Things that disappeared with Parkinson

Teasing and associated humor — We have been married more than a half century. That qualifies us as an old married couple. At one point we could finish each other’s sentences. I could understand what she wanted by a look. We would banter and tease each other. With Parkinson that is all gone. Mostly. For maybe an hour or two after breakfast mild banter can occur but later in the day she will start thinking that I am picking on her. The switch is sudden. Sometimes I miss it.

Implication, inference, analogy — the parkie brain seems to struggle with inference. But she will still do it to me. The garbage can is near full. Instead of, please take the garbage out. We all do it.

With dementia and memory loss issues it doesn’t work.

Linear logical thought

Ability to follow directions (recipes)

Stick-to-it-tiveness, persistence — the opposite of apathy– is completely gone. I have not had to deal with a child that has ADHD, so, I have no comparison but many of her behaviors seem to mimic this disorder.

Intimacy is very different and difficult… I make no reference to sexual intimacy. That left us a few years ago. These days it is necessary for me to intrude into toileting. Never when I said I do did I think I might have to keep track of bowel movements. It is typically a very private event. PD however brings with it the side benefit of constipation. Memory issues do not help. Self reporting does not accomplish what it might if she could remember the last time she pooped. Hanging on to feces for long periods can send one to the hospital. PD patients should do all in their power to stay out of the hospital.

Carpe Diem — stay connected.

Recurring Themes

There are days, and this may be one of them, when I wish for Cheryl’s physical Parkinson’s symptoms to be worse and her mental Parkinson to be less. She actually moves quite well with the C/L in her system during the day. If in the middle of the night she might get up to toilet once or twice she moves pretty well then too. She might be slow and slightly disoriented but at 3 AM I am too.

Late Autumn and Winter is the worst for her mentally. Last evening she stayed up very late; frantically organizing and reorganizing her papers and cards in her office. She eventually allowed me to help her to bed about 11:30 PM. I heard the clock strike midnight before she succumbed to sleep. She had been talking gibberish about the kids.

five repetitive themes

She is often confused as to who I am. I am that other Paul. I am Dad (as I was last night encouraging her to get rest before our big outing with Marilyn.) Some times I am Scott but if not she will ask, “Did Scott go home? Or, Is Scott here?” Some of this is simply aphasia and she cannot find a name in her head. (Me too, occasionally.) If I cause stress in her by insisting on something she will be very anxious about me being around. Insisting is always a bad idea but I often forget that. I try to hedge and let her decide she wants to – go to bed, eat dinner, have a cookie, have cereal for breakfast, etc. Often that works, often it does not. It can be frustrating when you are also tired.

“I want to go home now.” – She believes for a time often late at night that she is not home and wants to go home. Sometimes this delusion is overpowering and I help her find shoes and a coat and I drive her around a four mile circle and home. I reinforce the we are home thought by saying plainly, “we’re home now. I’m glad to be here finally.” That will reset her brain and she starts to think we are home. Sometimes it works only partially and she thinks – wow, this is neat. How did they get all our stuff here so fast?

Recently she has asked how we will get all our stuff home? Do we need to get some movers? I merely replied yes, I will call them tomorrow and set it up. — I wonder how long the “I will take care of that tomorrow” ploy will last. For now it does. She has not yet asked when I was going to call the movers in the morning while I am organizing breakfast.

“We are in Detroit” When Cheryl went to high school she was following the prescribed path to become a Franciscan nun. I met her originally in the summer between her junior and senior years in high school. When she was a freshman, a teacher she had realized she may have some potential in english or journalism and arranged for Cheryl and a couple of her classmates to attend a journalism workshop in Detroit for a couple weeks between her first and second years in high school. It made a deep impression on her. In many ways, when she talks about it, it was as though she traveled to a foreign land. And she thoroughly enjoyed every aspect of it. Her favorite TV show and the only one she really watches is a show called Bob (<3) Abishola which is set in Detroit. Watching the the show, she will tell me stories about Detroit but mostly I think she looks at the screen because some views will spark a memory.

