FOR GREGORY. He was not a VICTIM of ALZHEIMER'S DISEASE, he was a HERO!

PLEASE NOTE: Even though this blog is now dormant there are many useful, insightful posts. Scroll back from the end or forward from the beginning. Also, check out my writer's blog. Periodically I will add posts here if they provide additional information about living well with Dementia / Alzheimer's Disease.

Showing posts with label Companion. Show all posts
Showing posts with label Companion. Show all posts

Monday, June 2, 2014

Happy Birthday Alaksh



Alaksh joined Gregory and me as Gregory's companion about a year ago. He would spend some 10 to 15 hours with Gregory so I could run errands and have a little time to myself as well as to provide Gregory with companionship and an alternative from being with me .

Alaksh and Gregory  and Alaksh and I got to be good friends in a father/son, grandfather/son, fairy god mother/son kind of way.

When Gregory moved to Lieberman's Memory Care Facility, Alaksh would spend time with him there.

Most recently Alaksh has been cooking Indian Cuisine dinners on Sunday nights for Gregory, me, Manny (Gregory's private care aide,) and himself. These meals take place in a second floor classroom which provides a lovely alternative for the general dinning room on the fifth floor. Only the four of us, delicious food, conversation and none of the commotion that is often times present at dinner on the fifth floor.

Today was Alaksh's 25th birthday and Gregory and I were honored that he chose to spend it with us. We ordered out Chinese, Manny presented Alaksh (on behalf of Gregory) with a bouquet of flowers and some almond brioches. I gave Alaksh a copy of my second book of poetry.

We sang the Happy Birthday song several times and Gregory actually tried to join in with a word here and there. When it was time to blow out the birthday cake candle, Alaksh moved the cake near Gregory and encouraged him to blow out the candle.

It took until the candle was almost gone, but with loving repetition and samples of what blowing air through one's mouth looked like by Manny and Alaksh, Gregory finally took a big breath and blew out the candle. All present; Gregory Alaksh, Manny, and I took great pleasure and pride in Gregory's accomplishment.

The following was posted by Alaksh: "Things half said can be so beautiful. Thanks Michael Horvich and Gregory Maire for a beautiful, yet learning and emotional experience in my life....will cherish you guys forever."

Manny, Gregory, Alaksh


















Friday, September 27, 2013

A Letter to Gregory's Last Companion

Ken,

Hope all is going well with your studies, and your assistantship. We are doing as well as can be expected. If you've been reading the BLOG (not expecting such) you will know what's going on. G continues to decline but I am continuing to rise above it in his support. We miss you but honestly do not think of you too often if only because we need to let you move on. You were the first companion and not only that you proved to be a special, loving person, so you will always hold special place in our hearts.

Alaksh has settled in and is doing well with Gregory. He is slowly learning how to interact with Gregory and not to read too much into their interactions as the Alzheimer's (as you know) is so completely unpredictable. One of the many good things about Alaksh that is different than you is that he cooks! And he is good at it. We loved your Ramen adventures but I have included Alaksh's cooking as part of our weekly time. Gregory and he go to Whole Foods, and together (as much as possible) decide what we will have for dinner (I just say "Surprise me!) and Gregory helps (as much as possible) with the cooking. And as you know, since Alaksh does the cooking, I have to clean up. But it is nice to be away and come home to dinner on the table. 

I am about to send my second volume of poetry to the publisher. When it is ready, I'll send you a copy. It is called, "Sit With Me A While Longer." It has at least as many if not a few more poems than the first volume and has lots more "chair" pictures. I am pleased with the results and as you can imagine many of the poems are informed by our journey with the big "A."

We are enjoying the beginning of fall, have mums on the balcony, and have been having the windows open more. Our kitties are now cats, continue to develop separate but interesting personalities and while they are the "demons from hell" at times, we love them and they give a lot back to us with their own kind of love.

Take care, I still have your pillow case and will mail it soon.

Fondly,
Michael (and Gregory)

Tuesday, August 27, 2013

First Day, New Companion

On Aug 27, 2013, at 12:57 PM, A wrote:
Hi Michael,

Tomorrow is the first time when I will be spending time with Greg alone. I am super duper excited about it and also a little anxious. Last minute checklist, what all are things that I have to keep in mind. I have read the docs and some of the blogs, I just need some inputs from your experience and also a short list of things that you think would be nice to do.

Looking forward to your reply.

Thanks and Regards,      A


A,

The anxiety is expected. I am a little anxious as well. Gregory, with his Alzheimer's BUFFER, has no fears or doubts. 

First, when I send a calendar notice, please let me know as soon as possible that you received it and that the day and time are OK with you. Often we will book our times when you are here so we can look at the calendar together. I want to be sensitive to your schedule and needs as well as "locking in" my schedules.

Getting used to being with Gregory and what to do will take time and experience. As you get to know his abilities (or lack of them) you will be able to make your decisions more easily on how to spend your time with him. You will be able to guess at what he is trying to say. Give him time to formulate his needs. Try not to offer too many suggestions at a time. Sometimes understand that "trying to help" complicates things.

Also, whenever a question comes up you should feel free to text or call. Even little details like "Where is the milk?" After your time with Gregory, you and I will make some private time to debrief and address any questions/issues/concerns you may have.

PRIMARY: Gregory's safety, especially when outside. Never leave him alone. For example, you do not have to watch him pee but be in the same room at the restaurant. At home he can navigate the condo by himself but for example you wouldn't want to let him take out the garbage by himself.

On your first time together I would suggest you not venture too far from the condo. Take a walk to the lake. It is not too far, G loves the lake. There is a lot to see and watch there. People, the dog beach, etc. Sit in the shade and watch the world go by. KEEP AN EYE FOR FATIGUE REMEMBERING THAT HE HAS TO WALK THE SAME DISTANCE BACK HOME. MAKE SURE HE TAKES A WATER BOTTLE. It is supposed to be less hot tomorrow. 

Often G like to take a nap (either on the sofa or in the bedroom) when he gets back. 

You could also sit on the balcony, look through a book that Gregory grabs for you to share. Again, while all his memories and intelligence still exist, the Alzheimer's prevents it from being accessed. 

