Tag Archives: dementia

Freedom’s echoes: An afternoon visit with my dad

Another day, another visit.

I stopped yesterday afternoon to visit with my dad after skipping a couple of days. He’s been confined to a Honolulu nursing home since late 2008, suffering from a combination of dementia, Alzheimers, and less serious physical ailments. He will be 96 on December 7. There are good days and bad days. I would count yesterday among the latter.

I arrived at the nursing home just around 4 p.m. and was lucky to find several empty parking spaces in the small parking lot. There’s a routine. Lock the car, stop in the tiny elevator lobby downstairs for a few squirts of hand sanitizer from a dispenser mounted near the elevator, then hit the call button with my elbow, avoiding the still gooey fingers, ride up to the third floor, sign in the facility’s log book at the nurses’ station, check to see if he’s out in the common room, then head down the hall to the room my dad shares with three other men. He’s lucky to have a nice bed next to the window, which gives a little connection to the outside world.

I found him dressed in a t-shirt with a pocket (he insists on a pocket) and shorts, well worn running shoes with elastic laces, shuffling with tiny 6-inch baby steps behind his 4-wheel walker, heading out of his room towards the hall with a nursing assistant hovering at his elbow.

He says hello, but keeps moving, although it’s very slow going, even compared to his normal pace.

“Where are we headed?” I ask.

He gives the answer that I really don’t like to hear: “I’ve got to get downstairs, I’ve got two cars parked on the street and I’ve got to take care of them.”

While we’re moving slowly into the hall, I ask when he last saw the cars.

“I drove one this morning,” he replies quickly, “but I can’t remember where I parked.” Then he tells me that it was a very busy morning in Hana, with a lot of electrical work getting done. The story hung between us as he realized he couldn’t have driven to Hana, which is on the island of Maui, a plane ride away.

“I didn’t have my car there,” he backtracks, recovering some semblance of order.

The cars are an image that haunts him whenever he’s agitated, or perhaps the lingering image of driving off in his car gets him upset when compared to his current restricted routines and causes the agitation. I don’t know.

But if he tries to leave the third floor without being accompanied, alarms ring and the elevators automatically shut down. So they keep a close eye on him.

I distracted him by detouring off into one end of the large common area used for meals and recreational activities, steering him towards a chair at the table closest to the door. There were several picture books on the table, one a photo book about Hawaii, the other a collection of vintage cars. The table was unoccupied.

With a little encouragement, repositioning, and a bit of physical assistance, he abandons the walker and sort of falls into a chair. I pull another chair over to the table and sit down. A staffer brings over a small cup of juice and a spoonful of orange jello, and sets them in front of him. He says he’s not interested, then downs the juice in one go.

On this afternoon, I brought along five or six photos of events in Waikiki, probably all in the 1940s. One shows a group on the beach, diamond head in the background. All are wearing many flower lei. It looks like a winning team of canoe paddlers. It’s the kind of picture which, on a good day, he can tell you a lot about, who, when, why.

Yesterday he looked at it for a long time. Finally he pointed to the man on the far right.

“Rabbit,” he said simply.

I’m assuming he means that it’s a young Rabbit Kekai, one of the well known Waikiki beachboys.

“Whaley,” he said, pointing somewhere in the middle of the group. Ed Whaley was in that same cohort of Waikiki beachboys.

I try asking a follow-up question or two, attempting to dig out more from his memory. No answer. He looks at the picture some more. Nothing else comes.

At this point, another resident is steering his own walker towards our table. It’s the man who sleeps in the bed next to my dad. A curtain separates their beds into different worlds, but they still can’t help seeing each other frequently.

My dad looks up, asks: “Did you lose something?”

He didn’t get an immediate answer, so he repeated, “Did you lose someting?” His roommate was busy doing his own maneuver from walker to chair.

Once seated, the man then looked back, and replied in a loud, clear voice:

“Just my freedom!”

My father didn’t understand what he said.

“Your what?”

“My freedom!” Sharp. Emotional. Direct.

The echoes are still ringing in my ears. It was a very heavy moment, weighted down with unstated loss, fading memories, past lives that hang just out of reach like that word on the tip of your tongue that you can’t quite find at a crucial moment.

Luckily, my dad didn’t connect fully to it. But he has his own struggle going on. He wants to find his long-lost cars, but he lacks the freedom to do so. He also lacks the cars, which no longer exist, or a clear memory of what cars he is thinking about, but he doesn’t know that and it wouldn’t matter anyway, since he knows he just drove one that morning.

I tried to squeeze past the moment, again seeking distraction by passing the old Waikiki photo across the table, and the other man takes it, holds in in its fingers, feels the texture, looks at it carefully. Appreciating the moment. He takes it all in, then passes it back. I offer other photos, one at a time, reminding my father in the process that he had already looked at each of them. It works, for now. Freedom is perhaps forgotten, at least in this brief moment.

