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My father has a fixation of sorts with a t-shirt he has that says 'World's Greatest Grandpa.' I don't remember who got it for him, but I know that he got his 'world's greatest Grandpa' coffee cup because he made it quite clear that it hurt his feelings that Granny Tea had at least half a dozen and nobody had bothered to get him anything proclaiming his parallel excellence in his patriarchal role.
There's a reason for that, but if he wanted to pretend to himself that he'd actually been a very different sort of person than he had been, we figured it was a harmless enough amusement at his age. We knew the truth, and we could certainly understand why the truth was far too uncomfortable to live with from his point of view. We'd prefer fantasies, too, in his shoes, so we let him have them and he has the t-shirt and coffee cup to prove it.
He brings it out to show us every time we come over. I wonder what it is about that t-shirt that means so much to him. Is he showing us his credentials, telling us "I must have been a good person and a great grandpa, the t-shirt says so?" Is it simply that he doesn't make connections very well any more, but he knows that shirt has something to do with us? Because he's not always quite sure of our names, does he want to make sure we know his?
But then, I am not even sure he knows the shirt refers to him. He keeps trying to give it away to my 9 year old son. Whenever he does this, my mother and I admire the shirt, listen to him talk about it and try to give it to the boy, and then, when my father's back is turned, we look at each other with raised eyebrows and hide the shirt away. Last week, my husband, full of sympathy unmixed with the confusing conflicts of that painful past (and just a nicer person than I am), privately told our son to go ahead and wear the shirt for the duration of our visit, just to please his grandpa. The boy put the shirt on willingly enough. I am not even sure that my father realized it. A few days later my father mentions his shirt again. He explains to my mother and our eldest daughter that he gave it to the boy because he just felt so sorry for him.
Sorry for him? They ask why. "Well, you see," he explains, "I could see that his dad was really at the boiling point with him and the little boy wasn't really doing anything. So I felt sorry for him."
My husband doesn't have a boiling point, or at least not one the children have ever been able to trigger. I am afraid I have the dubious distinction of being the only person in the world who has ever managed to make my husband lose his temper, and I could probably count those occasions on one hand. He is not perfect, but he simply doesn't have a boiling point. To give you some idea of just how flawed I am, this enrages me sometimes.
I can't imagine what my father saw that made him think it my husband was about to lose his temper- an event I believe nobody other than I has ever witnessed, and the last time was probably 15 years ago. I wonder about that. Is he reliving his own fatherhood and mistaking it for my husband's altogether different (and far superior) parenting? Is he projecting, or is he remembering?
And then I wonder about just how rational it is to try to make sense of what a person with dementia says and does, to figure out some reason for it, as though reason and dementia were even kissing cousins. Today while two of the Progeny were playing ping-pong in the Grandparent's basement, another sibling came down to report that they should quiet down their hilarity. Grandpa was on the phone, she said, and he was telling the person he was speaking with that the two siblings in the basement were screaming at each other. The nurses, he complains, are mean to him and rude. The doctor explains to my mother that actually, my father was quite a handful.
Where he once would ham it up, acting like a reporter when he couldn't remember our names, whipping out an imaginary pencil and asking us to spell our names for him, now he only says, "Hey, you, thanks for dropping by."
He tries to explain to my mother that he will still need to be able to drive into town for 'short' errands, she reminds him that the doctor has said he is done driving. He told her, "I still do know how to drive, you know. I know what the steering wheel is for, and how to operate the brakes and the gas, and I haven't forgotten any of that. I still know how to operate my truck." I suggest, again, that if she finds this too hard, she can just tell him, "Don't you remember? You told me not to let you drive anymore." He won't know the difference. She laughs.
This is, in a sense, how we have handled many touchy moments. For a while my dad was sure that his real problem was that he didn't have a job. He put in applications, or drove long and impractical distances looking for places he thought were hiring, but he couldn't find them. He started calling my husband to ask him to help him to apply for these jobs, most of which, if they existed at all were wildly inappropriate for my 70 year old dad. At first my husband would demur, hedge, and try to talk him out of it. This was stressful for everybody. Now he just agrees, and makes an appointment to take him the following week, because we know it makes my father less unhappy if we don't argue with him, and he won't remember the appointment next week. It's another fantasy we permit, like the t-shirts and coffee cups. I don't know if this is mean or kind or just cowardly, but I can't see what good it does to argue with him about it, when not arguing produces the same results- he forgets it all in a week.
He has spent most of the last week dozing in front of the television. It wasn't on. He doesn't watch his favorite shows anymore. We think he can't follow the plots. One afternoon he wants to tell me about a comic strip they've cut out of the paper and put on the fridge. It's very funny, he says. "It's this one," he says, "and she says this thing to him. This is dumb, but she says it. And then he says this other thing back. That's the really funny part. I'll get it in a minute... What is it he says?" and then he looks at me as if I can tell him. I gently say I don't know. He gets agitated. "You do know. It's that one on the fridge." I remind him that he was telling me about it because I hadn't seen it. "Oh, I know!" he says triumphantly. The punchline is "Did you unplug the sofa?"
