Tag Archives: Alzheimer’s marriage

The Case of the Missing Car Keys: A Clash of Memories

Alzheimer's Spouse Issue, Uncategorized, , , , , ,

keys.jpg

“It’s the unacknowledgement of a reality that is constantly hitting us, as spouses, in the face, but for which reasonable, constructive dialogue is either ineffective or impossible any more. Quite draining, and erodes the bond we knew and loved with our spouses.”–Jabberwalky08, responding to my last post, expresses the predicament of the spouse caregiver beautifully.

 

So Ralph’s car keys are missing. Actually he couldn’t find them the morning after his evening of too many beers, but I didn’t think too much about it when I wrote last because I assumed they’d show up. They haven’t

That first morning I’d already left the house when Ralph discovered he couldn’t find his keys. I told him where the extra set was and he seemed mollified. But that afternoon when he still had not found them, he was upset.

“You don’t remember where you put them when you got them out of my car?” Ralph asked as I helped him look. His tone was level and very polite, as if he was trying to avoid embarrassing me.

“But I didn’t get them out of your car.”

“Ok, but if you had where would you put them?”

“I would hang them on the key hook with the other key.”

“That doesn’t make sense since you’d want to hide themfrom me.”

“But I didn’t want to hide them, because I didn’t get them out of the car.”

“I remember you getting them out of the car. You were afraid I’d drive inebriated.”

“No, I had not reason to be afraid because you went straight to lie down. Anyway, I was holding raw chicken breasts when you came in the house. Don’t you remember?” Stupid question to ask, I know.

“I remember you getting the keys.”

“I didn’t get your keys.”

“But if you did, where would you hide them.”

Are you getting bored and frustrated yet?

This conversation, or a longer version, was held and repeated in several variations every time we were together. Ralph always remained remarkably calm, probably because he didn’t remember asking or answering the same questions two minutes ago. I became increasingly annoyed. “Which one of us has memory issues?” I blurted out at one point.

I have learned over time that what is remembered by someone with cognitive impairment can be just as problematic as what is forgotten. But now we were on a new level of looping memory.  We’d become a microcosm of what pundits are so busy discussing about facts, alternative facts, news and fake news. I knew I had not been out to Ralph’s car, taken his keys and hidden them. But he knew I had.

Ralph can be very convincing when he believes something, and his certainty was stronger than mine. After all, I have the niggling awareness that there have been enough occasions when I have done something similar—hiding beer cans for instance on a daily basis. I didn’t take the keys this time, but I could have and might in the future.

So I began to question myself. Could I have done something with his keys and forgotten? Was my memory going. 

NO, I really couldn’t have and didn’t. And NO, my memory is not less trustworthy than Ralph’s

BUT there was no reconciling my sense of reality and Ralph’s and no arguing to a comfortable conclusion.

It would have been a darkly depressing state of affairs except that in saying I’d taken his keys, Ralph was also acknowledging that he’d drunk too much–that the drinking caused the loss of the keys, whether by his hand or mine. That knowledge has made him more willing, at least for now, to follow my rules and schedule. Last night as he headed to the porch, I nagged him to make a check on his life list to account for the beer he was holding. He merely shrugged, but a minute later he came back inside.

“Thanks for  working so hard to keep me alive.”

I was speechless. For a moment we were living in the same reality. Then, lulled into thinking we could chat, I mentioned that our older grandchildren were arriving on Thursday.

“Why are they coming?”

“Christmas.”

“Is it Christmas? Oh so is everyone coming for Christmas?”

“No, we’re all going to New Orleans on Friday.”

“We are? Oh, I forgot.”

It has been twenty-four hours since Ralph has mentioned the missing keys; that’s good news but the bad news may be that he’s forgotten he lost them. And because we live on different planes of communication, I can’t bring myself to ask him.

When Forgetting The Past Becomes Remembering the Present Wrong

Alzheimer's Spouse Issue, Uncategorized, , , , , ,

error

“So, Alice, when do we have to leave for the birthday party”

I come home at five in the afternoon to find my husband showered, shaved, and dressed in a clean shirt. Sounds great, doesn’t it, Ralph getting ready on his own?

Only problem is that the  party he is talking about is a dinner I wrote about here weeks ago. The one he clearly didn’t enjoy attending at the time.

“We aren’t going to a birthday party.”

“Are you sure. Well, why did I think we were?” Puzzlement all over his usually placid face.

“I’m don’t know. We had dinner for H’s retirement three weeks ago.”

“We did? I don’t remember.” It is almost physical, how hard he is thinking before a memory takes shape. “Oh yeah, it was boring. Well, I’m relieved. I spent all afternoon dreading the birthday party.”

“Since you’re dressed, why don’t we go out to supper?”

“I don’t feel like going out. It’s too late.”

