Tag Archives: Acknowledging Alzheimer’s

“So, How Is Ralph Doing?”

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An old friend called to catch up yesterday. We talked for maybe 40 minutes, were nearing the end of the conversation, when she asked, “How is Ralph doing.”

She’d clearly been both hesitant and dying to ask. I had been equally hesitant and dying to answer.

This scenario seems to be repeated in one form or another multiple times a week these days. Everyone who knows, however vaguely, about Ralph’s cognitive problems wants an update but everyone seems slightly uncomfortable asking.

For my part, I am both reticent and overeager to share.

I always find myself answering, “He’s holding steady,” and then launching into all the little negative changes I’ve noticed, interrupting myself to say, “I know this sounds trivial but…”

Because, really, I don’t know how he is.

Ralph is scheduled for his annual testing in two months. As the appointment nears, I find myself thinking about it more and more with both dread and anticipation. (Ralph doesn’t know it is coming up and there is no reason to mention it; either he would quickly forget or the fact of the looming appointment would lodge like a lost jigsaw puzzle piece in his memory, making him anxious on a constant basis.)

Whenever I think that Ralph’s cognitive abilities have slipped, I wonder if I am over-analyzing. This testing will tell me if we are maintaining the status quo. But a sliver of me also wants to hear that my perception of Ralph’s condition worsening is correct.

This is not comfortable to admit. I realize it sounds as if I want Ralph’s diagnosis to be worse than it has been. Maybe part of me does; the Purgatory of our current status quo is certainly preferable to the Hell that may well lie ahead, but the gray haze of impermanence is difficult to sustain emotionally. Sometimes I just want to know the worst and get on with it.

Also I can’t help hoping that once we have definitively crossed the River Styx from MCI to Alzheimer’s, Ralph will be more willing to discuss our situation and plan for the future (ie. leaving the farm) in ways he will not consider now—of course I realize that not only is this wishful thinking but dangerous wishing because what is more likely is that once is denial defense system stops working, a spiral of distress will set in.

So I mostly hope that I am wrong, and that he IS holding steady…that as imperfect as things are, we can continue to muddle along as long as we can. Like any couple in a marriage full of ups and downs.

Ralph’s Famous Adventure in Hog Killing —or Keeping the Stories Alive Despite Alzheimer’s

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I was making dinner the other night when Ralph called me out to the porch where he was having his daily late afternoon cigarette and beer listening to the radio. A story on All Things Considered had piqued a memory from his childhood.

“Have I ever told you about the hog killing?” he asked.

Oh God, not the hog killing story again, I thought as he launched into it. How many times over the years have our kids and I have heard this story–how he was a little kid visiting relatives on a farm with his family one fall during hog killing season, how his easily hysterical mother started shrieking, how the gory killing is mixed into a memory of getting ice cream cones. But it’s a better story in his telling than mine.

“You know you should write that story down,” I told him. “All your stories, actually.”

He nodded. “Yes, I should.”

This conversation is not a new conversation. Every few weeks we agree he has a lot of great stories, and is (or was) a natural storyteller of the Southern charm variety. I suggest he get a notebook and write the stories down. He says, yes, he definitely will do that.

But given Ralph’s inertia fed by his place on the Alzheimer’s spectrum, that’s only going to happen if I make it.

And so far I have been a slacker. I tell him and myself I will get a notebook and set aside time each day for us to work on stories, but then I let the whole idea slip off my radar as quickly as it slips from his. His excuse is cognitive impairment. Mine is laziness at making one more effort. The discipline it will take for me to get him to get the stories down is the same discipline I need—and have so far lacked—to get him to exercise more. His lack of enthusiasm gets me off the hook and feeds my own penchant for lethargy.

But I am making early New Year resolutions. I need to get Ralph walking before he puts on more (not to mention my inches and pounds). More important, I cannot wait until Ralph and I are both inspired to record, whether on audio or in writing, his stories.

Because otherwise the day will come when I ask him to tell me one or he tries to remember, and the story is gone.

Finding the Right Words for Ralph’s Condition

I have been struggling with terminology lately after reading essays by people who do not want to be called victims or patients just because they live with dementia.

I totally understand. I hate victim theology.

But I am also uncomfortable when I hear the word hero being batted around. Or survivor. As if the world owes gratitude or praise. Why does dealing with a certain disease or a disability make you heroic? Don’t most people deal with something? And what seems unbearable to one person is no big deal to another because everyone’s pain threshold—physical, emotional, and psychological—differs.

I don’t think of Ralph as a victim and he certainly would never describe himself that way. He would say he’s a guy with a memory problem. Of course, that’s not quite the whole story either, but I respect how he sees himself. So I usually don’t say more unless someone presses or unless Ralph is going to be in a situation that might be awkward; for instance his art class teacher knows why he has difficulty finishing each painting and knows she has to tell him he’s ready to move on to the next or he never would—not a simple memory problem but easy to manage. He loves his class. And the paintings once he’s told they are finished.

