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Aug10ThuA retired Salvation Army officer deals with vascular dementia. August 10, 2017 by Doug Field
My brain is freezing up! My brain isn’t wired right.” A cry of frustration from a man who has always been able to express himself and his thoughts with clarity. Many people sometimes have trouble recalling names, dates and places as they age, but this was much worse, with whole blocks of knowledge seemingly erased from memory.
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This was the first sign that something in Ralph’s brain wasn’t working as it should, and it was the beginning of a five-year quest to find out what was happening. Now, after many tests, an initial diagnosis of mild cognitive impairment, a brain scan and a consultation with one of the leading specialists in the field, Major Ralph Hewlett, retired, has been diagnosed with vascular dementia, a disease that affects more than half a million Canadians.
Ralph is my brother-in-law and I have known him for almost 60 years. A thoughtful and reflective man, a caring and conscientious Salvation Army officer, and a loving husband to Anne, he is now facing the most difficult challenge of his life. He has a disease for which there is no cure and which will, day by day, take away those abilities, personality traits and faculties that have made him who he is. But now that he knows what is wrong and has some idea of how the dementia will progress, he is accepting of the condition and has not succumbed to bitterness and recrimination because, he says, “That’s a dead-end street.”
Something Was Wrong
Anne says that both Ralph and those around him had an inkling that something was wrong because he couldn’t remember Scripture quotations he knew well, and he couldn’t find things in the Bible from memory. As time went by, other symptoms became apparent (see the sidebar below for a summary of symptoms).
When Ralph and Anne were given the diagnosis, the specialist described it in lay terms as follows: “The normal brain is like cheese curd. The Alzheimer’s brain has large holes like Swiss cheese, and the vascular dementia brain is like havarti, with lots of pinprick holes caused by multiple mini-strokes, which usually go unnoticed.”
Ralph says that early in the process of diagnosing the disease, he asked, “Why is God allowing this to happen to me?” (This is typical of Ralph. Others would simply have screamed “God, why me?”) Sometime later, another sufferer said in answer to the question, “So you can help others who are going through this.” Ralph has seized on this notion and, as his ability to do those things that have been so much a part of his life—public prayer, the conducting of services and his chaplaincy of the local unit of the Korea Veterans Association—is leaving him, he is finding a new way to minister to others experiencing the same decline of mental capacity.
Ralph has never been a voluble man. I have never heard him raise his voice or speak hurriedly to make a point. Thoughtful and deliberate best describe his thought and speech patterns from a youth at the then-Windsor Citadel Corps to a mature officer who has served across the Canada and Bermuda Territory. But now, his speech comes in short and slow phrases, his sentences followed by long pauses. The listener quickly learns to be patient, because Ralph will complete the thought, which will make perfect sense—eventually. That said, his sly sense of humour (often at his own expense) is still alive and well, and funnier because it is always totally unexpected. For his family, this has become the new “normal” and they have adapted with love and patience as their husband and father operates mentally and verbally on an entirely different plane. For someone engaging with him only occasionally, the urge to interject in the silences has to be resisted to allow him to complete his thought.
Vascular dementia shares causes and symptoms with other forms of Alzheimer’s disease—specifically changes in brain areas that play a key role in storing and retrieving information, causing memory loss. Hence the confusion and fear that surrounds patients, family and friends prior to a diagnosis.
It also means that it can go undiagnosed for long periods, when earlier diagnosis could slow its progression. This is an area where there is lots of room for progress.
Ralph is following the advice of physicians and therapists to maintain physical activity and engage in organized and informal social interaction and other programmed activities to maintain mental activity. He has consciously chosen not to sit and fade to black, and in this he has the support of his family and a circle of caring friends.
Ministry of Prayer
Ralph was commissioned as a Salvation Army officer in June 1966, a member of the Defenders of the Faith Session, and married Captain Anne Jackson in December 1967. They retired from active service in July 2001. In a career spanning 35 years, Majors Ralph and Anne Hewlett served in many parts of the Canada and Bermuda Territory, including Lethbridge, Alta., Goderich and Oakville, Ont., Hamilton, Bermuda, and Nanaimo, B.C.
In the early days of his officership, Ralph sold hundreds of copies of The War Cry every week, not only to support the corps but as a ministry, knowing of at least one backslider who was restored and reinstated as a soldier as a result. One woman who attended their corps as a young girl contacted them years later, tracing the beginning of her spiritual journey to her time in Sunday school and becoming a junior soldier. She has served the Lord by teaching in Korea, Taiwan and now China.
Before the Internet, The Salvation Army’s missing persons service was one of the most effective anywhere. Using its worldwide network of on-the-ground personnel, the Army often found people when nobody else, including the police, could. Ralph had numerous successes using nothing more than the phone book and city directory.
His most notable case, while appointed to Oakville, was a woman from Yorkshire, England, who asked the Army if they could find her sister, thought to be living in Oakville. It took some time, but he did track down the missing woman and the two were dramatically reunited the day before the requesting sister returned home at the end of a Canadian visit. Today, that would be the stuff of a reality TV show!
Anne says that Ralph hated being stuck in the office “doing admin.” He felt it kept him from his ministry of visiting and supporting people and “preaching the Word.”
Throughout his ministry, Ralph maintained a disciplined prayer life. He still prays for people from every corps in which he has ministered—a prayer list that now numbers in the hundreds.
Ralph has always loved to learn, and has amassed a huge collection of books along the way. It is a family joke that with every change of appointment, the size of his library doubled the moving bill.
“Do not go gentle into that good night,” wrote the Welsh poet Dylan Thomas. Ralph is only partially following this advice, since he has not succumbed to the rage the poet speaks of later in the poem, though he does express frustration at not being able to preach or officiate at “sacramental” occasions—dedications, weddings, funerals.
We cannot know why Ralph Hewlett, God’s obedient servant, was stricken with a disease that robs its victims of precious memory, as well as the ability to communicate and continue to perform tasks of which they are still physically capable. Many of us would be raging against such an apparent injustice after a life of service to others. But on reflection, we must remember other obedient servants who endured physical, mental and emotional turmoil without turning against God—Job comes to mind.
Ralph’s medication seems to have arrested the progression of the disease, but he and his family know this is only a temporary reprieve. Eventually, he will continue to lose his mental capacity. Even so, Anne says emphatically, “He’s still the same person.”
When asked what he prays for, Ralph’s answer was surprisingly quick: “Archeological evidence of the life of Christ, and that God will show healing—real miracles for myself and others.” The Ralph Hewlett I have known most of my adult life is still there.
Doug Field is a retired broadcaster and performing arts manager. For a number of years, he wrote the “Hot Topics” column in Faith & Friends. He is now an occasional writer and videographer living in Oakville, Ont.
What is Dementia?
Almost 40 percent of people over the age of 65 experience some form of memory loss. When there is no underlying medical condition causing this memory loss, it is known as “age-associated memory impairment,” which is considered part of the normal aging process.
Brain diseases like Alzheimer’s and other dementias are different. Age-associated memory impairment and dementia can be told apart in a number of ways.
Normal Aging Dementia Not being able to remember details of a conversation or event that took place a year ago Not being able to recall details of recent events or conversations Not being able to remember the name of an acquaintance Not recognizing or knowing the names of family members Occasionally forgetting things and events Forgetting things and events more frequently Occasionally having difficulty finding words Frequent pauses and substitution when finding words You are worried about your memory but your relatives are not Your relatives are worried about your memory, but you are not aware of any problems
Source: Canadian Alzheimer’s Society