I am a witness to the rationalizing and lies born from the mouth of dementia. Most of the people that come in contact with Mom don’t pick up on these untruths. She’s experiencing nearly stage five of Alzheimer’s: poor short term memory, inability to pay bills or manage finances, forgets details about life history, simple math may be difficult, getting dressed is challenging. But in passing interactions with her it can be impossible to pick up on any of signs.
She’s very social and can carry on basic conversations. Her smile and enthusiasm are engaging.
“Hi! How are you?!” she’ll practically squeak, her eyes lighting up.
Although your face looks familiar, she probably doesn’t know your name. And if she knows your name she might spend the afternoon repeating how wonderful it was to see run into you, but by tomorrow the memory will be lifted away like dust.
Oh, and that detail she told you about what she’s up to lately? It’s probably not true, or only half true.
As expected, having dementia causes big gaps in memory and brain functionality. Often if you ask a question she doesn’t know the full answer to, she fills in those gaps on the spot, like the sweetest, most well intentioned compulsive liar.
She has never been to that vacation destination you mentioned visiting last month, but she’ll say she has, with conviction.
The movie theater date she had with me was last week, not yesterday. She couldn’t tell you what we watched, just that she liked it. She didn’t.
Instead of recalling details of experiences or conversations she is more likely to remember the emotion involved in that experience. Sometimes I catch her scowling at someone. She doesn’t know why she doesn’t like them, she just knows that she feels negatively when seeing them. Occasionally it’s for a valid reason, like the person was rude to her, but more often it stems from a small instance of misunderstood context. She may not have deduced a joke, or a person may have interacted in a way that she didn’t like, and so when she sees them next she glares, studying their face for answers. Her distaste like a neon sign. The filter between inner thought and how she presents herself to the world looks more like a half-swatted cobweb, with little function or use. I am on edge a lot, a mediator in wait. I anticipate her generating a random comment or look that will be misconstrued as something mean spirited by anyone who receives it.
One of the best examples of how dementia takes over her reasoning process is a tic of sorts that began over a year ago. I noticed that on days when she was feeling a bit down or anxious she would tell me that she “really needed to get this sinus infection checked out.” Apparently she “had it for months.”
I was confused and frustrated. During two separate check-ups the doctor had assured us that Mom did not have a sinus infection. I couldn’t figure out why she was so adamant that it was there. At one point she worriedly proclaimed that the infection would go into her brain.
I probed, “Who told you that?”
“Someone I know who’s a nurse.”
“Oh really? Well Mom, the doctor said you’re fine so there’s nothing to worry about. Okay?” I would sigh.
“But I can feel it. It hurts,” she’d insist.
Shaking my head slightly, I would quietly ponder what in the world was going on. I was confident that she didn’t have a sinus infection, but I didn’t want her to feel unheard.
After a few more instances of her trying to convince me of the ailment, the answer finally clicked. In her brief moments of stress and self-awarement her dementia was causing her to use the “sinus infection” as an explanation for why her brain was having trouble working. The infection was “going into her brain and causing issues.”
Although rare, apparently certain infections can increase the risk of dementia. This wasn’t the case. There was no evidence of an infection (per myself and her doctor), and the dementia was prevalent years before any mention of supposed sinus issues. She was filling in the blanks, creating answers where she had none.
Now I know better. When she is having a rough day, triggered by something she heard someone say, or learned of from the news, I know that a complaint of the “sinus infection” may come up. Phantom pains in her face might cause her to paw at her nose, but just as quickly as it appears, it slips from the forefront of consciousness. And with that I am left to translate a language that is just as nonsensical as it is rational.