Ulf suffers dementia and lives in a nursing home. He often interacts with Lena, who also has dementia. They seek each other out, invite each other to their rooms, hold hands and kiss. They can clearly express what they prefer (or not). The staff think they enjoy life and each other’s company. There is just one problem for the happy couple: Ulf is married, and his wife is not happy. She and their children strongly dislikes the relation between Ulf and Lena and asks the staff to keep them apart. They argue that if Ulf had been free of dementia he would not have desired contact with Lena; he might sometimes even be confused and think Lena is his wife.
The situation was posed as a question to the ethics committee of the National Board of Health and Welfare in Sweden, and it recently responded that the staff should not try to interfere in the relationship: the welfare and autonomy of Ulf is prior to the wishes of the family. An earlier question dealt with a somewhat similar case, where the cuckolded wife demanded that her husband be both separated from the other woman and medicated to “dampen” him. The committee found that it would be against the autonomy of the man to be medicated against his will, and the staff did not have a right (legally or morally) to prevent patients from seeing each other.
The interesting question is what to make of romances that come about due to dementia. Are they authentic? How do they relate to the interests expressed earlier in life?
‘I was always the life and soul of the party, flirting with everyone’, wrote Lucille Howe, in ‘Fabulous Magazine’, (22 July 2012), ‘but I wanted John to fall in love with the real, quieter me’. In the same article, Charlotte Ruhle notes how her psychotherapy helped her to recover from a broken relationship. ‘[My] friends started saying I….seemed more like my old self.‘
The media, and indeed our ordinary conversations, are awash with this sort of language. Not only are we conscious – having a sense that there is an ‘I’ that is in some sort of continuity with the ‘I’ that existed yesterday, will hopefully exist tomorrow, and to whom things happen – but we have firm convictions about the nature of the ‘I’. When it is not allowed to express itself – to ‘be itself’, we complain. Depending on our education, we say that we’re ‘out of sorts’, ‘not myself’, or ‘ontologically vertiginous’. Continue reading