All posts by MCI Alice

Small Difference Radiate Out in Our Alzheimer’s Marriage

Sometimes it is the smallest moment that is the most clarifying about what my life with Ralph has become.

This morning was absolutely beautiful weather, sunny and warm in the early seventies. Shirtsleeve weather.

I ran my early morning errands and did some work in my office while Ralph and Lola were, I thought, comfortably ensconced in his office.

But when I came down to check on him, Ralph was lying on his bed in his coat, shoes, and wool cap underneath the wool thrown rug.

“I’m freezing.” 

“The thermostat says it’s 71, and anyway I was out early and amazed how warm the air felt.”

“No, it’s not warm at all.”

I opened my phone to the weather app and showed him the temperature.

“Look, 72.”

“Your phone is wrong. Go feel the air.”

I opened the bedroom door to the back patio. Still sunny and warm.

“Close the door. Don’t you feel that breeze?”

“You’re being ridiculous. If anything, it is warmer outside than in this room.”

“I know, this room is always cold.”

“Well, why don’t you get up then and come in the other room. If I open the new shades the room the sun will pour in and will really heat up the space.”

I recently installed these solar shades, which Ralph has loved because they keep the room warmer in winter than it used to be by creating a strong layer against the cold. But in warmer weather like today’s, the shades block the sun to keep the room from getting too hot. But that if that’s the heat he wants, I’d just roll them.  I was quite proud of myself for having created such an easy solution to our ongoing weather issue.

“No,” Ralph said quite emphatically bursting my bubble. “Now I have made myself comfortable, I’m not moving.” 

“Suit yourself. But you really should not lie on the bed all day.”

“Why not?”

I paused. There we were, two people whose body temperatures were totally incompatible, whose experience of the world around us not longer aligned, if it ever did. And neither of us was really in charge, because while in practical terms I made most of our decisions, every decision made revolved around him (not unlike when he was the obvious dominant head of the family). He is always cold, I am always hot. It’s such a small difference and yet…

I know all the reason I should have given, but I looked at him and shrugged, why not indeed.

Ralph’s Alzheimer’s Social Anxiety–or Mine?

Yesterday I held a garden party. A baby shower actually for a friend of my daughter. I had volunteered us as hosts after several glasses of wine at a dinner the three of us shared a few months back. We scheduled the shower, pre-omicron, for the first Saturday in January, but the virus messed up our plans so we rescheduled and started thinking outdoors if possible. Then threatening weather and heavier covid numbers forced us to reschedule again. And again. But the third time stuck. Beforehand Was very nervous how it would go. I didn’t know most of the guests and was worried the weather would force us either to cancel or move inside, not really an option under the circumstance.

By it turned out to be a lovely day, light sweater weather under clear blue skies. The scones and petit fours were tasty, the tea was hot, the Prosecco bubbly. As an added surprise, the mother of the mother-to-be who had arrived the night before from her home in Spain to stay for the next two months It was fun for both of us to hang out with a bunch of young women and each other. 

Ralph came outside for about five minutes to take a group picture and was absolutely charming. Otherwise he watched from his office window, a ghost no one but me and maybe my daughter even noticed. 

His reaction/behavior encapsulated much of his/our life over the last six weeks. Close friends rented a house near us for those six weeks. Except for the week I quarantined after my grandson tested positive, we spent a lot of time together, probably seeing each other at least every other day. Sometimes we cooked together here at my house. Ralph loved when they came by and after the first week of my repeating reminders that they were here for a long visit, he began expecting them to be here for dinner every night and asked me throughout the day what they were doing or where they were.

Around them he was fully engaged and extremely witty. But he did not come out to dinner with us even once. I would go through the motions of asking him to come, but he wasn’t interested and I never pushed. For one thing he hated the idea of eating outside, even with the gas heaters keeping diners perfectly warm, but mostly he just didn’t want the hassle. Even in the house, he wasn’t interested in sitting in our very comfortable, warm living room. To be with Ralph we had to sit near where he was enthroned in his chair. 

My friends enjoyed being with him at first, but the unequal footing on which Ralph and the husband in particular stood became difficult for them to navigate after a while. I could tell they began to find it a bit trying, or that Alzheimer’s mix of trying and funny, to spend longer periods of time with Ralph. And they never quite got used to (and why should they?) Ralph’s endless repetition of questions. (The truth is that their discomfort was kind of a comfort to me, and release valve. I also have to admit I enjoyed those dinners out without having to watch over Ralph.)