And Ralph is frankly no hero and has no desire to be one. He does not want to acknowledge anything in common with others in his condition. He won’t attend a support group for MCI/Early Alzheimer’s. He is not interested in educating the public on the condition or talking about it. He also doesn’t have much interest in fighting the manifestations in himself, in exercising his brain or his body. He is going “gentle into that good night” watching the sunset from his chair on the porch.bird night

Ralph is not a victim, not a patient, not a hero. Not suffering from Alzheimer’s or dementia.

I tried out a new term with him the other morning. I explained (for the umpteenth time because this is one fact he chooses not to remember) that, yes, his brain shows the plaque build up connected with Alzheimer’s, that there is no telling how quickly or slowly the Alzheimer’s will progress but so far his meds are holding his memory function steady. He accepted both the facts and the term I offered.

So from now on if anyone asks, Ralph is on the Alzheimer’s spectrum. Not a perfect description, but it works for us.

RALPH LOVES TO TALK BUT… PHONE COMMUNICATION WITH THE KIDS

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The big issues connected to Alzheimer’s and dementia are almost too hard for me to grasp at this point despite the never-ending stream of factual information pouring off the internet and in the media. It is the small moments that capture what it means to live with memory loss.  For instance:

When I get home in a grumpy mood after driving my daughter through rush hour traffic to catch a plane, Ralph is in his usual spot, the front porch rocking chair, with cell phone to his ear. I head inside without stopping to ask whom he’s talking to.

After all, Ralph has his regulars: one loyal friend who checks in weekly, his sister, and the oldest of our three kids.

He talks to his sister almost every day. Both have a lot of time on their hands. Often they can talk for over an hour. Whenever I ask what they talk about, Ralph shrugs. “Small talk.”

He talks to our oldest son almost every day. If Ralph is laughing, but again, I assume it’s Josh, but again when I ask what they’ve been talking about, Ralph says “Small Talk.”

Our much younger two kids love their dad but they are of the text not talk generation. Their phone conversation with their dad are fewer and farther between.

So I was surprised when Ralph came inside and said he’d been talking to our younger son Jacob.

Surprised and pleased until Ralph added, “I called him but he didn’t seem to want to talk. It was a short conversation. I don’t think he likes me. Was I a bad father?”

This is no excuse, but I was hot and tired when I answered with the truth. “Not exactly but not always very nice. You weren’t very supportive.”

Ralph gave me a heartbreaking hangdog smile. “I wish you hadn’t told me.”

“But you asked.” (I know, I know, I could kick myself.)

“You should have lied.”

By then I was already desperately texting with Jacob: Dad said he called but you didn’t seem to want to talk. / Really??? It didn’t seem that way to me but ok / I made it worse because I said he was kind of mean / LOL

Jacob immediately texted Ralph saying he hoped he didn’t sound “out of it” but he’d just  come in after riding his new bike home from work. Evidently they had talked at length about the bike during their not hour-long but not short conversation.

Of course, then I had to figure out to get Ralph to find the text since he never checks for texts on his fliptop unsmart phone.

I waited about twenty minutes, said my phone was dead, asked him to check his because I was expecting a message from our daughter to let us know if she made her flight. He said he didn’t know how. We looked together.

“No message from her, but look there’s one from Jacob,” I said casually and read it to him out loud.

“Why would he send that?”

“I don’t know. Didn’t you talk today.”

“Maybe so. I don’t remember. But this was nice of him.”

Guilt, angst, manipulation, all for nothing maybe. Or maybe not. Ralph went to bed smiling.

CHANCE ENCOUNTER/MUTUAL SUPPORT

So there I was in a store at the shopping center looking for a cheap picture frame when I ran into a woman I have half-known for years. Our daughters were in school together at some point in the distant past but never actually played together. Susan and I run into each other occasionally at the grocery store. We’re always cordial when we meet and joke because we seem to have the same shopping schedule, but we barely know each other. She grew up in this small town; I’m a relative newcomer. She tall, blonde and well-mannered. I’m short, frizzy haired and socially awkward.

So after we said our usual brief hellos and asked about each other’s child, I moved down the aisle. A moment later someone called my name. I turned around and it was Susan smiling but looking slightly nervous.

She explained that she had seen my name on a group email address from a local Alzheimer’s support group I attend sporadically. For a moment I was a little shocked and almost defensive—I admit I have not quite figured out how to be totally comfortable acknowledging Ralph’s condition except to close friends—but then came the flash of recognition: She saw my name on that list because she was on it too.

We stood in that aisle for I don’t know how long, sharing our stories, commiserating, advising, laughing, and occasionally holding back tears. For two women who barely knew each other, we felt a new but very real bond and a genuine affection, not unlike what many of us care-giving bloggers feel for each other.

But this was in person. And not at a meeting of a support group, which is in some ways a time out from day-to-day life in order to focus narrowly on my caregiver identity. I certainly appreciate the lovely people I have met there, but connecting to Susan was different, a reminder of how widespread Alzheimer’s is of course, but also something larger I am not sure I can articulate. About openness, and not only openness concerning Alzheimer’s. About hoe people are always deeper and more interesting than we assume. In making facile assumptions (in my case writing off Susan as belonging to a world where I didn’t fit), opportunities for real friendship may be missed.

Susan and I parted that day promising to get together again for lunch one day. I hope we do…