I'll show you how to use the HVAC (Heating Ventilation Air Conditioning,) if he or you are too cold or too hot. Also this time how to use the coffee machine and where the cookies are. Next time I'll show you how to run the music. On Saturday we will do a Swimming dry run. Next week we'll look at the TV and running DVD's.

Every now and then, (a couple hours) and especially before the walk, suggest that Gregory use the bathroom.

I usually post these kind of e-mails on my BLOG because it helps our family and friends and readers keep in touch with our "progress" and sometimes offers good suggestions for when they are with Gregory or other loved ones who are dealing with dementia. 

Looking forward as well,
m





Friday, August 23, 2013

The following is an e-mail to Gregory's new companion. We are excited about his joining us and are hopeful that it will work well. In the beginning, the key to success is lots of communication between me (the employer) and the companion about what to expect as well as how things go when with Gregory (the client.)

A

Enjoyed dinner with you last night. 

In the beginning you and I will be communicating a lot about how to work with Gregory. As I mentioned it is important not to talk or whisper behind his back. I mentioned that in the beginning after each time you are with Gregory, I'll walk you to the elevator "to get the mail" and we can check in about how the day went. You should feel free to ask questions and I will fee free to inform and comment. Also feel free to e-mail me afterwards. 

You can text me when with Gregory and if I do not respond within a reasonable amount of time please follow up with a call. Sometimes I do not hear the text "ding." 

Not knowing how to handle a situation isn't as important as discussing how it might have gone. 

Primary is Gregory's safety followed closely at hand by his happiness/contentedness and all done with respect. I know you understand that but want to mention it again.

Things you can do include:

going for a walk in the neighborhood, on campus, to the lake. You need to keep an eye on how he is holding up, especially in hot weather, as he is not able to monitor that for himself. There are small metal water containers in the refrigeragtor with a belt hook. Please make sure he takes one when you go for a walk (and also that he doesn't put it down accidentally on a bench and leave it behind. Those buggers are expensive.

browsing Barnes and Nobel.

5:00 coffee and cookies are a must. (I'll show you how to use the coffee machine.)

going to Starbucks for his 5:00 coffee.

swimming downstair as LA fitness. (I'll walk you through this.)

working together on a LEGO building or on a jig saw puzzle.

looking through books/magazines (by himself or sharing them with you.)

listening to music. (I'll teach you i-tunes)

sitting on the balcony or going down to the roof top garden.

whatever he wants to do by himself. 

take a nap (you can also!)

watch TV or a DVD

any other ideas you may have (be spontaneous or check with me.)

NOT OUT OF THE NEIGHBORHOOD

You do not have to occupy his every moment and should feel free to work on your own stuff now and then. I'll give you the wifi password so you can get online. Just quiet time together can be wonderful.

Ask now and then "Do you have to use the bathroom?" especially when you are about to go out for a walk.

When you look through books or discuss buildings you probably know by now that he is not too good with language. The ideas and knowledge are all there in his head but he cannot get the words and/or associations out for proper communication. 

One idea is that you can comment on what you see and he can confirm. Be careful asking too many questions because he cannot process or communicate and that may lead to frustration. I find that our best days are ones that are somewhat zen, just being one with our environment and place. I'll comment and tell my stories AS WELL AS his.

I'll let you know when we are ready for a cooking adventure with you and G shopping and preparing dinner. First I'll "walk you around" the kitchen and show you where things are.

Not sure if you'll encounter this but if he becomes concerned about something you might say something like, "We'll talk to Michael about this later." or "I'll check with Michael." or "I am sure it will all work out." I have found that white lies, distraction, and redirection also help.

I am sure there will be more later ðŸ˜„

m

Monday, June 17, 2013

Horoscopes and Breakdowns



June 17, 2013


AriesAries (3/21-4/19)
No one -- not even you -- can be selfless and generous all the time! It's okay to mix a few selfish acts in with your good deeds today. Don't do anything too egomaniacal -- just put yourself first a few times when you usually wouldn't. This isn't an excuse to forget your manners -- you should still hold the door for old ladies, and say 'please' and 'thank you' -- but it is a reminder that you need to treat yourself like the star you are a little bit more often.
• • • • •

While it is hard to say this horoscope is meant for me alone (how many people in the world were born between March 21 and April 19?) it does apply.

Last night I cried myself to sleep wondering how I look to the rest of the world. Strong? Together? Even? Supportive? Loving? Giving? While recognizing those adjectives as part of who I am, I was not feeling them. I was sad, lonely, and feeling devastated as I walk along with Gregory and his Alzheimer's - every morning, every day, every night.

I don’t expect you to comprehend this life we’ve been forced to lead; however, I do expect and need your understanding. I want to be treated as normally as possible with the knowledge that my life has been turned upside down. The love of my life is dying before my very eyes. Each day he dies a little more. I’m in a continuous state of grief. It is like having a funeral every day of my life. I try to spare you my pain, but it’s there. If our lifestyle appears to be the same to you, I’m doing a good job of camouflage. I do what I do for Gregory, for myself, and for you.  
Michael Horvich (2006)


No one really to turn to in the hopes of making "it" go away. The Alzheimer's? The feelings? The tears? Last night, I just needed to cry, to howl. I needed someone with whom could cry but not someone who would try to comfort me for there is no comforting in dealing with this INSIDIOUS disease.

In some ways, even with loving family and friends, there is no one there for me since the only one who truly matters is Gregory, my life and soul mate of 35+ years, and he is less and less available. To himself? To me?

He seems content, happy, loved. He bumbles along day to day in a good mood, laughing at his inabilities. When I am at my grumpiest, he forgives me or lets me know that my role on the path is a difficult one. He appreciates me, he loves me.

So last night through my tears I heard a voice in my head say, "Tomorrow you die." No not death, but another part of my life gone as I re-evaluate Gregory's needs and try to accommodate them. Accommodate them not in what I consider my recently, once again gruff, impatient, angry way but only with patience and love.

Instead of treating him like an invalid, which I have been avoiding although sometimes without the use of language that is all that is left, I will be there to assist him for what might be or feel like 24/7. 

