Dementia and the person inside
by Jamie Duncan, HPCCR volunteer
Canadian author Alice Munro’s 1999 short story “The Bear Came Over The Mountain” is the heartbreaking account of a man, Grant, losing his wife, Fiona, to extreme dementia-related memory loss. He visits her in a nursing home on a regular basis, thinking of the years of marriage they shared. She does not recognize him. Instead, she is developing a relationship with a new man, Aubrey. When Aubrey’s wife, Marian, removes him from the home, Grant intervenes, convincing Marian to allow Aubrey to visit Fiona in the home so they can continue their relationship.
His decision strains our society’s notions of marriage even as it confirms them: he loves his wife, so he accepts her as the person she has become. He helps her find happiness, even at the risk of losing his own. The conflict of the story rests on an important question: is this woman still his wife? Must he define their relationship according to their shared lives together or according to the person she has become? In the end, he does both, taking care of his wife because of their past, and letting go of her because of her present. Despite her memory loss, her identity remains defined by the life she had lived and the relationships of her past. And yet, that woman of her past no longer exists.
Extreme memory loss causes drastic changes in a person, and often dementia patients are described as having lost all identity. However, it is important to acknowledge that a person cannot lose her identity to dementia any more than a 40-year-old adult woman has lost the identity of her 12-year-old self to an earlier stage of aging. The person has changed, but she is still the same person. A person’s identity simply cannot be defined as a fixed point on the line of a life course. That is the meaning I find in Munro’s story: identity is fluid and relationships are constructed from memories of the people we once were. Even in the case of dementia and severe memory loss, the patient is still the same person. And every person changes.
In my hospice visits, I am not under the impression that a dementia patient has always behaved in the manner I observe on any given day. But neither am I under the impression that the patient is not a person. Viewing a person’s life in its entirety may reveal early behaviors and factors that suggest a high probability of developing dementia. Even so, reading the journal of a twelve-year-old girl would do little to help us understand the behavior of her 40-year-old self; yet, they are the same person. A dementia patient’s whole life must come to bear on the question of her personhood, or else she is not allowed to be a person at all.Explore posts in the same categories: advocacy, awareness, dementia, end of life, hospice, volunteering comment below, or link to this permanent URL from your own site.