Sometimes old dogs are good sticking with old tricks

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We just returned from a week with my parents in Florida. At 80, they continue to amaze; fully independent, active, and enjoying life. But there are changes. My mom’s ankle is now giving her trouble. She visited a specialist who took one look at her X-ray and solemnly pronounced his best medical opinion: “your ankle is all whacked out.”

My mom and my daughter Sophia

My mom and my daughter Sophia

While steroid shots are helping, she can’t walk as far as she used to, but she has readily adapted, taking sitting breaks during our traditional marathon mother/daughter/granddaughter shopping excursion to Sawgrass Mills mega outlet mall. She was also content to have us rent a “Safari Cycle” during a trip to Zoo Miami and declare “I’m not going to pedal”.

The fam (minus my dad who preferred to walk) in the Safari Cycle at Zoo Miami

The fam (minus my dad who preferred to walk) in the Safari Cycle at Zoo Miami

For my dad’s part, his knees give him trouble, but that didn’t stop him from taking 10-year old Theo to the park every day to play basketball. On one trip, he did “a funny move” and fell like a bug on his back and had some trouble getting up, but some “nice young men” playing in the adjoining court came over and helped him up. He told them he was eighty and “they couldn’t believe it!”; their disbelief made his day.

My dad and his bball buddy Theo (who was mad at my flash)

My dad and his bball buddy Theo (who was mad at my flash)

My folks have a lovely routine: a sunny breakfast; trips to the bookstore for the (multiple) newspapers they read; tandem crossword puzzle solving; going to the pool; and lastly, but most importantly, Publix. My mom has been to every Publix in a 30 mile radius, but her favorite is about 2 miles from their place. She loves the layout and ease. Going to Publix is an occasion. She is now what I call a “European” shopper, getting daily groceries rather than making a weekly trip. There was talk of going to Whole Foods while we visited, but my mom said “I know my limits. I can’t handle that store. I don’t know the layout. It is overwhelming. And let’s not even talk about the parking lot”. I thought that was kind of….”rigid”, but I let it go and off we went to Publix.

After the zoo, I arranged for a lovely dinner at a highly rated Miami restaurant. The scene was gorgeous with an incredible sunset to watch, an attentive server and delicious food.

View from the Miami dinner table

View from the Miami dinner table

My dad however, looked like he smelled something bad. My husband turned to me and said “Your dad is NOT having a good time”. I mentioned this to my mom later (who loved the whole thing) and she said “Dad is most comfortable at the places he knows…knows the people, knows the menu.” Again, my thought bubble said “Rigid?!”.

rigidBack home in Ann Arbor, I mentioned the dinner experience to a colleague also with parents in their 80’s who nodded knowingly: “When we go back home, there are only 2 restaurants we go to–the steak house and Applebee’s. Do I want to go to Applebees? No! But I would rather that than have to deal with my mom’s extreme discomfort at a place she doesn’t know”.

Then I was in the local Whole Foods the other day and got in a very short line with only 2 items. I was in a hurry, needing to get a birthday card for one of my staff and still get to clinic on time. The lady in front of me (about 85 by my guess), wanted a gift card. Seemed simple. Then the employee told her that the gift card itself would cost a dollar because they were donating it to a “good cause”. That triggered a lot of confusion and a 10 minute discussion (my thought bubble “it’s a frigging dollar!…ok, stop that, you are a geriatrician…yes, but I need to get to clinic!!”). Once that was finally resolved, it turned out the lady actually had a little cart full of items that had been hidden in front of her, unloaded. Without a word, she suddenly turned in my direction, practically threw my 2 items off the belt and started unloading hers. While her behavior seemed rude, I deduced that she was simply overwhelmed by the whole gift card debacle. I also changed lines at that point, because like I said, I had to get to clinic. When I left the store, she was still checking out.

I have been mentally trying to jive these personal experiences with my professional work with older adults. We constantly tell older adults to try new things: “Stave off dementia! Learn a new language! Play the clarinet! Take samba lessons!”. But if new things overwhelm and stress the person, could they be defeating the purpose? Stress and anxiety are also not helpful for your brain. Perhaps the message should be try new things in moderation, kind of like the old childhood song “Make new friends and keep the old…one is silver and the other gold”. Routines, like old friends, are comforting and good, and folding in a little, but not an overwhelming amount, of novelty is also good.

 

A lawnmower, an older woman, a Mexican immigrant and the police

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It sounds like the title of a bad joke.  But it’s a real story.

