Wednesday, November 30, 2016

Some Hope for the Future

Jim and I are in the process of changing our health care provider to a local gerontologist. Jim has been followed by the same doctor for more than 35 years. The doctor is in his early 70's, and I'm guessing close to retirement. My personal physician was actually part of the same medical group as the gerontologist, so the transition for me was easy. All my records were accessible electronically, and I was able to get a "new patient" appointment fairly quickly.

For Jim, because his transfer of care is coming from a different medical group, it is taking much longer to get him in to be seen. It just was not possible for this to be done before we leave for 3 months. Jim has one more appointment with his physician in a couple of weeks, and then when we return in early April he will transition to the care of the gerontologist.

At first it bothered me that I couldn't get Jim transferred before we left. But I'm realizing that it really works out better this way. Jim is easily upset and anxious by any changes. To start a formal geriatric evaluation with a new doctor, just before leaving for 3 months just didn't make sense. Especially since I anticipate testing, evaluation and likely new medications. All of this will be much easier to handle once we are back home; not under the pressure of the holidays and preparing to leave for FL.

I had my initial "new patient" evaluation with Dr. S. I love her! She is just as I remember her from about 10 years ago when she evaluated my dad and diagnosed him with Lewy Body Dementia. She said she remembered me, which surprised me too.

She is clinically very smart. And, she has the BEST bedside manner. So kind, thoughtful and patient. I am fortunate to have very good health. Because I have no acute health issues, the majority of my appointment I spent talking to her about Jim. It was a wonderful opportunity to set the stage and pave the way for his first meeting with her.

She will be evaluating him over two separate appointments. Blood work, imaging etc will be done. She expressed great sensitivity regarding the fact that Jim does not recognize that he has any limitations.

I cried on my drive home. They were tears of relief and hope. Relief that I was finally able to talk to Jim's (future) doctor about my concerns. And now I have hope that there will be some help for Jim and the challenges he will face during this next stage of his life.

Our Thanksgiving day went reasonably well. We enjoyed spending time with family. The next day, Jim asked me "When is Thanksgiving?" I gently reminded him that yesterday was thanksgiving and then gave him some details of the day. His reply: "Oh, yeah". What still surprises me is that this lapse in memory does not bother him at all. But that is a good thing, I think. Better for him to be oblivious about it as opposed to upset, depressed that he can't remember.

I've written before about how difficult it has been for me to leave the house without Jim. It's a combination of him wanting to be with me, and Jim feeling anxious if he is home alone. The detailed notes I leave help, but it still bothers him. Thursdays are especially problematic, as my mom needs my help for groceries, errands etc.

I'm thinking about hiring someone to spend time with Jim. I have a couple of guys in mind. One is the son of a friend of mine whom I could hire under the guise of helping with yard work etc. Jim could "supervise". The other guy is a good friend of Jim's. I could hire him to come over to hang out, or even to go out to lunch. I'll likely start this in April after we return home. This would provide me a couple of times a week when I could get out of the house without worry. It would free me for support group, helping my mom etc.

Well, thanks for stopping by. It always feels so good to put my thoughts into words. As always, thanks for listening.

Saturday, November 19, 2016

What I Didn't Know

I'm still learning. I wish I knew everything there is to know about dementia and cognitive impairment, but of course I don't. I am grateful that I approach this journey with an open heart and an open mind. I truly believe that it is the only way that I can be of help to Jim as we travel this dementia road together.

Jim has been going to the same dentist for many years. The dental practice was about a 40 minute drive from our home. In addition, Jim was becoming less happy with the practice. I don't know the basis for his dissatisfaction, as he had a hard time clearly articulating his concerns. He drove to his last appointment 6 months ago.

Given the issues with driving and his increasing unhappiness with his dentist, I suggested he switch to my dentist. Much closer, and her practice is great. She specializes in gentle dentistry. The appointment was made. I called ahead of time to make certain that the dentist, hygienist, and office staff knew about Jim's dementia. I thanked them ahead of time for their patience and understanding.

