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All the while
he loses language
he develops
the ability
to find
and use words
that du-
plicate his
emotions.

In this aw-
ful season
of rain,
he's found
a new way
of learning,
of teaching him
self
more
about him
self
and his
seventy-seven
years
of life.

In so doing,
this moment
in our lives
together
gifts me
gifts him
gifts us
with unraveling
questions
and apostrophes
between us.

This new use of language -
the mumblings and ramblings –
(that others think are meaningless
unhooked together sentences of drivel)
contains answers I have looked for
throughout our twenty-five
year-old marriage bed.

Now,
indecipherable
speech
is breath
ing
moreness
into
our
unused up
lives.

-Esther Altshul Helfgott

Reading with Alzheimer's

Sprawled out
in the recliner
wearing
a tie-dyed shirt
the kids
gave him,
a Middle Eastern
yarmulke
on his head,
he holds
a book of stories
in his hands,
turns
the pages
as he always did:
carefully,
respectfully,
leaning, learning
words the brain loses
before he under-
stands.

-Esther Altshul Helfgott

No Ativan This Night, He’s Home With Me

He did not need an Ativan last night.
He did not need restraint,
even redirection.
He was with me
here at home
sleeping comfortably
in his own bed.

Bessie Burton’s Alzheimer’s
unit is supposed to be one of the best
in the city. I beg your pardon.
I doubt if there is a best
in any city when speaking
of Alzheimer’s.
There is no differentiation
between high functioning, as Abe is,
and low functioning
where people take their clothes
off in the halls, need constant redirection
and restraint.

Is it not the psychotropic drugs
that psychiatrists and drug companies
push down our throats – and it is our throats,
all of ours –
to keep us out of danger
as they say,
that make Alzheimer’s patients
that way in the first place,
instead of calming them down,
as they’re supposed to do.

I could not leave him in that place of horror
where people are doped
up and warehoused
without concern
for individuality.

He didn’t need Ativan last night
and I doubt if he needed it in the hospital.
What he needs, of course:
lips on the forehead
a back massage
and the strength that I give him.

As I gave to my children
(even as a single parent)
and to my mother (or tried to).
And I can give it to him,
even more than I did then.
Because I am, believe it or not -
it is true - wiser
for the age
I have been given,
so far.

May age be for a blessing
instead of a curse.
Amen.

-Esther Altshul Helfgott

Laboratory Visit

The first time
I see him
hold a colon,
blood dripping
through the fingers
of his latex
gloves, I
want to flee
the laboratory
and the team
of hovering
technicians, this one
handing him a scalpel
that one, the scissors
he took from home.
But instead of running
as I want to,
and I really really want to, I
slump ouside the door
as he cuts.
The procedure ended,
my breath just back,
we return to his office
with the sign: Dr. Schweid,
on the door. I watch him
change from his white lab coat
to a tweed sports jacket
in time for a meeting
and a tuna salad sandwich
I can't touch.

-Esther Altshul Helfgott

The Old Pathologist

I hold him
in my arms
as if he were
the remnants
of the baby au-
topsy he did
that day
in 1990
when I lost
those forty pages
of my writing
to the broken harddrive.
And looked, as he said,
as stricken
as the infant's mother
when the doctor said:
Your child is dead.

Now his head in my lap,
I stroke his brow and kiss his lips.
Our tears fill each other's mouths
as we gasp for sounds of one more tomorrow
and give us back our yesterdays.

-Esther Altshul Helfgott

I didn't know Abe was my shul

I
did
n't
know
Abe
was
my
shul

The Tragedy of Alzheimer's

Nobody knows what to do, including/especially the doctors, at least those I am associated with at Group Health. They have absolutely no idea what it means to go from A to B with an Alzheimer's victim, no understanding of what it means to get him dressed and into a car to take him to an appointment.

Too exhausted to go on with this, just to say he needs a hospital bed and we're waiting for one to become available, no thanks to his MD.

Thanks everyone for calling/emails/etc. Keep 'em coming. This is a most isolating experience for both of us.

Movies I've Watched This Week

The Sea of Grass (1947) - drama/western - Hepburn and Tracy

The Locket (1946) - film-noire - Loraine Day, Robert Mitchum, Brian Ahern

To Have and Have Not (1944) - thriller - Bogart and Bacall, Walter Brennan

Dangerous (1935) - drama - Bette Davis, Franchot Tone

Nursing home? I don't think so, Doctor!

