Daddy, dementia and me: how can I tell daddy his son is dead?

How can I tell daddy that Dermot is dead? His dementia means his short-term memory is shot. George increasingly lives in disparate moments that hang on fragile threads before melting into a miasma of confused matter. Where in that shrinking mass of frayed neurons would the dramatic news register that his youngest son died nine months ago? Would the words freeze in their enunciation and then disappear?

Or, would they fly to some other organ – his failing heart – and cause it to shatter into a thousand pieces?

That is what I fear. That is why when daddy asked about Dermot – out of the blue – during a recent visit to his nursing home, I brought him back to life, talked about him in the present, with a lump in my throat and my own broken heart in smithereens. What else could I, should I, do?

“I haven’t seen Dermot for a while, Áine. Will you please tell him I’d like him to visit me.”

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(When George is emphatic, a request is an order.)

“Did you hear me, Áine? I want you to tell Dermot to visit me soon.”

My face was frozen, my heart hovering in the middle of a beat. “Of course, I will, Daddy.”

“Where is he, anyway? Is he here in Dublin?”

"No, he is in Italy. We are in Westport, Daddy. You have lived here in this nursing home for the last three years."

“Don’t bullshit me, Áine, I only came here last night. How did I get here, anyway?”

The incorrigible George Ryan has been in the care of the wonderful nursing home staff here in Westport since he was expelled for being a bold boy from his Dublin nursing home almost three years ago.

I cried all the way home that evening.

My baby bro was 48 when he died from pancreatic cancer in an Italian hospital on the morning of May 9th last. It was just three months after his diagnosis. Poignantly, this was made on February 2nd by one of his wonderful colleagues in the Midlands Regional Hospital, Portlaoise, where he worked as a clinical psychologist – ironically, specialising in the needs of older people.

This dramatic news was made after a series of misdiagnoses. Before discovering he had metastatic cancer with secondaries already on his liver, Dermot was told by an Italian specialist he had a second spleen (turned out to be a tumour); by an Irish GP that there was nothing wrong with him other than stress; and, in the case of one Dublin hospital’s emergency department, to come back again in three months time.

He was dead by then.

A Dublin resident, Dermot not only commuted to his work in the midlands, but also fortnightly to Mozatte, near Milan, to spend time with his Italian wife and two teenage sons, Patrick (16) and Liam (13).

Despite his hectic personal and professional life travelling the byways of Laois and Offaly for his work – Dermot ran 10 kilometres three times a week along the Liffey at Lucan where he grew up and lived, pumped iron in the gym on the alternate nights and practised his drums as if he was Steve Gadd in a New York studio. Indeed, as he completed a second Phd in 2013, he was the main carer for our mother, a victim of vascular dementia, as well as Parkinson's disease, and now also oblivious – we think – of his death. Mammy can't communicate. Her eyes have lost any lustre, her mouth barely able to swallow.

Like a rag-doll, she sits in her wheelchair in a luxurious Dublin nursing home, her face frigid and her mind lost. Surrounded by an oasis of gardens, even her sense of smell abandoned her long before the formal diagnosis.

When Dermot got stressed about our parents’ dramatic debilitation, he joked occasionally: “I will be dead before them.”

That was one quip none of us took seriously. Unlike his oldest sister, he was a paragon of healthy living. Not only did he not drink alcohol, he didn’t even drink tea or coffee and had such a regimented diet – balancing good proteins with greens – he could have swapped careers overnight and become a nutritionist.

Instead, my beautiful bro’s ashes are in a cask in his widow Barbara Borghi’s family tomb in a sun-soaked cemetery in northern Italy.

Meanwhile, George shuffles up and down the corridor to the smoking room of his new home, oblivious that his youngest son is dead.

SERIES: Daddy, dementia and me
Part 1: I couldn't face seeing him so confused
Part 2: How can I tell daddy his son is dead?
Part 3: The stand-off about a car
Part 4: Daddy talks to me about Mammy
Part 5: He left the wedding for a cigarette
Part 6: If granny had drowned that day