Christmas Joy

The past few days Christmas music has been playing and it seems to bring great joy to Jean. Songs like "Rocking Around the Christmas Tree" and "Frosty the Snowman" have made Jean swing her feet, and gleefully smile. She knows Christmas time is near and has asked about ALL of her children by name in the last two weeks.
Sunday it snowed and she seemed mesmerised with the blanket of white outside.
Happy Holidays-
margaret

This Is Your Brain On Alzheimer's, Part 2

I recommend four short, superbly designed, videos titled A Quick Look at Alzheimer's: Four Pocket Films. Narrator David Hyde Pierce, filmmaker David Shenk, and illustrator Jossie Malis walk you through an introduction to the illness.

This wonderful series can be downloaded from/viewed at  www.aboutalz.org.

This Is Your Brain On Alzheimer's

Here at the Fremont Street Center for Healthy Aging, we have concentrated so much on researching the care management of the illness that we have neglected public outreach. Luckily we are not the only people grappling with the impact of this degenerative disease. New resources on the web give lots of information about the actual mechanism within the brain which causes the loss of ability. 

An interactive tour of the brain, illustrating the progression of Alzheimer's, can be found at 

www.alz.org/brain/01.asp.

Take A Look

The August 2008 issue of Discover Magazine, a side project run by  Sarah R. of Fremont Street's sister institution, the Morningside Heights Health & Well Being Project, contained this photo of an A-beta peptide fibril. This is the peptide which, when found in the brain, provides positive proof of Alzheimers.

Community Mental Health

Mother's cognitive health is failing. By paying attention to her physical and psychological needs, and practicing full acceptance of her illness, we have been able to keep her daily life as routine and recognizable as possible even as she progresses through the downward spiral of Alzheimers. But we haven't been able to stem the tide of the illness itself.

All caregivers report that Mother is losing the ability to cooperate with them as they perform for her and with her the daily tasks of self care. Everything is harder for her to do. I have seen her have trouble figuring out how to climb into bed. Her illness has removed parts of her brain with a bulldozer.

From my perspective, she seems to be gravitating toward spending more and more time sleeping or inert. But there is a time period every day where she is alert and active. Between lunch and dinner, she moves around the house, moving things around and touching everything.

During this period she will agree to go for, and will sometimes initiate, walks around the block. She will start art projects, where she folds and rips paper. She will initiate conversations. Conversations with Mother are mostly guesswork on the part of her conversational partner, but she will occasionally make herself completely clear.

The other night as I was putting her to bed, she commented that her caregivers were not there. I explained that one of her caregivers would be back in the morning. She said "Where did you find them?", a perfectly logical question, and one I would have expected her to ask, before she lost so much intellectual ability to Alzheimers.

We have had a straight across trade, Mother and myself. I accepted that she needed help. In exchange, she accepted that she needed help. I supplied the caregivers. She accepted them.  We had to work together  & we did. 

Mother's cooperation with the caregivers made it possible for Dennis and me to feel a sense of progress, even as her cognitive health declined. She was eating better, getting more exercise, interacting with people who cared about her well being all day long. By many of the most basic standards of health, she was doing well. 

But as her brain shuts down, it is harder and harder for her to cooperate. This is the final outcome of the illness: total isolation. The body is OK, the social being is intact, but the brain is gone. You are still alive, but you can't help yourself. 

In Mother's case, we are trying to forestall the final chapter of Alzheimers by providing her with enough support so that she is only fighting her illness, not fighting her illness and ostracism and social isolation and the resulting depression and anxiety and despair.

The learning curve for this approach was in the years I have spent accompanying my sisters who have schizophrenia, a similarly specific illness which targets the brain, but leaves the body and the social being intact. Like Alzheimers, schizophrenia has no cure. You learn to handle the illness. You can't eliminate it.

In the most understandable impulse on earth - the urge for self preservation -  people instinctively go for what is impossible: the elimination of schizophrenia, and the elimination of Alzheimers. Unable to eliminate the illnesses, we achieve this goal by eliminating from our lives people who suffer from these illnesses.

Community mental health puts ill people right in the middle of well people. It does this in the name of health. I know very well that most people do not regard their health as being improved by the presence in their daily lives of someone with an incurable illness which has targeted their brain. I have watched my sisters struggle against isolation, and now my mother.

But in the long run, the communities in which my sisters live, and the community (the block) on which Mother lives, experiences greater health from the presence of ill members. If I see the most vulnerable members of my community being cared for on a daily basis, I am better off than if I live in a community where I am told, and I clearly see, that all mentally ill people are viewed as undeserving of help. In community A, I know that if I became mentally ill I would be cared for. In community B, I know, with equal certainty, that if I became mentally ill, I would be consigned to care for myself, and my own diminished capacity would be the measure of my health care. 

When we take mother for walks down the block now, we pass people who have known her for decades. Their faces register pain. The sight of Mother pains them. 

Some can handle the pain, and greet her. Others retreat to the fantasy world of "the way I wish things were" and go by without showing any sign of recognition. Yes, it would be tidier if Mother disappeared from the block and was being cared for someplace no one ever saw her. And in the case of Alzheimers, it is reasonable to expect that this "other place" would be doing a good job. But the neighbors on the block who stop to say hello have conquered their fear of Mother's Alzheimers. They have used her illness to become healthier (more self aware, more self reliant, more reality based) themselves. 

This is the unexpected bonus of community mental health. That the community - the well people - experiences increased health as a result of daily contact with people who live with incurable illness.

Kindred Spirit

The above list is from blag/xkcd.com. Randall Munroe, the creator of xkcd, found this list among his things in his room, and while he can positively verify that it is in his handwriting, he has no idea what it means, or what impelled him to collect these words.

He gets lots of  helpful suggestions from his readers. I think this is an excellent use of the internet, almost as excellent as The Mother Project, in its incisive grasp of the way online communities can redress inequities of distribution of basic human resources, such as intelligence and memory.

Who Was That Masked Man

Dennis is making a mad dash through Europe so he can be back in time for Bart's birthday on Nov. 24. ( And Thanksgiving, Jenna's birthday this year, on Nov. 27)

Catch up with Dennis at the following locations.

October 17 Morning Arrive Milan
October 17 Evening Bern
October 18-19 Lausanne
October 20 Idle
October 21 Limoges, France
October 22 Rotterdam
October 23-25 Idle, possibly Manchester
October 26 Birmingham England
October 27 Idle
October 28 Groningen Netherlands
October 29-30 Arhus Denmark
October 31 Viborg, Denmark
November 1-2 Kiel
November 3 Bordersholm, Germany
November 4-5 Idle
November 6 Fly to NYC from Milan

Follow me, boys!

Taking a page from research conducted by the Fremont Street Center for Healthy Aging in partnership with the Morningside Heights Health & Well Being Project, the Academy of American Pediatrics just announced they were doubling the minimum recommended dosage of Vitamin D for infants, children and teens.

