Tag Archives: Alzheimer’s and food

Ralph and Alice Move Just In Time to Stay In Place–Comic Relief in the Time of Corona

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Moving to a new city in the middle of a pandemic with a physically frail, cognitively impaired husband may not have been the wisest decision I ever made, but it was the only one available.

We’ve been here almost a week and every day has been crammed with incidents that make for fear, anxiety, but also a surprising amount of laughter. Problems that would be minor in normal times loom larger when they can’t be fixed in the foreseeable future; problems that would freak me out in normal times seem humorously trivial now. What follows are just a few of the highs and lows of Alice and Ralph’s misadventures because I’ve already forgotten the rest; there have been so many.

THURSDAY  We arrived much later in the afternoon than I’d hoped but with Ralph and the dogs in better spirits than I’d expected. Workmen were still here finishing the dog’s fence and putting locks on doors before heading into c-virus hibernation. The bedroom, bath and kitchen were ready though, and Ralph lay down oblivious while I met for two hours with our contractor. He wore what looked like a futuristic gas mask as he led me through the rest of the house pointing out all the work that would have to wait until who knows when. Around 8pm I woke Ralph to share a microwaved frozen pizza –fortunately my daughter had stocked our kitchen with food to make sure I was not tempted to shop.

Close to the front lines herself as a nurse practitioner, she’s very protective of her father and me. Ahead of the government, she has mandated absolute isolation: o grocery shopping or even taking the dogs on walks. And because she works at a health clinic, she and everyone in her family, including babyRalph, are off limits. I go to bed wondering if coming to New Orleans was a huge mistake.

FRIDAY   I’m up with sun telling myself optimistically that it’s a new day. I can’t wait to try out our new white and shiny shower (with a doorway big enough for a wheelchair if that time comes). I turn on the spigot. It falls into my hand. I call my contractor who forgot to tell me he’d ordered a new spigot that would be put on later today. No shower obviously so I get dressed.  Oops, I seem to have left the bag with my underwear and socks in Georgia. I am laughing as I text about my “crises” to friends.

Ralph doesn’t mind skipping a shower; he is remarkably happy lying in bed with the dogs nearby.  But to avoid contact with the plumber in the afternoon, I drag Ralph to sit in the kitchen where he watches through his window as two guys finish a few exterior tasks before leaving for the duration.

“Why are they wearing masks?”

“The virus.”

“Right, The SARS thing?” SARS it will remain in this house.

My daughter checks in from work at the clinic where her boss has just described their work as ‘staring at a freight train heading full speed straight at you.’

A bit rattled, I put a pot on the stove to start dinner listening to a news report that mentions the governor’s new regulations about social contact. Click click but no gas. I light matches. No gas and no gas smell. I take a breath and text our contractor although I know he’s had nothing to do with the stove, which came with the house. I quickly teach myself my first lesson in how to use the intimidating microwave that also came with the house.

SATURDAY   We’re schedule to get WIFI/TV this morning but given the governor’s order limiting work to essential services, I am not sure the installer will show, or if I want him to. He shows. I follow him around at a distance with a bottle of disinfectant. It’s exciting to have TV and WIFI. I fire up my Mac no problem, but when I try to turn on my business computer, it doesn’t recognize my password.  I start to panic. All our finances are locked in the computer. I take a breath; the tech guys who helped me set the password days before we moved (who needed a password on a farm?) aren’t available until Monday. I face the reality that there’s nothing I can do and that if necessaary I’ll bookkeep by hand the way I used to as long as necessary. The good new remains Ralph.  He’s forgotten all about his back pain, also that he was sick last week. He willingly sits outside with me to drink our morning coffee. He doesn’t miss the farm one iota.

The washing machine is the next thing I can’t get to work. I text the contractor, thinking to myself I can hand wash from now on if I have to.  The contractor face times with me. First he figures out why the stove is not coming on and that there no way for me to get it fixed for now. Oh well, I have an oven, a microwave, and a George Forman grill, plus an electric teakettle; I’ll get by. As for the washing machine, once we check the breakers, my contractor has me snake my arm with the phone around the machine so he can see behind. It’s unplugged! Twenty minutes later I find my bag of underwear. I am ECSTATIC.

SUNDAY (or maybe it was still Saturday, my days are beginning to run together) My daughter calls. Her boss at the clinic has tested positive. Telemedicine is going into place. Did I mention my daughter is pregnant?  I am sick with ANXIETY.

I do not tell Ralph.

He is oblivious. Physically he’s back to what he was before his hospitalization, but mentally he’s made a shift. It’s subtle, a matter of passivity more than memory. If I don’t give him a plate or a cup he doesn’t eat or drink. If I don’t order him into the shower (now working and lovely), he stays unwashed.

MONDAY  I am about to call the tech guys about my computer but give it one last shot punching in every combination I can come up with. It turns on. Maybe anxiety had me typing in wrong letters the other or maybe I have a sticky key. I don’t know but I’m not turning that machine off any time soon. I have a relatively pleasant day avoiding the world outside. I do editing, I work on a writing assignment. I unpack more boxes. I’m more relaxed than I have been in a month, but being in this new environment and out of our old routine forces me to see more clearly how much my relationship with Ralph has deteriorated as a partnership. The silence.

TUESDAY  After looking out my window and realizing that I am looking into my neighbor’s bathroom at an inopportune moment, I figure out how to hang some impromptu curtains. I am proud of myself, becoming someone who solves physical problems. I also solve a problem concerning Ralph’s prescription drug insurance. All before 10 am. But I’ve been so busy I haven’t checked on Ralph, assuming he’d call me on his cell if he needed me. I go to the bedroom where he is fine, but his phone is dead. No charge even plugged into a working outlet. I call Verizon, am put on hold, then on call back status during which time I take a quick shower. Finally a technician comes on. It takes us five minutes to fix the problem. I think to myself that I’m glad I’ve sent up a landline for Ralph to use in an emergency. Of course now I need to order an actual landline phone.

WEDNESDAY Here we are. Ralph in his realm downstairs, me up here doing work and texting friends. I’ve been entertaining my friends with daily blow-by-blow accounts of our foibles. The humor may be only skin deep—it feels flimsy in retelling here—but it is what works to pull us through.  And oddly, Ralph is almost an inspiration. He’s so damn relaxed!  I am trying to stay relaxed too, by worrying about only those issues I can actually problem solve, like cooking rice in the microwave. Or the fact that Ralph’s phone just died again.

(losing) Memory and (losing interest in) Food

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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

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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….