Alzheimer’s: We weather an anxiety attack

My friend had what I interpret as an anxiety attack – big time.

What happened?

We’d gone to visit my family for a weekend.  That was two days spent away from our home, and a bit more than a day in a house that wasn’t our house.

Two hours into the three hour drive home on Sunday, Carl slid into an anxiety attack.  He’s never done this before.

He was asking me, “Where are you taking me?”  The only answer I could come up with was that we were going home.

He asked, “What did I do wrong for you to do this to me?”

Things progressed gradually, and at one point, he shouted, “WHY?”

At another point, he put his face in his hands and started crying.  I pulled over to the side of the road and tried to comfort him.  He just pulled away from me.

I knew that we needed to get home directly.  As I drove, I tried to reassure him.  As we got closer to home, I asked him if he recognized where we were, thinking that I needed to re-connect him with familiar anchors.

Once we were back home, things slowly got better.

After I got him calmed down, and lying down, I said I would unload the car.  He jumped up and said, “I’ll help you.”  I figured that helping me would be distracting, so I elected not to try to press him to stay lying down.

What brought this on?

There was the general departure from our normal routine and environment.  This is challenge enough for me, but I can make adjustments, and I can ride it out.  For Carl, it must be enormously more difficult and distressing.

On Saturday, I spent several hours power washing Mother’s front walk.  Carl came out and asked if he could help.  It wasn’t a two man job, so I said I didn’t need help.

Eventually, he came out again and asked, “What did I do wrong?”  At this point, I started to try to be a little more helpful.  I suggested that he handle the hose – to keep it out of my way.  We continued, with him guiding the hose, until a thunderstorm forced us inside.  When the rain let up, we finished washing the walk.

After the anxiety attack, in the car on Sunday, I didn’t immediately connect it with the power washing episode.  But the “What did I do wrong?” question suggests a connection.

What I did?

I look back, and I’m amazed that I didn’t freak and curl up screaming.

I was trying to do two things.  One: get us home as directly as I could – without going faster than five over the limit – and trying to drive calmly.  Two: I was trying to reassure Carl – and re-connect him with familiar sights and feelings.

I was concerned that he would unbuckle his seatbelt and try to get out of the car.  Fortunately, he didn’t do that.

Earlier, we’d planned to have lunch at our local Taco Bell, before going home.  Clearly that was no longer a good idea.

I had a Toastmaster meeting scheduled for Monday evening.  As we drove, I decided I couldn’t leave Carl alone that soon.  Once we got home, I sent an e-mail message telling them I would not be able to make it.

Aftermath

The next day, Carl said he had a wonderful time.  I observed, “Except for a rough return trip.”  His puzzled look told me that he didn’t remember the anxiety episode.  I didn’t explain further.

A few days after we got back, we went out shopping after dinner: Barnes & Noble, Bed Bath & Beyond, Target, Trader Joe’s.  On the way home, Carl started asking me where we were going.  He didn’t get upset, but he was confused and a little distressed.  It occurs to me to wonder whether the Sundowning phenomenon (see previous post “Alzheimer’s Disease and Sundowning”) could have contributed to this moment at least some.

Recently, Carl has wanted to be close to me, more than previously.  If I’m working in my study – working on my writing – he prefers to sit with me, rather than sit alone on the sofa.  That of course has a predictable impact on my productivity.  I try to adjust and continue to make progress.

I’m thinking that all of this indicates an unfortunate progression of my friend’s cognitive decline.  And of our situation generally, considering our lack of financial resources and the fact that I haven’t figured out how to make a living from my writing.

Carl doesn’t have the power to remember what happened five minutes ago, but ironically, he has more power than is helpful to feel that something horrible is happening to him.

At the same time, I need to not get pulled down by changes that could be due to normal variations.  I have to allow that tomorrow could be better.

I find that Carl tracks OK when I guide him in our normal routine.  I have to make that routine work for him – and for me – for as long as I can.

Sometimes it seems that going for a walk – or walking on the treadmill downstairs – helps some.  And, at other times, I feel that that idea is illusory.

I am researching dementia and Alzheimer’s disease.  After reading about preventing, delaying, and slowing dementia – which all turn up the same recommendations – I thought that Carl and I ought to try to read together.  We used to do that – once in a while.  I had my misgivings, but eventually – actually, it was on a walk at the nearby park – I suggested that we sit together and read poetry.  Carl enthusiastically embraced the idea.  I was worried about how difficult it would be – for both of us – but Carl read better than I expected.

And I’ve discovered that with endless patience and guidance – historically, not my strongest suit – Carl can learn.  At the mailboxes, he had trouble picking the right key and the right box.  I kept guiding him.  Once, he picked the right key and the right box, and I clapped excitedly from the car.  Since then, I guide when needed – and I make my excitement loud and clear when he gets it right.  And he gets it right regularly now.  That’s encouraging.  But I have to be realistic.

I must work to continue these physical and mental activities.

So …

Like I said in an earlier post (Alzheimer’s: “I don’t know what’s wrong with me”), in the Lord of the Rings, the elves fight what Galadriel calls the long defeat.

I have to keep pushing on.  I have to try to keep things as good as they can be for Carl – and for me – for as long as I can.

I can’t think of anything else that makes sense.