“When are we going home?” Is her theme some evenings when she is sure we are in Detroit. I did not realize at first where she thought we were. I discovered this later through conversation. — I can respond, “We are staying here tonight and going home in the morning. Is that okay with you? It is late and would rather drive home in the morning.” Most times traveling along with this theme she responds with, “Yes that is a good ideas. We should rest first.” Once in awhile the Detroit delusion lingers until morning. It is often gone at breakfast.

It is time for office work — is usually a physical activity. In our second bedroom that became her office when we bought this condo she will spend time organizing. Or doing nothing. It is her version of punding. If she starts doing it at 9 or 10 PM there is no easy fix to getting her to be interested in sleep even when it is obvious to me that she is very tired. She takes a prescription to help her sleep as well as melatonin to help her fall asleep but her will is strong when she decides to – get this stuff organized. It breaks my heart to see her do this mindless activity. Last night I sat with her because the later she stays up the wobblier she gets but her confused mind will not let her see this in herself. In her brain she is a 35-year-old computer database analyst and the deadline is tomorrow.

These behaviors generally occur late in the evening. I sometimes succeed in not being Mr. Cranky Pants. This part of His plan sucks for sure. It is hard to be calm when the Plan has dumped on you and the previous night was smooth and uneventful.

Whiskey Tango Foxtrot comes to mind.

Carpe Diem.

Merry Christmas

In this season of happy and family and celebration, after I have gotten through all the wrapping and cookie making and other organizational tasks, I slow to take stock of the year. Good things happened and not so good things happened but mostly this year was. It is in the past now.

Throughout this year Facebook is a personal source of joy, amusement, interest, empathy and puzzlement. When some political whiny rant appears, I am puzzled by the things total strangers will say to others that they would not say in person. I am filled with joy at the pictures of children both young and old. I am amused by the various MEME cards that folks post, sometimes without thinking. I am interested in other care giver’s thoughts as they travel down their road of Parkinson. And I am empathetic to their particular struggles. In this collage of pictures selected in no particular sequence are pictures of things, people and MEMEs that appeared on Facebook during the past year and I downloaded to my tablet as I watched the TV news and waited for Cheryl to wake up.

The good things

  • The joy in Zachary’s face. He always makes me smile.
  • Luke’s artistic muses in photography
  • Family
  • family gatherings
  • Max is off to Miami University — I am class of ’72
  • Laurencia is 21!
  • Cindy Smith
  • Linda Weisgerber
  • Kathy Mellen
  • Mary Jo Horton
  • Jane Pohlman
  • Parkinson Community Fitness
  • UC Health
  • Jeff and Stephanie’s ELFie – Elizabeth Laura Fisher
  • Zane and Charlotte
  • Lydia (think songs from the Music man)
  • Anniversaries
  • Anna’s 50th birthday (I love you)
  • trips and vacations
  • New people in our lives
  • Looking back and memories
  • Learning how to make cookies
  • Sr. Carren and Nancy Strapp
  • Visits from friends of Cheryl
  • Phone calls to Cheryl from her friends
  • Special friends
  • small faces and their happiness
  • Jana Ann
  • The class I took on being a good care partner (Linda stayed with Cheryl so I could go.)
  • A new found interest in cookies and muffins
  • Finding out that adjusting meds, schedules and eating has reduced Cheryl’s upset stomach to non-existent almost. (and the neurologist MDS says bravo.)
  • Lunch with Marilyn

The not so good things

  • Constant reminder of Parkinson
  • Anna’s Fiftieth birthday (wow, I am old.)
  • Cheryl’s lost memory
  • Learning how to make cookies (there have been disasters.)
  • Cheryl’s worsening confusion in the evening
  • dementia in all its forms – delusion, hallucination, Capgras, sundowner, showtime
  • frost on the window (I have never been a big fan of winter)
  • avocados
  • Cheryl wanting to talk (call) to her mother in the evening (which worries me – I think – unnecessarily.)
  • Late night punding in her office

These are both incomplete lists. However the good list is already way longer than the not so good list. (And a couple of those are tongue-in-cheek jokes.) I constantly try to turn away from letting Parkinson and dementia drive our life.

