ageing – The Octogenarian

S1E6. Did I Do That?

Instead of electric blankets, we have electric sheets. If you’ve never tried them, please do! One of the highlights of our day is getting in bed at night, just to feel that head-to-toe warmth. Sally and I both squeal with pleasure!

But in order to make sure our bed is toasty warm at 11pm, I go upstairs and turn on both sides of the dual-controlled sheets at 6pm.

(No…that is NOT where I’m going with this. I NEVER forget to turn on the sheets and I don’t need any reminders or accommodations to make certain I do. Clearly, memory is fine when one is highly motivated!)

So each night at 6pm, I walk up the stairs to our bedroom, turn on the sheets on her side of the bed, place her nightshirt under the covers so it will be toasty warm when she puts it on, and then place 2 pillows on top of the covers to weigh them down so they have contact with the sheets.

Then I walk around to my side of the bed and do the same (except I don’t have a nightshirt).

I am about to leave the bedroom when I stop in my tracks. Did I turn on the sheets on my side? I can see the pillows on top of the bed, but from where I stand, I can’t see the control. I have no memory of turning the sheet on. So I go back and check.

It’s on.

I check the control on Sally’s side–just to make sure–and it’s on, as well.

I wouldn’t be writing about this event now if it were not for the fact that the same thing happened the next night, and the night after, too. With the same result each night: I had turned my sheet on, but had no clear memory of it.

This was very different from the experience I described in my second blog entry (https://mistakesonthejourneytonowhere.com/2020/12/12/peek-a-boo/) where I forgot what I intended to do on the way to doing it. Forgetting that I did something after I had already done it, though, was an error of a different magnitude.

There are many aspects of daily life for which we don’t create episodic memories. Things that are rote, routine, automatic, done without thinking and/or repetitive are not worthy of space in our memory bank. Memory is for experiences that are unique, special, emotional, important and/or worthy in one way or another.

I decided to make this activity important to see if that would make a difference. Instead of automatically going through my routine (and allowing my mind to wander where it would while I turned on the sheets), I made a special effort to stay in the moment. When I clicked on the sheet on my side of the bed, I looked at the control. It registered an ‘8’ on its digital display. There was one red light to the left and 3 red lights to the right.

When I walked out of the room, there was no doubt in my mind that I had turned on the sheet. The image of the digital display was clear and vivid.

So, too, the next night and the night after and the night after that.

. . .

A week later, I had cataract surgery which requires using eyedrops for several days during the recovery period. Sally was my nurse, administering the drops 3 times daily. But one day, she wasn’t available and so I did it myself.

And an hour later, I wasn’t sure that I had…

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S1E5. Testy & Edgy

“Do you remember that I have a ZOOM session with my sisters this afternoon?”

It was a simple question and a fair one that Sally asked. She uses my ZOOM account and I have to start the session before making her the host. I do it all the time. So why did I resent her question?

“Noooo,” I replied with attitude, “I haven’t checked today’s calendar yet.”

She picked up on my tone and shot back, “Aren’t we testy and edgy today!’

Why did I snap at her like that? The therapist in me knows that emotions are triggered by underlying beliefs, so I knew I needed to think through what it was about her question that triggered me.

As I explored my thoughts, I realized that I felt as if I was under attack, as if Sally was questioning my ability to remember and not just my memory of this one specific event. Was she keeping an eye on me? testing me for signs of decline?

Sally has volunteered with hospice since her 20s and she truly is a comfort to those with whom she works and their families. She’s familiar with reminiscence therapy and she knows how to help dementia patients stay in touch with their memories, even as they fade.

Is that what she was doing with me? She loves to ask me about my life before we got back together 9 years ago after not seeing each other for 41 years. She is fascinated by the details…most of which I can’t remember. I often get frustrated when I can’t answer her questions.

The more I reflected, the more I came to wonder if her questions were also part of her concern for my mental status…and the more I resented her for it.

So after apologizing for my testy & edgy retort, I told her what was going through my mind. She reassured me that I couldn’t be more wrong and I immediately felt silly for thinking those things of her. But since I knew it was still a trigger, I asked her to try not to start conversations with: “Do you remember…” She was more than happy to do that for me. I felt a lot better.

This conversation unfolded several weeks before I made the decision to start this blog. I was already monitoring myself and thinking about writing it all down, so I was sensitive to the topic of dementia. I hadn’t yet told Sally about it, so she didn’t have a clue when she inadvertently stumbled across it.

So, as usual, there’s good news and bad news here.

The good news is that I was aware of my feelings, was able to think it through, and then talk with Sally about it to allay my fears and work up an accommodation. That was nice work for me as an individual and for us as a couple.

The bad news is that my mind wandered down this dark path. There is a word for when you suspect people of having ill intentions towards you when they, in fact, do not: paranoia.

It pains me to admit that paranoia describes what happened. After all, I’m probably the #1 fan (with Sally a close #2) for #TeamNormalAging. The episode was brief and easily resolved, but an episode nonetheless. I’ll have to keep an eye out going forward.