As the weeks past and there was talk of moving the baby shower, he became particularly obsessed and confused when any mention of it came up. He couldn’t remember knowing the mother-to-be, whom he has spent time with on several occasions. But more than that, he could not get his head around the idea that I was having a party at all. 

Why are you cleaning the yard?  

Why are you going to the bakery?

 Is it a birthday party?

 Who is coming? 

Who’s pregnant? 

Who is she? 

How do you know her?

Is it her birthday?

 And of course, Do I have to come? 

The conversational loop gathered momentum over time and became inescapable. And inevitably so did giggles and impatience to cut the evening short. Last night, post shower, he was still asking the same questions as our friends stopped in for their last evening before heading home this morning.

So here we are.  Ralph has taken to his bed to recover from his busy weekend although he has already forgotten there was a party. And I think he’s beginning to forget our friends were here too.

Alzheimer’s and Dementia-I Finally Erase the Line

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I remember when I bridled at the interchangeable use of Dementia and Alzheimer’s. This was back when Ralph’s diagnosis was MCI, Mild Cognitive Impairment, or may even slipping over in Mild Alzheimer’s. I clung to narrow definitions back then. The plaque build up his tests showed signified Alzheimer’s and served as my point of gravity. I could tell people, i.e. myself, that he had a specific physiological condition. I did not want him lumped into the big vague world of dementia. No, really, I did not want to think of him as “demented” as in the pejorative taunt “You are so demented.” 

Now the boundaries between definitions matter less and less. While repetitive questions and conversations are annoying, Ralph’s memory loss feels routine except when a visitor comments and I recognize the behavior afresh through her eyes. As an echo to Ralph, or a habit I’ve picked up from him, I think I also repeat myself more.

As for Ralph’s general behavior, his passive has inertia has become, like the radio he listens to all day, the background noise of my own more active life. I come and go, I clean and cook, I talk on the phone and escape to my office, I mess with the grandkids. He sits and watches. We spend large swaths of time together in near silence. 

I find I don’t really want more from him: I find most of our longer conversations, which occur while he watches me prepare his meals, deadening. He usually wants me to clarify some fact from our past that I have clarified many times before. As he gets entangled in what seems simple logic to me, as he repeats the same questions or commentary, I sense his desire to connect on the only wavelengths he has available. But I often resist, am short and evasive. I don’t want to face that he might be lonely and I could make him less lonely if I engaged back, if I were a little more loving and patient. A little less wrapped up in my own anxieties.

As for his dependence on me, it is really just another part of our routine I don’t notice anymore, especially when we are alone and I’m not comparing our relationship to others’. 

Ralph’s condition is what it is, ever changing in small increments and this is the life we both lead, one I find myself adjusting to on a daily basis. I don’t have time or energy to worry about definitions now.

Do You See What I See-the Alzheimer’s spouse refrain

Ralph enjoyed his Christmas from what I can tell. He was not excited about going to my daughter’s house on Chrismas Eve, but he was totally involved in “surprise present” game in which Ralph opened a big cardboard box inside which LittleBoyRalph popped up pretending to be a mechanical toy with an off and on button—both Ralphs had no problem repeating the game over and over to everone else’s delight. Nor was he excited about Christmas dinner but then was charming. I was told by several at the dinner how “good Ralph seemed, better than I expected.”

I always hate those comments, well meaning as I know they are. And KG’s recent response to my last post definitely came to mind. What he wrote—“Others don’t see what I see”—really hit home. I am struck that there are elements of daily life with Alzheimer’s that don’t get discussed because they seems so trivial in the scope of things (the weather and certain small fixations like Ralph’s daily Nutty Buddy) or slightly embarrassing (issues of hygiene come to mind and my allowing Ralph nightly beers). I see the hitches in his most basic problem solving, his passivity (often a godsend frankly, like this afternoon when I had to drive our neighborhood streets aimlessly for an hour because I had a napping child in the backseat and Ralph was perfectly happy in the passenger seat), his social disconnect when he wanders back to his bedroom despite having guests in the room talking to us. 

At the same time, I don’t think I pay the same degree of attention as I used to in the early days. I’m afraid I don’t note as carefully as I used to every small Alzheimer’s wrinkle as it crops up. I don’t worry so much about whatever new normal has arrived. Everything is normal.