“Are you sure.” He is spiffed up after all, and it would be good to get him out of the house and his rut. Also, frankly, I wouldn’t mind not having to cook.

“No, I don’t feel like going out anywhere.” He shakes his head, standing by the door to the porch. “You sure you didn’t tell me we had to go to a party tonight. Why would I think we were going to a party?”

“I promise, we went to dinner for H’s retirement three weeks ago. Maybe you had a dream while napping and it felt real?”

“Maybe.” He shrugs and heads onto the porch, unlit cigarette already  in one hand, beer in the other, dog at his heels. We will repeat the same conversation throughout dinner but now, clearly shaken, he needs time to himself (as do I).

The way that facts once forgotten can’t be retrieved has become our normal problem as an Alzheimer’s couple, annoying but easily handled. But now Ralph has presented me with a created, or rather mis-created memory. A new process has misremembered, twisted and reshaped a fact before lodging it in Ralph’s brain. Will our new normal problem encompass not simply a loss of Ralph’s sense of the past but a reshaping of his present reality into something unpredictable, unreliable and disturbing.

Alzheimer’s Shrinks Ralph’s World and Ralph

Alzheimer's Spouse Issue, Uncategorized, , , , ,

sculpture

 

I have been focused a lot recently on my reactions to Ralph’s slide along the Alzheimer’s continuum. But after a weekend apart, I am struck anew how much Ralph’s world has changed.

His memory seems to be holding, at least as far as facts are concerned. Not that it is good or anything like normal, but it remains generally on the same plateau it’s sat on for a while now. He repeats himself; he asks the same questions over and over. He remembers certain details from a conversation and obsesses on them. And he repeatedly forgets not only conversations but also what might seem large basic facts. While I was away he spoke on the phone to a friend who was disturbed that Ralph seemed to think I was home. “He’s never seemed confused that way before,” she said to me with concern. His forgetting can seem like confusion, but really it is not. When he called me to ask me to pick up some dog food (which I had forgotten to do before leaving for the weekend) and I joked that I could get the dog food in New Orleans, he laughed and admitted he’d forgotten and then went on with following his daily routine “life list” perfectly well.

But while he has remained on this memory plateau, the sands have been shifting beneath him. The lack of memory has changed who he is.

So while I would define his forgetting for the moment that I was not in town as a memory problem, not a confusion problem, I have seen him confused, and I think he is more prone to confusion than he used to be. When he can’t remember, he grows anxious, and when he grows anxious he has even more trouble remembering. A spiral top starts spinning. Similarly, sometimes he can’t grasp what I’m trying to explain because his anxiety about not understanding twists him into an emotional knot. (And I realize that when I talk to others now, I tend to over-explain out of habit, but that’s another subject.)

He is also fearful–in part because his weakening memory leaves him uncertain from moment to moment, but also because he’s become a person with a very limited world and like many confined to limited worlds he has a fear of the unknown.

And hand in hand with fear is a sluggish passivity, a disinterest in what lies beyond the immediate scope of his memory . He has less and less physical, mental or emotional energy to engage with others. I have noticed that his sister and oldest son, both of whom  used to talk to Ralph frequently and enthusiastically, seldom call now. And I understand. It is hard to talk to someone who only wants to repeat the same few conversations over and over. Patience wears thin. People have their own lives to get on with.

Of course, I often resent and feel trapped by Ralph’s limitations myself. But today I am sad–for Ralph and for how his identity is being chipped away in small but steady increments. Does he know? I’m not sure. It feels as if I were watching the act of sculpture in reverse—the vibrant image of a man being returned to stone in slow motion.

Stasis Defines this Alzheimer’s Marriage, At Least for Now

Alzheimer's Spouse Issue, Uncategorized, , , , , , ,

“Stasis (from Greek στάσις “a standing still”) may refer to: A state of stability, in which all forces are equal and opposing, therefore they cancel out each other. Stasis (political history), as defined by Thucydides as a set of symptoms indicating an internal disturbance in both individuals and states.” From Wikipedia

Well Ralph and I definitely fit the definition, which I looked up after one of those small moments that clarify the big picture

 

knox toddlerWhile face-timing with me this morning, BabyRalph threw a little tantrum when my daughter wouldn’t let him hold the phone. As he kicked his legs, my daughter laughed, “He is becoming a toddler.” My emotional reaction was “Oh no, I want him to stay an adorable baby forever.” But of course, I also want him to grow up and am excited by every developmental step he takes. Just now, I had the odd and uncomfortable realization that my wishes for Ralph follow parallel lines, only maybe in reverse.

Ralph has maintained his cognitive abilities on about the same level for long while now, around five years. This plateau has been an incredibly lucky break for us. When I read and talk to other caregivers whose loved ones were diagnosed and then nosedived quickly, I marvel at Ralph and my good fortune.