Soon I have to excuse myself and let myself out of the room, off the floor, out of the building, to our car, waiting where I left it in the parking lot, leaving them there at the table, together with their thoughts.

Thursday…Falling down the memory hole

I made a quick trip over to visit my dad at lunch yesterday at the skilled nursing facility on Beretania Street where he’s been since the end of last year.

When I arrived, he was in bed asleep, but the cart bringing lunch was being wheeled down the hallway, so I woke him up.

He opened his eyes, confused, perhaps startled.

“What day?” he asked, hoarse, mouth dry. “What day?”

I told him. Wednesday.

“A week day.” Processing.

Yes.

He thought about it. “That’s why there’s a lot of activity around here?” Gesturing towards the door to the hall and the common room beyond where people tend to gather.

Yup. I suppose.

He looked around.

I slowly realized that he wasn’t sure who I was. Usually he will greet me by name, with a hearty welcome learned in his 60+ years as a salesman. “Hello, Ian, thanks for taking the time to stop by.” Use the name, be positive.

None of that yesterday. Long pauses. Silence. I think he was trying to connect my face with parts of his memory. It wasn’t clicking. At least not yesterday.

The food came. He exchanged pleasantries with the nursing assistant. Asked her how she had enjoyed her trip. So that meant he remembered that she had been gone. Good sign.

She took the cover off his plate. Unwrapped the fruit cup. Shook up the nutritional drink. Got out a straw and stuck it into the can. Moved the small glass of milk within easy reach. Set his fork and spoon alongside the plate. Went on her rounds.

Then he ate. Slowly. First the fruit cup, one small piece at a time. Cantaloupe. What looked like Honeydew melon. A grape or two. Then the fork moved over to the rice, and what might have been creamed tuna or something of that variety. One bite at a time, each movement of hand to mouth a delicate balancing act. But he managed. Peas were harder. Several were lost on each repetition.

Trying to help with an outstanding issue, I asked if he could recall whether there was an insurance policy on his boat. Said that I knew it might be hard to remember. I could see him searching for a memory, any memory, failing.

Finally he spoke. “I don’t do the paperwork,” he said. “I wouldn’t know.”

For several decades, this boat was a huge part of his life. I’m sad that he’s barely able to remember. What to say?

Finally, with conversation stalled, I said I would have to get back to work.

He asked: “What do you do?”

I told him I was working at the City Council for a little while longer.

He thought about it. “Do you know Ian?”

Ah. It gets complicated. How do I answer? All the advice we’ve gotten is to go with the mental flow.

“Of course,” I replied. “I see him all the time.”

True, in a way.

He was looking straight ahead into some other part of the world. He went on.

Talking through that long stare into space. “I don’t think he did as much with his politics as he could have. But he felt differently.”

I felt his regret. Weighed it.

I think he would have liked to see me run for office, become a public official, wield power. But somehow I’ve never wanted to walk on that side of the road. He obviously didn’t understand my choice, but had never said anything to me directly. Is it too late to talk about it?

He shoveled his fork under a few of the remaining peas, got it balanced and level, then shakily got hand to connect with mouth. Chewed.

I thanked him for the visit. Said I would be in touch. He waved a quick goodbye.

And I took the elevator downstairs to catch the bus back downtown.

Thursday…Update on my dad, another two-newspaper morning, and weather here and there

My dad continues to deal with dementia, while we learn the strange ways of the brain.

When I stopped by to visit him yesterday morning, he wasn’t out in the public room. I found him in bed and apparently asleep. But when I pulled a chair over by the side of the bed, he woke up.

“How did you find me?”

It’s a question he often asks. I think it reflects that he’s not really sure where he is, so how we locate him seems mysterious.

Then he immediately complained of increased dizziness.

“I can’t stand up. What’s wrong? I’m in bad shape.”

He seems to go through a cycle lasting 6-8 weeks, with a week or 10 days during which he complains of dizziness and is more disoriented, then getting relatively better until the next downturn. This seems to be the onset of another down cycle.

I asked him what happened.

He thought about it.

“I was exercising. It was a class, you know?”

I think he was referring to taking part in the morning exercise session they have right there on the third floor of the nursing facility.

But the idea of a class seemed to trigger complex “memories”, and he went on.

“I drove my car up to the university,” he said. “I had two classes. I went to the first one, but got dizzy. Then I couldn’t find my car. It wasn’t where I parked it. But I finally got back here and thought I should go to bed.”

He’s talked about his car a lot recently after learning that we had it towed away and junked. I told him it was unsafe and he couldn’t drive it any longer. My sister told him it was traded in on a newer car. He says, “it was a good car.” Meaning–there wasn’t anything wrong with that 1982 Nissan.

I worry about this latest bout of disorientation, but we just have to wait it out. So it goes at age 95 and counting.

I noticed another “two newspaper morning” in today’s news. Both newspapers have stories on an upcoming state bond issue.

