Jewish World Review Sept. 13, 2004 / 27 Elul, 5764

Russell Friedman

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Consumer Reports

You seem like a nice young lady — what's your name? | On a sunny day, anywhere in the world, a daughter walks into her mother's room at a convalescent home. Mom sits at the window staring out at nothing, though there is much to see. The daughter bends down, kisses mom's forehead and says, "Good morning, Mom, how are you today?"

Mom looks up, smiles mechanically, and says, "You seem like a nice young lady — what's your name?"

"Mom, it's me, Peggy — I've come to visit you."

"That's nice, dear, what did you say your name was? Do you work here?"

A few minutes later, a very sad young woman walks out of that building. The sun may be shining in the real world, but not inside her heart. She gets into her car with tears in her eyes and makes a decision that will negatively affect the rest of her life. She decides that she will not visit mom anymore. It's just too painful.

Life goes on. The daughter goes about her day-to-day activities, tending to family and career. She thinks about Mom a lot, but keeps her vow not to visit. Over time, Mom's condition deteriorates. About two years later comes the inevitable phone call saying, "Your mother has been taken to the hospital, if you want to see her one last time, you'd best head over there."

When the death occurs, the young woman is left with the horrible thoughts and accompanying feelings that she'd left her mom to die alone in a place where no one really knew who she was, nor who she had been.

We picked up this all too typical story at the end. But Alzheimer's does not occur as the flick of a switch, taking a person from light to dark in one swift plunge. It is a long, tortuous process. In order to understand how and why the young woman made the decision to stop visiting, we must go back and see how this kind of thing evolves.

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The early indications of impending Alzheimer's are subtle, and often masked within what appear to be normal signs of aging. At first, the lapses are minimal, seeming to be just short-term memory gaps, which soon return to normal. Family and friends are affected only to a limited degree.

After a while, the lapses become more significant, more frequent, and more open-ended. The children try to get Mom to be who she used to be. They remind Mom of things they all did together. They ask her questions about major events in their lives, but she cannot relate to them, as if those events and those people have evaporated from her memory bank.

Fraction by fraction, Mom slips away, frustrating her children to a level of despair. As she morphs, the children try even harder to get her back the way she was. But Mom goes further away — no matter what attempts the children make to help her remember their mutual pasts. Eventually, the Mom they knew is gone, and in her place is this other woman who looks and sounds just like her, but isn't Mom anymore.

Now we've returned to the point where this story started, when the young woman made the decision to stop visiting. Understandable? Yes. Necessary? No.

The devastated daughter, sitting in the parking lot, could not perceive anything other than a black or white solution to the pain of seeing her mother disappear. The ongoing frustration at not being able to get her mom to recognize her and to be herself again was too much to bear. She believed she could only choose to visit or not to visit.

But there is an alternative to that kind of all or nothing approach. Sadly, most people are not aware of it. It involves the principles and actions of Grief Recovery. The daughter must "complete" her relationship to her mom - to the way the relationship was before the Alzheimer's. Then, and only then, can she begin a new relationship with the woman who looks and sounds like Mom, but isn't really Mom anymore.

We put the word "complete" in quotes because it is a piece of language unique to what we do in helping people deal with the grief events that affect their lives. Grief is not limited to death. It includes divorce; it includes career and health issues; and it most certainly includes the massive changes that occur when someone we love is no longer who they used to be.

One of the benefits of getting "complete," is the ability to continue visiting Mom. The new relationship with the woman who looks like Mom can be very nice, even though it will be very different. In this healthier scenario, when Mom dies, the daughter who has become "complete" with her Mom, does not wind up haunted because she stopped visiting Mom and left her to die alone. That does not mean she will not be saddened by her mother's death, just that she won't be emotionally crippled by her own decision to stay away.

That is a mighty difference. We know - because we've helped many people who stopped visiting and wound up carrying the heavy burden of feeling as if they had abandoned the very person who had taken care of them earlier in life. Yes, we could help them, but it is far better if people do not put themselves in that position.

Needless to say, this is not limited to mothers and daughters. Whether Alzheimer's attacks a spouse, a parent, a grandparent, aunt or uncle, or anyone else important to us, actions must be taken to "complete" the old relationship so we can start the new one.

Hopefully someday soon, there will be a full and complete cure for Alzheimer's. Until then, we must all acquire the ability to "complete" those relationships with living people that have been altered by circumstances and events that we could not control.

We didn't want to make this article into an infomercial, but maybe there is no other way. It's unfair to present a problem without suggesting a solution. Get a copy of The Grief Recovery Handbook — The Action Program for Moving Beyond Death, Divorce, and Other Losses. (Available by clicking the link in the bio below) Use it to help you get emotionally "complete" with someone who is important to you so you can stay with them all the way to the end. If you do that, you will not rob you or them of the connection that joined you for so long.

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Russell Friedman is Executive Director of The Grief Recovery Institute in Sherman Oaks, CA [ ] and co-author of "The Grief Recovery Handbook & "When Children Grieve. Comment by clicking here.


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© 2003, Russell P. Friedman