I Can See Clearly Now

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This initially started off as a blog about transition into retirement and continuing to observe the world thru my liberal social work perspective. It has now changed into gradual acceptance of mortality and the stages that occur as we age. One of the really difficult things for me to face is my continuing denial. It is much more than a river in Egypt. In March of this year I finally had to accept that I needed eye surgery for Cataracts. I had been putting this off for at least five years and my denial continued until I had to accept the truth. My vision in one eye was blurry at best and increasing power on my reading glasses did not seem like a long-term solution.
The eye surgeon whom I consulted had recommended this for a long time and whenever I questioned him about this he would get irritated. I continued to think that I knew best and was proud of the fact that I had never had surgery. I think what helped make my decision was having to face the reality of our current situation. My wife cannot drive any more and we decided to sell her car. Now we only have one driver and one car. If my vision continued to worsen we would have no real transportation.
The surgery went well and I have been pleasantly surprised with the result. I still need reading glasses, but my vision is much better overall. I complimented the surgeon, but I know I am not one of his favorite patients. I continue to wonder why I put it off as long as I did.
Denial affects almost every area of my life. My vision was only one aspect. I continue to have difficulty accepting getting old. I know this is not the most surprising thing in my demographic, but sometimes I think I am still in my 30s and 40s until I experience the consequences of doing too much.
I think denial really affected me the most in my marriage. My wife has been diagnosed with Alzheimer’s Dementia. I would make excuses for her for years for her memory loss and losing things. I really had to accept it two years ago. We went on a Mediterranean Cruise for our 50th wedding anniversary. We were both very excited about it, but she had a difficult time keeping up on the cruise with the other passengers and it was evident that there was something wrong. When we returned I set an appointment with her primary care MD. Her physician thought she had had a stroke and ordered and MRI and a PET Scan. The Scans indicated a small silent stroke and indicated possibility of Alzheimer’s. We then went to a neurologist who confirmed this. The one thing the neurologist said that still bothers me is that there is no cure and the goal of treatment is to slow the progress.
Over the last two years the progress has accelerated. She has trouble with memory on a daily basis, has trouble dressing and right now cannot be left alone. I continued to think we could manage this but our sons both said our current living situation was not manageable. We began to explore senior living facilities. These facilities have three levels. Independent living which is basically apartment living with meals included. Assisted living which provides additional help such as help with medication management, dressing, showering etc. Memory care which is basically for individuals who can not be left alone and need more intensive care . I initially though we could live in our home here and then move into Independent Living. Over the last nine months that has changed. Her disease has progressed. Assisted Living does not provide enough protection or safety for more advanced Dementia. We are now on a wait list for a Memory Care placement. This is still incredibly difficult to accept. This hasn’t happened yet, but it will and I know it will break my heart. I also know that this is the care she will need. Hopefully I can stay strong enough to carry this thru .

My Mind is Going Thru Them  Changes

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I recently heard a talk about prolonged stages of grief for caretakers of Dementia. Every day you see a loved one lose a little bit and every day another part of you slips away.  Right now I can recite Kubler-Ross by heart –Denial, Bargaining, Anger, Depression, Acceptance. I foolishly thought this would be like dealing with death of my parents or sister. It is not.

I think what stops this is the daily contact and gradual deterioration. I keep expecting it to stabilize or even get better and it doesn’t. I initially thought this was just a part of aging like forgetting words or where you placed something. I would make excuses or jokes about it. Physical problems like walking slower I thought just needed encouragement to move quicker.  I would listen to my sons about her problems maneuvering on stairs and danger of falling. They began suggesting a move into senior centers in December/January. We even visited one with them and had lunch there. I kept saying we could stay in our home, and we could manage this. Over the last nine months I have had to change. I agreed to visit other senior centers. I would always find excuses like cost or loss of freedom or problems with moving from townhouse to a one- or two-bedroom apartment. We finally put a deposit on a nice apartment with independent living. We even went out and began measuring what to bring.

Then reality struck again. My wife began having increasing problems with memory and physical activities. Her primary care physician now classified her as severe and said independent living, or assisted living would not be enough. We had our deposit returned and she is now on a wait list for a memory care placement.

If I have time, I begin to think about myself. I think I worked thru Denial and Bargaining, but right now I am on the elevator between Depression and Anger. I get really irritated at something my wife does. I raise my voice and then feel overwhelming Depression until the Anger surfaces again. I will wake up at night and feel guilty about placing her in memory care.  Friends and family all want to know how I am doing. I always say fine, and that my focus is my wife.

What is really hard to accept is that the girl I married is gone .She doesn’t remember much of the past.  I will bring up something and it’s obvious she doesn’t recall it. She has trouble remembering her sons names and really can’t remember her grandchildren. She recognizes them if when sees them, but still has trouble with their names. I know this is the process of the disease and I know it will continue to get worse. What is hard is trying to remain positive with her. She doesn’t smile much any more. I used to say that she made me laugh at least once every day. Now she doesn’t laugh at anything I say and prefers to sleep rather than talk to me.