The Star-Bulletin ran a story from Bloomberg News:

State’s credit outlook reduced

Hawaii’s credit-rating outlook was reduced by Fitch Ratings as a drop in tourists to the state has weakened revenue and depleted large reserves built up in recent years.

Meanwhile, the Advertiser ran a story by reporter Greg Wiles:

State ready to sell $616M of bonds

The state hopes to issue more than a half billion dollars of bonds next week with some of the proceeds going to fund building projects in Gov. Linda Lingle’s construction stimulus plan.

You had to read down a bit farther in the story to get news of the rating change.

My first impression was that the Star-Bulletin should get credit for highlighting the rating change, which could have significant impact. But that was balanced by my appreciation for the ‘Tiser’s own story vs. the wire service copy from the Bulletin.

So, once again, I’m glad we’re still a two-newspaper city.

What a difference a couple of thousand miles makes. When high temperatures were predicted for the Seattle area this week, the National Weather Service issued an “urgent heat advisory“. High temperatures were predicted to reach 90 degrees, while the low temperature was predicted to be higher than normal, only cooling off at night to around 60 degrees. The dew point was expected to rise from the 40s into the low 50s, “making it feel a bit more muggy and uncomfortable.”

A HEAT ADVISORY MEANS THAT A PERIOD OF HOT TEMPERATURES IS EXPECTED. THE COMBINATION OF HOT TEMPERATURES AND RATHER HIGH HUMIDITY CREATE A SITUATION IN WHICH HEAT ILLNESSES ARE POSSIBLE. DRINK PLENTY OF FLUIDS. STAY IN AN AIR-CONDITIONED ROOM IF POSSIBLE. STAY OUT OF THE SUN…AND CHECK UP ON RELATIVES AND NEIGHBORS.

Scary stuff.

Meanwhile, in Honolulu, the temperature yesterday ranged from a high of 88 to a low of 74, according to the National Weather Service, with the dew point in the mid-60s.

And here in Hawaii that just meant “have a great day!”

Tuesday…Opening scenes

First it was a somewhat hoarse meow in the dark. Then two large paws started kneading on whatever part of my body they were closest to. Next, the whole 16-pound cat climbed onto my stomach as I lay in the dark, front paws towards my face, paws & claws pumping up and down in a satisfying kneading motion while a low rumbling purr filled the silence. It was just Mr. Romeo’s way of letting me know that it was almost 5 a.m. and the cat dishes were empty and in need of filling.

So I’m awake.

[text]I stopped by after work on Monday to visit my dad at the Oahu Care Facility, a nursing home on Beretania Street where he has been since mid-December.

He was sleeping when I arrived. I gently woke him up. He was surprised, and it took several seconds for him to recognize me and get somewhat oriented.

Good news. He recognized me relatively quickly. “Ian, thank you for coming!”

But he was not happy. “This is crazy,” he said. “I’m supposed to be somewhere for an important meeting, but…I can’t remember. But it’s important. How am I supposed to get there? I keep forgetting that I can’t just walk.”

He looked imploringly at me.

I backpedalled. “No, I think you were supposed to be right here for my visit.” He seemed to accept that version of reality.

Of course, he can walk. It just isn’t safe to let him try to walk alone because he forgets to use his walker, or forgets how to use it, and his balance is so bad that he’s likely to fall. And it was a bad fall that put him in the hospital back in November. It’s the danger of falling, and the additional dangers caused by dementia, that have kept him in a nursing home since then.

I asked about a visit earlier in the day from Wally and Moku Froiseth, old friends from the early days of the Waikiki Surf Club. I had seen their names on the sign-in sheet at the nursing station there on the 3rd floor.

He beamed. It was obviously important that they remembered him and made the effort to get here to visit. He also remembered that Wally is 90 and has had more than his share of health issues as well. It made the visit all the more important.

He complained about not being able to buy them anything during their visit.

“I don’t have a penny on me, and I haven’t for five years!”

We’ve been through the “no money” complaint before. He misses that feeling of his wallet in a pocket. We’ve explained that his expenses are covered, just like in a good hotel. That satisfies, but never for long.

At 5 p.m. his evening meal was delivered. He elects on most afternoons to eat his meal in bed. I’m not sure why, except that it’s probably depressing to eat in the common room with so many ailing oldsters. He ate with vigor, as he has done most days when I’ve visited.

I made small talk while he ate. I tried to describe the scene at the State Capitol during last week’s Taro Festival, when a large group gathered for a mass poi pounding session right there in the Capitol rotunda.

“Oh,” he asked. “You’re still working at the Capitol?”

“Yes,” I replied. “The session doesn’t end for another month.”

“Do you get paid?”

Again, I answered in the affirmative.

He considered what he had heard.

“When was the last time they had people pounding poi in Washington?” he asked.

Sigh. A logical connection from the capitol to Washington, but also an indication of a short circuit along the way.

In a little while, I said my goodbyes and slipped out to wait for Meda and the ride back to Kaaawa.