Jim takes very good care of his teeth. We didn't expect much at the appointment, other than some x-rays that were due, routine cleaning, and check up by the dentist. Jim asked me to come into the exam room with him, which I was glad to do.

It was just short of a disaster.

The x-rays were "painful" (his word) as he held the x-ray apparatus in his mouth. The cleaning caused additional pain for him, and he was quite vocal about it. I felt bad for the hygienist. She was on pins and needles from the moment Jim started insulting her. This of course made it worse, as her hands were shaking and she was having difficulty manipulating her instruments because of her nervousness.

Jim called for her to be fired. He complained loudly to everyone who could hear about how she hurt him badly. Once home, he insisted that I call the office and demand our money back. And, he started talking about a lawsuit against the hygienist! Oh my.

I fibbed, and told him that we were reimbursed for the cost of the visit. Regarding the lawsuit, I started talking about the thousands of dollars we would need to pay, for a lawsuit with an uncertain outcome. He let that drop. But he was still so angry about the hygienist. I appeased him by telling him that I was certain she would be fired.

I know that sounds crazy, but what else could I do? My goal became one of helping him to get to a place of calm. We're still not there yet, but it's better.

Here's what I didn't know: dementia alters a persons perception of pain. They experience pain at a higher level than those without dementia. MRI's have verified this with areas of the brain that light up when someone experiences pain. The research showed that someone with dementia is much more sensitive to painful stimuli. You can check out a very interesting article from Science Daily here.

If I had known this, I would have asked for pre-treatment pain medication. He somehow made it through the appointment, albeit very unhappy and pretty angry. His teeth are perfect, and he needs no additional work, thank goodness.

And it's not over yet. Apparently the hygienist slightly nicked an area close to the gum line. I'm guessing it occurred when he was moving around in the chair, combined with her shaking hands. He complained mightily for 2 days. I honestly couldn't see it. I called the office and arranged for the dentist to look at it. She showed me with the magnified mirror the tiny nick that was causing him so much pain. She compared it to a nick you might get from a sharp potato chip. She reassured him, advised tylenol, bland diet and warm salt water rinses for the next few days. Every day, he has me look in his mouth to check on the progress, and this of course triggers another rant about the hygienist.

There was a silver lining in this experience. The dentist and all of her staff were wonderful. I was of course mortified at the cruel things he was saying to the hygienist. But in spite of his melt down, everyone treated him with the utmost kindness and respect. I will always remember and be grateful for that. I have written a thank you note to the staff that will go out in tomorrow's mail.

The other day I had my own doctor's appointment. It was for 3:30 in the afternoon. I did my usual note, stating where I was, when I would be home, and wrote down my cell number for him to call if he needed me. It is now getting dark here pretty early. I actually got home at 4:50 (10 minutes earlier than I wrote on the note). He was pacing and a nervous wreck.

"It's dark out! Something could have happened! I almost called the police!"

To his credit, he did call my cell phone, but I did not hear it! It was in my purse, and there must have been competing noise that prevented me from hearing it.

So, it has been a rough week for Jim. But it has been a week of learning for me, and for that I am grateful. The last couple of years his response to minor discomfort has always seemed overblown to me. I guess I just chalked it up to a psychological exaggeration, perhaps fueled by anxiety. And maybe anxiety is a part of it, but now I know that the pain is real and is experienced at a higher level for Jim, than it would for me.

I did not make it to the support group this week. After the rough week for Jim, I just didn't dare leave him again, especially since it was an evening group. I don't know what I am going to do about that, but I will figure it out.

On the lighter side, I was experiencing a very strong hot flash (yes, still having them after all these years!) and I told Jim I was going to step outside to cool off for a couple of minutes. Next thing I know, he opens the door

"Are you all right??!!"

"Yes, I'll be back inside in another 2 or 3 minutes, once this hot flash passes."

