Alzheimer’s

1.
Remember the name of the President
because they always ask you that
and the date – month, day, and year
write it beforehand, between your knuckles
if you need.
If they hold up some pencils,
ask you to count backwards,
some other math problem
concentrate like a motherf____r
it’s a test
you won’t get another chance.

You won’t remember these instructions.

Keep a bag in your front closet
some clothes that fit, a few favorite things
one fall –
and it’s straight from the hospital to the home
you’ll need something to wear
a radio would be good
if you can remember how to run it
some framed pictures
to help you find your bed

the tray tables will all look the same.

each time you wake up
you’ll know something’s missing
months, months, maybe years
home, things, people
we’ll visit; try to explain
even after you stop looking for us.

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2. She forgets that we have just left the hospital, and she thinks I’m taking her to the dentist. That’s a fair mistake – she has an appointment in a couple of weeks, but not today. Her eyes narrow a little when she sees the low building with all the wings (“Is this where the dentist is?”) but she doesn’t remember. The nurse does an assessment for pain, and she tells her about the crown on her tooth.

It takes about a week for the bruises from her fall to fully bloom out, spreading from the back of her shoulder to her neck. I suppose they go down her back as well. The unfortunate part is that the pain and confusion keeps her in bed, and in the wing where she stays first the aides bring the meals directly to the room. By the end of the week she can hardly walk.

We start to clean out the apartment and box up her papers. The old furniture (most of it) will be put in the basement for the time being, although a couple of pieces will come up our living room. Some of it is beyond saving. There were some bladder control issues towards the end of her independent living. It takes a month of Saturdays and Sundays for us to finish the sorting and culling.

It’s like an estate sale, except that she’s up there at the nursing home while we’re disassembling her house. If we wanted, we could go back to ask her, “What is this thing? Where did it come from? Whose was it?” In her current state she might access the memory, or she might not. It would be easier to sort if she could be here with us, to help us see which books and boxes were kept because they were important, and which were kept out of comfort, convenience, or habit. She would be mentally and emotionally spent by the experience in a few minutes, though, and that would not do anyone any good. She can’t make these kinds of decisions anymore.

On the first weekend that we work in the apartment, her neighbors talk to me as we come in and out. They ask about her – where she is, how she’s doing – and then they yield a little information. It turns out that she has fallen several other times, but they always heard her calling out and went in to help her up. This last time nobody came, and she ended up calling the ambulance. I am surprised that none of them has told me about this before. They knew who I was. Why didn’t they call? Only one of them ever said anything at all, after th/B locked herself out of her apartment in the middle of the night and knocked on all the doors down the hall as she tried to find her way back.

I decide that it’s some sort of elderly omertà, a code of silence imposed as a defense against the Watership Down risk that each of them faces. When someone leaves this apartment building, she goes to a place that’s worse and she loses control to to a younger generation that none of them trust. The apartment has been a safe place, with few threats to person or property. The internal jealousies haven’t been too brutal. “We miss her,” they eventually say. “She was always sitting there in the lobby.” She always was personable, even after she couldn’t remember whom she’d met and who was new.

She maintains a desperate cheerfulness in the new place, even though it can be grim. She always was the good girl. There are fifteen other residents, and at least two of them are shouters. Meal times are hardest, because they must all eat together at three round tables. Some of them throw food. They start with three small plastic glasses placed out in front of them – milk, water, and juice. Dessert comes next, placed between them and the water. The entre’ comes last. It is often finger food, or soup and chips, and some of them have forgotten how to use soup spoons.

It will take her a while to enter the zone of the present, where the apartment is forgotten but where she still understands that she is in a particular place. Beyond that, it will become all half-thoughts, little fragments of understanding that pass in and out.

Meanwhile, we continue disassembling her life, in the form of her apartment and furnishings. I sift through Christmas cards to find addresses and try to collect papers that might be useful. T and I both find it to be emotionally draining. What am I supposed to do with all this stuff? What am I supposed to do with all the cross-stitch? What am I supposed to do with her two old dolls with their sweet cracked faces, packed with a few little handmade outfits lovingly made back in 1934?

(For the record, the little girl doll was named Mary Annetta. The name may be all that can be saved.)

Th/ B loved to collect clippings from papers and magazines. Every book is full of slips of paper that fall out when I pick it up. We scoop them off the floor and put them in plastic trash bags. I’ll read the old family letters and look at the old pictures sometime, but the rest is overwhelming. Throwing books out is hardest, because every book is a promise and an obligation, but I can’t recreate her life by reading all the books she read. I have my own load of memories. I don’t think I can take on another set. She carried both hers and what she knew of my father’s life, although her knowledge of him was clearly limited to the perspective of a bookish bride in the first six years of a marriage. She loved him, so strongly that she didn’t let go at all when he died. It’s all boxed up now, stacked in a row in the basement. I’ll figure out how to let go later.

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3. It’s been a horrible spring, becoming an oppressive summer. We are not strengthened by exhaustion.

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4. One of the residents in the nursing home’s memory unit is unable to speak. She does not seem very old, but it is plain that the lights are nearly extinguished. Often when I visit she is sleeping upright in a chair. When she is awake, she shuffles along in straight lines that never reach an endpoint.

I stop in on a Saturday just as lunch is ending. Th/ B is still finishing with the beans and cornbread, so I sit with her at the table. The silent one is up, walking around the edge of the room because there is nowhere past the edge for her to go. There is a line of chairs against the wall, leading a window with a couple of house plants. She walks, and when she gets to the last chair she looks down and sees a chunk of food on the seat. An old memory of tidiness and obligation comes to her, and she slowly reaches down to scoop the morsel up with her fingers. Then she does not know what to do with it, so she carries it to the table where one of the crabbier residents is still eating. She holds it out, as a question and a request, but Crabby just snaps, “That’s nasty!” and slaps her hand away.

The silent one is startled into unusual quickness and turns back towards the chair. Facing it, she sees that there is one more scrap in the seat. She picks it up as before, but then she stops. Maybe it was the hand slap, or the maybe the irritation and anger. She has remembered something, and it has made her unsure. She looks at the chair, and out the window – and then places the food quickly down in the potted plant. She turns and walks away in her straight, expressionless line.