I think I see Ralph as clearly as I need to. But then he still can surprise me. Ralph used to be something of an artist. After his diagnosis of MCI I found him an undemanding art class he attended weekly with great devotion for years, but then the teacher had to stop teaching and although I set up a studio-office for him behind our house here, he has not picked up a paint brush or pencil since we moved in. Until yesterday.He had found a blank artist pad I’d bought at the drugstore for LittleBoyRalph and sketched from memory our old dog house on the farm as well as some kind of fighter jet. He also wrote his name on the sketch pad to make clear it was his. It now sits between the cushion and arm of his chair. I am amazed at his initiative and his spark of pride, like a sudden blip on a flat graph line. I also wonder whether he remembers that the sketch pad, which he didn’t touch today, exists. 

Alzheimer’s Weather Has Arrived in Time for Xmas

“Do you have the AC on?”

“No it’s 72 degrees on the thermostat”

“It’s freezing in here.”

“You might try putting on a sweater.”

“Why is it so cold.”

“It’s only 65 degree outside.”

“That’s cold.”

“It’s December. Christmas is in four days.”  

“It is?” (Our house has two Christmas trees and an advent calendar the grandkids come and mark daily)

“It was not this cold last year.”

“Yes, you complained last year too.”

“No I didn’t.”

This conversation has actually occurred in some similar form for years, here in New Orleans but also before at the farm. One of Ralph’s earliest symptoms of cognitive loss was his weakening sense of time and another was his sensitivity to the weather. In the summer he complains of the heat unendingly—while often wearing a flannel shirt. And in the winter, he cannot get warm—while ignoring the sweaters in his closet.

I have not always been as patient as I could be during these repeated conversations, but I finally have made an adjustment in our lives that might help. After resisting covering our beautiful old French windows for selfish aesthetic reasons, I have ordered solar shades for the room where Ralph most often sits. And meanwhile it will be warming up here in time for Christmas, although the temperature might not stop Ralph’s discomfort or this conversation.

As for the holiday itself, I am not sure how it will go. Now that I’ve adjusted to Ralph’s move into “moderate” Alzheimer’s, I recognize that that this may be a period in our lives that I will be nostalgic about someday because while Ralph’s cognition may be diminished, he is also undemanding; as long as I don’t set expectations too high, our day-to-day life is not that demanding —as long as Ralph’s routine is not disturbed and he can stay within its narrow confines. But Christmas is going to disturb his routine big time, 

My son and son-in-law are arriving tomorrow with their negative tests in hand. So are my sister and her husband. Everyone is coming, despite the new covid risks, largely to see Ralph, not sure where Alzheimer’s will have taken us by next Christmas. This year will be in untraveled territory enough. As recently as two years ago, our last full scale celebration, Ralph was tstill he center of our big, raucous Christmases, while I cooked and cleaned in the background. 

Now all he wants is to be left alone and he can’t remember that it is December even as I ask him to water the Christmas tree. My guess is that even when the family gathers, he will prefer not to participate. 

And that will be okay too. 

Living Between the Cracks as a Caregiver

Lola has not adjusted to the switch from daylight savings time so last week I started a new regiment. I fed the dog at 5:30 am, was at the pool at by 6:20 and home by 7:40 to bring Ralph his coffee and pills. 

I do not think of myself as either disciplined or a willing early riser, but midweek as I was kicking slowly down the length of the pool on my back, I realized that this schedule was actually perfect and also a metaphor for how I was learning to handle my life in my newest normal by finding personal time between the cracks, even if the crack is at dawn or ten pm.  

Then this Wednesday a child in my four-yea-old grandson’s pre-school classroom tested positive for Covid. Everyone in the class was (understandably) required to quarantine. Because the kids are so young, the school is not letting kids return for two weeks although once a child tests negative at five and seven days he can be around others. Since Four-year-old Ralphie’s one-year-old brother is not vaccinated, the family has divied up. Baby, Papa and teenage sister are staying at their house while Ralphie and his mother are with me. Both parents are working full time. So I have been spending my days masked, like Ralphie, playing hours and hours of his version of The Christmas Elf and of Christmas Day (A lot of the same small household items end up under the tree and in stockings and I get to express great surprise, O a coaster!)

