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.
Cheryl fell in the shower this morning. Slid down the wall is probably a better description. I heard no thumps. It is always our discussion – I’m going to take a shower. Okay, I will listen for thumps. Thanks. And then she goes to the big bathroom to get cleaned up. Today I thought I heard her futzing with her walker but she was occasionally bumping the shower door as she tried to reach the hold bars to pull herself back up.
I ordered a shower mat from Amazon. I told her from now on we put the bench in there with it. A few weeks ago I had the plumber put in the really fine hand held shower head in preparation for this day. Several times I have suggested that she use the bench. Resistance to infirmity is great. No bench she insisted up until now. I will insist but I want her to maintain as much independence as she is able.
The shower floor does not seem slippery to me but I could be wrong.
One foot in front of the other. One step at a time.
Today sitting in Anna’s house chatting, Anna told her mom that today was June the fifth. Did Mom know whose birthday was today. I thought, shit, I forgot to write that detail on the white eraser page that I put on the kitchen table in the morning. And I had lost that fact also. I have been so focused on Cheryl and getting some activity for her each day I lost track of my own son’s birthday.
Cheryl always wants to make a list so she does not forget something. How does one even begin to write a list of things or events not to be forgotten when one cannot remember what is to be on the list?
That is a tricky question. It is hard to remember what you have forgotten or maybe did not know at all.
Another subject for a list is the places and people we need to visit . Maybe we have not seen them in person for awhile. there are many people that we have not seen in person for at least two years. I did travel to see my sister about a year ago. We attended my nephew’s wedding in California. It was hot. It was fun. My brother-in-law, my nephew’s father, had brought along his fiance to the celebration and for some arbitrary reason she blew up and their wedding is not happening. Cheryl is working on a list for visiting folks. My nephew and his new wife are expecting a baby very soon.
Should she ever get her list together I will make every effort to figure it out. Planning trips is hard. Cheryl needs a lot of extra equipment these days. The new U-Step walker, although it folds, is better transported by a pick up truck. She is much more steady behind it.
Cheryl’s Parkinson’s disease interlaced with dementia has taken a turn to the negative over the past three months. It is tough but necessary for us to explore extra help and other options to our living situation.
I feel a sense of sadness. It is not exactly that I have failed because I recognize in my heart that her disease has a progression. I suppose it is a progression that I had not anticipated.
I also feel a sense of relief, an acceptance of the fact that I cannot do it all alone anymore. I recognize that we have to do something different. That first recognition came when I decided to buy a new bed and change our sleeping arrangements. At least, I thought a split king would keep us from awakening each other at night.
We drifted off to bed about 10 PM after watching a couple of her favorite shows on television and visiting with her sister for a couple hours. We probably eventually fell asleep about 10:30. Overnight I got up to go to the toilet twice and the second time around 3 AM she got up with me and seemed as though she wanted to stay up. I had prepared to sleep on the sofa bed we had and then she came out looking for me. We had our often discussion about church and I suggested we lay down for two more hours and then get up. She got up at quarter til noon.
I got up around 8:30. It was bliss.
I took the time to call the assisted living facility nearby that had housed both of our mothers at the end of their life. I still refuse to believe that we are here yet BUT it does not hurt to find out about various options to move forward from here.
I also set up a couple doctor appointments. She is having problems hearing occasionally. And I wonder about a UTI.
FIND RESPITE – If you’re focusing most – if not all – of your time, energy, and resources on caring for a loved one with dementia, you may find you cannot sustain doing so over the long-term. With proper self-care, you can relax and recharge, manage caregiver stress, and become a better and more effective caregiver. Consider sitting on the porch and reading a book, a brisk walk, a cup of Starbucks, an ice cream cone, a massage, a warm bath with soothing scents. These things need to be done regularly in order to maintain your own health.
I read these words again this morning. Only I can find respite for myself. That is often hard for the care person to see clearly. I went outside to straighten the small garden area we have. The steady rain over the past few days which has darkened Cheryl’s mood also has loosened to soil around a Jacob’s hook holding a hanging plant Cheryl got for mother’s day.
So what can the Care Partner of The Year 2021 do with all of this wonderful knowledge? In an inadvertent fluke of fate and its fickle finger Patty send me an email with the information about a Caregiver’s Class put on by Catholic Charities of Southwestern Ohio. I am all for being as educated as I can about how to take care of Cheryl better by taking care of myself.
Being an engineer and amateur scientist I thirst for knowledge. That is corny but true. The problem with that statement overall is that there is no complete solution to Parkinson’s with dementia added. There is not even a partial solution. Cheryl’s sister hopes for a cure. I do not hold that same hope. That being said, the situation is not hopeless.
I bought a book called “Dementia Reimagined”. I was hoping for a cookbook style answer manual. It was not that at all. It is an incredibly tiring tome about public policy and where it fell into the dumper over the years. Engineers are always hoping for a cookbook for their situation. When this happens, do this. Alas there is no such manual for life situations as defeating as PD with dementia.
