In his poignant essay, “How Much a Dementia Patient Needs to Know”, Dr. Oliver Sacks asks, “[s]hould we have told Mr. Q. that he was no longer a janitor but a declining and demented patient in a nursing home?” Through portraits of former dementia patients, Dr. M. and Mr. Q., Dr. Sacks shows how they flourished (at times) when given the freedom to be who they knew best — themselves.
When admitted as a long-term resident of a hospital where he formerly served as the Medical Director, Dr. M.’s agitation subsides while he chats with the nurses at the nurses’ station, much as he did throughout his career. Mr. Q., a former janitor, wanders the halls of his nursing home with keys jangling as he ensures the facility doors are locked before he retires for the evening. Both Dr. M. and Mr. Q. exhibit equanimity while reliving their professional lives.
Dr. Sacks questions the ethical implications of forcing Dr. M. and Mr. Q. to confront their new, much harsher, demented reality. Taken a step further, the article offers implications for dementia care. It is a herculean task to care for a loved one with dementia. Very little can ease the load for such caregivers. In the least, this article should give families comfort knowing that allowing their demented loved ones to relive former their lives, not matter how distressing it may be to witness, is likely to bring the patient comfort; it is not a behavior that needs to be corrected or treated medically.
We should also question whether professional providers have an obligation to learn about their patients’ personal lives? Who they were? What they liked? Must we offer dementia patients creative ways to recreate their life experiences in an effort to provide the best care possible?