The Caregiver Calling

Even at our age and in a wheel chair, Mary Ann is pretty.  Looking at those pictures of Mary Ann from the time before we started dating and pictures of her in our dating years and early marriage, I was reminded just how pretty she has been all her life.  No wonder I fell in love with her.  I am not so shallow as to have only looked at the surface.  Her personality has always been intriguing, exciting, unpredictable, entertaining and complex.  There has never been any pretense about who she is.

One of the things that jumped out in the pictures from earlier years was her bright smile.  That is one of the things that Parkinson’s steals from those whose lives it impacts.  Facial expressiveness diminishes.  Those pictures were poignant reminders of just how expressive and beautiful that face has been.  They also confirm and reinforce the image that still comes through when I see her.  It is a good thing when people grow old together.  These old bodies still contain young people.  When we grow old together, we can see past the old bodies to the young people living inside.

Mary Ann revealed that she was excited to have the chance to reconnect with her family.  It meant so much to her.  She has felt very disconnected after losing her Dad two weeks after we were married and two brothers, both when they reached the age of 51.  Her Mother has also been gone for many years.

The old pictures and conversation gave our two children a chance to discover more fully the family with which they have had little contact.  Their Cousin Diana and her Daughter Rachel provided through their presence and their stories about family a window into the other half of the gene pool from which our Children have emerged.

Mary Ann soaked it all in and responded as she could.  The night before last had been a tough one with multiple times up.  She crashed during lunch.  She could not hold her head up any longer as I tried to help her eat.  Finally, she gave in and decided to lie down.  After a long nap, she was able to interact and enjoy Diana, Rachel and our Children as they talked about and asked questions about the past.

Last night, Mary Ann went to bed and was asleep as soon as her head hit the pillow.  This morning, she was in exactly the position she was in when she fell asleep last night.  She had not moved a muscle, nor had she gotten up during the night to use the commode.

Our Daughter, Lisa, along with Husband, Denis, and the girls, Abigail and Ashlyn left for home early this morning.  Diana and Rachel were able to spend the day with us.  It was a good day, a little less intense and more relaxing.  We just spent the day getting to know each other better.

I had thought about giving them a quick tour of the area.  Mary Ann reminded me of the Tulip Festival at some spectacularly beautiful gardens at the edge of a lake on the other side of town.  The flowers provided clusters of vibrant colors, one after another, some more formal and symmetrical, others very natural with an asymmetry that was pleasing to the eye.  The weather was perfect, sunny, cool and clear.  The lake was sparkling and serene at the same time,  The gardens are filled with ponds and streams and waterfalls.

We moved on to travel west into the Flint Hills.  It would have been a crime to come this far and not see those rolling hills, prairie as it was hundreds of years ago.  Some areas were green with fresh grass growing.  During April comes the burn.  All the random seeds brought in by wind and wildlife germinate during the growing season and threaten to overpower the natural prairie grasses. In past centuries, buffalo fed on the grass until there was nothing left above ground. Roots extending fifteen to eighteen feet would assure that the native grasses returned the next spring.

On account of the decimated buffalo population, burning the foreign growth returns the hills to their pristine past.  Through the ashes soon burst the Big Bluestem, Little Bluestem and Indian Grass.  There is nothing like the contrast of that bright green emerging through the black ash cover.

The tour of the Flint Hills was a treat for me, and seemed to be so for Diana and Rachel.  We found our way to a little town called Paxico.  There is no grocery or gas station there, at least that I have found.  The buildings contain lots of old things for sale, ranging from flea market fare to expensive antiques. It is not a contrived and artificial imitation of an old town just for tourist consumption.  It is the real deal.  There is an outlet there for the pottery made by the Potter who turned the dishes and bowl that Mary Ann uses.  We have other pieces, bowls and cups and pitchers.  The name is Jepson Pottery.  His studio is in Harveyville, Kansas.

Mary Ann was ready for ice cream when we left Paxico.  We had leftover Grasshopper and Mud pies from Baskin and Robbins for supper.  Mary Ann is in bed and, after a snack and some Tums, she seems to be sleeping.  Tomorrow is likely to be a recoup day.  Hopefully, she will have another restful night tonight.

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Then comes: Assign a home, Containerize, and Equalize.  You now have the secret formula for making SPACE in which to live without succumbing to the clutter.  Easier said than done!!!

As Mary Ann and I looked at the symbols of our life as individuals and together, the sorting and purging has had implications beyond the things themselves.  While Mary Ann has been better at letting go of things than have I, I have inferred from a couple of reactions that she struggles with so much of her life being out of her control.  She has to get me to do for her much of which she has always done for herself.  She has an independent streak a mile wide.  It has to frustrate her to no end to have to depend on someone else, someone who gets grumpy and complains far too often.

