Friends I've Made Who Don't Know Me

 
Lately, some of the most interesting people I've been getting to know are residents at Autumn Leaves, the dementia care facility here in Arlington, Texas, where my Dad spent the last ten months of his life.

And let me tell you, not all dementia patients are alike!  Within each of its victims, dementia manifests itself as uniquely as each of these dear folks were in their pre-dementia life.  For proof of this, consider the individuals I've already blogged about, like Miss Mary, Mr. Laurel, and Shirley, one of the most legendary residents ever at Autumn Leaves.

Let me introduce you to a few more of them here.  And, by the way, to respect the humanity each of these people still possess, and since they can't give their consent to me talking about them, their names have been changed.


Bob

Talk about the bizarre challenges of dementia care, and I give you Bob:  A short, emaciated, wiry little White geezer who, from what I learned of his stubborn pre-dementia days from his proud son, would likely approve of the term "geezer!"

Of all the disturbing behavior Bob displayed at Autumn Leaves, one of his most memorable was when he gummed the shear curtains in one of the facility's activity rooms.

He didn't eat them - he quietly gummed them and left strips of thread hanging from curtain rods. Caregivers had already taken away his dentures because he bit people. So without any teeth, just with his raw gums, he shredded the curtains one afternoon - we watched him, perched on the top of a sofa - no blood or anything. We don't know how he did it, but the staff just left him alone, since he seemed content, and wasn't hurting himself, or anybody else. 

And David, the maintenance guy, simply ordered another set of curtains when Bob was done.

In his dementia, Bob hated curtains. Before we arrived with my Dad, he'd ripped down EVERY set of curtains in the facility's public rooms. He kept pulling down curtains along a hallway leading to the two dining rooms (it's a hall of windows), so staffers finally stopped re-hanging them; David removed the curtain rods and spackled everything up to look like there had never been any curtains to begin with.

Once, Bob ripped out a fire alarm box with his bare hands - and those are bolted into studs, not simply affixed on drywall. He ripped out electrical sockets, completely immune to the shocks he'd get. His arms and legs were a patchwork of open sores (covered by bandages that caregivers could barely keep him from pulling off) and bruises in various stages of healing.

One day, there was a caregiver tasked with following him around the facility, cleaning whatever surfaces he touched (and left blood).

He was CONSTANTLY in and out of the hospital, mostly from his many falls. One time, his son (a police officer) told me that although Bob allowed himself to be placed on an ambulance stretcher calmly enough, an EMT was otherwise invading Bob's personal space a bit too much. The son had been called by Autumn Leaves staff, so he was on-site before the ambulance left, and Bob's son told the EMTs not to handle his father more than they needed to, and certainly not to get into his personal space, particularly around his face.

But one of the EMTs didn't obey.  And Bob, laying flat on the stretcher, limp and barely alert, somehow summoned enough strength to reach up and pop the EMT full in his face, knocking him out cold.

Did I mention Bob had been an amateur boxer in his younger days?

Miss Polly

Even when she's down, Miss Polly rarely seems to have a bad day.

She's one of the higher-functioning dementia residents where my Dad used to be.  A soft-spoken Black single woman, Miss Polly has a large extended family and, according to one of her nephews, used to love the color yellow.  When she first arrived, less than a year ago, she was walking, but now she needs a wheelchair most of the time. Yet she's always dressed smartly, in coordinated outfits, with either a wig or a Pocahontas head covering.  (I had to Google that!  My paternal grandmother in Brooklyn used to wear them when she hadn't had her hair styled).

She's exceptionally friendly, even though she has no idea who anybody is. And it's relatively easy to have a brief, reciprocal conversation with her.

One day, she was sitting with some other residents at a table of crafts, and she was quietly mumbling something to the woman sitting next to her. Miss Polly saw me, and she broke off what she was saying, looking up at me like she was Miss Innocent.

"Oh, Miss Polly!" I teased. "What were you gossiping about?"

Her face blanched, and she quickly drawled, "I wasn't gossiping. I was just telling it like it is."

Yesterday, during snack time, a caregiver wheeled her up to a tray displaying a variety of cookies.  The caregiver gave her one, and I commented, "Oh, it looks like white chocolate with Macadamia nuts!" Another caregiver glanced over and said, "No, I don't think those are nuts; we don't normally serve food with nuts to avoid any allergy problems."

But Miss Polly was too impatient. "Well, let's just see what it is," she interrupted, stuffing the cookie into her mouth. She chewed a couple of times, and confessed with her mouth full; "I'm a mess with sweets."


Sharon

Increasingly, Sharon is lost in her own fog that is dementia. Everything about her now seems to be quieter, dimmer, and a bit more disheveled than when she arrived at Autumn Leaves a couple of years ago. 

When I walked past a group of ladies at my father's dementia facility today, however, Sharon took full notice of me.

Although she is slowing down, Sharon remains the resident vamp of Autumn Leaves.  Tall, White, relatively slender, and relatively young (compared with most of the other residents), Sharon displays the classic dementia hallmark of an eroded social etiquette - particularly, um, when it comes to her feminine wiles.  If I told you some of the stuff she's done with a couple of the male residents in full view of many other people, let's just say that you would be incredulous.  Her son insists she was never that way in her pre-dementia life.  But today, her behavior is all part of the grim world of grown adults whose propriety filters have been destroyed by dementia.

And some of it simply ain't rated PG.

"WOW!" she exclaimed this morning, straightening her posture, and summoning from within herself a gusty enthusiasm that we haven't heard from her in a while. "Look at that MAN."

Have I ever mentioned that sometimes, dementia patients can be really good for your ego?  Of course, the other ladies sitting with Sharon - fellow residents of hers - merely looked at me with a mix of confusion and utter disinterest.

Which, frankly, is more the story of my life!


Flo

Flo is always a delight.

She's an even higher-functioning resident at Autumn Leaves than Miss Polly.  Slender, of average height, with dyed brown hair, some jewelry, and makeup applied appropriately, it took us a while before Mom and I realized Flo is a resident at Autumn Leaves, and not visiting a loved one like we do.

Many dementia victims develop a strange look in their eyes that seems to reflect their disconnection from reality, but Flo doesn't have that.  The only way I know Flo has dementia is that day after day, week after week, she can tolerate eating in dining rooms with other residents with dementia.  And let me tell you, watching a dementia patient eat is not for the faint of heart.

Well... I say Flo eats with the other residents... but there's a reason why she's so slender!

Last week, for example, it was lunchtime, and caregivers were helping residents into the dining rooms, but Flo just stood in the hallway, with her back literally towards the open French doors.  Actually, most of the residents have to be taken to eat - dementia somehow robs them of their ability to process hunger as their body's prompting for nourishment. So I encouraged Flo, "Hey, it's lunchtime! Time to get something to eat!"

Flo's face blanched. "I can't eat this food," she confided to me. "You know, I'm Italian, and the stuff they serve here just isn't any good."  And no, while I never ate any of the meals there, we'd been told that the cooks usually put some sugar into most of it, since sweetness is the last taste sensation to fade for dementia patients.  And the goal of mealtimes at a memory care facility is encouraging residents to eat for sustenance, not necessarily nutrition.

(I did once have a generous slice of fresh apple pie made from scratch by one of their cooks, and it was excellent... likely thanks to her liberal use of sugar!)

"Are you a good cook?" I asked Flo, fully aware that mine was a silly question to ask an Italian.

"Listen," Flo retorted, putting her well-groomed hand on my arm. "If I had cooked this, it would be FABULOUS!"

Today, Mom and I were visiting a resident at Autumn Leaves who is on hospice. We were chatting with the spouse of another resident in the main living room, and Flo strolled by. We welcomed her into our conversation, and then Madge trudged through, in her wheelchair, looking for trouble.

After angrily instructing us - pointed finger and all - that somebody had to get their act together (we don't know who, or what they'd done wrong), Madge started to wheel herself along again.

Looking at the departing Madge, Flo shook her head.

"With some people, I have to count to 30!" she muttered.

