Should a child visit a grandparent with Alzheimer's?

Yes

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by T McGiver

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We don't usually ask ourselves whether our children should visit grandparents who have disabilities that accompany old age. They are, after all, family, and it is often a great comfort to them in their last days to be accepted as they are.

Why, then, is it so common for us to wonder about having children visit grandparents with Alzheimer's Disease (AD)? In just about all cases, seeing grandchildren boosts the morale of grandparents considerably - no mean feat when they may be worried about their health or uncomfortable in their surroundings.

What motivates our concern? Is it the well-being of the child? of the grandparent? Or our own comfort and convenience?

If AD is involved, when it comes to grandchildren visiting their grandparents, are we right to be more concerned than with other conditions?

WHAT MAKES ALZHEIMER'S DIFFERENT

Alzheimer's Disease is a form of incurable, degenerative dementia with long-term memory loss, language breakdown, confusion, irritability, aggression, mood swings, and general withdrawal. Rightly or wrongly, it has become the very embodiment of the suffering that may await us in old age.

Most of us, of course, will not be affected. But some of us will be diagnosed in our 50s. And one sex is hit harder: around 70% of AD patients are women.

But it's not only the uncertainty about when and whom it strikes that makes it so fearsome. AD patients also lose the ability to control their lives in fundamental ways. Their speech, thought, reasoning, emotions, and memory erode to the point that they no longer seem to be the people we once knew. As they lose their autonomy, they eventually become almost entirely dependent on family or institutional care-givers.

Seeing the deterioration in the faculties of a parent afflicted with AD can make us anxious about what lies ahead for us. If it's anxiety-producing for us adults, doesn't that also mean that it's too disturbing to put a child through?

CHILDREN: VULNERABLE, YES, BUT ALSO ADAPTABLE

Children, after all, understand much less about life than we adults do. They are, we assume, too vulnerable and naive to be exposed to the suffering that occurs in AD patients at a time of life so far away from their own. Won't knowing that life sometimes comes to an end in unpleasant ways make children less buoyant and optimistic about their own lives?

If we reflect on the assumptions about the fragility of children that underlie these questions, we may realize that we're forgetting about that almost miraculous ability that children have: adapting and adjusting. While it is true that psychological trauma during childhood can have serious consequences later in life, that is not by any means always so. Many children emerge from horrible experiences to lead normal, and even exemplary, lives. Trauma can spur great achievement.

Children are sometimes much more robust than we think they are. We all known children who, after spending years with parents who were fighting or separated, came through difficult divorces with matter-of-fact attitudes. We've seen some of them grow up to enjoy rewarding relationships in adulthood.

Children can show remarkable resilience especially when events that we might consider traumatizing happen only once or twice. Psychologists tell us that this resilience comes from being present-focused. The past and its implications for the future carry less weight in a child's mind than pleasant or stimulating events in the present.

If children can recover from psychological trauma in childhood, isn't it likely that they'll adjust to seeing a grandparent with AD? Resilience, however, is not the sole factor in the equation.

THE RISE OF THE NUCLEAR FAMILY

Only in the past half-century or so have children and adolescents been spared exposure to family discussions, preparations for illness and death, and their rituals. Why? Because larger families (those with more than, say, three siblings) and extended families (where grandparents, aunts, uncles, in-laws, and cousins were often present) have given way to small "nuclear" families, which usually comprise one or two parents and one to three children.

The nuclear family had gained a lot of ground when AD started to enter public awareness - in so doing, garnering considerable notoriety for the extra care AD sufferers required.

Nuclear families have greater geographic and social mobility than do traditional families that remain where their ancestors settled. As a consequence, it's not at all uncommon for nuclear-family members to live far from their extended families. It can then become much more difficult for them to participate directly in extended family affairs like the onset of disease, death, and dying. Families with two working parents also have even less time for nuclear-family events.

Thus, nuclear-family events, because there are fewer of them, have taken on a larger relative significance. As the nuclear family has become the main family type, seeing death and dying seems likely to affect children more today than a century or more ago when it was more common.

MAKING DEATH A PART OF LIFE AGAIN

One way or another, we will never be able to prevent children from being exposed to death and dying. Nor should we want to.

We can affect HOW they learn about them, though.

Do we want our children to form their impressions about the process of dying from television dramas, rumors, hearsay, projected fears, and speculation, just because the topic is avoided by parents? We certainly have had few qualms about exposing children to fictionalized death and virtual dying in films, on television, and now on the Internet.

Or would our children be better off if they also experienced these events first hand, in a loving environment? Television deaths rarely afford families the opportunity to show children how taking care of a dying grandparent can bring families closer together. What if the image of death, as presented in the commercial media, were tempered by visits to a dying relative, where children would be in the presence of adult role models? Wouldn't children gain a more wholesome appreciation of the end of life by seeing their parents caring for and accepting their own parents' physical and mental decline?

An actual first-hand experience can also be the perfect time for parents to explain the situation in a way that has positive, lifelong meaning. "Your grandmother cared for us as her children for many years. Now that she's very ill, it's our turn. Your grandmother is family. She is part of us, and we are part of her. This is what belonging to a family means."

VISITS BENEFIT ALL CONCERNED

By seeing a relative in the final stages of life, children learn that life is finite. It's a lesson of considerable value because it teaches that opportunities to accomplish what we want to do in life are not unlimited. Who would not prefer to learn that lesson in childhood rather than in mid-life? Not everyone has the chance to do so.

But let's not forget that children are not the only parties who reap benefits from visiting older family members with AD. The very presence of a child, whom a grandparent may have known from birth, could exert healing and calming influences on a grandparent.

Even if a grandfather suffering from AD shows no outward signs of knowing that his granddaughter is in the room, can we really be sure about what he's perceiving and feeling? After all, it is well known that people who lapse into comatose states sometimes can when they regain consciousness recount what they've heard said to them or about them by those who were nearby.

CONCLUSION

It's all but certain that, for a grandparent, merely being with children and grandchildren who will carry on the family tradition eases some of the effects of AD. Parents, too, who once knew their children's grandparents as their children now know them, can enjoy the sense of continuity across generations that visiting grandparents makes evident.

Parents and grandparents have much to gain from having children visit grandparents with Alzheimer's - perhaps as much as the children themselves do. Wouldn't it be a shame indeed to miss out on those once-in-a-lifetime opportunities?

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