Apathy
Apathy destroys an Alzheimer’s Victim’s Self Worth. A wise Caregiver is one who actively pursues an understanding of the various forms as well as the subtle-ness in the rise of Apathy. And once gaining that perspective, proactively encourages the enhancement of the Third element of the Three Vital Essentials of providing proper Care for an Alzheimer’s patient.
Unrecognized Apathy
in an Alzheimer’s Caregiver’s performance of duties
May well prompt an early rise of Apathy in the Alzheimer’s Victim…
Which may lead to a Shorter, Less Than Pleasant Life
Almost always, the best way to offer instruction or even present offerings for consideration is when you are speaking from a position of first hand experience. What you are about to read below is not necessarily wholly from my own personal experience though, but from the first hand experience of a dear friend whom I explicitly trust.
Due to the sensitive nature of this presentation, the names are changed. The idea, you see, is not to disparage or bring forth blame to one or more individuals, but to offer for your consideration one manner of care-taking that could have been handled quite differently… resulting in peace and harmony within the mind of the Alzheimer’s Victim. Not the horror she’d previously gone through for months. Perhaps you’ll pick out bits and pieces of the following with which you can identify. And, if appropriate, make necessary changes earlier, rather than following the footsteps of my dear friend.
We’ll call my dear friend, Roma. Her Mother, Frieda, has Alzheimer’s Disease and is now in the final stage. Roma’s Step Father, Jorge, married Frieda over twenty years ago. Frieda was brought up in an era and culture wherein she was taught that a good wife was always submissive. (A not so uncommon adaptation, by the way, of what many people incorrectly believe to be what the Holy Bible has to say on the subject.) In that their ages were similar, Jorge, unfortunately, was taught the same cultural standard believing he was ‘right’ to keep his wife in a subservient mode of existence. Problems with such an existence, as you might guess, come and go, but to compound things, Jorge was not the brightest guy in the world. He spent the bulk of his life as a lower level sergeant in the military always giving orders only to privates and taking them from everyone else. His standard outlook on life as was regularly expressed to his wife, Frieda, was ‘I’ll bring home the bacon… your job in life is to serve me’. Nevertheless, due to each of their long term seemingly inbred system of ‘how things worked in a marriage’, life did work well for them throughout their marriage. Until Alzheimer’s Disease struck Frieda.
Coming from a military background and being ‘the Boss’ throughout their marriage, for the first few years Jorge constantly yelled at Frieda believing that if he were to dramatically call her attention to her errors, she’d become better able to see the reality of what she was doing and how she was thinking. Then, and only then shoe would change back to the way she was. No matter who or how many times the facts of Alzheimer’s were explained to Jorge, all such considerations fell on deaf ears. He knew best. From his perspective, he was a good sergeant and no one needed teach him anything. Like so many people in all arenas in life, he felt he knew all there was to know on the subject at hand. Facts didn’t matter. The idea of pursuing facts was, to him, not relevant. He’d proceed to do what he felt was right. After all… the ‘right’ way had always been, ‘My way or the highway’.
Now we’ll cut to the chase…
Roughly five years into Frieda’s Alzheimer’s, over a period of less than two months Jorge’s ability to comprehend, think and reason… digressed dramatically. During the eighth week of that period, his capability to employ the use of his brain dropped even more substantially.
Roma began to learn the reality of that which she’d always heard was true… (at least in her parent’s case.) ‘As people age, they tend to migrate toward being either a person with good relational traits or, a person with very poor relational traits. The direction of their travel based upon the bent of the lifelong habitual workings of their minds and hearts.’
Her mother’s digression, though having its expected ups and downs, went relatively smoothly because Frieda’s nature was one of a kind, compassionate person. She was always willing to serve another; to be helpful. Jorge, on the other hand, had always been what is commonly known as a ‘control freak’. He was always of a domineering nature. ‘Always right’, angry if he didn’t get his way and generally ignorant of many arenas of commonly accepted human communication. That is not to say he was not a man capable of love. He did love Frieda a GREAT DEAL in the only manner he had life long known. The unfortunate thing was that his idea of what real love entailed was hugely lacking the entire scope of reality.
During Jorge’s last week of dramatic decline as noted above, Roma had to almost completely isolate Frieda from Jorge. Frieda, of course, infrequently and then only momentarily recognized Jorge at all… rarely knowing he wasn’t around. To her, his absence simply wasn’t noted. Jorge well recognized the situation and sometimes started to become somewhat aggressive toward recapturing his dominant role and regain his subservient wife. His aggressiveness caused Roma to be particularly careful to ensure intense supervision was the norm; otherwise, the separation of the two remained near complete. Else, Jorge’s wrath might be taken out on Frieda. (Which in part and to a small degree it was, anyway. Twice in that last week he feigned hitting her in the face and to Frieda, spoke of wishing her dead.)