I will probably add to these lists during the holiday down time.

Carpe Merry Christmas Diem.

A Friend Called

Sheri called yesterday afternoon and talked to Cheryl some time. Cheryl was working on “organizing her office”. It was a slow day for her. It was the anniversary of her father’s birth. He has been gone for some time now but if he was alive he would have been 100.

Sheri had called a couple days ago in response to getting a Christmas card from us. I found the message she left on our phone when I listened to the message from my brother-in-law. He had called to wish us a Merry Christmas and I did not pick up right away because we were eating. I discovered Sheri’s message from a couple days prior. Sheri is a dear friend. Her sister has Parkinson in one its many flavors also.

Sheri,

Thank you so much for calling Cheryl yesterday. She was having a slow day. 

Yesterday was her Dad's birthday. If he was still alive he would have turned 100. Her brothers and us gathered at her Dad's favorite bar in St. Bernard last night. She had a good time I think but did not always know what was going on. 😔

When you hung up the phone she asked me who she was talking to. She sometimes forgets who called and is too embarrassed to ask. I often stay near her when she is talking to someone and ask something using the person's name. I was busy with other chores. Memory loss, aphasia  and confusion is a constant struggle for her.

You called while she was sorting through a bunch of old Christmas cards and some new cards on her desk. She reads and rereads them and has long conversations with each person that she tells me about later. Greeting cards are important to her. She cherishes all of them and rarely throws them away. 😁

Thanks for calling. I could hear that for awhile she was talking to a friend on the phone and working on her stuff. You lifted her spirit. Earlier in the day she told me she was sad that all our parents are gone now which is a pretty lucid thought for her. She talks about and to her Mom and deceased sister Janice a lot. 

You have no idea how much you helped yesterday. 

Thanks again, 

I thanked Sheri for talking to Cheryl. Cheryl becomes very animated when someone calls her on the phone. When we come back from anywhere her first thought is to go into her office and check for messages on the landline. real people rarely call our landline. It is not actually a landline as voice over IP became popular perhaps 20 or more years ago. Cincinnati Bell changed its name to Fioptics (again) to highlight its business. Many years ago it was Broadwing. (I don’t know either.) I have digressed.

This article talks about the importance of staying in touch with older adults. It target was old people during the height of the pandemic pandemonium but it is a thing to think about with any older adult with an isolating disease like Parkinson’s or Alzheimer’s. Older adults do not always realize that they are isolated. Children and family could call and check up if they wanted to do that.

Now if I could get her brothers or sisters to call arbitrarily out of the blue once in a while, much would be better.

Carpe Diem

A Nice Dinner

We went to one of our favorite places to eat dinner tonight. Friday night with my girlfriend, best friend, lover, mother of our children and life companion. It was a good time. Christmas decorations are everywhere. People are visiting and gathering for the holidays. Bacall’s Cafe was loud. It was full of us old people chatting and eating and drinking and gathering. We were all catching up with each other and the world.

It seems to me that the smaller local restaurants have better service. Those restaurants seem to provide employment to the youngsters in the neighborhood.

Friday night has a special atmosphere. It always has for us. When we were younger and still working full time for others, it marks the end of commitments for the week. Often Cheryl and I would meet for a quiet dinner somewhere. Just us and our conversation was a special time to relax and take stock of things. When the kids were small Friday was often chaos. But those years passed by too fast and it was just us again.

