Category Archives: Aging & dementia

Wondering about my father’s automobile anxieties

It’s good to know that my dad’s persistent anxiety focusing on his car isn’t unique. Apparently it’s quite common for people suffering from Alzheimer’s or other forms of dementia. He often goes through the same refrain.

Where are my keys? I have to go downstairs because I can’t remember where I parked the car. I’m going to get a ticket if I don’t move the car. Do you know where it is? I know I drove it this morning. Where was that? Do you think someone stole it? The’ve been taking my keys.

I got an email a couple of days ago from a woman going through a similar struggle with her father.

My father has been diagnosed with Alzheimers in October. He too was driving up until January and we sold his car last month. He would drive to Ala Moana Center and forget where he parked his car after he walked around the mall. This happened about half a dozen times that I know of. Since last month he has been constantly asking where his car and keys are. When we tell him it was sold he would repeat the same question a few seconds later and just can’t remember. For the past few weeks, he has been writing a list of “stolen items”, i.e., wallet, house phone, car, house key and car keys, etc. Of course they weren’t stolen, my mother has the keys and wallet. Last week he lost his wallet which had his drivers license in it. We still can’t find it and hopefully it’s in the house somewhere.

This week, while waiting to begin a quarterly meeting with the nursing home staff to update us on his condition, I asked whether women also had automobile anxieties.

Kate, the activities director, said women have a different set of anxieties, often relating to taking care of children and the household.

Where was I supposed to pick up the kids? I need to get to the store to shop for dinner. Etc.

So these tell us a whole lot about our culture and our relation to different cultural elements. I’m amazed at how fundamental the car is to my father. I’m guessing I would have a very different worry list. Are all the cats accounted for? I can’t find (fill in a cat’s name). Have you seen my computer? Somebody stole my camera!

Now I’m wondering how dementia’s anxieties express themselves for people who live in less automobile-dependent cultures? Do they obsess about train schedules? Loss of a bicycle? A bit of a cross-cultural and gendered perspective would probably be most interesting and informative.

You’ve got to do more planning if you don’t have a car

My dad was still thinking about his car, or the lack of the car, when I stopped by to visit yesterday.

I arrived just as they were finishing lunch in the common room. There were a couple of dozen people spread around the room. Three other men at his table. There was a lot of food left on his plate.

He was wearing a t-shirt, with a gait belt riding high above his waist, and knitted stretch pants with a flowery design. I’m guessing they weren’t among the pants we’ve bought for him. Those have been disappearing at an alarming pace. Bonnie complained to the nursing director last week after yet another pair of fleece plants went missing. She chanted down a partial list of missing items. It wasn’t a short list.

We adjourned to a small seating area by the elevators. That sounds simple, but getting around is now a major effort.

I moved his walker from its parking space along the wall over next to his chair as he prepared himself for the effort of getting to his feet. He reached out and tested available points of support. The corner of the table. The arms of his chair. The walker. I reminded him to set the brakes, and he remembered that it requires locking the handles. That was good. All signs of memory are good.

Getting up onto his feet was difficult, and I was less help than I should have been, not sure where to push or pull to get the most leverage. But after several tries, he managed to lurch into a standing position with his weight shifted forward, then began the shuffle to the door, following his walker slowly into the hall and out towards the small seating area in front of the elevators. Several staffers moved to monitor his movement, but relaxed when they saw I was with him.

Then comes the process of getting back down, the walker-to-seat move. My dad shuffles into the right position, backs towards the seat, starts to bend his knees, slowly at first, then he drops the last foot or so onto the sofa. We both know it’s going to be hard to get back up.

We’re on the third floor. The window looks out over Beretania Street and a busy bus stop. There are two stuffed sofas with a view of the television near the elevators, with one high backed chair and several stacking chairs arrayed under the bulletin boards that contain legal notices, news for visitors, photos of guests, a calendar of activities that lists days with mid-afternoon breaks for ice cream, morning exercise classes, and occasional special outings or programs. There are green streamers hanging from the lights, some cut in clover shapes, signaling the arrival of St. Patrick’s Day next week. The television is tuned to a basketball game, Sam Houston v. SFA. Sam Houston was ahead. There’s only one other person there and I don’t know if she is watching the game.

Our conversation, such as it is, turns to the car, but with a twist.

On my last visit, he surprised me. First came the regular lament over his missing car. Can’t find it. Can’t even find the keys.

Usually it’s something like, “What am I going to do?”

But he shifted gears on that last visit.

“I don’t need a car,” he said with a shrug, his first expression of acceptance of carlessness. “I don’t mind walking. But I won’t be able to give you a lift home.”

“I don’t mind walking.”

I cringe inwardly, as the recollection clashes with the thought of our slow walk from the dining room, my hand firmly on the gait belt, helping to keep him upright and moving.

Today the car conversation picked up where we last left it.

He started with the familiar, “I don’t have a car.”

But then it was off again into new territory.

“It means that I have to be careful and do more planning when I go out. If I get too far, like out in Pearl City somewhere, it might be hard to get back on the bus. I don’t want to get in a situation,” he said, his voice implying the things that could happen if you aren’t careful with your travel plans.

He had several “situations” when he was still at home and driving. He didn’t give up driving completely until he was 94. His ancient Nissan station wagon with diesel engine and gasoline body had a tendency to break down or run out of fuel in the most awkward or dangerous places. Then there were the times when he got lost on the familiar track between the house in Kahala and his boat moored at the Ala Wai. Situations.

