pumpkinstrokemarrow

The second eureka moment came from a chance encounter with a book about dementia by a psychologist from the Netherlands called Bère L. Miesen, a chap who appears to be something of a world expert on the topic. Terrific value at 30p reject from Bourne Hall library with the best offer from Amazon being £9.91 for a used one or £17.48 (not including the sometimes expensive P&P) for a new one. I share a few thoughts.

First, my understanding is that a lot of care work is done by decent older ladies for low wages, largely without training. While caring decently for those with dementia is a very demanding and sometimes draining, rather than rewarding, business. I am reminded of the building and agricultural labourers of my youth who scored in the labour exchange as unskilled as they were not ticketed for a recognised trade, but who were, nevertheless, apt to be very skilled. Or of the once lowly status of a GP compared with that of the consultant.

Second, he has a simple but compelling model of why sufferers appear to revert to their childhood, which goes something like this. When something happens we lay down lots of traces in the memory banks. The number of such traces laid down for any one happening will tend to increase with the importance of the happening and will tend to decrease with age - and with dementia. To the point where one is not making new traces at all. Traces are persistent, but they do not last forever and they die on a random basis, although as long as there is at least one trace of a happening, there is the possibility of recall. But then, if one gets the parameters in this model right, after a certain point there are no recent memories at all and the memories that are left, paradoxically, get older and older as time goes by.

Third, he (implicitly) offers a very simple explanation of why dementia sufferers often cling to their carers - behaviour which is hard to accommodate continuously. The dementia sufferer has no short term memory and is condemned to live in the present. Each encounter with the carer is an encounter with a new and strange carer, something which frightens or upsets the demented. But who has got enough marbles left to work out that this fright or upset can be avoided by keeping the carer in range at all times. Preferably, just to be on the safe side, in touching range.

All in all not a pretty way to go. But there is a person inside, a person whose quality of going is very dependent on the quality of care. It is worth the bother.