These days I think that it is important to stay with her in her remembrances. If she wants to talk about long ago I try to stay with it. But I also try to gently steer her to the present if she has strayed far off the road. As we were driving to the cafe she asked me where I wanted to celebrate my birthday next week. — Her deceased father’s birthday is next week and her brothers had been talking about meeting for dinner somewhere to commemorate that event.

I am still on a learning curve with this sort of conversation but I calmly reminded her who I am and reiterated the conversation about celebrating her dad’s birthday. I switched the conversation to where do you think we should go? She switched it back to I wonder where Dad would go if he was here. And we went down that road for a bit until we arrived at the cafe.

AHA: Preserve any routines you can. Embrace any memories she has. Calmly help her find her way back to the here and now. Emphasis on calmly and watch the pitch and tenor of your voice.

Date nights are not always for the young. We had a long wandering conversation about the place we were eating. We talked about other places we have been. We talked about family. She had a coke. Years ago it would have been a glass of rose or white zinfandel. I had a gin and tonic. Years ago it might have been a nice single malt scotch. As we have aged we both like sweeter things. It was a good time.

As we were getting into the car for the drive home, one of her old time friends, Donna, called my phone. I almost did not answer. Robo-calls are annoying. Donna had gotten my number from one of Cheryl’s friends that she had met in church. She called to get together for lunch one day after the holidays. A new conversation about Donna happened on the way home. We will have lunch somewhere in a couple weeks.

Carpe date night Diem.

We Had a Frank Discussion

We had an open and frank discussion about me, my death, if it was okay to date, how I died or was no longer here, Capgras Syndrome, how it was that her mom died, and other topics. I explained “impostor syndrome” and that I was not dead. it took a lot for me to not openly cry as I began to understand her terror at not knowing what was going on around her.

We talked about our love for one another. I told her I would never leave her alone or as best I could not let her miss anything important. We talked about memory and how scary it is to not know what is next.

She was anxious about being home but not thinking she was home. In the midst of that our upstairs neighbor, Joe, bought me a couple cans of beer. A couple days ago we were discussing an article in a local magazine about the best microbreweries in the area. He had found some of the stuff that won.

Cheryl added Joe into the discussion about how she and he were working on the same project at the house. We went around and talked about going home and Joe had brought her home last night. I said that when she woke up she was home? Even though when she went to bed last night she was not home? Yes she said.

I explained to her once again that we were home even though she was unsure that we were home. (Another nuance of Parkinson dementia). Capgras can occur with things and places also. In Cheryl’s case it happens with time.

She knew she was home now.

She seemed calmer afterward. It wore her out and she went to bed early and was okay with me helping her to bed.

Carpe Capgras Diem. (but what a miserable fucking disease.) (sorry)

More on Parkie Time

There is lots of discussion about apathy and Parkinson. This morning I decided that Parkinson merely enabled Cheryl’s brain with a different sense of urgency or importance. Perhaps I needed to embrace that.

Last night as I coaxed her to bed her impostor syndrome was strong. We drove around for a few minutes and looked at the Christmas decorations while we “drove home”. It usually works and she thinks she is home. It did not work completely that night but she seemed to accept the fact that she was very tired and needed to rest. She went to bed with pajamas on the bottom and her normal daytime shirt on the top (just in case).

In the morning she slept late. When I woke her and got her going I pointed out that she had about two hours until her exercise class started, so she had to move it along unless she did not want to go. She refused to be speeded up and responded that I have been late before. She thinks exercise is important and wants to do it and enjoys it once she gets started. I know that it helps her too. But my sense of urgency and lateness is much different than hers.

I shifted my schedule to agree with her parkie time. My urgency evaporated along with my stress associated with getting her moving.

Small adjustments reduce stress

Carpe late Diem.

