A Mindful Approach to Dementia & Psychedelics: Our Shared Journey Series - Sacred Agreements

I consider this particular entry one of the most intimate. For me, it touches on the sacred. I hope you read it when you are in a still place and your heart can be open to receive. Henry and I welcome you to be a part of this most intimate moment in the journey of dementia, psychedelics, and mindfulness that we are sharing with you and the world.

I want to preface this blog entry to let you know that it was written in real time. What you are about to read, I reread to Henry during and as part of our conversation. He gave permission and support to include it as a blog for you and others to read (after he had shared with our children, relatives, and close friends).

Thank you for bearing witness in this unfolding journey as we navigate it together.

Sacred Agreement

We have nothing planned until early afternoon, so Henry and I are having a quiet morning, sipping coffee as the sun comes overhead to warm us in the cool breeze of the mile-high winter clime.

Yesterday, we had an emotionally wrought discussion about what I was observing in Henry's decline. Henry felt a swirl of raw, difficult emotions. Henry’s gut reaction was to reject what I was sharing, especially as it was a window to the future… a future that is already presenting itself in bits and pieces now: confusion and disorientation, only to increase... Henry admits that at first, he wanted to dismiss what I was observing, even though he was the one who initiated the conversation, asking me what I had been noticing and to give him some specific examples. The hardest was expressing that he seems to "check out" more and more and that he may not recall where "he was" or what he was saying or thinking.

The fractured sadness, loss, and even departure of the known and familiar were palpable. We sat in a loving silence the rest of the evening. More words were not necessary.

So today, Wednesday, the middle of the week, we wake up to a fresher perspective—one that has given clarity to Henry's heart and soul. We have a pending trip to beloved India, where we lived for over a decade, where our children graduated from high school, and where our professional and spiritual lives flourished. A pilgrimage to a cave nestled halfway up the sacred Himalayan mountain of Pandocoli, mentioned in the Mahabharata, is Henry's true soul-calling.

Henry's wishes for his future pour out in a well-articulated, cohesive statement.

It is monumental.

“I am ready to go to India. I want to go to the cave one last time. Then I will be ready to go to Switzerland and exercise my right to die with dignity,” Henry declares in his quintessential, soft-spoken manner.

Silence. Calm silence. Hearts open.

Like a gossamer feather making its way to soft moss, this rests gently in both our hearts.

Then… feeling how naturally this settles into the deepest place of love, we are aware of the sacredness of this moment.

The loving silence lets murmurings of certain details for such a pilgrimage break its spell. I express my desire to write all this down, which I am doing now, as we sit together—capturing our thoughts in time.

Interestingly, similar to other decisions along the way, whether exercised or not, it paves the current path. Henry’s decision may well change, but for today, he is already putting into place his wishes: to see certain colleagues—now friends—he has worked with in India during his decades-long work there; to gather friends and even families together as our lives have become intertwined over the years; to bring special gifts of thanks and remembrance to others; for our daughters (who grew up half their childhood in India) to join us for the last leg of this sadhana (a spiritual journey) to the cave. It will include a dip in the river we cross below the cave—a symbolic baptismal blessing. After meditating at the cave, Henry wants to leave a lasting legacy or memento near its entrance.

Two important factors under consideration are, firstly, Henry's ability to walk, and secondly, his ability to be cognitively agile during this sadhana. These considerations could determine the time frame for such a trip. Ideally, Henry would like to walk the arduous last leg of the journey. There are actually two destinations. The first is where we would be staying. That requires walking a mile up a dirt path in the Himalayas. Then there is the half mile to the cave. Henry agrees that if he needs help being lifted, he would accept it. We hope that his cognition and awareness will be good enough to make the trip in early 2026, almost a year away; but realistically, we would be prepared to move the trip up to early fall, after the extreme temperatures in India have subsided.

When Henry and I further discussed the half-mile walk on a small, narrow dirt path to the holy cave, and that Henry hopes to do so on his own, without help, this seamlessly led to talking about Henry losing his ability to walk, and that he may need a wheelchair in the next year or so. As part of this morning's discussion, when thinking about being in a wheelchair, Henry said, "Enough is enough." If he gets to the stage that he needs a wheelchair, symbolizing the inability for his brain to communicate to his legs, that would indicate a stage of Alzheimer’s Henry does not want to enter. He said that might be the point where he would exercise his right for MAID. This was the first clear benchmark that informs me when to exercise MAID, as is his advanced directive wish, if he were unable to do so.

Interestingly, even at the beginning of COVID, when we naively thought we would be quarantined for a month or two at the most, Henry declared he wanted to leave everything, in the spirit of the sannyasa, the fourth stage of life according to Hindu tradition. It is considered the renunciant stage in which all possessions are given up and life is devoted to spiritual practice. As he shared his deepest desire, tears pouring out of him; at that very moment, I understood that I was also called upon to release Henry of any bonds or commitments so that he would be free to pursue his inner callings back to the cave in the Himalayas, his spiritual home. It was a pivotal moment in our marriage. It was a goodbye of sorts, even back then.

