We had to call an ambulance to take her to the hospital. She had a hairline fractier in her hip. Since her mind was so gone, she couldn’t tell us she was in pain.
Hmm…I’ve got lots of potassium cyanide capsules here. I can end my life easily for any reason whatsover. I have personallly had the honor of shaking the hand of Dr. Jack Kevorkian. What more can I say?
I would imagine that senility would make it worse-you might be in pain, but you wouldn’t know why, you might start to think that the people around you are causing it, you’re frightened, confused, etc.
Personally speaking, I’d prefer to be completely cognizant of my physical condition up to the point of death. I dislike not knowing what’s going on around me, like Guin said, it would make me more frightened, and I wouldn’t want to live the last years of my life in fear. Also, I’m fairly terrified of Alzheimer’s disease, and plan to bow out at the first sign of it. To me, there’s really nothing worse than senility.
When my intern class and I were having discussion sessions on hospice care, we talked about all the different ways to die, and which one each of us would choose. The attending we were working with, the local hospice director, said she wouldn’t mind getting cancer when the time came–she’d have a reasonable idea of how much time she had left, she could keep her mental faculties, and she was confident in the ability of her colleagues to treat her pain.
I was completely the opposite. I don’t really fear death as much as I fear the anticipation of death, so my ideal situation would be to lead a long, healthy life and then drop dead of a heart attack, preferably in my sleep. Failing that, Alzheimer’s wouldn’t be a bad way to go; I would feel my mental status slipping, for sure, but by the time the end came I wouldn’t be aware of it.
While most doctors are pretty good about treating pain these days, I don’t think most are that good about treating agitation; they’re often afraid of the drugs and afraid of sedation, much like they were with pain a generation or two ago. As long as I had competent docs who wouldn’t let me stay in a screaming fit, I think I could handle dementia fairly well.
A good question, Quartz. What I don’t know is how conscious the senile are of their physical state – witness what bouv said about his grandmother.
It’s not just the bodily pain that torments my mom. She used to be quite active, both before and after my father died. She loved to travel, went to Florida for vacation each winter, spent summers at the family’s little cottage on Lake Winnipesaukee, had a bunch of friends she did things with regularly. In fact, as a widow in her 60s she took a trip to Alaska.
Now she’s a prisoner in her crumbling flesh. Leaving the facility requires arranging for a chair car and scheduling any activity around its schedule. Many of her long-time friends are dead or no longer able to spend time with her. She can’t attend our family gatherings any more because it’s impossible for her to join them at my brother’s (formerly the family) house – stairs, bathroom facilities are insurmountable problems now. (This is after several years during her physical decline when my brother would build a ramp over the outside stairs, and he and I would haul her nonmotorized wheelchair up it.)
She’s been a reader all her life, kept up with current events, followed the local sports teams faithfully. Now her hearing and vision are fading away. She has terrible difficulty reading her daily newspaper, or even large-print books.
The last few times she’s been hospitalized, she’s asked for DNR orders. She speaks often of wanting release from her suffering. What kind of life is this?
Exactly how it happened with my grandmother. She was convinced that her home care giver was piling rocks on her chest as she slept. When we finally decided to move her, she was constantly accusing anyone near her of theft, because she didn’t have the same stuff around her any more.
So, to answer the title with my own limited experience: NO
Isn’t it ghastly? I spend every other weekend and all my vacations visiting my mother at “Agatha Christie House,” and I can’t tell you how much I look forward to being dead after a few days there. My mother’s mind and body are deteriorating pretty much neck-and-neck with each other; she could go tomorrow or she could live another ten years (the women in my family live into their 80s or 90s, but the last few years are hell).
I see these women (and the few men) at this place–and it’s a top-of-the-line facility–sitting there like the stone heads at Easter Island. Not all happy and wisecracking like in Waiting for God, but senile or depressed or just pissed-off, or having just given up. Just sitting there, staring. I make as many friends there as I can and try to engage them in conversation and not treat them like five-year-olds, as so many of the staff do, so I am a popular kid down there. They call me the USO Girl, 'cause I get them all coffee and doughnuts.
There’s one really beautiful, wraith-thin old woman, who just sits and stares and never says a word and I wonder what, if anything, is going through her mind.
Interesting question- one that my family has been dealing with. My aunt is 84, strong and agile as a 20 year old. However, dementia has made her an evil person. This past autumn my parents and other aunts/uncles had to put her into an assisted care facility against her wishes. It was horrible. But she could not live on her own anymore. The state took her drivers’ license away, but she firmly believes my dad made them do that so he could steal her car (he bought the car from her). Since she’s been in the facility she’s escaped three times, even attacked a 25 year old aide who attempted to bring her back. It is heartbreaking to know she is so scared, but knowing there is nothing you can do about it.
OTOH, my dad has prostate cancer which has spread into his bones. Mentally he is 100%, but he is in almost constant pain. He knows he doesn’t have a heck of a lot of time left and it trying to enjoy it as much as possible, but he gets exhausted just climbing up a flight of stairs.
According to my dad, he would rather be in the shape he is now with all his mental faculties than be perpetually frightened like his sister is. I guess I would agree with him. He can obtain meds that will allow temporary relief, but my aunt is in such a fog that she will never be whole again.
Just coming in to provide an alternative picture. I have a neighbour just coming up to her 97th birthday. She is physically frail but mentally alert. Recently she was hospitalised briefly following a fall at home but was moved almost immediately to a rehabilitation centre to prepare her for returning home, which will be soon. For years she has lived in fear of going into a “home” but she loves it in this place. She cannot praise the food, the facilities or the staff enough. The residents have their own rooms and the place is divided up into small wings, each with their own dining and sitting room. When I go up to visit I find her cheerful and chatty – though she is looking forward to coming home. Up til now she has managed on her own at home with relatives’ visits, when she returns she will be having nursing care and meals provided as well. She does suffer some pain from arthritis but since she has been receiving physiotherapy that and her mobility have improved. She does get down sometimes about being old of course but I find her to possess a strong will to live that is truly admirable. Let’s hope we all finish up like her shall we?
Oh, man, how I wish it could be like that for my mom! She bears up remarkably well for all her burdens, and she’s in a nice place, but what you describe would be paradise for her.