We still live a mostly normal life, at least on the surface. If anything, Ralph’s routine has hardened and within its walls he functions very well. I keep his pillbox filled, his clothes clean, and his meals prepared just as if I were any wife (well any wife in the 1950s, although my housecleaning and disposition fail the Leave It to Beaver test). He spends most of his day in his “office,” even if all he does in the “office” is listen to the radio and talk to his dogs. So I have plenty of free time to carry on my life. We eat dinner together watching Jeopardy and then he goes to bed.

This is not a hard life. Yes there is the underlying stress of his shot memory and his general cognitive decline, the loss of his curiosity and engagement with the world beyond our mailbox. But really, life could be so much harder. Living with Ralph is now like living with a child who is not going to grow up. Whose developmental steps if he takes any will be backward, toward a kind of funhouse version of babyhood.

As much as I want BabyRalph to stay my snuggly grandbaby, it is fun to imagine him big enough to pull that rake in the picture above. I cannot and don’t want to imagine Ralph’s future. And yet I also have to admit an ugly truth. I imagine what my life will be like when Ralph’s cognitive abilities deteriorate with horror but also sometimes with a kind of relief. The urge to get out of the stasis–which in the case of Alzheimer’s includes both standing still and inner disturbance–is real, even when I know the escape will be to a much darker, harder place.

I Commemorate my Dad’s 100th Anniversary; Ralph Celebrates Him Daily

aging parents, Alzheimer's Spouse Issue, , , , ,

scotch.jpgMy father would have turned 100 yesterday if he were still alive. Ralph and I celebrated with one of Dad’s favorite dinners: roast beef with truffle sauce, or rather a cheap cut of beef I found on sale and a dab of Croatian truffle olive spread we received as a gift.

“I really miss Charles,” Ralph said several times during the meal. Charles was my father. Ralph brings him up almost every night at dinner. And frequently at other times as well.

“You know I was thinking about your dad today.” “Remember the time your dad….” Charles was a character.” “I really miss old Charles.”

Me too.

My father was tall and elegant, charismatic if not traditionally handsome (bald but in a Yul Brenner way), an extrovert both charming and domineering. And he definitely had a temper. My siblings would agree that he was a better father to his daughters than to his sons, who were made to feel that they didn’t live up to his standards and expectations. My sister and I adored him, and as a little girl I never doubted that he adored me back, but our relationship grew complicated during my teens as I began to rebel. We never quite regained the closeness.

But if anything redeemed me in my father’s eyes it was Ralph.

Ralph and Charles were soul mates. They came from completely different backgrounds—my father the son of a Russian Jewish immigrant who made good and sent my father to an Ivy League college, Ralph the son of a Pentecostal mother who spoke in tongues and a father raised dirt poor in the hills of Alabama with ancestors who fought in the Civil War and possibly the American Revolution—yet they recognized themselves in each other from their first meeting.

They liked to schmooze as my father called their never-ending conversations about business and politics. Again, it would seem they had little in common. My father ran the business his father had started; Ralph was an entrepreneur just starting his real estate business when they met; my father was a Nixon republican, Ralph still a socialist when I introduced them. Nevertheless they talked and they talked and they talked, often loudly though never angrily, into the wee hours long after my mother and I had gone to bed. No doubt they were fueled by scotch, my father’s drink of choice, which he introduced to Ralph.

After a restaurant dinner with my parents months before Ralph and I ever discussed marriage, Ralph told me that my father had proposed while I was in the ladies room. My father used my absence as an opportunity to tell Ralph he would be very happy to have him as a son-in-law. I am not sure how Ralph responded.

Of course I was pleased that my father approved of my choice in husbands, but I admit I was also a bit jealous that my father clearly enjoyed Ralph’s company more than mine. I can only imagine what my brothers felt witnessing Ralph and Charles’s rapport, a rapport they did not have as Charles’s sons.

As for Ralph—whose own father, a skilled but uneducated mechanic, was a master sergeant when he retired after twenty years in the air force and never quite adapted to life as a civilian—he suddenly had the father he’d always wanted. He listened to my father’s advice with rapt attention. He lapped up the affection and praise.

And when my father died at 73, Ralph mourned much more deeply than he had when his own father died.

Months later, a whippoorwill settle outside our bedroom window at the farm and Ralph and I began to joke that the bird was my father’s reincarnation keeping us up at night . It was a comforting joke, an intimacy I look back to now with nostalgia, but it was a joke, a way to ignore or minimize sorrow.

Since Ralph’s cognitive impairment began, my father has loomed larger in his memory. As I have mentioned before, Ralph only holds onto happy memories these days. And his memories of my father are among his happiest. In the last few years he has decided that my father’s old marble top bar, now in our small formal parlor, is haunted by my father. In a good way of course. At least several times a week he calls me to come into the room because he senses my father’s presence.