Yes, three days in and I am already exhausted

Ralph, on the other hand, is very happy having Ralphie around the little he sees him. He must be masked when in the same room so has been spending a lot of time with Lola in his room.Since I am basically not leaving the house—no swimming and no socializing over coffee, that’s for sure, also very little time for my editing and writing work— he also has me at his beck and call, albeit my attention is divided.

The cracks in my metaphor have temporarily all been spackled. And yet as I look forward to the time ahead when our schedule re-normalizes into whatever normal may be in two weeks or two months, I have a sense of how to approach my time—I’ll grab what I need when I can, feel not an ounce of guilt for grabbing but also accept the limits. 

Thanksgiving and an Anniversary

Yesterday was Thanksgiving. It was also Ralph and my 44th wedding anniversary. And although the flowers I received—from myself—are lovely (and to brag a little more, I made the vase they’re in during my glassblowing days), I did not expect much celebration.

The day before yesterday I’d begun to write a post  with the line, “One of those I’m at my wits end moments”, and assumed my mood would continue. My anxiety has been increasing for weeks, in part because of Ralph’s diagnosis, in part because I have taken on more work deadlines than I should have, and because my ongoing sciatica has drained my patience just as Ralph’s neediness has increased. Ralph’s constantly repeated questions and inability to grasp or retain simple concepts have irritated me to the degree they used to in the early days of his MCI, before they became the wallpaper of our lives. 

My wits were pushed to their end over a dog issue that I cannot seem to resolve: Lola’s almost daily, sometimes more often than daily disappearances, and Ralph’s resulting panic. Lola, now upgraded to the center of Ralph’s life since Zeus’s death, is a lovely, loving terrier; but if left alone in the fenced back yard off our bedroom, she sometimes finds a way under the house. Because the house is in the process of being painted and some plumbing work is also going on in the crawl space under the house, controlling access is a problem; we keep closing off vents and holes and she keeps finding new ones. 

Each time Lola disappears, we follow the same routine. Ralph comes to me distraught that Lola has gotten loose and run off. I tell him she is probably under the house (sometimes, we can actually hear her), but he begs me to go search the neighborhood. I drive around and never see her. I come back and remind him she is probably under the house. He doesn’t remember that she has that habit and argues there is no way she could get under the house because he has blocked all entries. I suggest he open an entry wider because I suspect going down and in through some tiny opening is easier than climbing back out. Finally Ralph agrees and five minutes later Lola appears. 

The first time or two this happened, I was as concerned as Ralph. Now I realize Lola is not going anywhere. That she cannot escape to the street once she is down there. I also know we cannot block access to the crawl space until improvements are complete and workers are gone. Until then, when Lola goes out, someone needs to stay with her. That would be Ralph or me.  And there lies the problem since Ralph is always in the room when Lola wants out, and I often am not.  

On Wednesday morning, Lola disappeared, Ralph freaked out, I did my obligatory drive/search, Lola then showed up, and I explained to Ralph that he had to stay with her. He agreed. I wrote it on his white board. He read it. He promised he’d remember. 

I began my other care-giving job, watching my adorable, but high energy demanding grandsons both under five. Usually I pick them up after pre-school at three and keep until one of their parents gets off work at 4:30 but Thanksgiving break meant I had them at our house most of day. When I got back after taking the kids home, Lola was missing yet again. We went through the routine. She showed back up, while I was dealing with the IRS, or rather trying to get through to a human person because the website was “unable” to verify my account for a refund. 

I was much less patient with Ralph this go round. I don’t think I yelled at him exactly, but he said I did. So maybe my voice went up a notch before I stormed off to make his dinner, which he ate with no memory of Lola disappearing or me raising my voice. My memory was less forgiving.

I went to bed thinking that I didn’t like—no I hated—always being responsible, always being caring, always putting someone else first. I didn’t want to be a wife or a mother or even a grandmother.

Then came Thanksgiving. My friend M to come over to share a very unconventional Thanksgiving with Ralph and me: Asian dumplings in broth from our favorite restaurant Luvi’s, my homemade cranberry sauce, M’s homemade pecan stuffed squash, and my knock out Tres Leches for dessert. M and Ralph don’t know each well, but she’s a natural extrovert and made him comfortable. 

