Charm



A rose by any other name...circa 1980

My father was a charming man.  Or rather, he was good at charming people- to call him always "charming" would be a serious overstatement.  He was the president of the international division of a prestigious insurance company and traveled around extensively- by the time he retired when I was eight years old I had already been to more than 25 countries with him on business trips.  He quickly made friends with all the new people he would meet, from the foreign businessmen to the hotel clerks.  At my young age, it seemed as though everybody was catering to Mr. Jackson and his wife and family.  I remember elaborate parties for his birthday in Japan, private cars driving us around London, and participating in special local festivals in Thailand.  His lifestyle took a dramatic shift when he retired- instead of people giving him rides on elephants he was carting two kids to gymnastics, piano, and horseback riding. 

I think it was a difficult time for him- the retirement wasn't entirely his idea- but he did the best he knew how to.  He would pick me up from school on his bike, with our neurotic dog Rusty riding in the grocery basket.  My friends loved going home for lunch with me because he would make the best grilled cheese sandwiches on sourdough bread, and as a special treat he made stove-top hot chocolate.  In the morning he would cut up plates of fresh fruit and bring them to Mom, my sister, and me while we were getting ready as an "appetizer" before  breakfast- before he made his own famous fruit bowl with a huge scoop of cottage cheese on top.  Many years later, when he could no longer figure out how to cut a grapefruit by himself (and we didn't trust him with a knife), I made sure the caregiver or myself always started his breakfast with fresh fruit. 

I remember taking Dad to Old Navy a couple of years ago to stock up on basic clothing.  Fortunately, I didn't have to get him to try anything on in the dressing room- for as long as I can remember he had been a size 32w x 34L so shopping for him was easy.  While we waited in the checkout line he laughed at the doggie costumes they had set out for Halloween and we imagined trying to get Rusty into one of the ladybug suits.  When it was our turn to check out, he smiled at the clerk and glance at her nametag.  "Michelle," he said.  "That's a beautiful name!"  She smiled, and in his perfect tenor voice he started to croon out his best Paul McCartney.  "Michelle, ma belle.  These are words that go together well...my Michelle."  The young clerk blushed, but she was delighted.  "My parents named me after that song!" she exclaimed.  Dad started beaming, obviously thrilled that he had made her happy.  We walked out humming Michelle and talking about the Beatles.  While this scenario wouldn't have worked out so well in every circumstance- I can imagine it would be different and slightly awkward if I had been the one singing or if Dad had been 30 years younger- in this case the clerk was obviously charmed by the gentle octogenarian on an outing with his daughter. 

I was reminded of this story last Sunday morning as I was driving to work.  I was listening to Breakfast With the Beatles, a show dedicated to all things Beatles on WXRT.  Although Michelle won a Grammy in 1966, I think it sometimes gets overshadowed by their even bigger hits so when I heard it on the radio I was taken by surprise.  My mind immediately went  back to that October day in Old Navy, how happy the clerk was to be acknowledged, and how happy Dad was to make her smile.  While he had a horrific temper and it was easier for him to swear than say "I love you," I choose now to remember the softer, more charming side of my father that was beautiful when he let it come out.

Fresh Air

Somewhere in Pennsylvania this morning, after much prodding and poking a groundhog stepped out of his resting spot and somebody decided that he could see his shadow.  According to folklore, that means that we will have six more weeks of winter.  Here in the Midwest we're not sure what that means.  On the second day of February, the temperatures are predicted to reach 48 degrees today.  Yesterday was the anniversary of last year's Snowmageddon, which dropped 26 inches of snow in two days and shut down Lake Shore Drive for the first time ever in Chicago.  This year I've only used the snow scraper once and it almost wasn't necessary.  As Tom Skilling likes telling us repeatedly, this is the warmest winter Chicago has had in 80 years.  I've only lost one pair of gloves (so far), in large part because there have been so many days I haven't needed to wear them.  I was worried that the cute pink coat I got for $30 at a secondhand store in October would only last for a month or so because it's not lined in down; instead, I've been able to wear it all but five days this year. 

What does this all mean?  Putting aside all the practical worries of global warming and confused birds messing up their migration plans and flowers coming up months early, I am loving this weather.  I find I have much more energy and motivation when the thought of doing an errand isn't sidetracked by "ugh, but it's so COLD outside!"  I'm walking more, not using the heat in the car as much, and haven't had to fight with layers of long underwear.  Mostly, I'm reminded of how much I love to be outside.  I love fresh air.  I work in a stuffy, dry, hot building and it's so refreshing to get outside at lunch even just for a quick walk around the block.  Having the wind blow my hair and getting a little chill when it goes down my neck.  Squinting from the sun and getting some natural vitamin D.  Feeling the softness of the ground under my feet- not frozen as it usually is at this time of year.  It's all a reminder of the might and potency of nature and it's somehow both humbling and empowering.

