Tragedy of dementia never-ending

Dear Dr. Gott: Here’s a bit of mythology.

Tantalus, the son of Zeus, was admitted to the society of the gods until he divulged to mortals divine secrets. As punishment, he was hung from the bough of a fruit tree over a river. Every time he tried to drink, the waters receded from him and the wind blew the fruit from his reach. Thus, he was condemned to an eternity of agony, thirst, hunger and unfulfilled anticipation. From this myth comes our word “tantalize.”

Lest you think that this is an obscure literary reference, I’ll describe a situation that has befallen an elderly patient of mine in a nursing home. To my knowledge, this kindly old man divulged no divine secrets and was, until his mental powers waned, an upstanding member of his community.

However, with advancing years, he eventually became unable to care for himself at home. His memory failed, he couldn’t shop or address his personal needs. He’d try to cook but burn the food because he didn’t remember leaving the stove on. His finances were in a shambles. In the end, his family reluctantly decided that he must go to a nursing home or risk an untimely death from malnutrition or trauma. This patient’s situation is far from unique. He represents the thousands – perhaps millions – of aged grandparents who live at home with few support services.

So, my patient entered the nursing home where I first met him. “This is temporary,” he assured me, “I’m just here for a week or two.”

That was three years ago.

Each time I see him, he makes the same pronouncement, smiles and then, as his brow creases with worry, looks questioningly for reassurance. Each time, I respond: “I’m sorry, sir, but this is where you’re living now.” And every time we have this transaction, his disappointment is palpable, his hopelessness more pronounced.

The nurses tell me that he relives the same scene with them, many times a day. Five minutes after leaving me, he’ll buttonhole a nurse in the hall, explain that his living arrangements are temporary, smile, wait for acknowledgment that never comes, and then – with downcast eyes – shuffle off down the corridor to repeat the identical transaction time after time, in sorrowful cycles of happy expectation and despair. My Tantalus.

He is doomed to ride his emotional roller coaster until he dies or his dementia takes him further into intellectual wilderness. And nothing anyone can do will ease his pain. It goes up and down, on and on, day after day.

Dear Doctor: The tragic situation you described is all too common. In case you haven’t tried this approach, perhaps your patient could be helped by low doses of psychotropic drugs to stabilize his failing intellect.