La Professora

The Ames Center for Human Development sent in this photo of a Fremont Street research associate, pictured here complete with her research. Between work and family, Dr. K. R. Bruna has been so busy that she hasn't much bothered much with research into her own aging process, as you can see. 

A Fellow Traveler

Mystery Train
by Sherman Alexie

I boarded the Amtrak in Portland on my way
To Seattle and searched for an empty seat—
Hopefully an empty row. In Coach Car C,
I saw a seat next to a teen. The train swayed
As I approached him and asked, "Can I sit here?"
He wouldn’t look at me. His face was blank.
Asberger’s, I thought. "I must warn you I’m weird,"
The kid said. "I’m weird, too," I said and thanked
Him for his kindness. I worried he would talk
Too much, and he did, but he was charming and rude.
He said, "You’ve got a big head and face, dude."
He said, "I like rap music more than I like rock
Because I like blacks more than whites,
Especially when I play the royal game, chess."
With Asberger’s, I knew the kid might obsess
Over certain objects or ideas, like
The boy I know who collects Matchbox cars
And recites the manufacturing history
Of thousands of them. "It’s not too far,"
The Train Kid said, "We are on a train journey,
But I take it twice a month, on weekends.
I’m sorry I’m weird. I don’t have many friends.
My mother and father love me, but they
Got divorced when I was ten. You could say
They hate each other as much they love me."
He told me his father lived in Portland
And his mother in Seattle. "It’s kind of fun
To ride the train," he said. "I like to see
The landscape out the window. Pretty soon,
There will be a yellow truck parked outside
A blue and red house." Of course, he was right.
As we traveled north, the kid always knew
What was coming next. I asked, "What’s your name?"
He ignored me and said, "There used to be
A dog that lived in that junkyard. It’s a shame,
But I think he’s dead now." Then he looked at me,
Made eye contact for the first time, and said,
"In seven years, I have taken this trip
One hundred and nine times. I have only missed
Two trains because I had the flu in my head."
Jesus, the kid had become a nomad
Riding rails through the ruins of a marriage,
And, at first, I was eager to disparage
His parents, but then I realized that
His folks must love him as obsessively
As he loves them. They put him on the train
Because they need to see him. It was lovely
And strange. I wanted to ask this kid about pain
And what that word meant to him. I guessed
He could teach me a new vocabulary—
I was vain and wanted to be blessed—
But then he asked, "Are you old and married?"
"Yes," I said. "I’ve been married for ten years."
He nodded his head and looked out the window
At the sunlight flashing between tree rows,
Then whispered, "I have cried a lot of tears."
I was breathless. Stunned. I wanted to take
The kid into my arms, but I knew he’d hate
The contact, so I could only smile
When the kid said, "In a little while,
We are going to see the Mima Mounds."
And there were thousands of those things, six
To eight feet tall, dotting the South Sound.
Created with gravel, rocks, dirt, and sticks,
Those mounds escape explanation. They’re not
Indian burial sites. They’re not homes
For gophers or insects. They don’t contain bones
Or fossils or UFOs. They’re just odd
Geologic formations that will keep
Their secrets no matter how hard we try
To reveal them. When our train arrived
In Seattle, the kid walked beside me—
I had quickly become a habit, I guess—
Until he saw his Mom, short and pretty,
And pulled her tightly against his chest.
He said something to her, pointed at me,
And she smiled and waved. I walked home,
Chanted the first lines of this poem,
And committed them to memory.
And if a few strangers thought me crazy
For writing poetry, aloud, in public,
Like another homeless schizophrenic,
Then fuck them for wanting clarity
And fuck them for fearing mystery.
© 2008 Sherman Alexie

Siblings, please note

Mother is entering a new stage of her illness. She is becoming more cognitively disabled, and more helpless. She is physically healthy, and emotionally peaceful, thanks to the attention she gets from her caregivers, and her awareness that she is never alone. But she is not on a plateau. She is folding up shop.

When she sees me, she reaches out to see if I am real and says "Is that really you?"

Quest for Collective Intelligence

Research associate K. R. Bruna at the Ames Center for Human Development has been following our progress here at the Center. In a recent communique she observed that the Fremont Street Center for Healthy Aging's focus on close collaboration embodies the principles sociologist Etienne Wenger finds in a "community of practice".

I asked her what that meant.

Here's her reply.

Here's what Etienne Wenger, one of the originators of COP theory, says

Defining Communities of Practice
Communities of practice are everywhere. We all belong to a number of them-at work, at school, at home, in our hobbies. Some have a name, some don't. We are core members of some and we belong to others more peripherally. You may be a member of a band, or you may just come to rehearsals to hang around with the group. You may lead a group of consultants who specialize in telecommunication strategies, or you may just stay in touch to keep informed about developments in the field. Or you may have just joined a community and are still trying to find your place in it. Whatever form our participation takes, most of us are familiar with the experience of belonging to a community of practice.
Members of a community are informally bound by what they do together-from engaging in lunchtime discussions to solving difficult problems-and by what they have learned through their mutual engagement in these activities. A community of practice is thus different from a community of interest or a geographical community, neither of which implies a shared practice. A community of practice defines itself along three dimensions:
* What it is about - its joint enterprise as understood and continually renegotiated by its members
*
* How it functionsmutual engagement that bind members together into a social entity
*
* What capability it has produced - the shared repertoire of communal resources (routines, sensibilities, artifacts, vocabulary, styles, etc.) that members have developed over time.
*
Communities of practice also move through various stages of development characterized by different levels of interaction among the members and different kinds of activities (see "Stages of Development").

Communities of practice develop around things that matter to people. As a result, their practices reflect the members' own understanding of what is important. Obviously, outside constraints or directives can influence this understanding, but even then, members develop practices that are their own response to these external influences. Even when a community's actions conform to an external mandate, it is the community-not the mandate-that produces the practice. In this sense, communities of practice are fundamentally self-organizing systems.

The shared repertoire of communal resources here at the Fremont Street Center for Healthy Aging includes the front yard garden, tilled by Dennis and planted by Marcie, and the kitchen bulletin board & calendar,  a joint effort by both Marcie and Margaret. The contents of the refrigerator, curated by Marcie, with input from virtually all adult research staff, is a definite communal resource, as is our increased appreciation and understanding of the role of Mother's "folding art" , which comes to us courtesy of Margaret.

While we were out

About a week ago Jean and I went to the store and I had my camera so I took some recent photos of her. Jean pushed the cart around and was very social with many people. Later we had a snack and OJ, she was content making some of her folding art while we enjoyed our small meal.

Hospice Dog

Author Jon Katz has an article on Slate about bringing his therapy dog to visit a woman with advanced Alzheimers.

Second Marker

The second marker for the progression of Mother's illness is the trouble she has taking pills. Up until now, she has been able to swallow her pills whole, as directed. Just since Marcie and Margaret have been here, she has lost the ability to do this. Sometimes she can, but more often the caregivers empty the contents of her hydroxyurea ( treats her blood condition) capsule into a small amount of applesauce and give it to her that way. They also give her warfarin (a blood thinner, prescribed after her blood clot)) this way.