Sorry to leave you on a down note, but I promised to follow the road wherever it leads…

S1E4. Mistakes on the Journey

Making morning love. Delightful. Surprising. With a different kind of awe and sense of discovery we experience now as lovers pushing 70 than we would have felt at 17, but awe and discovery, just the same.

A beautiful way to begin the day, yes? Making mistakes was the furthest thing from my mind, but it wouldn’t be long before I committed my first.

I got out of bed and went downstairs to the kitchen to take my medicine. I had the two pills in my hand en route to getting water when I picked up a scrap of plastic left overnight on the counter. I pulled out the garbage can to deposit the scrap and dropped the pills in, too.

See what I mean?

Or the check I put in an envelope without signing it first. Fortunately, I caught it before I sealed, stamped and mailed it. No harm; no foul. But the fact remains, I did it.

I was looking for the keys to Sally’s car on our key hook near the kitchen door. The keys to my car were on top, and so I removed them. When I lifted her keys off the hook, I saw that there was yet a third set of keys that remained. I asked her if that was also for her car. She correctly identified them as the 2nd set of keys for my car. When I looked a second time, I saw she was right.

Sally corrects me as I am telling a story because I said ‘wedding’ when I mean to say ‘funeral.’

And here’s one that we all know all too well: the word you want is on the tip of your tongue, but you can’t find it. Your listener is kind enough to provide it for you.

The mistakes are becoming more frequent. I monitor them.

The good news is that I catch a lot of my mistakes as soon as they happen…or, at least, I catch the ones I catch. (Obviously, I can’t catch the errors I don’t know I make–unless Sally flags them for me–and there is no way to tell how many of them there are.)

Making errors, though, is not really a problem. When they happen more frequently, it is a sign of subtle changes in mental status, but that might very well be normal aging.

It’s only a problem when the errors become so severe that they get in the way of your successfully completing your daily activities. Or when you become so upset about the errors (or being corrected by friends and loved ones) that you lash out at them. Or when you start to make up stories to convince yourself and others that you didn’t really make the error, or that it was someone else’s fault.

In clinical terms, mental mistakes are diagnostic of dementia if (1) they represent a substantial decline in your previous level of functioning, (2) what you are experiencing places you significantly below average for your age and education level, and (3) the mistakes are causing problems in your life.

So here I am, 17 days short of my 70th birthday. I’m still hitting pretty much on all cylinders. After all, I’m writing this and making edits as I go. And I’m paying bills. And I’m taking my medicine. And I make love in the morning. And I’m aware of errors I’m making and correct them when I can.

In the great scheme of things, I’ll take that as a win.

S1E2. Short-Term Memory Peek-A-Boo

I’m sitting on the couch in the corner of the living room, the lamp beside me illuminating a jumble of flotsam on the end table below it: my wallet, scratch pad and pen, small spray bottle of eyeglass cleaner and cloth, a bag of almonds, assorted business cards, 3 tv/vcr remotes. As I compose an email, it occurs to me that I’ve been putting off the trip to the grocery store. I click ‘send,’ set the computer aside, and get up to check the refrigerator to see what we need.

I pause in front of Sally’s recliner to ask if she wants anything from the kitchen. She pauses a guided tour from the Barnes Museum, removes one earbud, asks me to repeat the question, and then tells me, ‘Thank you, but no.’

As I pass through the dining room, I notice she’s printed something that is still lying in the tray. I make a note to myself to bring it to her when I return.

I flick on the kitchen light and stop. The question forms itself quickly: Why did I come in here?

—————

Memory. The Big Kahuna. Everyone’s worst nightmare because memory failure is an essential feature of all forms of dementia. It’s the group of errors to which we all pay exquisite attention. Not a day passes on social media when there isn’t a meme referencing the experience of going into a room and forgetting why you went there.

Sound familiar? It’s probably been happening since we were 40, but the increase in frequency draws our attention to it as we get older. You don’t need fancy neuropsychological tests to identify it. It’s just there…and becoming more commonplace…and so we worry…and the memes help us laugh about it and not feel so alone…and then we learn it’s part of normal aging and might not mean anything more…but we still worry.

At least I do…or did.

A little over a year ago, I noticed that when I had these episodes, what I had forgotten would come back to me a few minutes later when I was thinking about something else. It was a comforting to know that the thought wasn’t completely gone…I just hadn’t been able to hold it online in current, short-term memory. It was still there in intermediate memory and I was still able to access it and, more importantly, go do what I had originally set out to do.

(Before going any further, and in the interest of full disclosure, I should tell you that I am not a neuropsychologist, but I did take 2 graduate courses and 3 practicums in neuropsychology en route to my doctorate in Clinical Psychology. Which means I have a sense of what dementia looks like and have some understanding of the basic principles of brain function. Please take what I say with a grain of salt because although I haven’t kept up with the literature, I’m not one to shy away from offering theories, observations and conjectures for discussion!)

