I think your comment about the dog is very insightful. And the fact the insight occurred to you naturally then, not later now, makes it very genuine. Thank you for that.
I have very little direct experience with dementia sufferers. But here’s a story for everyone to consider using the “what-if-a-dog?” rubric.
My grandfather was pretty physically and mentally vigorous up until about age 84. He gave up tennis at about age 80 because all his partners had died or become infirm. He still walked and rode public transportation in San Francisco where they had lived for decades.
One fateful day at age 84 he had a stroke at home. Left him a bit physically weaker & his balance a bit unsteady, but it really destroyed his mind. He could talk but often made little sense. He had vague notions of fuzzy memories of people, but he simply could not follow a simple conversation, or remember who he was talking to or about for more than maybe 30 seconds. Sometimes he could string two or three sentences together, but often it was more like “want coffee” “need bathroom” or “who you?”
His wife, herself in her late 70s tried to care for him at home, and at least at first his disposition was placid, if not much company. After IIRC ~6 months that began to change and he would by turns be awake but totally inert, placid and seemingly aware but aloof, or angry / verbally threatening. His already small verbal abilities continually dwindled.
At that point he was moved to a stroke / memory care facility where his wife could visit regularly but didn’t have care duty. At the facility he too did small activities overseen by the staff, fed himself, and when not inert seemed agreeable enough most of the time and distressed / angry only some of the time. Though now non-verbal except to shout when agitated.
Now the kicker: One day while he was in bed awake and placid and she was visiting, just yakking about stuff, he suddenly sat up purposefully, said in his pre-stroke strong voice “Oh <her name>, I’ve been in a terrible fog. It’s awful. Help me come back.” Then he lapsed into inertness. He died almost a year later, not having uttered a coherent sentence since that day, nor many in the previous couple months at the facility.
In all he lasted a bit shy of 3 years post-stroke. I am convinced in his case that post-stroke inside his head it wasn’t like being a dog. It was like being a man reduced to being a dog and knowing the difference. He knew, at least sometimes, how much of his mind was gone. He knew, at least sometimes, how the hours and days and weeks and months dragged out in his “fog.” And it caused him great psychological anguish.
We will never know for sure in his case, or countless others like him. We may someday be able to instrument the demented and the stroke- and brain-trauma patients to know who has insight into their condition and who does not.
But my personal prejudice, formed from my personal experiences, limited though they are, is that placidity or inertness on the outside need not correspond to placidity or inertness on the inside. We may be torturing a lot more innocent people than we know.