Blog Posts

One Benefit of Dementia

This blog is one of a series that Alix Kates Shulman wrote for Psychology Today about her life after a shattering accident left her husband with a brain injury and dementia. She describes a roller coaster ride many caregivers will recognize, but these blogs are also a tender love story—the gist of it is captured in the title of her deeply moving memoir, To Love What Is (2008). Published by Psychology Today on September 14, 2009.

Sweetheart that he is, my 80-year-old husband is usually very cooperative, despite severe dementia resulting from a traumatic brain injury suffered five years ago. But for the last year or so, he has recoiled from anyone, including me, who approaches him with a sharp instrument, making such normal grooming acts as nail clipping and beard trimming, as well as necessary blood drawing, all but impossible. Consequently, his toenails were so long, they were like knives, one even cutting into the neighboring toe until it bled.

Once I saw blood, I felt I had no choice but to call the podiatrist, who makes house calls to patients who can't walk or who have dementia.

On Scott's geriatrician's instructions, in preparation for the visit, I tried out a Valium-type drug a few days in advance, in order to determine the right dosage. Because of the danger of falls, often life-threatening to the elderly, it had to be the minimum dose to do the job.

An hour after swallowing the pills, Scott was barely able to walk to our bed, where he quickly fell into a sort of twilight sleep. He was so woozy that I was actually able to cut his fingernails. Not that he didn't halfheartedly object as I did so, but he was too doped up to stop me.

Continuing the experiment, I also seized the moment to clip his mustache, which had grown down over his top lip, making eating a messy affair. During President Obama's health-care speech I sneaked the scissors up, snipped a few mustache hairs at a time, then hid the scissors, while Scott swatted vaguely at my hand. I felt like Harpo Marx.

Finally yesterday, one and a half hours after I gave Scott the meds (same dose and time frame as before), the podiatrist arrived. Scott was dozing on the bed. But as soon as the doctor started in on his feet, my husband, who had been an accomplished athlete in his youth, got a massive infusion of strength and an impressive supply of curses, which he continued to hurl all through the clipping. It took four of us, using all our strength, to get the job done: the doctor, my son, Scott's aide Gloria, and me. I held his legs, while Gloria and my son—who can usually calm Scott by talking to him but succeeded only intermittently on this occasion—each held an arm.

Clipping completed, the doctor pulled out a small, battery-powered file to use on the thickened nails, and despite the noise, Scott calmed down. The minute the procedure was finished, he completely forgot that anything had happened—one of the benefits of dementia—and reverted to his sweet self. A few minutes later he was asleep again.

Whew! It's done! But the doctor says we must repeat this task every six weeks—next time, he admonished, before the blood appears.