We all laughed, and I clarified, "you mean, to diffuse a situation, you normally count to ten before saying something, but with Madge it's thirty?"

"You got it, boy!" she affirmed heartily.

Flo usually carries a book around Autumn Leaves with her, even though it's usually the same one, and it's doubtful she remembers the plotline.  I once asked her what the book was about, and she gave me an uncharacteristically blank face, her wit apparently unable to make something up on the spot (which is a common tactic of dementia patients).

Today, however, Flo was sporting a new book.  "Such a suspenseful page-turner, you can't put it down," gushed a blurb on the bookjacket.

"So," I asked Flo. "Is it such a page-turner that you can't put it down?"

She looked at the book, sitting closed on the table, next to her cup of coffee.

"Not yet," she chuckled!


Mr. Zack

Technically, I broke the rules.

Miss Polly had one last cookie remaining after snack time this morning, and she told me she didn't want it.

Mr. Zack, on the other hand, still seemed hungry. He was sitting next to her, his head down, his eyes closed, like they always are.  I'm not sure how tall Mr. Zack really is; his chin always rests on his chest, even when the staff has him shuffling along with his walker, with his eyes still closed, his broad Black face seemly set in an oddly contented smirk no matter what he's doing.

His left hand was resting in his lap, but his right hand was still drawing circles on the table.  It was like his big hand was some sort of automated machine that hadn't been shut off.  Both his hand, and the spot on the table, were wet and sticky from him occasionally stuffing some fingers into his mouth, his "cookie-transfer system" from table to mouth missing a vital component: a cookie!

Mr. Zack doesn't talk.  Ever.  He'd lost that ability before I'd met him at Autumn Leaves, when we brought my father.  I've seen him during visits with his family, just sitting; eyes closed, chin down, those huge hands of his piled atop his knees, yet he'd somehow be transmitting an understanding that he was in the company of loved ones.

Dementia is strange, indeed.

So I suggested to Miss Polly that perhaps Mr. Zack would like her unwanted cookie. After all, the spot on the table being circled by his right hand wasn't going to generate a new cookie for him all by itself!

And, to my surprise, Mr. Zack grunted loudly at my suggestion!  It was an obvious affirmation that my idea sounded pretty good to him!  I confirmed with Miss Polly that it was OK to give her cookie to him, and she drawled, "well, if he wants it."

It was on a napkin, so I scooted the napkin and its sweet cargo over to the messy spot on the table, right underneath where Mr. Zack's right hand was now hovering.  He reached down and tried to pick up the cookie, but his big fingers don't move very well - those enormous hands - and the cookie slipped onto his lap.

Instantly, his left hand felt for it, found it, and grasped firmly onto it.  Eyes closed the whole time.  He reached up and stuffed the whole thing into his mouth, fingers and all, reminding me of Cookie Monster, from Sesame Street!

Technically, I'm not supposed to give food to any of the residents at Autumn Leaves, but Mr. Zack certainly won't report my misdeed!


Ricardo

Ricardo is a slim and dapper Hispanic gentleman. Quiet and reserved, he sports a well-trimmed white mustache and wears his graying hair slicked back in an elegant man-about-town fashion.

It's tough guessing the age of dementia patients, since the disease can wreak strange havoc on its victims' personal appearance, but I'd estimate that Ricardo is in his late 70's.

He prizes order and neatness, even in his dementia.  So the staff usually have a basket of fake "laundry" ready for him to fold.  Towels and washcloths in bold, bright colors, so residents with poor eyesight can sort and stack them and get a sense of accomplishment and worth.  Ricardo takes his time to make sure all the edges of each towel line up, and the stacks are neatly ordered on the table.  Frankly, such precision is remarkable among dementia patients, so we usually take the time to compliment him on his work.

Today, he was lounging in his wheelchair near a large window, our cheerful Texas sunlight washing across him. And a young, attractive, female caregiver was massaging his hands with lotion.  During wintertimes, especially, the staff rub lotion into residents' hands to help moisturize them, as dry skin can help spread germs.  Some dementia patients can't stand having their hands being gripped by another person, which obviously is what happens during a lotion massage, but most love the sensations of being rubbed and feeling their skin soften.

Ricardo clearly is one of the latter!

I leaned into him, and slyly whispered, "So, you're letting her hold your hand now, are you?"

And Ricardo, as if suddenly transported back to his prepubescent life, burst into goofy giggles that he couldn't stop!

Bill, the Lillie of the Valley

Bill was a tiny spitfire of a woman.

She never much cared for her given name, Lillie, so she went by “Bill.”  However, my brother and I  always called her "Mrs. Watson."  Even our parents did.  It confused us greatly when Mrs. Watson signed her first Christmas card to my family with “Bill."  Back in 1978, at least, seeing “J.C. and Bill Watson” on a Christmas card seemed so odd.

J.C. was her husband, a taller, portly man who always wore a black suit and a white shirt.  Back in the day, he and his brother owned a small chain of department stores across a few then-small towns between Fort Worth and Dallas, at a time when “main streets” really were main streets, and townspeople did all their shopping along them.

Mr. and Mrs. Watson made for a study in contrasts – with him taller and stocky, and Bill so short – incredibly short – and petite.  And their personalities didn't seem terribly similar, either.  He was quiet and unassuming; she was not loud either, but she talked more, and had definite ideas about things, and knew how to advance those ideas firmly yet graciously.

She was always a traditionalist, while at the same time, she could defy convention.  She personally designed their beautiful yet unpretentious home, and acted as general contractor during its construction, which was indeed an unusual thing for a woman in the 1960's, in provincial Texas.  Her design is simple and elegant - a long, low-slung one-story home, based on the type of farmhouses that were typical of her growing-up years in far south Texas.  Her parents had owned fertile acreage in what Texans call "the Valley," near Texas' southernmost border with Mexico, a region particularly famous for its ruby-red grapefruit.  She incorporated a full-length covered porch on the front, and another long porch on the back, all with Saltillo tile flooring she'd personally selected from a tile factory in Mexico.  The tan-colored hand-made bricks sheathing her home she'd also selected in Mexico.

The Watson house; image from Google Maps

It's a theme you'll notice often in Bill's life:  her love of hand-crafted things.  Their intrinsic uniqueness seemed to speak to her.

She installed hand-made front doors from Spain, and while their wood is beautifully fashioned in a classic Spanish style, she'd specified the wood to be of a particular variety.  A variety that, even today, has some sort of wormy, gooey fungus that, from time to time, oozes out of the wood.  It's as gross as it sounds, and the first time I saw it, I feared Mrs. Watson's doors were woefully flawed. 

"Mrs. Watson!" I remember exclaiming, "You have puss oozing from your doors!"  It looked like a case of really bad acne.  Oh, it was so gross.

Yet the ever-proper Mrs. Watson was mostly surprised that I was unfamiliar with this species of wood (I can't remember what she called it; I researched it for this essay, but can't find anything like it on the Internet).  Apparently, she'd chosen it because it helps to keep the wood moist, which is technically a feature to accommodate Texas' often-arid summers.

The more I've thought about it, her front entry doors contribute a great deal to understanding Bill Watson's character. On the one hand, viewed from the street, they look attractive, but not particularly exceptional. Yet upon closer inspection, they were obviously constructed with extraordinary craftsmanship, each piece of wood still solidly in place, as if straight out of an old-world carpenter's shop.  And they possess that secret, intrinsic ability to provide for their own maintenance; a quality even a botanist friend of mine was entirely unfamiliar with when I asked for her input.

Once behind these doors, those pink-hued Saltillo tile floors extend throughout the home's main rooms.  So although Mrs. Watson had plush Aubusson rugs on her floors, sounds do tend to echo a bit.  And her crisp voice tended to predominate in those echoes, while her husband’s was far more muted.  Not that she ever yelled, of course.  Bill was a genteel Southern lady, with a lilting laugh and a poised diction that disguised her humble roots from “the Valley.”

