Compassion paramount in treating dementia

A mother and her child were riding an escalator at a railway station. The little boy was quick to notice a strange object sticking out of his mother's hip pocket. "Why did you bring the remote?" he asked.

"Silly me. Why indeed?" the mother asked herself and laughed at the folly of taking a television remote control with her.

Most of the silly mistakes we all make from time to time can be dismissed as an amusing story to be laughed at.

But in some cases, the seemingly simple mistakes can be a sign of the beginning of a long struggle. Six years ago, Koichi Osawa, 66, a Gunma prefectural assembly member, became convinced that something was wrong with his wife Masako, 60, when he repeatedly found empty dishes in the refrigerator. She had developed early-onset Alzheimer's disease.

I recently met Osawa at a symposium on caring for dementia patients held in Yokohama. The event was sponsored by the Japan Association for Bioethics.

"I give my wife a dose of laughter so that we won't go down together," he said in a speech. The comment left a deep impression on me.

Before going to bed, Osawa clowns around to draw laughter from his wife. If he is successful, they can both sleep well. Her reaction helps him gauge the progression of her symptoms.

He also makes sure to abide by three self-imposed rules of not getting angry, not saying no and not forcing her to do something against her will. How can anyone hurt the dignity of their loved ones?

We tend to think dementia causes human character to break down and eventually leave the person living in an empty shell.

But Masako Minooka, a physician who organized the symposium, thinks differently. "I want to overcome the shell theory and deal with persons with dementia not as patients but as ordinary people.

"They may be different from what they were before, but they feel, have needs and want to have ties with others."

I want to think that the disease does not deprive people of their characters, but hides them. I also heard that emotionally, they become more susceptible rather than insensitive.

Is it not possible to maintain their quality of life as well as that of their families by ensuring that ethics and compassion are placed foremost among nursing techniques? This is a weighty assignment for an aging society.

--The Asahi Shimbun, Nov. 18(IHT/Asahi: November 19,2009)