Jeremy: The contradictions of dementia

Jeremy was a former British Rail engineer from Ashford. He was a young-looking 65 year-old, well dressed and seemingly functioning well. That is until his wife left him in the care of the ward. Within a few days his memory lapses became very evident, he became confused at times and neglected his self-care. On admission he was clean-shaved with Brylcreamed hair neatly combed back. By day three his hair was all over the place, he’d missed bits of his face shaving, lost his glasses and he had buttoned up his shirt wrongly. He had lost his slippers and couldn’t always recall where he had to sleep.

Jermy's conversation and language were pretty much unaffected and when his wife brought in a working model of a steam train, that he had constructed from scratch, he was able to talk about it in great detail. This really puzzled me. Over the next few weeks he became more anxious and agitated. He seemed to have periods of lucidity when he would become rather demanding and aggressive and he was eventually transferred to a geriatric ward. I was told he had vascular dementia.