Almost certainly, it was those humble roots, during the Great Depression, with little money available for travel, and little opportunity for cultural enrichment beyond "the Valley's" Tex-Mex pluralism, that helped push Bill towards something different.  Something beyond the miles and miles of fields and placid agriculture in which the inquisitive and gregarious little woman had grown up.  After graduating from high school, Bill went on to college, which was a rarity for women in those days.  She ventured into office work for large oil companies in New Orleans and Los Angeles, and joined the foreign service to help with America's rebuilding of Japan after World War II.

In photos from her time in Tokyo, Bill looks exceedingly comfortable, especially for a small-town Texas farm girl, in the cosmopolitan culture of a capitol city, in a country that had been a bitter enemy of the United States just a few years earlier.  Her incredibly short stature helped her fit in physically with the Japanese.  She loved the propriety of their culture, the proud nature of the people, and their fastidious industriousness.  Their wartime allegiances aside, the Japanese were just like her.  Which, for Bill, seemed to affirm not only the similarities that can be found across humanity, but also her own enthusiasm for her country, since the United States was participating in a vast humanitarian exercise to rehabilitate a nation it had just defeated.  There was a virtue in America's civilized response to victory that energized Bill's patriotism, and continued throughout the rest of her storied life.

I’m actually fairly uncomfortable referring to her as “Bill,” since when I met her, I was 13; an age at which I was expected to politely refrain from calling my elders by their first names.   She was Mrs. Watson to me then, and she’s Mrs. Watson to me now.

My brother met her first, shortly after we’d moved to Arlington, Texas, from upstate New York.  He’d been riding his bike around our new neighborhood, and Mrs. Watson had been in her front yard, tending to her immaculate landscaping.  She saw a young boy riding down the street – the Watson’s lived at the top of a hill, which was a fun spot for young bike riders, as you might imagine – but she didn’t recognize him, since we were brand-new to the neighborhood.  And being an outgoing person, she introduced herself.  And my brother came home, remarking on how friendly one of our new neighbors was… and about how fun that hill was in front of her house.

She was in her mid-sixties by then, her husband’s business was slowing down thanks to America’s newfound preoccupation with regional shopping malls, and she was about to become a grandmother for the first time.  Much of her days was spent on what had become her favorite hobby - her yard.  She used to have turf grass as her lawn, the type you see on golf courses, and she owned a lawnmower specifically designed to cut it.  She clipped the edges of her lawn as precisely as any groundskeeper at any prestigious country club would, and she kept her shrubs trimmed to within an inch of their lives.  It wasn’t until she developed skin cancer from being outside so much – despite always wearing a huge, floppy hat – that she finally hired a yard crew… which she supervised like a mother hen.

And the stories she’d tell, as she'd take breaks in her yard chores!  At first, I struggled to understand why a young woman would go to Japan to work so enthusiastically in a nation we’d just defeated in war.  I’ve never liked traveling, and foreign cultures are… well, foreign to me!  But Mrs. Watson would almost glow, regaling me with anecdotes of her time in Japan… or about the time when she wanted to see the Caribbean, and somehow ended up as the only paying passenger on a freighter sailing to Barbados.

Not that she was a loose woman by any means – she was utterly moral.  She wasn’t exactly the type of woman who’d risk her virtue by sailing on a ship populated only by burly men.  Yet she ended up subduing those mariners and earning their respect at a time in history when women typically weren’t widely successful in that regard.

Her son-in-law reminisced with me recently about how she used to drive - well, "fly" would be a more accurate term!  She drove like a bat-outta-you-know-where, and she always drove silver luxury cars.  We could have called her a silver bullet, I guess.  And she was so short, in a couple of the cars she drove, they had to pay to have the driver’s seat removed from its factory-installed track, and re-bolted into place even closer to the steering wheel, so she could see over the dashboard to pilot her cruiser.  Her husband couldn’t drive her cars, because he was so much bigger than she, and the seat couldn’t be moved to accommodate anybody else but her.

I’ve never enjoyed driving into Dallas, which is about half an hour away from us, but Mrs. Watson treated Big D like it was her backyard.  She had friends from around the world, thanks to her many travels. She also enjoyed maps, and would study up on places she was planning to visit in such detail that one time, after flying into a city she’d never been to before, she accurately instructed her cab driver on how to get to her hotel.

Over the years, she stayed abreast of many details related to her husband’s business, and after he died, when their store in Arlington was finally shuttered and the property sold, she was indignant at its selling price.

“J.C. purposely built that store with a reinforced sub-basement and elevator shaft that could support several additional stories, so it could be re-purposed into an office building,” she sputtered to me.  “From day one, he knew that building probably wouldn’t always be a department store.”  And Mr. Watson was correct.  Today, it’s an office building for the University of Texas at Arlington.

Over the years, Mrs. Watson’s health would have its ups and downs, but the only reason we ever knew she had skin cancer came when she hired that outside crew to begin doing her landscaping.  She never complained about her health, except when her failing eyesight kept her from enjoying television and reading.  Eventually, those prized Saltillo tile floors came back to haunt her, when she fell on them more than once, but even then, she kept her stints in the hospital shrouded in secrecy.  Not because she was afraid of getting older, but because she didn’t want to burden other people with her problems.  She knew how fortunate she’d been in her life, and she knew that other people had things far worse than she did.

I did know about one of her surgeries, but not from Mrs. Watson herself.  Her beloved daughter told me – or, at least, told me when Mrs. Watson was due back home from the hospital!  The next day, as I was on my usual evening walk, before the sun set, I went by Mrs. Watson’s house, and down that hill into the cul-de-sac, and I saw her daughter leave in her own silver Cadillac.

I didn’t think anything of it until I began to hear some rustling and banging going on in the toolshed attached to Mrs. Watson's backyard carport.

“Who would have the audacity to break into Mrs. Watson’s toolshed at this hour, with the sun still out, and her daughter having just left?” I wondered as I rounded the cul-de-sac.  The odd noises continued, so when I reached her driveway on my way back up the hill, I simply strode down it to the end of her driveway, where her carport and toolshed were.  And through the open door of the toolshed, I saw Mrs. Watson, not yet a full day home from the hospital, in her housedress, fussing with that cumbersome turf grass mower of hers.

She looked up and saw me coming.  And with a stiff index finger pointed swiftly at me, she sternly ordered, “Don’t tell my daughter!  She thinks I’ve gone to bed.”

Instead, Mrs. Watson had been hoping her daughter would leave while it was still daylight, so she could fiddle with that turf mower, an apparently cantankerous machine that she didn’t entirely trust to her yard crew.

So I obeyed her command.  Until last week, that is, as I talked with her daughter, who was planning Mrs. Watson’s funeral.  She died two Fridays ago, after a three-year struggle with all sorts of ailments; quietly, in the house she’d designed herself, with her family around her bedside.  Elegantly, in full command of her family’s affections, and a nurse hovering next to her; well into her nineties, having outlived everybody else of her generation in her family.

I figured it was now safe to tell her daughter about the turf mower.

And she laughed.

It was so Bill... the Lillie of the Valley.

Mabel, My Belle

My 'hood in Arlington, Texas

I'm got a thing going on with a girl named Mabel.

She's beautiful, black, and very well-groomed.  Most days, she's sporting a stylish kerchief around her neck.  We live on the same street, and meet in the evenings, as the sun is setting and the temperatures are cooling.  I go out for a walk and stroll by her place; she sees me and comes out... so we can share some private time together before she quietly goes back inside her home.

Mabel is a beautiful black lab who lives around the corner from me, in what we long-timers in our neighborhood call the "Taco Bell House."  In actuality, the Taco Bell House looks nothing like a Taco Bell restaurant, but it does have a red roof made of those undulating tiles, and it has stucco walls, in contrast to all of our brick homes.  The Taco Bell House features a courtyard with a vine-covered archway opening to a fenced-in dog run that parallels our street.  And that is Mabel's domain.

Mabel's courtyard is mostly walled by sliding-glass doors, so from several rooms inside her home, Mabel can see who's passing by outside.  Her owners have built a little doggy-door into one of the glass doors, so she's free to go in and out whenever she feels like it.  At various times, as I've been talking to her owners, lounging in their courtyard, I've witnessed Mabel making loop after loop through an open human-sized door, and her doggy door.  Around and around.  It's as if she's afraid she might miss something interesting inside while she's outside, and vice-versa.

