Dementia, Identity, and Spirituality
The perception that with the onset of the condition the person gradually disappears seems to be one shared by many carers, some people with dementia, and a number of doctors, psychologists and psychiatrists, particularly those wedded to the medical model. Here is the psychogeriatrician Alan Jacques writing in 1992 (this text was republished unchanged in 2000):
At the final stages the patient may be assumed to have no real subjective awareness; no sense of self at all, and to be in this sense mentally ‘dead.’ (Jacques, 1992, 172)
A recent issue of the Newsletter Dementia in Scotland published by Alzheimer Scotland/Action on Dementia’ carried an article by a carer under the title ‘The Long Goodbye.’ Anyone familiar with such publications would recognise the assertions it contains. The first paragraph reads:
My husband died a few months ago. He had been suffering from dementia and I had said goodbye to the real person long before his physical presence left us. (Porter, 2002, 7)
Thomas DeBaggio, writing as a man diagnosed with dementia, says:
On a pleasant sunny day like this several years from now, I will die with no sense of what is happening and surrounded by mourners who can know nothing of my inner turmoil, a pain I will never be able to utter in my Alzheimer silence. (DeBaggio, 2003, 174)
In his case, however, he seems more to be expressing apprehensiveness, the fear of what might happen as a result of his loss of memory, rather than a reaction to its actual occurrence.