First, I want to thank everyone for your concern.
Ralph is still in the hospital, but the buzzer issue is fixed so we both got some sleep last night (although the fact that I lost both my phone and then my cup of coffee in the course of ten minutes in Ralph’s room this morning tells me I may need more rest.)
More important, new test results came in overnight showing Ralph does indeed have a bacterial infection. I am terrible with medical stuff so can’t articulate the details, but Ralph is now on intravenous antibiotics. More testing is needed to pinpoint the infection so he has to stay in the hospital at least one more night. But he is clearly doing better—still without an appetite and sleeping most of the time but his voice is stronger when he speaks and he seems to be paying some attention, answering questions, even occasionally smiling at a joke. His skin has normal color and his eyes are clearer.
I am obviously relieved. Actually I have come home to do his laundry and to hide all evidence of cigarettes because for now he shows no interest in smoking. Once he’s better, the smoking desire may return but I can hope….
This type of crisis was going to happen soon or later and I’m just glad we survived it. I am now facing a reality I’m not sure I realized, that people with Alzheimer’s are going to react to infections and other physical and also emotional problems more intensely while being less able to articulate what they are experiencing. And while being in a hospital is not easy for any patient, for a patient with Alzheimer’s the stakes and danger are much higher. The hospital medical staff has been diligent and caring, but if I had not been around, his medical caregivers would have been unable to interpret what was normal for Ralph and what was off-kilter.
The hospital doctor says he thinks Ralph will be able to go to his annual mental check up scheduled for later this week. I was hoping to have a cognitive baseline for Ralph before moving, but will tests be accurate right now? Of course I will ask Emory if taking the tests is a good idea and if he’s well enough will probably take him to see his neurologist one last time whether he’s tested or not.
I was going to write that I’m not sure if the hospital stay has had any long-term meaning. But the truth is I know there has been at least one important long-term change. I will no longer leave Rick alone. Maybe it’s been true all along and I have travelling in a fool’s paradise believing Ralph could still function for a few days on his own, but now I have to acknowledge Ralph cannot gauge if he is experiencing a mental crisis and perhaps lacks judgment in general. If I had been gone, I might not have picked up signals that he was falling apart—phone calls can be misleading—and then what would have been the outcome? Whether the slide is steep or still slow and steady, there is a slide and we have crossed a new care-giving line.