Category Archives: daily life with MCI/Alzheimer’s

Alice Takes a Short Quiz

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I used to love those self-help quizzes in magazines so now I have made up my own and taken in. I am not sure if I passed or not.

Questions:

Who did the following, A (Alice) or R(Ralph), in the last week?

  1. Who asked repeatedly where the other was going today?
  2. Who asked repeatedly what the other was doing all afternoon?
  3. Who went to an Alzheimer’s support group Friday?
  4. Who took the dog to the vet?
  5. Who could not find his/her cell phone for two hours?
  6. Who doesn’t answer the phone when called?
  7. Who answered the final Jeopardy question right?
  8. Who got in the car without putting the dog in the house yesterday?
  9. Who left the eggs boiling on the stove last night?
  10. Who noticed and turned off the stove last night?

Answers:

  1. R (Although I was only going to the gym) but also A (To remind Ralph he had a doctor appointment)
  2. A (Because I worry he just sits and smokes unless I push him to do a chore or activity); Not R (He has lost curiosity about my activities)
  3. A (Ralph refuses to go because he says one person always talks too much and he doesn’t get enough factual information)
  4. R (While I was at the support group actually; this was the first time he has taken responsibility for a chore in a while, and I was nervous about sending him alone. But he assured me that he knew the way and he did. The dog’s check up went without a hitch. The sense of normalcy was a good experience for Ralph and for me.)
  5. Well, I think that might be R and A, each on different days. (Actually I am not sure where mine is right now. Oops, there it is under an envelope on my desk.)
  6. R. (When I misplace my phone, I start calling it. When R misplaces his phone, he doesn’t notice. If I am out and checking on him, I get extremely nervous that he’s not answering. When I am the one home and he is not in the house and not answering the phone, I can get a little frantic. So far my worry has been needless, thank goodness.
  7. R (One advantage of having a husband with MCI/Early Alzheimer’s—he doesn’t lord it over me because he almost immediately forgets that he’s one-upped me)
  8. R (This was disturbing because, see 4., the dog is the area of responsibility where Ralph usually seems the most his old self; I took care of the dog without mentioning to Ralph who would have become very upset at his lapse)
  9. A (I put them on, left to check email and Ralph was the one who noticed and turned off the burner just as I was walking back into the room)
  10. R (See 9. Above.)

Answering my little quiz has been a good reminder to myself that the line between forgetfulness and Alzheimer’s related loss of memory is not always as clear. What is different is often more in the reaction. I fret while Ralph doesn’t know what he’s forgotten or that he’s forgotten. I think I may quiz myself more often to keep track of how we’re doing.

“In The Zone”

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Ralph took his first art class in twenty years this afternoon.

He agreed to go only because our physician’s assistant Stephanie gave him a “written prescription” to take art lessons during our last visit to the Memory Center at Emory.

Ralph has always been a natural draftsman, and in his thirties he took courses from a couple of relatively renowned artist/teachers who gave him real encouragement. Then life got in the way and he didn’t stick to the art. He always said he’d take up the painting again once he retired. But that was before he was diagnosed with (not so) Mild Cognitive Impairment and he has not touched a paintbrush since.

So when he told Stephanie that he had his paints all set up in his office in the barn and was going to paint soon once he had things organized, I probably rolled my eyes. He does go to his office to “straighten and organize” most days, but really he sits and smokes and talks to the dog. I am glad he has somewhere to go and be comfortable. I certainly don’t care that the office will never be organized, but I do fear and sense the mental atrophy setting in.

Like everyone involved with dementia and cognitive issues, I am aware of the benefits of art therapy. [For those interested there is a documentary, “I Remember Better When I Paint” worth checking out as well as numerous articles and essays to be read on-line.] But Stephanie and I knew better than to push that angle with Ralph, who shies away from that word “therapy”.

