Sparky's gone, and Mary's not doing too well, either

If there is something more gut-wrenching than watching someone mentally deteriorate, I don't want to know what it is, because it has to be something truly horrible.  We tried to keep Mary, my mom, at home for a time but, unlike physically-debilitating conditions, those of the mental variety soon outpace the ability of family members to keep up.  The neighbor ringing the doorbell at 4 am with mom in tow put the exclamation point on the effort at home-based care.  Mary is now at a nice facility, cared for by a round-the-clock staff and surrounded by older folks who are sometimes part of this world and, at other times, in their own universe.  The typical conversation includes a lengthy spell of trying to figure out the context of what she is talking about:  did something happen at the facility, did a friend say something, is what she is talking about even real. 

Some weeks ago came word that former baseball manager Sparky Anderson had died, just a few days after being put into hospice care during the last days of dementia.  I was a huge fan of the Big Red Machine in the 1970s, a baseball team that always finds a spot on lists of best ballclubs ever.  Sparky was a character, a latter-day Casey Stengel type who knew baseball but had a habit for mangling the English language.  His death was a stark reminder that while people sometimes beat back physical ailments, no one gets over on things like dementia and Alzheimer's.  Imagine knowing the day you talk with someone who has such a condition is the best day that person is going to have; that the next day will be a little bit worse, as will the one after that and the one after that. 

If there is an upside, it is that such patients are not in pain, not spending their last days and months in agony.  Mom has her own world that she sometimes lets us into; at other times, it is virtually impossible to know what she is talking about.  So, you nod where it seems appropriate, say clever things like "uh-huh" and "really?" to give the impression that you are following along a narrative that may as well be in another language.  Frankly, visits are depressing but what do you do.  We visit and try to make the most of it. 

The most maddening thing is that these patients retain a good deal of social skill; in other words, they can fool someone who is unfamiliar with things like the 4 am wakeup, or her calling for a husband who's been dead 9 months, or the other people she sees that no one else does.  But, if you don't know that, she can ask enough general questions or carry on enough of a conversation to leave you believing that the problem is just a few "senior moments".  Those who visit often, however, learn that is not the case.  It's a nasty thing, this dementia.  People don't get a choice but if they did, my recommendation is ask for a physical ailment at the end; the mental type is much harder.