A Singular Life an All Too Common End

Gerald Penny/Associated Press President Ronald Reagan was Margaret Thatcher s closest foreign ally. Their relationship was called the most enduring personal alliance in the Western world throughout the 1980s.

The long list of roles Margaret Thatcher played during her 87 years potent politician free market evangelist labor antagonist dominant global leader includes the one she never publicly discussed person with dementia.

The stroke that killed her on Monday was not her first. Mrs. Thatcher suffered several small strokes more than a decade earlier canceled all her speaking engagements in 2003 and largely withdrew from public life. Even before the strokes her daughter Carol wrote in a 2008 memoir she was losing cognitive ground repeating questions and showing other signs of confusion.

Heartbreakingly she often forgot that her beloved husband Denis had died of cancer in 2003. I had to keep giving her the bad news over and over again her daughter wrote. Every time it finally sank in that she had lost her husband of more than 50 years she d look at me sadly and say Oh as I struggled to compose myself. Were we all there she d ask softly.

At the time members of her mother s political circle and other British commentators denounced Carol Thatcher for invading her mother s privacy and supposedly diminishing her dignity. The criticism arose again in some quarters last year when Meryl Streep won an Oscar for her portrayal of Mrs. Thatcher s dementia in The Iron Lady.

The contrast with her fellow conservative and staunch supporter Ronald Reagan perhaps says something about American openness versus British reserve. Or maybe his movie star past made him more at ease in the public eye.

Mr. Reagan chose to disclose his Alzheimer s disease in a handwritten open letter in 1994 accompanied by an explanatory letter from his doctors. He too had experienced memory loss for a couple of years and once he got the Alzheimer s diagnosis he and Nancy Reagan considered how much to say.

In opening our hearts we hope this might promote greater awareness of this condition his letter said. Perhaps it will encourage a clearer understanding of the individuals and families affected by it.

Alzheimer s and other forms of dementia to this day carry a stigma that most other diseases heart failure for example do not. To my mind Mr. Reagan s public disclosure showed courage as Betty Ford s candor about her breast cancer and her substance abuse did 20 years before.

Mrs. Thatcher s family on the other hand has never discussed her diagnosis whether she had vascular dementia from the earlier strokes or some other form of the disease. Perhaps she forbade her children to offer details about her illness or perhaps by the time her condition was clear she was no longer able to make such decisions. We may never know.

But we do know that dementia will become an increasingly common condition in coming years that it s a terminal disease which doesn t respect the public stature or intellectual accomplishments of its victims that it can cause families to grieve for the people they ve lost long before they die.

Grocer s daughter. Chemist and barrister. Member of Parliament. First and to date only female prime minister of Britain. Major figure on the world stage. Dementia patient.

It is not why Margaret Thatcher will be remembered or why Ronald Reagan will be remembered but it is not something we should turn away from or something we can ignore. Dementia is part of their stories and of so many others .

Paula Span is the author of When the Time Comes Families With Aging Parents Share Their Struggles and Solutions.

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