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 While the medical explanation is outdated, the author seems on target in saying that bones of the elderly "are extremely brittle and easily broken."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.  

Of life, death, and loss of a loved one

In pioneer days, communication was by letter and telegram.
Today, we use text messages, email, and phone calls.
Photo credit: Gerri Bauer

In some ways, we're not so different than the pioneers. Many modern Floridians live far from extended family. When a loved one dies, we communicate by text message, emails, and phone calls instead of by letter or telegram. But the message, the hurt, and the feeling of loss are the same. The distance from close kin produces aches atop the existing sadness.

Another similarity shows up in how neighbors step in to help in the absence of family. If you're lucky enough to have a supportive spouse, good friends, and helpful neighbors, you're blessed. I am. 

This all came home for me ten days ago, when I lost my beloved mother. Next steps and care for my elderly father landed on me with an urgency. My nearest sibling lives more than 700 miles away, the others more than 1,000. Even I live 75 miles from the town my parents were in during their final years.

Like in pioneer days, distant people aren't always able to drop and run when and where needed. Then, transportation difficulties ensued. Today, our unfeeling world interferes. In both eras, financial and health matters factored in. Let's just say I'm grateful 75 miles is nothing today, in terms of distance. I glad I am and was available to the man and woman who raised me with love.

My husband, friends, and neighbors, both in my town and my parents' town, have propped me up with their care and help, just as spouses, friends, and neighbors did in pioneer days. Had the Lord granted earthly life to the two children I lost to miscarriages, I'm sure they, too, would have been by my side, as children in the past were with their parents. As children are today. 

My mother loved flowers. Maybe that's why the floral aspects of pioneer accounts of local deaths stay with me. In an 1878 letter to her son, who lived more than 1,000 miles away, DeLand innkeeper Lucy Mead Parce wrote about how a coffin was trimmed. The account is from The Parce Letters: Voices From the Past (Gerri Giovanelli Bauer, West Volusia Historical Society, 2004).  

"Mrs. Thomas's baby (4 weeks old) died last night. Miss Deane sent over for me to come and help trim the coffin last evening. We have some beautiful fine white wildflowers & I made a wreath and cross of those & geranium leaves."

In her memoir, Pioneering in Hillsborough County, Fla. (Daniels Publishers, 1972), Clyde Mansell Gibson mentioned flowers in a recounting of her Aunt Emma's 1900 death. The six-year-old Clyde and her siblings and mother:

"... cut all the flowers we had and took them to Miss Grace and her mother to arrange in wreaths and other floral arrangements. They used a lot of arbor vitae for greenery and made everything look beautiful because Aunt Emma was a lover of flowers and had coral vine and honeysuckle growing at either end of the front porch." (40)

Bereavement flowers today are factory farmed and corporately arranged. They're beautiful with a sanitized perfection light years from the messiness of real life. My mother loved sweet peas. I plan to plant them on her grave. 

Pulling together, not apart

Burial plots were often on the family homestead in pioneer
 Florida. This one is in the Big Scrub near Ocala. Neighbors
pulled together to help when death occurred on the frontier.
Photo credit: State Archives of Florida

Maybe I have jet lag from the time change, and it's made me cranky. Maybe I'm tired of the nasty election-year rhetoric on every side. But it seems more and more people are spitting and sputtering in fractious dialogues and encounters, and vying to be loudest and meanest.

 Are people tearing into one another because our society rarely calls on us to help one another? I mean, really help? As in next-door-neighbor kind of help?

I can't answer that question. But it arises because I encounter opposite behavior so often in old diaries and letters. Page after page reflects how people just assumed they would help neighbors in need and receive likewise in return.

I'm first to say the "good old days" weren't always so good. Settlers in pioneer Florida - and on any frontier, for that matter - faced tremendous odds. They needed grit to survive. Perhaps it was a requisite personality trait for anyone considering a move to a remote location devoid of most creature comforts. 

All I can determine is that, once in a place, people bonded. And not because they were all of the same class, ethnicity, or faith. They usually weren't. (Sadly, even these gritty pioneers usually couldn't overcome racial barriers, at least not that I've uncovered yet.)

The following sad example illustrates the way pioneers pulled together instead of pulled each other apart. In 1878, DeLand was still a raw Florida town despite its growth. There wasn't a hospital around the corner or an EMT a phone call away. Serious illness or accident could lead to death. And sometimes that death was the worst kind possible, that of a baby.

I'll let DeLand innkeeper Lucy Mead Parce tell the rest in the words she used in an October 1878 letter to her son in another state:

"Mrs. Thomas's baby (4 weeks old) died last night. Miss Deane sent over for me to come and help trim the coffin last evening. We have some beautiful fine white wildflowers & I made a wreath and cross of those & geranium leaves. ... A carpenter made the coffin. Mrs. Southworth and Leet lined it & Miss Deane made a wreath of geranium to finish it around the top with. I write this to show you that what is done we have to do ourselves ... The funeral was today at 12 o'clock. Your Father made the prayer. Adda, Will, Miss Deane and two or three others sang. It was buried in their yard. Mrs. Thomas is very poorly ... I should not be at all surprised if she did not live long herself."

She goes on to explain how Mrs. Thomas was being kept alive by neighbors who shared nursing duties. 

My point is this: Here you have people dropping everything to help a neighbor family through a time of intense grief. Tell me, do you know of someone who would craft a coffin overnight in today's world? Or stay up late to line it or weave flower chains to drape across it? 

Yes, they had to make-do themselves, as Lucy Parce states. But they didn't complain about it. Their unity leaps out from her written words, more than 135 years after she set them on paper. So does a gentle civility that appears to have vanished from the modern landscape.

I know people today rise to occasions when necessary. I know frontier dwellers clung to one another partly because their known world ended in a thicket of unwelcoming wilderness in the near distance. But still. Have we lost something of ourselves? I hope not.