The Grace of Dementia

We are all just walking each other home . . . 

We sit around the large round table off to the side in the memory unit or “Gardens Pavilion.”  Dad, me, hospice nurse Karen, and death doulah/friend Jane.

Mom is barely awake at the moment and is weak and thin. She does not appear to be uncomfortable. In fact, last night, Jane met her for the first time as Mom shifted in her bed in a semi-sleep state.  Jane, who has accompanied many people on their crossing the “threshold” as she calls it, kneels on the floor so she can get close to mom.  She rubs calendula cream on her elbow, red from friction with the sheet. She takes her time, slowly watching Mom’s movements and her facial expressions.  Mom smiles momentarily, looks pensive, then asleep.

Mom’s features are clearly outlined, the bone structure clear and skin translucent.  Her face moves easily through expressions.  “She is doing good work,” says Jane.  She nods confidently and looks at me.

I somehow know she is right. I have experienced my mom, even in advanced dementia, to have an unexpected twinkle in her eye at times.  The baby doll she carried around still lies on the bed.  I saw her kiss the baby’s head in a quick and natural Mom gesture, idly as she sat in the large dining and activity area a few weeks ago.

Jane has come to help us, my family, to traverse this last loping section of Mom’s life and our lives as a family, originally of five.  And I feel I can lean on her.  This work, of helping someone to die gracefully in their own time, is not a new practice, and the skills required harken us back to earlier times. 

We discovered that the musical instrument, the lyre, ancient in practice and familiar as the small harp held by angels or cherubs in paintings, has a magical quality when played for the ill or dying.  Since I have a small one, with just seven strings, I bring it over, tune it up, and play it for mom.  Amazingly, she stops the restless movement, sighs, and settles into a more peaceful posture.  Colleen, a woman who has played the lyre for years, comes the next day and plays while mom rests.  After she finishes, I put my arm around Mom and say, “Did you like the music?”  She looks at me and says in a resonant voice, “Yes.”   Years ago she might have just been polite, and we would not have known what she really felt.  Not today. It is clear.

After Karen does her exam, we gather at the table just outside the room and review her impressions and our plans for Mom.  It is a bright morning and the various memory unit residents stop by to smile at us, oblivious of the usual social boundaries.  It is refreshing when the woman with dementia who was once a skilled psychologist smiles at Karen and says, “perfect.” 

Just yesterday I drove back from Brooklyn, New York where I spent 24 hours helping my daughter, who is 8 months pregnant, get ready to move to Baltimore with the father of her child.  It is hard to miss the juxtaposition of life and death, of comings and goings in my own life.

I feel in awe and a bit out of my ordinary consciousness as I listen to my 90-year-old dad express his gratitude for this experience of the final spiraling of the life of his wife of 66 years.  I realize that I am too busy in these days and must slow down my pace of life to that of this graceful woman, my mom, who is showing me how to navigate the way towards death.  How interesting because, for most of her life, she never wanted to talk about it.

I contemplate what it will be like to be a grandmother, as I watch my 22-year-old daughter walk on the street, with nice round belly leading the way.  This is another opportunity for awe.  I feel a swell of grief that is a fullness in my whole chest as I look from one unfolding story to the other. 

Then I see my daughter’s latest post on Facebook and can hardly believe it.  I see a photo she took of her hand holding Mom’s just 18 short months ago.  Autumn leaves swirl on the ground, Mom’s feet walking next to hers, the old hand of my mother holding the young hand of my daughter. I read the quote that goes with the photo as Amelia relays what my mom said to her on that Thanksgiving day walk:

“If I could walk with you, I’d walk to the ends of the world.”

Amelia goes on, “She’s been really sick, going downhill with dementia.  I spent a lot of time with her growing up and she’s taught me many things to be grateful for. And I feel comfort knowing that she has lived a beautiful happy life.  No one knows how long she’ll be with us, and since she doesn’t talk to me much anymore, I’ll always remember what she said to me this day when we were walking.”

Things can be simple if we let them.  A young woman pregnant reflects on the love of her grandmother

And yes, we are all just walking each other home.