Mr. Visitor and Mr. Funeral

Many times, my wife has asked me how I'll react the day my father no longer knows who I am.

I've always answered that I don't know, but that it probably won't be clear-cut - he'll retain some details and lose others, and it'll be a long journey across a blurry line.  In practice, it's been like that.  It was nearly two years ago that he first told me about his visit the night before with Alan.  Since then, as you know, I've been many different people, sometimes simultaneously - son, brother, uncle, friend from the war, father of Alan, age 9 - but always a friend and helper and a significant person.

Today we may have taken another step farther from earth.  I'm not sure - it could also have been just an episode.  We'll have to see how it plays out.

I went to see him at the nursing home.  When I got to the dementia unit, he was sitting at one of the tables in the common area, deeply engaged in a conversation with another gentleman - a resident about his age.

"Oh," my father said, pointing at me.  "Here's a young woman who can help us.  Hey, Alan, can you tell us what you think about this?"

And that was the last I was Alan.  "See, what we've found here," my father said, pointing to the olive green border that ran around the edge of the table, "is that this goes all the way around here (he runs his finger along the border, toward my side) and it connects with 'visitor.'"

As he says this, he's pointing at my visitor's badge, which is a lighter version of the green used in the table border.

On several previous visits, my father has been very impressed by the visitor's badge, as though it represents some kind of authority.

"And I think you can help us with this, Mr. Visitor," he says.

OK, fine, it's a quirk, let's ride with it.  What does he need help with?  Long riff begins.  It goes around and it connects to the red (his shirt, which he spends some time trying to take off) and this here, which is right this way (his watch again), and that way, this gentleman can go home and be with his children.  You're from New York, aren't you sir?

Pennsylvania, says the other gentleman, who's marginally more together.

"Pennsylvania, that's right in New Jersey, and you go across the water, and it's right there, and before the rain starts, I think you should get ready to leave right now, and that way you can be home with your family, and Mr. Visitor can help you with that.  I know him, I know Mr. Visitor and he's a great guy..."

No, not just a quirk.  I've clearly become Mr. Visitor.

Conversation with other gentleman follows.  He's intrigued by the idea of going home to see his children, but he's confused because they came in this morning with the cough medicine and another medicine, and he wants to know what's the relationship between the two?

I tell him that it can be hard to follow, because they often change the dosage of the cough medicine, so the relationship keeps changing, and the best thing is to get one of the nurses to tell us.  He thinks that's a good idea.

The other gentleman is clearly a bit better organized.  He's puzzled, but he's puzzled about things that in reality are somewhat connected with each other - the dosages of medicines and the instructions for taking them.  My father is another story.  He has less information to work with, and he's trying to create connections between things that are barely related (like the table border and the visitor's badge, or his shirt and his watch).  But the brain works with what it's got and keeps generating patterns.  It's the same way that people who don't have Alzheimer's, but who have an overwrought sense of cause and effect and an aversion to randomness, develop conspiracy theories.

There are more long riffs, mostly repeats and variations on the same motifs.  Eventually themes start to emerge.  It's important for the other gentleman to get on the road before the rain starts.  There's no point in his sitting around here.  Mr. Visitor can arrange everything.  He can get the truck.  Did you come here by truck, sir?

Of course, my father came here by truck - a big Escalade, to be specific.  And leaving and going home to see the children?  That's probably something he's like to do, too.  He's projecting his identity and his desires onto the other gentleman.

As soon as I realize this, he makes it explicit.  "So you should really get ready to go now, sir," he says.  "And then we can go, too.  Mr. Funeral - I mean, Mr. Visitor - can make that happen."

Mr. Funeral.  OK.  Now we've got it.  No translation needed.  Visitor equals escape equals funeral.   It's all about leaving and going home.  I don't get the sense he thinks that a funeral is a bad thing.  It's another way out.  All of it comes down to leaving in a big truck.

I should mention that I have an audience for all this.  My father is very energetic and very loud - his voice fills the whole common area.  A couple of tables away, there's another visitor - a woman in her sixties or seventies working with a much older mother.  The daughter is trying to get her mother fitted with sandals, and the mother keeps making rhythmic raspberry noises with her mouth.  Not surprisingly, the daughter wanted to pull back from that a bit and couldn't help overhearing my conversation and came over to tell me that Mr. Visitor was sure going to be busy.  Then there was a young guy who walked by toward one of the rooms and left a few minutes later, nodding at me knowingly both times.  There's the beginning of a secret society here - the real-world equivalent of our blog community, I suppose.

The whole conversation took about 10 minutes.  Then my father was eager for Mr. Visitor (aka Mr. Funeral) to leave.  As in, right now.  So I could make arrangements to get everybody on the road.

I said I'd get right on it.  And I left, feeling slightly stunned, as though I'd never arrived.

Which, in a sense, I hadn't.  It's been nice the past couple of years, being several different people.  But today they all seem to have been left outside the door.  My new identity is less personal - Mr. Visitor is clearly an official person with particular powers, but he's less of a family member and more a background element of the broader caregiving establishment.  As is Mr. Funeral.  All of which is fine, by the way.  As I was saying yesterday, I've done the hands-on caregiving thing and it's time for a change of scene.  Or a change of self, as the case may be.

So to the question - how did I react to my own disappearance?  And to my emergence as the messenger of death?  Lightly, as it turns out.  I was actually laughing to myself a bit as I left - because it was over so quickly, and I felt like I'd been spun around in a revolving door, and because it's a little odd to have yourself transformed instantly into Mr. Visitor, who someday will be Mr. Funeral. 

But as with everything else on this gig, I suppose I'd better get used to it.

Comments

[Kim Bledsoe]

Oh Alan..i mean Mr. Visitor..i just had to chuckle...one of those stories you have to laugh to keep from crying..I hope I am not offending you in any way by that. I often have to laugh at my dad's stories also. I have not experienced my father not recognizing me yet. He still knows all of his children, his grandchildren and my mother so I know we are very blessed for that. People will say "oh you know the day is coming when your dad won't recognize you" I just want to scream SHUT UP! lol..I know it is part of this awful disease and I also know that it will be one of the worst days of my life..truly. We have been so close all of my life..my hero. I can't entertain the thought for long.
One observation if you will, I notice that you analyze your visits with your dad alot..is that the writer in you? I am just curious. Glad you dad seems to have adjusted and thank you for sharing the journey.

Cheers,
kim

p.s. I enjoyed your postings on healthcare (i'm a lefty too)=)

[Alan G. Ampolsk]

Kim -

Sorry for the slow reply. Fatigue continues, per my latest post.

Re: analyzing my visits - I guess that might be the writer in me, though I never thought of it that way. It just seems like second nature to me, which probably means you're right. But if I had to explain, I'd say that when I visit him, I get a huge amount of information all at once - cues about his physical condition and his mental state and his cognition, and about any changes since the last time. All of that tells me if there's something I need to act on - or it used to, when he was living in New York and I was the primary person concerned with his safety. Now it's less urgent that I keep on top of every symptom, but it's a hard habit to break. I guess that even if the caregiver in me has less to keep track of, the writer will pick up the slack. Does that make sense?

Glad you're on the left. Someday, somebody has to explain to me how educated professionals can tell you they're against mandatory wealth transfers... and want no cuts in their Medicare.

But maybe I'm the one who's missing something....