Tears and Laughter

Though the “going to the movie theater” experience seems to be less in vogue of late, I can think back, fondly, to a number of films I enjoyed over the years.  Among the “comedies” on my list of favorites are “Where’s Poppa,” released in 1970, and the holiday classic “Christmas Vacation,” which first screened in 1989.

Anyone who has seen the latter film will recall the scene at Christmas dinner where “Aunty Bethany” (played by Mae Questal) is invited to say grace before the meal.  Confused about what she is being asked to do, she pauses and then recites The Pledge of Allegiance … which causes Cousin Eddie to stand and put his hand over his heart.

“Where’s Poppa,” stars Ruth Gordon playing the part of George Segal’s rude and  “senile” mother.   As the plot unfolds, Segal’s frustration with being his mother’s sole caregiver reaches the point where he begins considering ways to dispose of her.  All the while, she demands to know where her long-deceased husband might be, asking repeatedly … “Where’s Poppa.”

Anyone who has seen either of these productions knows that laughter abounds.

At the risk of putting a damper on the hilarity, however, it should be noted that in both of these movies the actors are portraying individuals suffering from some form of dementia.  And though film credits use the term “senile” in describing the Ruth Gordon character, we have come to understand that to be an offensive and outdated term, generally avoided in discussing this awful condition.  But since both films are considered “comedies,” it is expected that viewers will find humor in what plays out on the screen. 

It makes some of us uncomfortable, no doubt, to admit having laughed or made light of behaviors we now know to be indicative of cognitive decline.  This is not to say that humor is or should be absent from interacting with and assisting those who suffer with this awful malady.  For many caregivers, in fact, laughter can be that precious healing moment, a mere heartbeat away from crying.  The difference, of course lies in “laughing with” rather than “laughing at.”

As a matter of fact, for the caregiver and the loved one alike, humor can play an important role in helping to alleviate stress by fostering connections, reducing agitation and providing comfort in challenging situations.  Additionally, shared laughter can enhance relationships, making individuals with Alzheimer’s feel safer and more connected to their loved ones.

Like most of society, Hollywood, now takes a more thoughtful and nuanced approach to the effects of dementia on families and individuals.  in the 2014 movie “Still Alice,” for example, Julianne Moore plays the part of a linguistics professor whose gradual descent into Alzheimer’s has a profound impact upon both her and her family.  It is heart-wrenching.

As the 6th leading cause of death in the United States, Alzheimer’s can have grave consequences for both the sufferer and the caregiver.  When Owen Darnell’s wife, Esther, passed away in 1993, he wrote a poem intended to help others understand just how devastating and debilitating certain forms of dementia can be.  His poignant words allow us to see this disease from the other side:

Do not ask me to remember,
Don’t try to make me understand,
Let me rest and know you’re with me,
Kiss my cheek and hold my hand.
I’m confused beyond your concept,
I am sad and sick and lost.
All I know is that I need you
To be with me at all cost.
Do not lose your patience with me,
Do not scold or curse or cry.
I can’t help the way I’m acting,
Can’t be different though I try.
Just remember that I need you,
That the best of me is gone,
Please don’t fail to stand beside me,
Love me ’til my life is done.

Aging Not So Gracefully

Some years ago on a trip to the Big Bend of Texas with My Lovely Bride (MLB), we went for dinner at a very nice restaurant in Alpine.  On the way out, I was helping MLB down the slate stairs leading to the parking lot when she lost her balance and began falling backward.  Not one to let her crash and burn without me, I proceeded to lose my balance as well, after which we both went down for the count. Looking back, the whole process seemed to have taken place in slow motion as we … in unison … dropped to a sitting position on the top stair and then … still in synch … collapsed all the way back until we were, side by side, lying on our backs in the restaurant entryway. 

I recall this event for two reasons … first, I am confident that we would have scored higher in the Olympic Team Tumbling competition if not for the fact that the Russian judge only gave us a score of 4.5.

The second reason I remember this event so vividly is that I know we dodged a bullet.  Though we both wound up laughing while struggling to get back on our feet, if that same scenario were to play out today, I am certain that someone would be dialing 911, and long-term rehab would be taking over our calendar.

All this is the long way around of saying … well … I’m starting to feel my age more and more of late.  That is not to say that I plan to spend my remaining time sitting on the porch yelling at kids to “get the hell off my lawn,” but I have to admit that the days of hanging on the rim in a pickup basketball game are behind me.  On the plus side, I meet regularly with my doctors, I try to stick to a healthy diet, and I engage in moderate exercise on a daily basis.  All of this, I am told, goes in the “plus” column.

