Let’s talk about “normal aging.” (This is a rant. I’m just telling you up front, so you’ll know. You don’t have to agree. I just have to get it off my chest.)
Okay. The medical profession and the related care-giving professions and the Alzheimer’s Association and everybody who has anything to say about dementia draw a line between “normal aging” and “cognitive impairment”. They all provide you with handy checklists to determine whether you or your loved one might be in the early stages of dementia. Because we’re all very worried about not being normal.
“How do you know whether a forgotten name or lost set of keys is a sign of dementia, or just a part of ‘normal aging’? What kinds of cognitive changes are to be expected in everyone’s brain, and what kinds indicate disease?”
In other words, who’s normal, and who’s got bats in her belfry?
I have spent time around a lot of elderly people in the last four years, since Mom moved to an assisted living facility five minutes from my house. I have seen people with walkers, people in wheel chairs, and people who could out-walk me in a marathon. I have seen people who repeat themselves or blurt out inappropriate comments (“Nice breasts!”), and people who could give a college lecture on the spot.
I have met people with high blood pressure, diabetes, bad hips, bad knees, and bad eyes, and people with none of those conditions. I have met people with curved spines and straight backs, bald heads and flowing manes, dentures and perfect teeth.
So I ask you: if there’s that much variation in the elderly, what the hell is “normal aging”? And why isn’t dementia considered part of it?
I ‘m reading a provocative book called The Myth of Alzheimer’s that raises this very question. I haven’t finished it, but I’m intrigued. Maybe, the authors argue, it doesn’t help to think of dementia as a Big, Scary, Abnormal Disease. Maybe it actually obstructs our view of the perfectly normal person we are trying to help.
I’m not saying Alzheimer’s doesn’t impair people. Of course it does. So does arthritis. But nobody claims that the 85-year-old with arthritis is not experiencing “normal aging.” The arthritis is an obstacle, yes. It’s something to treat, something to adjust to, something to learn about. If Grandma or Grandpa has arthritis, we expect them to change. We don’t ask them to do tasks they can’t do anymore. Yet we don’t cut them out of our lives because they’re impaired. Okay, Gram can’t snap the beans for dinner or hang the laundry on the line, but she can chat with us while we order take-out and toss the clothes in the dryer. She can be part of our lives.
We make it possible for the person with arthritis to live as independently as possible. If Gramps can’t deal with shoelaces or belt buckles, we give him Velcro shoes and elastic-waist pants (good-looking ones, if it matters to him). We acknowledge his condition, but allow him his dignity. We certainly don’t consider him abnormal. But the person with dementia? That person has a Big Scary Disease.
Changes in the brain are scary; I can attest to that. When they first show up in someone you love, they can shake you to your core. But when you step back and breathe, when you look at them calmly, you can begin to see brain changes the way you see physical changes: as a part of life. We get old. We decline. We die. That’s normal, isn’t it? We are still part of the community, whatever our impaired condition. We can’t do what we once could, but we don’t deserve to be written off.
I don’t know what’s “normal” anymore. I like to think there are endless ways to grow old, just as there are endless ways to grow up. Mom is growing old with dementia. So did her mom. So might I. That’s our normal. What’s yours?