On this first day of Rosh Hashanah, Abe and I pay a visit to his doctor, a geriatrician, trained to deal with the illnesses that develop as a result of growing old. Even though Alzheimer's/visits/the homes/of young adults, it is generally found in the brains of the old and the old old; so one would expect that medical personnel treating people with this disease would have information in their knowledge banks that includes resources and advice broader than time for a nursing home.

The words didn't come out exactly in that form, but for the third time in a row, nursing home emerged from this doctor's mouth within two minutes of my talk with him. (This time, after Abe was out of the room and a volunteer had come to take him for an EKG). Never mind, the geriatrician didn't ask me what I thought of such a suggestion, much less Abe.

After all, this is an HMO and 15 minutes, maybe it's ten, isn't enough time for discussing the hospital's approach to Alzheimer's, as the good doctor informed me. He had to see other patients and we were late anyway. Never mind, I've waited in that hospital 30 to 40 minutes to see health care workers.

There seems to be a policy, written or not, that once a person is diagnosed with Alzheimer's the attitude that follows is: be gone, be gone. If Abe is treated this way - he was a physician for 43 years, 20 at this particular hospital - how are others treated? I'll be darn if I'll squirrel someone away, anyone, - and certainly not my husband - just because society, including the medical establishment, doesn't know how to confront a disease that is growing in leaps and bounds in our 21st century.

I do not want my husband to go to a nursing home. If we got to the point where I absolutely couldn't take care of him, that would be one thing, but we have help and I'm doing a good job. We have a lovely home with a porch that sits in the sun (or rain) and he has a favorite chair and loves to watch the trees.

We had an elevator put in the house and are in the midst of enstalling grab bars in just the right places. All I ask of the medical establishment is to treat Abe as a whole person rather than what can I do for you today, what seems to be the problem? I had spent half an hour on the phone trying to get through to the doctor's office, including explaining to the nurse what was happening. The doctor said he only got a sketchy report. So you start to tell Mr. Professional and he says, oh, we can only talk about one thing today. Is it chest pains or agitation? Well, the two are entwined.... Hello? Are you there?

I'd like to discuss the possibility of hospice or other resources helping out. From what I understand 6 months is no longer the bar... that's when nursing home popped up and I wonder what a hospital system gets out of pushing (or suggesting)nursing home care on patients who are not ready for it and on families who don't want it. What is behind not helping patients stay in their own homes? Who's getting paid off here? Tomorrow I'll call for an appointment with the chief-of-staff.

Another peeve: shouldn't a geriatrician be cognizant of the fact that an Alzheimer patient has greater needs than most people and that slowness is characteristic of the disease, along with a long list of other physical and social impairments that not only affect him but his primary caregiver? Isn't there a place in the system for something happening along the way, regardless of the time you start out for the appoinment, that could immobilize progress toward the practitioner's door?

I guess that's enough ranting for tonight... I'll either read or find some junk on tv. I wish I had some chocolate in the house. What possessed me to pass it by when picking things off the super market shelves? oy!

Did I mention that I have three major articles coming out and got this last one done in August while taking care of Abe? That doctor didn't ask us one question about what I thought was best for Abe and me. Maybe he just assumes it's too much for you. That's the standard comment. Well, let me be the judge of that, Sir. Of course it's a Sir.

And I'll tell you something else, if the situation were reversed, Abe would be holding my hand every step of the way. He wouldn't put me in a nursing home unless he absolutely couldn't take care of me, and that's what happened with my mother. I just couldn't take care of her anymore (in many ways). But I still can, Abe, and until then, I will. To the best of my ability.

Mary Oliver's Bone

for Abe

Today, I read him Mary Oliver's Bone.
He loves it so, he cries
and cries
until the tears
fall
into his mouth
and flood
the tide she searches for
in the ear
bone
of the pilot whale
she finds
on the beach
in Provincetown.

In Seattle,
her book re-
turned
to our shelf
I fold
our hearts
in-
to each other
as we sleep
in-
to the
wet
night.

-Esther Altshul Helfgott