Instead Stephanie blamed human nature, explaining in the nicest way possible that if Ralph didn’t take an actual class he would never start to paint on his own. She told him that he needed the class to jumpstart and structure his time. (She also prescribed a weekly night out for dinner or a movie, but following that direction has proven harder for reasons I’ll explore another time.) What he would hear as nagging from my mouth became sound advice  when it came to Ralph from an authority figure who also happens to be attractive and charming.

Fortunately, as Stephanie agreed, Ralph doesn’t need to be in a special class for the cognitively impaired. He just needs a class period: A time and place on his schedule; plus an environment with other students good enough that he takes the class seriously but not so good that they intimidate him. Not an easy situation to find in a small town, but two friends separately recommended the same art teacher who has been working with a group of adult students for several years. We talked. I assured her that Ralph was not a beginner, but I also felt obligated to acknowledge Ralph’s M.C.I. just in case something came up. I assured her that no one in the class would be able to tell he had a memory problem. I could hear her hesitation, but she agreed to let him in.

Since I told him that I’d signed him up he has asked with anxious frequency what day the class was, where it was, how long it was, what he had to take to the class, who would be at the class and how good were they at painting.

He has not been asking with enthusiasm. His has been a litany of fears. On the drive to the class this afternoon—“Where is it again,” a moment of silence, “Where is it again?”—Ralph was such a bundle of nerves that I almost gave in and said he didn’t have to go. The gray, drizzly cold didn’t help; bad weather is always an excuse for Ralph these days.

But we made it to the parking lot and he did get out of the car with his supplies.

I sat with my motor running as he walked in, pretending to take a call on the cell phone. By then I was a bundle of nerves myself, the same nerves I remember suffering when each of my kids faced the first day of school. I watched through the window as he trooped into the classroom and walked up to the teacher to introduce himself.

“So how was it?” I asked when he came out two hours later.

I could tell he was in a good mood, but I was not expecting what a good mood.

“Once I got started I was in the zone,” he said and showed me the painting he’s begun. He can’t wait to go back…

How happy-making to offer a success story for a change.

A Mountain or A Molehill of a Bad Night?

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I have been avoiding writing this entry, wondering if I can skip it, but if this is to be an honest chronicle, there’s no leaving out the unflattering, ugly and/or embarrassing parts.

Ralph fell on Friday and ended up in the emergency room. He’s fine, but the experience was unnerving and upsetting on several levels: as a reality check on our life together now, as a glimpse into our possible future, as a mirror into my reactions.

Ralph had injured his back last Monday and spent the next four days in serious pain. He did what he always has done with his back issues in the past —lay on his back with a brace and took painkillers. I brought him food and Advil, but to say I was attentive might be an exaggeration since I went into Atlanta for someone’s birthday dinner without him Tuesday night and was in and out of house the rest of the time, actually finding as many reasons to be out as I could.

By Friday he seemed much better. When I got home from the grocery story at 5-ish, he was sitting on the front porch talking on the phone to his sister. I was glad to see he was back to his usual afternoon routine but also vaguely annoyed with him for no particular reason except maybe caregiver fatigue as I schlepped in the grocery bags by myself. Minutes later while fiddling around in the kitchen, I heard a crashing noise. I assumed it was the dog, but—and here’s where the embarrassing, unflattering part starts—a thought slipped into my head along the lines of, if that’s Ralph dropping dead it serves him right for sitting out there not helping me with the groceries.

Of course, it was Ralph. He lay crumpled face down on the ground by the porch steps. He was not moving. What had I just wished on him? To twist the knife a little more, that very morning he’d asked me out of the blue, “What will you do when I die?” In response I had laughed uncomfortably and changed the subject. What if he’d had a presentiment?

He was conscious but unable to move his legs. His speech was slurred. I thought, stroke. I couldn’t and knew I shouldn’t move him. So I made the 911 call.

Ok, here comes the next embarrassing part: The EMT said that Ralph didn’t seem to have had a stroke or broken any bones, a relief of sorts, but that he smelled liquor on Ralph’s breath. I got defensive and said all we had in the house was white wine, which was true, and how much could he have imbibed in the two hours I was gone. The EMT said I shouldn’t be embarrassed if Ralph was tipsy when he fell. Right. I was more than embarrassed. I was half-hoping it was a stroke because that would be less difficult to explain than allowing my 68-year-old cognitively impaired husband get so drunk he fell off the porch.