As I was driving out to Dad's on Tuesday afternoon, the thermometer on the car read 59 degrees and I rolled the windows down a little to feel the breeze.  I was planning on bringing him into the library and show him some of his favorite videos on YouTube- Singing in the Rain, Kick Your Knees Up Steppin' Time, Billie Holiday in concert, the What a Wonderful World hand-puppet show.  Okay, that last one is my favorite but I tell myself that he likes it too- I don't have a good way to tell for sure.  When I got to Maryhaven, however, I had a much better idea.  I walked up to Dad, wiped up the drool on his chin from the meds the nurse had just fed him, gave him a kiss, and asked him if he wanted to go outside.  He responded with a blank stare, but I thought maybe I could see a twitch in his eyes.  I got some blankets from the laundry room, piled them on his wheelchair and pushed him off the unit.  As soon as we went through the front doors his face softened and I realized that it's probably been four months since he had been outside.  I get stir-crazy after being inside for three hours, and that trait was definitely handed down from my father so I can't imagine how restless and claustrophobic he feels trapped in the nursing home day after day.  I asked him if it felt good to be outside and he nodded his head ever so slightly.  We only stayed out for 10 minutes- he started shivering- but I could tell the whole experience brought him a lot of joy.  Driving home, the sun was starting to set and it was getting cooler but I put on my scarf so I could roll the windows down anyway and feel the fresh air.  Whether or not Puxatawny Phil was right, you'll hear no complaints from me this winter. 

Transitions

It's been more than two months since my last blog entry.  I wrote of Dad's eyes following me, his hand grasping mine, him speaking with intent and urgency.  I remember he had just finished lunch and was quite alert.  His eyes, while not necessarily bright, were at least clear.  I can't help but wonder how he has lost so much ground since then and how it has been such a relatively quick and abrupt transformation.


"Pureed tuna salad".  If you say so...

 It seemed like he changed overnight, and while I don't think that's true, Alzheimer's is an unpredictable disease and maybe something just shifted in the brain to make this happen?  Now his eyes are distant, blank, empty.  It is like he is looking through me.  He barely utters a word, and I am unable to decipher if it's because he doesn't want to or is unable to- I think the latter.  He chokes on almost everything he eats now, because his body has forgotten how to properly swallow.  I can't bear to feed him the pureed shit that the facility provides, so I stock the fridge with yogurt and pudding, and at least when I'm there that's what he eats for dinner.

Feeding has become one of the biggest issues, but it's also one of the most important because food is the only thing keeping him going now.  Dad has always had a strong fear of choking- the story goes that he had a bad experience with a piece of hard candy when he was a kid and it traumatized him.  So for me to feed him yogurt and have him choke is agonizing for both of us, and I can only be thankful that I am there to comfort him.  It's a huge struggle for me- by feeding him I am giving him nourishment, and as long as he is willingly accepting food I will continue to do so.  At the same time, he is mostly likely going to eventually die from pneumonia or another infection that will develop when he chokes and aspirates, so each time I give him yogurt I am potentially enabling that.  It's my choice not to push him to eat- if he doesn't want it, I honor that. 

Julie, Dad's Hospice nurse, wanted to lower his psychotropic medication since he has been so much calmer and withdrawn but I guess every once in a while he still swears when they bathe him so the doctor said to keep the meds in place.  For the safety and ease of the staff, I don't want him to be combative but I also don't want to medicate away any awareness or expression that he is still able to communicate.  Henry G. Jackson Jr. never wanted people to take care of him and to do so without complaint wouldn't be my father.  And I want to hold on to any glimpses of him that I can while I still have the chance. 



October 2011



National Alzheimer's Project Act

The numbers are depressing- 5.9 million Americans are living with Alzheimer's disease right now, and someone new is diagnosed every 69 seconds.  Out of the 10 most common causes of death, it is the only one that isn't preventable, treatable, or curable.  It strikes me as odd, then, that until this year there was no concrete, centralized plan to combat this disease in our country.  The Alzheimer's Plan of Australia came out in 2006, the French Alzheimer's Plan was signed in 2008 and several other countries have followed with their own.  Finally, in January 2011 Congress passed the National Alzheimer's Project Act, a "coordinated national strategy to confront one of America's most feared and costly diseases."  NAPA is supposed to spell out how we, as a country, not only accommodate but care for the millions of people with the disease and their families and loved ones.  Still in it's infancy, it builds on the work of the Alzheimer's Association and the Alzheimer's Study Group and brings in representatives from the Department of Health and Human Services.  To their credit, the creators realized that nobody knew the disease more intimately than the people actually living with it and have been sponsoring NAPA Input Listening Sessions around the country to ask for advice and suggestions.  Earlier this week I participated in one of the sessions at a downtown hotel and was honored to have the opportunity to speak. 

