My search for grace and meaning after a former care partnering life with a wife who suffered from Parkinson's disease and dementia giving her a confused and disorienting world.
Three O’clock in the Morning is a novel by Gainrico Carofiglio. A story of a teenager who makes a trip to France with his estranged mathematician father to be cured of his epilepsy and ends up learning about his father in an intimate way during two days without sleep.
“Who were epileptics?” I asked, realizing that this was the first time I’d managed to say the word.
‘Just to give a few examples: Aristotle, Pascal, Edgar Allan Poe, Dostoevsky, Handel, Julius Caesar, Flaubert, Maupassant, Berlioz, Newton, Moliére, Tolstoy, Leonardo da Vinci, Beethoven, Michelangelo, Socrates, Van Gogh.”
I processed this information.
It’s strange how the same thing, exactly the same thing, can make us feel so different depending on how we see it, the mental context in which we put it.
Ever since I’d been diagnosed with it, epilepsy had been, as far as I was concerned, a stigma, a sign of inferiority, a disgraceful blemish that had to be hidden. After Gastaut’s words, after hearing that list of geniuses who had all apparently had a problem similar to mine, my inner world now turned a hundred and eighty degrees, as if moving from darkness to light. I had felt like a reject, and, all at once, for the very same material reason, I felt almost one of the chosen, a member of a special category of superior beings.
“Please sign your drawing,” Gastaut said, in an almost formal tone. I signed it, and it seemed natural to me, as if I were signing a contract with my new life, which was starting at that moment.
He stood up, shook hands with us, repeated that he would see us again in three years and walked us to the door.
— from the novel.
I found myself reading it at three o’clock Monday morning. At 2:30 am Cheryl was awake and longer able to sleep.
Bummer.
She ate a doughnut and some cereal. She drank some orange juice. I read my book for a bit. How appropriate, I thought. We did the Wordle. It was four in the morning. We went back to bed at four.
I was awakened by the EXTREMELY LOUD AND ANNOYING alarm clock at seven. I fetched her pills. She took them and we returned to bed.
At 7:30 am she arose to get dressed for school. I got up and finished the story. Not a crime novel which is my usual genre. I did not remember that I had finished the Wordle.
Some days things just seem to go better with pie. If you want to lift your spirits a bit, make a pie. Whatever kind of pie you want, just make one. You can buy a pie of course, and that will settle the need for a sugary delight, but if you want to ignore the world around you for a while, make your own pie. It might turn out ugly but it is yours and it will taste scrumptious.
I have been down on myself for a few days. I think I worry for the folks in Ukraine. I do not know anyone in Ukraine but it is kind of stinky that a short guy with big army and navy can just drive over the fence and poop on the short guy without a big army and a navy with only one boat. That situation just sucks.
This is an ongoing conversation in our house. Cheryl struggles enough with day to day things. She fears for those mothers and children showing up at the Polish border behind the reporters that flew there in order to record the history of the short guy beating up the other short guy. From the news reports it looks as though the partisans are taking root in Ukraine and in Russia they are taking a nap. The world markets are yinging and yanging around and today I paid $4.999 a gallon for 12 or so gallons of gas to fill up my car. It was the first time I have spent more than $50 to fill up a car. That situation just sucks.
Time to make pie and eat it.
an old favorite recipe modified
This particular recipe guidance is a favorite one. As you can see specific types of apples and the resulting pie has been noted by Cheryl. When she drug me down the cooking road a couple years ago I picked up what we call the “Big Green Cookbook”, so called because it is about two inches thick and has a green cover, to learn how to do pies. This book reads much like my grandmother’s cookbook that is a collection of church ladies’ recipes entitled “Culinary Cullings” from a farming community in Rich Hill, Missouri.