For example when I tell him at bedtime that it is time to brush his teeth, I usually go about the own business of closing up the house and getting the cats and myself ready for bed. Now I will wait to help him find his toothbrush (if he can't this time) and put the toothpaste on the toothbrush (if he can't this time) and run just a little water on the toothbrush to wet it (if he can't this time) and then make sure he knows how to get it into his mouth to begin brushing (if he can't this time) and when he is completely, and successfully brushing his teeth, I'll look back to my own needs.

And so tomorrow I die.

This process is the same for almost every life skill that Gregory attempts. Recently, at bedtime, he had on his shorts but not T-shirt (which I always put in the bathroom and announce, "Your night clothes are in the bathroom.") Having come into the bedroom without his T-shirt, he no longer knew where it was or even that he needed the shirt ... just that something is wrong. 

Another time, when he was getting his night shorts and shirt on, I come back into the room to find him with his feet through the arm holes of his T-shirt trying to pull the body of the shirt up around his bottom.

After my having taken the time to get his "stuff" and putting it in the bathroom for him and letting him know where the "stuff" is, you can see why I get a little frustrated (angry?) that even with all my help, it isn't working! And not only the anger but also the fear and worry about what the future will bring (although I try so hard not to worry about the future since I really cannot control it.) "Don't worry about those things you can control and don't worry about those things you cannot!" A Buddhist saying.

Having to do EVERYTHING for us, you can see how easily it is to fall into the frustrated, angry, gruff, impatient, fearful mode. 

With Ken, Gregory's companion living with us since April, my life has been a bit easier. But Ken will be leaving at the end of June to go back to Japan and then return to Vanderbilt University to begin his Master's Degree. So last night, I was also grieving not only Gregory but also our loss when we send Ken on his way. We have come to love that man with his gentle, loving, respectful, helpful ways!

So tomorrow I die but know that somehow I will survive. In last night's grief then, I realized that the next step has to be follow through, follow through, follow through. Not on Gregory's part because he is no longer able, but on mine. 

When I hand him his vitamins and medications I will wait there until he knows how to begin taking them. When I tell him to "fill your pockets" with wallet, keys etc, I will wait there until he begins doing so (and I will double check after while that he got everything he needed.) I will no longer ask him to wait in the car when I have to run into the drug store for a quick purchase, I will have him come with me. Recently he got out of the car and came into the store looking for me.

These activities and follow throughs will be difficult for me and I will have to learn how to attend with patience and love but they are a necessary next step. And like other "next steps" once I have mastered the step, I feel better able to cope, am less angry, less frustrated. 

The additional energy I have to spend in support of Gregory's daily needs is made up for by the less emotional energy I have to spend on anger, frustration, fear, guilt, etc etc etc. So tomorrow I die, but I am also reborn and continue on the path.

• • • • •

From the New York Daily News, January 1, 2013:

  1. Year ahead: This is a year of personal transformation, and a time when you will feel compelled to review, reassess and restructure your life on many levels. At some stage you can feel cut off from the support you have become used to having and forced to be more self-sufficient, particularly on a monetary level. The role other people play in your life will be highlighted with you realizing their contribution to your life and you in theirs. Your home life takes on a greater level of importance, and you will desire to settle down on a more permanent basis and have more stability and security in your life. Personal growth: Over this year, your world view will continue to expand with you letting go of prejudices you once had and replace them with a broader more accepting view of yourself as well as those you come in contact with. Romantic month: Jupiter the planet of expansion enters your solar fourth House of home and family on June 26th, and stays there until July 2014, a period where you can make favorable changes in your personal lifePower month: March, a positive change in your career can move forward and a personal situation gains momentum to move to the next phase. Your annual new Moon is April tenth, which is the commencement of your next solar cycle. Angel advice: The structure of your life, as well as your values and beliefs, will be challenged this year. As you question the meaning of life and how purposeful your life is, it is important to be open to change and see any forced or unexpected changes in your life as the universe’s way of steering you back on the path you are destined to walk.
  2. Love, family, friendship: With Jupiter shining its beneficial rays on your personal life from midyear, your focus will be on family and your home environment. The full Moon three months beforehand on March 27th, can provide the energy to be the catalyst to jolt a relationship into reality with a purposeful decision being made, even though plans may not eventuate until later in the year around July or August. There is very much an essence of fate around your love life this year, if it is meant to be there is nothing you can do to stop love from capturing your heart. It can sneak up on you and all of a sudden your life can be different from what it has ever been. Setting up home so you have comfortable surroundings for you and your family will also be high priority this year. You will be conscious of developing healthy bonds with family members and adhere to a schedule of regular contact to stay closely connected with those you love. Friends can suddenly leave your life, for no other reason than you are travelling on different journeys as you seek where you fit within the big picture of life. The first half of the year can present situations you feel impatient about. The second half sees you more relaxed and satisfied as you have a vision of where your life is heading, and although there are compromises to make, you will feel what you give is well worth what you receive in return.
  3. Career, money, purpose: It is no longer an option for you to go through the paces at work. Over this very important phase with transformational planet Pluto in your solar tenth House of work and purpose right through to the end of 2024, you will strive to make a positive and substantial contribution to the world through your career and business dealings. You now need your career to be more meaningful and to achieve this, some of you will change your career, and others will put more focus on aligning your work with your overall goal of excelling at what you do. Your ambition will be heightened over this period; however, be careful you aren’t too impulsive about changing your path, as a rash move can cause setbacks. It is advisable to think through all the pros and cons of a new endeavor to ensure it is what you truly want to do on a long-term basis before you put action to your thoughts. Ethics and the way you morally handle your business also come into play and at all times it will be best to take the high road, regardless of the actions of others. At the end of December 2012 a fortunate transit occurred with your professional life that can provide a financial bonus. The ongoing challenging squares between planet of sudden changes Uranus and power planet Pluto affecting your career life continue through to early 2015, with two direct degree hits this year on May 21st and November first. If you have not made a considerable change to live a life of purpose by November, a fateful event is very likely. Destiny will take matters out of your hands and place you where you should be. This is a transformational year on many levels, which promises to be eventful to say the least.



Saturday, May 25, 2013

In addition ...