On the 45-minute drive behind the ambulance, I called both my kids to prepare them just in case it was a stroke although I very calmly told them it probably wasn’t. Meanwhile I was composing titles for my next blog entry in my head, along the lines of From the Border of Early Alzheimer’s into the Abyss.

At the emergency room, Ralph was awake but very out of it. He had no memory of falling or riding in the ambulance and didn’t understand where he was. I panicked oh no this is going to be my life from now on. I have read so many blogs by wonderful people caring for their seriously debilitated spouses, but I wasn’t ready to be one of them.

The hospital tests clarified that Ralph had not had a stroke. And that his alcohol level was way over the legal limit. I was horrified. How had I allowed this to happen to him? Was he an alcoholic and I his enabler or was he a guy with a bad back and a worse memory who drank some wine on an empty stomach because his wife didn’t bother to make him lunch before she went out and he forgot to eat)? Either way, I was at fault. The medical staff didn’t seem very concerned—a 68-year-old man drank too much and tripped was the general consensus.

But to me and to Ralph it was a nightmare. I had never witnessed him so totally confused. And each time he asked me to explain his current situation, he became more deeply upset that his life had come to this point. “I am a man who is in control,” he repeated shaking his head.

As I drove him home minutes after he was released, he’d already forgotten we had just been at the hospital. I panicked. Was this his new memory level? I dreaded what I would be dealing with the next day and every day to come.

In the morning Ralph woke up sore, but he remembered the fall and the hospital. If anything, his memory was sharper than it has been for a while. He was mortified, worried that someone we knew had seen him in the hospital. I assured him no one had. We discussed how much he had drunk. He didn’t know but he had eaten very little and drunk on top of his meds and a lot of Advil. I explained how alcohol exacerbates cognitive impairment. He has not exactly sworn off his lite beer forever, but hasn’t had one since. He says he is more groggy/foggy than ever, but it seems to me that his memory is better and he has more energy. We are both relieved, enjoying life the way you do when you have just skirted disaster.

But for those five hours Friday night, I saw what our future might hold—Ralph’s nightmarish confusion, my cold calm covering inward fury—and it wasn’t pretty.

Joy Still Happens

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Today we went on our annual Christmas tree hunt. We have cut down a tree on the farm almost every Christmas since we moved down here.

Ralph and I still remember the first time, 25 years ago. Piled into our old Suburban with our two kids, our friend Amelia and our two dogs, we drove all over the land we had just purchased. We didn’t know our way exactly and the roads were overgrown so we got stuck several times as well as a little lost, although Ralph wouldn’t admit it. He shot mistletoe out of some very tall trees—who knew that’s where you found mistletoe—and cut down two beautiful pines, one for our family and one for Amelia’s. Then we drank hot chocolate. It could not have been more greeting card perfect.

But of course life changes. Amelia moved out of our lives. The dogs died and were replaced by several generations of new pets. The kids grew up and although they have never have missed a Christmas yet, I worry every year that this season will be our last together as a family. Then there is the change in Ralph himself. He used to be the center of activity and now often prefers the sidelines, napping when the others go off on adventures.

And it has become harder to find a decent pine. There aren’t as many out there, either because we cut down the good ones or let them grow too large. For the last few years, Ralph and I have dragged along grandkids or nieces, city kids who try to be patient but quickly get bored traipsing through fields. But this year there is no one around but the two of us.

So I expected Ralph to tell me that looking for a tree would be “too much trouble”– his current catch phrase regarding so many activities we used to enjoy. Frankly, in this case I was secretly thinking he might be right, that a bought tree, with its perfect limbs, might be a pleasant change from our usual Charlie Brown monstrosities. But Ralph surprised me.

He was eager to go out tree hunting. And he remembered for two days straight that we were going to go today. He even made sure we gassed up the truck before we started. And off we went. Although our paths were mowed during the recent wedding preparations, the grasses are back up high and it was our normal bumpy ride, but at least there was no rain and it wasn’t too cold.