This gets repeated at least 3 more times in the time span of less than 2 minutes. Next thing I know, he has joined me outside with his down jacket on and says "I thought I would keep you company."

Kind of like the young mom who locks herself in the bathroom for 5 minutes, just to have her toddlers banging on the door for her :-)

Well, another challenging week has passed. I'm learning! And I like that. One of the more interesting observations that I had with the dental experience is that while I was embarrassed for the cruel things he said, the other (stronger) emotion I experienced was compassion for Jim in his very real struggle to get through what was a very difficult experience for him. Another step forward in my transition as a caregiver. For that I am grateful.

Once again, thank you dear readers for stopping by. You are all such great listeners, and I am grateful for each one of you.

Saturday, November 12, 2016

No Days Off for Dementia

Every day. Yes, it is every day. Dementia does not offer any days off. Not for Jim, and not for me. But, I feel like I am emotionally starting the transition that will help me to find peace and contentment with this altered life of ours.

One of my fellow dementia bloggers and I have been corresponding a bit my email. She has been "in the game" for a longer period of time than I have been. Her gracious and helpful emails have just been a breath of fresh air for me.  She observed  that once she accepted that caregiving is her life, things started to flow a little easier. This, as opposed to trying to maintain what was a "normal" life, and working in the caregiving around life as she knew it.

So there you have it. Sounds simple enough, but I know that this transition is psychological and emotional. It is a journey that every caregiver must go through. I've been doing a lot of reading lately related to dementia caregiving. As I read about others' experiences it helps me. It helps me feel less alone, it gives me hope that I can do this, and it gives me some guidance for this journey.

Jim has some compulsions that are difficult for both of us. It causes him anxiety, and in turn causes me anxiety as I try so hard to make things right. He is very compulsive about clothing. He always was a very snappy dresser. With the progression of his dementia, this has turned into an obsession over the minutiae of his clothing articles. Almost every day, we are headed to one store or another in search of t-shirts, blue jeans, socks, long sleeve shirts, the list goes on. NONE are acceptable. He will focus on imperceptible  imperfections, as he sees them, and then rules out any purchases. He gets so frustrated.

I feel so sorry for him. I can't imagine how hard this must be for him. I'm getting better at just saying  "let's go look in another store". At least it gives him a purpose, and something to do. And, it works much better than trying to talk him into buying something that he sees as imperfect. That just doesn't work, and makes him even more frustrated. When he sees the gerontologist I will make sure she is aware of this issue. A little medication to ease his anxiety would likely help a lot.

I recently discovered some new local resources through our county's Office of Aging. They operate separately from the Alzheimers Association. They offer courses, classes, consultations, and resources for the caregiver. In addition, I discovered a support group that is even closer to my home, with meetings every other Thursday. I'm looking forward to attending this support group. It is getting harder for me to leave Jim alone, even with all my reassuring notes I leave him when I have to leave. So I'm grateful to have a group so close to my home. Hopefully it is a good fit for me.

I drove him to his haircut appointment yesterday. It was interesting to me that as we travelled along the highway, he was uncertain which exit he should take. This is after many, many years of driving here to get his haircut. It just reinforces the decision I made that I need to be doing all the driving.

Holidays will look different this year. Usually family (30+) gathers at our house. This year, Jim and I, my disabled brother, and my brother whom I am very close to, and his family will take a Wegmans prepared T'giving dinner to my mom's. There will be 8 of us. Disposable dinnerware makes clean up very easy. I am so relieved to not have to think about a huge party at our house!

Today we went to Home Depot and purchased a very cute artificial Christmas tree that is is only 4 1/2 feet tall. I can carry it by myself up and down from the basement. The last couple of years we have struggled to get our 7 1/2 foot tree up and down the stairs. Last year was very shaky. Jim has definitely lost some of his dexterity and balance.

Downsizing holidays, a smaller Christmas tree, these are all signs of my transition to accepting that caregiving is my life. I'll continue to hope, plan and strive for the grace and understanding that comes with thoughtful caregiving.

