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Yesterday morning, Mom said to me, “I couldn’t remember if your guys’ name was Jesson or Devaney.” I asked her if she was talking about my brother, sister, and me. She was.
It is, of course, Jesson. But Devaney was my sister’s first husband’s name, and obviously her children’s name. Both names were familiar to her, but she couldn’t suss out who they belonged to.
Mom has showed signs of long-term memory confusion, but never quite so close to home. She often gets confused about what year it is. Whether or not various aunts and uncles are still alive, or how long they have been dead. Whether or not she still has her car.
But not being sure what my last name is, which incidentally happens to be her last name, kinda shook me. She’s surprisingly been relatively stable, dementia-wise, since she was first diagnosed almost three years ago. In fact, at her last follow up earlier this year, she had actually improved in some cognitive areas, which is almost unheard of. So, I guess I sort of thought, or hoped, that she would never really decline further.
The Filing Cabinet
I learned early on in my research into Mom’s condition that dementia attacks memory as if it were in a filing cabinet, which I guess is what memory actually is. Instead of a repository of paid bills, insurance documents, and bank statements, the filing cabinet that is our brain stores birthdays and faces and events and things that made us happy and people that made us sad. The newest files go first. That’s when she can’t remember if we had supper a few hours afterward. That’s why she can’t follow a movie or even a one-hour TV show. That’s why she can’t remember that the cutting boards are stored vertically on a shelf and not under the counter with the pots and pans.
Because the ability to lay down new memories is impaired, once those newer files are gone, they don’t get back filled with anything, and eventually reality becomes skewed. That’s why people with advanced dementia often believe their children are their parents, siblings, even spouses. If an eighty-year old man only has the first thirty years worth of files, the only way to make sense of a thirty-year old woman who looks like his wife is to believe she is his wife, because at thirty, his daughter was a little girl.
When All You Have Left is Hope
That she wouldn’t decline further was wishful thinking, of course. People with dementia don’t get demonstrably better. They always decline. At least in this day and age. Research is being done all the time into treatments and prevention. With so many living longer than ever before, dementia is almost a foregone conclusion, (if only because the human body isn’t meant to survive indefinitely), and many consider it an emerging, if not current, epidemic.
I ardently believe that Mom’s decline will be slow. She’s tough. She’s got resolve. She always has.