“6 apples” but no reference to general size. “1/2 to 2/3 cup”is the same as writing some but not too much. It makes me smile to read these measurements. (1 recipe plain pastry — but no hint about where to find that.) I have modified and added to the instructions myself. Since it is unspecified I use dark brown sugar with my teaspoon of cinnamon. I also add a couple tablespoons of tapioca. I got this last one from my mother who learned how to make pie from my grandmother. I think I got my bravery to adjust ingredients and try new spices from Mom. She was pretty damn good cook and liked to have a gin and tonic while doing it. Perhaps I will try a gin and tonic with my next pie.
So today is PIE day. A little early actually because the math enabled folks celebrate 3/14 as pi day. But I digress.
Yummy
For a short time this afternoon I have bumped Cheryl off of her worries and anxiety about world idiots.
After the pie got to the condition shown above I went of to find the big round Tupperware pie saver we have owned since about 1975. Gone. I was worried that Cheryl had put it in a special place so that it would not get messed with by the little girls that live in her head. I put out a text query to the kids and found out I had left it at our son’s house. I probably took a pie there.
She asks me if we are staying here tonight. It is a repetitive theme in her thinking and confusion. Not knowing any better I try to answer her honestly and without any teasing (which she does not understand anyway). Looking at my old notebooks and blog posts it seems that this particular confusion and some others, who I am, for example, have a cyclic appearance.
That was last night. This morning she wants to pack a suitcase for college. The idea that she needs to get ready to go off to college is totally new. The college she wants to go to happens to be the one I am a graduate of and our grandson has been accepted into for the Fall semester. These facts are probably all tumbled up in her head and sort of explain her confusion.
Another interesting nuance is conversing with me as though I am an acquaintance, someone she has not spoken with for some time. We are catching up. We spent most the of the day talking in the third person as though acquaintances. It was a warm late winter early spring sunny day so we took a walk in the park. We talked about many things. We talked about the weather of course. We talked about how far you used to be able to see across the little creek we were walking next to. On the other side of the creek is a concrete and asphalt reclamation business with mountains of paving to crush and recycle. It once was a smaller pile of refuse.
We talked about children. She told me about hers and asked me about mine. She was amazed and intrigued by the fact that our children had the same names. It seemed that the only difference was that her children were in their teens and twenties and my children were middle aged. (smiley face here) It was unimportant to her that these teenagers had children which were her grand children. These conversations were hard to follow but I was able to ask questions and find out more like any good friend would. Most of the time I was able to keep the tears out of my eyes as we created a memory of a good day for her.
She suddenly switched topics and talked about what to do about Thanksgiving dinner. I gently pointed out that it was barely March and Thanksgiving day plans were several months away. Undaunted she replied that it would be here quicker than you think. There is a lot of truth to that last comment. I have noticed as I get older the year goes by quicker.
I promised to get right onto organization of who does what. I fired off a text message to our family text-party line and got positive responses from everyone. Our daughter volunteered to host.
beliefs of simple things, such as, whose job is it to do this chore or that chore. Mowing the lawn, for example, is it a male or a female job? And why do most people grow grass around their property that is not native to their part of the continent? From my perspective it is a male chore to mow the lawn.
As a boy – it was mine
How do things like this get started? I have always – at least in my memory – thought of mowing the lawn as a man’s job, chore, duty. No doubt dating to my childhood when it was the chore I was assigned somewhere around the time my brother graduated high school and left for the Massachusetts Institute of Technology. I would have been about twelve years and certainly tall enough to push a lawn mower and not injure myself. I have no memory of whom in our family mowed the weeds before me. I assume it was my older brother but I have no memory of watching him do that task but he probably did. He is gone now and I cannot ask him.
It was my chore to keep the estate spiffy and shipshape. Did I like it? Indeed I did not.
As a man – I thought mine
Over time things get ingrained, ground in, always assumed. That is your job. Just do it. When we bought our first house I purchased or somehow obtained a ultra low end lawn mower. It was a tiny back yard and much was given up to english ivy. Why I ever decided to remove much of the ivy and turn it into lawn is beyond me now but at the time we had one child with another on the way so a place for the kids to play was probably the motivation. I also built some garden boxes, a sand box for the little people to play in and the neighborhood cats to crap in, a raised vegetable garden area, a strawberry bed, a swell picnic table and a rabbit hutch with rabbits. It was a busy six summers there. I was not yet thirty years old. We were fertile. We had three children when we moved to the big house.
