Ronnie Polaneczky: When dementia strikes, hope and faith are …

‘GETTING OLD is not for sissies,” my 84-year-old mother told me when I visited Sunday, quoting the famous line by actress Bette Davis about the hardships of aging.

She ticked off the insults: Withering muscles, disintegrating bones, faulty memory, loss of mobility and independence.

“Getting old is not for sissies,” Mom repeated, as she does all the time, now that her dementia has progressed to near-constant forgetfulness, punctuated by unexpected moments of clarity followed by bouts of confusion.

But she is never violent. She remains loving toward my 82-year-old father, sweet to her children, kind to the nurses who tend her on the assisted-living unit in my parents’ retirement community.

If she ever becomes aggressive and mean – typical dementia behaviors, which may yet manifest themselves – it will be awful beyond words.

Last weekend, Ernest Rayfield, 88, dealt with the dementia-related violence of his wife, Mary, 87, in a most horrible way. He stabbed her to death in their Delaware County home, then called 9-1-1 to confess.

Neighbors have described the Rayfields as a wonderful couple whose bond was evident in the gentle way that Ernest took care of his wife as her illness advanced.

Mary, though, had recently become violent toward her husband. Indeed, one neighbor said that, when she heard that there had been a stabbing, she thought Mary had hurt Ernest.

According to police documents, Ernest said that he “had had enough” and “couldn’t take it any more.”

But why did he think he had to “take it” in the first place? Why didn’t he seek help, before doing the unthinkable?

“There is nothing worse to us than hearing stories like this,” says Claire Day, head of programs and education for the Delaware Valley chapter of the Alzheimer’s Association. Since news broke of the Rayfield slaying, she said, there’s been an uptick in help-line calls to the chapter’s Center City office.

“It reiterates to us that we need to provide help to more families, so no one goes through what [the Rayfield family] is going through right now,” Day said. “There are a lot of good, free services that provide respite and support before and during a crisis.”

But getting caregivers to use them can be a hurdle, said Barry Jacobs, a Crozer-Keystone Health System psychologist and author of The Emotional Survival Guide for Caregivers.

“A lot of people, men in particular, feel like it’s on them to be strong enough to do whatever needs to be done,” he says. “They think if they just tough it out and buckle down, they’ll get through it. But those are the people who put themselves most at risk for eventually lashing out at the person they’re caring for.

“They might begin by screaming. Then it moves up the line of severity to hitting or [in the Rayfield case] killing the person.”

The sad irony, says Jacobs, is that aggressive dementia behavior can often be calmed with medication to address “atypical anti-psychotic” behavior of the kind associated with the disease.

“Sometimes the side effect is that the patient can become lethargic or confused,” he concedes, “but we’ve had some real success with medication, too.”

The bottom line is that unless a caregiver reaches out for help, there’s no way to know what might work.

In my own family, my mom’s dementia has required more acceptance than I ever thought we’d have to muster.

Acceptance of her receding mental capacity. Of our inability to fix or change her plight. Of the limits of what we can do to help each other through the progression of a disease that steals small bits of my mom from us every day – and then, inexplicably, returns those bits from time to time, when we least expect it.

Only to steal them again.

Patti Davis, daughter of former president Ronald Reagan, wrote a memoir of her father’s slow descent into the faded world of Alzheimer’s, and its title is so poignant, I can’t type it without crying.

It’s called The Long Goodbye. A conversation with my dad yesterday reminded me why the title is so apt.

“I was straightening out a closet in the apartment,” he told me, referring to the one-bedroom home he shared with my mom until we had to move her to the assisted-living unit elsewhere in their retirement community. “Mom has a couple of coats she hasn’t used in a while, and I thought, ‘I should get rid of them. She’s never gonna use them, anyway.’

“But then she had a really good day. And I thought, ‘Hey, maybe she’ll get better enough to move back in here with me.’ I know that’s denial on my part, but I have to balance my sadness with hope. Hope and faith in God are the only things that are getting me and Mom through this.”

Hope and faith. If Ernest Rayfield had felt just one of them, I have to believe his wife might be alive today.

For help, call the Alzheimer’s Association hot line, staffed 24 hours a day, 800- 272-3900.

E-mail polaner@phillynews.com or call 215-854-2217. For recent columns:

http://go.philly.com/polaneczky. Read Ronnie’s blog at

http://go.philly.com/ronnieblog.

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