Depersonalizing the Dementia Patient

Televangelist Pat Robertson made another high-profile gaffe last week when he told a caller on “The 700 Club” show that a husband who is tempted to cheat on his Alzheimer’s-stricken wife ought to leave her for someone new.

“I know it sounds cruel,” Robertson said, “but if he’s going to do something, he should divorce her and start all over again, but, you know, to make sure she has custodial care, somebody looking after her.”

When Robertson’s co-host asked him how he squared his unorthodox advice with Christian marriage vows — which traditionally promise fidelity “for better or for worse, in sickness and in health, ’til death do us part” — Robertson dismissed those promises as inapplicable to the demented. Alzheimer’s disease, he said, “is a kind of death” since the spouse one loved for decades no longer exists. “That person,” Robertson said, “is gone; they’re gone; they are gone.”

Not surprisingly, Robertson’s statement drew widespread condemnation. Prominent Christian pastors denounced his words as a repudiation of Jesus’ teaching on the indissolubility of marriage and the dignity of every human person. Alzheimer’s specialists and patient advocates rapped him for perpetuating crude stereotypes about the demented. Once again, the man famous for making half-cocked public pronunciations about everything from God’s reason for sending an earthquake to Haiti to the need for somebody to assassinate Venezuelan dictator Hugo Chavez has united Americans across the religious and political spectrum. Their consensus: Robertson’s words are an embarrassment.

And that would be the whole of the story — tone-deaf televangelist misfires again; outrage ensues — if not for one inconvenient fact: Robertson is not alone in his chilling view of Alzheimer’s patients as “gone … gone … gone.” While few Americans openly advocate the abandonment of a demented spouse as Robertson does, more than a few share his belief that Alzheimer’s is a soul-stripping disease that renders its victims de facto corpses — hollow shells who are living, as Robertson put it, “a walking death.”

I know how common that view is, because I encountered it on a regular basis during the dozen years that my own father struggled with Alzheimer’s. I heard variations of the “he is gone” trope from strangers and friends, health care workers and nursing home aides, even some relatives.

Some put it as bluntly as Robertson did. Most revealed their depersonalizing beliefs about the demented in subtler ways: by talking about my father in the past tense or third-person, even as he stood in their midst; by chiding my mother for the time and attention she devoted to the husband they considered no longer worthy of such intense concern; by making offhand comments to me about how they hoped ‘someone will just shoot me” if they ever wound up demented like my dad.

There were exceptions, of course, glorious ones: the hairstylist who sang along with my father as he belted out the Irish tunes he still remembered word for word; the aides at the adult day-care center who laughed heartily at his shopworn one-liners; the geriatrician who treated him with affection and deference throughout his long decline; the aged friend from his youth — now suffering from Alzheimer’s himself — who exerted every ounce of energy he had to continue visiting my father in the final stages of a disease that had scared away many other longtime friends.

These people saw in my father what my mother, brother and I did: a man still very much alive, still bursting with wit, wisdom and grace despite the dementia that had stolen his memories. They looked beyond Dad’s debilitation and dependence to the beauty that lay beneath, the enduring beauty of a man whose dignity depended not on his usefulness or achievements but the simple fact of his humanity.

Alzheimer’s is an awful disease, one I would not wish on any individual or family. Like the loved ones of the 5.4 million other Americans afflicted with this condition, I look forward to the day when a cure will be found. In the meantime, though, I hope for a more modest miracle: a gradual recognition in our culture that the demented deserve the same love, loyalty and respect we accord to the most powerful among us — the same we would want for ourselves, if the frailty we lament in them someday became our own.