This summer, I guess Mabel has learned that I usually take a walk in the evenings, and she's started to watch for me from inside her Taco Bell House.  Last night, as has become our custom, I walked by the fence along her dog run, next to the courtyard with the arched entryway, and a familiar pattern played itself out yet again.

I'll hear the quiet flapping noise of Mabel's doggy door after I've passed, and as I continue walking along, with my back to the Taco Bell House, I'll hear a muffled bark and a moan from Mabel.  I turn around, and there she is - standing up against the fence, looking at me, with her soft, black eyes and floppy, fuzzy ears, waiting for me to turn around and return to her.

For all I know, she may do that with anybody who walks by, and we have a lot of people who walk for exercise in our leafy neighborhood.  Yet I've seen other neighbors walk by Mabel's home, and she never comes out to greet them.  So I like to think I've got a little something special happening with her.

And she knows I can't resist her.  Yes, I turn back around and stroll over to Mabel, whose seems to be begging for some attention, since she wants me to think her owners don't give her any...  which I know is a lie on Mabel's part...  but I let her think I haven't caught on to her little ploy.  Some people say a dab of deception is good for a relationship.  I don't know about that, but I know that it gets Mabel what she wants.  I reach through the wrought-iron fence and scratch behind her ears, rub her head, stroke her neck, and pat her on her back.  I talk to her and tell her how beautiful she is.  It's all an ego trip for her, of course - we both know that - and she drinks it up.  And then, after a short while, she backs away.  Her ego has been well and truly restored.  Without a sound, she turns around to head back inside.

I realize that these secret meetings of ours probably aren't the best basis for a long-term relationship.  But we seem to have had little problems with the racial thing; her being black, and me being white.  Even the species thing hasn't been much of a problem.  And there's little commitment involved, which works well for both of us.

Although... I've begun to worry a little bit about what will happen to our relationship this fall, when our human clocks get set back an hour, and the sun sets so early.  My walks will be in the dark, so will Mabel be able to see me?  Will she be looking for me before the sun sets, which will then be a couple of hours before my walk?  I hope she won't be devastated if she doesn't see me.  Or... will she forget all about me?

At least I can find some solace in the fact that the two of us will have had the Summer of '17.

_____

Update - March 5, 2019:  Yes, during the two dark winters that have passed since Mabel and I began our little thing, there were times when I'd walk by in the darkness, and Mabel happened to see me, and she'd come out of her little doggie door so we could steal some quality time together. 

Or, so, that's how it seemed to me. 
 
The other day, however, I was talking with Mabel's human mommy, and my bubble was burst.  It seems that Mabel goes out to greet EVERYBODY who walks by, whether she knows them or not.  And we have a lot of folks in our neighborhood who walk, and they carry doggie treats with them for furry friends like Mabel.  They've asked Mabel's parents for permission to give her the treats, and they feed them to Mabel through their wrought-iron fence. 

When I learned that, I realized Mabel comes out to greet me, not because she has a special affection for me, but because I'm just another humanoid passing by who probably has a treat for her... that's why she eagerly sticks her nose through the fence.  And when I never provide one, after about a minute, Mabel cuts her losses and goes back inside. 

And here I thought we had a thing going on!

Actually, while learning the truth is hard, frankly, it fits more with the way my life's experiences with romance have gone.  Perhaps I guess I expected a different result from "man's best friend."  

Oh well - at least Mabel keeps giving me a chance, right?

I Visited America Today

I visited America this afternoon.

Have you ever been there?

It's really a special kind of place.

I was there with about two hundred* other Americans to honor 13 fellow citizens who had served in our military.  Yet those veterans had died either homeless, or alone, or without any family members to claim their body.

This America today was populated by all sorts of people from various walks of life who didn't seem to care how wealthy, or powerful, or conservative, or liberal any of us are.  We were assembled at the Dallas-Fort Worth National Cemetery, nestled among rolling hills in a far western corner of Big D.  A couple of local media outlets had broadcast the news that today, at 1pm, the National Cemetery was burying its largest group to date of "homeless" veterans.

Officially, the term is "unclaimed," and of the twenty veterans in today's ceremony, 13 died without any known family or next of kin.

They were:

Army Specialist Joseph David Dobson, 84
Army Private Ned Carlston King, 56
Army Specialist Dennis Wayne Moore, 63
Marine Private Edward Charles Gipson, 60
Marine Private Grant Wells, Jr., 63
Navy Veteran Glenn Allen Gatton, 65
Navy Ensign Patrick Michael Kelly, 62
Navy Veteran Daniel Ray McKinley, 46
Navy Veteran Michael Snyder, 58
Navy Veteran Elbert Louis Wilson, 79
Air Force Staff Sergeant William Brugemann Beeson, 86
Air Force Master Sergeant Bobby Ray Gleason, 71
Air Force Veteran Jerry G. Marshall, 81

The seven others honored today had at least one family member who accept the traditional folded flag, "from a grateful nation."

I saw a story about this on the Internet this morning, and told Mom I was going to attend.  Without hesitation, she said she would as well.  So we showed up about 15 minutes early, with me figuring a small yet respectable crowd of other grateful Americans would also be there.  But when we turned the corner, driving past the gates into the cemetery, two snaking lines of backed-up traffic greeted us!

A burly groundskeeper on a golf cart glided by our car, and I rolled down the window.  "We're here for the homeless veterans' service?" I asked, trying to clarify whether the big turn-out was for that service, and not maybe for some other veteran who may have simply had a big family and lots of friends.

"Yup," he confirmed, saying that there indeed was another burial at 1 o'clock, and they were trying to separate the traffic for each event.  "I'm checking now to see what lane y'all need to be in."  And he was off.

Sure enough, there were about ten cars for the other service, but there were dozens - with more arriving every second - for the "homeless" veterans' service.  Another cemetery employee - obviously an office staffer who did not expect to be standing outside patrolling traffic today, at least considering her short skirt and short sleeves - gushed appreciatively at my opened car window that ours was the biggest crowd they'd ever had for a burial, and they were caught off-guard by all the attention their event had received. 

In a normal year, our local National Cemetery buries about 40 unclaimed veterans, but not in as large a group as they did today.

We waited for about 10 minutes - past the ceremony's official start time - before beginning to snake our way around a loop and then down into the cemetery itself.  There were easily fifty, sixty cars or more, and even more as we looked across a valley to where we could see a crowd already gathered with a color guard, flags and ribbons flapping in the stiff breeze.

We'd had rain this morning, and temperatures still hovered in the 60's, with a damp wind and no sunshine.  Appropriately dreary for a funeral, I figured.

I finally found a place to park, and Mom and I walked quite a bit further to an open-air stone gazebo where the ceremony was taking place.  We could hear the 21-gun salute and the playing of "Taps" as we walked, along with dozens of other people.  Perhaps protocol should have made us stop stock still, in observance of these two hallmarks of a military funeral, but we all kept trudging along in the cold breeze.

Even once we reached the stone gazebo, none of us could hear what was going on, the wind was so loud.  Crisp American flags lining the venue flapped, slapped, and crackled loudly in the wind.  But it didn't seem to matter to anybody, except for a couple of children who didn't understand why everybody was just standing around in the blustery air.  Yes, there were children in attendance.  Old people, too.  Whites, blacks, and several other shades of skin color.  Well-dressed people, men and women in business suits, some wealthy-looking folks, and some that looked almost as destitute as those unclaimed veterans must have been.

One lady with a smart hairdo and a sleek black business suit had an infant and a toddler in tow, as if she'd left the office, run by day-care, and gotten her kids to witness this. 

Plenty of people were brandishing smartphones, but nobody was talking or texting - they were taking photos and videos of the crowd, and the line of fully-suited military personnel in the gazebo, stiffly presenting those folded flags to the seven assembled family representatives. 

