Madness and the Stages of Grief

Recently, I was asked a question about Alzheimer's and the five stages of grief as defined by Elizabeth Kubler-Ross. I think the question was meant to ask if Alzheimer's patients experience these stages with regard to knowing they have the disease. If they receive the diagnosis early enough to be aware of their condition, I guess it's possible. Who knows for sure? Once the disease sets in, something like that would be very difficult to evaluate. BUT, for those of us who love somebody living with Alzheimer's, I think it is a certainty. Or, at least that has been my observation.

Like Groundhog Day, I've experienced the five stages of grief -  Denial. Anger. Bargaining. Depression. Acceptance - over and over and over. 

Some losses of my mother's major physical abilities and cognitive skills actually do feel like a death. A piece of my mother has died and I will never get it back again. Maybe it's the piece that wanted to have lunch at Chili's and order the same quesadilla salad every time. Or, maybe it's the piece that taught herself to crochet elaborate afghans. Or, maybe it's the piece of my mother that could walk, watch television, and hold a spoon. 

The first time I recognized the five stages of grief in myself was when I realized that my own mother had actually totally and completely forgotten my name.

• DENIAL- I couldn't believe it. No way. It was impossible. She was just tired. She was just having a memory burp. Don't we all do that? She wasn't fully awake yet.
• ANGER - It was not fair!  Why me? I saw her all the time! She remembered my brother's name and he was three hours away and saw her less frequently than any of her kids.
• BARGAINING - Maybe if I remind her every time I come in the room by saying, "Hi, Mom, it's Mary", I can reverse this thing. 
• DEPRESSION - What's the use? I can't help her. I can't save her. I don't even want to get out of bed in the morning.
• ACCEPTANCE - Okay. This is our new normal. At least she still knows who I am. 

Each loss seems greater than the one before, like a harsher death. Not recognizing me when I came in the room was a harsher death than forgetting my name. Losing her ability to communicate with me was a far worse death than forgetting my name or not recognizing me. And, with each progressively more painful loss comes a longer period of grieving.

Sometimes, acceptance for one loss does not arrive before another loss begins. When that happens, and because people progress through these stages at different paces for varying losses, there may be times depression for one loss overlaps anger for another. Or, bargaining for one loss overlaps denial for another. At times like these, I do two things (1) seek help from my support system and/or (2) step away and go somewhere quiet where I can "be still and know that He is God" because I am most certainly not God.

• Support System -  my friends, church members, neighbors, doctors, etc. who will recognize unusual and unhealthy behavior and will hold me accountable for taking care of  my mental health. My support system cannot be made up of solely family members. They are sharing my losses. People grieving together can console one another but are less likely to be able to pull each other out of the stages of grief since we're all experiencing one stage or another.
• Stepping Away - we all need perspective. Soldiers cannot see the battlefield if they stay in the foxhole and we cannot self evaluate if we don't step outside of ourselves. Neither can we get perspective on our lives if we're always in a room where the television is on, people are talking, dogs are barking, doctors are coming in and out, or equipment is making a racket. We all need quiet time where our brains can process what we're feeling and we can come to terms with our own pain. For me, part of that is acknowledging that none of this is in my control and my mental health is too high a price to pay for something I cannot change. 

Coping with Alzheimer's is, as I've said before, soul-sucking madness. Not much I can do about that. But with some action on my part, some recognition of what I'm experiencing, and a willingness to be held accountable and make corrections, I can soldier on through the madness without sacrificing my mental health.