Soon, not far from our pond, we noticed a tree with potential, despite a flat side. I suggested we tag it with a pink ribbon, but Ralph insisted that he would remember where it was. After a lot more driving, also jumping out of the truck opening gates and stomping through high grasses, we found another tree, a tall one in a thicket of our old cow pasture. This one I made him tag. We spotted our third possibility in the fenced pasture directly behind the house. Ralph was happy to tag this one, and I took a picture to compare to our other choices.

By now Ralph had no clue where the other two choices were—or that we had seen other potential choices at all. As he followed my directions back across the pond, we joked about his memory in a way we don’t any more. And then we agreed, almost casually, that his condition was likely to get worse. Ralph’s potential future with Alzheimer’s has become the elephant we don’t always acknowledge taking up half the room, but in that moment of acceptance, it seemed less scary.

Because we were having too much fun. Both of us. There we were, two sixty-something-year-old cynics driving around in a beat up truck debating over the perfect height and shape of straggly pine trees as if our lives depended on making sure we didn’t end up with a bare spot in the branches. And it was great.

Lately I worry that we no longer connect as equals. It bothers me that Ralph is not interested in all the issues and concepts we used to discuss/argue about so energetically. Not only has he lost his appetite for current events but what is worse, he doesn’t want to challenge me about anything more important than whether he’s taken his pills. When he talks about the dog and the weather or repeats and repeats his anxiety about some mundane issue that has long been settled, I feel myself patronizing him. Not a good feeling. I have to remind myself who he has been in his life.

But this afternoon I didn’t have to make myself remember what I used to enjoy about being married to Ralph; I simply enjoyed being with him.

 

The Ever Changing New Normal

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Eighteen months ago I was sitting in a six-week support group I had recently joined for caregivers when a new member walked in late, sat down and burst into tears in. She was a young woman in her late forties with a child in college and another in high school. Her husband was a former economics professor no longer able to teach due to his Early Onset Alzheimer’s. While she struggled to maintain her high pressure banking career to support their family, he spent his days in his home office playing chess on the computer and supposedly organizing his files. She tearfully described what a mess the office had become. She said he was depressed and angry and she was not sure how to go on.

At the time I was full of pity and secret relief. Her husband seemed so much further along the Alzheimer’s path than Ralph. Interestingly enough, her husband was the one person Ralph genuinely liked in the care-getters group which met at the same time as our care-givers group.  Ralph complained continually about having to listen to people drone on in his group, but when givers and getters came together for a luncheon when the six weeks series ended, he made a point of going up to the former professor to shake his hand and wish him well before we left.

Flash forward to the present. On my way to the grocery store this afternoon after a morning of office work, I realized that Ralph was not at home in his usual spot on the porch or out in the field mowing, but at his barn office/painting studio where he keeps a few files, his fishing equipment, and his art supplies. Ralph has always been a talented painter and always said that once he retired he would take it up more seriously. But despite my nagging, he has not lifted a paintbrush.

Still I became briefly excited.  Now that  the weather has turned cold, sitting on the porch smoking might be less appealing, so maybe Ralph was going to buckle down and begin to paint again after all.

But no. Ralph was sitting in his messy office, smoking a cigarette  with his dog at his feet.  When I walked in and asked what he was doing, he  said he was organizing his files.

DRIVING AND PAYING

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A few days ago Ralph had an appointment at the same dentist’s office he has frequented for thirty years. When I first made the appointment, I asked if he wanted me to come along. He said I should just write out the directions (he doesn’t use GPS). A lot of me wanted to agree since I don’t much like giving up the time—an hour each way plus the visit itself.

Then reality set in. After confirming the appointment a couple of days ahead, I began to worry about sending Ralph off on his own. I imagined him circling Atlanta, lost on streets that have been familiar to him for years. Fortunately, if  sadly, Ralph decided he wanted me to drive him after all. The anxiety was too much for him.