Perhaps it was no small coincidence that at the end of the flag presentations, the wind died down significantly, enough for all of us to plainly hear a white-suited chaplain read some Scripture and give a brief benediction.  If I was a journalist, I'd have made a note of the Scripture reference, since neither Mom nor I can now remember what it was!  But even if few others in attendance were believers in the God of the Bible, we all heard a passage of the Gospel.  And everybody stood reverently, whether they really appreciated it or not.

Indeed, the crowd's decorum was profound, maybe because decorum seems to be so missing in our modern life.  Then, too, by that point, I think we'd all realized the obvious:  What we were witnessing, and participating in, was a genuine slice of honest-to-goodness America.  Not the political America, or the pop-culture America, or the squabbling America.  Our individual political views didn't matter just then.  Neither did anybody's sexual orientation, or skin color, or background, or criminal history, or occupation, or level of education, or home address, or what we drove... although quite a few very expensive vehicles lined both sides of the winding roadway.

I particularly noticed a tattered Subaru with ecology-themed bumperstickers parked there, alongside humongous pickup trucks and a brand-new white Mercedes sedan.  One businessman in a serious suit, wearing a huge, expensive-looking wristwatch, claimed a silver Prius.  One short, thin young man with dirty hair patiently crept through the crowds in a beat-up old Mitsubishi.  An elderly woman looked on from her Ford minivan, apparently unable to walk the distance up to the gazebo.

Up at the gazebo, however, it was just us grateful citizens, and the moment, and the patriotism.  No Democrats or Republicans, just a lot of people who had recently learned that 13 "homeless" veterans were being buried.  Men who had at some point defended us and our country, and who may have made some bad choices in their lives, or maybe suffered the ill psychological affects of battle fatigue or PTSD.  Maybe these men had intentionally separated themselves from their loved ones.  Who knows?  Yet right now, none of that dissonance really seemed to matter.

We all shared a common goal, those of us out there on this chilly, sunless afternoon.  We were taking an unplanned detour in our day and pausing to commemorate something we could all value:  Sacrifice for a cause.  Maybe none of these guys died in combat, but apparently they were willing to at some point, otherwise they wouldn't have been in the military.  Maybe the wars in which they fought were not originally conceived by the most altruistic of world leaders, or maybe they didn't end in a way many Americans welcomed.  Maybe some of the folks in attendance today were mostly motivated by the "homeless" and "unclaimed" designations of these men, saddened by the apparent breakdown in familial bonds, and disturbed that people can die so alone.

Hey - It's not as if any of us left the cemetery and immediately went to sign-up as volunteers at a local homeless shelter, after all.  But that wasn't the main purpose of attending today's ceremony, was it?

Mom and I attended - as I suspect just about everybody did - to honor not death, but life.  Our lives as Americans; our corporate life as free - or mostly-free - residents of this planet, with all of its evils and ills.  Our life with its freedoms safeguarded by people who volunteer to serve, even if our vast military industrial complex doesn't do as good of a job as it should to help make sure veterans don't end up homeless.  Indeed, maybe even a little shame that the greatest country in the world doesn't do more to make sure our veterans don't die unknown and unrecognized.

This America that we visited this afternoon came into existence with our gathering, from all walks of life, at this one spot, for one purpose.  And it likely dissipated just as we dispersed back into those various walks of life, as we all got in our cars, and drove away.

Funny how it takes thirteen people to die as unknowns for us to realize how much we share in common.

As much in common as those 13 fledgling colonies so long ago.
_____

* A dubiously-written report by the Dallas Morning News estimated the crowd total at 100.

Has Your "Long Good-by" Begun?

FYI:  If you or a loved one is dealing with a diagnosis of early-onset dementia, consider visiting this website, run by a guy who was diagnosed at (yikes!) 55 years old.




Have you or a loved one recently been diagnosed with dementia, or with short-term memory loss?

Or do you suspect that you might have that condition, or that a loved one might have it?  Are you afraid of what such a diagnosis will mean for you and your family?

I've written a lot about dementia and Alzheimer's in their later stages, but I haven't spent a lot of time exploring issues that come about during the earliest of stages, which is the diagnosis.

And by diagnosis, let's be clear right off the bat:  There is no official, sure-fire, absolute diagnosis of Alzheimer's disease.  Alzheimer's is the most common form of dementia, with dementia being the most common result of short-term memory loss.  And short-term memory loss doesn't necessarily develop into Alzheimer's, although it usually is the first rung on the dementia ladder.  Yet dementia can take years to develop into its most tragic expressions.  So if you or your loved one is facing a diagnosis of short-term memory loss, it's not exactly the end of the world as you know it.  At least, not yet.

Yet, at the same time, yeah - it's pretty close to the end of the world as you know it.  Sorry for being so blunt, but frankly, you already knew that, didn't you?  Besides, this is not a time for pussyfooting around the truth.  For one thing, if you are indeed on the road to dementia, you and your loved ones need to arm yourself with facts and a realistic assessment of your options, since things may rapidly change regarding your ability to conduct basic activities such as driving, making changes to your legal documents, and preparing your personal finances for the exceptionally high monetary costs of your future care.

However, just as this is not a time for ambivalence and rose-colored glasses, it's not a time for panic, either.  For one thing, panic rarely accomplishes anything, regardless of the situation.  And with regards to your diagnosis, there's little you can do medically to change what this diagnosis means.  There are no surgeries to consider, no pills to reverse the damage being done to your memory, no chemotherapy options like there might be with cancer, nor new diets to adopt like there might be with diabetes.  No known cures exist for short-term memory loss, dementia, or any of dementia's forms, like Alzheimer's.  So don't waste your time - and your money - dabbling with home remedies, natural supplements, or any of the other gimmicks out there being peddled to people who are desperate.

And don't feel guilty.  As far as we know, there's nothing you could have done medically to prevent dementia, so there's no use blaming yourself for having it.  And there's nothing you can can do medically right now to even minimize your dementia.  Dementia happens for reasons we're not sure of.  But one thing we know is that the length of time you have remaining as a fully-functioning adult will now be growing shorter by the day.  Your memory's functionality has maxed out through no fault of your own.  Your capabilities for reasoning, comprehension, logic, and alertness will be no greater than they are today.  Which means your mental resources need to be deployed smartly right now.  Not because you've suddenly begun your journey down what we call "the long good-by."  But because there's little point being morose about it.  At least, not yet.

Believe me, perhaps the time won't come for you, but the time will come for your family when the journey you have now begun will become a tortuous burden.  But that's still a long way off, and by then, you likely won't be aware of how bad you've become.  I've heard of one dementia patient who had three years between her diagnosis until her death, but most dementia patients I know have a journey of six to ten years - or more.  In your case, it's probably early days yet, and dementia is something for which you and your loved ones are going to have to pace yourselves.

For example, you still have time to travel, and work through a "bucket list," if you have one of those.  However, from now on, regardless of whether you're traveling to Paris, France, or the nearest grocery store, you cannot go alone.

Don't fight me on this one.  We found out my Dad had dementia when what should have been a half-hour trip to the grocery store turned into a several-hour ordeal, trying to track him down, calling the police and fire departments for word of any senior citizen in a car crash, driving around to all the grocery stores we used to frequent, only to have a kind-hearted employee from a store miles from our home call and put Dad on the line.  The employee had noticed Dad looked a bit disoriented in their store, and when she approached him to ask if he was OK, Dad managed to remember his home phone number (but not that he had a cell phone with him that he could have used).  That was a horrible evening for us - well, except for Dad, who didn't remember any of it, and wondered why I showed up at the grocery store to help bring him home.

Dad continued to drive for the next six years or so - but never, ever by himself.  We let him walk his faithful collie dog around the neighborhood for a few more months, but I was always a block behind them, making sure Dad found his way home.  After a while, Dad lost interest in walking the dog (a typical mark of dementia), and then not long after that, the pure-bred collie's advanced age required us to put him to sleep.  We'd show Dad photos of his beloved dog, and he said he remembered him, but we weren't always so sure he really did.

