When Dementia Is "Pleasant"
When Dementia Is "Pleasant"
Here's a phrase you might be hearing a lot more, thanks to a puzzled daughter's investigation, which she describes in the current Newsweek: Pleasant dementia.
Pleasant? Dementia?! The oxymoron describes the drastic shift in personality some people with dementia experience, to a sunny, even cheerful, in-the-moment state of being. Writer Sara Davidson was grappling with how her once "strong-willed, opinionated, and demanding" mother had become oddly easygoing as she lost her memory. Pleasant dementia isn't an official medical term, but it's a widely recognized phenomenon. And it's useful to give it a name.
I've seen it with one of my own loved ones. It can seem like a personality transplant. This brings a confusing stew of emotions to the rest of us:
- Relief — if the old personality was sharp, judgmental, or querrelous
- Guilt — for feeling relieved and for finding a silver lining to their misfortune
- Sadness -- because you were used to that old sharp personality, and miss it, or because losing one's mind is a sad thing, period.
- And bittersweet gratitude -- that your loved one seems to be enjoying life and not really noticing their decline any more.
Why does dementia turn some people paranoid, angry, and aggressive -- but make others serenely oblivious? Researchers aren't sure. I wonder if the care situation makes a difference. Not as the complete explanation, but we know that people with dementia are sensitive to their surroundings. And things like routine, feeling secure, and familiarity are factors that help reduce episodes of aggression or agitation.
Davidson and some researchers (such as Oliver Sacks) draw a comparison between pleasant dementia and the state of mind that people take meditation classes to learn: Acceptance, letting go, being fully present. Ironically, that state of mind is called mindfulness, whereas dementia is, basically, mindlessness.
Even more ironic: That these loved ones with such reduced cognition are nevertheless also showing their caregivers the way, by example: Let it go... What a beautiful sunset...I'm not mad at you anymore...no complaints here... taking the scenic route...Who, me worry?
Stamp image copyright 2007 USPS. All rights reserved.
This stamp was just released into use yesterday, in time for World Alzheimer's Day on Sunday, September 21.
I long for the day my mother is so far gone she forgets who I am and why she hates me. Unfortunately, in her situation, her life-long personality disorders are just becoming more pronounced.
You give interesting examples, thanks. I have known three variations among people close to me: tightly controlled person turned "pleasant", jolly person turned pleasant, and jolly person turned dour and crotchety. What are the influences and mechanisms behind these different changes? A fascinating area of research!
could it be that critical cantankerous folks stress themselves out more even than they weary those around them...leading to their own RELIEF and pleasantness when they can't be the ones in control anymore? at some level it MUST be a tremendous sigh of contentment not to feel like you have to be in charge and make everything come out as close to perfect as (super)humanly possible! Two examples from my own strict upbringing and now watching Mom having eased up on herself most of all: one of the very few talk-back times i can recall was not having finished a puzzle and having to put it away. My primary-school self flared and said "you wish it looked like nobody lives here." To which she replied, "Yes, but since we can't have that, we'll just have to do the best we can." NOW, it matters not where anything lands or stays or for how long ~ she's just sweetly oblivious to the clutter, the dust, the spills (even on herself). Keeps her nice and relaxed not to notice such trivia anymore! As her autistic daughter who never did care much about such things, SO glad i lived to share her pleasant dementia. Other "case" is, even though she made really fine meals day after day that seemed to me to bespeak caring, she never really liked to cook for us. Found that out a few decades ago, when she confessed it to me by way of saying, she was looking forward "someday" to moving into a house that had NO KITCHEN! Well, she didn't get her wish quite that way, but she now has a couple of home health aides who prepare all her scrumptuous meals for both my folks, and even clean up afterwards. What's not to be genuinely appreciative and pleasant about, i ask you?? So, i suspect there may be a correlation between this perfectionism and sense of duty that yields quite blissfully to being put out to pastures full of getting to take all the time in the world to stop and smell the flowers...at long last! at least, i could partake gladly in that kind(of) well earned pleasant dementia, and i do so hope that's where my Mom's happy detachment is continually being reFreshened since i can't add wonderful surprises to her dazey days anymore. tHIS is indeed my prayer for all our loved ones: the Blessing of Resting! Jesus'n'val (aka gollyboy@peoplepc.com ~ glad to hear your reactions!)
Very interesting! My husband of 25 years has always been difficult, antisocial, critical and volatile. I assumed he would only get worse as he aged, and was set for a long, bumpy ride. I have noticed some cognitive changes in him, most prominently a loss of his more abstract sense of humor - of the absurd, the ironic, the sardonic, etc. I also notice, though, that he has become much more pleasant, even tempered and patient. I thought maybe it was gratitude that I stuck around through all the miserable years (!) and possibly some cognitive changes as well. Whatever it is, I have kind of fallen in love with him all over again. Thanks for the article.