Category Archives: Aging & dementia

Happy 96th!

Today is my father’s 96th birthday.

It’s just over a year since he was last at home. Just a week or so short of a year since his arrival at the Oahu Care Facility, a skilled nursing facility in town, after being discharged from Queens.

We plan on celebrating with a mid-day visit, armed with a batch of my sister’s cupcakes. She bought him a new t-shirt. I’m taking a message from one of his boating friends at Ala Wai Harbor, and I’m taking a camera, but otherwise going empty handed. I can’t think of a present that says more than our simple presence.

In honor of the occasion, I hope that they’ll have him up, dressed, and out of bed.

I made a Sunday morning visit, timed to catch him just before lunch. I thought that would assure that he would be awake and probably out of bed.

No such luck.

He was in bed. His t-shirt had a message printed on the pocket: “I made it happen”.

He was sound asleep, mouth open, under a single sheet. I could see that he wasn’t dressed.

Often he’ll wake up when he hears me come in. Yesterday wasn’t one of those days.

I wanted to shake him awake, but I hesitated. I can’t say why. I guess I’ve got mixed feelings dealing with his slowly worsening memory and declining overall abilities.

I think he’ll understand his birthday, and he’ll laugh at realizing how old he is, and he’ll shake his head and, with an aside, recall the long life he’s experienced. And he will enjoy the cupcake, I’m sure of that.

Chinese food for Thanksgiving

The good news was that we arrived well before lunch and found my dad sitting at a table with three other men in the third-floor common room of his nursing home. Small paper turkeys decorated the walls, signaling that Thanksgiving had arrived. There was a little sign on the table in front of him, a single piece of heavy blue paper folded lengthwise into a triangle, resting on one side, with his name hand-written on the side facing him: “John Lind”, it said simply.

John LindHe was dressed in the Winnie-the-Pooh t-shirt Meda found recently in the Kaimuki Goodwill Store, and a pair of flannel pants from Costco that he enjoys.

He insists on t-shirts with pockets so that he has a place for his glasses, and Meda’s been on the prowl in the thrift stores she visits.

He was surprised to see us. We explained we were there to have lunch with him.

“Oh, lucky you found me here,” he said, as if he might have been out and about town instead of here at a table with several other men on one end of a big room with dozens of other elderly patients in various degrees of ill health.

He quickly asked if Bonnie, my sister, was also coming. We said she wasn’t expected. It didn’t sound quite as bad as “no”.

“And Helen?” he asked, referring to my mom.

I told him that her knee has been hurting and she hasn’t been getting around much. All true. I didn’t say that at age 95, she also finds visits to the nursing home to be a trial.

Then he asked if I had a pen. Nope, but Meda produced one from her purse.

“Write a 4 on the sign,” he said, pointing to the paper in front of him. Meda dutifully wrote “4” in small print next to his name, then asked what it meant.

“That’s so they won’t forget our reservation,” he said.

In his mind, we’re in a restaurant where he had a reservation.

After a few references to the holiday, we quickly figured out that he wasn’t making the mental connection to “Thanksgiving” and all it entails.

First, he told us that they was expecting an eight-course Chinese meal to be delivered.

“It’s all supposed to be arranged,” he said, a little friendly conspiracy in his voice.

“Do you like Chinese food?” Meda asked, surprised by the idea.

“Some of it,” he responded somewhat noncommittally. Actually, come to think of it, that was probably a very honest answer.

We explained that it was Thanksgiving, and that they actually would be serving a special turkey dinner. That’s why we were there, along with other residents of the third floor and a handful of their family members. Not as many visitors as I had expected. Perhaps some people took their old folks home for the occasion. We weren’t prepared for that.

I did tell him the good news that Bonnie would be cooking a pie or two.

He asked quickly: “What kind?”

“Pumpkin,” I say, realizing again that the Thanksgiving connection isn’t being made.

But, obviously, it could be a lot worse.

Then he was off about his car, a theme that returns, like the seasons but on a shorter cycle.

“I’ve lost my car again. Both cars,” he told me, somewhere between worry and anger. “I can’t find the keys. I don’t know if someone is playing games with me.”

To Meda, who was sitting over on his right: “How do I report a stolen car? Actually, I’ve got two cars that are missing.”

I don’t press for a description of the missing cars, because the last time he couldn’t remember anything specific about them, just the concept “car”, and I don’t like to lead him down the trails of dead-end memories.

“Maybe I’m better off without them,” he finally says. “I should just ride my bike.”

We encourage that line of thinking, and soon he’s forgotten that the cars were an issue.

He’s now anxious for lunch to be served, although it’s still early, only about 11 a.m.