To have things thrust in front of her with the question, “keep or give away,” can’t have been very easy, especially with an impaired Executive Function (reasoning things out rationally) due to the Parkinson’s Disease Dementia.  We wore her out.  She went to bed early.  We made a point of keeping anything about which there was any hesitance on Mary Ann’s part. She retained the veto power.

As the memories of past times are triggered, there are questions that lurk behind them: Is that all there is?  Is it enough?  Are there more memories to be made?  Does letting go of the symbol diminish or dishonor the past experience symbolized by it?  What on earth is this and when and where did we get it?

Actually, we have only done the relatively easy items.  For me, there will be boxes of ministry related items and memorabilia that have to be dealt with.  What does a person do with forty years of sermons?  Why do I suspect there are a number of smart aleck comments wandering around the minds of readers?

I have mixed feelings about the sorting, purging and organizing that is going on.  The benefit seems to me to be gaining space in which to live, both physically and mentally.  The clutter occupies a lot of space in my world.  On the other side of it, there is a bit of fear that having that job done will remove a goal that helps define my purpose.  I need to clean the basement.  That is a job for retirement.  Once it is done, what will fill its spot in my sense of purpose, my intentions?

Anyway, the task goes on.  While we were in the garage working on that task, a couple of medium-sized, maybe Labrador mix, stray dogs wandered by to visit.  They had no collars.  They were friendly, and appeared to be well-fed and in good health.  They were great with the kids.  We called animal control, but they dogs had wandered away by the time the truck arrived.  After he left, they returned and spent an hour or hour and a half, hanging around, playing with a tennis ball the kids were throwing, lying on the deck as the family sat out there.  I phoned animal control again, but this time no one showed up.  Finally, they wandered off.  I hope they are caught and find a good home.

Well, again, I am too tired to write any more tonight.  It is time to get some sleep.  Hopefully both Mary Ann and I will sleep well.

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This morning, Mary Ann asked Daughter Lisa how things were going in her marriage.  It was just the opportunity needed for Lisa to tell her in a natural and gentle way the truth that all is well.  The general wisdom is to go along with delusions/hallucinations when interacting with someone suffering from dementia.  We are using the truth in love approach. 

Maybe Lewy Body Dementia [LBD] is different enough from other expressions of dementia to warrant an approach different from the general wisdom.  Parkinson’s Disease Dementia [PDD]  is a dementia with Lewy bodies, and presents itself in a way that is almost identical to LBD.  Those who suffer from LBD or PDD live in the margin of reality.  There are forays into a world with little, sometimes no relationship with reality.  Those with LBD/PDD can return to lucidity in a moment or a day or seldom. 

It seems that since there is movement between reality and hallucination/dream/delusional perceptions, surrounding the person with the truth can help the person move back to the reality side of the margin between the two.  Mary Ann may move back to the hallucination/dream/delusional view of reality, but having the truth surrounding her seems to help. 

Just a few moments ago, when she was moving in bed, I went in to see what I could do to help.  She asked if the party was over.   In her mind, a large group of people had come in the door at the same time for a party celebrating the new sun room and remodeled deck.  It was Good Friday.  I went with it enough to ask if they liked it.  She said they did.  I asked her to include a request for donations to pay for it the next time there was such a gathering.  She laughed.  I described the truth to her.   There was no party, Lisa, Denis and I had just watched the NCAA basketball tournament final — a great game!

She seemed to accept that description of reality.  It just seems to me to be better to speak the truth in love to hallucinations/dreams/delusions.  It makes sense to me that the more truth in those of us around Mary Ann, the more secure she will feel, even though the truth runs counter to what she is convinced she has seen or heard.  It would be too hard to try to keep track of anything other than the truth. 

Mary Ann slept well last night.  She has napped some during the day.  In general, she seems to do better with hanging on to reality when she is well rested. 

Her nap time gave us a chance to continue a task that started yesterday when Daughter Lisa and Son Micah were here together.  We began going through boxes.  What a frightening task — overwhelming.  There are so many boxes of things, so many decisions to be made about what to keep and what to give away and what to throw away.

Daughter Lisa is now a professional in the area of organizing.  She has always been the most organized person I know.  Now she gets paid to do it.  Gratefully, she is not pushy about it.  I had to open the door to this task.  We carted boxes from the basement storage area to the garage and began going through them.  We brought Mary Ann out into the garage to look at the contents of some of the boxes.  She said her childhood was there when she looking into a large box of dolls, mostly disintegrated after being stored for so many decades. 