She also likes to sing and asked if he’d like to join her on guitar. He said no, but as we sat and chatted, he suddenly pulled out his guitar. The next thing I knew he and M were singing Willie Nelson’s Crazy. Then while M looked through for a song in Ralph Dylan collection, Ralph started playing Mr. Tambourine Man, singing the rather complicated, twisty lyrics from memory. M and I were astounded. Soon the three of us were trying to thinking of more songs. We ended clobbering Yesterday and reminiscing about our first times hearing the Beatles.

So when M went home, Ralph actually agreed to watch the Beatles documentary Get Back on TV. It was the first time we’ve sat together sharing an actual experience in I don’t know how long. And this morning he remembered and discussed how Paul came across versus John. Furthermore, we actually agreed

Thanksgiving indeed. 

Ralph’s Newest Test Scores-Not Great

Ralph went in for his annual mental check up last week.

Ralph was first diagnosed with MCI (Mild Cognitive Impairment almost eight years (eight years!) ago. At the time his personality and interests were what they’d always been despite his memory issues. I remember being angry in the months (years?) before his diagnosis, thinking he never remembered what I told him because he wasn’t paying attention, or even less attention than he used to. Getting an actual diagnosis was almost a relief for me—having a name to excuse Ralph’s behavior, at least in one area. He was upset, anxious and scared, but as I kept reminding him, MCI, stood for MILD impairment.

For years Ralph was what one of his former practitioners called her Poster Boy for Alzheimer’s Care: year after year he avoided the cognitive and behavioral slide statistics predict. While I noticed subtle changes—slowing down, turning inward, growing passivity—his actual memory skills held pretty much steady from year to year. Then last year’s tests showed a slip from MCI to Mild Alzheimer’s. Still, MILD, I reminded myself. 

I knew we were lucky yet I have sometimes felt a tinge of resentment when friends, family members, and even professionals didn’t notice the changes I saw. Was I imagining things I something wondered.

At the check up Ralph and I are interviewed/tested separately. Despite having noticed, and written posts about, more recent changes in Ralph—his growing lack of interest in talking on the phone; a drop in his problem solving that shows up as confusion managing minor tasks he used to handle adeptly; and some loss of memory about the far past—I told Dr. K. that despite what I’d noticed, I didn’t expect his test scores to drop. A moment later Dr. S. came in and dropped a small bombshell: Ralph, who has dropped a point a year at most in the past, dropped three points on the 30 point MpCa scale this year, moving from Mild to Moderate Alzheimer’s.

Knowing the numbers doesn’t really change anything. They just acknowledge the changes I already recognized. But I do find myself thinking in new ways about the future and how my needs as a caregiver are bound to change. The last six months of hip and back issues that impede my own mobility—I hope temporarily–have colored my thinking. Last week I was in something of a funk, wondering if I should sell our house, the one I moved us into barely 20 months ago and spent a huge amount of energy renovating. I thought about elderly high-rise living, a place with a memory wing of course. But today, I am more upbeat. There is no knowing the timeframe in which we will be adjusting. All I can do is adjust day to day. So, the other day, after he suffered an anxiety attack while I was having a quick dinner with a friend—fifteen calls I in the space of half an hour inside the restaurant and several more calls after I talked to him because he couldn’t remember what I’d just told him—I bought a white board. Not to remind Ralph to keep to his routine, which would be a waste because he wouldn’t remember to check off activities once he did them, but to make sure he can see in writing where I am at any hour of the day. He loves it.  

I’m sure there are more small innovations to come, and more anxiety.

Ralph loses his best friend—Alzheimer’s and grief

Ralph’s beloved 17 year-old lab died last Monday. It was time. But getting Ralph to realize it was time proved a challenge.

For the last eight weeks Zeus had been on a steady decline. When we returned from the family beach vacation in early August, our regular dog sitter admitted she had worried the whole week that Zeus might die on her watch. He had been so much frailer than in the past and was having what she thought were mini-seizures. 

Our vet explained they were not seizures but neurological problems that affected controlling his back legs. Acupuncture would help but not solve the problem. About the same time a gaping wound appeared on Zeus’s hip. It turned out to be a bed sore. The vet, whose own lab had succumbed not that long ago to a similar combination of ailments, warned us that the bed sore was going to be very hard if not impossible to treat, not only because it was an internal infection but because how do you stop a dog from lying down, especially one who can barely stand up. Zeus began weeks of intensive treatment—lasers, oral and topical antibiotics, acupuncture, and a huge bubble bandage that could only be changed by a professional. I was administering his various doses at home and taking Zeus to the vet office several days a week, no small task since he had to be carried into the car. Ralph helped with the lifting but he couldn’t really keep up with the dog-nursing.

