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.