Signs of dementia
Those of us who have cared for loved ones with dementia become aware of common elements in the progression of the disease. First is the ability of dementia sufferers to mask the disease by controlling the context of their encounters with others, so the progression of their dementia is not noticeable, even by their loved ones.
Second is the erosion of the veneer of sociability that allows us to engage others civilly. In some, this veneer falls away, exposing the internal voice that cares only for self, not recognizing the need to be considerate of others.
Third is the “sundowner effect.” The loss of cognition and control becomes more pronounced at the end of the day. Odd behavior, lack of recognition, hallucinations and other symptoms become obvious. Many crazier encounters with a dementia sufferer occur in the evening or at night.
Consider President Trump. His appearances are carefully choreographed by White House staff. His rallies follow the same script with the same rants and grievances. The Oval Office matches the gold kitsch and comfort of his homes in Trump Tower and Mar-a-Lago.
He has more moments when he abandons decorum and civility. He berates reporters, telling one “Quiet Piggy” and calling another “a terrible person.” He posted a cartoon video of himself in an airplane, dumping feces over crowds of Americans. In his Thanksgiving and Christmas messages, he disparaged opponents as “sleazebags” and “scum.” And so on. His most unhinged rants come late at night, often after midnight.
If I had a 79-year-old loved one who exhibited our president’s behavior, I would take steps to care for him and see that his mental decline could not harm himself and others. Trump, however, claims that the only constraint on his behavior is “my own mind. My own morality.”