We allowed Dad to drive his minivan to familiar locations within about a one-mile radius of his long-time home.  And, frankly, considering how poorly so many people drive these days, his driving was certainly no worse than anybody else's.  His reaction times seemed spot-on, and for a long while, he needed few reminders about where he was going or how to get there.  He'd often complain that we wouldn't let him drive alone, but we'd simply say we wanted to keep him company.

What kept Dad's driving instincts so sharp, even as his other memory issues were in obvious decline, likely involved the years he spent driving around as a sales manager for a concrete construction supply company.  He drove to visit customers all over Texas and the Northeastern United States by himself and only ever had one accident - when he was driving all of us, when my brother and I were kids, down to Houston - and even then, the damage to our car didn't prevent us from driving out the trip in full and returning home.

However, if you or your loved one hasn't logged the extensive time behind the wheel that my Dad did, your driving days might be coming to an end fairly quickly.  And if that's the case, it's for your own good, as well as for the good of all the rest of us out on the open road.  After all, driving isn't just about you, but everybody else, too.

And about those bucket lists:  How many of those unfinished events and fun times will you remember next year?  In two years?  I understand the whole sense of accomplishment behind the bucket list thing, but frankly, trying to do things and visit places before you'll forget you've done them or been seems more a waste of time and money than a fulfillment of your life's dreams.  Right now, is what's important something you haven't yet prioritized?  How important are those things on your bucket list, if you haven't already done them?  Do you really need that sense of accomplishment before you forget all that you've accomplished?  Is the existential satisfaction really worth it?

After all, time is working against you here.  Remember?  You've only got a limited amount of time remaining for you to build memories - not for yourself, but for your loved ones!  If dementia takes as ugly a course as it does for most of its victims, your loved ones are going to have many awful things about your eventual condition seared into their own short-term memories of you.  Wouldn't you like to spend the quality time you've got left helping them cultivate happier, more positive remembrances of you?  Simple stuff, like the foods you cook well, or of the stories you tell, or the crafts you enjoy?  Not new stuff, but the same stuff that you don't need to still learn, and risk the frustration of not learning or experiencing as fully as you might otherwise desire?

It's the time with your loved ones that they'll likely remember the fondest.  It's who you were in the ordinary, every-day life that they knew you to live.  How you act in the present, in the familiar, in the real; not the artificial of vacations to places that are more exotic than natural.

Yes, there is the argument that the pursuit of a bucket list at this point would be an act of defiance in the face of dementia's impending doom.  And if you're independently wealthy, perhaps it doesn't matter what you spend your money on now.  But frankly, considering the many unknowns about dementia and dementia care, the wiser person would conserve their financial resources now, instead of spending them on trips you won't remember for much longer.

I'm not trying to be cruel here; just honest.

Granted, if your life up until now has been all about the pursuit of bucket-list-type things, then maybe I'm raining on your final parade.  But I have yet to talk with any loved ones of a dementia patient who reminisce about things that have happened recently.  They reminisce about the loved ones as they knew them "back in the day."

It's an ironic twist on the "short-term memory" condition, a state of mind which can seem so confounding.  Indeed, short-term doesn't just mean that you can't remember things for very long.  It's also that you can't remember things that happened only a short while ago.  And as dementia continues to take its toll, that "term" creeps ever longer, with your ability to remember the past extending not by seconds, or hours, or days, or months, but years.  Decades.

In fact, as long as I'm being blunt, let's go ahead and face more reality:  For better or worse, your family will eventually be able to identify the memory period of your life in which your brain is functioning, and it won't be the present-day.  One of the hospice nurses caring for my father told us that actually, at that point, the patient is mostly unaware that they have any sort of dementia, and I like to think that she is correct, for the patient's sake.  You see, dementia patients give many clues about the period of their former life in which they're now living; the job they may have had then, the home or city in which they used to live, the people who were still alive then.  With my Dad, we could track his decline by the homes he longed to be in.  He seemed fairly comfortable in his Texas home, where he'd lived for 30 years, for quite a while into his dementia journey.  Then suddenly, his memory seemed to completely skip the 13 years we'd lived in upstate New York.  It went back to an old address in Brooklyn, then to the address before that, and then even to the address where his family lived before he entered school.

But let's not get that far ahead of ourselves - or that far behind.  After all, if you're still in shock from receiving your recent diagnosis, you're likely struggling with identifying the things you need to get done before, ...well, they can't get done anymore.

Speaking of finances, in case you're now thinking of shifting all of your assets into somebody else's name, your lawyer may sign off on those changes, since you're still relatively "of sound mind."  But don't drag your feet, because nobody knows the point at which your lawyer might actually say you're mentally incapable of things like wills, financial reallocations, and property settlements.  If you're thinking of trying to hide your assets by placing them in other peoples' names, in case you need to go on Medicaid in the future; forget it.  When someone applies for Medicaid, the government goes back about seven years, and even longer, tracking the movement of your assets, and significant changes to your estate or financial portfolio will be nothing but red flags for them.

With the money that you have, instead of splurging on a bucket list, perhaps you should consider remodeling your home to make it handicapped-accessible.  If you've only lived in your current home for a short time - say, five years or less - then it might not make much difference if you decide to move out of it.  But the thing about short-term memory care is that the longest memories will last the longest, and staying put in a familiar home will benefit you and your family in the long run.  Although you might not have any mobility problems right now - and maybe not ever, memory loss can impact physical mobility, and for many dementia patients, keeping one's balance becomes a problem at some point.  So if you can afford it, widen your doorways to accommodate wheelchairs, and retrofit at least one bathroom with fixtures suitable for adults who need somebody to help them with bathing and attending to the toilet.  If your bedroom is upstairs, try to create a sleeping space downstairs now, so maybe you can develop some familiarity with it.  If your backyard isn't fenced in, fence it in, since dementia patients tend to wander.

Hey, even if being placed in a memory-care facility is in your future, that future is still likely several years away at the earliest.  That means you'll still need to enjoy your current environment as much as possible - yet as prudently as possible, too.

If you're a pack-rat, begin to de-clutter now.  Clutter will only confuse you later on, and possibly become dangerous trip hazards.  Save photos and keepsakes you frequently look at and enjoy; chances are they'll be the things your loved ones use to try and entertain you years from now.  Throw away items that hold bad memories for you.  Keep your current technology, and don't worry about buying new televisions or computers from now on, because you'll risk unnecessarily confusing yourself.  The idea is to develop as light, bright, easy, safe, and encouraging a physical environment as possible.

I hope you weren't reading this to find some cheerful nugget of comfort after your otherwise horrific diagnosis.  I'm sorry if I've further discouraged you by laying bare the reality you'll likely be facing.  But I've been there with my Dad, and with his sister.  There is no helpful way to positively spin the specter of dementia.  There's also no legitimate pathway to determining what dementia will have in store for you specifically, since dementia varies by as many degrees as their are individual people.  Some patients end up having a relatively peaceful journey through memory loss, while others... well, let's just say that there's enough heartbreak to go around.

Many end-of-life illnesses have a way of clarifying the aspects of life we most cherish, and these next few months and years of your journey through memory loss will undoubtedly be a clarifying experience - although, unfortunately, probably not for you.  You will likely become less and less aware of what is going on to you and around you, which as the hospice nurse told me, may be the one blessing in all this.  Meanwhile, your loved ones will be forced to assume more and more of your care, and there won't be anything you can do about it.  Stronger families, obviously, fare better during crises like these than dysfunctional or scattered families.  Your close friends, your faith community, and even your neighbors will likely play intimate roles that you will never see.

Yet through it all, our response to human tragedy both affirms our commitment to life, and our resolve to honor those who, for whatever reason, lack the ability to participate in it as fully as we would otherwise desire.  We effortlessly enjoy our human experience when things are fun, or happy, or easy.  But when life turns arduous, melancholy, and painful, we tend to show what we're really made of.

Maybe that's a challenge you and your family would prefer not to pursue!  But it's happened to you, and there's nothing you or anybody else can do to change it.

