Could the human capacity to remember be imagined as a shelf on
which rest the things we know of the world? And if the shelf disintegrates, our
memories have nowhere to rest?
That’s a poor analogy in some ways, because the
shelf itself holds the kind of basic memories that tell us who we are and where
we belong in the world. It seems to me that some of the less important
understandings – the items on the shelf – dissolve or disappear before the
shelf itself completely gives way.
My mother has cognitive impairment. Her short-term memory is
terrible and continues to get worse. She is fast losing her understanding of
how the more complex aspects of the world work. She probably has the beginnings
of Alzheimers or some other form of dementia, but until she gets tested,
nothing can be done. Yet she doesn’t care whether or not she gets tested, and
my father is in a state of active denial. The more you try and bring him around
to the need for testing, the more defensive he gets.
My mother knows who she is, that she has daughters and
grandchildren. She drives to Chadstone alone and walks up and down the main
walkways; she doesn’t buy much, but she says the walking is her form of
exercise. She rings me and leaves messages saying ‘This is your mother here’. She
complains about finding it hard to buy clothes because she’s so short; she
recently found a new skirt that she likes, and showed it off to me with great
delight. She is as obsessive as she ever was about keeping the house tidy.
But her short-term memory is terrible. She’ll remember some of
what she did the night before, but specific details get wiped. Visiting my
sister one night she commented on the large, efficient clothes airer that sat
in front of the fire. A week or two later my sister found an identical one in a
hardware store. She rang my mother to ask if she should buy it for her. My
mother had no recall of admiring my sister’s clothes airer, and no interest in
the one my sister had found. ‘We don’t really need clothes airers’, she said.
More serious than that, she’s losing her grasp on the world’s
complexities. She could probably no longer explain distinctions such as the
difference between state and federal, a premier and a prime minister. And while
she is still aware of the things that affect her life – her grandchildren, her
friends and so on – she finds it hard to follow the thread of conversations
that go beyond the basic.
Her memory continues to get worse. A few months ago, in her own
kitchen, she began cooking a birthday dinner for one of her nephews. Soon afterwards,
she forgot that she’d already started the cooking process.
Memory also includes what goes where. Months before that, another
of my sisters dropped over at dinner time one night. Mum was in the kitchen,
having just put the electric kettle on the lit stove. When my sister’s
horrified eye moved towards the stove and saw what had happened, Mum saw too,
and understood right away what she’d done. But it was the fact of her doing it
that was the problem.
Yet to my knowledge she’s never had one of those
catastrophic existential moments that can confront sufferers with the reality
of their illness – the ones where they suddenly become so disorientated they
don’t know where they are or what they’re doing.
Such a moment is dramatised in
the biopic Iris, about the life of
the philosopher and novelist Iris Murdoch, an Alzheimers sufferer. Murdoch is
in the middle of a pre-recorded television interview when her magnificent brain
fails her. She’s talking about education when she halts – what was she going to
say? What’s going on? What is the meaning of the camera, the interviewer, and
who is that person on the array of television screens? On the way home she gets
hopelessly disorientated.
At the possibility of this happening to my mother, it is tempting
to join my father in his denial. There are a couple of factors that encourage
such a stance.
Factors that can cause poor memory
My mother is on a few different drugs for her ailments,
which include high blood pressure and osteoporosis. Many drugs can
cause forgetfulness. One researcher even developed a questionnaire to determine
whether a drug regime was causing toxicity. This is something I would like a
specialist to look at, but I realise it can’t, at this point, be the whole
story.
The other factor is diet, but as I am the only one in the
world who perceives this, there’s a fair chance that it is delusional thinking
on my part. For Mothers Day this year my sisters pooled their money to buy my
mother a coffee maker. I was horrified.
Ever since I was diagnosed with the
little-known and incurable condition of low blood sugar, or functional
hypoglycaemia, I’ve thought that this condition was implicated in my mother’s long-term
fatigue, forgetfulness and low-level depression; caffeine and concentrated
sugar, both dear to her heart, are the worst things for this condition.
Her memory’s been poor for years, and she’s always useless in the afternoons,
slightly better after her obligatory nap. I can’t count the number of times,
even before her memory problems became serious, I’ve suggested she give up
sugar and caffeine. Each time in her airy way she acts as if it’s the first
time she’s heard of it. This is understandable now, but she’s always been
completely uninterested when I broached the subject in investigating diet for
her fatigue – she’s a long-time foodie.
However, I am fooling myself that Alzheimers or some form of
dementia isn’t the culprit.