I had my own schedule when it came to maintenance items such as mowing the lawn. Building the lawn is way more interesting and fun than mowing it. Occasionally she and I would argue until I discovered that she actually enjoyed mowing the lawn. She would mow it and I would assume incorrectly that she was trying to show me up. Our first lawn was tiny and I had an electric mower with a 100 foot long cord. She loved it and she could do it during nap time. It was quiet. I gave up the maintenance duty on the lawn.
As a father – my son’s job
When we moved to the new big house with the new big lawn and the mostly dead American elm in the back I bought another 100 foot long extension cord. This worked for awhile until it became too cumbersome and I gave in to purchase a low end gas powered mower from a big box store.
The elm was removed, another vegetable garden was installed and a cherry tree added to round out the crop yield. The kids were growing rapidly. She and I decided that it would be good for the kids to have some responsibilities around the homestead and its maintenance. Some jobs more important than making sure that the two freezers did not contain too much food. We gave our middle son the duty of mowing the lawn and he seemed to like it initially. I eventually gave in and bought a riding mower and he liked it even more. There are many fine stories to go with the riding lawnmower of questionable manufacture.
Household chores in our new life with PD
In our current life with this disease of Parkinson we try to avoid having it be the center of our life and rule over all that we do but some days that just seems impossible. Some days the distraction is insurmountable but over time we have come to grips with the fact that it is simply more efficient for me, the husband, the father, the care partner to assume most of the regular chores and Cheryl can do ones that she deems need doing and she is up to the task that particular day. Some days she does nothing other than survive. Some days she busies up her day with several little things which takes a toll on her physical well being and the following day is a survival day. I like routine so I have selected certain days for certain major chores.
I have developed three laundry group days. Monday is wash-the-bed-sheets day. Wednesday is wash-the-towels day. Friday is wash-the-clothes day. On Friday I split the wash into loads that make sense to me not her and we have sparred a bit about what is in each load but we do not any longer. I believe she has lost interest in laundry and its routine. On wash-the-clothes day I also look at the checking account to be assured that we are not getting too rich and do any book keeping and bill paying. Over time I have put many regular expenses on automatic.
On a daily basis there are a myriad of other little things that I do to keep things rolling along. It now seems trivial when I reminisce about my anger with her stealing my thunder and mowing the lawn without telling me. (Yes, that was the source of my once ill-placed anger.) These days I look forward to being with her and caring for her.
Morning routine includes dressing the bed. In our other younger life I never did this. In this life I have made some adjustments to suit me since it is principally my daily job. Evening routine includes making dinner and when I am out of gas or merely think we are isolating ourselves too much we go to a restaurant and let them make dinner.
Cheryl has had difficulty lately with an evening routine that allows her to wind down and sleep through the night. We have been adjusting the timing of her evening meds. Because she often complains of taking so many pills, we have adjusted her dosage slightly and on her nurse practitioner’s recommendation we have adjusted the timing of a med that is intended to help her sleep. She takes that about thirty minutes before she heads to bed.
These slight adaptations seem to be working for her, not always but for the most part. She seems to be sleeping better and generally through the night except for the occasional bathroom trip. In addition she occasionally makes the bed – well twice so far – because I think she feels good enough (rested enough) to do that little chore.
After the second time I thanked her for making the bed up and got push back in the form of, I know how to do it!
AHA – store the little victories away in your heart for later. Keep your mouth shut if you are unable to make your praise and thanks not sound demeaning. And do not take it personable when she snaps at you, for at that moment she is there as she always was before this disease of Parkinson.
And never raise your volume, she will think you to be angry whether you are or not.
“I appreciate your help but sometimes I just want to be left alone”, she said to me today.
I suppose I do get too much like a helicopter parent.
She could have become more angry and told me to “Back off!” but she did not.
I stepped over a line that I am still looking for.
Carpe Diem and learn.