Another post has been written, and as always, I find it therapeutic to be able to share my thoughts with my dear readers. So thanks for stopping by, for listening and for caring. And until next time....

Saturday, November 5, 2016

"I've Never Done Such a Thing Before!"

Boy, sometimes this is really hard.

Most of it is pretty manageable. The repetitive questions, the loss of words, the forgetfulness, the loss of  skills and ability to do things, having to go to places I dislike (the mall! for fear he would drive if I didn't go with him), the confusion with any slight change in plans; all of these can be a little irritating at times or even frustrating for me. But it really is no big deal.

It is easy to hide my inner annoyance and still be able to help/direct/answer for the 50th time. And, do it in a way that I am smiling and portraying a happiness that I can help him. Which I am!

But there is sadness, because it represents new losses every week, sometimes every day.  And it won't get better, only worse. It helps me immensely when I remain cognizant of the fact that Jim is the one who is losing his abilities to function, not me. He drew the short straw, and I lucked out by still having all of my cognitive abilities.

The times that are the hardest for me are when he becomes angry at me. I am getting better at predicting and avoiding situations that cause his anger, but not always.

One of the things that can change with the progression of dementia is taste. This excellent post by Elaine Eshbaugh, PhD, tipped me off to why Jim has experienced these changes. I used to love to cook. I would enjoy creating a nice meal to share with family/friends. But quite some time ago this love of cooking waned. As I look back, it started with Jim finding fault with meals I would prepare. Things he used to enjoy, he suddenly expressed dissatisfaction with the food I had prepared. Talk about putting a damper on wanting to cook!

As I look back, this was probably one of the earliest signs of change in Jim. We are now down to about less than 10 entrees that he finds acceptable for dinner. It's pretty boring at our house at dinner time! Lunch is even harder. He used to love certain items, but now can't stand them. The latest thing that kept him happy at lunch time was prepared chicken salad from the deli. Nice and easy!

That is, until yesterday. Now he hates the chicken salad, claiming it tastes different. He was obviously frustrated and angry, and I was the object of his emotional upset.

Jim: "I'm sick of not having any food in the house that I can eat!"

Me: "Oh, that must be frustrating for you..." (he interrupted me)

Jim: "Don't give me that! Do something about it!"

Me: "Let's go to the store to see if we can find something that looks good to you."

He was angry, but he agreed. We got in the store and he is stomping around, saying harsh, sarcastic rude things, and very negative at any of my suggestions. At this point the tears started to flow. I just couldn't help myself. I was so hurt, crushed, and frustrated. And feeling very helpless. How do I fix this? I just can't.

We managed to make it out of the store and went home. I don't cry often (although more so lately), and it really made Jim feel bad. So at some level he knew that he was being a jerk. He apologized, and of course I accepted.

Jim: "I've never done anything like this before! I never yell at you, I just wouldn't do that! Please forgive me. I'll never do it again, I'm so sorry."

He really has no memory of other times that he has been mean to me and brought me to tears. Damn this dementia.

The other stuff is easy. This personality and behavior change is not. So, what am I going to do? Well, Jim's health care is in the process of being transferred to a gerontologist. Unfortunately this will not take place until we return in April from FL. She has a busy practice and he is on the waiting list. It will happen, just not as soon as I would like. I've asked to be called in case there is a cancellation that would get us in sooner. My hope and expectation is that she will prescribe something that will help Jim deal with his anxiety.

There are a few different support groups in the area. The one that I think I can go to is the third Tuesday of the month at 5:30 (uh-oh, dinner time!). So I am committing to go to this at least once, to see if it is a good fit for me. If not, there are others. It is getting harder and harder to leave the house by myself. Jim ALWAYS wants to go with me. And if I do leave him home alone, he easily develops anxiety until I get home. But I know that if I can't take care of myself, I won't be in any shape to help Jim.

On a totally different note, I'll be so glad when the election is over! And not just because I am tired of the negativity, but because I will no longer be asked "Are we supposed to vote today?" I'm smiling as I type this.