In a previous post I discussed an interesting phenomenon in which Gregory is more comfortable at times to go to Ken, his companion, for help than he is to come to me.

In that post I had wanted to, but forgot to mention that it seems very much like when a child goes to one parent with a question, doesn't like the answer, and so goes to the other parent to see if they can get a different answer. That is probably the reason that eventually when the child asks the mother a question, she replies, "Go to your father," and when the child asks the father a question, he replies, "Go to your mother."

Another interesting thing happened when we were discussing my taking Gregory to the swimming pool after Ken leaves us. I have slowly been "dropping pins" about Ken's leaving for Vanderbilt to continue his studies in psychology so that when he finally has left, Gregory will have had a chance to deal with the leaving.

When I dropped the "pin" the other day, Gregory looked concerned, worried, frightened? I asked what was the matter. "You'll take me swimming?" he replied. "Oh."

"Yes. I'll help you begin and then while you swim I'll do the hot tub or something." Gregory's worried face continued. "Do you want me to be there while you swim?"

Both Gregory and Ken agreed that Greg swims alone once in the pool and doesn't need assistance. Finally, Gregory said (or stumbled,) "Well ... then ... you'll have to come and be there. And Ken will help." In other words, Gregory wanted Ken to show me what to do to help Gregory when he goes swimming. Ironic since I "trained" Ken on what to do for Gregory. I gently reminded him of this, said that we all three could go down a few times, and perhaps that would make the transition easier.

Gregory liked this. He did comment, "You did?" in response to my comment about having shown Ken the swimming procedures. Ken was very supportive and added, "Yep, Michael showed me and I'll show him back. I am sure there won't be any problem.


CLICK HERE to see previous post. Opens in a new window.

Tuesday, May 21, 2013

An Interesting Phenomenon

I have been noticing an interesting phenomenon with Ken's living with us. When Gregory needs help with some things, he goes to Ken for that help. I do not mind but have been observing and have learned a few lessons based on my observations.

Ken is always, and I mean always patient with Gregory. I am not.

Ken is always fast on the ready to help or do something for Gregory while often I will make him figure things out by himself.

Ken will be supportive and positive while at times I become angry, frustrated, concerned, worried for the future based on an imagined, new, or periodic failure on Gregory's part.

I do not want to seem judgmental towards Ken or myself, just observant of the differences. The lesson here, however, is that Gregory TRUSTS Ken to deal with some things that he doesn't TRUST me to deal with.

For example, after hundreds of times helping or instructing Gregory on how to put on his "Medic-Alert" necklace, now I just tell him, "Just do what you can, it doesn't matter." Ken still spends the time trying to verbally tell Gregory how to put on the necklace. Other times I just take it out of Gregory's hand and put it on for him. I have never seen Ken do this.

My very "in touch niece" Colleen once drew an understanding about cats and how they will continually come back to you based on the MARGIN OF TRUST you allow them. You can discipline them or step on their tail accidentally, but they will still come to you to get pet and will purr and love you.

For example, you can hold them firmly, but when they really, really want to get down and when they show you this with their squirming, you put them down. The trust continues. You may swat the cat when it is chewing on a book in your library, but they still trust you. If you swat them all the time, however, or continue to hold them against their will, the trust margin decreases.

So my lesson with observing Ken and Gregory's interactions is that I need to be very careful not to extinguish that margin of trust which Gregory has for me, my intentions, my being here to help. The last thing I would want to do is inadvertently cause him to be afraid to come to me for help.




Wednesday, May 15, 2013

Ken the Kompanion

Haven't posted for a while. With Ken, Gregory's companion since last May and living with us since Easter, things have been going pretty well. As I have mentioned, both Gregory and I get along well with Ken and he, us.

If you missed them here are two BLOGS about the experience: It's Only Fair and Companion

Ken is easy to live with, allows us our privacy, and keeps his own. We also spend many dinners together and often times will just sit around the living room chatting. Gregory and I have learned a lot about the Japanese culture and Ken has heard a lot about the American as well as Gay cultures.

Ken has met many of our friends, has joined several parties that we have hosted, and has chatted with Roger, Scott, and Richard about their experience in Psychology as Ken will be starting his masters in Clinical Mental Health Counseling at Vanderbilt University in September.

Ken and Gregory make a good team when cleaning up after meals. A few meals into Ken's tenure with us, I smilingly suggested, "You know ... it's ... only ... fair ..." And they both finished with, "that we clean up since you cooked.)

Among other support activities, Ken sets the table, takes out the trash and recycle, helps bring groceries from the car and even helps put them away. Often Ken will pick up a few things at the close by Whole Foods or return books to the library. He brings up the mail and when I need an extra hand fixing something around the condo, his are very able.

Gregory and Ken go swimming at the pool in the building two or three times a week, go for walks, go for haircuts and manicures, and spend time at Starbucks.

Today I am just home from a week in New Orleans. Gregory and Ken spend 24/7 together very successfully and I felt totally at ease with not being home. Periodically I would send them texts with added photos of what I was doing in NOLA. A day or two into my getaway, photos of what they were doing began showing up in their texts to me.

Following is a gallery of photos from Gregory's Great Adventure:

Gregory & Ken at the beach

Gregory out on the pier

At home with a sandwich and 
soup from "Pret-a-Mange"

Gregory in the swimming pool

Gregory at "San Germaine" with
a dinner crepe

Gregory at "San Germaine" with
a dessert crepe






Thursday, April 25, 2013

Ben

Today was the last day of Ben's being a companion for Gregory. He has been with us for one year, time flies, and we appreciate not only what he has done for us but getting to know what a wonderful person he is. He graduates Roosevelt next week and we wish him well.

When Ben first came on board, I had just begun playing with the idea of getting someone to spend time with Gregory, partly to give me a break and partly to give Gregory a break from me. Ben came to us via our good friends Chuck and John, Ben is their nephew.

The whole idea of having someone pick up the responsibility of making sure Gregory was well taken care of while I was away was scary to me but a necessary move. Knowing Ben since he was a little boy at Chuck and John's July 4th parties made the risk seem less.

