When the mind goes

I appreciated the articles on dementia in the April 9 Health section.

My 93-year-old mother lives nearby in a small nursing home, and we have gone through so many of the experiences the articles mention.

Janice Lynch Schuster’s story [“When the mind starts to go”] about her grandmother reporting that she’d seen giraffes in her yard was where we were several years ago, after we had moved Mom to an assisted living facility. There were no giraffes, but there were stalkers, a pack of dogs, a swarm of bees and probably other things poised to attack my sweet mother while she was alone in her room.

I learned the technique of validation here, as the staff asked my Mom to describe the dogs, and to my amazement she did, with a great amount of detail. By the time the bees came along, I was able to tell her that while she was at lunch, the maintenance staff and I had opened the windows and we got them to fly away.

I have been accused by my mother of poisoning her with homemade banana bread. I had to reassure her over and over that I was not being stalked by my cousin.

Mom has been obsessed many times about going home, and when I tried to explain that she sold her house, she says she will go to her mother’s. I learned the trick of then saying: We will have to pack; let me go and see what needs to be done in your room after we visit for a while. Or: You’ve been so sick, Mom, you are here so they can take care of you. She thinks on that and usually offers, yes, they are so nice here.

Now I am about where Peggy Brenneke is with her mother [“She is . . . no longer the boss”], unable to use the phone, who barely speaks and likes my visits but isn’t always sure who I am.

I am writing, though, to ask: Where is the pamphlet about what to expect with dementia?

Where is the little guide the doctor should give youthat says: Your loved one may see or hear things that you cannot see or hear, but to her/him, they are real, and you can validate this by asking questions about them. Where does it tell you that if your loved one is sick for another reason, confusion will increase?

When Mom had cataract surgery, there was a pamphlet. When she broke her hip, there was a pamphlet.

When my mom first moved to Virginia in 2007, I wanted her always to feel cared for, to feel safe when I was around. I vowed never to argue with her, and I have kept that promise. But I could have used a little guidance.

Evelyn DePalma, Woodbridge

The perils of CPR

“Emotions aside, CPR isn’t always the proper way to respond to cardiac arrest” [April 2] includes an important statistic: that the chances of a beneficial outcome when a person receives CPR from a (nonmedical) bystander is about 2 percent.

Actually, it may be closer to 0 percent, since there’s a large chance that a nonmedical person will determine a false negative when checking for a pulse in this situation. That is, the collapsed person actually has a pulse but the bystander fails to detect it.

Most people who pass out on the street do not have cardiac arrest or ventricular fibrillation. They faint from low blood pressure or a neurologic seizure.

To initiate unwarranted cardiac compression in these cases has the potential for major harm (from broken ribs puncturing a lung or liver, and even causing death). It is time to banish the myth that it is helpful for nonmedical people to do CPR in such situations. (The exception would be if an automated external defribillator is available and the bystander is adept enough to use it properly.)

Many will claim that since CPR has been studied and refined by the medical profession for over 50 years, surely there must be good evidence to support current practices. I was a pathologist for over 40 years and saw a number of autopsy results of CPR patients and have been unable to find a sufficiency of such evidence. Indeed, the evidence discussed above says otherwise.

Dennis Heffner, MD,


Dealing with cancer

Regarding Joel Achenbach’s “Cancer as a non-tragedy” [April 2]:

As a peer counselor for almost 20 years to women newly diagnosed with breast cancer, I have seen my fair share of women who thought they would pray, smile or eat their way past a cancer diagnosis — because they read in a publication about someone who had supposedly done just that.

I hope that the readers of Mr. Achenbach’s story understand the full picture, and certainly a big part of it is that:

●While a positive attitude can be an incredible aid to treatment, a sunny and upbeat approach to the disease, in the absence of medical treatment, has never (from what I have seen and researched) cured cancer.

●Cancer, when attacked in its earlier stages, can be treated effectively and with less negative physical consequences to the patient.

Even when I was diagnosed with breast cancer 21 years ago, tests on the tumor resulted in diagnostic indicators, criteria relating to the aggressiveness and growth habit of the tumor that were used by the doctor to determine appropriate therapy.

Since then, science has progressed to genetic typing of tumors: Certain breast cancer patients are eligible to have a test that, based on the genetics of the tumor, assigns a score that quantifies their recurrence risk and helps inform treatment choices.

Readers need to know that breast cancer can be a one-time occurrence — for some, a mere slap on the wrist — and highly survivable if you use the available tools (which include chemotherapy, radiation and hormone therapy) and listen to the people (the doctors and researchers) who have been studying, treating and fighting this disease.

And they need to know that, sadly, the now more arduous fight of Mr. Achenbach’s mother could, quite possibly, have been avoided.

Ann Waigand, Herndon