Justice Sandra Day O’Connor: Relationships Among Dementia Patients

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Sandra Day O’Connor was the first woman appointed to serve on the Supreme Court of the United States and was also the first female majority leader of a state senate, as a Republican in Arizona. She did everything better than her peers and opened doors for women to be successful in professions that were dominated by men. After serving on the U.S. Supreme Court from 1981 to 2006, she succeeded Henry Kissinger as the chancellor of the College of William & Mary. In 2009, she was awarded the Presidential Medal of Freedom by President Barack Obama.

On December 1, 2023, she died at age 93 from complications of dementia, a condition that affects three percent of people age 65-74, 17 percent of people age 75-84 and 32 percent of people age 85 or older (Neurology 2013; 80(19): 1778-83).

Appointed by President Ronald Reagan
O’Connor was appointed to the Supreme Court by President Ronald Reagan in 1981.  A few days after O’Connor’s death, Patti Davis (President Reagan’s daughter) wrote in a memorial article that O’Connor and her father “. .were two people who were athletic, strong, driven to make a difference in the world . . . both would later be eroded by dementia . . . and both would die from complications of the disease, which always wins in the end” (New York Times, December 5, 2023).

O’Connor’s husband, John Jay O’Connor III, developed dementia at age 59 in 1989, and she was a devoted wife who took care of him. In 2005, she announced that she would resign from the Supreme Court to spend more time caring for him.  By 2006, he was so debilitated by his brain damage that he was unable to even recognize his wife, and she had no choice but to place him in a full-time care facility.  He died from the disease at age 79, in 2009.

In Love With Another Dementia Patient
O’Connor and her husband had a long, healthy and loving relationship, but after he entered a dementia care facility, he fell in love with another demented person. The O’Connors had met in the early 1950s when both were in their early twenties and students at Stanford Law School. She was brilliant and beautiful and had already turned down three offers of marriage, including one from William Rehnquist, who later became chief justice of the U.S. Supreme Court. Sandra and John married and raised three sons. When her husband was diagnosed with Alzheimer’s disease in 1989, she took him with her to work at the Supreme Court so she could watch him. He quickly became helpless and in 2005, she announced that she would resign from the Supreme Court to take care of him. The next year he was so incapacitated that she had to place him in a full-time memory care facility.

By 2007, John O’Connor was spending time with, and had fallen in love with, a fellow Alzheimer’s patient. In an interview with Phoenix station KPNX-TV, their son, Scott, told how his mother watched her husband and his new partner sitting together, looking at each other lovingly. He said that his mother was happy that her husband had been able to form this new relationship, and she continued to visit him, even though he was completely unable to recognize her. Scott said that the family was happy that his father had found rays of contentment in the darkness of his disease.

O’Connor’s Own Alzheimer’s Disease
O’Connor was always recognized as brilliant and she had finished near the top of her class at both Stanford College and Stanford Law School. She had been treated successfully for breast cancer at age 58, but otherwise was healthy. In 2013, at age 83, she started to become forgetful and spoke very little to her friends. Spouses who care for partners with dementia are six times as likely to also suffer from dementia (J of the American Geriatrics Society, May 4, 2014). I do not have a good reason for this but there are several possible reasons. A husband and wife are likely to share the many of the lifestyle risk factors for dementia.

In 2017, she developed back pain so severe that she had to use a wheelchair, and she moved to an assisted living facility. In 2018, at age 88, she retired from public life and announced that she had been diagnosed with Alzheimer’s-like dementia. On December 1, 2023, she died at age 93 of advanced dementia and pneumonia.

Demented Patients Often Fall In Love With Each Other
Aging is a major risk factor for dementia. A patient may not recognize anybody so that the caregiver can suffer every bit as much as the patient and it may become necessary to place the patient in a full-time care center. When this happens, the patient is exposed to other demented patients far more often than to the spouse.

As the severity of dementia progresses, a person loses their ability to remember their loved ones and everyone else. Demented people who have been married for years stop recognizing their spouses and start to depend on anyone who is nearby. Their spouses watch helplessly as demented patients fall in love with someone else.

The patient often enters into a close relationship with a demented person of the other sex who was not their previous partner. If the former partner of the dementia patient can understand that loss of memory has obliterated them from the mind of the demented person, the patient and the partner both can benefit from this new relationship. Having a close relationship, even with another dementia patient, offers support to a person who can’t remember anything (Aging Ment Health, 2012; 16(6): 699–711).

Sandra Day O’Connor
March 26, 1930 – December 1, 2023