It had already been an emotional day.  I had a care plan conference at Maryhaven, Dad's nursing home, earlier in the afternoon and had only a minute to run in and say hi to him afterwards.  He was sitting in the activity room with the rest of the residents, watching a John Denver video.  I cringed at the irony of them hearing "take me home," when for him that would be the ultimate gift.  Every time I come he says, "canwegohomenow? canwegohomenow?"  I don't know what his idea of "home" is, but I am certain it's not a nursing home.  I ignored Mr. Denver and as I walked over to Dad his eyes followed me.  When I got close enough he grabbed my hand and mumbled "Iloveyouforever," which is what I always say to him when I leave.  So for him to say it was incredibly powerful, and by the time I raced home and hopped on the El I was already a little teary.  I got to the hotel and was whisked down to one of the large conference rooms.  There were representatives from the Alzheimer's Association milling around, and I recognized the VP of Communications and the Special Events Coordinator, two women I met when I did a fundraiser with the association last year.  We talked and caught up for a few minutes, then everybody was asked to sit down.  We were welcomed by Harry Johns, the CEO of the association, Erna Colborn, the president of the Greater Illinois chapter, and representatives from the Department of Health and Human Services.  There was a recorded welcome by President Obama, assuring us that he would back NAPA and understood the importance of it.  Then it was our turn to speak.  Out of the 200 or so people in the audience, 21 of us got up to tell our stories and share our ideas.  I normally have no problem with public speaking, but when it was my turn I could feel my voice quiver. 

"Forlorn, discouraged and despondent, he spends his days in a reclined gerichair, mumbling and swearing at the memories, or lack thereof, that plague his thoughts....Alzheimer's disease is a thief.  It slowly, painfully robs the victim of his very existence.  It's not just the memory that fails, it's the actual ability to process and understand daily tasks....we need proper funding for research into prevention, education for medical professionals and resources for families and caregivers....(people with Alzheimer's) need to be treated with respect, courtesy and compassion and not be stigmatized for their symptoms."

I had hoped to astutely but passionately cover the issues that were the most widespread, and judging from the applause at the end I think I did a decent job.  Other people talked about the importance of early detection, specific problems with early-onset, assisted living deserts (communities that have no access to them) and tax incentives for caregivers who have given up jobs and made other lifestyle sacrifices to care for their loved ones.  In spite of the painful stories that were shared, I felt that there was a lot of positive, productive energy in the room.  After we all spoke, Rep. Mary Flowers from Illinois got up and promised that as chairwoman of the Health Care Availability Access committee, she would lead forums and sessions in the state and push to make funding into research a priority.  The evening ended with more words from Mr. Johns and Ms. Colborn, and a reminder that we could still submit ideas and suggestions online. 

Sitting in the audience and listening to the other family members, friends and caregivers speak was incredibly moving, and for the second time that day I teared up.  There was the 17 year old whose mother was diagnosed with early-onset at 53, the woman who lost both of her parents to the disease within seven days of each other, and the man who stood at the microphone stammering for 30 seconds before his wife jumped in and spoke for him since he was having trouble remembering how to.  I hope that by hearing our stories and seeing us as real people and families and not just numbers and statistics, the people on the NAPA planning committee will be moved and impacted enough to push forward quickly and urgently, and we can begin to make progress on finding a cure to this harrowing disease. 

Grasshoppers and Robins



What is it thinking?



The other day, I took Dad outside to read some poems.  A friend has just given me one of Mary Oliver's collections, and I thought maybe he would find her descriptions of nature peaceful.  It seemed fitting to start with one of my favorites, The Summer Day. I had always been moved by the last line, which asks, "Tell me, what is it you plan to do with your one and precious life?"  I was planning on focusing on that with Dad, but as I read the poem out loud I was drawn to a line from the beginning.  Mary writes, "Who made the grasshopper?  This grasshopper, I mean- the one who has flung herself out of the grass, the one who is eating sugar out of my hand..."  Thinking so much about the end of life has made me revisit the beginning as well, and this line made me pause. 