There is a subtle difference between caregiver and care partner. We seem to be on the cusp of that some days. So I felt it was necessary to find back Edie’s prayer modified by me and read it again.
… so much to learn and as I write this Pink Floyd is singing “Comfortably Numb” on Alexa nearby. Perhaps I have become numb or non-listening lately.
Cheryl does not drink coffee. She never has. I do. When I make a pot of coffee I ask her in a teasing fashion, do you want some coffee? I made a pot. She says, nope. No coffee for me thanks. it is a conversation we have had for fifty plus years. I love her. Sometimes she will ask for something else; tea, juice, Coke and I will get that for her instead. She seems to be back in this time and place now. Earlier she was not.
This morning that seemingly innocent exchange stuck with me. Her early morning sun-downers syndrome was staying with her and the sometimes accompanying hallucination was staying with her. It made me nervous. I had purchased a couple apple strudels from Marx Bagels the day before and kept them aside for a breakfast treat. Lately she is only interested in doughnuts for breakfast. That part of the breakfast was okay but she kept offering some to someone named Tim. Tim who? I asked as I had not heard that name before. Tim Fiebbig, I go to school with him, she said.
She thought the strudel was okay but she was hoping for doughnuts. I told her that if she really wanted doughnuts I would get some but do not leave until I get back. I zipped out to a nearby UDF for a couple doughnuts and some coffee. Back in a record fifteen minutes with three doughnuts and fresh coffee. While I was gone she sat with Tim in her office to chat until the doughnut man returned. She broke one up into little pieces and offered it to Tim.
In an effort to understand where she was in her mind I quizzed the siblings. This was (is) an elaborate illusion for Cheryl to set up a chair in her office so that she could converse with Tim her imaginary friend from her childhood. She did not seem puzzled that he was in her office. I hoped that it would pass and left her to talk to Tim for a bit. After a conversation of several minutes she came back out and sat with me to watch the morning not-so-newsy news program on CBS.
It is later in the day as I write this and she is still struggling a bit with the images and memories. Those seem to be easing and she went to shower and put on clothes. She seems to be back.
Some is, no doubt, grief caused by family circumstances. Paul Welch, our son-in-law’s father passed away yesterday. He had Parkinson’s disease/ Lewy body dementia also. An incredibly aggressive version apparently because he was only diagnosed about two years ago.
As we head down this road of Parkinson, it is helpful for me to understand what she is remembering. I am often unsure of what to do with that information. Sometimes I turn it into a conversation about that time in her life and let her reminisce for a bit. Sometimes it works and she gently realizes that she is reliving a memory. Sometimes it does not work.
It is a twisty-turny journey. My training many years ago as an engineer has been poor preparation for this time in my career. Spiritually it is a challenge. Engineers want to fix things. This appears to need a total redesign by the Chief Designer.
I am not a huge sports fan, so, should I write or should I read? On that day I elected to read after hanging the new calendar on her office door, putting away most of the Christmas decorations and helping her finish a batch of cookies. It was a pleasant two hours of downtime before preparation for church.
Church was sadly uninviting as the pastor is out with illness due to covid. We are back to socially distanced mask wearing in a gathering of perhaps eighty people in a building that holds 450 but has not experienced that level of participation for many years prior to the whole pandemic pandemonium.
So today is January 9, 2022. I checked with Cheryl and it is time for the three kings to go back to the orient. But the storage area is actually slightly west of where they are displayed this morning. Balthasar, Melchior, and Gaspar (or Casper) are their names according to Western church tradition. Balthasar is often represented as a king of Arabia or sometimes Ethiopia, Melchior as a king of Persia, and Gaspar as a king of India. So, maybe, the fact that the bucket and the storage area is west makes little difference. It is a much shorter walk than the guy going back to India.
Guys chasing a suspected super nova…
The past week has been a bit of a trial. Cheryl has been having trouble sleeping through the night. It is a common issue with Parkinson’s disease. As a consequence during the day she is easily upset, occasionally moody, somewhat apathetic, quick to anger and often fatigued. The rivastigmine was making her nauseated so it was discontinued. She has been taking quetiapine (Seraquel) and in working with her nurse practitioner we are slowly changing the dosage and timing of that to help with sleep. It is an annoying process but it seems to be working sort of.