So I drove him into town and read People Magazine for an hour in the waiting room. Then I paid for the visit with my credit card and drove us home.

Driving and paying are small acts.

But they epitomize just how much our lives have already altered since Ralph’s diagnosis of MCI. Ralph, the man who spent his career as a self-proclaimed entrepreneur, no longer is comfortable or even interested in handling money. Ralph, the fix anything guy who was refurbishing and selling old telephone trucks for a living when we first met, prefers not to drive at all. And impractical, absent-minded professor type Alice, who couldn’t balance my own checkbook or change a tire to save my life and whose kids still tease me about my nervous driving, has taken over all the practical issues in our life.

Driving and Paying: changes that not only  define our daily mundane routine but  serve as metaphors for the larger, psychological and spiritual landscape we have begun to inhabit . And it is scary to examine that landscape, not only for Ralph’s future but also my own. But in my next few postings, I will try–if the daily and mundane don’t get in the way as they usually do lately.

The Wedding

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the wedding

The Wedding last Saturday was…well frankly, it was perfect.

After a stormy Friday, Saturday was sunny and cool. All my daughter’s detailed planning and iron-willed determination to have everything the way she envisioned resulted in a pitch perfect experience—simple but elegant, from the burlap covered hay-bales that guests sat on for the ceremony to the candles that guests lit and floated on the pond. And the emotional intensity was overwhelming, from the way Ralph and our daughter Hilary strode (and I mean strode) down the aisle grinning to the way my daughter included and embraced her ten year-old step-daughter as an integral part of the wedding ceremony, to the tears in the groom’s eyes. Actually there wasn’t a dry eye in the pecan grove. I could go on describing the details forever (like the way Jason rowed Hilary across our pond to the reception).

As for Ralph, he was totally in his element.

For the previous week he had been a wreck, repeating his certainty that the wedding would be a disaster about once an hour and generally unable to keep anything in his head. My impatience combined with my own anxiety didn’t help matters.

Then Thursday night our sons both arrived. The guys live on opposite sides of the country and last saw each other in an airport for fifteen minutes several years ago. Ralph, who is asleep every night by 8:30, sat up with them until three in the morning. I wasn’t about to take that family time away from him, but I was a nervous wreck assuming the beer consumed coupled with exhaustion coupled with tension would leave Ralph unable to function during the important two days to come.

And Friday morning he was still incredibly anxious about the wedding; the intermittent thunderstorms all day didn’t help. But Ralph was also remarkably sharp—what did help was the arrival to the farm of the bridesmaids who paid Ralph lots of attention. (“Why do young girls flirt with me so much,” has become a new refrain, half-boastful, half genuinely curious.)

During the rehearsal, when the minister explained to Ralph that he had a line to say during the ceremony the next day, Ralph was obviously concerned that he might mess up. I was concerned too until I realized that the minister, a good friend who knows Ralph’s situation, would take care of him.

Ralph, whose sense of time gets wobbly, especially when we’re going somewhere he doesn’t want to go, complained how interminable the 30-minute drive to the rehearsal dinner seemed. I was worried. He was clearly dreading the dinner where he would have to interact with more people than he’s used to in a setting that was unfamiliar. I was selfishly dreading embarrassing interactions, afraid he would have a panic attack as he has in the past or even refuse to participate.

But when we walked through the door Ralph transformed. He didn’t have to recognize anyone because everyone knew him. He began to hold court. When the speeches began, he became so inspired that he stood up to give his own toast extemporaneously, regaling us with a story about Hilary and a friend’s escapades. No one who didn’t already know would have had a clue that Ralph has issues with memory. After we got home from the dinner, he stayed up late again with the crowd staying at the farm. Again I worried that he would not be able to function the next day.

And again I was wrong.

Saturday afternoon, when he walked our girl down the aisle, he was completely assured. When the minister asked who gave Hilary away in marriage, Ralph boomed out, “Her mother and I do.” The ceremony went without a hitch. And the reception, full of good food and dancing to a great band, was a huge success crowned by my new granddaughter’s toast, a speech she wrote all by herself that brought down the house.