I keep remembering that this is the girl I met fifty-four years ago and have been married to for fifty-two years. We had a good life and went thru raising two sons, watching loved ones die, having grandchildren, going on wonderful vacations and all of the other events of a long marriage. We have both had reasonably good health and no real external crises in our lives. I know I need to keep focusing on positives, but the reality is that I really wasn’t prepared for this. I don’t know if anyone could be.

I think Kubler Ross’s stage of Acceptance is just a myth for me right now. This may be due to our current life being so fluid and unpredictable. I know that after my parents death the grief passed after awhile. My grandmother from Ireland never let the death of her husband pass. She wanted to go to the cemetery weekly and would say two rosaries a day for him. This might have been because he died suddenly and she didn’t have a chance to say goodbye. I keep thinking that I am saying goodbye every day and then get up and start another day. I treasure the good days but they are getting harder to find. Maybe today will be different.

Free Parking

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The funny thing about aging is you often don’t feel old. Senior citizens are those other guys. Then there will be days when you realize there are now things you can no longer do. Reality is a bitch sometimes. As a professional therapist a large part of my job was to take care of people and be there for the crises of their lives. Now I am having difficulty accepting that those crises can happen to me.

My sons are worried about their mother and me. My wife now does have serious health concerns that need to be monitored. Both of our sons accompanied us to a tour of a senior living facility this past week. The facility was probably the top one in the area. It was absolutely spotless and was newer construction. The facility offered three levels of care: 1) Independent Living, 2) Assisted Living, 3) Memory Care. Our tour included all three levels.

They have both one and two bedroom apartments. The one bedroom is very small. The two-bedroom apartment is much larger, but it is still an apartment. Walking thru them was difficult. We have been in our own homes for over 50 years. During that time we have accumulated memories along with the many possessions we have. The thought of giving up those things and the independence of our lifestyle is difficult to accept. As I write this California is going thru their terrible wildfires. There are people being interviewed who have lost everything. Moving into a senior center doesn’t compare to that, but it still involves major life changes. The last time we lived in an apartment we were just married. You forget how small an apartment is and the lack of personal space available.

The other levels of care (Assisted Living, Memory Care) also have apartments but with much more structure and monitoring by facility staff. It appeared very professional with both caretakers and nursing staff. I was impressed with the facility but still depressed with the concept of having to make a decision about living there.

I asked our guide about activities and she told us there was a lot available. They have a mini gym, Movie Theater, various rooms for many other activities. She continued tell us how pleased the residents were there. We ate lunch there in their dining room and saw some of the other residents. I went up to a family member who was eating with her mother and asked how she liked the facility. She said that she was quite pleased with it and her mother, who I also met, was happy there. The daughter said she had visited many facilities and this was by far the best.

I think our sons would really like us to consider selling our home and moving into a place like that. They have realistic concerns that if either one of us has a catastrophic health crisis, they would be left to resolve decisions about our home, possessions and lifestyle. I think that is part of the aging dilemma that is not talked about much. This not only affects us, but also our family members who have their own lives and responsibilities.

When I was growing up my grandmother lived with us until she had a stroke and died in a nursing home hospital. It was common back then in the 1950s-1960s to take in older relatives. My grandmother cooked , cleaned , and took care of us and that made it possible for both of my parents to work. Today that doesn’t happen very often. The demands of the 21st century make that type of arrangement very difficult if not impossible.

I don’t think there were many, if any, senior living facilities back then. There were nursing homes where families would place relatives who could no longer take care of themselves. They would live there until they died.

Now facilities like the one we visited exist. They offer more options for healthy seniors who still want some independence. However it still seems very lonely. We visited on a Sunday. We saw many residents, but very few family members. I wonder if families begin to think that senior living is the answer. It’s almost like parking your car in a covered garage and that solves a difficult problem. I know our sons are worried about us isolating ourselves since we moved here. However we still have each other and maintain contact with a few friends. We moved from our home of over 37 years to be closer to our sons and their families. We go to family activities with our grandchildren but come back to our own home. We could still visit our family and grandchildren, but would then come back to a place that is not a home. It is still possible, but we still have some time before we are parked.

Passionate Kisses

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In 2008 I was working at a very busy clinic outside Chicago. We rarely talked about anything except our patients. One of the young Doctors there really liked Barack Obama. This was unusual because most of the other MDs were Republicans. I remember the day after Obama was elected the first time. He was coming to Chicago with his family to give an acceptance speech. My friend said that he was going there no matter what. After work he left and drove into Chicago. It was incredibly busy because of the speech. He had to park miles away from Grant Park where the speech would be held. He told me he didn’t care. He got out of his car and ran at least 2.5 miles to get there. To really understand this you have to know Chicago and some of the dangerous neighborhoods there-especially at night. I remember seeing the speech on TV. There were thousands of people there. Cameras kept sweeping the area and showing people weeping and hugging each other. They all just wanted to be part of the experience and close to the man they voted for.