It began as another one of our "Nobel Experiments" and the idea of having a Companion proved very successful, and a life saver.

We are grateful to Ben. Below is a photo he took of Gregory on their walk to the lake today (after going swimming at the health club.)

P.S. Ken, Gregory's other companion will be with us until sometime in June. Read about Ken's moving in with us until June.


Thursday, April 18, 2013

Joyful Heart

Noticed that recently I have been in a good place. Not sure if Gregory has plateaued for the time being or if I have. I have been calm, patient, understanding, respectful. I have felt peaceful at a 9.5 out of 10 level. It feels good to feel good. Few if any apologies necessary, little if any guilt, lots if even abundant amounts of love.

Why? On one hand don't question or analyze the feelings just enjoy them. On the other hand look, learn, and grow.

Maybe things feel good because of how well our "Nobel Experiment" is working with Ken, Gregory's companion, living with us and while not needed all the time, being available 24/7.

Maybe Gregory is at a new plateau and we have learned how to deal with and accept the new challenges.

Maybe I have grown and continue to do so with the progress of my meditation and yoga classes with Corinne.

Maybe it is SPRING and the warmer weather and smell of tulips and hyacinths in the flower market air.

Maybe it is because of the renewed flow of creativity with my new endeavor at The Galleria, belonging to an artist collective, having a space in which to sell the results of my creativity, having fun with marketing and signage and display.

Whatever the reason, it feels good.




Saturday, April 6, 2013

Companion

Gregory's companion Ken has moved in with us for three months. A while ago, he had mentioned that his lease was up in March, that he couldn't renew it because his building was doing some renovation, and that he was here for school until June. I asked him what he was going to do and he said he didn't know, he would have to find another apartment.

This caused my "opportunity light" to go on. I thought about the possibility of his moving in with us, discussed my idea with Gregory, and a few days later we presented our proposition to Ken. In exchange for a very little rent from him and more time available to be with Gregory, he could have our guest room and the guest bath as his own. We could also share meals when he was home and when I cooked.

The offer was made at two levels. One was altruistic because Ken was in need of something we could provide and we have come to like him a lot over the year that he has been Gregory's companion. Secondly it would provide me with what I have been calling, "The Nobel Experiment." How do I continue to provide for Gregory's needs as the demand increases and yet still maintain my sanity?

The idea of having someone live with us 24/7, the fact that the condo while comfortable is not huge, and with Gregory and I having to give up our guest/TV room, we had some hesitancies and concerns.  Even with Ken's being excited about the idea and his accepting our offer, I am sure he had concerns as well.

The idea was to see what having "live in help" would be like. Most likely this is the future if I want Gregory to be able to stay at home for as long as possible. As his medical and personal needs increase the person will have to be more health care oriented but that is not necessary at this point. Also, I am healthy and able to take care of Gregory's needs and while I expect to stay healthy, it is always good to plan for all possibilities.

The transition has been very smooth and most of our worries unfounded, Ken is comfortably ensconced in the guest room and besides his being supportive as a companion to Gregory and providing me a friend I can actually communicate with, he has been an excellent, respectful long term "guest.

It has been nice having someone around to let me get out to play, to run errands, have a life of my own so I can be in a better place and more emotionally available to Gregory. Most of the time Gregory and I are together but Ken's being around has given me more opportunities for myself. He has also given Gregory company when I am at my computer running the household or writing or taking a nap.

Ken has provided me with a companion in many ways as I have someone to talk to and share complex ideas which Gregory is no longer able to do. Ken can give me feedback and helps make me feel less alone.

Another thing Ken has provided is putting me in a place of "wiser adult" and almost a parent figure as he asks for my advice, as I sometimes offer it on my own, and he seems to value what I have to offer. I know Gregory needs me, but the interaction and communication with Ken meets those needs on a different level.

Also, Ken has on his own taken over house hold responsibilities like emptying the dish washer, taking out the garbage, picking up groceries, helping me with condo maintenance. He has begun to give Gregory his breakfast and goes swimming with him.

So the only problem with this "Nobel Experiment" is that both Gregory and I are enjoying it very much but it will end in June. Will enjoy it now ... and worry about loosing Ken when that comes.


Thursday, February 28, 2013

Companion Report # 2 by B.P.


I started working with Greg about nine months ago. Since our companionship's beginning, I have thoroughly enjoyed my time with Greg. We share similar dispositions and temperaments and a common taste in music and film. Perhaps greatest of all, we share an ability to sit quietly in one another's company, each of us occupied separately. Many others would find this uncomfortable or awkward, but I think we both find it one of the more enjoyable ways to share another's company. When I began visiting Greg, he seemed fairly stable, at a plateau in his degeneration. However, in nine months there have been deteriorations both significant and insignificant.

More often than not, I work with Greg during the middle part of the day, beginning in the later morning and leaving around the middle afternoon or early evening. For several months, Greg would often make himself a salad for lunch, and I would assemble a sandwich for myself. I would occasionally have to help him in some small capacity: he  might need help finding the forks or removing and reinserting the vegetable crisper/drawer from the refrigerator (cumbersome for anybody). It's been months since I've seen Greg make himself salad. Nowadays, he is content for me to make him an open-faced sandwich (very very simple fare). It's worth noting that his salads often included some small part of decoration. It was never anything elaborate, but slices of cheese or rolled up sandwich meat were placed with a certain amount of care and consideration. The "meals" I create contain no such consideration. But he seems satisfied. He still retains his ability to use a cutting knife, though I keep a close eye at all times.

Greg loves to take a walk when I visit. This shared activity forms the core of my time with Greg. It is difficult to judge any significant changes in his directional abilities as we take the same basic route as my very first day with him. While he is tired by the end of these walks, he always seems happy for having gone out, despite the elements. In all honesty, he seems a little more lucid after our walks. I still wonder if this has anything to do with his great affinity for water and our route's proximity to the lake.

