I was concerned when I came home and couldn’t find my mother. The back of the house has a steep incline off the deck that leads to a forested area. When I saw that the gate leading down the stairs was open, concern turned to panic. At that time, she was in her mid-sixties and often became confused when situations or discussions were anything other than linear.

I raced down the stairs expecting the worst. There she was, emerging through a stand of trees, carrying a handful of leaves and twigs, smiling as if she just solved a complex puzzle.

“Mom, what are you doing?” I said.

“Straightening out the forest.” When she saw my bewildered look, she started explaining. “From inside the house, it looked so messy. I thought it would be nice to clean it up a little.”

“But Mom,” I said, “It’s a forest.” She stared at me as if I just couldn’t understand what she was doing. And she was right, I didn’t.

Now, 20 years after she died, as I’m approaching the same age she was, I think I finally understand. I believe I confused “just being Mom” with the early signs of dementia. She died from a heart attack before the symptoms could develop into anything definitive.

As I deal with an increasing number of hospice patients with Alzheimer’s and other forms of dementia, I think back to my mother’s efforts at tidying up the forest. I’ve come to realize that a need for structure increases as those elements that allow us to make sense of our lives gradually, or sometimes suddenly, disappear.

I’ve seen families and healthcare staff misinterpret older people’s behaviors, or the behaviors of people who are near death, as the inexplicable result of losing their minds, rather than understanding that it may be an attempt to regain a sense of structure that allowed them to map out what was familiar in their lives. With various forms of dementia and many terminal diseases, the ground — that base which allows people to know where and who they are — continually shifts, pausing occasionally to give a false sense that its frightening progression has finally stopped.

Straightening out the forest is just another way of making the ground shake less.

Reach Stan Goldberg through his website, stangoldbergwriter.com

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