It occurred to me that perhaps a circuit here and there had shorted out and that was what was causing periodic breakdowns in my ability to hold something in mind for 30 seconds if I wasn’t actively trying to remember it (e.g., by repeating ‘Check to see if we’re out of milk…Check to see if we’re out of milk’ over and over again as I walked to the refrigerator). If so, then maybe I could grow new connections (brain cells are very good at that!) to provide an alternate pathway around the short circuited area.

The next time it happened, then, instead of giving up and walking away, I stayed right where I was and consciously tried to recall my purpose.

It was work. It was effortful. It was successful!

Over the next few weeks, I discovered that I could reclaim the memory in 15-20 seconds. And it seemed that the more I did this, the more easily I could expose the lost trace the next time it happened.

I don’t worry too much about that kind of error anymore. It still happens, of course, but I don’t worry about it or get frustrated when it does. I know it will pass momentarily.

Now I have a new worry. It’s the same kind of thing, but it happens more quickly, within just a couple of seconds.

After looking up an email address to send to someone else, I forget the extension before I finish typing it. Was it ‘@yahoo.com or @comcast.net?’

I can’t keep an entire 10-digit phone number in my head while dialing.

While surfing the net, I get the idea to open a new tab and check out another website, but by the time I open the tab, I’ve forgotten where it was I wanted to go. I end up staring at an empty address bar until I can reclaim my intention from its hiding place just outside of awareness.

So that’s the bad news. The good news is that I’ve come up with accommodations. I copy and paste the email address instead of trying to remember it; I’ll focus on the last 7 numbers because I can quickly press the area code numbers without having to memorize them; I force myself to open the new tab and go to the target site as soon as the idea appears instead of waiting until I’ve finished reading the article that triggered the idea in the first place.

The really good news here is not that I can complete my phone call, etcetera, but that (1) I am aware that I am having the problem, (2) I can problem-solve to find an accommodation, and (3) I use the accommodation going forward. Those are all examples of what’s known as ‘executive function’ and as long as you have that working for you, you’re in relatively good shape. With a modicum of thought and effort, you’ll find your own accommodations, too, and that’s one of the keys to aging successfully.

So that’s where I find myself today: In relatively good shape and playing peek-a-boo with my thoughts.

S1E1. Happy Box

I’ve been hauling it from place to place for nearly fifty years, dating back to when you could mail a first-class letter for six cents. Never had time to spend quality time with it before. It always sat in a corner or in the attic or was relegated to the basement, a labelled box, usually re-discovered whenever it came time to move to another house. Never considered throwing it out and always thought I’d get around to looking at what was inside someday.

I’ll turn 70 next month. Someday is now.

We are preparing for the next downsizing move, so we need to slough off some of the skins of our former lives that we’ve been carrying with us. It’s hard to let go of these things. They are part of us, even if we never use them for their intended use again. Like the vinyl LPs in original dust jackets. More than 100 of them. How do you say good-bye to yourself?

Old pictures, wedding invitations, mementos from the places I’ve worked, resumes and letters of recommendation, newspaper articles, my term papers from Brown, transcripts and diplomas, birthday and anniversary cards from my first wife of 36 years along with all the cards and photos from our wedding, condolence cards upon the deaths of my mother and father, programs for sports events, from a racetrack in Mexico City, to the 1996 Olympic Games in Atlanta to the 1999 NCAA Mens Basketball Championship in Tampa, letters from old friends, some passed away, others passed from recent memory.

I know why I saved some of these things, yet others astonish me. Why? What was I thinking? What would have convinced me that this item met the high standard for preservation in my Happy Box?

I’m savoring every discovery, like the courses at a tasting menu at the table of a gourmet chef. So unexpected, the feelings and memories ferreted out and released. So warm and wonderful…I’m all aglow!

I share important finds with Sally. It helps her get to know who I was during the 41-year hiatus when we disappeared from each others’ lives. She’s heard me tell the stories, but now there is evidence she can hold in her hand, and imagine herself to be a fly on the wall in the rooms where it happened. It’s nice to be able to share myself with her at this deeper level of intimacy.

This is the moment my Happy Box was waiting for. It did a great job. I know I’ll look back at these few days fondly and cherish the moments when I was surrounded on my couch by all those I loved and who loved me throughout my life.

But my work is not done. I’m also performing a triage to determine which of these memories will move on with me.

It’s not just about reducing the volume of what we carry to our next home. It’s also about doing a favor for whoever will clean up after us when we die. We’ve both been the ones to do it for others, sifting through dusty attics and deciding what might be meaningful to pass on to relatives and what needs to be thrown out. So we’re taking the time now to do it ourselves so as not to burden the sister, niece or great-nephew who will draw this assignment.

And it’s about one more thing, too: creating the Happy Box that we and our caregivers will use to help us reminisce as we near the end of our journey to nowhere.