Ralph had a ball.

He can’t remember any details now. He has no memory of the ceremony having happened. He doesn’t recall the dinner outside under the trees or with whom he danced (and he danced a lot). He does remember the girls paying him attention. And he wishes our sons had hung around longer. We both wonder how he’ll fill his time…but that’s another post.

Mostly he’s let down that it’s over. After months of doom and gloom that the wedding would be disaster, now he’s upset we don’t have an excuse for another party.

Because as he tells me every ten minutes, “You know, I think that went really well.”

 

Ralph’s Pre-Wedding Jitters

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We are down to the last few days before the wedding and it is bittersweet in all the expected ways, but Ralph’s MCI/cognitive impairment adds a layer of intensity.

The bride and groom seem to be over the humps of pre-marital jitters and moving into pure excitement and impatience for the day to get here already, although I do spend a lot of time calming the bride-to-be down about mostly minor issues.

The rest of the time I am walking around the house in my glittery new silver pumps getting used to two-inch heels on my still-recovering ankle when I am not running out to buy flashlights (a little obsession of mine, that the path to the parked cars will be too dark) or pecan pralines for the guest goody bags or garbage bags (controlling the mess, another embarrassing obsession). My day starts early and ends late, including quickie visits to my mother, whose health is shakier and shakier as the wedding approaches.

But adrenaline is fueling miles of energy I never knew I had. And I have moments of incredible joy when little details come together that seem symbolic of the coming marriage.

We spent last evening with our daughter and one of her two brothers and our granddaughter, whom we had not seen for a year. Like at the Thai restaurant last week, Ralph was amazing. There were the usual discussions that began “remember when” and he always did remember, at least some version. When sibling issues began to percolate, he jumped in and smoothed the waters. I saw him through the kids’ eyes:  the patriarch, imposing and beloved.

But today Ralph is suddenly a little lost, probably because he has finished all the pre-wedding chores that have kept him scheduled into a routine. Plus this is his baby girl getting married and as much as he likes her intended, he is only half-joking when he says he would rather she move home and take care of him.

When I left the house at 11 this morning, he was still in his bathrobe. When I got back at 2:30, he had forgotten to eat lunch—I suspect he had been asleep. After I gave him lunch, he drove to the gas station for a six-pack of beer. That was his only activity of the day.

Yet he is exhausted and talks openly about how anxious he is feeling. Tomorrow I will have him help me put up signs to the ceremony and reception sites. He does much better when he has a chore to accomplish.

Tomorrow night, the whole family descends and my guess is he will rally, at least outwardly. (No, I am not cooking; take out bbq will do fine.) But the anxiety is not going to abate. His inability to keep straight the details of when-and-where-and-who is staring him down in a way he can usually avoid but finds impossible to ignore this week. He is openly nervous about the physical details but I suspect his bigger concern is interacting with so many people and keeping straight the details. Since I may be busy with hostessing duties, various friends are planning to keep an eye on him, but I know that when Ralph starts getting disoriented I am the only one he wants nearby.

He keeps asking, “How do you  me  stay so calm?”

I avoid answering, but really, I have no choice; someone has to stay calm, the same way one of us has to keep remembering for the other.

Dinner Out

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What a wonderful evening we had tonight. I am giddy over it.

A few years ago running out to the local Thai restaurant for an hour would not seem a big deal, especially given that we were home in time for Ralph to go to bed by his usual 8:30. We used to eat out several times a week trying new places, some fancy, some ethnic, some greasy spoons. One of the real joys we shared as a couple was food because both of us have always been adventurous eaters.

Tonight the food (though it was surprisingly good for our small town) was beside the point. The point was that Ralph actually came with me. Lately when we make plans to go anywhere–dinner, a movie, to visit our daughter– Ralph decides at the last minute that he is too tired to go, but tonight he showered and got ready without my nagging.