I've never had a solid answer to the question Where Did We Come From?  On a basic level, I believe in supernovas and evolution and the scientists' explanations.  But on days when that sounds too harsh and technical, I can't help wondering if there's a little...more.  Smelling the early blooms in spring, hearing a newborn cry for the first time or feeling true love in somebody's eyes are such indescribable moments that I want to think there's something greater.  On the flip side, sickness and natural disasters are so hard to justify.  Science can tell me that grasshoppers are part of the Melanoplus Differentialis species, which is great for an insect in a book, but looking at a specific insect landing on your arm and seeing its little beady eyes and delicate antennae makes you look at it differently.  Is there something else that adds to its beauty, its magic, its charm?  The man sitting next to me always denounced that idea as inexplicable fluff, but here he was yelling about getting to Hollister, unable to move much more than his left hand, looking blankly right through my eyes, and I was having a very hard time explaining that to myself. 

Later that evening, I was sitting on the patio with a glass of wine reading The Long Goodbye.  It's a memoir by Meghan O'Rourke about the time leading up to and following her mother's death from cancer, and the book has been a valuable resource for me to find some congruity and understanding about the process.  I was a little more than halfway through, and at that point Meghan was struggling to get back into a normal routine and grappling with where her thoughts are taking her.  That night I read,
     
     "And as I sat, a robin hopped toward me.  Its red breast was shiny, and it had bright, bold eyes.  And I thought: OK, so, resurrection; I don't know.  But what in the world- in the universe- made this creature?  Can evolution account for the mystery of life?  As a theory, it doesn't go as far as I'd like toward explaining the world....I watched it for some time, half wondering if in any way it could be my mother.  What MADE you, robin? my mind practically shouted....How could I disregard the bubbly, foolish sense of beauty I felt looking at it?  And: How could  I reconcile that with the pain my mother endured before she died?"

Sitting on the porch that night, I saw a bird in the tree above me.  As I took in the vibrant yellow of its wings and the ease with which it floated from branch to branch, I again came back to the confusion, apathy, alienation, frustration, terror and sadness that I see on Dad's face every time I visit.  On a bad day, I would use the word "suffering".  In what world that can be filled with so much magic and beauty is it okay for pain and disease to endure with such vehemence?  And when it does come to and end...then what?

All Choked Up

It's common for the elderly to have problems with swallowing.  As the body starts to decline, it's just one of the basic functions that starts to fail.  They are at high risk for aspiration, which is when food, saliva or anything else enters the trachea and lungs, often leading to infection and pneumonia.  It's especially common in people with dementia, because the body essentially forgets how to swallow properly.  The larynx no longer closes, which is key to preventing aspiration.  Oddly, thin liquids like juice and water are especially problematic, because the muscles don't identify them as substances so they sneak past and can cause choking. 

Dad starting having problems with this about a year ago, and ever since he has been on either "nectar thick" or "honey thick"- a thickening agent is literally added to his beverages so he remembers to swallow it.  In the past few months, he has started coughing more and more when he eats and Julie, his Hospice nurse, has noticed more buildup in his lungs.  Three weeks ago we downgraded him to a "mechanical soft" diet, which basically includes foods he doesn't have to chew very thoroughly but leaves room for some texture, such as Sloppy Joe meat and scrambled eggs.  Eating has always been a source of pleasure for him, so I was reluctant to even take that step, but it seemed necessary. 


Pureed lasagna...yum

 I talk with Julie several times a week so when she called this morning I figured it was just with a medication update or something like that.  Instead, she said, "We have to put Henry on a pureed diet."  Then she paused before adding, "He choked this morning during breakfast.  Carrie, he turned blue.   His lips were purple.  It could have been...really serious.  He was visibly scared, actually panicking."  After I caught my breath, she told me that she was feeding him and he started coughing, then stopped coughing and stopped breathing.  Fortunately, one of the hefty med students was nearby and was able to lift Dad out of his wheelchair and dislodge whatever was stuck.  Had that not happened in time, well...I shudder to think...Dad choked on a piece of candy while lying in bed when he was a teenager, and I think it's the only thing he's ever been afraid of.  He's always said it would be the worst way to go, and yet it almost happened to him this morning. 