Back in the Olden Days

Gift wrap at a department store was free for purchases from that store. The malls often had a bunch of girl scouts or boy scouts wrapping boxes and raising money for their troop. If you did not want to get stuff wrapped boxes were available from the department store. (With their logo)

That slowly faded away over time. It was part of the season and might still be there but I have not shopped in a department store for several years. Parkinson disease interlaced with dementia does not enable that to occur with ease. I lament that fact.

This year we did spend some time shopping at J C Penney. Cheryl has always liked Penney’s store. It is one of the few department store chains still surviving after Federated Department Stores sucked up many of the littler ones and became Macy’s. A couple days ago a nice gentleman gave us a couple coupons on the way in the door at J C Penney and bid us well as we began our shopping experience. Later when we had a bunch of carefully selected gifts piled onto Cheryl’s walker and headed to the front to purchase them, he saw us coming and as the line to check out was long he asked the woman staffing the cosmetics counter who was idle to check us out. She smiled and said sure she would do that.

As we approached the counter to do that another frantic old woman who had just come in the door barged in front of us and asked the cosmetic counter staff if she could “pay her bill here” because the line was too long to stand in.

Two things I have not thought about perhaps ever in my life; driving to the actual department store to make a minimum payment on an invoice that was sent to me via USPS, something that can be done by return mail and manifesting surprise at the length of the checkout line at 1 PM on a Sunday afternoon two weeks before Christmas. Perhaps she could not afford a stamp or did not have a stamp and the bill was due on Monday. This woman decided to chat with me about those things while the woman behind the counter opened a different computer to access the billing records and accept the $35 minimum payment on her J C Penney account and applied it to the customer’s Visa account. It is easy to understand how cash strapped elderly women get over their head in debt. (Sorry, that was unkind.) I did not chat. I merely stood silent and waited while Cheryl stood there looking tired.

Eventually the nitwit was gone and the cosmetic woman picked up our purchases on her counter and said, I need to get some larger shopping bags. She was gone for about 20 seconds. She checked us out and I helped put the stuff in the bags because she had very little space on her cosmetics counter.

We completed our purchase and I thanked the woman for allowing us to check out with her. She smiled. Perhaps no one had thanked her for helping them that day.

As we left the store I noticed that the long line had dissipated. I remarked about that to the gentleman who was still staffing the door passing out coupons. He smiled and wished us a good afternoon.

Carpe Christmas shopping Diem.

With This Ring

With this ring I thee wed. It was a long time ago and I do not remember the actual wording of our vows as I slid the wedding band on her finger. Lately she has the delusion that her wedding band belonged to her deceased sister Janice and was give given to her by her mother for safe keeping. Last evening she told me that she wanted to give it to her sister’s granddaughter.

Stories and delusional narratives like this that she makes up out of whole cloth disturb me. And, at the same time, they are very interesting to me. They are a kind of window into her confused mind.

In the past few months, Janice, is on her mind a lot. She talks to her in her sleep. She talks to her in her head during the day. She will find an old photo of Eric or Kevin and remember Jan. At night if I awaken her when I visit the bathroom, she might say, “Jan, what’s going on?”

She mixes up her sister Nancy with Janice. Nancy was very close to Janice in life. That thought mingles the two sisters in her current mind.

Occasionally she will say to me, I should call Jan and see how she is doing but I don’t know her number so I’ll call Mom first. With people dealing with dementia and confusion the experts say to go with the conversation and accept what the delusion may be at the moment. I do mostly but I avoid promotion or continuation of a mistruth. I respond with, “Think about Jan for a minute” and she will say, “oh, yeah she’s gone isn’t she?” To which I respond yes, she is but you can still talk to her in your head. You can say Hi to your Mom too. (I always worry that it will make her sad. It does not seem to do that. She seems calm with the fact that she remembers her mother and sister’s passing.)

She brought me this photograph last night that she had found in her office. Her little note “Hoo? is this” made me chuckle. I still have that Hilton Head hat and occasionally wear it in the summertime. That is her shoulder off the left of her posty note. I have a gray mustache but Cheryl’s hair is still brown. I put it on my desk to look at and remind me where we are on this road.

