Second Visit

Am just back from the second visit.  I suppose it'll get routine at some point, at least for a while, but that hasn't happened yet.

Once again he looked good - clean, well kept up, alert (within bounds).  The scene was a little more chaotic than last time.  When I got there he was in the middle of the common area, twirling around in a wheelchair that he couldn't quite navigate.  There was a bingo game in progress in one corner, and across the way, a woman was shrieking out the numbers reflexively as they were called.  Other residents were wandering up and down the halls.  It was sort of a bright, airy, fluorescent-lit Bedlam.  But my father wasn't bothered by any of it - he didn't react to it and mostly talked over it.  Good meds, good staff - they're able to maintain a prevailing sense of calm in spite of it all.

I brought along a few copies of the magazines he used to edit.  A couple of weeks ago, at the preliminary conference just after we moved him, I mentioned that it might be good for him to have the magazines on hand - he could show them to people the way he used to in his apartment.  Everyone agreed that was a nice idea.  But in the intervening time, he's lost the ability to relate to them.  He was fascinated by them by thought they were something I'd produced - told me I should be proud of them, and that I was a good reporter.  I showed him his name on the masthead the way I used to, but it didn't register.  He seemed to enjoy them but at the end of the visit I packed them up and took them home and he didn't protest.

He asked whether his father was dead.  The question goes back to a conversation he had a week or two ago with P, who told him that his father had died ("Well, I'm not going to lie to him," she explained to me).  A contrast to my approach, obviously ("Parents?  Oh, they're... around"), and I wasn't sure whether I agreed with it - what's the point of honesty when he can't hold onto the information?  But to my surprise, the bluntness seems to have had a positive effect.  I said yes, I'd heard that his father had died.  And his mother?  I was distracted by the reflexive Bingo-calling person and hadn't been listening closely, so I inadvertently told him she had died, too - "Yes, I heard that," I said.  "Well," he said, "I guess I might as well stay here, then."  Points to P.  Maybe he's happier without the illusion - he can cut the ties.

Overall the conversation was short - roughly half an hour - and like the last one, it ran out of steam at the end.  There continues to be something different about the way he engages with me - it's less intense, and once again he was less dependent, and I seem to have become more of a background element, or at least one among many people coming and going.  As noted, he still knows that I'm significant (this time he remembered me as the little baby that he met when we were both in school) but doesn't regard me as his only lifeline.  Another plus.  In general there's a difference in his affect - when we talk, there's continually less content and detail.  He'll focus on a couple of elements and repeat them - today it was the magazines, and his watch, and something about his sleeve that I couldn't completely make out.  He was also impressed by my badge, which said "Visitor" and which he took as a mark of authority.  The loss of detail has been going on for a long time but there seems to have been a sharp break between the apartment and the nursing home - the contrast is noticeable.  Could be meds or stress or disease progression, or some combination of the three.  I'm anticipating that the slow fade will continue. 

Related to this - here's another respect in which the atmosphere of the nursing home helps him.  There isn't a hugely diverse range of activity and as a result, there isn't too much information to process.  The right amount of activity is good, it's stimulating, but too much leads to distress.  They seem to have it calibrated for people who are limited in what they can take in. 

Walking back out into the parking lot felt like coming to the surface from a great depth.  I used to feel that way leaving the hospital when he was there - once again, the hospital analogy holds, I guess because he's in one, more or less.  But it's a good one, and I'll feel all right about where he is this Thanksgiving, in contrast to the last two.  The one before that, as detailed here, was the one when we took him to Philadelphia and saw the first of the really profound symptoms (he had a long conversation with my mother-in-law, then couldn't recognize her when she got in the car to drive him someplace, because he couldn't process her in a different context).  Three years later, we're three years farther along.  That sounds circular, but if you're on the same journey, you probably know what I mean.

I'll try to see him again at the end of the weekend, or failing that, early next week.

Comments

[Kim Bledsoe]

hey Alan..you sound well and by that I mean you are handling all this very well...do not be surprised if your dad asks about his deceased relatives again..and again...my dad does this quite a bit...he even wrote his mother a letter in his journal last week (yes he journals) when he asks me about the deceased..I choose the option of saying they are busy or I haven't seen them...I just don't want him to live that horrible feeling over and over...then I just redirect really fast. I am glad your dad is adjusting well...it sounds like he is in a very good NH..

Have a relaxing Thanksgiving friend,

kim