At first Zeus seemed to hold his own, more or less. But the hurricane evacuation took its toll. The bandage fell off. The wound festered. The legs gave out. And by the time we returned, Zeus was basically unable to stand without being righted by human hands. 

We did another round of laser/acupuncture/antibiotics/band aids. I could tell Zeus was not getting better, and when the vet warned that if Zeus did not improve this go round we would have to discuss “quality of life” I was ready. In truth, I am not a dog person by nature and my patience was strained. Not to mention that poor Zeus was increasingly incontinent, shedding profusely and smelly.

I reported back the vet’s remarks to Ralph.

“I am not killing my dog.”

“No one is talking about killing.”

“Would you kill me?” 

When I next took Zeus back to the vet, I brought Ralph with me. Covid era vet visits take place in the parking lot. Ralph was chatty with the vet until she said there was no improvement and used the dreaded phrase “quality of life.” Ralph went dead silent. 

“I am not killing my dog,” he repeated once we were back in the car and throughout the evening.

I scheduled another appointment. This time inside the vet’s office for THE TALK. Ralph listened as the vet described how hard it was for him to put his own dog down. Ralph nodded and seemed to hear the vet’s explanation that Zeus was not getting better. 

But as soon as we were alone, Ralph asked, “So is Zeus getting better?”

“No, he is not going to get better.”

“Well, I am not killing my dog.” 

We reached a compromise: We’d revisit the situation in two weeks. That was a Thursday afternoon. 

The process so far had been grueling. I was constantly on edge, expecting Ralph to explode in fury and fear. I also resented that I was caring not only for Ralph but his dog. And I was aware that Ralph saw the parallels between his own infirmities and his dog’s every time he asked “Are you going to kill me?” 

On Friday, Zeus was definitely weaker and even Ralph noticed the way he whimpered at times. By Saturday, Zeus was unable to untwist his back legs. 

Ralph struggled with Zeus, let him lie down and turned to me.  

“Ok, as long as I don’t have to be there.” 

With his blessing, I called the vet and made an appointment for Monday morning. 

For the 36 hours Ralph was as weepy as a man who doesn’t know how to cry can be, frequently wiping the edge of his eye with one finger.

But on Monday he was surprisingly calm when he carried the dog like a child  to the car for his final trip to the vet. Then he went back inside the house as I backed out the driveway. When I got home, alone, he asked for the details. I described Zeus’s calm comfort at the end. 

Since then Ralph occasionally says he can’t get used to Zeus being gone. He asks me if I think we did the right thing. He asks me to remind him “What was wrong with Zeus again?” and “How old was Zeus when he died?” I tell him.

“Oh, you know 17 is very old for a big dog,” he always explains to me then, as if I’m the one who needed convincing. 

And I nod, thankful I gave Ralph the time to come to the choice on his own.  

Post Script: Evacuation Return

Hurricane Ida did very minor damage to our home, blowing a turbine fan off the roof to create a small hole in the roof which we quickly fixed before the new rains came. And assuming we’d be back in a day or two, we had foolishly not cleaned out the fridge so it was a stinking disaster, but thanks to my daughter’s help it is clean and almost sweet smelling once again. In other words, I have nothing to complain about, especially compared to the suffering of others from this hurricane and from all the other covid and climate disasters the world is facing.

However, I inadvertently planted a red herring in my last post by mentioning the leak in my ceiling the day we left and then never telling what I found when we came home: A large chunk of my kitchen ceiling waiting for us on the kitchen floor.

Ralph had turned off the washing machine (but not the water heater as he thought, a mistake that didn’t matter in the end). The problem was that he didn’t notice that the hose that takes the water to the drain had come loose and disconnected from the drain. When my contractor Enrique–who has finished my renovation but now considers me his customer for life and actually contacted me during evacuation to see how we were– came by to assess hurricane damage, he not only took care of my roof but in five minutes reattached the hose securely. I spent the next day deep cleaning the kitchen, a strangely gratifying chore, and we’ll fix the ceiling once we know its all dried out. Of course, pre-Alzheimer’s Ralph would have figured out the problem before it got so bad, but I have to stop relying on that Ralph and start relying even more on myself (and, thank God, Enrique ).