The reason I thought of this is because the same type of images were being shown at the Trump headquarters after he was declared the winner. I began to think of why people attach themselves emotionally to certain candidates and ignore anything negative about them. Certainly Donald Trump has a lot of negatives with his history and divisive speeches. It didn’t seem to matter.

On Tuesday November 5 I saw a red pickup truck with a huge Trump banner. On one side it said Trump. On the other it said “Take Our Country  Back”. I then remembered that I had seen many trucks and cars with huge Trump banners paired with American flags. They didn’t care who saw them. They just wanted to be seen. I have never seen a Harris flag or even a Biden one on any vehicle. There would be stickers on the back of cars or signs in their yards, but never something so in your face as that flag.

It just seems that sometimes people open themselves to people who don’t deserve it. There are libraries written about narcissistic relationships and the difficulty understanding how they occur and how long they last. For whatever reason Donald Trump was able to key into a certain population and they accepted and believed in what he presented. Their loyalty has stood no matter what evidence the media presented against him.

Kamala Harris seemed to be a good person. She had difficulty because of her ties to President Biden and her past liberal history. However some of her ideas were good and she was able to excite a large part of the Democratic Party. However that did not last. She was not able to ignite the kind of passion that Trump did. She lost much of the male vote and even the African American population was not as committed to her as she would have liked. Her issues on abortion attracted a large part of the white female population, but not as many males.

Perhaps one way to think about this is to look at as a process of relationship .The beginning of any intimate relationship has a period of  “limerance” where there is almost a golden glow to every moment. That usually ends with the first disagreement. How that is managed predicts the future of the relationship. Kamala Harris had a very short “limerance” and it seemed to fade with much of the population she was trying to reach. Donald Trump’s has lasted now for almost 10 years . He is the hero of the underclass and the working population who will “fix” our country. Everything he does is viewed thru the distortion of his attraction. Harris never had that type of relationship with the American people. There was an initial attraction because she was new and wasn’t Biden. She never was able to go beyond that with the groups she needed.

So for the next four years we will see how long the Trump relationship lasts. In 2028 we will have to go thru this again. Perhaps there will be a new “wonderful one’’ or perhaps we will have to decide what kind of real future we all want and not be swayed by momentary attraction.

Thinking of Sal

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One of the tools I used when I was working was my version of Structural Family Therapy. This is a therapy that was developed by Salvador Minuchin, one of the fathers of family therapy. He basically looked at the family as a system with many parts that could be reorganized. One of the things I remember him saying at a conference was that for a child to act out, there had to be some type of alliance with one of the parents. I remember him putting this 10-year-old girl on her father’s shoulders and showing the mother how powerful that made her and how it sabotaged the mother’s interactions with the child. He tried to have both parents act together as a unified front to organize the family around parenting..
The reason I’m thinking about this now is because of what is happening in Chicago and other “woke” cities.  I have always been a moderate Democrat. I have never voted for a Republican in my life . What bothers me now is that I love Chicago, but at this time don’t want to go there because of what is happening with violence and the political upheaval.
How is this related to Structural Family Therapy? It seems that some of the social structures that have been used to organize society are misaligned.  Recently on April 14 & 15, 2023, groups of young people took over downtown Chicago. They harassed adults, set cars on fire and caused a lot of damage. The police were overwhelmed and the new Mayor of the City, Brandon Johnson, seemed to give the young people a partial excuse for their behavior He said we shouldn’t blame them because of their lack of resources and recreational activities. He said violence was unacceptable, but don’t demonize youth. In the past he has called on defunding the police. Over the past six to eight years the morale of the police has suffered. They hear negative comments about overreacting from the media and politicians. They arrest violent criminals and see them out on the street in a number of hours. Criminals are given ankle bracelets to monitor their whereabouts, but often the system is overwhelmed. Guns seem to be everywhere. Hardly a week goes by without some tragic story of a small child being shot in a crossfire. The city need more police, but is having a hard time recruiting because of the current situation .
I hear politicians saying this is a mental health problem.
No it is a problem of control. I keep thinking if I was still working, would I want to be called out in the middle of the night for an attempt to defuse a violent episode. The answer is no. The situation has to be under control before therapy can be attempted.
I think Dr. Minuchin would look at the current problems and try to get the adults in the room on the same page. He would not give excuses for problematic behavior. He would not want any individual who acts out to not have a consequence. It would be like promising an acting out child a new video game as a way to stop problematic behavior. The police need to be supported. They are our primary protectors. The legal and political systems need to work together to provide this support. If this doesn’t happen I doubt if any real changes will occur.