All that said to offer the following for your consideration… Roma, a loving, nurturing person was appalled when during the first three days or so after largely separating her Mother from Jorge, her Mother quite out of the blue and with tears in her eyes constantly asked her , ‘Am I dumb?’ ‘Am I bad?’ ‘Am I wrong?’ ‘Am I a bad person?’ ‘Am I crazy?’ ‘Am I nuts?’ Along with a multitude of Etceteras.
It was only then that other things began making more sense to Roma. Probably because it is a part of the Disease, before this point Roma didn’t think twice about Frieda’s extended sleep habits. As she began thinking about the history of the last two months though, she realized that whenever she left Frieda in Jorge’s care as she retired to her ‘Private Sanctuary’ for a few minutes respite – Frieda almost always went right to sleep. (Years before, Roma had installed a surveillance system so during her short periods of respite she could still keep an eye on things.) The thing was that when Roma had Frieda with her, Frieda almost always remained awake… and much happier than when she remained with Jorge. Only then did it begin to make sense that likely as a subconscious self preservation tactic, Frieda’s mind likely initiated a sleep pattern as a way to avoid Jorge’s ongoing comments such as, ‘You are dumb.’ ‘You are bad.’ ‘You are wrong.’ ‘You are a bad person.’ ‘You are crazy.’ ‘You are nuts.’ Along with a multitude of Etceteras!
After Jorge’s departure to live with his daughter, Frieda’s eating habits noticeably changed, as well. Previously, she had been to the point where, largely speaking, she wouldn’t/couldn’t eat unless she was spoon fed. And yes, that is part of the typical digression of Alzheimer’s Disease, as well. Yet, after Frieda began to better realize she was ‘a good person’, ‘a kind person’, ‘you are not wrong’, ‘you are not bad’, etc., she began to sometimes take the initiative and even grab the fork or spoon and begin to once again feed herself. Not at all a complete reversal, of course, but a noticeable change for the better.
Roma realized that in her effort to nurture both her parents toward happier moments of togetherness during their ordeal with Alzheimer’s Disease, she didn’t escalate her watchfulness to the appropriate degree she should have as Jorge’s mind began to dramatically slip. Given his nature, she now understands such offerings to Frieda had likely been ongoing for even a far greater period of time, not simply a result of the last two months they were together. Roma indicated it would have been best for both her Mom’s and Dad’s sake to separate them sooner… surely at the very least a month or two earlier. Her Mom for obvious reasons; her Dad’s departure due to his quickly advancing inability to maintain oral communication with his wife at the level they’d happily existed at for just over 20 years.
I’d say that what I most learned from Roma’s struggles is that while trying to keep both parents as much together as was emotionally and physically possible, one simply cannot give minimal heed to a person’s innate nature. And the fact that due to the disease and/or how the effects of the disease are handled by others who are immediately involved.
I well understand some may not consider this an issue of apathy.
Nevertheless,
I placed it under the section ‘Self Worth’ for two distinct reasons…
1) Though we, as Caregivers, are not necessarily apathetically inclined when we don’t recognize in advance things of this nature… we must teach ourselves not to merely accept life without proactively attempting to comprehend reasons why life is the way we see it. Had Roma, myself or anyone else experiencing similar occurrences, been a bit more proactive in her search for understanding the whys and wherefores of her Mother’s emotional content, then she might have held at bay at least a degree of emotional pain her Mother went through during her last several months of life. Something to think about. (By the way, Roma concurs.)
2) The degree of peace, joy, love and happiness one who is afflicted with Alzheimer’s Disease might experience just might be found in how their internal nature has been and is currently being groomed. Could a good part of the development of apathy revolve around the victim perception that they are receiving a lessening of kindness from those around them? Could the internal ‘cup’ holding the victim’s daily emotional infilling be leaking because for any number of reasons… it has been shattered; even subtly? Is their emotional ‘cup’ not recurrently being positively filled? How much does the ongoing lessening of positive emotional input affect the Victim’s digression into Apathy?
Certainly decisions must be made on a case by case basis, but each of us as Caregivers might wish to look more closely at the nature of couples, proximity to each other, etc. in order to attempt to better determine if and when an earlier than required separation, IF ANY, might be best for all involved. Without question, a solid consideration of the current ‘Emotional Content‘ of the Alzheimer’s Victim should be paramount in the decision making process.
Having said the above and in this case having identified Jorge as the probable primary culprit in his wife’s less than happy emotional decline… we nevertheless still cannot diminish consideration for him, or he or she who might be the ‘offending’ mate in your circumstance. An old adage applies… Have we walked a mile in their shoes? Have we any idea of the early ‘mental implants’ as well as the life long adjustments experienced by the current offender? Regardless, though, we must take care of the problem TODAY. To excuse the offender by allowing a continuance of his or her performance is ludicrous because it invites further difficulties for the Victim. The idea though, is not to ‘nail one person to the wall’ in favor of another. Just solve the problem. The case by case decisions made must include your best estimate as that which leads toward the best ‘end of life‘ benefits for both. For both.
You may wish to turn to…
Or…
