Distressing behaviour can be an upsetting part of the dementia journey. But some families claim their loved ones have become calmer and happier than ever before. Kate Corr examines the phenomenon of so-called Pleasant Dementia.
Let’s be very clear; there is nothing pleasant about having dementia. So when I first came across the term ‘Pleasant Dementia’ in a best-selling novel I was slightly taken aback. It was used by author Karin Slaughter in her latest thriller Pretty Girls to describe the protagonist’s mother, an elderly woman who used to be a cantankerous old witch but was now totally serene, having forgotten her copious grudges.
Was this simply another bad-taste joke about dementia? Had the author coined the phrase herself I wondered? On further investigation, however, I discovered she hadn’t made anything up at all. Pleasant Dementia is a well-recognised phenomenon.
Anecdotally, of course, we’ve all heard about people with dementia who remain generally placid. Whilst this definitely wasn’t true of my mother who had vascular dementia and was often tormented by fear and confusion, it was true of her sister. Aunty Meg smiled serenely (if somewhat vacantly) when visitors arrived and rarely made a fuss about anything.
Does this mean Aunty Meg had Pleasant Dementia? Strictly speaking, no. The term usually refers to someone who had previously behaved in a very different manner, then experiences a reversal of personality when they’re diagnosed with dementia. Aunty Meg had always been the most lovely, laid-back member of our family, so there was nothing new about her behaviour. Pleasant people, apparently, don’t get Pleasant Dementia.
However, according to her daughter Sara, Alice Davidson definitely did have the condition. In a searingly honest account of her mother’s dementia, Sara explains how a once fiery, opinionated, demanding woman became a serene, smiling individual who saw no point in complaining and truly lived in the moment.
Describing Alice’s first day in a care home, Sara says: ‘I used to call her the ‘send-back queen’ because in restaurants she would send back every dish if it wasn’t prepared exactly as she’d ordered. At her new home, she ate an overcooked hamburger in a dry bun with no complaint. Then she joined the group in singing and went to bed with a smile.’
Perhaps it’s possible to live more happily if you no longer remember the reasons why you were sad, angry or bitter in the first place? But Pleasant Dementia may not simply be the result of a happy accident, it could be caused by a particular sort of damage to the brain. Some experts suggest it may be the result of damage to the frontal lobes, an area of the brain which plays a key part in controlling anxiety and decision-making.
Others say damage to the left hemisphere (the side that deals with logic and reasoning) may lead to the right hemisphere (which deals with creativity, insight and imagination) becoming more dominant. So a person once driven by logic becomes more emotional, intuitive and in touch with their feelings.
External factors may be at play too though. If your loved one is well cared for, has enough mental stimulation and generally feels safe and secure, it’s likely to make a difference to the amount of agitation, paranoia and aggression they display.
But not always. If, despite all your best efforts, the person you’re caring for is rarely pleasant, try not to take it personally or to feel envious of those experiencing something quite different. For whilst you may wish your loved one had their peace and serenity, Pleasant Dementia can cause a whole mix of emotions for the families dealing with it. After all, how would you feel if someone you loved underwent a personality transplant? It might be a relief to see them shrugging off a grievance or smiling instead of shouting, but it could also be quite unsettling, too. Occasionally, families find themselves yearning to have the person they knew come back to them, warts and all. And when they don’t, they probably feel very guilty indeed.
So be careful what you wish for. Every dementia journey is unique and contains its own unique challenges…and Pleasant Dementia may not be as pleasant as it sounds.
What do you think about Pleasant Dementia? Is it a useful term? Is it something you relate to? We’d love to hear about your experiences in the comment box below, or by sharing your thoughts on our social media pages.