By Teah Mogae
She was staring into space as I walked into the waiting room to call her name. As she stood up slowly, her stooped posture became more obvious. I realised how much she had changed in the four months since our last consultation. As we walked to the consultation room, her slowly pushing a four-wheel frame along the corridor, we discussed the usually safe topic of the weather. With the pleasantries completed I started the consultation with the standard question – How can I be of help today? “I am sick and tired of my failing memory, and I am hoping that since my dementia diagnosis six months ago, there have been developments in what you can offer me to help,” she said, sounding despondent with it all.
It was almost 12 months since Joanne had initially presented, reporting she was struggling to manage her cheque book and forgetting her mothers’ recipes she had used to cook meals for decades. As we completed her clinic-based assessments, it became apparent that indeed her memory was failing, prompting further investigations via blood tests and brain scans. A specialist confirmed our worst-case scenario – she indeed had dementia- the vascular type- and there was no special pill I could use to fix our predicament. With management of her high blood pressure and ensuring she did not develop diabetes and high cholesterol etc, we were hopefully reducing further risk of worsening memory but there was no actual medicine to bring back what she had started to lose. Breaking this news to her was one of the most difficult consultations I had had in my career.
“You mean if I had cancer there could be options you would give me but now, I just have to make sure I take my blood pressure medicine and develop no other illnesses?” she asked, disbelief apparent in her face. “How long will it take before I lose my sense of humour?” she asked as she started tearing up, consumed by the grief of losing what she felt was her whole personality. “I hate getting old, you should make sure you stay young,” she chuckled with tears streaming down her cheeks.
Watching her going through her grief was heartbreaking. I was not able to offer a cure but could provide comfort and companionship during this challenging new phase of her life as we navigated all that she was struggling with. A referral to a psychologist and regular appointments with me meant I could keep an eye on her and pick up on issues before they snowballed. Putting in place power of attorneys, automating some banking tasks and grocery shopping, and organising regular help to manage the household chores reduced the distress that had been all consuming for her. Most of all, in that phase of her life with dementia, I was a friend, able to laugh at her jokes which reassured her that her sense of humour was still intact. We both hoped it would be a long while before that also became lost to her. Only time would tell.