Age, a birthday, and encroaching silence

My mother turns 90 tomorrow, and a pleasant family gathering happened today at the aged care facility where she now lives.

Her health held up well until about the age of  87, when a decline in mental function started to become apparent, and pretty quickly set in at a more rapid rate.  The specialist had referred to it as Alzheimer's, but he also noted that her brain had a quite distinct shrinkage, even allowing for her age, and more on the left hand side than the right.   I suspect this may account for her sudden decline of ability with language.  This happened really quite quickly, pretty soon after moving into aged care.  In fact, so quickly that a mini stroke seemed also a possibility, but at her age and with some dementia already clear, further investigation is not high on the priority.

She recognises us all, we are sure, but it is unclear how much of what she is asked she understands.  Most visits are lucky to get a "what?" or "what d'you say?" as the sole response  (and I mean sole - she only speaks once during the entire visit, if you are lucky).  But then suddenly, she will sometimes respond to something indicating she did understand a comment clearly.   To take a mundane example, we were watching TV a few months ago and that awful Celebrity Diving show was on.  I said "oh, that's Denise Drysdale" (a minor TV celebrity, most notably in the 1970's), and Mum's immediate response was a knowing "yeah".   But to more useful questions or comments like "how are you?" or "did you see X today" (when I know a brother or sister has been in) invariably gets no response at all.  (Of course, her short term memory was already going before she went into the home, so I don't really expect her to remember even if the other visitor only left an hour before me.  But the point is more that she attempts no comment at all.)

I have noticed this about the other residents too.   The dinner table, for example, is silent.  No one tries to speak; perhaps because even the ones who can communicate well (and there is at least one pleasant lady there who is an enthusiastic reader and is capable of pretty normal conversation) know that they can't get a good response from most of the others.   That is the most unnatural thing about the place - the stony silence at meals.

I wasn't around too much as my grandmother (my mother's mother) aged - she lived to 96 I think - but I do recall that she always lived in a silent house, and herself grew increasingly silent and withdrawn as she aged.  Mind you, her house had always silent, except for the sounds of a grandfather clock.  That always felt a bit creepy to me - she long outlived her husband, who I barely remember, and had lived separately from him for many years anyway - but living alone in a small house with just this grandfather clock noting each passing second, minute and hour always made it feel as if she had been noting the passing of time towards death since her 60's.  My mother used to say the same thing - she hated the silence in Grandma's house and always had the radio on at home to hear music throughout the day.  In fact, her loss of interest and ability in turning the CD player or radio on was a sign that she was changing a couple of years ago.

Along with the silence there is the increase in sleep.  At least it is peaceful.  Mum can get around - just barely - with a walker, but seems happy to sit and doze and watch TV or DVDs the staff put on. They do get her out of her room for some attempts at stimulating group activities, but I have my doubts that they can be very successful, given the apparent lack of abilities of most of the residents. 

So it's a case of happy birthday, but tinged with inevitable sadness at watching the decline of a formally active and quite strong woman.  There are people with much, much worse aging stories, of course; and it's nothing like the tragedy of children dying.  But still, it seems an unfortunate design of a universe for it to allow for protracted mental decline and the slipping into silence.