Denial? Check. Anger? Check. Fear? Check. Grief? Check. Acceptance?

Denial? Check. Anger? Check. Fear? Check. Grief? Check. Acceptance?

Last weekend I went to North Carolina, ostensibly to see Dad. The main reason was because I had not been down there since the holidays. The secondary reason was to attend a meeting with a financial planner. The tertiary reason was actually to visit my father. This hierarchy is a little embarrassing to admit, but there you have it. I feel as if I am not able to maintain a decent grasp on the reality of the situation my parents inhabit unless I am actually face to face with it myself on a regular basis. That is what brings me down each time.

Being face to face with my father is a different matter. Last visit, back in the supposedly joyous days of late December, our interaction was very limited. At some points my father’s eyes were blank – I am sad to say that they reminded me of the eyes of a goat, which you can look into but see no sense of recognition or intelligence or awareness. Of course, my father displays all of these characteristics, at times, but that blank look caused an existential shudder somewhere deep inside each time I saw it.

Until I found myself looking into that void exhibited by my father’s heretofore windows to the soul, I believed I had been through the first four stages of personal loss. I thought I had actually made significant headway in the grieving department, as discussed in a prior entry, and was well on my way to acceptance. Even when I left Fox Hollow in the waning days of 2007 I believed this.

During my latest visit, though, my father’s eyes never clouded over. He stared off into space sometimes, but he appeared to be contemplating something, somehow, somewhere. I picked up a digital photo frame in his room, the type that runs a slideshow of pictures, and held it in front of Dad and narrated the photos to him. Perhaps the interval was too short for him to grasp the context of the photos, but he meekly looked at them and listened to me and gave no real indication that he recognized most of what he was seeing. Most of the time. The way he did indicate to me he recognized the pictures for what they were was by crying – and they were not tears of joy. I think when his mind recognized something, when the image was strong enough to rouse his memory, it made him sad rather than happy. Whatever joy was associated with the people or places in the image was overridden by the sense of loss he must have been feeling. When the photos were of my family traipsing around Europe, he meekly stared, but when the photos were from his old house on the water by the Gulf of Mexico his eyes teared up and he was sad.

My father is definitely in the Grief stage of his illness. There is a lot written on the stages and eventually people are hopeful that they will reach Acceptance of their fate. I do not see how the brain afflicted by Alzheimer’s can ever reach that state. The confusion inherent in the disease works against any semblance of serenity. The uncertainty imposed by the damage to the memory leads to self-doubt and frustration. With that backdrop, it seems highly unlikely that an Alzheimer’s patient will ever be afforded the self-awareness to reach the acceptance of their disease and impending death. Hence, until the brain is nearly completely shot and the body is simply operating at only the most basic level, the Alzheimer’s patient must be caught in the Grief stage. So much is lost to them, both realized and unrealized, that the sense of loss must be overwhelming – loss of freedom, loss of places and people they know, loss of vocabulary, loss of memory, loss of awareness. When the recognition of this loss trickles into their consciousness, it must be depressing. Agonizingly so.

The caregivers from AOS, helping out at Fox Hollow, had mentioned this crying tendency for the past several months, but my father had not exhibited this response in front of me before. I assumed it was because of my naturally buoyant personality that the tears had not flowed before, but perhaps I overestimate my effervescence. When I try to consciously empathize with my father, imagining the situation in which he is trapped, I find myself wanting to cry as well. Although he has family and friends in attendance and there is a regular supply of (no-sugar) cookies, he has lost most of what he held dear in the world. His own abilities, mental and physical, have abandoned him, and there is no way back for him. There is no hope of recovering his life by working hard or analytically planning a strategy that will end-run his illness. It is a damn sad situation. And he is sad. And he has a right to be. And if he finds a way to acceptance, he is a much much better man than me.

On Grieving

So there we were, squared off across the table, the emotional side of the family over there, the more guarded side of the family aligned with yours truly. At the far end of the table was a psychologist and grief counselor, Kevin or Keith. And, on the speaker phone from China, was our brother Bob, who really does not fit into any family characterization other than “unique.” I suppose he would have sat at a different table.

I am an introvert, and I am not publicly emotional. To some I would appear stilted, even stunted emotionally, but I am not. And I have come to grips with my father’s impending demise. Still, there we all were, to discuss the process of grieving. Although it seemed to me to be a rather formal means of discussing a rather personal topic, it was important for our family to discuss this and make clear that we would indeed “be there” for each other to assist in the grieving process.

Family members tend to revert to specific “roles” when they get together as adults. My brother the lawyer arranged this meeting. He believes in meetings and counseling. My siblings and I all assumed our roles (I am a “listener”) around the tables, to some degree, and I believe overall this was a beneficial meeting. The psychologist’s description of the many ways that people grieve, and the many different time tables, was of the most value to me, as I know from past experience that I do not spend a lot of time grieving right away, but tend to dole out grief in measured bursts, staggered at intervals that I can handle. Since I am fundamentally unable to handle a lot of grief at once, this tends toward a long period of grieving. But I already knew that. Now I know that’s OK. The others discussed what is important to them. Largely, I came away with the awareness of needing to support my mother more than ever, and to keep in touch just as much with my siblings after Dad’s demise as during the time we have been managing his illness.

I am thankful my brother instigated the meeting, and that we were all available to attend. Perhaps this would have been a good idea when our older sister Mary died in a car crash six years back, when I was just about convinced we were all dysfunctional because the grieving processes were varied and many, and that I must have been doing something wrong since I could not relate to how the others were handling things.

While I was in the Navy, a dozen of my friends died. All while flying, usually while flying into the ground, but sometimes the water. And all were avoidable accidents, mishaps, not war time losses. Considered “aircrew error” except for the F-14 that disintegrated when its afterburner blew up instead of igniting. My sister and my nephew died in a sudden car crash, an accident for which they were blameless. These were all losses that happened suddenly. The death watch for my father is a different situation. It is a slow motion mishap, the kind you can see coming from a mile away and brace yourself for the impact. So there is time to prepare, and, although you cannot avoid it, you can prepare yourself for it. The wise will take the time to make these preparations while they have the chance.