We went to Philadelphia last weekend. We both enjoy this city, rich in history. We stayed downtown and used the Phlash bus to get around. The Phlash bus runs a continuous route that takes you to all the different historic sites. We did a LOT of walking as well. We had a wonderful dinner with friends of our's on Sunday night. A good time was had by all.
I did all of the driving down, and most of the driving to go home. Jim didn't seem to mind, thank goodness. Even with our GPS and with me helping to navigate, it would have been too much for him. He does OK driving locally, but anything new and different causes anxiety, frustration, and generally makes for a miserable time for both of us.
Being in a different city brought to the surface the many limitations he has when he is out of his element. I heard him ask with amazement many, many times "how do you know that?" The funny thing is, he does not view it as a deficit that he has, but rather he sees me as being very smart.
The last few times we have traveled he has forgotten to pack some pretty obvious things; socks, favorite sneakers etc. On this trip I surreptitiously checked his bags prior to leaving and was then able to casually say "did you remember to pack your ..."
I planned our activities so that we would enjoy the best that Philly has to offer. We managed to check everything off our list! Jim struggled with the details of our plans; I just focused on telling him that we were OK. He responded well to reassurances that we were on the right bus, at the right location, etc.
There are different descriptions for the stages of dementia. Based on this one http://www.alzheimers.net/stages-of-alzheimers-disease/ I would say that Jim is in stage 4; moderate decline. I'm guessing that it is not an exact science and that there are probably variations that don't hold true to the description. Plus, some days are better than others. And some are worse.
I am learning a LOT about home maintenance. Jim has always maintained a list of resources for any house related problems. I never really paid any attention to it before, but now I absolutely need to. He is not really capable of handling a phone conversation with any complexity in it. He gets confused, forgets what the issues are, leaves out critical information etc. So now it's up to me. I'm getting used to it.
From what I have read, denial is fairly common in Alzheimer's dementia. It is not necessarily an intentional denial, but rather a lack of insight. I've also been reading about doctors who are not forthcoming with patients in giving them a diagnosis of dementia. Reasons for this include fear of damaging their relationship, concern the patient is too fragile to handle the diagnosis, trying to protect the patient. It must be frustrating for physicians, as there is no cure, no fix. Doctors will sometimes prescribe cholinesterase inhibitors (such as Aricept). But this is often done at the request of the patient or family. Research shows that while the medicine may improve cognitive functioning for a year or so, it does NOT stop the progression of the disease. How sad.
Our next trip is in August for a wedding. Travel plans are underway, and I'm anticipating a wonderful weekend celebrating with friends.
Memory for 2. I'm ready for the challenge!