Just like cancer, Alzheimer's must have its denial stage, and he concocted ingenious ways of trying to wallpaper the disease. Prior to a pacemaker surgery the year before he was institutionalized, a nurse entered his hospital room and attempted to analyze his mental state. The battery of questions began simply. "How old are you?" He hesitated for seconds, the murky thoughts churning behind anxious blue eyes before replying, "I was born in 1909." He knew his year of birth, but didn't know the present year, so he couldn't calculate the answer.
Even in the disease's early stages, when patients can communicate their terrors, he kept it all mainly to himself. He was always reluctant to accept medical attention, but while in Rochester to go through the Mayo Clinic he lay in bed one night and told my mother, "I sure hope they can do something about this brain of mine." It is the only time I can remember him conceding that he must defer to others to continue his life. That had to be difficult, because he persevered through everything.
In the 18 years I spent in his home he took two weeks of vacation, walked to his barber shop during bouts of cold and flu on bitter, dark Minnesota winter mornings. He once worked through what was diagnosed as a recurrence of malaria, and refused Novocaine from the dentist.
On frozen winter mornings following even the lightest dusting of snow, I would be awakened by the rasping of the shovel against the sidewalk . By the time I was in high school he added scraping frost from the windows of my car to those pre-dawn chores. He seemed to enjoy work, although he never criticized the lazy. He wasn't much of a complainer through any of the snow or work or illnesses, and he wasn't much of a complainer through Alzheimer's. He essentially slipped away from reality by himself.
A bitter realization
"Sometimes I think I'm going nuts," he said one summer afternoon. in a rare acknowledgement of his condition. The disease had bitten at his mind for two years, and he had to know it was winning. He leaned against my car in our backyard and dragged on a cigarette. The neighbor's dog eavesdropped across the alley, panting heavily in the heat.
"Going nuts isn't so bad, is it?" he invited. I just looked at his smooth skin, marred only by deep creases leading down his nose and past his mouth, where shallow dimples once formed during frequent smiles. The birds chirped, and he looked back at me. " It's hard for everybody else," he continued, "but not for you, because you don't know whether you're coming or going."
I told him he smoked too much.
Before the disease came upon him, life for my father had never seemed complicated. I rarely saw him agitated, he wasn't prone to taking stances during thick barber shop discussions, and he punctuated conversations with jokes in a harmless, self-assured manner. Even when we took him to the veterans' hospital on a bitterly cold, sunny, December day he clung to that sliver of extroverted personality that made him popular.
He couldn't grasp where he was or retain the reason for his visit, he just knew he wasn't at home. Yet as an array of bewildering faces in admissions scribbled on forms, he didn't grumble and feel sorry for himself, he just playfully repeated his unusual first name to the nurses. "I bet you've never heard that name before," he'd tease and smile, as if joking would make it all vanish.
My mother had become overwhelmed caring for him. His appetite was poor, his hygiene had slipped and he was a danger to himself if left alone even for a few minutes. With my sister and me a half-day's drive away, the growing reality of placing him somewhere had arrived. My sister visited several places, all equally bleak. But a neighbor of ours, also an Alzheimer's patient, had lived in a V.A. hospital and his wife reassured us that her husband was always well cared for there. Based on that, and a wish of my father's, the V.A. was where we placed him. My father never gave a reason, but he had once told my mother, "If it ever reaches the point where you can't take care of me, put me in a veterans hospital."