Pat Robertson, Alzheimer's and Confronting Absence

The trouble is that dementia defies linearity in all its forms: the clear answer, the proof text, the incisive definition.
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I have a friend whose wife suffers from Alzheimer's. She doesn't even recognize him anymore, and, as you can imagine, the marriage has been rough. My friend has gotten bitter at God for allowing his wife to be in that condition, and now he's started seeing another woman. He says that he should be allowed to see other people because his wife as he knows her is gone ... I'm not quite sure what to tell him.

Pat Robertson's response to the above dilemma has garnered considerable criticism. Robertson's central assumption--an assumption shared by many across the political spectrum--is that human worth is determined by cognitive capacity. Armed with this common conception of human value, Robertson's characteristically literalistic and simplistic reasoning concludes that the person with advanced dementia is "gone" and "a walking death." Thus the non-afflicted partner is--for all intents and purposes--already a widow/widower, making remarriage permissible.

If you watch the interview, you will notice that Robertson clearly struggles, with no absence of pathos, to respond to the very real heartrending personal experiences of this caregiver and the murky ethical waters of advanced dementia. The problem is that Robertson feels he must answer the question at face value. He must provide concrete advice to the complex and emotionally-devastating dilemma before him, so he seeks footing on the familiar moral ground of avoiding adultery.

Robertson gropes to find the answer, even admitting that an ethicist other than himself should be consulted. Robertson realizes he is in over his head but retains certainty that there is an answer, even if he himself can't exactly come up with the definitive one.

The trouble is that dementia defies linearity in all its forms: the clear answer, the proof text, the incisive definition.

As Robertson's squirming indicates, dementia, particularly in its advanced stages, forces all of us to confront hard questions regarding the locus of human worth, the relationship of mind, body, and spirit, and the radical contingencies of life.

What we must stare squarely in the face is absence: the absence of sequential memory, the absence of logical conclusions, the absence of control. Absence is scary. It leaves us feeling vulnerable, so, in an attempt to alleviate our fears, we fill the absence with answers ("you should get a divorce," "you shouldn't get a divorce," etc.).

The primary offense is not necessarily the answer Robertson gave but that an answer was offered at all, that the complexities of the situation were reduced down to a debate about whether the man in question should or should not get a divorce. The dilemmas presented by dementia, however, transcend narrow moral quibbling. Rather they call us to grapple for meaning and meaningful relationships in the shadowy realms of absence and finitude.

The Robertson controversy highlights the complex renegotiation of relationships that dementia requires. Loved ones often need considerable support in this shifting relational landscape where spouses become caretakers, children become parents, and friends become helpers. Families and friends must reconfigure the relationships that had once seemed so stable and predictable in new, never-imagined ways.

In my work with caregivers and their loved ones with dementia, I witness the many creative and compassionate ways caregivers navigate this difficult terrain. Finding themselves in unchartered relational territory, caregivers often seek and find support in a variety of people and places.

Caring relationships may develop that are difficult to categorize. Because of our limited vocabulary, we have trouble talking about the close relationships that emerge between members of the opposite sex without framing them in primarily sexual terms.

One gentleman I know comes to mind. Ed's wife Barbara who suffers from Alzheimer's has been nonverbal and minimally responsive for years. He visits her each day at the care facility, holding her hand, sitting in the garden with her, offering his presence and love to her. Ed also has a female companion Shirley, with whom he attends shows and eats dinner. The question of marriage between Ed and Shirley would be an absurd one to ask, yet it is obvious they have a special and supportive relationship.

Robertson can only conceive of the man's relationship with another woman in terms of the threat of adultery and the possibility of marriage. In the shifting relational sands of dementia, we need more nuanced conceptions of the various forms of life-affirming relationships. We need faith and faith communities that make room for the experience of absence, a robust examination of the roots of human worth, and the ambiguities of relationships.

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