Pre-MCI Ralph might have joked about a whippoorwill, but he is completely sincere now. And his belief is NOT a case of dementia. It is a case of affection so strong that it has taken a shape or at least a form. For all the negatives of Alzheimer’s, Ralph’s ability to feel purely is really a joy. And I am a little envious of his relationship with my father all over again.

Another’s Sorrow

Alzheimer's Spouse Issue, Uncategorized, , , , ,

________________________________________________________________________________________________________________________________________________________________________________

The other day a friend with whom I’d fallen out of touch let me know that her husband had died suddenly and unexpectedly in the last year. Although I’d met him only a few times, and his was certainly not the first death I’ve heard about lately,  the news struck an unexpectedly sharp chord.

The thought of one’s one mortality is inevitable when someone else dies. Death has becomes a tickle at the back of my thoughts over the last few years , and although I have more or less adjusted to the fact that Ralph has cognitive impairment, I don’t like to be reminded that I am aging too, that my capacities are altering. But I also found myself disturbed for reasons less socially acceptable, less acceptable in every way.

Even as I mourned his death and felt deep sympathy for my friend’s sorrow, I found myself comparing marriages. My friend and her husband had shared a long marriage, one of those rare solid marriages that withstand challenges, obstacles and the inevitable periods of disconnect that happen to us all, only to grow stronger with the passing years. While there had been physical impairments, they had shared travel and adventure right up until the end. Ralph and I share so little. The stab of petty envy I felt was ridiculous—she’d lost her husband for heaven’s sake—but I felt it.

And what’s worse. I also found myself envying the purity of her grief, longing to possess that capacity for heart-wrenching love for a spouse. My love has become so mottled.

These are embarrassingly ugly reactions to another’s loss I know. But I record and sort them out so I can put them aside. Grief is complex. I am only beginning to navigate its complicated waters.

 

2 Conversations With Ralph–one bittersweet, the other just bitter

Alzheimer's Spouse Issue, Uncategorized, , , , , ,

 

When the kids were small, I always knew our best conversations happened in the car.dialogue.jpgStrapped in seatbelts the kids tended to open up more about their lives; now Ralph does the same. We were driving home from a visit to his dermatologist when he brought up an issue that has clearly been bothering him.

“My IQ score has dropped,” he announced out of the blue. “Is that normal?”

“How do you know that?”

“I saw it on my chart last visit.”

I don’t know how he saw this nugget of information (or even if he read it right), let alone remembered, but I realize that problems  he cannot sort out seem to get stuck in his brain, like gum on the bottom on his shoe that he can’t shake off.

“Well memory probably affects IQ results.”

“117 is still above average though right?”

“Right.” My heart ached with protective affection.

…xxx…

On the other hand, Ralph and I have always had our worst conversations at night when we are tired and Ralph has had some drinks.

dialogue two.jpg

So last night while I was trying to relax after a long day by watching mindless TV at the kitchen table, Ralph stormed out of the bedroom.

“What was the name of that real estate agent who tricked you into selling too cheap?”

I told him the names of the agents we used, one a friend of his. He grumbled some more and went back to bed, only to return moments later and begin to rant about how we were cheated and I should have known better.

He was talking about some property we sold in 2013, the year he got his diagnosis and was still half running things. He had chosen the agent and begun the negotiations pre-diagnosis; I had completed the deal post-diagnosis. Ralph and I had discussed the terms exhaustively. I didn’t want to sell the building at the time but he insisted.

Those months were among the worst in my life, a time I’d rather not remember myself, filled with my mother’s precipitously failing health, Ralph’s heightened, often angry anxiety over his diagnosis, our desperation to sell our business profitably, the sharp learning curve I had to master while laid up in a cast after I crushed my ankle falling on black ice. I did not necessarily make stellar business decisions, but frankly I handled it all pretty damn well considering.

In Ralph’s head last night, we had sold the property just weeks ago and he was obviously obsessing over the numbers (which he had wrong). As he began to berate me, I pretended to be absorbed in Saturday Night Live. In fact I was stewing in resentment and in memories of Ralph during the middle years of our marriage when I often felt he bullied me.

Then he switched gears.

“Where’s our money now? Who are those people who supposedly manage our investments? How do you know they are not going to take our money? You need to make sure they can’t steal our money.”

What I felt as he ranted was about as far from protective affection as you can get—hot white hate tinged with damp self-pity that I was stuck with him until one of us died.

This morning Ralph brought me coffee in bed, as sweet as could be. The conversation has erased itself from his brain as if it never occurred. I wish I could say the same, but I can’t.

 …xxx…

 

*A side note: as we were entering the examining room, the nurse behind the desk said to another nearby, “The Alzheimer’s patient is here now.” I clearly heard and am sure Ralph did too, but neither of us brought it up, not even in the car.