Of course, as I drove us into town I had to remind him whom we were meeting , my friends Francis and Susan who are sisters. Francis recently stayed at our house for two weeks; we ate together every night and she sat  with Ralph on the porch. Nevertheless, it took some serious prodding for Ralph to remember exactly who she is. He has met Susan a numerous times; she works with several of Ralph’s buddies from his twenties about whom they have gossiped with great pleasure. I don’t think she noticed that he didn’t have any memory of her or their connection.

Everyone felt new to Ralph; and Joe, a friend the sisters brought along, really was new, someone neither of us had met.  As it turned out, having new faces gave Ralph just the audience he needed. He told stories while eating whatever I ordered for him. If he repeated himself, no one particularly noticed or cared. He laughed more than I’ve heard him laugh in ages He was relaxed and completely charming. Wonderful company. The man I fell in love with years ago.

So what if he went to bed as soon as we got home? Unfortunately Ralph probably will have forgotten by tomorrow what a lovely evening we had, but  I can remember it and savor it for days. And one thing about MCI, at least at this early stage, is that I have finally begun to live in the moment, at least occasionally.

Wedding Preparations Don’t Stop For MCI

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Long before she received her engagement ring, our daughter made it clear she wanted to have her wedding  on our farm, where she and her brother grew up doing chores, riding horses and complaining that we lived in the middle of nowhere. Watching the recent cognitive changes in her father only made her more determined.

“Something simple, a simple farm wedding.”

In barely two weeks 120 guests will trek a wooded, far-from-manicured path out to a clearing within a pecan grove where they will sit on hay bales  to witness  Hilary’s wedding. Her older brother will play the bagpipes AND the sitar during the ceremony. A close friend will officiate. The groom’s ten-year-old daughter will be maid of honor. Everyone will then stroll back to the banks of our fishing pond to celebrate with  dinner, drink and a live bluegrass band under the stars (with a covered hay barn nearby just in case). We’ll eat wedding cake baked by my daughter’s best friend’s mother along with the 130 individual jelly jars of tiramisu she and I made together on Sunday.

It all sounds and hopefully will turn out to be delightful, but that “simple farm wedding” has ballooned into quite a production. While my daughter and her intended have done most of the decision-making and a lot of the organizing, the party is in our backyard—not to mention that a lot of guests will be camping out afterward and I’ll be feeding them the next day—so getting the farm ready has been Ralph and my responsibility.

Responsibility is not something Ralph likes to take on these days. His Mild Cognitive Impairment means that he can’t remember making or receiving phone calls, let alone the content of the calls. He gets anxious about dates and times. He needs 12 hours of sleep at night plus a nap in the afternoon. Nevertheless, as the wedding approaches he has stepped up and taken on extra responsibilities, just as he did this past winter while I was recovering slowly from a broken ankle.

In the last couple of months he has mowed our big pastures on his tractor, used the smaller mower at the reception and wedding sites, made the small repairs I’ve requested around the house because I am mechanically inept, and done various other chores. Given his limited mental and physical energy, he usually starts around 11am and quits by 2pm to sit on the porch until his nap before dinner. The farm, which was looking more than a little downtrodden, has spruced up in slow but steady increments. Next week he will use the tractor to smooth our ¼ mile unpaved driveway. As long as I remind him with his daily list.

I have to be careful though. Too much instruction or pressure definitely backfires. His memory blocks up. I am learning to control my natural impatience over how slowly long-term goals get accomplished and to bite my tongue when Ralph mows where he’s not supposed to instead of where I asked. Eventually he seems to follow through on every request more or less.

So although I lie awake every night worrying about where people will park, this wedding has been a boon. For a man whose attention span for reading and even television has dried up, Ralph has been remarkably focused. And he’s so good-natured about it. (Pre-cognitive impairment, he would have been super competent but grouchy.) He’s even relented and agreed to a new suit.

But there is a downside. As the day approaches, his anxiety rises. “This is going to be a disaster isn’t it?” he asks everyday, and since cognitive impairment has not impaired his fatherly ambivalence, he always adds, “Jason’s a great guy, but I don’t want my baby girl getting married at all.”