So once again I must thank my dear readers for listening. How did we find each other? I'm not sure, but it means a lot to me to know that these kind, caring readers are listening. Until next time...

Saturday, October 29, 2016

What A Difference A Year Makes

It's been an emotional rollercoaster over the last couple of weeks, as I think about and plan for our future. Recently I had a meeting with our finance guy and an attorney who specializes in elder law. It has forced me to think about the inevitable future of providing care for Jim. I like to think that I can do this at home. At times I feel very brave and confident in my abilities to do so. Other times, not so much.

I spent much of Thursday with my elderly mom, getting groceries, banking, etc. She wanted to stop at a local nursing home where one of her friends is living. Well, not really living, actually she is dying. I almost did not recognize her, she was so emaciated. My mom commented that "this is a nice nursing home because it does not smell". Well, her sense of smell is way off. Once we got off the elevator to head down the residential hallway, the smell was over powering to me. So depressing. The vacant, sad look in people's eyes was heart breaking.

No one can judge the hard decisions made by families when the time comes to consider the best options for the individual. But this visit made me all the more determined to do whatever I can to keep Jim at home. Needing help with Jim's care is not in the near future. But it doesn't hurt to think and plan for the best options.

In my last post I talked about the Leaf Study . I was accepted into the study, and it has already begun. I was randomly assigned to group 2, which means I start the daily "emotional surveys" now, and the video conferencing will not start for another 8 weeks. The daily surveys are a quick survey (less than 5 minutes) done at the end of the day, tapping into what emotions you were experiencing that particular day. I've done this 3 days now.

The most striking thing to me so far is that the two emotions that elicited the most powerful response in me were hopelessness and sadness. It's not that my life is without hope, but when I think of our life, it is pretty sad and there is not much hope. It's just the reality of this terrible disease. I'm looking forward to the "intervention" part of the study that will focus on raising your happiness quotient, improve coping strategies and decrease stress.

I discovered this great article called Ways to Control Caregiver Stress and Sadness that I found helpful. I'm all about self-help, and doing whatever you can to take control of your life, including your emotional life. By the way, the Leaf Study is still taking participants, if anyone is interested. Just click on  this link and it will guide you through the steps for enrollment. The research project coordinator that I spoke to on Wednesday said that one recent enrollee mentioned my blog as the source for how they heard about the study :-)

Less than 5 miles from our home a Peregrine Memory Care facility is being developed. It is assisted living (not nursing home) and is intended for folks with dementia. Jim saw an article in our local paper about it and pointed it out to me. He said that this would be perfect for my mom. This gives you a sense of how off his perceptions are. My mom has no cognitive impairment whatsoever. There is a medical term to describe this lack of awareness of cognitive impairment: anosognosia As I have said before, I think it would be devastating to Jim if he actually was aware of him impairment, so I am grateful for this lack of insight.

The other day I was reminded of events from just a year ago. It got me to thinking and comparing how much things have changed for Jim (and for me!).

A year ago:

* Jim was able to drive safely, as long as it was local and familiar. Now, there are really only two very close locations where he is OK to drive.

* Language: A year ago, Jim was just starting to have a little problem with word finding. I remember being surprised by this, but the occurrence was quite infrequent. Now it is many times a day, every day.

* Money/Math/Spatial Relationships: A year ago he could still write a check or make change. Now, he is unable to do the simplest of math calculations or any financial business. Problems understanding spatial relationships is a relatively new development this year as well.

* Memory: It was 9 months ago (I remember because we were in FL) when Jim first had problems remembering his address, phone number, birthday, SS #. It was shocking to me, and gave me a glimpse of where things were headed. Memory loss has progressed to most events in the short term. If something has a large emotional impact on him, he is more likely to remember.

* Personality: Here's some good news! In some ways, things are better simply because I have gotten better at predicting and responding to things that upset him. I'm also doing better at preventing upsets before they happen. Yay!