At the same time, I have come to understand that while careful management of the physical dimensions of aging is essential, equal attention must be paid to emotional equilibrium and stress management.  In that vein, a recent Wall Street Journal article recommends the creation of a personal “F___ it Bucket” into which we can toss upsetting information that we can’t change.  An excellent suggestion … in fact, I have already put a few things in my bucket:

Family Drama  This one is not talking to that one.  The other one is still angry about something said twenty-five years ago.  Some blow off family events because … well, who knows?  This sort of thing used to make me anxious … now it just makes me tired.

Politics  Among the most volatile of areas, it seems few actually focus on listening or being respectful of differing opinions.  I will always vote, of course, but discussion of political views is off the table.

Media  Much like the political arena, limiting exposure to news media of every stripe is essential.  We subscribe to a range of news sources and it always entertaining to note how different media outlets report and editorialize on exactly the same event.

Sports  A life-long sports fan, I no longer pay attention to who wins any athletic contest, or the opinion of overpaid pro (and college) players.  This is especially so when their outrageous salaries are measured against the vast numbers of people in need of assistance.

Needless to say, there is ample room remaining in my “Bucket” for additional items and I am confident that, as time goes on, other nuisance issues will be added.

While expounding on the travails of aging in the midst of the holiday season, I can’t help but think of the classic Christmas poem “The Night Before Christmas.”  In particular, I can identify … up to a point … with the fellow who hears a clatter outside and “springs from his bed” to see what is going on.  The difference between that mythical fellow and me is that, first, I would slowly sit up on the side of the bed.  Then, I would take a moment to collect my thoughts.  Next, I would stand up carefully and after slowly limping to the window I would open the sash and yell:

Get the hell off my lawn!

Looking for Mr. Ames

Working as a police officer in the early 1970’s in upstate New York, I can recall being dispatched in the middle of the night to a remote dirt road to look for an elderly woman reported wandering aimlessly in her nightclothes.  Having been sent there previously, I knew that it would be Mrs. Ames, and that she was, once again, out searching for her husband and her son … both of whom who had passed away years before. 

Given our scant knowledge of dementia at that time, it was our understanding that Mrs. Ames was “senile.”  That being so, I did what we always did … I picked her up, took her back to her home, and sought a family member to take her into their care.

Over the many years since my paltry efforts to help a disoriented woman to safety, I have come to understand that Mrs. Ames suffered from dementia … an umbrella term encompassing a broad range of brain conditions that cause a progressive decline in a person’s ability to think and remember.  What’s more, the loss of these abilities makes it increasingly difficult for people to function or care for themselves.

Today, dementia in its many forms is far better understood and, in the law enforcement community, comprehensive training is readily available for police agencies nationwide.  The International Association of Chiefs of Police, for example, provides model policies   and training curricula to prepare officers for encounters with citizens suffering from dementia, as well as checklists to follow in mounting a search for someone who may have wandered away and gone missing.

My wife, Bonnie, and I, are fortunate to reside in a community where a number of resources are available to those suffering from dementia and to their caregivers.  Just a few of the very supportive entities upon which one can call in our area include Dementia Friendly Fort Worth (dffw.org), the James L. West Center for Dementia Care (jameslwest.org), and Musical Memory Singers (musicalmemorysingers.org).  

Given the fact that one in three seniors dies with Alzheimer’s or another form of dementia, having access to support and guidance of this nature is invaluable.

As I look back some fifty years to that rural road and my interaction with Mrs. Ames (not her real name), several thoughts come to mind.  First, I hope that I treated her with dignity and compassion as I picked her up, took her back to her home, and reached out to family to care for her.  Second, I am comforted in the knowledge that first responders, today, are far better prepared than I was, to identify and assist individuals suffering with dementia.

Finally, I have boundless gratitude for the efforts of those working to find a cure for Alzheimer’s, as well as for the many groups and volunteers who provide support and guidance to individuals struggling with that awful disease, and to their caregivers.

Gail Weatherill has been a practicing RN for more than 40 years, and is a board-certified Alzheimer’s Educator.   Her poignant words are an inspiration to anyone touched by this awful disease:

Dementia care … it’s not rocket science, it’s heart science.