Dr. Jekyll and Mr. Hyde – Dementia Comes Home


A friend for 30 years (I will use the name” Jason”) goes ballistic; Jason verbally attacks me, ranting and raving with scary yelling and gestures.  The trigger:  I have no opinions about the significance of the day after Halloween (All Saints’ Day).  The next day Jason calls like nothing happened; I remind him, he swears he does not remember; we have a normal, friendly talk, so,  I write the outburst off as several  “senior moments.”

The next week a group of mutual friends and I are at a weekly lunch meeting.  We are chatting about faux pas and embarrassing mistakes we have made.  One friend (let’s call him “Chad”) tells a humorous story about when he sent an email to his boss that was a passionate message to his wife.  We laugh and tease him, like guy friends always do.

Suddenly, Jason raises his voice and wags a finger at this “stupid screw-up.”  He rails and berates Chad until Chad gets up and walks out of the restaurant.  Then Jason follows Chad into the parking lot and beats on his window, still yelling.  Five minutes later, he comes back, smiles at everyone, and asks me if I can stay after lunch to talk about an idea he has for a photography business.  He was clear and pleasant the whole time; he was the friend I know again.

Jason’s problem becomes traumatically real to me.  Alzheimer’s, or bipolar, schizophrenia, mad cow disease, I am at a complete loss.  Does he have a brain tumor?  Has he taken some mood-altering drugs?  Is he still going to be the friend I have known all these years?  Is he some kind of hybrid being, who “identifies” differently some days, or hours?  Has old age stolen his mind?  I am confused, sad, and worried.  What should I do?

My nature is to research problems before I act.  I discover that his condition is probably medical.  Advancing age is fraught with declines, distortions, amplifications of who we are.  What people dread most, is not death; it is the loss of independence and identity.

My research yielded interesting, enlightening, conflicting, and vague ideas.  The mysteries of Alzheimer’s and Grumpy Old Man syndrome are beyond us now.  I am going to make the best suggestions I can to give Jason a chance to live independently, to retain his self-respect, and to let his friends know when he needs them.

Phase 1.  Find out what he can about what is happening to him.  Whatever it takes to know what he is dealing with.  Doctors, tests, interviews, and the lot of modern medicine.  Most likely, they will be semi-inconclusive.  Mood shifts, forgetting, risk taking, those are the symptoms.  Jason will have to choose a path, a theory, a diagnosis he can pursue.  He cannot do everything, but he can do some things.

Phase 2.  Implement the universal common denominators of healthy lifestyle.  All bids for health share wellness and mindfulness as crucial, non-pharmaceutical elements (although medication might be needed for some things).

  • Complete examination
  • Enough good:
    • Sleep
    • Hydration
    • Exercise
    • Nutrition
  • Stable daily routines
  • Thinking/learning/puzzles
  • Stress management/mindfulness
  • Social/spiritual support

Phase 3.  Comply with doctors’ orders.  Try everything long enough to be a fair trial.

  • Take all prescribed medications when and how the prescriptions direct.
  • Show up for appointments and tests
  • Give regular feedback on efficacy of treatments

Phase 4.  Accept your mortality.

  • We all exit this world, unexpectedly. Be gracious until then
  • We all get to choose our friends, revere who we love, and forgive our families
  • Acknowledge your family, friends, doctors
  • Add to that acknowledgement list
  • Do not hold back because you feel vulnerable or embarrassed

I do not think we can guess who will be our Jason, or to whom we will be a Jason.  Maybe these thoughts could help.