A Visit to Fox Hollow

Today I saw my father for the first time since he was released from the hospital two weeks ago, a stay during which the family agreed to stop the aggressive medication regimen he had been on. Since his return to the Memory Unit at Fox Hollow, I had heard from other visitors that his behavior was more erratic, his thoughts and speech less clear than even a month ago. So I went down to Pinehurst NC to see for myself. I brought my elder daughter Cindy along, bribing her with the opportunity to hang out with her favorite cousin Katie in Durham. And the opportunity to skip a day of school.

When we walked into Fox Hollow, ambling through the hallway between the elderly denizens, we both felt very young. My father was sitting in a wheelchair, watching something on the television in the common room area of the Memory Unit. Yawning. He smiled to see me and shook my hand. I pointed to Cindy, he smiled, and asked her name. After she told him, he said he had been kidding, but I suspect he was not. We were not able to hold a very coherent conversation. Essentially, each sentence my father spoke tended to peter out before reaching a conclusion, and each sentence was entirely independent and, from my viewpoint, unrelated to the sentences immediately preceding and following. It seemed very difficult for him to speak with me.

Then Charlotte, his regular AOS caregiver, who spends mornings with him Monday through Friday, and with whom, essentially, he has more interaction than any other person, walked through the door. Dad lit up, smiled, held out his hand, asked where she had been, what she was doing, and if she would marry him. She answered all of these questions, and I abandoned Cindy with her grandfather to get a quick update from Charlotte as she delivered a supply of very large diapers to my father’s room. He had been getting to physical therapy for his legs every morning, and it took a full two hours due to his lethargic pace. But he made this effort in her presence. She was upbeat about the PT, and we discussed finally getting a handle on the rate of diaper use and arranging a regular delivery from a supplier.

After Charlotte left, my father returned to his rather less enthusiastic vocalizations with me. He reverted to seemingly random comments. Most of these were apparently attempts at sorting out a problem; his mind would be trying, in fits and starts, to analyze something, and his words were his disjointed conclusions. Everything from the grab rail in the bathroom to the fabric of my jacket triggered this type of comment. What I never seemed to trigger, though, was the type of genuine focus that my father demonstrated when a female of interest walked into the room, whether it was Cindy, Charlotte, or my mother.

So I am left with the conclusion that I, third son from the father, do not quite rate any more. Although my Dad recognizes me, and seems to appreciate my visits, his mind does not rise to the occasion and put forth its best efforts when I walk in the door. That level of mental exertion is reserved for women in general, and the important women in his life, more specifically. I do not feel personally slighted, of course, because this is apparently a manifestation of the Alzheimer’s and my father’s brain prioritizing what to use its remaining capacity to focus on. I feel like I have slipped a little bit into the periphery of his consciousness, though, perhaps sooner than I expected – although I cannot say I consciously anticipated this happening.

Once again I am left with the feeling that my father’s disease has progressed more quickly than anticipated. He stayed in his wheelchair this weekend, although I know he walks for PT with Charlotte. My own exertions with assisting him in getting in and out of the wheelchair to use the bathroom were very strenuous, even when I employed the aid of “T”, the very large fellow who works afternoons at Fox Hollow (I call him Mister T in deference to his scary size (nice guy, of course)). During one of these extended operations in the bathroom, though, it became very clear to me that we had made the right decision to “place” Dad in a care facility. There was no way my mother could deal with him in his current condition – it would have required two round the clock care givers, not just one – unless they were all the size of T. And if he were at home, he would not have been able to attend the cheese and cracker social in the non-locked-door side of Fox Hollow, with its soulful sing-along of Amazing Grace and other familiar tunes. And we would not have appreciated his loud singing at home as much as the residents of the senior living facility.

My mother and I were discussing all of these events during the weekend, and how we make choices and press on with life. You can try to second-guess the decisions you have made dealing with Alzheimer’s, the choices in moving, medical treatment, placement in a facility, but you can never know how alternative courses of action would have turned out. Maybe better, maybe worse. My father’s sisters recently began visiting more regularly, and after we decided to stop some of his medications, became very concerned and wanted to have a nurse in Ohio talking to our AOS case manager, Jennifer, etc. What they did not try to do was voice their concerns directly to those of us who had been dealing daily with my father’s afflictions and making the hard decisions of the past several years. We, his wife and his children, realize they are reacting emotionally to his worsening condition, and we are obviously willing to maintain a dialogue with them regarding his care, care which has fallen upon us to insure. What we are not willing to do is suffer second-guessing of our long-debated decisions regarding the life of our father and his eventual death. Nothing in the painful process of dealing with Alzheimer’s comes easily nor is any decision made lightly. For someone who has sat on the sidelines during the gradual decline of a loved one to insinuate those who have been carrying the burden of care are somehow in the wrong is reprehensible. It is a difficult enough journey when you naturally find yourself second-guessing your decisions, it does not need to be made that much more difficult by others doing so.