Mostly, I find that there is something terribly and quietly sad about old age psychiatry.
I see a lot of people who are grieving for the loss of the memory of their loved ones. It is a difficult thing to accept and an even more difficult thing to comprehend. It is, for me, one of the saddest of all the things I’ve done, more even than my time in palliative medicine, not because the loss there is smaller or the pain less, but because, as a society and as a profession, I feel that we are far more able to deal with the consequences of systemic physical illness than we are with mental illness, especially in the elderly.
At the end of my first day, all I could think to write was an email to my mum:
“I love you very very much and I always will, even if a time comes when you don’t remember that I do.”
The Road Less Travelled 
Ah. There are compensations – knowing that my gran, who has stroke-induced dementia – doesn’t remember the stylish lady who changed outfits – down to shoes and jewelry, thankyouverymuch – twice daily. She also doesn’t really know my Aunt Gertrude, who is her carer, or my mother, who visits her daily – she has them down to The Mean Lady Who Makes Me Do What I Don’t Want, and The Nice Lady Who Chats To Me. And yet, my gran does her best to amuse or exasperate them both – she knows she’s being entertaining. She is somehow… okay for now, even though she’s faded.
It’s not easy for my mother or aunt, but at least they’re keeping their promise, to never, ever put her in a home. THEY know that, even if she will never remember…
Ugh, now I have to go cry.
So true, Beth. We’re very aware of this as we watch the inexorable decline in my beloved mother-in-law’s memory. She still copes, but it’s a slippery slope and she’s sliding faster now.
Tanita and Perpetua, thank you both for sharing your stories.