Era of the De-Words

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I think of the period beginning in 2005 as the era of the “de-words”: The prefix de- means to reverse, reduce, or remove. Dick’s health declined following surgery for an enlarged prostate in September of 2005. Surgery was the tipping point. It pushed my husband beyond coping, deeper into the dementia. The list lengthened: dehydration, delirium, delusion, depression.

            Then came the hallucinations, the anxiety, agitation, anguish, and violence. The word violence seemed less frightening when I learned that it originates from the Latin violentia, “vehemence.” Vehemence is a display of strong feeling. I think that best describes the agitated behavior of persons who have dementia. They can’t explain what’s disturbing them, but they urgently want it to stop.

            The geriatrician G. Allen Power explains that what often is interpreted as “challenging behavior” actually is “adaptive behavior” in persons with dementia. They might be attempting to convey their confusion, fear, frustration, pain, boredom, or illness. It’s how they express agency—in their “own unique way.” And that unique way may be vehement.

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I thought that after 2005-2007 the violence ended, and our life together calmed down. Then I read his discharge summaries from Mayo Clinic’s geriatric psychiatric unit:

June 2008 – Worsening psychotic symptoms, paranoia, rumination, hallucinations.

July 2011 – Transient auditory hallucinations, confusion, disorientation, word-finding difficulties.

January 2013 – Mutism, confusion, visual hallucinations.

April 2013 – Worsening visual hallucinations and psychosis, behavioral dyscontrol.

            When I began writing this, I found that I’d forgotten events and confused the ones I did remember. When was Dick’s surgery? The first trip to Mayo Clinic? When was it that he had the swallowing anxiety?

            During those tumultuous years, events pushed me onward. That might explain the gaps in my memory. I got through, like someone guided by GPS who passes through a city with little memory of the terrain. Except with GPS, your destination is clear.

Anne-Marie Erickson