jmgoyder

wings and things

Doing it

I bumped into some relatives today at our local, rural, shop and they said they had intended to go and see Anthony today, but it was too late in the day. It was raining relentlessly so I admitted that I, too, hadn’t gone into town to see Anthony but that Ming was doing it.

Doing it?

Why did I describe my visits to Anthony as a job that needed to be done? Why didn’t I say, “Ming is visiting Ants today”? instead of “Ming is doing it today.”

I am so embarrassed that I expressed myself this way because for all of these years I have felt and believed that the romantic love I share with Anthony would somehow sustain us. In fact, as Ming often points out, Anthony is now mostly lost in his world of Parkinson’s Disease Dementia. Yesterday, for example, Anthony was mostly asleep during my 2-hour visit and this is often the case.

Perhaps love is not simply a feeling but also a decision. For me, this realisation has made all the difference recently because in deciding to love someone, that ‘do it’ decision, is an absolute in the face of multiple contingencies.

Do it.

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“A person with dementia is not a person who is dead and gone.”

This was the sentence that I began, and ended, our TEDx talk with last week. Like the other speakers, Ming and I only had 15 minutes to deliver this talk which was a challenge as I had written this massive missive of around 20 pages! Thankfully Ming convinced me to turn this into a cue card presentation and we practised it in a hallway before the event began.

It is extremely difficult to talk about Dementia because everyone has a different story of what it’s like (for both the person with the disease and the carers). Ming and I now have a disclaimer that admits our luck in that Anthony’s personality hasn’t changed and that this is one of the many reasons we still find joy in our interactions. We acknowledge that other people, coping with the multi-faceted aspects of Dementia, may be in hellish situations.

I am so glad that Ming and I had the opportunity to talk about our own situation. Anthony is immobile now, his previously loud voice a whisper, and mostly he doesn’t know who Ming is. But he is still alive, free of pain, accepting and full of love for me; it’s a beautiful thing.

If I can influence just a single person to visit their spouse, parent, friend, I will feel I’ve made a slight difference. There are so many thousands of people with Dementia in nursing homes who never have contact with loved ones; these people are, quite possibly, the loneliest people in the world.

A person with dementia is not a person who is dead. And nobody is ever, ever, gone.

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Doubts

Ming and I did our TEDx talk at the Bunbury Entertainment Centre a couple of days ago, and I think it went well. Ming and I have discovered that we can do this kind of presentation by bouncing off each other. This is our fifth joint presentation via radio or podcast; I think Anthony would be proud.

But I have so many doubts!

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10. Dementia Context

Yesterday afternoon, when I visited Anthony in the nursing home, he was in bed. He’d been showered and had been up in the broda-chair (armchair-on-wheels) all morning and was tired.

I positioned my chair so that my face was close to his and this was our conversation:

Anthony: I was so depressed yesterday, Jules.

Me: Why? What happened?

Anthony: Well, I went down to Bridgetown to help out but all the farms are in disarray.

Me: So did you manage to fix some of the problems?

Anthony: Only some.

Me: I can ring Fred if you like, or Simon? Just to make sure?

Anthony: Good idea.

Me: So are you still depressed?

Anthony: A bit.

Me: So what can I do? I’ve rung the guys and they are fixing everything right now! It will all be okay, Ants – I promise.

Anthony: Beautiful.

Me: What is beautiful?

Anthony: You.

Dementia doesn’t equal death. People like Anthony can survive for many years with Dementia, either at home, or in care.

I feel so passionate about raising awareness that people with Dementia, even if they don’t know who you are anymore, cognitively, still appreciate a conversation, a hug, and, most importantly, your presence in their lives.

To begin with, nearly six years ago, I could hardly bear my visits to Ants because of how heartbreaking they were. He wanted to come home and I wanted him to come home and, yes, we tried this over and over again but his Parkinson’s Disease won. Once he couldn’t walk that was it and I had to get the wheelchair taxi to come and get him and take him back to the nursing home. I felt as if I had abandoned my soul one Christmas when this scenario played out in my mother’s driveway in the midst of our family get-together.

