I Can Still Remember.....

After a discussion with an associate recently about one of her present residents, I couldn’t help but recall my first resident clinically diagnosed with Alzheimer’s. It is a sad, but happy story.

Alzheimer’s, in my opinion, is one of the most devastating disease processes I see in my resident population.  It literally destroys the memory piece by piece (I visualize it as being “Pak-Man” of the brain) leaving only dead ineffectual brain cells in its wake.  In the early stages, patients may be aware of their memory loss.  They become apprehensive and frightened at the capriciousness of what can and cannot be recalled.  As the symptoms escalate, unconscious of the changes taking place inside their brain, they fail to recognize spouses, children, or friends.   It is painful to watch the effects of the increasing dementia.  Adult children are often heartbroken when their mom or dad no longer remembers who they are or confuses them with someone else.  Everyone emotionally involved with a loved one with Alzheimer’s suffers a significant sense of loss.

 Ralph was a delightful soft-spoken, kind gentle man who doctors had diagnosed with Alzheimer’s almost a year ago.  He came to our community as a daily visitor because his wife, Laura, felt she could no longer endure the draining effect of the 24/7 supervision he needed.  During the week, she would bring him in the morning and pick him up after dinner in the evening.  She also hoped the social environment would help Ralph have a more meaningful life; more than just pacing back and forth in the same spot or wandering in and out of the lonely rooms in their house.

 At the time we had very few residents with a diagnosis of Alzheimer’s, so we were able to keep him safely within the general population rather than isolating him in the secured area that had been renovated for dementia care.  Ralph was a talker, and although it was difficult to understand the drift of his conversation, it was impossible not to be attracted to his cheerful disposition. He suffered many of the effects of Alzheimer’s without losing his charming personality.

Ralph was an engineer, and he had owned his own business designing machines for small independent companies.  His expertise as an engineer was so innate that he never quit working, and we encouraged him to continue with his trade.  Our staff would give him a small, soft fabric measuring tape, and supervise while he measured the furniture, the walls, the doors, the windows, and any and all objects he could reach.  He came to my office once a day, whistling with delight.   He took his measuring tape along the wall behind my desk. He pulled the end as far as it would stretch vertically, then horizontally.   When he finished, I would jot the numbers he gave me on a sticky note and hand the paper to him.  It became our private ritual.

Ralph soon had a girlfriend, Maggie.  She, like Ralph had been diagnosed with Alzheimer’s.  I marveled as I watched the two of them.  They frequently sat across from each other at a round table in the activities area.  They talked and laughed, their heads bobbing up and down in agreement. Occasionally they would reach across the table and touch hands like two teenagers.  Listening, I could not recognize or interpret a word or a phrase, but the conversation between the two was explicit to them.  They had been blessed with their own spiritual means of communication.

Laura, Ralph’s courageous wife, is the heroine of this story.  I never heard her complain.  As husband and wife, they must have been well matched.  Like Ralph, she was always friendly and surprisingly cheerful. I admired her spirit.  She was able to love her husband despite his changes, and she patiently accepted his need to be free to meet the challenges he faced without criticism or interference from her.

Although they had been married close to 50 years, she understood that the person she now cared for was not the Ralph that she married, but a new Ralph; one that did not recognize her as his wife, merely as a helpful friend.  Although her heart must have been suffering, she embraced each change in his personality and allowed herself to enjoy it.  “I’m just so happy he’s happy,” she would say.  “If he can’t join me, at least I can be grateful that he is content in his personal world.”  On Christmas Day, she came with a gift for Maggie, Ralph’s new friend.

I regret not keeping in touch with Laura.  She taught us all a lesson in kindness and generosity.