Comforting the Demented

For the past ten years or so I’ve kept what I call a “120 file.” It contains materials such as copies of our wills, advanced directives, health care proxies, and the mechanics of dealing with our various accounts. I update it at least once a year, all of which is to make my wife’s life easier when, as it likely, I check out before she does.

Recently we’ve been joking that each of us should add a new item to the file, instructions to our successors – mine to my wife’s new husband, hers to my new wife, should either of us remarry after bereavement. Neither of us can imagine living with another partner, accommodating ourselves to a new set of crotchets and idiosyncrasies, but it’s hard to live alone, and if one of us should remarry, wouldn’t the new spouse welcome advance knowledge? Why learn the hard way? My new wife, for example, should know that when I’m hungry, particularly during that poisonous hour before dinner, I feel that the world is coming to an end. She shouldn’t think that she’s done anything to provoke my gloom. All she should do is remind me to eat something, and if that fails, to pop something into my mouth.

Now an additional list is suggested by a recent article in the Times, “The vanishing mind: giving Alzheimer’s patients their way, even chocolate.” It reports the award-winning program for demented patients at the Beatitudes nursing home in Phoenix, where the emphasis is placed on the patient’s comfort.

Patients are allowed to eat what they want, no matter how unhealthy the food, and whenever they want, even at two in the morning. One patient is soothed by a life-like baby doll that she carries with her all day. "Demented patients at Beatitudes are allowed practically anything that brings comfort, even an alcoholic ‘nip at night,’ said Tena Alonzo, director of research. ‘Whatever your vice is, we’re your folks,’ she said.” Interventions such as these are effective in alleviating patient discomfort and disorientation, diminishing emotional distress and behavioral problems.

This article, then, suggests another document for my “120 file,” interventions that are likely to give me comfort should I become demented. Visits from those I love would of course be at the top of the list, if I still recognize them. Recordings of Bach and Mozart would be helpful, as would unlimited amounts of vanilla ice cream with caramel sauce. One advantage of dementia is that the second dessert would taste as good as the first, which is likely to have been forgotten as soon as it is eaten. I’ve always enjoyed caring for plants and arranging flowers, and perhaps those skills would still be left to me and could be enlisted. Funny movies have been found to improve demented patients’ moods, so I’d like to view that scene in When Harry Met Sally, in which a customer at a diner, watching a young woman simulate an orgasm in the a nearby booth, tells the waitress, “I’ll have what she’s having.” With dementia, I could watch it over and over again. If it’s not impractical, the provision of a lapdog that I could pat during the day would help, but perhaps a stuffed animal would do as well. I like watching tropical fish, and if demented I could probably watch them for hours at a time.

Of course I can’t know if any of these ideas would work, but it can’t hurt to produce as long a list as I can. It’s always good to be prepared.