Context: Anthony was/IS a dairy farmer.

He has never lived in Bridgetown.

 

 

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9. “You seem like a very nice bloke.”

Ming visited Anthony yesterday and once again wasn’t recognised. I am so proud of the way Ming is handling this. Instead of feeling hurt and upset, Ming just goes with the flow and has fun with Anthony anyway.

Ming: Do you know who I am?

Anthony: Well, you seem like a very nice bloke.

Ming: Yes, Dad, but do you know WHO I AM?

Anthony: Aren’t you the hairdresser?

Ming: No – I’m your son – I’M MING, DAD!

Anthony: Yes, that’s right.

Ming has the same booming voice that Anthony used to have. He also has a similar gait and the other day as he suddenly appeared in my view through the front window, I thought for a split-second that it was Anthony. The nostalgia was unsettling, but also quite pleasant. He loves the stories I tell him about how Anthony used to be before and just after Ming was born. These stories have helped Ming to cope with Anthony’s ill health over the years, especially lately. Ming has very few childhood memories of having a father who was robust, gregarious, the loud, life-of-the-party, generous host because he was a one-year-old when Anthony suffered his first cancer – kidney cancer.

One of the most wonderful things for me is to see so many of Anthony’s qualities embodied in this larger-than-life son of ours. Ming is full of humour and a kind of boisterous grace. To hear him tell me about how fantastic his visit to Anthony was yesterday is like a gift.

Two very nice blokes.

 

 

 

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8. Carrot juice

Several years ago Anthony and I embarked on a carrot juice diet and we went through two juicers (warranteed and replaced) in our quest for better health. We did this for around two months until our skin took on a rather strange, yellowish hue and Anthony developed arthritic pain. At the time, I did a bit of research and discovered that an overabundance of carrots can actually be harmful so we gladly quit the carrot juice and laughed ourselves silly about what idiots we’d been.

Looking back to that time, I now think that perhaps Anthony was showing signs of the Parkinson’s Disease Dementia that has now pretty much paralysed him, physically and cognitively. I guess I was trying desperately to find a solution?

I am a great fan of cold-pressed juice but I also know that it takes a hell of a lot of carrots to make a single glass of this elixir and nobody in their right mind would ever eat that many carrots in a single day. Nowadays I make juice with the outer lettuce leaves most people throw away, a single carrot, an apple, and orange, and a bit of ginger. This quest for health has consumed me lately due to my recent battle with mycoplasma pneumonia; I need to be well again and it has taken so long to get better. The hospital doctor did actually include (in his written report) my suggestion that my illness might have something to do with grief but, in the end, that was dismissed, the evidence of the mycoplasma bacteria was found, and I was given mycoplasma-specific antibiotics.

Anyway, back to carrot juice; once I was out of hospital I decided to go on a health kick. I’d lost five kilos so fast that my arms were (and still are) wasted and (hilariously for Ming) still stick-like. The other day, I reminded Anthony of our carrot juice adventure and he smiled. He remembered!

Anthony: But it’s good now isn’t it?

Me: Yes.

Anthony: I prefer chocolate.

 

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7. “When do you get your soul back again?”

[As I prepare for the talk Ming and I will deliver at TEDx in Bunbury, I wrestle with challenge of being concise when I could talk forever about our experience with Dementia: Anthony’s unawareness that he has Dementia; Ming’s transition from anger to acceptance; and my own attempts to find and create meaning in our interactions. I want this 15 minutes to somehow make a difference in the way people in general respond to people with Dementia. Once again, the following is a draft of a chapter for the book, Dementia Dialogues and any feedback appreciated.]

7. “When do you get your soul back again?”

It was a few months ago and I was already attuned to our cross-purpose-ish conversations, where, for example, Anthony would mention a tractor and I would counter his tractor-anxiety with an exclamation about how sweet potato was in season again.

So, as I switched the television station from Dr Phil to the ABC news, Anthony did the exact same thing with our conversation:

Anthony: When do you get your soul back again?

Me: WHAAAAT?

