The Thief of Time: Dementia

I can't help but worry about me . . .

In the final decade of his life, my father had dementia.

What about me? Is dementia lurking in my future? A decade has passed since Dad’s death and the “me” question continues to rattle about my soul.

Will I detect the disease’s beginnings? And if I did sense something “wrong,” would I admit to struggles with memory? Would I openly talk about other unsettling changes? Would you?

Dad never—never, never, never—wanted to visit a doctor. Any ailment he had would always get better tomorrow. So why should he waste precious minutes of his life with people in white lab coats?

Other than hypochondriacs, who would voluntarily allow strangers to poke and prod our bodies? Why would anyone want a doctor to make you cough when you’re well, require present and/or future blood removal, scare you with sharp needles or lengthy, flexible tubes, and generally treat you like a specimen to test rather than the fine, upstanding human being you are?

About a year before Dad died in 2012, Mom and I took him to his one and only appointment with a neurologist. It was a visit prompted by the need for additional confirmation that Dad had a form of dementia and wasn’t competent in financial decisions. It pained Mom to arrive at this point. In over six decades of marriage, they’d always made choices together. But their discussions had become a relic of the past. Mom now needed a medical/legal paper trail for the unsettling but necessary demands involved in caring for her husband.

The visit to the doctor’s office was brief and awkward. Before the neurologist appeared, a nurse entered the exam room. In a kind voice and with gentle gestures, she asked several low-key questions. Dad either ignored the nurse or berated her. One of her questions was about a commonplace experience in everyone’s life.

“Mr. Patten, can you tell me what time it is?”

The exam room had a large wall clock. Dad still wore a watch.

I don’t recall Dad’s exact response, but it may have been “What for?” or “Who are you?” Or he may have just glared. Some people with certain kinds of dementia are no longer able to talk. Indeed, one of the guidelines for determining dementia is whether or not a patient can speak a sentence with six words. Until the final days of his life, even after several years with dementia, Dad easily surpassed the minimal number of words. Any of the staff in the facility where he had lived would’ve confirmed his ability to voice insults and indignation far beyond six words.

But did he know what time it was? Or was he so oriented toward resistance and anger that a question from anyone would prompt belligerence? His attitude didn’t improve when the doctor joined us in the cramped, sterile space. Dad continued his negative responses, the neurologist seemed bored, and the nurse escaped the room. We also soon left. Later, the doctor wrote a vague but sufficient letter, confirming Dad’s incompetence.

Much later, I discovered one of the standard tests for dementia involved telling time. There are various ways to present this, including the nurse’s simple request for the current time of day. Another variation is asking a patient to draw a clock.

In a completely non-scientific way, I attempted to sketch a clock without “hands:” a circle representing the bare bones of a timepiece. From my reading, I knew the next step would add hands in order to designate a specific time.

Yikes, did I ever fail!

At first, I couldn’t recall what number was at the top! Was it a zero (0), one (1), or the twelve (12)? In my second attempt, I remained unsure about which number to start with . . . but then remembered the film High Noon. The number “12” had to be at the highest point! And don’t forget “watching your six,” the clock-inspired military jargon about guarding a fellow soldier’s backside.

Nonetheless, I could never space the numbers evenly on either attempt, and felt stupid and clumsy when I tried to pencil in a clock. I’ll give myself a D-minus grade for the timely effort, and only because of self-pity. Does my failure mean I might have dementia? Or, in these modern digital days, am I simply less familiar with analog clocks and their traditional faces” Or was it because I’m such a pathetic artist? Or because . . .?

For the life of him, Dad couldn’t tell time in his last years. Dementia is a literal time thief. Right now, I can (mostly) joke about my dismal hand-drawn clock. But what will the passage of years bring? Rationally, I know dementia isn’t contagious. Realistically, there’s conflicting research about children inheriting dementia from parents. Nonetheless, DNA is truly the gift that keeps on giving. I have my father’s thick ankles and (long ago) his red-tinged brown hair. What other “gifts” has Dad bequeathed to me? My doctor reassuringly states that exercise, curiosity through life-long learning, and positive interaction with friends all represent key ways to reduce dementia’s risk. Hey, I do those things even without a doctor’s advice!

Dementia is clever and brutish in how it robs the present moment or the past memory. Along with stealing, it can leave troubled thoughts. Since Dad's death in hospice, my wondering about the future always includes dollops of worry and dread.

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Image from Alzheimer’s Disease Data Initiative (ADDI)

My book, A Companion for the Hospice Journey, is available at Amazon.