Why won't my Mom tell me Happy 50th Birthday?

Dear Anonymous:

First of all, a belated Happy Birthday to you!

The best gift I can offer is to tell you that, as you know, your mother who has Alzheimer's disease, is no longer the same person who for celebrated your birthdays when you were a little girl, and who no doubt never missed a chance to make a big deal out of your accomplishments during the years in which she was able to do so.

But sadly, that person, the mother who used to be, is gone. She's not doing this out of spite or with any malice directed at her loving and caring daughter, she's simply no longer thinking in a clear, rational way. That's one of the painful realities families face when caring for a loved one with Alzheimer's disease.

Let me share a story with you. Perhaps you recall Supreme Court Justice Sandra Day O'Connor. Her husband suffered from Alzheimer's disease. Justice O'Connor was forced to watch her husband of decades slowly slip away, as he forgot who she was, or that they were married. In his new, demented reality, he ultimately found a "new" soul-mate while living in the skilled nursing home.

That tragedy, the loss of her husband, was handled by Justice O'Connor with understanding and grace, as she accepted the difficult fact that the man she knew and loved was no longer the man to whom she was married. While she didn't divorce him, she had to let him go, because as with all advanced cases of Alzheimer's, there is no way to rationalize or explain things to an Alzheimer's patient in the hopes of hearing or seeing the "right" responses or behaviors.

Hold onto the good memories of your mother, and recall the many years she wished you Happy Birthday. If she still loves the idea of parties, and celebrates her own birthday, simply celebrate yours with her on that same day. You can try saying something like, "Happy Birthday mom, did you know that today is my birthday too? Isn't that wonderful?" If that works, great. If not, you tried. Don't beat yourself up, and do your best to move on.

Your mom may or may not respond the way you want to this and future situations. She may reach a point where she cannot remember your name or that you're her daughter in the months to come. You have to be strong and know in your heart that you've been and are being a very loving daughter and care provider.

I suggest that you seek out a support group for yourself, and realize that you have done the best you can.

Make your peace with the fact that what you're doing for your mom speaks much more loudly than the words Happy Birthday.

Good luck on your journey.