Mother has no trouble swallowing. She enjoys meals, both the food and the company.

What she lost was the ability to follow directions. Before she could comply with the directive "Swallow, Jean, don't chew it!" Now she can't.

Welcome Christina & Rebecca

Mother just spent Saturday with her two new Saturday caregivers. Rebecca Field, who has known Mother for 40 years, is taking care of her two Saturday mornings a month. Christina Elston is taking care of her Saturday afternoons.

Rebecca is studying gerontology at PSU. She initially agreed to take care of Mother for two Saturday mornings because we were short staffed during Margaret's August vacation. She wanted to help us out and get some personal, hands on experience that her academic program can't deliver. She likes the Fremont Street Center for Healthy Aging so much she decided to continue.

Christina's last caregiving job was as home health aide to a man with cerebral palsy. She did this for a year. She also has worked in nursing homes, where she said she was responsible for delivering care to 20 Alzheimers patients - simultaneously. She and her husband recently moved to NE Portland (they live not far from Tom). She also works for Community Warehouse. Christina was born in Portland, but grew up in Missoula.

Mother's most active time of day is the afternoon. Today the block association was having a barbeque at 5:00. Mother, Christina, and I walked down to say hello and to introduce Christina to Mother's neighbors. Mother has no trouble recognizing John Morrison as her special friend. He spent time with her at the party, and walked back up the house with us, Mother holding his hand.

It is an artistic block. John Morrison's recent book of poetry has been nominated for this year's Oregon Book Award. He is up against stiff competition - both Judith Barrington and Brian Doyle have books nominated in his category. A few doors down is installation artist Jacqueline Ehlis , whose most recent exhibitions have received ecstatic praise. Inbetween John M. and Jacqueline E. is a family of Robert Hayden, a jazz musician.

It is an ingenious block. Dennis blogged about Russell Senior, who plants wheat every year in his front yard and makes strawberry shortcakes for the entire block with his harvest. Architects Kathryn and Howard have a container vegetable garden in their driveway which looks as if it will continue throughout the cold season.

Right now Dennis is out at the block party showing films. Mother is sound asleep. Christina is pedaling home on her bike.

Midnight Rambler

Taking care of Mother in her own home has always meant two things: taking care of Mother and taking care of her home. The central challenge where these two goals converge is Mother's Alzheimers' caused incontinence, which makes her a hazard to her own home. Without intervention, incontinence renders any environment unlivable. This is one of the main reasons people get moved to nursing homes.

Here at the Fremont Street Center For Healthy Aging, we are interested in delivering reality based care. We want to see Mother's Alzheimers for what it is (an illness), and what it is not (the end of life as we know it). We don't want to exaggerate it or underestimate it. We want to respond, with individualized attention, to the impact of Alzheimer's on this particular, unique human being.

Incontinence has provided one marker for the progress of the Alzheimer's caused dementia which has disabled Mother for at least six years. In the spring of 2006, when Dennis and I arrived in Portland, Mother had stopped being able to do housework, but she still was putting herself to bed, and getting up in the morning without help. She made her bed every morning. She slept in her clothes. Occasionally she experienced incontinence while she slept - I only knew this because we would find her standing in the living room wrapped in a blanket. She knew how to take off her wet pants, but had lost the ability to dress herself.

About a year ago, she moved to wearing paper diapers around the clock. This turned out to deliver immediate huge psychological benefits. She was relieved not to have constant daytime worry and embarrassment about minor incontinence. Paper diapers were a godsend which returned her dignity to her. She was visibly more relaxed. Around this time, she lost the ability to put herself to bed. I mandated a bedtime for her caregivers to observe. In a rare moment of lucidity, she thanked me for doing this.

She lost the habit of making her bed every day around the same time as she lost the ability to dress herself and to put herself to bed. She never lost the ability to use the toilet.

She still has not. However, her dementia has progressed so that in addition to using the toilet correctly, which she does 98% of the time, without supervision, she will also mistake/appropriate other objects to serve as a toilet. Because there is always someone here with her, this has not been a problem. She can be redirected to the bathroom, and she has no objection to that.

In the middle of the night, however, there is no one there to redirect her. She has trouble finding the bathroom very rarely, but when it does happen, we come down and discover a wet spot on her bedroom rug. We also, for the first time since the arrival of the new caregivers in February, have begun finding wet spots in her bed. Her only problem was finding the toilet to urinate. She never has trouble finding it for bowel movements.

We were temporarily stumped as to how best to address the wet bed dilemma. All the best support in the world delivered during the day couldn't help her during the night, when everyone was asleep. Then, in a searing flash of insight, we realized that we could change Mother's diapers midway through her night.

I have begun doing this. I gather it is a standard practice in nursing homes. I thought Mother would dislike it. She doesn't mind. William used to change her diapers in the middle of the night. So she had a memory of the experience, and it wasn't new to her. She is so fit that she can help, even lying on her back.

The true obstacle to this, most practical solution to an Alzheimer's caused problem, was Dennis' and my own emotional reaction. Changing your Mother's diapers is one thing when she is standing there, clothed, during the day. When she is lying in bed in her pajamas, the role reversal you are experiencing is so complete it has to be confronted, and the emotions processed. Dennis, who has been able to do everything else with Mother, found this job impossible. There was nothing in him which found the practice of waking up a woman and pulling off her pants acceptable. But after a few tries, I have found that changing Mother into clean diapers while she is in bed is not that hard.

The reason I am spelling this all out in such detail for my fellow aging specialists across the country is that this particular job - that of addressing incontinence- is what sends most elders to nursing homes. This is what it comes down to. I am not minimizing the size of the problem. Eventually for us too this may become the problem that sends Mother to a nursing home. But if we had thrown up our hands and said "Impossible!" before trying the simple step of changing Mother's diapers while she was in bed, we would have been essentially outsourcing one extremely simple intervention to the staff of a nursing home, and asking Mother to move out of her house in order to make that happen.

We would be changing her whole life so that professionals could change her pants.

This problem solving update is the latest new development in our daily routine here at the Fremont Street Center for Healthy Aging. Mother remains physically healthy, active, and emotionally connected to the people around her.

Harvest Time

Yesterday Mother's kitchen was overflowing with red, ripe, juicy, organic tomatoes. Too many to eat in salads! We planted eight tomato bushes last June, and all were productive. Marcie found one tomato which weighed two pounds.

Marcie took on the challenge of turning this bounty into food. She spent the morning chopping onions, garlic, tomatoes and our own basil. By the end of the day she made four freezer containers of tomato sauce, and one delicious lasagna dinner.

