The languages of Dementia
On a daily basis men and women will walk through congested airports. They will check in luggage and Show identification. Those whose trips will extend across borders of foreign lands will reach into their pocket or purse to pull out a passport. This is a symbol that the next stop will be in a place where the language is different. And beyond that the local dialect may be different. Spanish in Spain is different from Spanish in Mexico which is different from Spanish in Guatamala. Even in the United States we have regional intricacies of language. The you of Michigan is the yinns of Pittsburgh which is the y’all of the south.
When I travel to work each day I use my passport to enter the community and culture that I have so joyfully learned to function in. My passport is my work badge. I gently walk to a little noticed out of the way door. This door keeps the people of the community safe. I swipe that badge over the electronic monitor. A quiet click and a tiny green light gives me the go ahead just like the TSA agent at the airport. It is my passport into a culture packed with different languages. The language of the 42 residents that live in three houses, connected by large hallways and a beautiful courtyard, is that of Dementia. Each morning I pass through the door that leads me to my favorite land. Immediately I will notice the smell of bacon being cooked as if it was made to order just for me. It is the homemade breakfast that the people of the community will eat. It is made fresh just as they wake. Every inch of this living space is made for them so they can enjoy the commuity that their lives craft. I will greet Elaine who has just finished her breakfast of eggs and oatmeal. As I speak to Elaine I use my interpretive skills to speak the language of the “repeater.” After a friendly reply to my good morning Elaine will inquisitively look at her daily schedule of programs and then look up intently into my face. Her eyes are strong and thoughtful. She will ask me about the morning gathering. “Where is this morning gathering at?” I respond, “It is in the music house down the hall Elaine.” She will ask me, “what do they do at morning gathering?” I will explain to her about the group discussion and daily reflection that takes place. We will have some more small talk and a minute later she will come back to the question, “Where is this morning gathering at?” I will respond just as I did the first time. She will follow this up with, “What do they do at morning gathering?” With my best customer service smile I will respond just as I did a minute earlier explaining to her what goes on at the moring gathering and how enjoyable it is. As we continue to talk she tells me about selling real estate and what it was like to be a girl with seven brothers. Elaine will eventually circle back to the same questions about morning gathering. Elaine moved in three months ago and everyday we have had the same conversation multiple times and each day she will greet me with the same conversation and litany of questions. Many of the neurons of Elaine’s brain have turned into bundles of plaques and tangles. This is what the disease of dementia does. It turns the fully functioning computer called the human brain into a confused jumbled set of wires that keep if from operating as it once did. She remains a wonderful storyteller and giver of advice and a humorist. She will tell me stories from fifty, sixty, seventy years ago with attention to the specific details that make me feel as if I was part of the original story. But she will not remember the questions or conversation we had three minutes ago. She will not remember the stories she tells me and she has told me every day with the same fine attention to the details that paint the portrait of her life’s narrative. She is ninety one years old and she speaks with the same confidence that she did when she was selling property in mid life. Her strong Jewish eyes speak of her heritage as if she had just learned it. She sings the songs of her youth, recalling every word and detail as if she had just heard them. I speak Elaine’s language of consistent repeating, I give her hope to enjoy the day and I make my way farther along in our community.
Here comes Stew. As always he sees me, greets me with a smile and handshake and a pat on the shoulder. Stew treats me just like one of his old cronies in the lawyer world. If anybody walks by same will compliment me in front of the passer by. The words off of his mouth say, “Da uh ga mea over there. I min odo si br ha.” I will not interrupt him and I listen closely as he speaks one of the other languages of dementia. I will interpret Stew’s word Salad, as it is called. A visitor to our neighborhood would think this is a bunch of jumbled words. It actually has a clarity to it that one can understand if you spend time getting to know Stew. And he is worth listening to and getting to know. after graduating from West Point, where he participated in one of the greatest football rivalries known which is the Army vs. Navy football game he was sent to Viet Nam. He survived the rigors of warfare and went on to become a big time lawyer. When we drive across the City, Stew points out all the buildings he knew so well. “I dro tha ba mat in that. dru plst crd.” When we go on these bus trips he is always sure to say, “don good.” He is positively reinforcing my quality of work driving the bus. Stew is well known for his honest eyes when his is giving positive reinforcement. The strict discipline of West Point, the trials of war and the high positions he held as a lawyer have not taken away Stew’s humble nature. He is a man who genuinely loves people. While I never know exactly what Stew is saying, I listen closely, I think back to his story of days past and I live in his story of today. With that informantionI know that he is talking about getting ready for a meeting or seeing the boys downtown or he is telling me about his family. When I tell him I live near the airport he tells me stories with his word salad. He has said something about some work he did near the airport or when the airport opened. Or maybe it is a story of an airplane in the war? I am not sure which because in the long run it does not matter. What matters is that I listen to him with dignity and respect. He is a man who has served his country, his community and his family. He has welcomed me into his home and neighborhood and made me feel like one of the boys . Stew has the same character he has had for his entire life. Whether you have been a fellow plebe, a fox hole mate, a big shot business man or a person like me, who holds no special titles and has not done near the work that Stew has done, Stew makes you feel important. He is the kind of man you want to be around, people are drawn to him, you could only hope that he would be your mentor. The people in this community listen to him, they laugh with him and they want to care for him. Stew has lost his ability to orate the way he once could and it takes some effort to understand his language. He will talk about topics which make complete sense to him but not to the average person. But for those of us who know Stew, we hear him we understand him, we talk to him with dignity and respect. And even when we do not totally understand, we listen to him as if we do. Parts of his brain have atrophied and do not fully function. Dementia has melted away some of the grey matter that exists in the protection of his skull. He has left his life of complete independence to live in this community where caregivers take care of him. But he is the same honorable man that devoted his life to doing what is right, treating others with dignity and respect. When we make an effort to interpret his language and understand who he is today we gain a greater appreciation for his story. Stew has a story. Stew is a living story. In his dementia and with his word salad, he is full of life and vigor, humor and sometimes anxiety. Whatever story he tells and creates today I am privileged to have the honor of being his friend.