Corne van Nijhuis
I have been working as a volunteer at a hospice for several years now. From there I am generally deployed to provide support to single elderly people still living at home who have a life expectancy of only a few months. Since many are quite elderly, they occasionally suffer from mild dementia. In those situations, the complaints are often still manageable and the end of life is often approached before the dementia is no longer manageable for independent living. However, if you experience what dementia does to someone, the question naturally arises to what level dementia is still humane. In this contribution I would like to give my view on this based on my personal view of humanity. So it is not the truth, but just my perspective
Dementia is a condition in which a person’s mental capabilities increasingly decline to a potentially seriously low level. As a result, a person can no longer perform daily tasks that were previously performed effortlessly, less well or sometimes not at all. This concerns, for example, actions such as dressing, cooking food, taking medication or banking matters. In the Netherlands, almost 300,000 people now suffer from dementia, which will increase explosively to more than 600,000 in 2050 due to the aging population. People with dementia live with the disease for an average of 6.5 years. During the disease process, both the number and severity of complaints increase. There is no cure for dementia and ultimately a patient dies from the consequences of dementia. Dementia is the most common cause of death in the Netherlands after cancer and cardiovascular disease.
Dementia is a disease that ultimately makes us completely dependent on others. That seems to go completely against what we (want to) see as a normal process, namely to become independent and learn to take responsibility – both for ourselves and for the world in which we live. It is therefore a distressing disease, painful and sad for both the person concerned and all relatives. Nowadays, euthanasia is often chosen at an early stage. The underlying idea is that dementia only means pointless suffering and that you should be able to spare each other and yourself such pointless suffering. In such a view it is impossible to think about the meaning of dementia. How could such a horrible disease that makes us dependent and gradually destroys our ability to think have any meaning? And indeed: if you only look at the outside, dementia seems pointless.
But IS dementia really just pointless, or is there something else to observe if you look beyond the outside? In my view of humanity, there is more than our physical and mental capabilities. I am neither my body nor my mind. In my view of humanity, I am the underlying consciousness, or in other words, I am the experiencing subject. And the question then is whether underlying mental and/or spiritual growth could still take place during the disease process, despite the decline in mental abilities? The essential question then is: what happens to the experiencing subject in dementia?
De-mentia literally means ‘de-mind’ and is ultimately derived from Sanskrit ‘manah’ which means ‘mind’. Hence the description in the Dikke Van Dale: mental decline, mainly due to old age. So it is not about the perceiving consciousness (subject), but about the thinking capacity of the brain. It concerns the physical body that is affected by old age. The build-up in the cerebral veins and the accumulation in the brain of improperly broken down protein cells lead to the brain no longer functioning properly and the mind to express itself less and less. But that is why the underlying consciousness, in which the mind or thoughts manifest themselves, is still there! Because we no longer reach the consciousness of a demented person, we can only see degradation from the outside, and we usually think that the consciousness itself of a demented person has also deteriorated. That is not true. Just as the sun is still there, even if it is hidden behind clouds, so it is with a demented person. His consciousness is still there, it has just become less or unapproachable, not only for others, but also for impressions from one’s own senses, including the inner sense, one’s ‘own’ mind.
However, this creates inner space and silence where old emotions and impressions can come to the surface and still be processed. In this way, the dying process can proceed more smoothly and the karmic balance, which provides content in the next life, can become more balanced.
The meaning of dementia is that the subject (prior to the final physical and mental dying process) can silently process the karmic effects of the life one is still leading without earthly responsibilities.
For this reason, I believe that we should not focus our attention on dementia too one-sidedly on the loss or the apparent meaninglessness of suffering. We could look at it in a much more balanced way, namely also at the spiritual side beyond the visible things.
If I go back to the original question “Dementia: worthy or not?”, I come to the following conclusion based on the foregoing. For me, dementia is a natural process. As long as no intervention is made, it is a pure process that has its own function and value in a person’s life. Fortunately, in order to limit any inhuman suffering, we are able to suppress the awareness of physical and mental pain without substantively disrupting the life process.
I hope to have provided an inspiring insight for others who are looking to deepen or nuance their own views on dementia.
Dhr Corne van Nijhuis is a Vedanta scholar. He contributes regularly to this magazine. He has written and translated books, and has travelled extensively almost all over the globe. His in depth study into Vedanta and other systems helps him express difficult ideas in a simple and easily comprehensible way.