It's bleak, and confounding, and it seems so unfair.  I know.  It happened to my family and me, too.  And we're here today, on the other side of the dementia journeys we took with my Dad and my aunt.  And we're certainly not weaker for those experiences.  I think we still have questions, and we're still emotionally tired, but we did what we could with the resources we had, and I think we honored our loved ones well.

Hopefully your family will be able to say the same.

Ready or not, your journey through your long good-by has begun.  Let it be as life-changing as it can be.

Let These Bowls You Over

What is this?

If I had the hubris of a post-Modern artist, I could claim it as a sculpture that weds two pieces of conventional artisanal functionality from two disparate cultures.

But I'm not an artist, and these are merely two bowls, with one set upside-down atop another.  On the top is an upside-down Paul Revere pewter bowl reproduction by the Stieff Company of Baltimore, Maryland.  And below it is a Hmong ceremonial pedestal bowl.

Both belong to my Mom, and have been about her house for years.  The Revere bowl was a wedding present from a wealthy family in Nyack, New York, who used to employ Mom as a nanny during her college years.  The Hmong bowl was a gift from the leaders of a Hmong refugee congregation, given to each elder at the church my family used to attend here in Arlington, Texas, back around 1980.

It is believed that the Hmong culture can be traced as far back as 2,000 BC in China, although it long ago was forced southward, into Laos, Burma, Vietnam, and Thailand.  A number of Hmong people were part of the Laotian resistance who assisted the United States military during the bitter war in Vietnam, and were subject to persecution after Hanoi fell to the Communists, after the United States pulled out of the conflict.  Thousands of Hmong (spelled the same whether singular or plural) and Laotians were granted emergency visas to flee Vietnam for America, and they resettled in Minnesota and Wisconsin (where the winters were a shock in every way), California, and even here in Arlington, which has one of the largest concentrations of Vietnamese immigrants in the country.

Hmong from Laos who had been converted to Christianity back in their native country wanted a place here in Arlington where they could worship in their language, and our small church was a member of the same denomination that had missionaries who had ministered to them back in Laos.  The elder board at our church welcomed the Hmong with open arms, not just as allies in war, but also brothers and sisters in faith, and to show their appreciation, the Hmong gave each of the elders one of these intricately-detailed ceremonial cups as a gesture of gratitude.

I'm not sure what material these Hmong cups are made of, but it's almost certainly tin, or perhaps aluminum.  They're decorated by hand with etchings and impressions hammered into the soft metal with special tools.  The overall design is of lotus leaves, which while usually a Buddhist symbol of divinity, are also widely understood in Thai and Laotian cultures to represent purity.

When it comes to the Revere bowl, on the other hand, there's a lot less divinity involved, although its purity may rest in the eye of the beholder.  Paul Revere, of course, was that celebrated American patriot who was a silversmith by trade.  Back in 1768, when those British tea taxes were roiling the Colonies, Revere was commissioned by a drinking society in Massachusetts to craft a rum punch bowl in honor of opponents to the British tea tax.  And for his commission, Revere used as inspiration for his design a style of Chinese commemorative bowls that were being made of porcelain for export to Britain and the Colonies at the time.

And we thought the "Made in China" stuff was a recent phenomenon!

At any rate, those Chinese bowls - remember, the Hmong are originally from China - were already apparently popular in the New World, meaning Colonists readily understood the significance of Revere's model.  And since Revere's bowl signified a special resistance to England's draconian taxes, his rum punch bowl quickly assumed a symbolic cultural status.  Indeed, by the time my parents got married, and received this replica as a gift, the Revere bowl had become well-established in traditional Americana, and remains so to this day.  Even if most modern brides probably don't receive them as wedding presents (although the famed Tiffany studio still makes a Revere reproduction in silver).

All this to say that, while I studied these two bowls in my parents' house, I came to realize how identical they were, even though the Revere bowl is relatively unadorned.  The sides of both bowls have the same slope, and the height of their cup shapes are almost the same.  On a whim, I decided to place the Revere bowl on top of the Hmong bowl, because it looked like their circumferences were the same.  And indeed, they are!

Maybe that's not cool to you, but it was to me.  How ironic that two bowls representing significance within two completely different cultures end up having almost the same exact shape, size, and proportions!

For the record, you'll note that the Hmong bowl is actually two bowls bolted together at their pedestals.  The smaller bowl is the same shape, just in a smaller size.  So technically, I could unbolt them and have two bowls.  Which, maybe, some Hmong families do.

And, although maybe it's hard to tell, the square base under the Hmong bowl is actually a square of granite from Deer Isle, Maine, and is intended to keep the bowl's metal from scratching the wood table.

Okay, so none of this is Earth-shattering news.  It's not controversial or kinky.  But doesn't it kinda make our world just a little bit smaller, realizing that no matter how different our various cultures may be, we share more than we may realize?

Not because ceremonial or commemorative bowls are the way to achieve world peace.  But they can be the same shape of things that used to be, from the opposite sides of our planet, and our history.

Humble Strength

I'm no ultimate authority on anything.  But the Bible is.  I believe it's the ultimate authority on everything.  So maybe you don't take the stuff I write seriously, but if you believe the Bible is literally God's holy word, then you can't ignore what it says, can you?

As we lurch ever closer to Donald Trump's imminent presidency, perhaps now more than ever, you and I need to be preparing ourselves for how we should represent Christ when the media - mainstream, social, left-wing, right-wing, and otherwise - strips the final prudence filters from our nation's narrative. 

So, let's remember some truths that won't change like the political tide:


Clothe yourselves, all of you, with humility toward one another, for “God opposes the proud but gives grace to the humble.” Humble yourselves, therefore, under the mighty hand of God so that at the proper time he may exalt you.
  - from 1 Peter 5


What causes quarrels and what causes fights among you?  Is it not this, that your passions are at war within you?  You desire and do not have... You covet and cannot obtain, so you fight and quarrel... You ask and do not receive, because you ask wrongly, to spend it on your passions.  You adulterous people!

Do you not know that friendship with the world is enmity with God?  Therefore whoever wishes to be a friend of the world makes himself an enemy of God... Therefore it says, “God opposes the proud but gives grace to the humble.”

Submit yourselves therefore to God.  Resist the devil, and he will flee from you.  Draw near to God, and he will draw near to you.  Cleanse your hands, you sinners, and purify your hearts, you double-minded... Humble yourselves before the Lord, and he will exalt you.
  - from James 4


Pride goes before destruction, and a haughty spirit before a fall.
  - Proverbs 16:18


"In quietness and in trust shall be your strength."
  - from Isaiah 30:15


Let brotherly love continue.  Do not neglect to show hospitality to strangers, for thereby some have entertained angels unawares.  Remember those who are in prison, as though in prison with them, and those who are mistreated... Keep your life free from love of money, and be content with what you have... Jesus Christ is the same yesterday and today and forever. Do not be led away by diverse and strange teachings, for it is good for the heart to be strengthened by grace... Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God.
  - From Hebrews 13


Finally, all of you, have unity of mind, sympathy, brotherly love, a tender heart, and a humble mind.
  - 1 Peter 3:8

Dementia: When is Home Care Not Enough?

For some basics on dementia in general, click here.
 
 
If you have a dementia patient in your family, there may come a time when you will be forced to grapple with this question:  Is it time for professional memory care?

My family has been forced to answer this question twice; first with my Dad, and then with his sister.  I've also talked with a number of families at the memory care facility where Dad lived for ten months.  So, if you are facing this situation, the information you'll read below isn't merely theory or supposition.

For purposes of this discussion, I'm going to assume that your loved one isn't currently living alone.  I can't really imagine a loving scenario in which a person who has been diagnosed with dementia is allowed to live by themself.  If your loved one has lived alone up until the point of their dementia diagnosis, they will need to either be moved into the home of a loved one who will become their primary caregiver, or someone will need to move into their home to act as a caregiver.  Remaining alone is not an option.  Dementia is going to demand big, significant changes from people who most love the patient.  And living arrangements constitute a major part of this disruption.