This last paragraph is actually very encouraging to me. Especially since the personality and behavior changes are the hardest to deal with. The rest is easy stuff. I guess I should give myself credit for getting better at this. Maybe tonight when I do my daily "emotional survey", I will have more hope :-)

Well, once again I am lifted by being able to share with my wonderful, caring readers what is on my heart and mind. Thanks for stopping by, and for being such good listeners!

Sunday, October 23, 2016

Almost Never Alone

Jim went to get his hair cut the other day. It is one of the few places that he has been able to drive to by himself. When he came home, he told me that he "went the wrong way on 690".  It turns out that he was NOT driving against traffic (which is what I thought he meant at first), but instead, he went east instead of west. He somehow managed to get to the hairdresser in spite of this misdirection. He was unhappy with the haircut this time, saying that she did not get the sideburns even. He was correct about this, but it was off by only a tiny bit.

This is not the first time he has complained about the cut. He has been going to the same person for many years. According to Jim, she is always very animated and more interested in telling him about the latest crisis in her life, sometimes at the expense of a precision haircut. I decided to use this as an excuse to go with him next time.

Me: "Why don't I start going with you. That way I can keep an eye on her and ask her to correct any problems before we leave the salon."

Jim: "That's a great idea. I hate to say anything to her, but if you don't mind, that would be great."

I have noticed that when I am driving, he will frequently ask me "how do you know how to get there?".  His car is seldom driven. There are now exactly two places where I feel it is safe for him to drive; his friend Mike's house, and the local restaurant where the guys meet for lunch every Wednesday.

When we get ready to go someplace, I make sure I am the first out the door and quickly hop into the driver's seat of my car. This seems to be working pretty well. The other day he was admiring an Audi SUV.

Me: "We could probably go down to just one vehicle now. If we did that, we could certainly afford an Audi."

He was suddenly very quiet and never responded to what I said. I won't push it, not yet. The other day he wanted to go to the mall to look for some new jeans.

Jim: "I think you better go with me. I'm not sure I'd be able to find my way around in the mall. And I think I'd have trouble finding where I parked my car."

I am so grateful for this insecurity that he has about driving alone. It seems like we will be able to transition to him not driving at all without too much anguish. The down side is that it now becomes  difficult for me to have any alone time. I'll enjoy my Wednesday lunch time, as this is when he meets the guys for lunch. Otherwise, I'm on call 24/7 as the entertainment committee. "What are we going to do today?" or "I'm bored to death." "Let's go someplace!" I can still leave the house for short periods of time by myself, but it leaves him home alone, "bored to death". Another new reality, and I will adjust.

Leaf update. The battery operated leaf blower that I purchased works great. When he first saw it, he loved it. He then tried it out on our driveway. 15 minutes later he came in, very unhappy saying it was a "piece of junk". It has a turbo button. When turbo button is used, it goes through the battery pretty quickly. Operating at normal speed, it will last an hour. There has been a learning curve, as he is realizing that it works well if you avoid the turbo. So now he loves it again!

Even though I am retired, I've managed to keep up some professional links that are still of interest to me. One such website led me to this: It is an opportunity to participate in a nursing research study for caregivers of loved ones with dementia. It is intended to increase levels of positive emotions, with the goal of decreasing stress and improving coping skills for caregivers. I have a phone interview this Tuesday to see if I qualify (I think I do).

They use video technology, so that you can participate from any part of the country, as long as you have access to wifi. I think that this might work well for me. Over the last couple of weeks I've had a couple of appointments (finance guy, Alzheimer's Association) where I've had to fib to Jim about where I was going. I hate that. I'm hoping that this format of video conferencing will be easier for me. And, I like the idea of supporting nursing research.

Well, once again I have managed to share what is on my mind and in my heart. Thanks for stopping by, dear readers.