There are some complex dynamics to what we are doing, given the time in our life and Mary Ann’s circumstances.  There is an element of sending our things on their way to our Children and Grandchildren, since we are late in life and Mary Ann is so vulnerable.  Since Mary Ann lives as if death is not a part of her reality and my health is still good, we are not ready to let go of things that have a sentimental attachment.  Actually, Mary Ann is not very sentimental, so it is easier for her to pitch things. 

It is a good thing that our space is very limited in this little townhome, so we are forced to let go of things we might try to keep if we had more room.  Somehow the combination of the need to move out a full cabinet due to the addition of the sun room, Mary Ann’s decline in these last few months, my retirement, and just the weight of what we have accumulated has pushed me over the edge of procrastination and into the throes of purging. 

At the moment, we are making some progress.  The task is huge.  I am hoping now that we have started, to keep momentum going even after Lisa and her family have headed back home.  It is much harder to get motivated on my own, and to make enough progress when Mary Ann is awake and in need of my help. 

Tomorrow we plan to continue the task.  I hope it is a productive day.

I have very seldom seen Mary Ann cry.  This Easter morning as we sat together with Daughter Lisa and her family in the pew during the Easter worship service Mary Ann’s tears flowed. At first, I just thought her nose was running when she indicated that she wanted a Kleenex.  Her nose has been running for the better part of two decades.  It wasn’t until later in the service when handing her a Kleenex that I noticed tears on the inside of one of the lenses of her glasses.

She went through many Kleenexes as the service went on.  After church at one point when we were alone together, I asked what she was thinking about in the service.  She answered, “Nothing good.”  Then later when we were at home, I asked if she had been thinking about the chance that this might be her last Easter.  I thought maybe the music and language of the day in message and prayers and music and hymn texts had allowed the reality of her situation to finally sink in.

She said no.  She said she was thinking about Daughter Lisa.  She had managed to tap into the delusion/dream that Son-in-Law, Denis, was divorcing Lisa.  I explained again that what she was thinking must have come from a dream, since Lisa and Denis were solid and secure.  She seemed to accept my explanation.  Later in the day, she seemed to be drifting back into that delusion, but she caught herself and moved back into reality.

I talked with Lisa and Denis about it tonight.  Lisa will see if there is some way to ease into a conversation that might reassure her Mom of the strength of their marriage.

Our Son Micah and his family came early today so that he could fire up his smoker.  It took all day, but we had the best Brisket and Pulled Pork that I have ever had.  We have prided ourselves in liking only the best of the BBQ places.  We lived in Kansas City for fifteen years.  KC has some of the best BBQ in the country (in my humble opinion). This was better than anything we have had at any of the best BBQ places around.

It was a great day  The weather was outstanding, the family was together, we got to church, and we had a great meal.  I was too tired to write last night, and this is all I can handle tonight.  It is off to bed in hopes of a decent night’s sleep!

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It felt good to be with other people in worship at the Good Friday service at noon.  The events remembered this week are at the core of what my ministry was about those forty years.  The events remembered this week are what provide access to a relationship that shapes my world day by day.  The events remembered this week heal my sometimes wounded spirit, wounded more by my own thoughts and actions than those of anyone else.

I was bummed yesterday afternoon when dressed and ready to attend the Maundy Thursday service Mary Ann’s circumstances did not cooperate.  That worship service has always been one of the most powerful in the year.  The words and, more importantly, the actions of that liturgy reveal the healing of wounds and the consequences of that healing.  The traditional liturgy as I have done in my years in the ministry includes an action that provides a painful look into the mirror, followed by words that create the freedom to begin again and write a new story for our lives.  There is a time in the service when one action, the foot washing, demonstrates that new story as one of service to others.  There is a meal called Holy Communion or the Lord’s Supper.  There the joy of community with one another and our God is celebrated.  We become family in the best sense of that word.

It was hard not to be there and draw on the words and music and actions that speak so powerfully to my spirit.  I was grateful that circumstances here at the house allowed the possibility of a corporate worship experience today.  While we have been able to get out of the house for one thing or another, most of the time it has been in accord with Mary Ann’s readiness.  Other than her Tuesday morning group and most of the doctor appointments, we have not often been able to get to something with a specific scheduled time.  Admittedly, that has been one of the challenges for me, since I have tended to be a planner.  I no longer have a shred of control over what we do and when.  The Parkinson’s and Parkinson’s Disease Dementia are currently running Mary Ann’s and my schedule.

I was too tired to stay up and write a post for the blog last night.  The night before had been one of those nights filled with needs, up many times, and then up very early in the morning.  Mary Ann had a couple of long naps during the day.  There were some hallucinations/delusions beginning a bit.  After she had been in bed for a while last night, she asked if the Thursday people had gone yet.