 

My husband and I were walking our dogs in our neighborhood the other day.  “Hey!” Jane* called.  “Do you live in this neighborhood?”  “Yes” my husband said.  Later, he told me that as he said this, he steeled himself for some complaint about our dogs.  My husband and I have 2 adopted shelter dogs, each has their own “special qualities”.  Veritable “bulls in a china shop”, and not welcome at the neighborhood dog party.

Anyway.  Jane approached.  “Ok.  Alejandro* has done jobs for you, right?”  Alejandro is a Mexican immigrant who does the occasional odd job for us and others in the neighborhood.  She continued,  “Alejandro has worked for me for years.  I trusted him.  But he took an old lawnmower from my garage!  Then, he took a vacuum cleaner from my daughter and got rid of it.  I called the police!”

My husband and I didn’t know what to say except that we trust Alejandro implicitly.  He is a wonderful man who has been alone in our house a number of times and has only shown us hard work and a kind disposition.  Jane appeared angry that we didn’t take her story more seriously.  “Don’t say I didn’t warn you!”.

As we walked away, my husband and I felt worried.  About Alejandro: with thoughts about how the police might handle a Mexican immigrant who speaks no English and is accused of “robbery” by an older white woman.  About Jane: Beyond that she speaks no Spanish, and so her communication with Alejandro is largely through hand motions and gestures with lots of room for error, what if this accusation was really a symptom of a failing memory?

But here’s the pleasant twist to the story.  I ran into Alejandro today and told him what Jane had said.  He got a wry smile on his face and said “Todo está bien” (all is fine).  He went on to explain that Jane DID call the police.  One of Jane’s adult children gave him a heads up and Alejandro went to Jane’s house with a friend who spoke English and explained his side of it to the officers (He had used the mower to mow a section of Jane’s lawn that his newer larger mower couldn’t reach. He had returned it.  He had thrown away the vacuum that wasn’t working at the request of one of Jane’s kids when he was cleaning out the garage).  Alejandro said the police were fair and listened to him.  He said that the police told him that Jane’s memory was faulty (in fact, one of her kids was living with her to help out) and that no charges would be filed.  The officers were also compassionate to Jane, treating her with respect despite the fact that they didn’t lend credence to her story.

And here’s the even more pleasant twist to the story.  After we got done talking, Alejandro told me he had just come from Jane’s house having done another odd job.  “Yo la perdono. No es su culpa. Ella está perdiendo su memoria.” (I forgive her. It’s not her fault.  She’s losing her memory).  I was caught off guard.  In these times of divisiveness, it is all too rare for people to forgive, to be tolerant and to love in spite of bad things that happen.

I am thankful for Alejandro and Jane’s story as it gives me hope.

*Name has been changed.

 

Found in Translation

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Hello (or Cheers) from London.  I am here (and in other places in the UK and Ireland) for one month of my 6-month sabbatical.  I am meeting with dementia experts to learn about their research into managing the behavioral symptoms of dementia.  There are many parallels with our work at Michigan into finding ways to better integrate non-pharmacologic treatments and target medications for these symptoms.  I suspect some exciting collaborations to come from these meetings.

But while that is the main part of the experience, there is also the experience of living and working in another country (albeit briefly).  This experience has brought to mind the movie “Lost in Translation” where Bill Murray and Scarlett Johansson roam Tokyo and contemplate their lives in the jet-lag laden fog of operating in another country. While there is no language barrier here in the UK as in the movie, every day is a new experience.

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Going to meet a colleague at a new place (while on one level involves simply going from one place to another in the city) exercises my brain’s executive function with multiple tube/other rail line changes.  It sounds simple, but timing it right, and getting on the right train and right place in the midst of hard-charging crowds can be challenging. Not to mention that I am depending on wifi for internet, so don’t have the crutch of everpresent GPS.  I have definitely had a “lost” feeling a number of times, but the feeling of accomplishment when I get to the right place is pretty nice.

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Since I have been here with my 2 teenage daughters living in an apartment, we have also had occasion to experience grocery shopping and other typical daily living tasks.  While the grocery stores and the foods in them are similar to what we are used to including self-checkout options, they are as a friend of mine put it “just a little bit different”.  For example, I found out the hard way that what looked like a fruit smoothie was in fact a type of cream alternative.  Learning to operate the combo washer/dryer in the apartment has been another growth curve.  After a week, I finally seem to have mastered it.10378277_10152546137543875_8828090909655460246_n

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Despite these minor challenges and the constant stepping out of comfort zones, what is found in translation are so many amazing experiences.  I feel like the ruts of many years of routines have been washed away in such a brief time and it is a great feeling.