He gets up and shows it to me- an elderly couple are in bed, and she asks, "Did you put out the cat?" "Cat?" He asks. "We don't have a cat." "I know," she replies. "I was just testing you. Good. You passed."
The next panel shows that he's turned over to go to sleep, and then he asks her, "Did you unplug the sofa?" I laugh.
I don't tell my dad this, but once when my mother was having a particularly dithery moment, she said, "Pretty soon I will be as bad as your father, and then where will you be," and I replied, "Um, Mom? Actually, Dad is fine..."
She laughed.
Nervously.
When we describe what is happening with my dad to each other, we find ourselves making the same gestures to explain it. "It's like he was just going like this," we say, moving a flat palm in a straight and even horizontal line, "and then all of a sudden, he does this," and we drop that hand abruptly down in a steep vertical drop. It is like he stays at a plateau for a certain period of time, and then instead of a gradual slide down to the next level, he just plummets off the steep edge of that step and drops abruptly stomach heaving plunge to the next level.
Recently a friend who has observed some of this with us, listened to one of my 'guess what Dad did this week' stories, and commented, "Wow. It seems like he was just going like this," she said, moving a flat palm in that familiar straight and even horizontal line, "and then all of a sudden, he does this," and she dropped her hand abruptly down in a steep vertical drop.
Tonight at the library, the HG was discussing events with a homeschooling mom about halfway between the two of us in age. She is experiencing similar difficulties with her grandmother. "It's so strange. She seems like she was just going along like this," she said, moving a flat palm in that familiar straight and even horizontal line, "and then all of a sudden, she does this," and she dropped her hand abruptly down in a steep vertical drop, and as my daughter repeats this to me, my own hands move along with hers, following the stair step pattern we have all been tracing in the air for months.
I googled vascular dementia, which I have just been told this week is the sort my father has. I read:
Onset can be gradual or dramatic. ... Regardless of the rate of appearance, vascular dementia typically progresses in a stepwise fashion, where lapses in memory and reasoning abilities are followed by periods of stability, only to give way to further decline.
Stairsteps. Gi-aaaaaaa-nt stairsteps. We are all secretly reading about the disease that has created this giant staircase down which my father is walking- or leaping. And we often secretly look at each other, second guessing ourselves when we forget seomthing, or lose our own trains of thought.
As recently as six months ago when we tried to tell people that my dad was losing it, that he was not really all there, they would look at us with some surprise- or suspicion and say, "REally? But he seems just fine. He made perfect sense when he was talking to me." I've mentioned he always did have a fine Irish gift of gab, and he coupled this talent with brilliant acting skills. What would happen is he would start telling one of his famously entertaining stories- he always has had to be the center of attention, and then he would forget what happened next. This was obvious only to those who knew him well, evidenced by barely a flicker in the eyes, and he would quickly recover and go on telling a brilliantly entertaining story. Only those who knew the real story would know he'd completely forgotten what really happened and midway through his story just started making things up. They were entertaining things, but they were pure fictions, and he'd never be able to tell the same story twice. But if you'd not known the real version, or the man longer than 22 years ago, you wouldn't know that.
The most common type of vascular dementia is multi-infarct dementia (MID), which is caused by a series of small strokes, or “mini-strokes,” that often go unnoticed and cause damage to the cortex of the brain—the area associated with learning, memory, and language. These mini-strokes are sometimes referred to as transient ischemic attacks (TIAs), which result in only temporary, partial blockages of blood supply and brief impairments in consciousness or sight. Over time, however, the damage caused to brain tissue interferes with basic cognitive functions and disrupts everyday functioning.
My father had his first stroke 22 years ago, when he was just 48 years old. The HG was three. We were visiting my parents before moving to Japan. One week before he had his stroke we were camping together. My dad had high blood pressure for years, but he would not give up his fritoes and his favorite soda (I don't remember what it was anymore. I feel a tiny wriggle of fear in my brain because I can't remember- was it 7-up or Pepsi?). He was sitting on one of the beds in the pop-up trailer, swinging his heels and eating his chips. We remonstrated with him about those chips and all the salt and his high blood pressure. He merely grinned, and said, "But this is how I want to go. When I die, I want one hand in a Frito bag and the other wrapped around my soda. What a way to go."
It was almost exactly one week later when he came knocking at our bedroom door at the crack of dawn, and said quietly to my husband, "Can you get up and come out here, please? I need you." When my husband came out, he said, "I think I've had a stroke or a heart attack or something- and I can't remember how to use the phone. Could you call the ambulance." By the time he got to the hospital he was not so calm or so controlled, but after a couple years of therapy, if you had not known my dad before the stroke, you would not have known something was wrong. As a friend said when he heard about it, "That man with half his brain cells is smarter than the rest of us," and that was certainly true. But that was a long time and many brain cells ago. Now, he can't beat a 9 year old at chess, and he thinks my husband of 25 years is 'that guy with all the kids.'
Somehow, I do not this this is what he was thinking of when he said it was how he wanted to go.
