Matt of the Daily Telegraph cartoons a demonstration of elderly people. They chant: “What do we want? Why did we come here? What were we saying?” I giggle, but then I flinch a little. We have often spoken of the Big C as a euphemism for cancer, but the Big A, for Alzheimer’s, is in some ways even more threatening. It is surrounded by question marks: we do not know for sure what causes it, we do not know how to diagnose it, we do not know who is going to get it, we do not know how to cure it, we do not know how to prevent it.
The threat affects everyone. I am not only thinking of the sufferers but of those who have spouses, parents and other relatives who may become sufferers. They are faced with a loved one whose memory, so central to identity, gradually deteriorates so that they may not even recognise their marriage partner of half a century.
Although “early onset” Alzheimer’s can affect people in their 40s, it becomes more prevalent with age. Around half of those who reach 85 (men and women equally) will have dementia, and in 30 per cent of cases it will take the form of Alzheimer’s. In this country experts predict that 1.4 million people will have dementia within a generation, causing a crisis in the NHS. They deplore the lack of research funds which are badly needed.
We must be grateful to the scientists. As an indication, my very selective records show 17 studies published within the last month. Numerous different approaches are being investigated and although some of these show the possibility of future progress, just as many turn out to be dead ends.
Diagnosis of the early stages of Alzheimer’s is difficult and it is hard to distinguish it from vascular dementia – which requires different treatment. But there is general agreement that early treatment to avoid or at least retard progress of the disease is one way forward. But much work needs to be done to establish what the best form of treatment may be; there are many unproven candidates. Even the brain changes observable in post-mortem biopsies of sufferers are not certainly the mechanism of Alzheimer’s; they may be the result of the disease rather than the cause. Some people who have similar changes, as the recent use of brain scanning techniques are now able to show, do not suffer from Alzheimer’s.
Alzheimer’s is no respecter of intelligence. To take one example, Iris Murdoch, the brilliant novelist and philosopher, had Alzheimer’s. None of us can afford to pass by on the other side, for any of us may be pulled across the road at some future point. And some readers of this column undoubtedly will be.
There is some evidence, though far from a guarantee, that maintaining an active mental life, and good social contacts, can be helpful. I am in my mid-70s, and it may well be that writing this column, my large family and the philosophy discussion group which I lead are helping me. Not everyone will be so fortunate.
There are some important issues for us to consider here. The first is that loss of memory is not loss of humanity. Just as the embryo is fully human although its human capacities are not yet formed, so the sufferer from advanced dementia retains humanity although their human capacities are deformed. I will not easily forget the night I spent with my father in my arms: he thought I was his mother – who had died when he was 12. As I wrote later in a poem: “His loose brain played the scales of time.” The privilege of doing that was his last gift to me.
But my father’s dementia was short-lived. I have a friend who, with his wife, looked after his mother-in-law in her Alzheimer’s for many years. Soon after she died his wife herself developed Alzheimer’s; he visits her every day, and fears that he may die before her, for he is in his 90s. Those visits are not a chore for him but a communion of their love, which only one them can express. Even on the lonely road to Calvary enough love can bring its joys.
It is experiences like this which bring home to us what honouring our father and mother, or promising to love through sickness and health may mean. But it extends beyond those with whom we have a familial connection. The figures tell us, with some certainty, that the proportion of those who will need care and loving in their old age will increase. Many of these will not have relatives to play their part – and the fashion for smaller families will make the instances more frequent. A recent study suggests that a close relationship between carer and patient can ameliorate early symptoms as effectively as the drugs known so far.
This will be a harsh test for our society of how we value the dignity of human life. It has already failed the test with regard to the unborn, and in the – often grotesque – experiments concerned with the beginnings of human life. But the question of care for the old is still on the public agenda. Perhaps it has a better chance because the politicians of the day will be among the sufferers of tomorrow. We must be ready to play a vigorous part in ensuring that society pays attention and that adequate research funds are available. Google the Alzheimer’s Research Trust and find out more.
* * *
Tell us about experiences you have had related to dementia and Alzheimer’s. Have they been a grace for you, or have they made you wonder about the goodness of God? How do you think our society will look on dementia as people live longer and the number of sufferers increases? You might want to bear in mind the current discussion on assisted suicide. A little bird tells me that the CH has a leading column on the subject this weekend.