Adapted from Dirge Magazine, August 2015
Mrs. Monkey-Suits and the Dark Beauty of Dementia
Cw: depictions of memory loss, mentions of violence
She was the last person left in the lounge, so I readied her wheelchair and strolled over with the warmest, least-threatening smile I could muster.
“Good evening! It’s nearly midnight. Would you like me to help you to bed?”
“Oh, no thank you, darling” she said. “I’m waiting for the flying boats to pick me up.”
“Um,” I said. “Okey dokey.” I sat down in the armchair next to hers and looked at her earnest expression for a moment. If I lied to her I’d feel like crap about it, but if I told her there were no airships coming to collect her she’d be angry and upset. This particular service user was usually volatile, often taciturn and restless, and liable to lash out with her fists or break down into fits of sobbing. I decided to roll with it. “What are you going to do on the flying boats at this time of night?”
She held her head in one hand for a moment. “They’re flying up here so I can help with the tea-party. Mrs. Monkey-Suits is managing the get-together this year, all the dog sandwiches and the teapots and the people-roasts. We always have fun and the girls always work hard; it’s quite enjoyable work, really. Except last year it all went quite wrong, and Mrs. Monkey-Suits was so angry at the girls, and she made them stand at the bough of the ship in two big long lines, and she was going to ‘whip them into shape’, that’s what she said. It’s a good job I was looking after them, but I had to get on stage at the front and shake my feathers at everyone to sort it all out.”
I didn’t feel the urge to laugh. The service user was taking all of this very seriously, and so was I.
“It all sounds really scary,” I ventured. “Mrs. Monkey-Suits sounds like a terrible boss, and I don’t think I could eat a person, never mind a dog sandwich. But I think I’d be most frightened of the flying ships. Don’t you get scared of the heights?”
She looked at me, her blue eyes sparkling and the wrinkles around them like cracks in pale earth, and it was the first time I’d heard her really laugh. “It’s fine,” she said, still giggling, “so long as you don’t look down.”
We went on to have a really enjoyable conversation about how an air-ship stays airborne, how long she’d been working as a hostess for flying steam-punk tea-parties, and which of my colleagues would make the best appetiser for the party. After about an hour I went to get her a cup of tea and a slice of cake, and in the time it had taken to make her supper she’d completely forgotten about the flying boats, had no idea who I was, and was wondering why she wasn’t in bed yet.
Picture found here.
Your brain hates gaps. It hates to be confused. If we can’t quite remember something, our brains sometimes look for an event that may possibly have happened or is close enough to the truth, and it plugs those cavities with a soothing half-truth or white lie. This is mild for most of us, and is normal. It’s why we have things like cognitive dissonance and false memories, and it’s why the details of someone’s story can change even when they are telling the truth. There’s a high chance I’m sealing some gaps in my service user’s story without knowing it, because it happened months ago and I’ve retold it to myself countless times over that period. It’s just a process of how we create stability and logic in our own realities.
In people with dementia and related illnesses like Huntington’s disease or Korsakoff’s syndrome, gaps in your memory increase into fissures, your inhibition shrinks, and you lose the ability to tell whether what’s happening in your own head makes sense. Your brain, wildly casting around for something that seems like it might be true, starts trying to find stories that matter and that will explain all of the fucked up shit within and without.
In psychology we call this ‘confabulation’. The person with memory loss isn’t lying, just trying to make sense of missing, garbled, or misunderstood memories. My service user wasn’t fabricating a story to mess with me; she needed a reason for why she was still up at midnight that didn’t involve being in a care home, being unable to walk unaided, trying to kick us when we’d asked if she’d like to go to bed a few times earlier in the evening, or having dementia. So her mind gave her flying boats.
In my own experience working with service users in hospitals and care homes, the themes of confabulation often revolve around those places, and why their family aren’t there with them. They can’t process that they have dementia and so believe they must be in a hotel, or a café, or a prison, or at work, or else about thirty people have broken into their house and they want everyone to piss off before they eat all the biscuits. Their (long departed) Mums have just popped to the shops for a loaf of bread; their children (often with grown-up children of their own) are sleeping in cots in their nurseries next door; their partners (usually incapacitated themselves) might well be out somewhere with a paramour.
Confabulation can be terrifying for all involved. One night I happened upon a service user in their eighties who was crying and bashing on the front door because they were fifteen again and their Dad was in the car park waiting to take them to a football game. Another service user used to be so convinced they were in prison – why else weren’t they allowed to leave? – that they came to believe they must be the Yorkshire Ripper, and began to act accordingly. Another has been waiting anxiously and tearfully for months and months for the bus that will take them home to their infant children.
The silver-lining, though, is that apparently the idea of a pirate-cannibal tea-party in the sky is no big deal to someone with dementia. Some of the most beautiful, glorious and other-worldly stories I have ever heard have come from the brains and mouths of very ill people who completely believe what they’re saying is true. A lot of it has been horror, but there has been romance, and adventure, and comedy. It hints to an inner life in some people with dementia that could be more rich, weird, dark and fun than we can understand. At least until flying boats are invented.
Picture found here.