On the note of water, another of Greg's preferred activities is swimming. We haven't gone swimming in a month or so, owing to the pool's closure while the heating is fixed. When we have swum, there has been a very similar effect to walking. Greg seemed far happier and again, a little more lucid after a good swim. He usually needed no real help showering, though I would have to start the shower and get out his soap. Once, he forgot to wash the soap out of his hair, but otherwise this process went without hiccups. When we were in the locker room, I would often have to help Greg change. Usually this simply involved pointed directions and occasionally me either offering him some article of clothing or gently tugging on the said clothing. He has thoroughly enjoyed our swims and has brought up his dismay at not being able to swim on multiple occasions.

When we are in the apartment after our walk or swim, my direct involvement in helping Greg with things is minimal. I might have to help him with his belt or tucking in his shirt on occasion, but that's about it. Every now and then, we'll watch a movie. This is throughly enjoyable for the both of us and involves little effort on either of our parts. Greg thoroughly enjoys simply sitting around listening to music or reading his newspaper while I work on whatever homework or projects I might have.

The most noticeable of Greg's deteriorations have manifested in his linguistic capabilities. He can still read. I can tell as much because he can select something from his menu when we go out to his favorite diner. Often though, Greg might forget what he chose, and I always have to help specify what sides he'll have and how he'd like his eggs. I have no way of telling how much he picks up from his daily newspaper as he never talks about it and can't really communicate anything when asked. What is most apparent is his steady decrease in speech and conversation. I remember the very first day that we spent together, Greg pointed out a building during our walk: "See it's French." I asked how he could tell, and he replied by pointing out the "rounds" on the windows. He has never since displayed such lucidity and clarity in perception and communication. A month or two later, when we were driving back from Wisconsin, he pointed out a building that I liked, and I asked what he liked about it. Greg could barely get his point across, and in the end mentioned something about the upper floor and that was that.

When Greg has a problem or needs help, I have to work a bit to figure out what exactly is wrong. Usually this means me being patient and offering a guess or two. I try not to guess, but it's difficult not to. When I do guess, the helpfulness seems arbitrarily dependent on the word choice. If he recognizes the word in question, Greg's eyes will light up and the problem is quickly confirmed. If not, we'll go several more rounds.

One final note: Greg's muscle memory still seems to be quite intact. He's still remarkably adept at opening the door which actively involves remembering what key to use and how to orient it to the door. Just like anything else, this is affected by his good days and bad days, but the process seems more resilient. Once he gets the key into the lock, you can almost see the engram click into place, and his hand turns in an easy practiced motion.

Many of Greg's abilities have declined, there has been significant and noticeable deterioration since our relationship began. I would not characterize it as severe. He retains many of his physical abilities. Given enough time and a relaxed situation Greg can usually figure things out. He is still relatively young to be diagnosed with Alzheimer's , and quite young to have had it for ten years now. But I have to say that in comparison, a great many things could be much worse. In all honesty, I would largely attribute this to his acceptance of the disease. My grandmother was also diagnosed with Alzheimer's and our family always had to be exceptionally careful about how her diagnosis was discussed. She was severely embarrassed about her illness and hated for it to be talked about. Greg is not so embarrassed. True, he does not often bring it up, and he is never happy about it, but there is a far greater acceptance of the situation. This makes many things easier: helping him with his coat/scarf/gloves/etc, gently telling him where to sit or what to do. In essence, when I first started working with Greg it seemed almost too good to be true: an easy job with someone whose company I enjoyed that paid well. Steadily though, it has become more apparent why I get paid to do this.

Wednesday, October 10, 2012

Swimming

Gregory has always loved to swim. When we first moved to the Condo we were very excited that a L.A. Fitness Gym was in the building. In the beginning, G was able to manage getting to the club, managing the locker room and his gym bag, swimming and showering, and then getting back to the Condo. Most of last year he lost that ability so he did not get to swim as often as he would like. I think he was actually afraid of managing the process by himself more than actually not being able to.

Now that he has two companions, between Ben & Ken and I we can provide Gregory with more time in the swimming pool again. He is very excited about being able to swim again.

Here is the e-mail I sent Ben & Ken awaiting their agreement.

Dear Ben & Ken,

Hi. Next time I see you, please confirm that this will be OK with you.

I just cleared it with LA Fitness (downstairs in the building) that there will be no problem with your accompanying Gregory at the club when he goes swimming. You would NOT be able to work out but you WOULD be able to swim as well.

You will probably have to sign a waiver since you are not members of the club. My preference then is that if you swim or just sit by the side of the pool, you should have a swimsuit on. The club provides the towels.

Gregory loves to swim, the problem is his getting down there, managing his locker & lock, getting into his swim suit, showering is OK, getting dressed might need prompting, and then getting back to the condo. 

It would be great if you had a swim suit you could leave here and also a lock and anything you would need in the locker room like a hair brush or whatever you need personally. If you had a small bag to keep everything in it would make it easy to pop in the closet until your next visit. I will accompany the first time. Let me know if you have any questions.

Tuesday, August 14, 2012

K.C.s Report

If you have been following this blog you know that we have two college student companions spending time with Gregory when I have "stuff to do," meetings to attend, or just need time to get away from the 24/7 of Alzheimer's to play. Each companion spends 4 to 8 hours with Gregory per week.


I asked each of the companions to write about the time they have spent with Gregory up to now. I wasn't sure what I expected or wanted them to write about but I was hoping for a perspective through their eyes of the time they spend with Gregory.

K.C. is a graduate student at Northwestern University studying Clinical Psychology. This is reproduced with his permission. B.P.'s report was posted a few days ago.



My Time With Greg
                                                                              KC August 12, 2012

Our time together

During our time together, we always have a great time and we both enjoy each other’s company.  We go for walks, have lunch, run errands, read, take naps, watch movies, and the list goes on.  I look forward to seeing him every time, and I get the feeling that he does as well.  Although he struggles from Alzheimer’s, there is a lot to learn from Greg as a person.  He is a great person and has made me realize many important things in life, and I thank him for that.

I think the relation we have now is different from what it was at the beginning.  He now feels comfortable being around me and also asks me favors more often than before.  I am not saying he has become dependent, but not hesitating to ask me is a good sign of our good relationship.      