I like the fact that he seems to be accepting the idea that his car is gone. It’s important. I don’t know if he’ll remember the next time I’m here. Our job will be to remind him, over and over.

It was harder to get back onto his feet from the sofa, which was lower than the chair in the dining room. It took several tries before he defeated gravity. We walked back to his room, slowly, but together. I had a firm grasp on the gait belt, ready just in case. He did fine.

[text]I had to remind him which room was his, but he remembered that his bed is next to the window. The other three men in the room were already in bed. I guess the schedule is lunch, then sleep. A nursing assistant saw us and came to help as he was getting himself into the bed.

“Mr. Lind, do you want to use the bathroom?”

He looked confused. Then he looked at me.

“That sounds like a good idea,” he answered.

As he started getting up again, the alarm on his bed went off. It now plays a robotic version of “She’ll be coming round the mountain”. It’s a lot better than the old alarm.

I laughed, and he followed suit.

It was a good visit.

He said he was at the club

When I stopped to visit my dad one day last week, I walked into his room (shared with several others) to find that my sister was already there.

Bonnie was busy working on his fingernails.

At age 96, his fingernails seem to be on steroids. They grow. Bonnie tries to keep them under control. She looked up from her busy filing to say hello. He added his own fulsome greeting.

My dad’s been quite lucid recently, able to carry on a conversation, respond to questions, show appropriate emotions, etc. But his here-and-now awareness is undercut by signs that more layers of memory are disappearing.

We exchanged pleasantries.

Bonnie looked over to me with a look that signaled something more was coming.

“I phoned yesterday to tell him that I wouldn’t be able to visit,” she said, her face again indicating I should pay attention.

“Guess where I reached him?”

I wait.

“He was at the Pearl Harbor Officers Club.”

Aha. He sold a lot of supplies and equipment to those military clubs in the course of his 65-year career in the hotel and restaurant supply business. I imagine he spent a good deal of time on the sales calls.

I look at him now, lying in bed, half-dressed, a T-shirt over a pair of disposable adult diapers, a sheet pulled up just above his waist, wires clipped onto his shirt and onto a bed pad that will trigger alarms if he tries to get up without assistance.

The Pearl Harbor Officers Club seemed a very long way off.

I asked if he had been stuck out there.

“No,” he responded deliberately. “I wasn’t stuck anyplace.”

Then a thought crossed his face.

“What was I doing out there?”

He laughs.

“I guess it couldn’t have been very important!”

He thought a bit more.

“I didn’t have a car because someone borrowed my keys. That’s been happening quite regularly lately.”

The car again. It’s a symbol for lots of things. Mobility. Independence. Individuality.

Bonnie jumped in.

“I didn’t have your car. I keep telling you, I don’t drive your car.”

He didn’t miss a beat.

“I’m sure glad of that,” he said slowly “because without a car I’m socially and…”

He groped for words, then finished the sentence.

“…and physically lost.”

He said it. I’m lost without my car. That’s probably a very astute summing up of his situation.

The car comes up in almost every visit.

When I was leaving after a visit yesterday, I apologized that he couldn’t offer me a ride back downtown.

“I don’t even have a car,” he said, gesturing at the possessions that surround the bed next to the window in a room shared with three other men. On a rolling tray/table that sits beside the bed there’s an old copy of Hawaii Fishing News that he’s probably paged through a hundred times. There’s a big photo book I found in a Barnes & Noble bargain bin, a photo album that’s grown as Bonnie carefully inserted copies of old photos, mostly from the 1930s, that trigger scenes he still remembers in great detail. His glasses were on the top of the stack and, at least on this day, he remembered they were there.

The lack of a car echoes between us.

I just nod in sympathy.

“It’s tough getting old, isn’t it?”

On that we agree.

It was a very good visit

This 6-minute video documents an unusually good visit with my father. When I arrived, I found my sister was already there.

Bonnie and I agreed that he was more alert and able to interact than he has been in some months. He displayed a sense of humor, and was able to dredge up some detailed memories of people and places dating back to his high school days, more than 75 years ago.

And he looked remarkably good, which led to my best line: “Yes, the hair color is natural. And, no, I didn’t inherit it.”

But I noticed some contrary signs. Although he remembers and can identify people in the photo of his high school graduating class, he doesn’t seem to remember specifics of his family back in Long Beach, California.

When I suggested he say hello to his family over there, he looked at the camera and said: “Hello, people in Long Beach. I’m told I’m supposed to be interested in you.”

That was painful, although he said it with a smile and an accompanying chuckle.

Then there was a brief moment as the tray with his dinner was brought in. Remember, by this time Bonnie and I had been there talking with him for over half an hour. So the tray arrives. He looks up at the nursing assistant who brought it in, and he asks: “Is…Ian and Bonnie coming?”

In that moment, he has forgotten that we’re already there with him. Or perhaps its more like having entered a parallel universe where he’s focused on his meal and we don’t exist.

But in this other universe, we’re sitting alongside the bed where we’ve been interacting with him for a while, and we both respond. “This is for you, it’s your dinner,” I said.

He looked at us and seems to realize the disconnect that had just happened. It flashes on his face as those moments collide in his consciousness. Then, briefly, he closes his eyes. It’s a poignant second in which he accepts the realization. Seems to get a grip. And moves on.