He asks if I’ll go remind the waitress of his order.

Then he asks, “How was the weather in Waipahu when you left?”

He’s surprised when Meda says that we came from Kaaawa. Waipahu was where my mother’s parents lived when my folks were first married back around WWII. Does he think I look like my grandfather? Another chip away on the self-esteem front.

He posed for a few pictures, pleased by the attention, although he worried that he hadn’t shaved.

Somehow, in the midst of keeping small-talk going, Meda asks if he ever has trouble sleeping.

“I have trouble not sleeping,” he responds without a pause. “If I put my head down”–he acts it out, his head going down onto the table in front of him–“I’m asleep.”

Then he looks at me and asks: “Who’s paying for all this?” The bed, the “hotel room”, the food service?

“Oh, it’s covered by your insurance,” I reply, lying. “Don’t worry, it’s all taken care of.”

In fact, it’s an expense that is quickly draining the assets he built up over the past 95 years, including over 60 years in business. But he doesn’t need to hear that. He’s obviously got enough to worry about, what with missing cars, lost freedoms, unknown locations. The money part keeps me awake now. It’s our problem at this point, not his.

Luckily the food arrives. All attention goes there.

Meal served

He quickly observes that we’ve got small plates of turkey and gravy, while his plate has mashed pototoes, vegetables, and ground turkey on a bed of bread stuffing. We pointed out that his ground concoction was also turkey, just easier to eat. A nibble on the first fork full from his plate seemed to do the trick. He slowly dug in.

A bite of turkey. A few vegetables. Very soon he cut into his slice of pumpkin pie and took a bite, and I thought he would just fast-forward to dessert. But, no. He ate slowly but methodically. Meda shared her little container of cranberry sauce. His fork was a little unsteady, but he managed to eat through everything on his plate, then his pie, and then he asked about the pie sitting uneaten in front of Meda. She moved it over onto his tray, and he was happy.

Clean plateThe result: Meal declared a success.

We asked if he wanted to go back to his room for a post-meal nap.

“No, I think I’ll go home.” He started to look for his walker, which was parked just out of reach, to start the journey.

It’s another awkward moment, repeated quite regularly, but we still haven’t gotten practiced with a graceful reply.

At this point, “home” is a jumble of memories. He usually means the modest single-wall wood frame home in Kahala where he lived for over 65 years before finding himself in a single bed in a narrow room shared with three other aged men. Sometimes it’s the house on Vista Street in Long Beach, built by his father after the family moved down from the northern part of the state. It might be his childhood home in Berkeley. It might even be the bunk on his boat at the Ala Wai harbor.

Luckily, one of the nursing assistants sees him struggling to stand and comes over to take charge, tells him to wait for her to come right back. He wants to get going before she returns, but we keep him in check. She’s back in a few seconds to help him stand, then transfer his weight to the walker, then slowly make his way out of the room. We somewhat sheepishly say our goodbyes and slip out towards the elevator as she steers him back to his bed. He’ll quickly forget that he had intended to go “home”, wherever that is now.

But, just in case, we decide not to wait for the elevator and take the stairs instead.

It’s not a graceful exit.

Thanksgiving

It’s Thanksgiving.

That means it has been a year–actually, a year and a several days–since my father fell at home, ended up in the hospital, was diagnosed with alzheimer’s and dementia, and finally transferred to a skilled nursing facility where he has spent most of the past year.

Thanksgiving will be difficult.

My sister, who has carried most of the burden of regular visits as well as laundry duty, decided she did not want to face Thanksgiving turkey at the nursing home. It’s depressing, to say the least.

So we’re splitting up the family’s Thanksgiving “celebration”. Meda and I will have lunch with my father at the nursing home, food pick-up between 10:45 and 11:45 a.m. We know parking will be difficult, although somehow the mundane task of finding a nearby parking space should help to dull the edge of emotion off of this turkey day.

Then we’ll cook a turkey and the trimmings on Sunday, when Bonnie and my mother will make the drive out to Kaaawa.

Last year at this time, we didn’t know if my dad would survive the week. He’s managed to get through a year, although with slowly diminishing capacities. He has much more difficulty walking now, which causes him to get up less, which causes more difficulty walking as he gets less and less exercise.

And I can’t help believing that the failure to get up and walk contributes to a type of sensory deprivation that worsens the confusion and memory loss caused by the Alzheimer’s and plain old garden variety dementia.

But it is what it is.

He has been sleeping a whole lot more than usual for the past month.

My sister named it first.

“He has been sleeping every time I have visited this week,” she emailed me a couple of weeks ago. “I have waited until late afternoon, hoping he would be awake. No such luck. He wakes up long enough to acknowledge I am there, then immediately falls back to sleep.”