Dennis and I were gone for much of the day. I left with the counters covered with fruit and came back in time to see thick sauce, simmering on the stove. From what I could see, a sunny day filled with cooking is Mother's idea of a good time. She was positively purring with contentment. When Marcie works in the kitchen, Mother putters around beside her or sits at the dining room room, watching what is going on. Cooking always makes the house seem the opposite of empty. Maybe this is why Margaret grated up a bunch of carrots and made a cake on Sunday. Cooking grounds Mother. It smells good, feels good, and results in food which tastes good -- everything about it is familiar to her. You don't do it unless you're planning a dinner, and Mother completely understands dinner.

I was struck by how completely Mother has switched roles. She is like a child, happy to have her mother nearby. When Marcie or Margaret is busy in the kitchen, her world is complete. Jenna used to be the same way.

Sunday AM

Mother went to church this morning with Margaret and myself. Margaret has been quietly and persistently advocating that Jean develop more of a social life. We have been thinking about starting a group which welcomed caregiver and caregiving recipent duos, but we never thought of the social life going on each Sunday one block away at Fremont Methodist Church.

Mother sat through the entire service, participating when she could. They have a wonderful ( volunteer ) choir, and while they were singing the anthem, the spiritual "I Want To Be A Christian", Mother leaned over to me and said " I used to do this."

After the service she was personally greeted by a wide variety of congregation members, one of whom turned out to be a caregiver herself.

The church is small - about 60 in attendance today. They emphasize inclusivity, so it is a perfect match for Mother. Margaret plans to take her back again. This Christmas season Mother may get a chance to hear the Christmas choral music she loves so much.

Walking Down 25th On a Sunny Saturday

It was such a beautiful day on September 13 that I was able to get Jean out of the house with no coaxing at all. Also, without a top coat. You have no idea how rare this is.

It was around three in the afternoon.

The walk started with a bang when Anna went racing down the opposite sidewalk. Anna is a standard poodle. She has no fancy hair cut and is very friendly. Someone down the block had called for her and off she had went. A galloping standard poodle, fancy haircut or not, is a sight to see. Katherine followed along shortly after with leash in hand, calling for Anna to come back. Anna finally did, meeting Katherine just about exactly across the street from us. If I had been in a capricious mood I might have called for Anna myself and she would have bounded over to us. A welcoming look probably would have worked just as well. I stayed the impulse and Katherine got Anna to sit before I changed my mind.

Jean and I then continued south.

Further down the sidewalk Jerry, who lives three houses down on same side as us, was talking to a man who we didn't recognize. They ended their talk before we got to them. The last time I saw Jerry was the night before he and his wife Teresa were going to Italy. I asked about the trip. He gave us a nice report and asked if we had sampled the lemon cucumbers. I told him that we had enjoyed them immensely. Our garden had produced two or three hundred cucumbers of two different types. We gave away dozens of them. Jerry in return had given us some of his, of the lemon type, which I had never heard of.

It is a very gardening street. Katherine and her husband Howard grow stuff all winter. Cattycorner at the end of the block is a man who grows a crop of wheat in his yard. He is also a great connoisseur of strawberies. Every year he grinds his harvested front yard wheat into flour and makes it into shortcakes for his own private strawberry festival. Just about everyone in the neighborhood shows up. Jean and I attended the last one and had an extremely nice time.

We continued our walk without anything else exciting happening. It is expected to be another beautiful day tomorrow.

Dennis

Second reported Glen sighting

Mother pointed to an empty chair across from her at the dining room table and said "There he is." "Who?" Dennis asked. "Glen." she replied. 

Hallucinations are part of Alzheimers. Mother mentioned seeing Glen before.

It Takes A Village, Again

I found Mary Pipher's book in Mother's room. It is a collection of case histories.

All of Dr. Pipher's case histories follow families as they learn how to work together to care for a newly helpless member. She advocates thinking of dependency as an inevitable and necessary state we all pass through - everyone as infants and most of us as old people. She recommends accepting as natural that people need help. Everyone. Everyone needs help. There is no point to pursuing an ideal world where no one needs anyone.

It is as if she had been present when we drew up the plans for the Fremont Street Center for Healthy Aging. It is as if she sat on our Board of Directors. 

Mother & Rabbits

On the way home from a walk, Dennis and I ran into Marcie and Mother. Together we visited Kathryn & Howard's vegetable garden, then Mother and Marcie continued the walk, and Dennis and I came home.

Twenty minutes later, Mother and Marcie trooped in the door. They had been invited to join by a neighborhood mom to eat ice cream with her kids on their front steps. Four children, all under the age 10. 

The children brought out their two pet rabbits to show Mother. She was more interested in their snow white Cairn terrier. Marcie said she enjoyed the visit very much.

Labor Day Report

On Labor Day we gave Marcie the day off. Margaret was not yet back from Burning Man. So Dennis made his famous Greek Salad, using tomatoes and cucumbers from the garden for Mother, me, Tom, Patti, Austin, Tim Smith,  Jenna, Charlie, Sam, Joy and Bart.

He also made Mongolian beef and brownies. 

Tom and Patti brought strawberry rhubarb pie. Austin arrived after visiting his mother in the hospital. Tina had emergency surgery for an ulcer earlier that day.

The next day Sam, Joy and Bart returned for the "Last day of summer vacation" in the back yard.

These three junior research staff members from the Emerson Avenue Center for Early Childhood Development are Mother's most frequent and enthusiastic visitors. Their own investigations into the aging process are well under way - Sam weighs 60 pounds and wears a size 1 shoe. Joy lost her first baby tooth and just started kindergarten. We're waiting to learn more about Bart's latest research. We can't get any information about it out of him. His favorite word is still "no".

Mother effortlessly mingled with dinner party guests, and participated in the conversation.

Oregon/Burning Man

To my surprise, I learned that Burning Man is the brainchild of an Oregonian, Larry Harvey. 

Burning Man was part of my life this summer because both Margaret Beeson, Fremont Street's resident Art Therapist, and Damon Eckhoff, the web designer for the Oregon Sesquicentennial Film Festival, were attendees. Margaret worked as a cook, Damon served coffee ( I think).

Margaret came back with a smile and a tan. She said the much reported dust storm was not severe enough to cause concern, and only occupied two days out of the entire festival. She and Depak, her boyfriend, were in charge of feeding 20 people throughout the festival - I asked her if they brought enough food along to last and she said they did. Miraculous!

Both Margaret and Damon are new to Portland. Margaret is from the Southwest; Damon from the Midwest. Both are artists. I suspect neither are aware that Burning Man is the creation of another Portland artist.

Jean Wyatt/Joe Biden: Separated at birth?

It has come to our attention that Mother's habit of touching her forehead to that of her conversational partner (cited in a previous blog posted by Jenna)  is one she shares with Democratic Vice Presidential candidate Joe Biden.

The Washington Times reports:

Mr. Biden also is able to connect more directly with caucus goers in part because his events are intimate. In Iowa City this past summer, he gripped a woman's hand and looked her in the eye while answering her question about regime change. He has a habit of touching his foreheads with voters when he's trying to make a point.

Perhaps Mother's great unexplored potential was as politician. She did get a Masters degree in Public Administration.

