Letters to the Editor
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He either knows or can't form an opinion either way
That disease is like that. One has the ability to know what's going on early then it drops off rather quickly and attempting to explain it will be pointless and will just scare them.
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Dementia
There is a danger that realizing the depth of the faculties lost in dementia can trigger a catastrophic reaction that will send the demented person over the edge into total panic or despair. The demented often need the denial to keep it together. I studied it as a researcher and then saw it with my own mother in the six months before she died. She seemed to have it together but she didn't, as my sister and I discovered after she died. I was closer and I could see it happening but never let on and I'm glad I did that.
There is never an easy answer. The soldier's mother's comfort with the situation is the most crucial aspect of the dilemma right now and she should be the one to decide. She has to manage any results of what happens with his father, not the soldier. He can suggest that his mother talk to the doctor about telling his father about the diagnosis but he should not do anything about it himself.
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Soldier John,
My Grandmother had this awful disease and she fell into a state of frustration and unfortunately, cruelty. You wrote that he has "no small amount of vitriol for those around him, including anger at what he didn't understand and couldn't control."
I wonder if he can process that kind of information because this means that he is already deep into it. Maybe the question shouldn't be how to tell him, but how to prepare yourself (and everyone in your family), because it only gets worse.
You can always call his doctor to ask what the usual protocol is and how they advise patients like your Father. What you wrote about him was full of respect and love, even though he was "away" for much of your childhood. It must be awful to see him in this state. Brace yourself for what is ahead though because you are going to have to be a different kind of soldier when you are with your Father. I wish you the best and thank you for serving our country.
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the best metaphor
I have ever encountered for Azheimer's is in Dan Simmon's sci-fi novel, "Hyperion."
A character in that novel has an illness that causes her to age backwards. Each day, she is one day younger, with no memory of her experiences as her "older" self. She slowly devolves from a grown woman to a child, to an infant. At first, her parents try to explain her condition, every day. Then she records a message to herself, explaining everything she's forgotten ("You've already been to college. You had a career. You had a boyfriend." etc). As the disease progresses (regresses?), hearing the facts of her shrinking life get more and more distressing. Finally, the character destroys the tape, and tells her parents "Don't tell me any more."
I imagine that living with dementia must be a little bit like that. At some point, it's kinder to the sufferer to spare them the knowledge that will only break their heart.
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After a night out with Amish cow milkers...
A concerned Lady decides the 'eccentric' bar-Pub behavior tonight warrants attention. The Veterans Administration professionals need to give a professional examination and a anti-war diagnosis. okay.
The good caring Lady takes the farmer-soldier to be examiined and diagnosed at the V.A. Health Clinic. The spouse/lover ask
the V.A. doc, "What's wrong with him?"
The V.A. doc, "We need to examine bebop-o and brouse the diagnostical statistical psychiatric manuel."
The V.A. doc ask the concerned Lady to come back in 3-hours for a pro-VA-report.
"Okay." She agrees.
Three hours later the lover/spouse/partner returns to the VA to pick up the soldiier. She kindly ask, "What's wrong with him?"
The V.A. doc says,
"We were very busy with freaked-out, neocon basket walk-in-cases all day today." The V.A. doc says, "And I can't remember what ails GoodCelery!?"
The Lady ask?
"What should I do?"
The doc said, "He either has aids, halotosis, gonad-problems, brain damage, or alzheimer's."
So, ask the lover/partner, "What am I supposed to do?"
The V.A. doc says, "Take him for a drive in a SUV several blocks away from the house. If bebop-o finds his way back home ~ don't dare touch him. Don't make love to him anymore
with a 10-foot pole!"
Gads. Time for bed.
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Dying By Inches
First off, my sympathies to the letter writer. My mother passed away several years ago from early-onset Alzheimers. It is a horrible disease that my therapist described at the time as like "watching someone die by inches". And in many ways, it is much harder on the family of patients than is is on the patients themselves (indeed, what is slowly melting away is their awareness of their surroundings, their histories and ultimately themselves).
The hard part about letting the patient know the diagnosis is that at times when they are reasonably lucid, they can be told of their condition -- at which point they may feel the full emotional impact and be aware of all of the implications of the diagnosis. But then a few hours (or even minutes) later -- in the truly sick cosmic joke that is Alzheimers -- ask you once again, as my mother often asked me, "what's wrong with my brain?".
Indeed, I've heard that often when people close to an Alzheimers patient die -- the patient is not told, due to the fact that they will likely relive and grieve the loss over and over again each time they are told.
So there are arguments for both cases.
And a bit of unsolicited advice for when you return: The toughest thing about this disease (to the families) is that you never know when the person you once knew will break through the fog to say hello. As my mom drifted away, I found that music and movies we'd once listened to or watched together sometimes acted as a sort of "lighthouse" to help us find one another again...good luck to you, my thoughts are with you.