Today was another fairly busy day.  The electricians came and put up the ceiling fan and outside light.  They did so during a pretty noisy thunderstorm.  Then Hospice Aide Sonya came to give Mary Ann her shower etc.  We managed a quick lunch for Mary Ann before the noon service.

Then in the mid-afternoon, Mary and Arlene came over to check out the project and visit for a while.  They were followed by Hospice Chaplain Ed.  Admittedly, Chaplain Ed does more to provide me with conversation, than to do any sort of pastoral counseling for Mary Ann or for me.  I enjoy the visits.  In that way, I guess the conversation is therapeutic.

Now that the ceiling fan is in and the waterfall is fully lighted, I am getting even more pleasure from it.  It is hard to describe how calming and refreshing the setting is becoming.  More samples arrived today, so Mary Ann is having more input into the color scheme.  She seems to be enjoying the project more and more now that it is almost fully complete.

Our Daughter, Lisa, and her family from Louisville, Kentucky, have arrived at our Son, Micah, and his family’s home in the Kansas City area.  They will come here tomorrow afternoon to stay for five or six days.  We will have a lively place for a while!

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First came Volunteer Maureen with a decorated basket fill with candy and dozens of home made cookies, along with some spaghetti for the freezer.  If that is not enough, after spending a couple of hours with Mary Ann, she left and returned with three containers of fresh strawberries with the greeting, Happy Easter.  We certainly are treated very well!!

Next came Edie, Paul and Shari for our Spiritual Formation Group.  For the first time in months, we were able to sit outside and enjoy the newly remodeled deck filled with the constant sound of water spilling over the rocks of the waterfall.  That and the birds accompanied the sound of the garbage truck and weed eaters.  What a rich environment for exploring mechanisms for allowing the awareness of the presence of God to wind through our days.  That two hours weekly has a profound grounding effect that helps sustain me during the unsettling times as well as filling with meaning the ordinary moments.

Shortly before the Group meeting ended, Bath Aide Zandra came to give Mary Ann her shower, wash her hair and get her dressed.  Apparently all went well.  We held off on morning pills until after Zandra was done.  That way we avoided the fainting spells that seem to be triggered when the meds first kick in.  There was some fainting later in the day, but it was very manageable.

When all those folks had left, a call came from Hospice Social Worker Kristin for her monthly visit.  She came over and, as usual, she asked lots of questions about how both of us were faring in our situation.  With all vagaries of Mary Ann’s cluster of medical problems, we seem to be healthy and secure — a credit to the support we get from so many folks.  During her visit, Volunteer Coordinator Mary phoned that she and Arlene would like to come by on Friday for a visit.  I could report that to Kristin as an example of the many folks who care for us and brighten our days.

Next came the Sister-in-Law of Jerry, our Remodel Contractor.  She is a gifted painter, who on very short notice was able to prep the ceiling for the electrician who, hopefully, will come soon to install the ceiling fan.  Actually, she was here while Hospice Social Worker Kristin was doing her task with us.

After Painter Diane left, Stacey came to talk with us about blinds and colors to paint the interior of the upstairs.  She brought wonderful ideas and helped us talk through some things.  Mary Ann was fully involved in the discussion, especially the discussion about colors of paint.  Mary Ann has an exceptional eye for colors.

After Stacey left, procrastinator that I am, we went out to eat using a promotional $25 gift certificate that I have had since before Christmas.  Today was the last day it could be used before expiring.  We ate a $34 and change worth of meals, that ended up only $4.61 (I realize the math doesn’t work, but the way the tax was applied also made a difference).  Yes, I gave a tip based on the charge before the discount.  The meal was at a good restaurant here called the Brick Oven.  Mary Ann allowed me to reach across and help her get the food to her mouth after she had struggled for a while.

After, of course, a stop at Baskin & Robbins, we got home to meet with Contractor Jerry who was there finishing up a couple of little things.  The main reason for the visit was to pick up the check for the work they did on the sun room and the deck.  There goes that inheritance, Kids!

Speaking of the Kids, Daughter Lisa called.  We got to talk with five year old Granddaughter, Ashlyn, who told us they were going to try to come a day early, which is only a couple of days from now.  They will arrive either late on Friday or early on Saturday if they stay with our Son and family in the Kansas City area before arriving at our house.  Needless to say that news lifted Mary Ann’s spirit as well as mine.

The day concluded with some deck sitting time after Mary Ann headed to bed.  Deck Therapy is one of the most effective tools for helping me keep perspective and fold into the day the support of the One who gives me breath.  I guess the day began and ended with the birds and the waterfall each providing their uniquely healing sounds.

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