I must admit I was a little puzzled not to have heard from my brother Derek in response to the 'big question' posts. Then, on second thoughts, I calculated that he was unlikely to say anything until he knew what he wanted to say - and on this particular subject that doesn't happen instantaneously. Sure enough, yesterday I got a rather good email from him, which I reproduce here:

Mike,

I have been watching you blog for the past few days but wanted to chew things over before replying.

Looking at your four goals, it occurs to me that goal two is probably the key.

It is easy for me to say that the main criterion for deciding the timing of placing Mum and Dad in a home has to be the well being of you, Rachel and Greg, because I won’t have to physically move them. I will not have to sell the house and contents, take Mum and Dad to the home, leave them there and then carry the departure image with me. I will not have to live with the knowledge that I physically placed my parents in a home. I will not have to endure the inevitable pleas to take them away from the ‘hateful place’ and back to a home which no longer exists. I,therefore, see this decision as being a balance between the stress which you suffer as a result of their remaining at home (together with any potential guilt which may arise if they injure themselves) and the feelings which may well arise if they go into an institution.

Clearly, the fact of having this discussion means that the wellbeing of Mum and Dad is an issue which needs to be considered but I think that the context given above is important, not to say crucial. Having said this, I am unsure how one measures ‘wellbeing’ for AD sufferers unless it is the absence of stress as the disease progresses. In this situation maybe death is the ultimate state of low stress and thus of wellbeing!

When Janet and I were leaving the UK to live in Tokyo I took Rebecca, then aged 15, to stay with friends as a paying guest for about 12 months. I shall never forget how lost she looked sitting in her room, surrounded by her belongings and among people whom she knew but who, in this context, were strangers. I still feel guilty after 18 years and I have had the advantage of being able to talk to Rebecca, subsequently, and express my regret.

Any distress being suffered by Mum and Dad will be over in a few years, but any guilt which you, Rachel or Greg carry may go on for much longer.

I was interested to read your analysis of your feelings for Mum and Dad as well as your more general musing on the nature of love. It was as though I was listening to my own thoughts.

Regards

Derek

Well, I took everything he said very seriously. In fact, many of the comments that have been left over the last few days have also struck very resonant notes. It has been so far a very worthwhile exercise trying to think aloud in public.