Saturday, October 15, 2016

Hot Means Cold, Yes Means No

Ah, the challenges of communication! Lately I find that I need cues other than the spoken word to really understand Jim. The more anxious or frustrated he is, the harder it is for him to accurately articulate what he is trying to say.

As I have written before, Jim struggles with climate comfort. For the most part, I find that if I keep the temperature at 74 degrees, he seems content most of the time. (As a side note, my body thermostat runs much hotter. I'd feel much better at 68 or 70, but 74 brings the peace, so that is what it will be.)

The other evening, for whatever reason, the 74 degrees was not working for him. The following conversation ensued:

Jim: "It's way too cold in here!!! What is the temperature???"

Me: "It's set at 74, but if you are too cold, I will turn it up."

Jim: " No! This says it is 54 degrees!" (He was looking at our inside weather monitor that measures both inside and outside temperature.)

Me: "Let's look at the indoor temperature, which shows it is 74. I can turn up the thermostat if you are  too cold."

Jim: (Angrily) "It's too cold in here!"

As he says this, he is taking off his zip up hoodie he was wearing over his t-shirt. I suddenly realize that he is too hot, not too cold.

Me: "Ok, I'll fix the thermostat so that you'll feel more comfortable."

Notice how I carefully chose my words with that last statement. And, I had to pay attention to his body language, not his words to figure out what he was trying to tell me. More and more this is happening when he is anxious or upset, where yes means no, and no means yes.

The problems with word finding continue and seem to be increasing. Last night as he came to bed he woke me up to ask:

"When is ........" (gesturing with his hands held palms up).

I'm half asleep and have not a clue as to what he is talking about.

"You know..........on Monday......."

I'll spare you the painful details of the belabored conversation we had, but essentially he thought the presidential election was Monday and he was afraid we would forget to vote. He has been worried about this for quite a while, and we've had several conversations regarding this. I put it in his appointment book, but I don't think that helps if he can't remember to look for it there.

We met with our financial advisor this past Monday. It really was a brief, general meeting for Jim's benefit. Later in the week I met alone with our financial guy. We reviewed our portfolio, and we discussed the reality of Jim's shortened lifespan given his dementia diagnosis, as well as the expected expenses of home care for Jim. This definitely impacts on our/my financial future.

Long ago, Jim and I decided against long term care insurance. Instead, we chose to self insure, taking the amount that would be payed for LTC premium and pumping that money into our investment portfolio. Our finance guy has this fancy software that evaluates and projects your rate of return on investments and projects the income flow over your life expectancy. It looks like we'll be OK, even with Jim's health changes and projecting the costs of his care. I know that life is full of surprises (!), and I'm prepared to adjust as needed if financially we need to do so.

I met with the local Alzheimer's Association yesterday. They are a wonderful organization! Two very caring young women spent about an hour with me. They listened, and they encouraged me to guide the focus of our meeting. They provided me with lists of resources (gerontologists, counselors, support groups), and also had some good advice regarding coping skills for the caregiver. I was so impressed with their professionalism, their knowledge and their caring, empathic listening skills.

Update on the "leaf eradication" project (as Patti describes it) :-)  I have ordered a battery operated leaf blower. Friends of our's have one, so I know that it is light weight and easy to use.  It should arrive on Monday or Tuesday. I haven't told Jim yet. This is the kind of thing where it works best if I don't tell him too much ahead of time, as he will worry and be anxious about it. Once it comes, if he does not like it, I'll tell him it is for ME and that I want to be able to blow the leaves. Once he sees me use it, I'm guessing he'll love it and want to take over the leaf blowing again :-)

It is still very early in the season; I would guess that maybe 10% of the leaves have dropped. Jim is out there several times a day with his push broom and rake, trying to get every last leaf. It's good exercise and gives him a focus, but it is causing him way too much anxiety. He frets during the evening about what the driveway will look like the next morning. And, when the leaves really start falling, he would really be in trouble trying to keep it all spotless with the broom and the rake. We shall see.

So goes another week in the world of Jim and Carole. As always dear readers, thanks for stopping by!