When deficits in cognition make it difficult for the self of the dementia patient to emerge, we can use our empathy and intuitive sense of the person to help them to bring out their submerged self. I can think of lots of examples of how this worked with my grandpa and also most of the other persons with whom I developed a personal relationship with in hospice care who had dementia. When a person emerges from the fog of dementia, they are recognizing and connecting with themselves and others.
Let me tell you a few stories that exemplify how this works. My grandpa flew on B-29s in the Second World War. As one of the many young men who went to war in his generation, he joined the Air Force at the age of 17. In visiting persons of his generation at the end of their lives, I have found that a good number of them joined the military younger than 18. My grandfather graduated early from high school and went directly into the service, because the Japanese had just attacked the United States at Pearl Harbor. Grandpa had a metal B-29 on a post in his back yard. I would often point to it and ask him questions. His memory for day-to-day affairs was spotty at best, but he could always remember and talk about being in a bomber above Japan. It would give him a sense of dignity, and dignify him in my eyes.
I also visited a woman who was profoundly demented in Western Oregon when I worked there. She was a former conservative politician in a largely blue state. She had pictures of horses in her room, and lots of Western themed artwork. She loved listening to music, and I often played her Johnny Cash or Elvis Presley on a little CD player she had. On occasion, she would smile at me after I would play music and talk with her. I learned from her daughter that she liked walking outside, so when spring turned the drip of the Pacific Northwest into sunshine, we went outside on walks in the garden. She would visibly brighten when we went outside.
When I visit stroke victims on the Neuro ICU in my current role, talking to them about faith or family, asking questions and then waiting a long time for them to form the words, gives them a sense that they remain someone who matters. Likewise when I listen to family present talk about the person in the bed who might not be able to talk for themselves, the person emerges as an agent in stories that the family holds dear. They recover a sense of personhood after the disorientation and fear of a stroke, and really this is not so very different than a person livening up after being submerged in their own mind.
What a person is, what makes us human, is much more than the ability to access semantic memory or even the details of life’s experiences. Humanity nestles in the habits of our body and the touch we share with our parents and children. It is in the idiosyncratic noises and looks we make. It is in our distinct way of walking. It lives in the mysterious nature of our becoming. Who we are is bigger than even how we feel about ourselves and others. Our being can be a wide open space of love and compassion that facilitates connection between our truest self and others.
By facilitating connection with grandfather and my Oregonian conservative, I found a wider field of of connection for me as well. When we give care, we align ourselves with the loving and nurturing force of this field of connection, the network of social relationships that make us who we are as unique persons and as communities.
