A week ago Monday my father was relatively stable. Tuesday night he called in a fair amount of distress -- said that he had only three two-oh-ones and three elevens and he didn't know how that had happened, but how could he give the five hundred to E? After a little bit of decoding I was able to work out that he was concerned about not having enough cash in the apartment. The two-oh-ones were twenties, and the elevens were singles. As for the payment to E, he'd lost the distinction between cash and checks. Fair enough -- such things have happened before.
But when I visited on Wednesday he was still upset -- and also more radically confused about the time of day and the day of the week (he'd been on tenterhooks all day about whether I was going to be able to visit or not, and whether something had happened to me on the way there). His speech was slurred and many of the sentences were incoherent, in a way that reminded me of sundowning episodes that he's had in the hospital. This would be the first one at home, however.
I got him calmed down and better oriented by talking about events in his past -- his relationship with his own father, in particular. That seemed to get him grounded. Then I showed him the cash I'd brought with me, and let him watch as I put it into the wallet.
The next three nights he called in a fresh state of confusion about the cash and how it had gotten there. Had it come out of my accounts? And if so, did I have enough cash left? How was I going to get by. It took a few days to work through the same description before he was able to let it slide.
Meanwhile, disinhibition gets subtly more pronounced. He's made a few sexual references about the aides, and dropped a few anti-semitic comments as well. You'd think I'd be alarmed about the latter -- especially since we're Jewish. But there's a backstory -- it has to do with his own equivocal relationship with formal Judaism, and some bad run-ins with fellow Jews he had in the Coast Guard, and his comparatively good relationships with Christians during that same period, and what that in turn did to his relationship with his father... The point is that it's worth noting, but not too much. It represents a connection to an emotional element of his core history, not a radical change in personality, nor, on the other hand, a statement that he'd make or live by if he were whole. So it goes into the logbook, but doesn't yet generate a 911 call to the cognition police.
Time-of-day issues are settling into a new, stable instability. He's resolved that up where he is, it gets dark in the morning ("and when did they start doing that? Isn't that a crazy way to arrange things?") But where I am, it gets dark at night, even though I'm in the same time zone (which is comforting, since it means I haven't moved that far away). So I call him at night and he asks me what I'm doing this morning, and am I on the way to work yet, and then he signs off and tells me that he's going to go on with my morning, and I ought to have dinner and go to sleep.
On the other hand... he managed to flag a New York Times article about cardiac stents (a topic of interest, since I have one). As J said, there's still a fair amount of cognition left.
It just doesn't run on the same avenues as it used to.
All of this is the current normal -- and it'll stay that way, until it doesn't.
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