Things Greg has trouble with (not always, but most of the time)

·      Figuring out where to hook his water bottle when we go out, or how to drink it after it’s already hooked on (he usually takes the cap off first, while the bottle is still hooked on).
       Figuring out how to hook his cell phone, or occasionally answering it (he would give me the phone to answer)
·      Figuring out which switch is responsible for the lights
·      Getting dressed or undressed
·      Figuring which keys to use (not for the house door, but other doors in the building).
·      Remembering or saying names
·      Conversation in general
·      Remembering certain things such as bringing his cap when we go for walks, buying milk, etc.
·      Sense of time

My Observation (What I’ve noticed)

I am not an expert so I do not want to make speculations, but there are some things I’ve noticed about Greg.  I’ve randomly written down things that I’ve thought about from the time I first met him. 

1.  I think he remembers quite a bit of what we’ve done in the past.  He might not be able to tell you the specifics using his words, but I believe he remembers the event.  The reason why I say this is because he sometimes will tell me something about what we've done or episodes from our time together.  Another reason is that he seems to be able to recall quite a bit when I tell him about what we’ve done in the past.  In other words, if I guide through him, he will know what I’m talking about.  

2.  It seems like events that involve some type of emotions are remembered more than events that aren’t.  Perhaps memory that is connected to emotion means more to him and thus better remembered.  Again, he might not be able to explain details using his words, but he knows how he felt or knows that the event occurred.  For example, although he might not be able to explain what we did that day, I think he knows that we had fun (that’s what counts!).


3.  Putting him on the spot does not help him retrieve what he is trying to say.  What I mean by this is that when he feels some pressure to say things correctly, I think it just makes it worse.  I have realized that asking him questions is not always a good way to communicate because he tries to say it right, but fails.  For instance, if I ask him “what’s the book about?” he might not be able to explain it because it is a question that requires explanation.  However, if I ask him “do you like the book you’re reading now?” he would either say “yes” or “no”, and then he might be able to explain about it better because I didn't ask what the book was about.

  
4.  I think that a lot of the time his memories are available, but not accessible.  What I mean by this is that it is probably somewhere in his mind, but he has trouble accessing the specific information that is needed at the moment.   

5.  When we go for walks or go to certain places, there is always a certain way he wants to take me.  He usually refers to “this way” or “ that way” and we always go the same way.  Sometimes he gets confused and stops to think, but he has a good sense of direction and will always take me to the destination.

6.  Sometimes, he makes things more complicated than it needs to be.  Perhaps his knowledge interferes from what the task is at the moment.  For instance, when he was in the process of changing his clothes, he had trouble with putting on his belt.  He had his belt on his waist, but it was over his long sleeve shirt, and he had no pants on.  He probably knows that the belt has to go on his waist, but he got confused where and how to put it on.

7.  Sometimes when he cannot say what he wants, he seems to get frustrated with himself.  He will say “never mind” and that will be the end of that.  It is important to note that even though he gets frustrated for a second, it doesn't affect his mood.    


8.  Along with his memory, there seems to be something going on with him not being able to focus quickly on the object that is the target.  What I mean is that he has trouble figuring out what I am pointing at or what I am talking about.  For example, he gets confused when I tell him how to hook the water on his pants.  He seems to have trouble figuring out the “what” “where” and “how” and what the task is.

9.  He seems to understand that he is struggling from Alzheimer’s disease.  He would not be able to say he has Alzheimer’s, but he knows he has difficulties in doing things and that things have changed over the years.  For example, he told me he was able to read and write fine in the past, but one day it became too difficult or confusing to write.  Or, he would say he could play the piano, but one day it did not make sense to him, and was no longer able to play.


10.Another thing I noticed is that he thanks me a lot when he thinks I helped him out.  He would usually say “thanks for doing that” and will even thank me several times.

11.His use of language might be the thing he suffers from the most.  He cannot retrieve the words he would like to use, and thus makes conversation a challenge.  He sometimes uses different words that sound similar or sometimes words that are totally different from the words he is trying to say.  For instance, he said “books” when he was trying to say “boats”.  He said “is dad coming?” when he probably meant to say “is Michael coming?”.  He experiences a lot of tip of the tongue moments, and has difficulty getting words out of his mouth even he knows what he is trying to say.

12.Sometimes when I see him in the morning, he seems to be still in his sleeping mode.  He might be a bit slower in thinking or doing things, but will gradually wake up as time passes. 

Like I said, I am not an expert so I don't want to make any judgments or assumptions.  Having said this, I don't think there has been any noticeable changes from the first time I met Greg to now.  In other words, I don't think it is fair to say his symptoms are getting worse.  I wouldn't say he has good days and bad days, but there are certainly some things that he is capable of doing depending on the day, which makes it harder to evaluate.  He can do certain things today, that he had trouble doing the first time we met, and vice versa.   





Sunday, August 12, 2012

B.P.s Report

If you have been following this blog you know that we have two college student companions spending time with Gregory when I have "stuff to do," meetings to attend, or just need time to get away from the 24/7 of Alzheimer's to play. Each companion spends 4 to 8 hours with Gregory per week.

I asked each of the companions to write about the time they have spent with Gregory up to now. I wasn't sure what I expected or wanted them to write about but I was hoping for a perspective through their eyes of the time they spend with Gregory.

B.P. is a senior at Roosevelt studying Psychology. This is reproduced with his permission. K.C.'s report will follow in a few days.


• • • • •

I am a senior student at Roosevelt University and psychology major, and I play music on the side [cello, guitar, bass guitar]. I sit with Greg about once a week, usually for four or five hours, sometimes longer.
            
Most of my days with Greg follow something of a pattern. Once Michael leaves (usually with an affectionate kiss and “I love you” to his husband), Greg and I go for a walk. He usually seems best in the mornings, perhaps half an hour after I arrive. As we walk, Greg will point out various buildings that he enjoys or disapproves with observations of “Oh what a hoot!” or “What a little shit!” While many parts of Greg’s personality and intellect may be deteriorating fast, his sense of aesthetic opinion is very strong. I often try to elicit an explanation of why he likes or dislikes something and this seems to fumble him. He can’t exactly put his finger on exactly why he feels one way or another about a building, rose, or “piece” (which can refer to a great number of different things from music to movies to sculpture). I don’t think that this artistic sense of personality is going to go anytime soon. I could certainly be wrong, and I was proven wrong before with my grandmother who also had Alzheimer’s, but I feel confident in my instinct.
            