I have no idea who took the picture. the print date on the back is June of 2006, so, it is pre-parkinson and his damned disease.

After we had been married twenty-five years we gave each other new wedding bands to commemorate the occasion. The inscription reads Cheryl to Paul 8-29-70/95 on mine. (This is so I would not forget our wedding date. We met on the 30th of August, so, I always have had a little mental confusion about the date.) Twenty-five years down the road her fingers were more robust as were mine.

Our 25th commemorative bands are larger. About a year ago she complained that her wedding band would simply fall off her finger and she wanted to get a chain to put it on to wear around her neck like a necklace. I took her to the jeweler and we found a chain. She later discovered her original wedding band and found that it fit again after losing Parkinson weight. She has been wearing it for many months.

In the past couple days she believes it to be Jan’s wedding ring.

Carpe Diem.

Janice

And Just When You Think

…. that all is going great something misfires.

Different events in my own life cause me to remember stories from the Bible sometimes. The Bible is full of stories. This story from the new testament, Matthew, I think, talks about two sons reaction to something that their father has asked then to do. The first kid says, Yep. I will be there. And then he does not go. I suppose he goes off to hang with his bros. The story teller does not tell us. The second kid says, not today, Pops, I am hanging with my bros. But after his father leaves he goes and does what his dad asked him to do. The elephant in the room is, which kid did the right thing? The first kid outright lied to his father. What an asshat he is. The second kid did the right thing but was grumpy with his father initially.

It always strikes me that there is not a lot of lead in to this story and the following paragraph does not seem to segue into the story about the tenant farmers killing the owner’s son. But I have digressed.

Cheryl slept poorly overnight. When we saw her neurologist he made some adjustments to the meds that are supposed to help with her dementia and memory issues. This was the second night that she had taken the new dosage. She told me at one point her mind was racing. She eventually fell asleep somewhere between 2:30 and 3 am. I did anyway and she did not disturb me awake.

In the morning I let her sleep late by turning off the 7 am alarm. I started to tease her awake at a few minutes before 10 am. She eventually got up at 11 am. While I was waiting for her to get moving, I did a few things that had to happen:

  • stuffed envelopes with the ninety or so Christmas cards we send out each year and added a little newsy note like the rest of us that only communicate once in awhile.
  • wrapped some of the presents we purchased for the grand children and for some unknown child whose request was hanging on the giving tree at church last week.
  • balanced the check book because I forgot to do it on Friday
  • paid the property taxes because the escrow account said this was the day
  • helped her get out of bed and into the bathroom for meds and the the toilet
  • got her breakfast going and helped her out of the kitchen to get freshened up for the day
  • helped getting the shower going and made sure she was okay to take a shower by herself
  • rubbed the magic stuff in her hair after her shower and hair shampoo
  • made the bed

And on and on – making this about me in my head. It is easy to forget and add up this huge column of pluses and equate that with one unsought request. (sad face) Cheryl in the midst of all of this activity as she was combing her hair said the garbage needed to be removed from the small receptacle next to the toilet the receives last night’s protection and the occasional Kleenex tissue. It did not I insisted in a volume and timbre that was unnecessary.

So what does all that have to do with the Matthew mystery story. The first kid could have said, yes, I will be right there. I have this other thing to get rid of first. Is that okay, Dad? (Any reasonable father would have accepted this first step to rid oneself of the prior commitment.) The second son could have taken a deep breath and gone to do what his father asked. (He was apparently intending to do it anyway.)

I for my part could chosen either one of these two reactions to Cheryl’s need to have the garbage removed. I could have said I will do that in a minute but I need to finish this thing first without the snippy response or I could have merely removed the trash right then. I did remove it a little later. There was no reason for me to feel put upon.

Before that silly reaction by me all was well. Then suddenly something misfired.

Oh well. Carpe Diem.