Margaret Beeson Appreciation Days

We're celebrating Margaret Beeson Appreciation Days here at the Fremont Street Center for Healthy Aging. Margaret is away on a two week vacation. While she is gone, Mother's usually stellar night time independent toileting is a little off. We don't know if there is a cause and effect relationship, but I am inclined to think when Margaret returns, Mother will be more settled.

Mother openly prefers her caregivers. Last night, after Nicole went home, Dennis and I made dinner to eat with Mother. She sat down and looked across the table where Margaret would ordinarily be, facing her. "Where's the girls?" she asked. 

Margaret is on a working vacation, feeding people at the Burning Man arts festival. She and her boyfriend have been doing this for several years. When she gets back, she may need a rest. I hope she'll be as glad to see us as we will be to see her! At least we can promise no dust storms.

Meanwhile the daily festivities observed here at the Fremont Street Center for Healthy Aging to commemorate Margaret Beeson Appreciation Days give us ample opportunity to honor how highly skilled Margaret is. Mother will be glad when she returns. She tolerates the step down in quality that Dennis and I represent, but she recognizes us for what we are - amateurs.

Strong DNA

Last night, two of our associate research staff from the Emerson Avenue Center for Early Childhood Development were observed investigating the anti-aging effects of the highly ritualized aerobic mating ritual known as square dancing at the Philip Foster Farm's Annual Barn Dance. Sam and Joy also played croquet, ate barbeque beef, played in the barn and listened to live bluegrass. 

More than one barn dancer noted the family resemblance between Dennis and his great great great great grandfather, Philip Foster.

 

Interview with Marcie Sims

The Fremont Street Center for Healthy Aging research staff includes Marcie Sims, whose approach to nutrition here at the Center has been effective in retarding everyone's aging, not just Mother's. Marcie is an experienced caregiver as well as being an acupressurist, Thai masseuse, gardener and cook. This summer, she has been perfecting her recipe for borscht.

We sat down with Marcie to talk about her success in returning Mother to better health, and ask how she did it.

Q: When you started this job, what were your goals, nutritionally, for Jean?

A: To introduce a well balanced diet throughout the day.

Q: Have you done this before?

A: Yes.

Q: Did you already have a plan?

A: No. I started from scratch, and used trial and error.

Q: What was your plan?

A: Besides serving well balanced meals, we started going out more. I did both things. Its hard to separate which one had the most effect.

Q: What did you find worked well for Jean, in terms of meal planning?

A: Adding more vegetables. Always having a salad.

Q: I know you are a vegetarian. What kinds of protein do you serve Jean?

A: Quinoa, beans, tempeh, tofu.

Q: Did you end up going by Jean's preferences?

A: Yes. She likes avocado and tomato salads, especially for lunch.

Q: What about portion size?

A: She eats more at lunch.

Q: Like what?

A: Apple and peanut butter. Mixed vegetables, curry, grain salads. Soups.

Q: Were you surprised to see her become more trim? (Ed. note: Mother hasn't lost alot of weight. But she has lost inches in circumference. Now she fits into her own clothes, the ones she wore before her dementia.)

A: I think it all has to do with eating right and going out.

Q: What are her favorites foods?

A: She really enjoys spaghetti. She likes vegetables.

Q: What would you like to see more of in her diet?

A: The only thing I would put more of on the menu would be spinach, kale and chard. But I can't do this because of the interactions with her blood thinner.

Q: Do you think Jean gets the 5-7 recommended fruits & vegetables every day? 

A: She gets that many just in breakfast and lunch.

Hooray!

Marcie has returned! Mother celebrated this morning by dancing with Marcie to country western music in the living room. Mother & Marcie have danced together in the past, but Marcie said Mother was so happy to be dancing today that they danced - whole body moving, arms, legs, you name it - for an entire song

Porch Swing: Antithrombogenicity Agent

Based on raw data supplied by the Fremont Street Center for Healthy Aging, the Morningside Heights based Health & Well Being Project has uncovered a possible link between time spent on the porch swing and the mysterious increase in the antithrombogenicity of Mother's blood.

Early in August, the Kaiser Coagulation Clinic, which tests Mother's blood every two weeks, found she no longer needed as high a dose of bloodthinner. Her blood had begun thinning itself. Marcie and Margaret were quizzed closely about changes in Mother's life habits. Had her diet changed? Had her activity levels changed? Was she under a lot of stress? 

Everything in Mother's life has changed, of course. But it changed in February when Marcie and Margaret arrived, and the Fremont Street Center for Healthy Aging opened for business. Nothing had recently changed, and this change in her blood was recent. Marcie and Margaret kept saying "No" to all the questions from the Coagulation Clinic. Everyone was bewildered.

I reported this development to Sarah R. , at the Health & Well Being Project in Manhattan. Famous for its fish oil research, the Health & Well Being Project specializes in non-medical life style change as an avenue to increased health. Sarah pointed out that there had been a drastic life style change in Mother's daily routine. The porch swing now meant that Mother was spending up to two hours a day in (shaded) sunlight.

She hypothesized that the increase in exposure to sun resulted in an increase in Vitamin D which had significantly changed Mother's blood levels.

Quick perusal of existing literature on her part revealed a study, done on mice, where it was proved that Vitamin D "played a pivotal role" in determining levels of antithrombogenicity (ability to fight clotting). 

The take home lesson here: go outside and get some sun.

Mother had been improving her blood levels with every minute she spent outside, sitting on the swing.

Jenna's Addendum

I forgot to add:

Halfway through our walk,  Grandma stopped and said "You know I think its kind of funny." She touched her forehead and pointed to mine. I said "What? Do I have something on my forehead?"

She said "You have these. You know...." 

I said "Wrinkles? Do I have wrinkles?" She said "I just think its funny. You're getting older."

I am sure Grandma Jean knows exactly who I am.

Jenna & Mother & Archie

Visiting research associate Jenna Bott reports that Mother had an unusually high functioning day today, and was especially verbal.

Here's Jenna's report on their morning walk.

First of all, she wanted to go out, and I didn't have to coax her. Once out on the front steps she stopped me and said "Let's try this." she pointed to where she wanted me to stand, and said "Put your feet here." Once she had me positioned, she stood very close to me, and looking straight at me eye to eye, she said "I feel like we're....." and she reached forward and pulled my head to hers so that our foreheads were touching. We stood there for a minute. Then she laughed, and we continued on our walk.

Getting to the bottom of the steps, she said "Let's take a left." She said this at every corner as we went around the block. While we walked,  she talked to me about people passing by and when we passed the Morrison's we stopped and talked to John Morrison's wife. We also saw a little cairn terrier. I said "That dog looks like Archie." 

She didn't agree. I said "Archie was a good dog. I think he was a little off his nut, though." Mother immediately objected "Well, I don't!" and was so huffy that I apologized to her for my offense.

This entire morning, I felt Jean knew who I was. When she first saw me she said " I'm glad you're here." She related to me as my grandma, not as a person tolerating the company of a friendly stranger.