But back to the help-book, It seems as though many of the ideas I have discovered on my own or others have told me about I merely have been ignoring them. Early in the book it talks about developing goals and achieving them. These are not care-giving goals. These are goals that allow the care-giver some relief.
Initial focus is on setting a goal or several goals and development of a plan to achieve it or them. The goals discussed are relaxing activities for the care giver. So, it is something you want to do. It is also something that is reachable and realistic. Something you can accomplish in the near term.
What do you want to do?
How much of it do you want to do? (more specifics)
When do you want to do it? (timing helps to plan)
How often do you want to do it? (repetitive relaxing activity)
This same technique can be used to plan any sort of activity, of course, but the book’s focus is care partnering and care partner health. Additionally this portion of the text asks the maker of promises and planning to predict the probability of achieving your activity. There’s an implied deep need here. Something that you may really feel like you want to do but have little chance of achieving. A life lesson in the manner of understanding that not all wants are achievable. (How driven are you to get to your goals)
The next portion of the focuses effective communication and recognizing emotional and stressful situations. Two forms of communication discussed are assertive and aikido. A comparison of these styles of communication is Assertive:”stand tall” vs. Aikido:”standing with” This portion of the book takes me back to my educational psychology classes and discussions about defusing confrontational situations.
ASSERTIVE
setting limits
asking for help
advocating for another
making difficult decisions
dealing with difficult styles of communication
AIKIDO
defuse emotional situations
help others feel understood
reduce anger
balance emotions to allow dealing with others
As I go through the rest of the book I will report anything else of interest to me.
Scott was here last night to be with Cheryl while I visited my stock club meeting. The fourth Monday of every month is the meeting of our little stock club. We started this little club in 1984. Over time we swelled to 20 members but the past few years attrition and death has shrunk our number to eight. And over the past few years the meetings are more social than business. Where else can eight old men get together and trade war stories about getting old, fortunes missed, grand children achievements, the proper temperature of beer for drinking, Parkinson’s disease, prostate problems, cataracts and hearing issues, but in the backroom of a local watering hole near a railroad track? It is always fun and over the years I have rarely missed it.
Before I left for the meeting Cheryl’s stomach was bugging her a bit as happens occasionally after her 4 pm meds. When I returned I asked her if she had eaten anything. She said yes but behind her Scott shook his head no. She answered my question how she thought I wanted her to answer it.
Eventually about 11:20 pm we went to bed. Over night she was fidgety and got up at 2:30 a.m. to make a list so she would not forget something. I sat her at the kitchen table with subdued lighting and with paper and pencil she worked on her list.
Her list is a business memory. I sat with her and about 3 a.m. she decided to sleep some more and finish later on. Buzzing around in her mind these days is the thought of creating a database of birthdays for the people in her family. Many times and in many instances she has started this task. Just like engineers this thinking starts with a pad and paper. Often sketches are made to indicate data flow and information input. Just like an engineer Cheryl’s notes switch back and forth from cursive to printing. And although she had an urgency about this activity in the very early morning hours, she had no ideas about what it was or what it was for in the daylight hours.
She seems so fragile to me in the morning lately. She is still working on the remnants of some dream as she awakens. This morning she got up and went into the bathroom. I got up also and put clothes on, got some coffee for myself and turned on the CBS news to see if any new wars developed or any movie stars got divorced overnight. About 20 minutes later I went back to check and see if any help was needed or if there were any special breakfast requests. She was seated on the closed toilet waiting for someone to bring more toilet paper. I showed her where the extra rolls were and asked if she wanted cereal for breakfast. Yes was her reply. I returned to the living area.
About ten minutes later I went to check again and she told me she was still waiting for someone to bring toilet paper. The thirty minutes of database design time in the middle of the night messed up her waking pattern.
More and more she seems to have a slow switch from early morning confusion to present. I have not found a solution to any of this confusion and delusion. I listen to her conversation and make a lot of rapid decisions about how to respond. If it seems like she is getting ramped up about someone coming (that I know is not) I try to gently steer her toward the correct thinking. If she is getting fired up about having a family gathering I merely agree with her plans.
On this particular morning she was concerned about whether David was going to show up any minute to cook the Thanksgiving turkey. It took several repeated conversations about date and time but eventually she seemed okay that Thanksgiving day was not today. Over several hours she came to the conclusion that she should take a shower and get ready for her exercise class. Over those same several hours I planted various seeds of the idea about taking a shower and looking for exercise clothes to wear.
Me and how I feel – It is wearying for the care partner to both console and encourage and direct and deflect her delusions and my own background anger (too strong a word – disappointment?; discouragement?; vexation?) with her brain and how it is operating with PD. My question – Why can’t she have the movement issues without the mental disability? (God are you listening? Why her? She has always been a sweet person. Why did you dump this crap on her?)
Observations about my reaction to her needs – (Shit! Not again. This is the same conversation we had 15 minutes ago. whiskey tango foxtrot.) How can I help dear? Cheryl – you can’t help. Perhaps not but let me hold your purse for you while you get out of the car.
Is this genuine love? … To have and to hold from this day forward, for better or for worse… Those where part of the original agreement. Too late to back out now. She looks so sad and distraught when she realizes that she needs me to help her up from the chair because her scoocher is busted. It is heartbreaking.