Anthony: Your soul.

ME: But I haven’t lost my soul, Ants!

Anthony: That’s good.

Anthony is the least spiritual person I have ever known so his mention of my soul was disconcerting as I’m pretty sure I have a reasonably healthy one. Nevertheless it made me realise that inside the mind of a person with Dementia are all sorts of references to all sorts of triggers, both past and present. His mention of soul may have been a bit like me telling him that the power was out at the nursing home one day, i.e. there was no electricity. Hours later, we had this conversation:

Me: Are you angry with me, Ants?

Anthony: Of course not.

Me: Then why do you look so sad?”

Anthony: My power is out.

So maybe Anthony’s casual reference to my soul, as if it were something I’d temporarily misplaced, like a bangle or a scarf (which I lose all the time), was just him using one word, ‘soul’ for another, more tangible thing? After all, I don’t even know what a soul is!

Nevertheless, that soul conversation still resonates, still makes me wonder, and still compels me to keep on trying to continue these dialogues. Sometimes, when Ants is too sleepy, or confused, to answer my ‘yes or no’ questions, and he tries to tell me something that I can’t understand, I just say this:

Me: It’s okay, Ants. I can read your mind!

https://tedxbunbury.org/

 

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6. The most beautiful word: Yes

“Could you just put that skeleton onto the hose?”

“You are always doubling and tripling and doubling.”

“There he is – that little bastard – see? In the corner. With the horse nose.”

“I don’t want to be in this school anymore.”

“This is the most wonderful pub!”

“The dogs need to be let out. Do it gently with the first ones. We have too many.”

“Does the congregation know that you found the bodies?”

“It was a pirate ship and those kids kidnapped me again.”

“See this thing? [often his knee rug]. “Can you loop it around these things?” [his hands.] “Yes, good, that will stop the rain from getting into the crevices.”

The above are just a few sample statements made by Anthony over the last several years. There is a context to some of these statements which I will elaborate on later in this book, but most are uttered spontaneously and sometimes with what seems a subdued desperation.

If you are caring for/or about someone with Dementia who is close to you – a spouse, parent, friend – it can be extremely difficult to know how to respond. For example, it can be very tempting to counter what seems like nonsense with logic, like:

There are no bodies, or a pirate ship. It’s not even raining! We only have two dogs, the hose is fine, we’re not in a pub or a school – we are in a nursing home! Who are these kids you keep talking about? What the hell are you talking about? You are paranoid, you are delusional and I can’t cope with this nonsense anymore. Please, Ants; this is so unfair on me. Pull yourself together!

I’ve highlighted the above to emphasise my frustrations over the years with Anthony’s gradual transition into the confusion of Dementia. Of course, I am not proud of my impatience with him but, early on – especially during the last year Anthony lived at home and the first year of the nursing home – my moodiness was acrobatic and just as unpredictable as his confusion.

The only thing that remained a certainty for us during these tumultuous times was our inviolable love for each other. Anthony’s reluctance to marry me all those years ago stemmed from his anxiety about the age difference (23 years). He didn’t want to burden me with his old age. I said I didn’t care but for some reason, despite my nursing background and my PhD research about Alzheimer’s Disease, I never once considered that one day Anthony would not only be old, but also very sick.

We were married in 1993 and at that time Anthony was fit, robust and full of energy – a passionate dairy farmer. Neither of us could have anticipated that in the first year of Ming’s life, Anthony would succumb to kidney cancer. I can remember taking baby Ming into the hospital to see Ants in between two surgeries, the first to remove a tumour from his left kidney, and the second to remove the whole kidney. Our tears then were not just about the trauma experienced and the idea of cancer, they were also about Anthony being advised not to ride a motorbike anymore.

Anthony was only 58 back then (the same age I am now) and he loved riding motorbikes. Dairy farmers don’t have much time for hobbies, but this was his and, in retrospect, I now see that this would have come as a terrible blow for Anthony. The cancerous kidney was gone, yes, but this experience altered things in a forever way.