Brain Health Playdates

We are not the only people experimenting with a multi generational model for Alzheimers care. A group in Australia has been doing the same thing, bringing preschool children to nursing homes to play with Alzheimers patients.

The Prime Minister of Australia observed that the model works well for people with Alzheimers "because memory and communication are not essential to enjoying positive and meaningful relationships."

A very interesting insight from a politician!

Ultrasound Scan Results

On July 31, Mother went in for a follow up ultrasound to see if the blood clot in her right leg had dissolved. 

Mother was not happy about the procedure, which involved pressing the scanner deep into her thigh. Margaret's professionalism carried the day. She was able to gain mother's cooperation, and despite Mother's discomfort and protests, the technician was able to finish the job.

The results came in the mail two days ago.

ULTRASOUND DUPLEX SCAN IN LOWER LIMB VEINS IN LATERAL

INDICATION: Followup for DVT in right lower extremity. Patient had deep venous thrombosis on the previous examination.

FINDINGS: On today's examination, there is no evidence of residual thrombosis in the right common femoral, superficial femoral, or popliteal veins. All veins demonstrated normal response to compression and augmentation. Previously identified thrombus has resolved on the current examination.

IMPRESSION: Interval resolution of deep venous thrombosis of the right lower extremity with no thrombus identified on the current examination.

Another Mother (Project)

I've learned there is another The Mother Project. Tierney Gearon took a series of photos of her mother, who lives alone and suffers mental illness.

JRSB/DWN

In response to public demand.....

Here is the story of "when Jenna first met Dennis" which Jenna told at Dennis' birthday dinner last night.

Jenna met Dennis when she was working behind the counter at Posteritati, Sam Sarowitz' movie poster store in Nolita  (North Little Italy). Dennis came in and inquired about a certain movie poster. Then he looked around at things in the store and left.

When she next met him, it was five years later. I was introducing her to him in my kitchen in Portland.

Marcie Sims Appreciation Days

The larger experiment being attempted by the Fremont Street Center for Healthy Aging addresses the issue of aging in place. Can the care for a late stage Alzheimers patient be provided within the everyday routine of a normal family household? Paper diapers, superb health insurance coverage, and professional caregivers during the day are all part of what has made the experiment at Fremont Street work thus far. 

The mini-experiment we are conducting within that larger one is - can we live without Marcie? 

The first day of Marcie's vacation, Jenna arrived and cared for Mother in the AM. Charlie spelled her in the PM. Both grandchildren (Charlie is a grandchild-in-law, I guess) know Mother very well. She got lots of attention.

As I reported, the next day Mother woke up with one thought on her mind - where is Marcie? We had arranged that Margaret come in that afternoon, 1:00 - 5:00, so that day didn't feel different from the ordinary.

Yesterday, Wednesday, is the day I am most busy with my job. Dennis took responsibility for caring for Mother the full day, and it went off without a hitch. But examining the exact contents of the day may be revealing, when it comes to understanding what makes a day with Mother- and no caregivers - work.

The biggest pressure on caregivers, both professionals and family members, is the stress and tedium of constant exposure to the workings of a disabled mind. The non-Alzheimers brain, the one you and I possess, reacts with alarm to the cognitive misperceptions and communication roadblocks which are part of everyday life with someone with Alzheimers. It makes perfect sense to avoid this stress, and most people do.

The consequence of this social avoidance is that the person suffering Alzheimers, who is already socially disabled and severely limited in their ability to make contact, is given even fewer opportunities to connect with the larger family of human beings. Someone who needs more gets less. 

Our theory, here at the Fremont Street Center for Healthy Aging, is that placing a person with Alzheimers in the middle of a functioning family is one way to effortlessly ( or relatively effortlessly) increase the number of hours they receive social contact.

On days when Dennis and I are away at work, and when Jenna and the kids do not visit, the house is pretty still, so Marcie and Margaret take Mother on outings so she can have the contact with other people.

Yesterday the day went really well for us, without a professional caregiver here to provide respite, but let's look at just what happened during that day.

While I was gone in the morning, the Kaiser nurse arrived to do a blood draw. This week the City of Portland is tearing up Fremont Street right outside the house, so there has been activity and crews bustling about right outside the window. Damage to the cable lines meant a Comcast technician spent the morning going in and out of the house checking to see if he had re-installed the cable line correctly. Plus Dyana was here doing her monthly cleaning. So Mother had three visitors, and the house was full of activity.

When I got back in the afternoon, Dennis, Mother and I went over to Perry's, across the street, to celebrate Dennis' 55th birthday. We were the only people there. Mother had a root beer float and some Thai chicken. It was Happy Hour, and we were very happy. 

Mother raised her glass to Dennis.

We returned home in time for dinner. Jenna brought her kids over and we sat around the dinner table eating hamburger casserole, and vegetables from the garden. Dennis and Jenna swapped stories about walking to school, and Jenna told the story of when she first met Dennis.

Sam, Joy, & Bart practiced climbing the rope which hangs in Mother's bedroom doorway. Joy helped me water the garden. Dennis explained baseball scoring to Sam while they watched TV. Bart divested himself of his pants, proving his genetic connection to Tom Richardson, who did the same thing at his age.

Mother went to bed at 8:00 on the dot. I don't think she had a boring/bored minute throughout the whole day.

Now the point of this story is this: that much hustle and bustle is what is takes to replace Marcie in our lives.

Mother has a great day with she gets visits from:

1. A Kaiser nurse

2. A Comcast technician

3. Dyana, our home environment specialist

4. City of Portland road crews outside the house

5. a root beer float at Perry's 

6. One grand-daughter and three great grandchildren

On a day when Mother has this much flotsam and jetsam of human existence flowing in and out of her life,  she doesn't need the attention of a highly skilled caregiver. But notice the convergence of unusual factors. Because we can't expect the road to be torn up everyday, or the birthday of a family member (a blood draw, a downed TV cable) to happen everyday, we have Marcie and Margaret to help Mother make it through the barren desert that is her social life.

Because Margaret and Marcie do such a great job at keeping Mother supplied with opportunities to be social, Mother was not frightened by the pounding of the road crews, perturbed by the technician rooting around her living room, uncomfortable sitting in a booth at Perry's or unnerved by the presence of three young children, all talking at once, at her dinner table.

Because it is Marcie's vacation,  we are renaming this part of the summer Marcie Sims Appreciation Days. (When Margaret's vacation arrives in late August we will do the same for her.)

This post is a tribute to Marcie, who is on vacation, taking time off from a job well done!

Mother Has Her Children On Her Mind

Dennis was helping Mother dress for bed. This can be a very slow process. He asked her to sit down so he could take her shoes off. She said "I can do that." Dennis said "But isn't it nice to have people do things for you?" She said  "I have children. I hope they know that."

Mother has been talking more than she did, but saying "I have children" twice in a week - after never mentioning us at all - this is new.