I recognize what she’s describing. It has become the norm rather than the exception.

She also noticed another thing. Fewer pairs of shorts coming home in the dirty laundry. That translates into the realization that he is spending more days without getting out of bed, so he doesn’t have to get “dressed up”. The blue & white disposable adult diaper suffices on these days. It’s another worrying sign of deterioration.

But he was wide awake one afternoon last week when I arrived at his bedside, and he hit me with a question as soon as his eyes fluttered open and he saw me standing there.

“Where am I?”

His voice was clearer than it has been on other recent visits.

He looked around, the curtains on one side separating his space from the next bed, curtains on the other side blocking the hot afternoon sun that would otherwise be streaming in the window.

“Where am I? The bed looks familiar,” he said quizzically, “but what is this place?”

I told it was the same place he’s been staying for a while. It’s the place he seems to like the best, I add, remembering that he sometimes tells me that he’s got several different spots where he can bunk for the night. He has told me that a number of times after I’ve explained that I won’t be able to drive him back to the house in Kahala, with the lawns that he mowed until last year and the large mango trees in the back yard with the fallen leaves that require constant raking.

“They take good care of you here,” I added, hoping it would let him relax.

He seemed to think about it. I couldn’t tell if he was satisfied by that answer or if the thought just evaporated and he forgot what he had asked about.

Then he had another question.

“What about that other project I was working on? How’s it going?”

I try to work with whatever he’s got in his head, so I just ask a question.

“Which project were you thinking of? You’re always so busy.”

And in his mind, he is busy. Traveling, meeting people, accomplishing things or at least trying to, driving here and there.

He looks at me directly. I notice that he has gotten a shave but they haven’t clipped his nose hairs. Make a note.

He’s still thinking, it shows on his face, the stress of concentration. Then it passes. He relaxes, and with a shrug of sorts indicates he can’t some up with an answer, and perhaps that’s okay.

We just sit for a few minutes.

We were never very close, my father and I, at least not since I was very young. Ours was an arms-length relationship. I have learned that I know far less about his life or his family and their origins than my sister, just four years older than I am. Perhaps I never asked. Perhaps I didn’t listen. Or maybe the opportunities were never presented. The last year has been that opportunity to learn more. Perhaps that’s something to be thankful for, despite all the rest.

Travels

At the end of October, I visited my dad at his nursing home and told him we would be traveling for much of the following week. He seemed to track the discussion, although he’s been slow, sleeping an awful lot, to the point that even he comments on sleeping too much.

When I arrived, I had to wake him up from a pretty sound sleep, as has been the recent norm. Then I worked the buttons on the little control panel to raise the head of the bed so that he was almost in a sitting position, a posture that encourages interaction, or at least the appearance of interaction.

As he listened to my description of our upcoming short trip, he got a funny look on his face, hard to describe, his lively eyes and cheeks conveying a touch of guilty excitement as if he was ready to make a profound confession of hidden pleasures.

“You wouldn’t believe the interesting travels I’ve had the past few months,” he said, looking directly at me, eyes dancing, emphasis on he word “believe“, conveying that he’s also amazed by it all.

“Man….”, drawing the word out as he shook his head, thinking about where he’s been.

I tried to go with the flow.

“Really? What was the most interesting trip?”

I waited, ready for another surrealistic description of a sales trip to Hilo, or meeting with clients on Kauai.

He drew back into his pillow, eyes suddenly far away, a veil of concentration covering his features. He’s trying to follow his thoughts back to those “interesting travels”, to recover and share them.

Seconds pass. Silence. More seconds. He squints into the distance of shifting memories. The silence extends almost to the point of discomfort, but I’m an experienced reporter, I’m used to letting silence work for me during interviews, creating pressure on the other person to say something to penetrate the silence, put an end to it. I wait.

Finally, he shakes his head again, but this time not for emphasis. It’s an apology as he shrugs off his attempt to recover those travels that just moments before had spoken so vividly to him.

“I’m not a good rememberer anymore,” he says lightly, his easy tone contradicted by the weight of this admission.

I let the silence grow again as we share the moment of candor.

This time I’m the one who speaks, breaking into the shared silence. I remind him that dinner will be delivered at 5 p.m. directly to his bed, since he regularly chooses not to get dressed and eat this meal out in the common room down the hall. He’s surprised, although the food is served at the same time every day. Then I say that I’m leaving and will see him again after the trip. I touch his shoulder as I stand, give it a squeeze, assuring us both that he is still there, and the rest doesn’t matter.

Today it’s a long wait for the elevator back down to the ground floor.