Research shows that mild cognitive impairment can
be a precursor of Alzheimers by many years. And Alzheimers is ‘by far the most
common cause of cognitive impairment’.
An incomplete diagnosis
About two-and-a-half years ago my mother did get tested. The
specialist told her she was on the borderline, could take anti-Alzheimers drugs
if she wanted to, and should come back again for another test in two years
time. I didn’t find out about this until almost a year later – my elder sister
deliberately lied about the results to shield me. However, it wasn’t, in my
understanding, a diagnosis of Alzheimers but of cognitive impairment.
Even once
mild cognitive impairment has set in, much can be done to
halt and even reverse it
and perhaps actually prevent it from sliding into Alzheimers. I curse the specialist and all my mother’s doctors for their slackness. Did the specialist tell her to do brain exercises? Watch her diet? Walk regularly? That she could arrest or at
least slow some of the decline if she wanted to? Not by the sound of it, apart
from offering the drug option. She was, it seems, just another bumbling 76-year-old
woman. Next, please.
When my sister told me the truth about these tests – about a
year ago now I suppose, I am vague myself – I wandered around in a daze of low
dread, of loss and helplessness. It was as if I was feeling my mother’s loss of
mental power in my own head. This laid bare, mercilessly, how bound up my
identity is with my mother’s. It was as if my own brain, my own self, were
under threat. In a way it was. I had never escaped the over-identification with
the mother that is the trap of poorly mothered women.
Yet I don’t want this to sound as if I have come to terms
with my mother’s illness. The move towards acceptance of Alzheimers in a parent
seems to come in increments. I cannot properly grieve for my mother’s
Alzheimers because there has been no proper diagnosis.
Of course, that dark dread, which returns periodically, is
not just about over-identifying with my mother’s brain. There is a much more
prosaic way in which it translates to my own experience. If she has Alzheimers
this means it runs in the family, so I have a greater chance of getting it.
And this is ironic too, because mental debilitation of
different sorts was an early symptom of what I now see as my OCD. I spent my
twenties and to a much lesser extent early thirties dreading the onset of
hallucinatory schizophrenia, and the future risk of Alzheimers. I had no idea
that these lonely worries were part of a completely different disorder that was
not in my future but very much in my present. I have always been a vague
person, and worry about my vagueness came second only to concern about my
social anxiety symptoms.
My identification problems with my mother make it difficult
for me to witness with any objectivity her poor management of her debilitation.
At the same time her shortcomings seem too conveniently related to her illness
(a selfish stance I know, reflecting my own damage).
There have been so many ways she could have improved her
memory, and even at this stage she could do more to preserve what she has. Frustratingly
yet predictably, everything about my mother’s character that complicated my own
development is writ large in her failure to take control of her cognitive impairment
to the extent possible. This failure is all too consistent with her careless
attitude to not only my illness as teenager, but her own physical health.
My mother’s identity has always been weak. Her lack of a
strong sense of self, her utter emotional slipperiness, her reliance on others
for affirmation – all these have been bound up with a chronic lack of
attentiveness, resulting in an inability to shield her children from nutty
relatives, poor teachers, the ravages of neurosis. Now these same weaknesses
impact on her own ability to hold off some of the effects of her illness. And
the illness accentuates those weaknesses to strengthen its hold on her,
encouraging her not to care.
More than that, the cognitive impairment itself seems to be
all of a piece with these weaknesses, a natural outcome of a lack of
attentiveness to self and others. It seems as if my mother is making the
ultimate escape. How dare she leave when she has never been fully present? And what does it say about me that I
am incapable of viewing her dilemma except through the lens of my own needs?
The upside
I don’t want to be completely negative. My mother’s
excessive acceptance has its good points. She is childlike and easygoing. She
has lost some of the more bitter aspects of her personality. If she does
descend to full-blown Alzheimers, I can’t imagine her being difficult to
manage. If anything, she will be overly compliant.
My father is in good health and at seventy-eight has more
energy and sprightliness than most men his age (‘sprightly’ seems the wrong
word for him – he doesn’t really seem particularly elderly to me) and is a very
giving person. He has taken over much of the domestic load, although his
semi-incompetence in this area is becoming a problem – he burned my mother’s
nylon undies recently when he put them in the dryer.
For a mother who was always so absent, so lacking in
maternal instinct, my mother gave a good impression of presence. I always
believed she was looking out for me even when there was evidence to the
contrary. Now I know she never will be, never can be. I must look out for
myself, be my own mother. It’s a heavy, difficult task. I cannot give to her at
this point the care that a fully functioning daughter could. But I will give
what I can when the time comes.