Mother Remembers The Important Things

As Marcie was preparing to go on vacation, I said to her, only half joking "Don't worry about us, we'll be OK." She laughed but said she actually had been a little concerned how Mother would cope.

Yesterday was our first Monday without Marcie since February 11, the day she arrived. This morning Mother woke up and came out and asked Dennis "Where's Marcie?"

Mother does not call me by name, or Dennis. The only person she calls by name is Jenna. And now Marcie.

More research results

Here's an article in USA Today which addresses some of the issues which lie at the heart of the research conducted here at the Fremont Street Center for Healthy Aging.

Great Minds, Thinking Alike

A study in Kansas bears out what we have found to be true here at the Fremont Street Center for Healthy Aging.

" They discovered that when nursing aides communicated in a kind of baby talk for seniors - using a high pitched sing song tone, comments like "good girl", diminutives like "honey" and language that assumed a state of dependence "are we ready for our bath?') - Alzheimer's patients were twice as likely to resist their efforts to help.

Patients would turn  or look away, grimace, clench their teeth, groan, grab onto something, cry or say "no" - behaviors that can be read as indications of distress at being patronized or infantilized, said lead researcher Kristine Wiliams, an associate professor at the University of Kansas School of Nursing.

"Communication can really impact care." she said."

The patients actions described above  - turning away, grimacing, groaning, saying "no" - is normal behavior about non-Alzheimers patients ( most of the world) when confronted with rude or unwanted behavior on the part of others. In other words, this is normal behavior, not caused by Alzheimers, but caused by inattentive care.

Another First

Margaret said the other day, while on a walk, Mother suggested that they go to the store and buy a bottle of wine.

A First

Mother invited me to take a walk.  A long walk for her now is around the block.  She likes to walk in the afternoon. Sometimes, if the weather is nice, she and the caregivers take several short walks a day.

I went with her and Marcie around the block. Halfway around the block she said "I have children." I was surprised to hear this, since she used to deny this strenuously. She said "They come over and then there's alot." I said "Your children bring alot of people when they visit?" She said "Yes. They act real nice, then......" and she shrugged. 

"And then they leave?" I asked. "Yes." she said.

Tools for Retooling

If you have been following the Oregonian coverage of the new phenomenon of bike rage, you may need the following recipe to help you reclaim your sense of familiarity with the world.

"Peaceful & Happy Tea

1 tsp. green or jasmine tea

1 tsp. rose petals

1 tsp. rooibos tea

1 tsp. dandelion leaves

1 tsp. lemon balm

1 tsp. chamomile flowers

1 tsp. crushed of sliced fresh ginger

1 tsp.  roasted brown rice and/or borage flowers

( What's a borage flower?)

1/2 cup fresh mint OR 1 tsp. dried peppermint

Add large pinch to 2 cups of just boiled water, and let steep for  2 - 5 minutes. Sweeten with honey and/or ginger candy."

This recipe comes from Sonia Gaemi, aka Dr. Sonia. To my surprise, all of the ingredients are either here in the house or growing in the yard. 

I theorized to Margaret that the easily enraged bikers were non-Oregonians. She theorized back that no, the easily enraged drivers are non-Oregonians. No one knows who all these infuriated people are. 

I am issuing an open invitation to them to come to the Fremont Street Center for Healthy Aging and drink some tea.

Name Game

Margaret told me yesterday that she noticed that Mother calls Jenna by her name. She doesn't do this for anyone else in her life, now that Glen is gone. She calls Dennis "Glen", and once in a while she will use my name correctly to a caregiver, but she doesn't use my name, ever, to me.  

Somehow, Jenna's presence in her life has been longstanding enough so that Mother remembers her by name.

Mother asks the caregiver who I am almost everyday. She always looks baffled when they say "That's your daughter Anne." However, when Joy was over the other day, Mother pointed to her and told Margaret "That's Anne."

Same Time, Same Place

The oncology appointment was brief. They took Mother's blood pressure, weighed her, did a blood draw, and told us that they'd see us next year.

Time Based Nurture

I have been trying to describe the exact model we are testing here at the Fremont Street Center for Healthy Aging. We eat well, get exercise, and try to live balanced lives - all well established avenues to health. But we are doing something else on top of that, and I was trying to figure out what it was. Last Saturday, we had a dinner in the backyard with Jenna and her family, Dennis' sister Debbie and her husband Jim, their daughter Heather and her husband Kyle, and their son Zander. The age range: two 2 year olds and one 80 year old. Four couples, one widow, one caregiver, four children.

This is the model we are testing. Can a person with Alzheimers be incorporated into family life? Can they live at home? Do the benefits of family life outbalance the practical problems/challenges/headaches/  rigors of living with adult who has advancing dementia? 

The ratio of caregivers to patient around that table was 13:1. Thirteen of us did not have Alzheimers. One did. Mother was very comfortable being part of the group. The conversation was free flowing, and Mother participated. At one point she volunteered the information that Marcie, who was sitting next to her, was a very good person and deserved all the best things in life.

Marcie, by the way, agrees with that statement.

Does living with your family confer powerful but invisible benefits similar to the micronutrients found in fresh vegetables which you cannot find in vitamin pills?

Mother was surrounded by relatives in the backyard of her own house. Her birdbath, her mini-trampoline, her raspberry bushes and roses. Was she there as a charity, because she was wearing diapers and being told not to eat toys? Or was she there in the place of honor, since she was giving us this setting. We were there because of Mother. She had planned her life so that this dinner could happen. 

Mother took many steps to plan for her own old age. She did everything right, as far as providing the legal directives, the pension, the health insurance, the home ownership, the well educated offspring, the model of helping others who are helpless ( I saw this up close when she worked with Gill and me to secure Susie's guardianship, something which did not flow out of her natural tendencies or personality traits, but was motivated solely out of concern for Susie) and a entire life of non smoking and non drinking. She did everything possible to care for herself, and she valued her family.

Sitting around the table in her backyard was the result: a micro community which is "healthified" by her (her example, her bookcases, her birdbath) and which "healthifies" her back (by finding the right caregivers, reminding her not to eat toys). 

This is the model the Fremont Street Center for Healthy Aging is experimenting with.  Is it possible that some ways of living together endow health, just as some foods endow health, or certain levels of activity endow health. The intergenerational approach of the Fremont Street Center for Healthy Aging is not exactly new. Why was it discarded? When Bart, who will be three in November, visits Mother, it is super apparent that caring for toddlers and caring for people with dementia is almost exactly the same job. 

Once we get to the bottom of this research question, we will move onto the second topic of interest to Fremont Street research staff. Does Alzheimers, all by itself, cause isolation and emotional distress? Or is it the way people with Alzheimers are treated which causes isolation and emotional distress. 

Oncology Appt

Tomorrow we will be taking Mother to the oncologist.