Lately, our days have been a little simpler. In the beginning of the summer, we would go for longer walks, come back and I would very earnestly try to keep Greg very occupied. We still go on walks most days, but now they are kept short, and the rest of the day is more quiet. One day, we did nothing but go to the library, read for an hour and a half, came back and listened to music for the rest of the day. He loved it. (Telling Michael “We listened to music the whole day!” with something near glee) It seems that variety is very healthy, some elements kept consistent, but no day being completely and totally patterned.
            
Some things do seem to help every day that I am with Greg. Going to the lake always seems to calm any agitation that might be present in the beginning of the day. Watching the dogs at the park has the same effect. The rose garden also seems to help, but doesn’t seem to produce as consistent results. While variety is certainly a virtue, so is consistency. The trick is to practice both in moderation.
            
Patience is a finite virtue, and I imagine that ten years of caring for Greg have taken a serious dip into Michael’s reserves. To my mind’s eye it is here clear that I provide some substantive help for both men. For Michael, I provide a chance to escape from his duties and replenish his stores of patience. And for Greg, I provide a company that is perhaps less easily frustrated and thus, a little less demanding. 

At the same time, I am provide a different set of demands: my knowledge of their house and the layout of the general area isn’t great and so Gregory has to work to recall these pieces of information. As I gather, this process of recall can take some time, and often, Michael will get frustrated and say “Let me do it” (with equal parts love and exasperation). On the other hand I will simply wait and casually look the other way. In fact, I make it a point to do this as much as possible. I think that it is important for Greg to frequently exercise his memory. If he doesn’t, I feel the results will be like that of a man who is bedridden for several months: the muscle will deteriorate. The same will happen to his memory, and at this point, nothing new can be made anymore: no new memories are created or preserved. This is especially apparent with smaller, less significant pieces of information. 

For example, Greg once answered a phone call from Michael, and I heard him say “500 people?! Wow…” Less than five minutes later when I asked him about the call, he said that Michael had had a lot of museum visitors, but he couldn’t remember the number. The insignificant things, those that aren’t immediately important to impact Greg’s daily living get dropped by the wayside within minutes. It seems clear to me that those pieces of information that are significant enough to still be recalled must be brought up regularly.
            
A prime example of this occurred the other week. As I gather, some of Greg’s family had come to visit for a few days, and thus Michael had coordinated all of their meals, including lunch. Normally Greg has a salad for lunch most days. This seems like a very good exercise of memory to me. He has to remember where all of the necessary ingredients and utensils are and has to figure out how to put them together. On an average day, he can work this out with few hiccups, though for whatever reason he seemingly can never remember to get a fork out or even where the forks are. 

The first day that I saw Greg after this stay with his relatives, Michael suggested that we stay in for lunch, and so we did. Greg had enormous difficulty making his salad. It took a large number of suggestions from me, and my getting out the salad drawer from the refrigerator. The endeavor also took significantly longer. It is worth noting that he still did it by himself for the most part. Once again, I simply sat back and ate my own lunch and let him work things out on his own. [It is also worth noting that in the beginning of our sitting relationship that I tried to make sure that he ate or at least prepared his lunch before me. Now I realize that I need to take care of my own needs in order to be patient, and that this patience is much more important than any misguided notions of manners that I had.
            
It seems that while Greg can’t make new and lasting memories, many of the old ones are still much intact. As Michael mentioned on the first day, the memories and the words are there, it is the trigger that is difficult to find. A prime example is seen at the beginning of nearly every day that I see Greg. He can very easily find his way around the city in terms of direction (watching for cars and knowing when to not cross the street are different matters).  Occasionally, he’ll get stuck at the beginning, not entirely sure how to start, or caught up in the delusion that things have been “moved” (for instance, there is a curiously persistent notion that the lake has been moved and thus it isn’t to the east anymore) But once he actually gets going, Greg is absolutely fine. 

The same is true of unlocking the door to their apartment. As I’m sure the reader is aware from personal experience, every door is a little different, and every lock requires its own special jimmy to actually trigger the mechanism. It always takes him a moment to figure out where the necessary key is, and which one it is (even getting it into the lock sometimes presents a challenge) but once these obstacles of recall are overcome, his hands seem to simply know what to do. One day when I perhaps pushed Greg a little too far on our walk (it was quite hot that day and he doesn’t respond well to heat) he had significantly more trouble in getting the door open. But once he had a glass of water and laid down, he seemed fine. 

Things like engrams aren’t affected in nearly the same way as more typical memories. But the point remains the same: the greatest obstacle in retrieving a memory is locating the trigger and taking the first step. Once that is accomplished, feats of remembrance of far greater magnitude are possible. It seems clear to me that triggers must be regularly exercised, and this is the main thing that I try to do throughout the day (besides keeping him safe and at ease)  
            
Throughout this report, I’ve gone over the ways that I feel I help Greg and Michael. But there are certainly ways that I too benefit, and there is one small way in which I have gotten something that I did not expect. Greg seems like a very confident person. When asked about music or his career as an architect, he stresses his ability to simply do  these things. For example, when I have asked how he would approach playing music or designing a particular building he always responds the same way: “I would just sit down and it would flow out of me.” To the unfamiliar, this may seem like bragging, but in all reality, I think Greg is simply being honest, and when the sheer elegance and excellence of his work is considered, it fits. 

The reason that I bring this up is that I have never been like Greg. I am far more self-aware and anxious. I almost always feel unbearably self-conscious when I show people any creative works that I have produced. And so I feel that I too get something out of my time with Greg. One day when I had my cello over at the apartment, I mentioned my anxiety and apprehension about playing in front of others. In a very matter of fact way, he said that I sounded just fine. To me this is high praise, considering the caliber of musician that he once was. I know that he won’t sugarcoat his comments on my playing, so I don’t worry. 

In essence, I very much feel that I too am getting something out of our relationship, and on some level, I think Greg is aware of this. I think this symbiosis is a very healthy thing, as I imagine many of his day to day relationships to be rather one-sided which can certainly present frustration.