Tag Archives: Alzheimer’s and food

(losing) Memory and (losing interest in) Food

food.jpg

My lunch today: a salted dark chocolate covered caramel. And it was just as delicious as it sounds. I am telling you this dirty secret (not that I eat that unhealthily every day, but the caramels were on sale at the store and called my name; plus it was my birthday) because I may not be the best judge of anyone else’s eating habits given that food looms so large in my life. I love taste and texture, salt and fat and sugar and acid. I eat for comfort and I eat for joy. I am as much gourmand as gourmet (and not a little obsessive about dieting as well). My favorite movie may be La Grande Bouffe, about a group of men who eat themselves to death. It’s one of Ralph’s favorites too.

In fact, I would say eating, along with arguing over politics, has been the activity we have most enjoyed sharing as a couple.

When we first met, Ralph was not terribly into food. He liked breakfast, mainly because it was cheap and fast. But he quickly converted. I was a restaurant reviewer for a while, and he loved going with me to restaurants. He loved the ambience of a fine dining establishment and of a funky, edgy dives. He loved experimenting with new flavors and spices. He also loved my cooking. And occasionally he loved to cook—there was a period when he got into soup making and took over making dinner for months on end.

I still love eating.

Ralph not so much.

We all know that in the late stages of Alzheimer’s, eating becomes difficult and eventually impossible. I dread that time and Ralph, thankfully, is nowhere near that incapacity. But day-by-day his eating routine has been evolving that mirror larger changes in Ralph.

He still claims to love my cooking. No matter what I put in front of him at the dinner table, he tells me it is delicious. Even sad leftovers mixed with canned soup. And he always eats his dinner. But he’s never what I’d call hungry. He never asks for a dollop more than what I put on his plate. He certainly never asks for seconds the way he used to every night. He always has a nuttybuddy ice-cream cone for dessert. Even if we have company and I’ve prepared a special dessert, he prefers his nuttybuddy.

This has been our dinner routine for a while. He also has cereal every morning for breakfast and a sandwich for lunch with a glass of milk. He has lost some weight over the last year or so because he doesn’t eat snacks anymore (unlike his spouse who may have put on the same number of pounds he’s lost), but if anything he looks fit and healthy.

The thing is I went away for one of my babysitting stints last week. Before I left I cooked chili and stew and bought a roast chicken. I divided meals into nightly portions I labeled. I filled out his life list in detail, telling which foods for which nights. He looked it over and we were all set.

Our friend R. came to stay with Ralph for the first few days I was gone. Then for the rest of the time I was away, I had arranged for another friend to “drop by” daily. One day she made him banana bread. The next she used up all the salad greens and pears etc. he wasn’t eating and made him a big salad. Every night when I asked him if he’d had dinner, he said yes he had eaten or he was about to look on the list and eat as instructed.

Nevertheless, when I got home all the chili and most of the stew I’d left was still there. So were the banana bread and the salad. And half the roast chicken. And some spaghetti R. had evidently cooked.

Ralph had found it easier to have a peanut butter sandwich for his supper than microwave a bowl or plate from the fridge.

This is not a big deal in the scheme of things. He remains healthy. He did eat. He can make a sandwich and he did heat and eat at least one bowl of stew. And I froze the leftovers to use another day. From now on, if I am gone I will be even more explicit on the life list and will verbally walk him through heating up his dinner every night.

But I feel sad. Ralph’s disinterest seems to be spreading slowly over our lives. I realize I can’t leave him as easily as I have in the past.  That he needs to be watched over, not because he can’t function but because he’s just not that interested.

 

Ralph’s Annual Alzheimer’s Test, 2018

drive thru

 

No surprise, Ralph’s subscription to Alzheimer’s has been renewed. I know the analogy is illogical but that’s how I sometimes think of his annual mental check up.

Does that seem blasé?

It’s just that every July the routine is so similar. We get to the building after a long anxious car ride, Ralph takes the standard hour long test while I meet with our Nurse Practitioner Stephanie privately, I tell her (every time) that I sense Ralph growing less engaged, Ralph joins us after his test and Stephanie checks the results before telling us that he has pretty much held steady. Some element of the test usually shows what she calls “a little slippage” from the previous year but never as much slippage as I expected or think I’ve noticed.

For instance, this year his tests results showed that compared to last year, he forgot three more words on the word retention section or two connection on the connect-number-and letters section (a test I found difficult myself when I took it as a part of Emory’s healthy aging study). Stephanie seemed less concerned about those scores than she was that he had answered two more answers denoting possible depression than he had last year. So we have upped his lexapro back to what it was a few years ago when in retrospect he seemed almost jolly.

I think Stephanie is wonderful, perceptive and caring. I think so particularly after she specifically asked if I still travelled to see my grandson; I said yes with a bit of embarrassed hesitancy, remembering a call from a friend who with best of intentions told me Ralph seemed lonely.

“Well you definitely should,” Stephanie began and in that half second before the next word I groaned to myself that she’d found me out as a caregiver will to abandon her caregivee), “continue those trips.”

So I love and believe totally in Stephanie.

But after four or is it five years, I’ve finally acknowledged to myself that the annual test is limited in its efficacy. My personal test results for Ralph were a little different this year. What I noted were two concrete-ish differences from a year ago and maybe a third.

  1. On our to Emory Ralph told me he was beginning to feel foggy more often. “Foggy” is a term he used a lot before he went on his medications way back when he was first diagnosed but has not used much since. I was a little, if not exactly alarmed, concerned. (Of course, when I brought up what he’d said in front of Stephanie, he didn’t remember saying any such thing and denied any new fogginess.)
  2. Two or three years ago, Ralph happily agreed when I suggested we pick up Cuban sandwich at a funky joint nearby that we used to frequent when we lived in the city. The next year he became less enthusiastic about the inconvenience of going out of our way to a restaurant. Instead we fell into the habit of dropping by the on-site café every time we came to Emory, which was quite frequent while Ralph was in his now defunct Merck study. But after this visit when I suggested the café, he demurred, not exactly adamant but firm. He wanted to swing through a drive-through, lately pretty much the only place he’ll reluctantly eat away from home. The Emory café is nothing special but the food is relatively healthy and I have always looked forward to that little break in our routine, a little moment of civilized social normalcy. That his unwillingness to eat in a café was upset me may say more about me than Ralph. Food has always been kind of passion. I feel the loss of eating out sharply. It was one of the few activity we always shared as a couple, both of us adventurous and willing to try pretty much anything, both of us fascinated by the culture of food, both of us drawn to both high and low cuisine. I briefly thought of insisting we go to the café, and maybe I should have. Instead I acquiesced and swung us into a Burger King. But I was resentful. After ordering Ralph his sandwich and soda, I passive-aggressively ordered only a diet soda for myself, while reminding Ralph, “I’m on a diet and there is nothing on the menu I could eat.” (Oh, please, I was starving by then dying for a greasy burger.)
  3. Bonus difference point, He didn’t notice I was upset. Me being passive-aggressive and resentful is nothing new in our relationship. It may have been the bedrock of our relationship: whenever I got passive-aggressively resentful, Ralph more than noticed and would turn surly and aggressive back. So I honestly don’t know if change number three is for the better or worse….