Multitasking

In one of the rare moments when my professional life and my scientific duties here at the Fremont Street Center for Healthy Aging overlap, I sat down to watch TV with Mother, and Hellboy (the first one) was on. Hellboy was produced by Mike Richardson, who is an Oregonian, so it qualifies as an Oregon film under the expanded definition we are using for the festival.   Once it was on, Mother fell instantly asleep and I began blogging, so it is pretty clear that we are not among the millions who love Hellboy. This still is from the production I am watching. The guy on the right is the director, Mexican cinematic genius du jour, Guillermo del Toro.

The Self Healing Human

Mother's discolored toe is all cleared up. It may be the problem came from Mother adjusting her sandals so tightly that they interfered with circulation. We are going to alter the offending sandal strap(s) so it is not possible for her to do this again. She can tighten them as much as she wishes, but not cause harm.

Mother is in excellent health: more trim and lively, with pink in her cheeks. She accepts her own reliance on the caregivers, Marcie and Margaret, and misses them (asks for them, comments on their absence) when they are not in the house.

 

This Morning, Thinking About Mother

Surprised to see Mother in the basement, Dennis asked Mother why she followed him down. She replied "Just looking for a little kiss". 

The Paul Simon song kept running through my head "....til he cried out/In his anger and his shame/I am leaving, I am leaving/But the fighter still remains".

Safeway Adventure

Marcie & Mother took advantage of the perfect weather to go grocery shopping today at Safeway. They went both there and back on the bus. Mother pushed the shopping cart.  Another example of holistic care - Mother was shopping, something she did every week of her adult life.

American Beauty

Margaret took Mother to the Peninsula Park Rose Garden yesterday. The intense heat wave is over, and the weather is mild so Mother likes being out.

She Does Yoga Too

Here's a link to The Sandwich Generation, a video by a filmmaker and a photojournalist who are caring for a parent with Alzheimers in their home. The Fremont Street Center for Healthy Aging has a more specialized focus than this family had - we are not trying to raise young children and study aging at the same time.

Dr. Report

The report from the visit to Dr. Harbison.

It had been six months since he last saw Mother. He checked her out thoroughly, and was not concerned about the discoloration of her toe. He recommended two things. He said he thought she should stay on the Coumadin, and that we should make an appt with her oncologist because the last time she was seen by that doctor was a year ago.

Mother has no problem going to the doctor. She is comfortable with all stages of the trip - the elevator ride, the hallway trek, waiting for her name to be called, sitting in the exam room. She was able to cooperate with all of Dr. Harbison's requests. Margaret was amazed by how relaxed she was.

Mother always liked Kaiser. She secured lifetime Kaiser coverage for herself (& Glen) when she became a civil servant. She planned to get the quality healthcare she now receives.

The discoloration of her toe seems to be going away. 

Doctor Appt

Mother is experiencing a side effect to one of her medications - her bloodthinner. We were told to keep an eye on her toes and call in if they became discolored. One of her toes has become discolored, and Dr. Harbison is seeing her tomorrow morning at 10:00 AM.

 

Home Base

Mother continues to ask about/refer to Glen. She sometimes calls Dennis "Glen". Besides carrying around playing cards which belonged to Glen, she sometimes carries around one of his harmonicas.

Mother no longer asks to "go home". I was feeling triumphant about this, thinking we could take credit for eliminating this Alzheimers symptom. My theory was that this symptom is not a symptom of Alzheimers cognitive disruption, but a normal, natural problem solving response of a person who feels neglected. So I asked Dennis if he had heard Mother ask to "go home" recently.  He said she asked to go home the other evening while he was watching baseball. She wanted to show him something in another room. He told her to wait until the end of the inning. That's when she wanted to go home.

The Self Healing Table

Three household mysteries I want to share:

1) We have what appears to be a food processor blade ( white plastic, curved) in the kitchen. Did Mother ever have a food processor? I never knew that she did.

2) We have what appears to be a dinosaur bone (round end of a femur bone, possibly) in the front yard. Dennis uncovered it last year when he was turning under the sod. We left it pretty much where he found it (only now it is above ground) , mostly because we don't know what to do with it. It is there among the rocks and plants, glowering with mystery.

3) Mother's dining room table has been returned to health. I never dreamt when I started washing it with Murphy's Oil Soap, and wiping it down with furniture oil, that I would see the transformation which has occurred. Wood must be magic. What was old, rough, bleached, and spotted, is now smooth, dark, and has a uniform glossy finish. 

When I took the one chair into Gerry's Furniture Refinishing to get it re-glued, Gerry remarked that it was an unusual piece of furniture because it was made of soft oak. It does not appear to have been a pricey dining room set. Nevertheless, it has withstood decades of use - Mother is eating today everyday at the table at which she ate everyday as a child.

  

Dennis' Friday AM With The Kids

Sam & Bart came over at 9:30 AM. We hung out in the back yard until 11:30.  I hadn't planned on moving to the front yard, but Bart followed me when I moved some stuff to the garage. We found Jean and Margaret sitting in the porch swing. Bart wanted to sit with them. I collected sam from the back yard. Various combinations of Sam, Bart, Jean and Margaret ensued in the swing. It was nice seeing Sam lay his head in Jean's lap. Around noon Margaret and Jean went inside.We stayed outside. I read them Matthew & Mia.

Dennis

John Roderick, refusing to age in Portland

A wonderful tirade, combining envy with disgust, on the unique charm of the city in which Fremont Street Center for Healthy Aging was developed and continues to operate.

A Choir of Soloists

An impressive round up of blogs about coping with Alzheimers as a caregiver can be found at http://yellowwallpaper.net/

Dancing in gym

The above portrait of the Gower family, painted in the 18th century, offers a great example of a one scientifically proven method of raising brain healthy human beings.  It has been reported in the New England Journal of Medicine  that 

"Among leisure activities, reading, playing board games, playing musical instruments, and dancing were associated with a reduced risk of dementia."

All of these genteel leisure pursuits begin in childhood. We are taught these brain healthy behaviors so that they are second nature to us before we need them.  

What if we never learned them? 

The Grant High School PE curriculum included square dance, fox trot, polka and waltz. We learned them with boys, although ordinarily the gym classes were sex segregated. After the social dancing unit was over, we had a modern dance unit. Everyone in class had to perform, using their own choreography. At the time I was baffled by the idea that I should learn dance from the same person who taught me swimming, track and basketball. 

Now it turns out our gym teacher was forward thinking as a health professional, and completely right.

Doctor Prescribes Yoga

My doctor wrote out a prescription for me  - to help me kick a very long lived cold. She said I would have no success getting rid of the cold until I did more yoga. My yoga teacher Barbara Fergusson will be happy to hear this. Barbara has been refining my understanding of yoga since last fall. She has been working on getting me to be more aware of building strength, as I am good in the flexibility and balance departments. She also has been a great example of how to fit yoga into your life, instead of the other way around.

Jenna and I did swimming yoga today (otherwise known as "swimming") at Matt Dishman Pool. Nancy, Jenna's mother-in-law, is visiting this weekend, and Jenna got a day's break from the kids.