Losing one's mind, for real

Cover of a 1904  home health medical manual.
Credit: UF Health

Watching and caring for an elderly loved one who is dying is no easy task. You see them decline, day by day, until the time comes when your nursing care is pretty much useless. 

They're near death, and you pray, and tell them you love them, and treat them with gentle care. Finally, the day comes when you kiss them goodbye.

I just went through all that. My husband and I nursed my father through his final days in our house. And thank God for that. 

Had my father been in a nursing home, he would have died alone because of the coronavirus lockdown. He wouldn't have understood why I or other family members weren't with him. His Alzheimer's had clouded his mind too much by then. 

AdventHealth Hospice Care guided us every step of the way. I'm grateful for that. You learn quickly how to do things you never thought you'd have to do. And you don't mind. Your life isn't your own, because the needs of a dying Alzheimer's patient are great. 

And then, suddenly, everything stops. You know the time is coming but you're not ever really prepared. Dad's been gone less than two weeks and the void in the house is great. I'm still reeling from it all.

With more time at hand, I started wondering how people cared for dementia-suffering elders in Florida during pioneer days. Nursing homes didn't exist. 

My early 20th century ancestors considered hospitals places to be avoided. My ancestors were in New York City. I don't know if Florida had hospitals outside major areas at that time. My guess is that eldercare was done primarily in the home.

To check the era's home-health advice, I turned to the U.S. National Library of Medicine's online version of Dr. Gunn's New Family Physician Home Book of Health. The book was popular and had been updated and reprinted numerous times over decades. I viewed the 1901 edition.

On page 722, we're told that old age is "the only disease natural to man." Dr. Gunn believed "dosing and drugging" with non-natural remedies would bring on an early old age. People were advised to stick with roots, barks, and herbs. They were told to steer clear as much as possible from "Mineral Remedies."

The book is massive. On page 1,022 there's an entire discussion about bones. While the medical explanation is outdated, the author seems on target in saying that bones of the elderly "are extremely brittle and easily broken." 

Other pages hold decidedly modern notions. One example is an emphasis on healthful eating and unrushed, regular mealtimes. People who acquire such habits were said to reach old age "cheerful, sprightly and youthful in their feelings." 

All that is interesting, but a home-health manual of that size ought to contain something about dementia. 

In the old days, people who had dementia were said to be senile. Yet that word doesn't appear in the book. Nor does the word dementia. Or forgetfulness, or memory loss. Yet dementia was recognized by the medical community at the time. "Alzheimer's" would be named a scant few years later, in 1906.

I had slightly more luck finding the word "senile" in HathiTrust digital library's 1904 - get ready for this title - The Favorite Medical Receipt Book and Home Doctor, Comprising the Favorite Remedies of Over One Hundred of the World's Best Physicians and Nurses. 

Those one hundred-plus medical experts didn't have a remedy for senility. In the book, the word senile is associated with something called Senile Gangrene. It was the name used to describe a limb that became useless in an old person. Heart problems were said to cause the ailment. 

Again, no mention of dementia anywhere in the book. 

Maybe people didn't live long enough to suffer end-stage dementia in olden days. Life expectancy was a lot shorter then. 

But people suffered from it. It just wasn't as commonly known or understood as it is today. I can't imagine how bewildered the sufferers and their caregivers were upon dealing with the relentless loss of cognitive abilities and memory. It had to be terrifying and sad. Because it still is today.