Today it occurred to me as I cleaned the Kleenex lint from the washer and dryer for the nth time, it was doing no good for me to lodge a complaint with Cheryl about putting tissues in her pocket. It also occurred to me that although I beat myself up about missing the tissues in her pocket, I will probably often miss one once in awhile.
Dementia is not a specific disease but is rather a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities. Alzheimer’s disease is the most common type of dementia. Though dementia mostly affects older adults, it is not a part of normal aging. (from the CDC)
Drat and alas. Drat, she cannot remember to do it. She cannot remember my complaint either but will detect the disappointment in my voice and probably interpret it as anger. And alas, I will occasionally forget to look in all the pockets.
I will forgo the complaint process. It is not useful anyway. I merely causes us to pick at each other. (Forgo was the answer to the Wordle a couple days ago.)
We had a wonderful dinner with friends last evening. This gathering had been put off three times for various reasons but yesterday we got together. Gary showed off his wine aerator when he was pouring the wine. He told me he cannot tell the difference. His palate is older than mine and I had gin and tonic. Perhaps he was sold a bill of goods by an aerator salesman.
Everyone contributes when we have these dinners. My job was bread. Yesterday after several false starts I got two loaves of italian (my version of italian) together. They were remarkably good so I should perhaps I will note in my notebook of cooking disasters what went wrong and what I did to recover.
Leftover from the french toast leftover loaf.
Today Cheryl is very tired. She refuses to admit it. I suppose I am tired also. We did not stay out late but we did sit up and watched a PBS show to unwind a bit when we got home.
We had french toast made from the second (leftover) loaf of bread from last night. It was good again. I am very thankful that I do not have celiac disease. One reason to not be grumpy today.
Cheryl spent some time cleaning the kitchen after she had her french toast with blueberries breakfast. All the time I was worried about her. I think I am anxious for her because the last few times she has fallen, it has happened in the kitchen. This time however she moved a lot of things around and wiped counters; swiffered the floor; threw the kitchen tablecloth into the washer along with the clean one she got out to replace it with (both will be clean in soon); and then became tired and uninterested. She took her ten o’clock meds and went to lay down for a bit. When she awakened, she announced, “Today is my birthday!”.
On top of the paper is my handy white note board telling today’s events.
It is not and stupid me pointed out that it is May the fourth. I thought about – may the fourth be with you – but left that unsaid. She responded with, I wish people would stop changing the dates or some other angry anxious comment. I backed off quickly. I apologized to her and pointed out that her birthday was next week on the tenth of May but tonight we should go somewhere and celebrate her birthday.
She became calm and sat down to watch the gabfest on the View. I brought her a coke and set about putting the kitchen back together. I discovered that she had thrown the tablecloth from the table in with the folded one from the drawer into the washer and I did not catch that before tossing a bunch more towels in on top. (Damnation. I became immediately grumpy.)
I sat down to write this little story and laugh at myself. I do not want to be grumpy today.
She actually slept pretty well and later today we will probably get out and take a walk in the park. And celebrate her birthday. There is nothing to be grumpy about. We had dinner with friends last evening. It was good company and good conversation.
With that thought she got up at 1:30-ish in the early morning. It has come to me that when her dreams become real, I have to just go with the flow. I tell myself that our experience has shown that this episode will last about two hours, so be patient and helpful during that time. Some might to this as a prayer but I think of it as description of what I need to do to help her get through this nuanced dream she is experiencing right now. (And Carpe The Damn Early Morning Diem. 🙂 ) I suggested that she should have something to eat and she would be more alert, her mind would work better while she was writing the article. She agreed with that and asked what we had.
I suggested cereal with a banana cut up on top and some o.j. She took her vitamins. Later after she decided a piece of coffee cake from yesterday morning would be good also, we discussed how she could get started. She looked at the two-day old paper on the kitchen table for I bit. Maybe she was thinking about what to write? She did not tell me.
I suggested we watch TV for a bit while her thoughts gelled. We watched a couple TV shows that were previously recorded. After a few minutes as was our previous experience she became tired again and we returned to bed at 3 am.
The alarm went off at 7 am and I fetched her morning meds and we returned to bed for a little longer as we usually do. Twenty to thirty minutes is usually enough for her to get moving. I fell asleep a little more soundly than ordinary.
I woke up and realized I could not hear her. I got up and put some clothes on. I searched the condo and could not find her anywhere inside. The front door was unlocked. This morning when she got up, she left the house.
Did the rapture happen? It scared me. It is my greatest fear, not the rapture, the fact that she had wandered off looking for something she could only see in her mind. Fortunately she was just outside the front door to our building and it was not raining.
Later as she was laying down to rest she told me, she was looking for anyone awake. She was scared that no one was here. She had decided to go look in the next building for anyone. She asked me if that woman who runs things here was around – whoever that may be. I left, “What are you thinking about?”, unsaid and suggested we go out and get some sun. Take a walk. Maybe we could have lunch.
Adjunct_Wizard 