Seattle WA
I’m visiting my son Kai in Seattle. He’s a carpenter and currently building a
basement apartment in his house. While
I’ve been here, we’ve been installing kitchen cabinets together.
IKEA cabinets are, apparently, of good quality and
relatively inexpensive … but you have to assemble and install them
yourself. IKEA sells internationally and
has chosen to obviate the need for translation by creating assembly
instructions comprising only pictures and diagrams, no words at all. The instructions are very clever, walking you
through complicated procedures one small step at a time. They are thorough and accurate, but they are
not simple.
Since Kai’s the carpenter and it’s his kitchen, I’ve
been the assistant, deferring to him in interpreting the diagrams. Yesterday, however, Kai asked me to attach a cabinet
door. The assembly was a little
different from the others we’d done, but not particularly complicated. On my own, however, I was completely
flummoxed. The two of us had previously
put one small part of the drawer together, but I couldn’t even find the place
in the instructions where we’d stopped.
I looked for ten or fifteen minutes and just couldn’t figure out where
to begin. I told Kai, he took over, and
we got the job done.
Afterwards, we watched football together, went for a
long walk and picked up a pizza. On the
way home, I asked him whether he had noticed any impairment in my cognitive
capacities, anything other than my reports of what I was experiencing. He pointed to the difficulties with the IKEA
diagrams. He told me that that’s the
kind of thing you used to do better than I could.
He’s right.
That kind of capacity to translate diagrams and interpret the proper sequence
of steps to complete that task had always been a strength. I’d enjoyed similar tasks and would have
looked forward to it as a challenge, knowing that if I took my time, I’d get it
done. But that’s changed.
Kai and I talked about it later, and he asked if such
impairment is frustrating for me. I
would have thought so, too, but, in fact, it hardly bothers me at all. I’m cognitively impaired, I understand I’ll be
increasingly limited and, importantly for me, that I am not to blame, so it’s
been easy to let it go. I remain
surprised by such equanimity, which had previously not been my forte, to put it
mildly. I’m very grateful.
In diagnosing cognitive impairment, there are several
different domains. Most common in
Alzheimer’s is problems with memory, the so-called “amnestic” type. Non-amnestic symptoms include limited
abilities to make sound decisions, judge the time or sequence of steps needed
to complete a complex task, interact socially, or translate visual cues. In addition to a dominant impairment in
memory, a second, lesser impairment in another of these domains is additional
evidence for Alzheimer’s.
What surprises me is how symptoms can be so
specific. Despite my inability to
assemble the door to the cabinet, I was able to analyze several single-step
problems that initially confused even Kai.
Also surprising is how sporadic symptoms can be. On another day, I could probably have gotten
the cabinet door assembled.
I am, of course, reading your blog through the lens of my own experiences and thoughts. As far as I know, I do not at the present time have Alzheimer's, nor am I caring for someone who does. But I am very encouraged by your equanimity and your positive attitude.
ReplyDeleteToday's blog in particular would be very reassuring to me, were I in your situation. You know you've had some memory problems; you've talked about them before. But then there were those tests that found nothing wrong. The IKEA experience would be, for me, just further confirmation that the original diagnosis is correct, and maybe the tests will catch up eventually or maybe they won't, but this confirmation would be a plus for me.
I admire your honesty and courage in sharing all this with all these anonymous people out here, and I am so grateful to you. I may or may not ever need to know about this, but here you are sharing it, just in case. Thank you! Blessings on you today, and I hope you have a wonderful Thanksgiving!
Yes, in that back-handed way, seeing such clear signs of my impairment is reassuring in that it confirms what otherwise be a somewhat vague sense of diminishment.
DeleteI am following your blog and find all of it very helpful. This help me to see things in different perspectives. We do have a family history of Alzheimer's so I've been looking into all areas of information, other than the Health/pharmaceuticals. Well, something of great interest has come along, which brings to mind the quote "When the student is ready, the teacher will appear." This info is from a renowned neurologist. David Perlmutter, MD, blows the lid off a topic that’s been buried in medical literature for far too long: carbs are destroying your brain. And not just unhealthy carbs, but even healthy ones like whole grains can cause dementia, ADHD, anxiety, chronic headaches, depression, and much more. http://www.drperlmutter.com/about/grain-brain-by-david-perlmutter/
ReplyDeleteDavid--thanks once again for sharing. After losing my own mother to Alzheimer’s, I find myself with a best friend who is losing hers. And I somehow intuitively know it will strike me as well if I live long enough. But suddenly, I barely know how to comfort her...reading your blog has helped in many ways and I certainly hope you can continue as long as you are comfortable writing it. Thanks so much for sharing--Cindy, Monroe, LA
ReplyDeleteDavid, thanks for this wonderful site. I have recently been diagnosed with MCI at the UCSF (University of California San Francisco) whose memory and aging clinic is among the top rated in the world. Although I am only 54 yrs. of age, the symtoms you have described fit to a tee. Additionally, there are episodes of dismissal by othersdue to normal aging. My immedited concern is my wife's outright anger when the subject of MCI comes up. I have been told by applicable professionals that she is just terrified of what the future may hold. My question is should I take UCSF's offer to call her and discuss applicable issues with her to try to alliviate some of the tensnion and fear. It is putting a lot of stress on our marriage.
ReplyDeleteThanks,
Steve.
You're obviously in a very difficult situation. I don't there's any way that I or anyone else not intimately involved can know the emotional realities you're wife is experiencing well enough to answer your question directly.
DeleteOne thing I would be considering is how long your wife has known about the diagnosis. If it's been a relatively short time, her anger may be the only way she knows to deal with her grief. If so, insisting that she "accept" the diagnosis may be counterproductive. After I'd received the diagnosis from my neurologist, Marja was reluctant to accept the diagnosis. After a short time of trying to convince her, however, I just let her go and stopped pressing her, figuring she needed to accept the reality in her own time and on her own terms.
Again, I don't know any of the details, so I may be way off base, but you may want to evaluate your own need to have her accept it. If part of the issue is YOUR need to have her come to terms with it, you might want to talk with a professional, not so much about what to do with your wife but about what to do with your own needs. You can't do much about her role in the conflict; all you can do is to change your role. It might allow you to back off and let her work with it on her own.
Another thing I would consider is whether you think she knows the objective facts. If she is already aware of what the diagnosis is, then it probably won't help to have someone call to tell her again. If it's not INFORMATION that she needs, then she isn't going to be very interested in a conversation with the experts.
On the other hand, if after a longer period of time she doesn't seem
to be making any progress, then someone from the UCSF might call, but I would think it would be best to have someone with real psychological sophistication who doesn't call so much to tell her as to listen to her.
My own opinion is that it's easier for the one who is cognitively impaired than it is for the spouse or children or whoever. At least for the first half of the illness, the caregiver may need more help than the person with the diagnosis. So we with the diagnosis need to be as patient and understanding as we can.
Good luck!