The right words

Due to mini-strokes and constriction of the blood flow in her brain, my mother has developed the same form of cognitive decline that my mother-in-law had: vascular dementia. In both cases, aphasia ravaged their speech as their conditions worsened. My partner’s stepmother also had aphasia due to stroke, so I have now witnessed the condition up close among three women who had very different backgrounds and personalities. As aphasia presents most noticeably as a loss of verbal expression (talk about being at a loss for words!), the condition fascinates me (a person who loves words).

And devastates me. My mother had never been “good at words” the way my father was, but she was a compassionate listener and often could find the right things to say when my glib and witty friends and family members could not. I recall many times when she would ask to talk to me alone and express something she’d been keeping to herself and reflecting upon, waiting until she could “say it the right way.” Now, she can say almost nothing “the right way.” Rain becomes snow; snow becomes green; hat becomes clark; tomato becomes red; table becomes place…and even these are unreliable substitutes, likely to change from one conversation to the next. The pronoun she has vanished from her lexicon. Her vocabulary is little better than a five-year-old’s, and she inadvertently invents words that are essentially meaningless while trying to convey meaning.

She can still read, a little, and slowly. A few months ago, I gave her a book by Eloise Klein Healy, Another Phase. Healy, a well-known poet, was stricken with Wernicke’s aphasia and–with a devoted speech therapist’s help–regained the ability to compose poetry again, though the work she now produces reflects her profoundly-changed expressive abilities. My mother was pleased that she could read the book and that Healy could make poems even with aphasia. And Mom understood the poems–had memorized a few image-lines that she liked. This stunned me–memory’s often wrecked by vascular dementia, or so we are led to believe. But my mother has a good memory. She merely has extremely limited verbal expressiveness–an inability to locate the right word, and a loss of numeracy and literacy. Alas, the result means she cannot make her ideas and thoughts known to others. Isolating.

The pandemic lockdowns at her assisted living campus, my father’s death after 62 years of marriage, her gradual hearing loss, her inability to drive or go shopping–all of these led to further isolation. And isolation, of course, worsens the dementia.

Now that the lockdowns have been lifted, my family members are spending as much time as we can visiting her. One Best Beloved drove her to the church she has been attending by Zoom, now that in-person services have resumed. This past holiday weekend, I picked her up at her apartment and drove her back to my house. Due to my dad’s ill health and the pandemic, it has been over two years since she was here; but for 25 years, she and my father drove here many, many times. It was heartwarming to watch her as she relished returning to a familiar and much-loved place, which also happen to be my house and yard.

She kept saying, “This is so good. This is so, so good!” We’d arranged a mini-gathering for lunch, and there was tasty food and lively conversation all around her. She doesn’t seem to feel frustrated at not being able to join in the dinner chat; I think she was glad just to listen. After awhile, her vocabulary even expanded a bit. She said, “This is fun!” and “This is so great!” in addition to repeating how the day was so good. The joy was palpable.

(I am reading about joy just now, as it happens–a book by Douglas Abrams, Archbishop Desmond Tutu, and the Dalai Lama called The Book of Joy. More on that another time, perhaps.)

After lunch, some dessert, and a brief nap, my beloved mom admitted it was probably time for her to return to her apartment. I drove her home, and the ride back was full of comfort and ease and quiet companionship such as I haven’t felt with my mother during the past couple of difficult years, though it’s been there my whole life. I was helping her out of the car when she said, “That was wonderful. Let’s do that again!” Two sentences in perfect grammar, and a boost in vocabulary from good to wonderful.

“Only connect.” I don’t think E.M. Forster was referring to aphasia or to isolation in Howard’s End, but the phrase suits today’s post. Human connection matters. Indeed, it’s wonderful.