Granted, depending on the degree of dementia being displayed by your loved one, at least in their early stages, perhaps it won't be necessary for them to have 24/7 care.  But that scenario will likely not last very long.  You see, it is not fair for people with dementia to be intentionally left alone when there's a risk that they could wander off, accidentally burn themselves, or otherwise harm themselves or others.  In many cases, it would be akin to leaving a two-year-old alone at home for hours on end - and a caregiver who allowed that to happen would likely be charged with abuse.


So now, you've arrived at the point where keeping your loved one at home is not just a burden, or a sacrifice, but it has devolved into something else.  Something that appears to be demanding from you a level of resources that your body, your brain, and your emotions seem far too taxed to meet.

If you are fortunate enough, and are able to patch together the finances to pay for professional memory care, here is when that care might be timely:


1.  If your loved one consistently displays no recognition of their current surroundings, it may be that placing them in professional memory care will be less distressing and disruptive to them than you think.  Of course, this applies mostly to dementia patients who are currently living in an environment they should otherwise recognize, such as their long-time home (longer than a couple of years), or even perhaps in the home of a relative that they've visited for years.

If they've lived in their current environment for only a couple of years, it's to be expected that they won't readily recognize it.  Remember that a hallmark of dementia is the gradual loss of memory, and that loss is measured from where they are today.  It's called "short-term memory loss."  The shorter the memory, the quicker it's lost.

If they can't remember how to find their way around a home in which they've lived for only five years, or even ten, that may not be as significant as if they can't find their way around the home in which they've lived for thirty years (which is how it was with my Dad).

And, if they keep saying they "want to go home," and they're still at home, chances are they'll keep saying that if they're in a memory care facility.  "Home" to them likely means someplace familiar to them from their childhood, not anyplace they've lived recently.  If they are particularly religious, "home" can also come to mean Heaven, or whatever constitutes eternal reward in their religion.


2.  If your loved one is consistently belligerent or combative to the point of trying to physically fight with a caregiver, it might be safer for you - and for your loved one - to be in a facility where trained staffmembers know how to better avoid things like flying fists or gnashing teeth.  Verbal abuse may be emotionally draining for you and other caregivers, but when the abuse becomes physical, things become far more dangerous because it likely means your loved one no longer can distinguish between proper acts of frustration and baser impulses of aggression.

It's not that professional memory caregivers wear body armor or are incredibly nimble, but they have more experience at recognizing warning signs of aggressive behavior.  They also have the ability to summon assistance quickly - something you probably don't have at home.


3.  If your loved one has lost the ability to talk, or clearly communicate basic needs, then it could be that you miss important signs that they are suffering from something compromising their quality of life.  Most memory care facilities will likely require you to sign a "Do Not Resuscitate" waiver when you place your loved one in their care, so this isn't about extending their life.  But quality of life - however tentative and ambiguous that may be at this point - remains important.  Things like pain and other internal discomforts might be more easily detected and monitored by professional caregivers.  Having different staff members in different shifts working with your loved one also creates a broader base of evaluation and trouble-shooting, another benefit you likely don't have at home.  (At my Dad's facility, we often saw the staff talking with each other.  If you see that, it's probably a good thing, because they're not just socializing among themselves.  They're probably sharing anecdotal stories about the residents, which cumulatively helps them all learn more about each resident, their temperament, what might be going wrong, and what information their loved ones may need to know.)


4.  Most reputable memory care facilities will invite prospective families to visit during mealtimes, so you can see for yourself in real time how the staff interacts with their residents.  The facility where my Mom and I placed Dad encouraged us to share a meal with him as well, but he was actually in the hospital at the time of our exploratory visit.  My point is, however, that if your loved one can eat a meal in the dining room of a memory care facility, they're a likely candidate for professional care.  Mealtimes are normally somewhat chaotic - don't let the chaos represent incompetence on the part of staff; instead, watch how the staff handles and responds to the chaos.

Indeed, mealtimes in a memory care facility are not for the faint of heart.  It is quite distressing to watch grown adults struggle to eat, or protest eating, or having to be fed.  If your loved one can tolerate an environment like that, it's a sobering indication to you that the experience won't be as traumatizing for them as you fear it might be.


5.  Some other considerations include the degree to which your loved one tolerates interaction with others.  There were times when it seemed my Dad enjoyed being around other residents in his memory care facility.  A good facility will have coordinated activities and live music that are surprisingly stimulating, yet things you may not be able to regularly provide in your home.  My Dad's place also prioritized getting residents out of their rooms during the day; only the sickest were regularly kept in their rooms.  Carpeting helps minimize excess noisiness, but it also has to be kept clean for sanitary reasons.  If the flooring isn't carpeted, make sure it's not slippery.  There should be no trip hazards, like throw rugs, or furniture with legs or feet that protrude from its undersides.

Speaking of sanitation, make sure there are no trash cans simply left out in the open - dementia patients love rummaging through them, which is a big health hazard.


6.  For some dementia patients, particularly those whose families are struggling with the enormous monthly costs of professional memory care, it may become unnecessary to have actual memory care.  If your loved one becomes exceptionally low-functioning, bedridden, severely detached from their environment, and otherwise incapacitated, a regular nursing home may be able to provide enough care without the expensive memory care pricetag.  If you're fortunate enough to have an elder care specialist as your loved one's physician, your doctor will help you determine if or when you can forgo professional memory care.

Of course, remember that many nursing homes, for whatever reason, still do not provide the type of care to dementia patients that you'd think would be obvious.  A friend of ours had his wife, with full-blown Alzheimer's, in a highly-respected rehabilitation nursing facility after surgery to repair a broken hip, and the nurses there would put a platter of food in front of her - covered by a plastic bowl to keep it warm... yet the woman had no idea food was under the plastic bowl.  They'd give her a cup of yogurt or pudding as a snack, and not remove the aluminum foil top.  They'd even give her a plastic cup with a beverage inside, a plastic cap on top, and a straw, yet the woman didn't know how to drink from a straw.  At her memory care facility, none of those things ever happened, because the memory care staff knew what dementia patients can't comprehend.


7.  If and when you visit professional memory care facilities, ask whatever questions you have.  This is a big deal, so don't be embarrassed by treating it like one.  If you feel rushed by the staff, or if you get the sense they are being evasive, let those be red flags for you.

When you're walking the halls on your facility tour, does your host acknowledge residents and employees by name?  Does the place employ at least one full-time nurse?  Ask if any local hospice companies are on a black list of theirs - a memory care facility that is zealous about their residents' health likely will prefer some hospice companies over others.

Visiting during a mealtime won't be comfortable for you, but it will be an eye-opener, and you need raw honesty, not sugar-coated platitudes.  If the place smells, feel free to ask why.  Don't necessarily assume it always smells like that, because bodily function incidents happen constantly in these types of facilities.  But if every hallway smells, and the furniture smells, and the smell is more of a stench, those aren't good signs.

Look for how well exit doors are locked and marked.  Is there a fence around the property?  What is the front door protocol?  Is there a staff member stationed nearby to prevent a resident's "escape"?  Are there security cameras?  Dementia patients tend to fall a lot, as their sense of balance is lost; do they archive videos for family members to review after an incident?

I'm not sure what a good resident/staff ratio is, but at Dad's place, I believe it was 10:1, not counting office and kitchen staff, and that seemed adequate.  They aimed to give each resident three showers a week, but with people like Dad, who could be quite belligerent at shower time, Mom and I were satisfied if they could get him in for two! 

Whatever your family is able to decide, please understand that you will likely feel some degree of guilt.  That seems pretty normal and unavoidable among all the families I know who've placed loved ones in memory care.  These are stressful decisions that not only drain you financially, but also emotionally.  All I hope to do with this information is help you in the decision-making process, and perhaps give you some things to consider that maybe hadn't already dawned on you.

Hopefully, someday, perhaps before you or I get to be the age of our loved ones with dementia, a cure will be found, and our families won't have to go through what we are.  Until then, however, like one nurse told us, "you've gotta do what you've gotta do" when it comes to loved ones whose minds are being stolen by dementia.