Last evening we made blueberry muffins for Sunday breakfast today and for awhile she sat with me to watch our used to be favorite CBS Sunday Morning show. She has not sat and watched this show with me for any length of time for many months. It used to be our Sunday morning activity after returning from church.
Times change and I suppose I am attempting to preserve as much of the routine as possible while we travel this Parkinson’s journey. I do miss watching various pieces with her and commenting about it.
As her memory, creeping dementia and other odd behaviors appear it is incumbent on me to not correct her or even explain those behaviors to others. Her friends all know what she is dealing with. I do not have to remind them. People will show kindness or not. Total strangers can be remarkably kind and generous. Maybe because Cheryl navigates with a cane in her hand.
Here is the setup. Cheryl has a wheelchair tag. In fact we have two. When Cheryl was still driving we applied to the state to get one for each car.
A few weeks ago we got in the mail on two different days a form for the state to renew our wheelchair tags if we wished to do that. The forms require a script from Cheryl’s doctor. When they came a couple weeks ago I put them in a special position on a ledge wall between the kitchen and the rest of our living area in the hope that I would remember to take them with me to our doctor appointment in December. Cheryl agreed that was a good spot to leave them.
Today, she re-discovered them and was telling me what they were. I let worry and anxiety about losing them before the doctor appointment come over me. I took them from her and explained why they were on the ledge. Thinking back on it, I was not that forthcoming with why I was putting them back on the ledge. She became very angry. I apologized for being a stinker. It is a delicate balance on some days and I admit I am not always up for it.
Of late, Cheryl keeps her emotions just below the surface. It seems to be a symptom of her disease. She is constantly thinking about what was. Hearing a particular hymn in church will cause her to weep. When she sees pictures of the grand kids on our electronic picture viewer, they become real to her and she will talk to them. If I take a deep breath or just simply sigh, she will ask me what’s wrong? If I do something and she feels slighted in some way real anger appears. All of these reactions are the same as any feeling person except maybe talking to the hallucinations. Parkinson’s is not real to her. The unsteadiness and jerky motion is not visible her until it is.
It is hard for me to not be a helicopter care partner and hover close by. It is hard for me to not be protective of things that I am certain will be lost in her PD and Lewy body confusion. She displays punding style behavior which in her case seems to be arranging and rearranging her papers in her office. These papers are often random collections of emails and news letters assembled with no apparent theme. (I worry that real papers will disappear in the organized randomness of her office.) I try to watch what goes into her office and short circuit anything of importance before it gets there.
Sometimes, like this morning, I do that without the gentleness that I should have used. When that happens I tread on her heart.
Edie’s prayer
I should have read this when I got up this morning.
Recently (yesterday) I convinced Cheryl to go to a chair yoga class. I thought it would be good for her. In my sometimes helicopter care partner mode it seemed to me that I might be able to find something for her to go to most everyday at PCF. She often wants to get different things that she uses in class so that she can do the exercises at home. But lately she does nothing at home that looks like exercise. There is nothing unique in that, many people to not.
Today when I talked to her about going to class she said, I don’t want to do that. I have a hard time knowing my right from my left. I have problems with a similar thing I said. I always have to say the alphabet jingle in my head. Elemenopee… I thought about what I said suddenly. Why was it necessary to make it about me?
She went on to say that all that reaching and stretching was hard. Somewhere in her conversation I realized she thought I was taking her to chair yoga. I spent another ten minutes or so convincing her that this class was one that she had been taking all along. It was not a new class. I realized that I was rushing her into trying new things to exercise her body (tired with PD).
Apathy and lack of interest to try new things or finish things once started is common in PD sufferers. I found myself reading about Apathy in Parkinson’s patients while she was exercising at PCF this afternoon. The internet of all knowledge directed me to Michael J. Fox; the APDA site; the Parkinson Foundation and others. All say approximately the same thing.