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Happy Sweet and Salty Mother’s Day

There’s a lot of sweet (and rightfully so) on my Facebook feed today.  Wonderful and lovely pictures of friends’ moms and friends’ kids.  But this morning, I am feeling a bit “salty” (my favorite new coffee drink from the Songbird café here in Ann Arbor is rosemary sea salt latte—it sounds weird, but the sweet and salty flavor is wonderful and delicious).  And to me, sweet and salty captures being a mom.

Take the picture below.  Last night, I arrived home late from being at my oldest child’s crew regatta in Columbus on Friday and most of Saturday.  There was a Bath and Body Works store across from my hotel in Ohio and I picked up LOTS of hand soap (typical mom multi-tasking).  When I got home, I asked Sophia, my middle child, to put the soap in the kids’ bathroom.  This picture represents her interpretation of that request.  Salty.

Sophia's interpretation of "put these in the bathroom"

Sophia’s interpretation of “put these in the bathroom”

I am reading cartoonist Roz Chast’s hilarious and poignant  graphic memoir “Can We Talk about Something More Pleasant?” about dealing with her parents’ old age.  In depicting her parents, she certainly does not have rose-colored glasses, and shows them warts and all.  The reader gains an understanding of their personalities and how they got to be who they are.  Her mom, a retired assistant principal, tended to anger when challenged and described this as giving people “blasts from Chast”.  While it is clear that her daughter experienced this as upsetting, she is able to add humor to her perspective and has an understanding of her mother that is lovely, albeit painful.

With my family, I too possess what has charitably been called a “Mediterranean temper” (and less charitably, “being a jerk”).  I have worked on it over the years, but my children have received many “Blasts from Kales” particularly in response to “Insubordination from Kids” (see above picture).  On reflection, the blasts are not that effective, and over time, I have tried to change my ways (we’ll see how that gets depicted when they write their own graphic memoirs, likely pretty salty).

My own mom is uber-patient, kind and always there to listen (sweet).  She is a hard act to follow. However, HER mom was pretty salty.  She was one of many children born to a farm family in North Dakota and didn’t receive much attention or love her way.  When she became a mom, that got played out.  Although my grandmother could be hilarious, fun and witty, she could also change on a dime and go to bed in a huff.  Interestingly, my mom describes some of her best times with her mom (who had developed Alzheimers’) as occurring after my grandmother was placed in a Catholic nursing home in Minnesota.  Somehow my grandmother’s love for my mom was loosened and she could express it more easily.  However, she was still WAY salty: one of my mom’s favorite last memories of her mom was when a music therapist was leading the elders at the home in a rendition of “If You’re Happy and You Know It”.  My grandmother’s response?  “Shaaaad-up!!”.  It makes us laugh to this day.

And being able to laugh helps you to accept the salty with the sweet.  Happy Mother’s Day!

The Power of Being Heard

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The other day my daughter Tasia was telling me about some things going on with friends in high school that were troubling her.  I listened briefly and then immediately jumped into “problem-solving” mode.  She stopped me short, “Mom, I don’t want you to solve this for me…I just want you to listen and nod your head.”  I laughed and made some exaggerated head nods and she replied “Yes!  Just keep doing that!”.

 

The next day with my own mom,  I was telling her about an issue going on at work that was bothering me.  She listened briefly and then immediately jumped into “problem-solving” mode (Apparently the apple didn’t fall from the tree!).  I felt irritation and realized this was how Tasia must have felt–  I had actually already mostly worked out how I was going to deal with the issue but just wanted to tell my mom about it.  I wanted to be heard.  Tasia wanted to be heard.  I related all of this to my mom and we talked about how the process of “being heard” is therapeutic.

 

The following day, I found myself in clinic with a patient.  She is a very sweet woman in her 80’s who is experiencing difficulties with her husband.  You see, he has dementia.  But that is not the hardest part.  Her husband had been a domineering person before developing dementia, and now with the illness has tried to deny any problems with his function.  Her children have entered the picture in a good way to help with bill paying (he was paying the wrong amounts) and transportation (he was getting lost and insisted he should keep driving).  So, in essence, she did not need me to solve any problems for her.  But, she wanted to be heard, and even complain about him.  She loves him but his behavior has been difficult, and sometimes she feels very disgusted with him.  She knows these behaviors are part of his illness, but used to feel guilty for even voicing her “bad feelings”.  Admitting this out loud was progress for her.  It occurred to me that creating the space where she is able to express herself and say “bad thoughts” aloud has enabled her to return to the situation with more peace about it.  When she left the appointment, she gave me a big hug and said she was going to miss seeing me while I was on sabbatical.

 

And to think, all I did was listen.

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