Ming had his first ever asthma attack in that hospital room. My mother took him into her arms while I rushed to find a nebuliser and Ventolin for Ming.

Later that week we brought Anthony home – wan, pale, diminished, and so weak. But he soon got better and went back to milking the cows, enjoying being a father, and loving me with a fervour that devastated me because I could already see the writing on the wall. I’m not a scientist or a psychologist but I do believe that our kidney cancer year somehow made Anthony vulnerable to the many illnesses he has contracted since then.

Now, nearly two decades later, Anthony often reassures me that he is getting better.

Me: YES.

 

 

 

 

 

 

 

 

 

 

 

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5. Banter

Anthony, Ming and have always enjoyed bantering and, fortunately for us, Anthony still enjoys it, despite his Dementia. He has very thick skin when it comes to being teased and has always loved making people laugh.

Sometimes, he flabbergasts with his one-liners and his quick-wittedness. Last Christmas we all decided to forego presents and instead just partake in some very expensive crayfish.  Anthony feigned disappointment and I became defensive.

Me: You didn’t get me a present either!

Anthony: Well, that was a calculated risk.

For someone who is so often unable to articulate what he wants to say, both cognitively (the Dementia) and physiologically (the Parkinson’s Disease’s effect on this throat muscles) he comes out with some absolutely brilliant come-back remarks. It’s not just us he banters with, he also responds to the banter of friends, family and the staff. If there happens to be a group of more than two in his room, he finds it difficult to follow what is sometimes a very lively conversation but one-to-one his wit is often surprisingly apt.

Nevertheless these kinds of dialogues are few and far between now as much of what Anthony says is either indecipherable or incoherent much to his obvious frustration. At those times Ming and I have learned to divert the conversation back to banter and this usually works really well.

Ming’s style of banter is very boisterous and he will pretend he is going to leap onto Anthony’s lap just as he did when he was little, and/or actually sit on his lap, ruffle his hair and yell things like, “Daddywaddy, my favourite parent!” (He especially likes to say this when I am there too) much to Anthony’s amusement.

Diversion is also a great way of steering a distressing conversation away from itself. For example:

Anthony: When are you taking me home, Jules? This recurring question is always tricky for me as Anthony has no idea that it is now years since I have been able to bring him home. So I resort to banter. I know it seems contrived but it works for us. In answer to the home question, I will often say something totally off topic, as I did the other day:

Me: You have such a BIG nose, Ants. 

Anthony: You just want to see me naked.

And in a matter of seconds the fraught and heartbreaking reference to home is forgotten.

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4. Lost for words

My visits to Anthony are often very silent and this is fine. The other day, as he was half-asleep in his broda-chair (armchair on wheels), I felt such a surge of love for him that tears filled my eyes.

At one point his own eyes opened properly and he said, “Jules?”

Me: I’m here, Ants. I love you so much!

Anthony: Yes I know.

Me: Actually, you’re supposed to say it back.

Anthony: Yes, I know.

Me: SO SAY IT!

He gave me his half-smile and said, “I love you Jules,” then drifted back to sleep.

Later on, when he woke again:

Me: Do you want me to stop saying ‘I love you’ all the time?

Anthony: Just for awhile.

Me: You want to sleep again. Am I that boring?

Anthony: No, you’re not boring.

Me: What am I then?

Anthony: Just slightly boring.

Me: How dare you!

Anthony: I didn’t mean it, Jules.

Me: So why are you looking at me so ferociously?

Anthony: DESIIIIIIIIRE.

Oh.

Any words I was about to speak were lost within my laughter.

Anthony’s half smile broadened to the best of its ability. The muscles in his face have been so affected by Parkinson’s Disease that he often appears to be angry or unhappy, so a smile is like gold. So one of my main goals for each visit is to somehow get that smile happening. When I can’t, I feel a bit defeated and ask for reassurance that he is okay. His answer is almost always the same but often uttered with a that masked facial expression.

Me: Are you happy, Ants?

Anthony: Always happy.

And once again I am lost for words at how accepting of our circumstance this wonderful husband of mine is.

 

 

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