Martti, my Finnish father-in-law, suffered from dementia—not from Alzheimer's but as a result of a series of small strokes, each of which chipped away step-wise at his mental abilities.
He had been a highly respected math professor at a teacher's college. He was a reserved man, committed to propriety, yet he also loved the tango and would occasionally roll up the rug to dance in the living room with his daughter, my wife Marja.
Find an Alzheimer's Care Community »
Finnish men and women of his generation were expected to make formal speeches on special occasions, and Martti prided himself on being able to speak well.
As his 80th birthday approached, however, he was increasingly aware of his decline, yet he knew he would be expected to speak at the gathering in his honor. He was uncharacteristically anxious and asked Marja to listen to his speech to reassure him it was appropriate.
In that 80th birthday speech, Martti said, "I have had seventy-nine good years; the last year has not been so good anymore." He was very aware of his cognitive impairment and much pained by it.
Shortly after that, he told his family he wanted people to remember him as he had been rather than as he was now. In his last years he saw very few people outside the immediate family.
Martti did not reach an advanced stage of the disease before he died; he always knew who we were and could basically take care of himself.
At one point in his disease, he said to Marja, "I used to be the head of this family but now I can't do anything." It wasn't a complaint; just a statement of fact. While he bore it without self-pity, Martti suffered from his dementia.
Before my diagnosis with Alzheimer's, I thought I would feel the same way my father-in-law did, wanting people to remember me as I was at the height of my powers and not as I would become as a result of my dementia.
My greatest fear was that I would lose that which I treasured the most: my intelligence and my independence.
To some extent I still feel that way: Perhaps my greatest sadness is that my grandchildren will likely know me mostly as a doddering old man.
Surprisingly, though, that fear of intellectual loss has diminished greatly; my attachment to what I used to be is decreasing.
It's becoming obvious that such attachment to who I used to be at a particular time in my life only leads to unhappiness. This is true even if we don't have Alzheimer's disease.
When I was in my thirties and forties, for instance, my self-image included being a good athlete: agile, strong, and able to run or cross-country ski for hours. As my body aged and I was no longer so agile or strong, I found myself sometimes depressed because I no longer fit my image of myself. It was a while until I recognized that hanging on to that athletic self-image was not a recipe for happiness or contentment for a man who was, in fact, going to get older.
Similarly, attachment to my IQ is not going to bring much happiness as the Alzheimer's slowly but methodically clogs up my brain.
Buddhist teachings remind us that there is no constant "self." (See my post "Losing Self.")
The Western idea that our self stays the same throughout our life just isn't very accurate. In fact, our self changes continuously and dramatically throughout our life.
The Buddhist teachings point out that clinging to any particular self-image is sure to bring suffering because the self will not fit the desired image forever. Let it go!
It may be harder for those of us who have prized our intelligence and seen it as the highest value. What else would there be, after all, if our intelligence faltered? How would our life have value?
Those thoughts just reveal our arrogance, our prejudice against those with low IQs. We fear becoming those who we have not valued very highly.
But I am beginning to see that—in addition to the losses—there may be another kind of joy available as my mental powers decline.
I'm reminded of parents and caregivers of the mentally retarded who talk frequently about the joy they find in the relationship with those whose intellect is deeply impaired. Feelings are more available; relationships are more immediate; the person is valued, not so much for what he can do but for who he is.
Perhaps it's the quality of our hearts and not the number of our IQ that matters more.
I'm still early in the disease and haven't yet lost too many of my intellectual abilities. At this early stage, it would be naïve for me to insist that I'll live up to my words above.
Maybe my equanimity in the face of this illness will collapse and I'll suffer like Martti did. I can, however, see the possibility of just letting this particular self go.
So far, I haven't clung to the capacities that have already slipped away, and I can foresee accepting the next steps as just part of my journey, too. I won't have to try to be the brightest bulb in the room, anymore. Been there, done that!
Now is the time for a new part of my journey. Perhaps that is my future.
I wonder about Martti.
Could he have suffered less if he hadn't been so attached to his previous self?
Would he have been so unhappy if he knew that his value and his worth did not depend on his IQ?
I'd like to think so.
A retired physician and accomplished author, Dr. Hilfiker was diagnosed in 2012 with a progressive mild cognitive impairment, which he says is almost certainly Alzheimer’s disease. His voice offers a profound perspective that will help AgingCare.com caregivers to better understand what it’s like from inside the diseased mind. View David Hilfiker’s profile.