ALL ABOUT ALZHEIMER'S: Tragedy at the Santa             Monica Farmer’s Market      
By Betty Weiss

When an 86-year-old man ran down people with his automobile at the Santa Monica Farmer’s Market in Southern California, many believed he had to have been demented. On TV, I recognized his same vacant smile I had seen countless times on my husband and others with dementia when they had no idea what was happening around them. They are very good at keeping up appearances, hiding problems. Imagine, being in a roomful of people playing a game and you have no idea who they are or what the game is, so a friendly smile, a friendly greeting, saying whatever seems appropriate will take you a long way. Few notice you’re not really involved in what is happening; most of the casual things we say to each other are so much chaff anyway.

I didn’t hear anything about the driver possibly having any cognitive impairment, maybe an illness like Alzheimer’s, medication reactions, a mini-stroke, and my writing about it is not meant in any way to defend or excuse him. I wasn’t at the scene nor the trial. Emotions ran high, witnesses saw what they saw. In October he was found guilty of vehicular manslaughter negligence. In November he was sentenced to five-years probation, the judge noting he should serve jail time, but his failing health precluded that. I just want to suggest the possibility that well-meaning people may all see the same event in a different light.

One witness talked about seeing the man smirk. But I didn’t see that smile as a smirk. To me, it was a way to cover up confusion. Attorneys for the driver fought to keep him out of the courtroom, one wonders why. Witnesses said he did it deliberately, avoided parked cars, hitting people instead, told of his coldness, lack of concern and even his arrogance after the crash. In court, he had no response to a picture of his car with bodies still on it—but if demented, he couldn’t connect such a photo to himself and what happened. Lack of remorse, getting angry, displaying a flat response, being unable to apologize are all typical of dementia. Jurors thought he had time to stop, but he couldn’t if he had any mental impairment. They rejected the idea that people can freeze on the gas pedal instead of the brake, but it happens. We’ve all seen photos of a car crashing off a parking structure, into a swimming pool, a storefront, mowing down people at a bus stop. Why didn’t they just stop!

People see a scrubby man mumbling and pacing on a street corner and think, correctly, that for one reason or another he is demented. They imagine uncontrollable, demented people confined to a care facility. But most people with dementia are not in such places; they live in the homes of ordinary people, in your town, being cared for by family that often covers for them. You have no idea there’s any problem when you see them. They can be well- groomed, personable, smiling, often well-spoken. No one realized anything was wrong with my husband. When I finally had to place him in a facility, everyone said, “I didn’t see anything wrong.” I am reminded of President Regan’s strolling in a nearby park, so neat and clean, smiling--yes, the smile—stopping when someone asked for a photo together. But few recognized the dementia that Alzheimer’s ravaged upon him. That was seen and tended to only by his family and caregivers.

Countless families have no idea anything is wrong with a loved one, and far too many are still driving! They have diminished capacity behind the wheel and it is so subtle, so vague that few see it. Families choose denial or truly believe quirky behavior is just normal aging. Even if they do see it, they often ignore it for years. It’s too hard to confront a parent or spouse; it’s fear of finally acknowledging that something is terribly wrong; fear of the unknown--and the known. It’s being embarrassed--no one wants to admit something is wrong with the mind. It’s too heartbreaking to take away someone’s independence, and since Mom never drove, who’s going to take her to the market?
Betty Weiss is the author of the best selling Alzheimer's Surgery: An Intimate Portrait, and When The Doctor Says, "Alzheimer's:" Your Caregiver's Guide to Alzheimer's & Dementia. She does not give medical advice.                           
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