I originally wrote most of this in December of 2021. The lessons I learned and techniques I developed for communicating with my wife who was dealing with Parkinson disease and associated dementia are applicable today. The lessons of life are illusory and fade if not maintained.
I am learning things about myself from Debbie that I was only beginning to learn from Cheryl and taking care of her at the end of her life. Dementia is a misunderstanding between the brain and it surroundings and the sensors it uses to detect the environment. An oversimplification to say the least but a miscommunication certainly. Missed communication is at the heart of any conflict or dispute.
Lessons from making cookies
December, 2021: Cheryl’s Cookies (Not the Commercial Venture)…
Living with a parkie (person suffering from Parkinson’s disease) makes me alert to new information when it comes up. That being said I do not always recognize my new task nor do I always recognize the information as new. This is about becoming a master cookie maker on the fly. I was not completely inept. I make bread often.
Executive function and loss of it…
Dementia occurs in about 50% of Parkinson’s sufferers who have had it for some time. Mild cognitive impairment often shows up first, followed by hallucinations, delusions, misunderstanding, memory loss and inability to follow simple directions. It is disheartening. Some behaviors are side effects of medications. Some come with build up of unpronounceable proteins in the brain. No matter the source, the behavior can be disheartening and annoying from a care partner perspective because the person you once knew is physically there and mentally not completely there. From a care partner’s perspective it seems that the medical community does not forewarn anyone about this aspect of the disease.
I am a retired engineer and have an innate curiosity about everything around me. Cooking, baking, bread making and all things requiring an oven have a particular fascination. There is practical chemistry in cooking both with the ingredients and the people cooking them. To the question, why do it that way? Near the end, my wife’s reaction often was anger to some perceived slight or merely to the wording of it. (She is the parkie in this story but that may have little to do with it. I caulked most of these reactions to her PD and her mental state at the time.)
It is an engineer’s question. It starts with me. Words and question structure are important factors. Engineers always want to ask why something is done some way or simply is some way. Why often sounds like a challenge, even to other engineers, if it is not asked properly. Tenor is detected in tone of voice both in the sound we make with vocal chords and inside our own head. Cognitive impairment interferes with interpretation of subtleties of tenor and tone of voice.
How to do…
December, 2021: Our latest challenge to our marital bliss is Christmas cookies. Baking is a hobby and a passion to me. I like to think I have perfected my meager talent at making breads of various types and shapes. I am proud of that but lately I have pushing into cakes and pies. The pandemic pandemonium gets to us all in various ways.
My perception of making cookies is one of a trivial exercise in baking. That is an incorrect perspective but one that I have internalized. December is cookie making time. Cheryl is helping me or I am helping her that is unclear in this reminisce but her Parkinson is affecting her more and more. Two cooks in the kitchen is a recipe for a challenge to peaceful coexistence. Two bakers near an oven enables battle lines to be established and defended with vigor. Starting a question with why is akin to removing one’s glove and casting it upon the dueling ground. [Emoji (:-)] Cheryl has made perhaps a giga-dozen (I just made up that word) of cookies. I have made none. What can I say to redeem myself? Engineers ask why a lot and in this exercise I learn to find a more agreeable way to get her to tell me what she knows.
The lead-in; I do not understand, why do… seems to temper the why. Small children ask why a lot until finally the because-I-say-so comes out.
Where to start…
To a skilled cookie baker the recipe is merely a guide, a refresher, a list that says these get lemon zest. Interestingly, that is much like how I view a new bread recipe. I am on familiar territory. (He thought to himself with arrogance.)
Not so fast apprentice! Nearby there is a master cookie baker. Do not question the master’s skill at her craft with disdainful utterances such as, why and how come? All will be revealed. But also keep an eye on the recipe and make answers such as, yes, we have put that in the mix and suggestions, such as, shall I add the butter?
Sometimes with creeping dementia ingredients are forgotten. Sometimes without that factor ingredients are forgotten. Try to be kind and remember that no one got up in the morning thinking, how can I mess with his mind today? Most importantly, do not raise your voice two octaves, that is a dead giveaway to your ignorance.
How does one check for doneness? (It is common sense!) Look at them. (the “fool” is left unsaid.) They will look right. What is right? (and on and on and on…) Cooking is a process. It is learned by doing. Life is random. It is learned by experience.
The 3C method – Cut out the Crap in the Conversation…
To a person standing nearby this conversation sounds rude. It sounds like one person is giving another orders and it can be that way. If done with kindness in the communicator’s heart and with understanding that a Parkinson’s patient also may be dealing with confusion issues, it is neither rude nor demeaning in any way. Often a person experiencing Parkinson’s cannot or does not get the implication or inference. Be clear. Have kindness in your voice when speaking. No teasing.
When tasting the cookies later after they have cooled, do not say, “YOU FORGOT THE SALT!” Instead say “These seem off somehow. Did we forget an ingredient?” Gentle discussion allows for thoughtful assessment rather than confrontational reaction.
The onus is on the care partner not the parkie to be patient, kind and clear. Be aware, care partner, that this is hard to do because you remember how your partner/spouse/parent/friend was before. (Good natured teasing may be misinterpreted. Be certain that your partner is not confused.) You too can be unaware of how they are now. The Parkinson’s patient may become sad or angry. Be persistent if you as care partner are very concerned about safety. Add some love to the conversation if you think you are not getting through the confusion. Strive to not become frustrated and raise your voice (two octaves).
We did wind up with our first battle batch of cookies. Although they were a motley crew, they tasted fine.
This episode came to me as I was thinking about other experiences that have cropped up in my new relationship with Debbie and I am getting to know her family and friends. Patience, kindness and clearness are useful aspects of communication with anyone, especially someone you care for deeply. Debbie has told me several times that she does not always know when I am teasing her. Perhaps I should not do that at all. The ability to tease someone comes with trust and love and familiarity. Perhaps I should remember that I do not know what I do not know and err on the side of kindness and ease, not tease.
Everyday is a winding road. I get a little bit closer. – Sheryl Crow (Good poem/song – read the lyrics)
Carpe Diem.