Apathy describes a lack of interest, enthusiasm or motivation. It interferes with the effective management of Parkinson’s disease (PD) symptoms, since apathetic people are less inclined to do things like exercise and follow their medication schedules. …
Apathy can be frustrating for people with PD, caregivers and loved ones. Understanding apathy as a symptom of PD and finding ways to cope with it are key to ensuring a good quality of life and for maintaining good relationships with caregivers, family and friends.
Therapies
Currently, there are no proven effective treatments for apathy — no pills or special therapies — but structured activities and opportunities for socialization are a useful approach. A regular routine, continuing to socialize and exercise even if you don’t’ feel like it…
from the Parkinson Foundation website
As I was reading along various sites, Cheryl was exercising three feet away. Same things are easier to get her to do. By that I mean things that she is familiar with, things she has done before. And as I watch her do the exercises she changes. Her motion becomes more fluid and steady. She does not quit. She pushes herself. And tears come me. What’s up with the emotional response in me? What a pain PD can be to people close by. Once she gets started all can be well. As class moves on she is an enthusiastic participant. I am merely an observer and not someone to argue with. (smiley face with tears)
More … My own thoughts … Usually when I write one of these messages to myself I struggle with what point I am trying to make. Not so here. It is easy to drift into making something about yourself. I believe that it is a natural act. To understand some thing, some idea, some opinion, some action of others we relate it to some local knowledge we already have. Educators call it scaffolding.
What happens when one has no similar knowledge? It can be made up out of whole cloth. It is natural. We, at least many of us, want to empathize with the other person’s unsatisfactory experience.
A life lesson, I suppose. Maybe an AHA moment appeared for me. Try to stop making it all about myself and still empathize with Cheryl. Or, at least, do not vocalize it to her.
Sometime ago about two years ago Cheryl struggled with fainting. The neurologist blamed it on orthostatic hypotension and she does have some of that. It is measurable. Her standing, sitting and laying blood pressures are all different. But two years or so she had fainting spells sitting at breakfast table after eating while working the puzzles in the newspaper. I got so used to it that I parked a pillow from the couch one one of kitchen chairs to be handy when I laid her on the floor.
Today we got up later than normal after Cheryl got meds on her 7AM schedule. She washed her face, brushed her teeth and we had the church funeral discussion. I made blueberry pancakes. Her alarm went off for her 10AM Sinemet and Entacapon so she ate them with her vitamins and pancakes.
After eating I got cleaned up myself , sorted the laundry and dressed the bed. It is Friday (laundry and checkbook day). I got the washer started on the first load and staged the rest in the utility room near the washer. As I came back into the living area I noticed Cheryl seemed to be asleep in the chair by the kitchen table. She had fainted midmotion while removing the snap top of a container of crunchy snacks she intended to munch on while doing the puzzles. She was seated stiffly in the chair.
I got a pillow from the couch and laid it on floor and laid Cheryl down. She was stiff. I put her feet up on the chair. In the past she would wake up immediately after I laid her on the floor. She did not today.
This morning she laid there for awhile still out of it. It was unusual from a couple years ago. The stiffness was also unusual. Previously she was very limp. Eventually I was able to get her up off the floor and into a chair again. I got her walking frame but she was unable to pick it up off the floor. Tried to help but she kept pushing down instead of lifting up. It was as though her brain had the directions reversed. I got her to sit again and I got her transfer chair from the garage and with that I moved into the bedroom and got her to lie down.
She had very low blood pressure. We have meds for that. I gave her the 1PM dose of BP medicine at about 11AM and coaxed her to drink more water. I nagged and hounded her to drink more water, orange juice, tea, coke, whatever she wanted. There is a background theme of anxiety about incontinence at work here.
Eventually she came back and realized we had missed the mammogram appointment. We also missed chair yoga. We made it to the finger exercise class. The checkbook balanced and the laundry got done. All was well again. A few more steps down the road were behind us.
Adjunct_Wizard 