COVID stopped that plan. Celebrating births of grandchildren ensued. Decline began to happen. Testing for Alzheimer’s took time. Looking for options, like we are doing here in Mexico, took priority. So now, five years later, India has been the top item on Henry’s bucket list. It is not so much an item on a bucket list but rather, a deep soul call.

For over a year, I have been thinking I would do my best to honor Henry’s request to return to India one last time. Traveling to India is hard enough when one is young and in good health. It is even more arduous now to get to a rural part of the Himalayas where roads end and walking is required. To make matters more trying, there is the long-haul flight followed by two weeks of jet lag, soaring temperatures and pounding sun in the summer months or frigid cold in the winter months, the cacophony of incessant sounds, dangerous and uncomfortable bumpy roads—to note just a few factors. India is not an easy place to travel, Alzheimer’s notwithstanding. Now with disorientation, especially at night, lack of mental and physical endurance, and dependency on me, this will be a trip that, if not done within a certain period of time, will not be possible. As much as I have been wanting to fulfill Henry’s desire to go, I haven’t been able to muster the strength I will need up until now.

I will need to secure the flights, figure out the itinerary, make a multitude of plans, gather those near and dear, and get help so Henry can literally lean on a strong body of someone he trusts to help him make the walk up the mountain. It’s tiring just contemplating such a trip.

Yet with today’s declaration, my heart bursts open to ensure this trip happens. And that it happens in time. I make a silent promise to do my very best.

Henry asked me how I would do after all this was over.

"How would all this change my life?" he asked.

I sat there a bit bewildered, finally answering, "I have no idea."

After further contemplation, I shared, "It is hard for me to even think about what that may be like or feel like. What I can say is that these last many years, all decisions and all my focus have been on the overriding question, ‘What is best for us?’ I have not been thinking, ‘What is best for me?’ So what will be different is not thinking about us but having the freedom—or is it luxury/privilege… or is it sadness… to only think about me. I don't even know what that will feel like.”

As I write alongside our ongoing conversation, we are both feeling this is enough for now. Indeed, this is coming at a propitious time as I am about to be interviewed by Hein Pijnakken, the founder of Microdosing Institute (MDI), for his podcast: Microdosing Table Talks. We plan to talk about microdosing, mindfulness, and dementia. You can listen to the podcast here.

Postscript: I reread the above to Henry the next morning to get his approval that I captured things correctly. He did say that I had; but at the same time, he seemed to be very noncommittal to what he had articulated. Living with Alzheimer’s is like being in a puzzle, with missing pieces, because things do not always fit or make sense. If you are determined to make the pieces of the puzzle fit, you may never succeed.

Even though I felt when Henry shared his wishes with determination, conviction, and clarity, I was left wondering. Did he mean what he said? Or does he not mean it at all? Was he clear-thinking when he made yesterday’s pronouncements, and now he is more in the Alzheimer’s mode? Will he ever be able to articulate his wishes so clearly in the future? Is this a roadmap I should be following?

As part of this unfolding journey, I am learning to hold things lightly. I believe Henry was, in fact, at a place of deep connection to his heart and soul when he shared these wishes. However, it doesn’t mean that there is a rigid timeline or even a final decision. I hope the trip to India does happen. It may. It may not. We may end up in Switzerland. We may not.

Post Postscript
Sunday, the day of rest. Henry shared some incredibly beautiful words from the book Japa Yoga by Swami Sivananda. As he reads, “‘…a tremendous power should there be in the Name of God! God is the completion or the fullness of existence… the name of God generates God-consciousness in the purified mind and becomes the direct cause of realization of the Highest Perfection, i.e., God, Freedom, Immortality,’” Henry’s eyes swell up in tears.

Imbibing the blessings pouring out, Henry walks a few paces from where we are sitting. He sits in the sun in deep connection. Eventually, I start up at the computer to edit our conversation.

Now, an hour later, I share with Henry and ask if we could note some agreements. He asks why. I reiterate that what he articulated a few days ago is so profound, I want to get it right. I state that this is important to me. I also remind him that this is similar to some of the other agreements we have made along the way. If we note them as we agree to things, we have them as a reference in the future, if need be.

I gently say we are not sure how things will be in six months from now. After just a bit of initial resistance, he does agree that he is clear thinking at this moment, and at most times. I also say he was extremely clear thinking when he made his wishes clear on Wednesday. However, we both agree that may not be the case in the future and that it is important for me to know his wishes clearly. I wordsmith one or two things before coming up with the AGREEMENTS below.

AGREEMENTS
We hope to make the trip to India in early 2026, but would move the trip up if we notice rapid decline.

Henry may go to Switzerland after India.

If not clear thinking and needing a wheelchair, Henry would want to be taken to Switzerland.

If clear thinking and needing a wheelchair, Henry would reconsider things at that time.

- Lauren Alderfer, PhD.