I had been doing okay.  I had gone several weeks without a breakdown, and can't remember the last time I cried.  It's been a year and a half since Dad was first admitted to Hospice, and it sounds strange but I'm actually sort of kind of getting used to it.  That in no way means that I've stopped my care and concern, or take it for granted that he will be there the next time I visit- I make sure that every time I leave the last thing I say is "I love you" and I am somewhat comforted knowing I will have no regrets, should something happen to him while I am not there.  But still.  The call this morning set me off in panic mode again, and after I hung up with Julie I sat down on the floor and cried.  And the memory of the taste of salt and tears on my face gave me flashbacks to some of the things we've been through, and I cried some more.  The release left me exhausted and nauseous, but it obviously needed to come out.  All day I've pictured his blue face and even now, eight hours later, I can't stop shaking. 

I somehow have it in my head that Dad is going to die this nice, comfortable death that they describe in the Hospice books.  He'll stop eating, become less responsive, his body temperature and blood pressure will go down, and he might even feel like he's in a peaceful place.  Julie will see that death is more imminent, and I'll be able to spend his last two days or so with him, holding his hand and singing.  Even if he does catch pneumonia, which is likely, they can usually predict the actual death within a few days.  But what if it doesn't follow that pretty, linear pattern and something happens while I'm not there?  I've read so much about grieving, talked with so many Hospice workers, commiserated with so many friends going through a similar journey.  But you're never prepared.  I thought I was ready-ish.  But my father almost died this morning without me there.  And I'm not ready.

Back to Biking

I don't remember ever not having a bike.  Growing up in Chicago, we lived across from Lincoln Park and would ride everywhere- to the park, the zoo, the beach.  My school had yearly Trike-A-Thons, and we would decorate our rides with streamers and balloons and parade them around the park with pride.  We moved to Evanston when I was six, and I was finally old enough to ride a Big Girl bike- a beautiful red Schwinn with a glorious sparkled banana seat.  I remember my father holding me up while I practiced balancing, but it was pretty natural for me and in no time I was riding solo.  

Riding away, circa 1983

For a few years we lived in Barrington Hills, which lived up to it's name and since Evanston is completely flat I loved the change of elevation.  I would go out every morning, climbing up the hills and gliding down.  It was a difficult period in my life, and biking was a source of joy and escape and a way to feel grounded. 

In college I was casually enjoying biking, swimming and running, so when a friend asked me to do the Chicago Triathlon with him I thought, why not?  Without a doubt, the bike ride was the easiest and most fun part for me and I'm glad it was sandwiched between the grueling swim and exhausting run.  Until a few years ago my participant number was still stuck to my helmet, and seeing it was always a source of pride.  I later studied in England for half a year, and I was able to find a shop that let me rent a bike for $70 for the whole time.  It allowed me to get to a job and take classes at a branch of the campus that otherwise wouldn't have been accessible.  At the end of the six months it was hard to give that bike up. 

I've had my share of accidents.  My chin has been stitched up twice and I got doored on my birthday one year. I crashed in the woods while trail riding and have stitches in the pattern of the gear that cut through my calf.  My friend made a tourniquet out of his shirt and took off to go for help but it was a good 45 minutes before the EMTs made it back with a gurney.  Finally, five years ago, thanks to a hit-and-run driver I face-planted into a lamp post and bit through my lip.  My top four teeth were all replaced, I had 9 root canals on my bottom teeth, I have 13 stitches on my lip and I can't bite down all the way on the left side of my mouth, even though I had 6 months of physical therapy after the accident.  I get really bad jaw and headaches, have to sleep with a retainer, and now have a goofy half smile that I default to- I'm pretty sure there was some nerve damage to the right side of my face.  Alas, I was up and riding again after as soon as the doctor ok'd it. 
I inherited a car a few years ago when I took Dad's keys away, and I know it's made me lazy.  If the weather is iffy or I'm tired, it just seems so easy to take the car instead of hopping on my bike.  Still, until this past winter I was still using my bike almost daily.  Then Chicago had Snowmageddon and the bike I've been riding regularly for 10 years got abandoned.  It wasn't in great shape to begin with, and six months of non-use took a real toll.  When I guiltily brought it in to the shop for a tune-up a few weeks ago, they said the cost of fixing it almost didn't make it worth it.  Instead, they sold me a completely refurbished Trek that had new brakes, chains, a new tire, the works for just over $200,  and I love it. 

In the past week I've reconnected with the joy I've always gotten from riding- the wind in my face, being self-propelled, moving past cars stuck in traffic.  I've already saved almost $10 on meters I would normally have to had paid by driving, and saved on gas.  It's better for the environment, and great exercise, but most importantly it's just fun, and I'm looking forward to a great summer on two wheels.

Man vs. Dog

Last Friday, Beau's osteoarthritis flared up after what was probably an averse reaction to his rabies shot.  Although he has no other major health concerns, at 16 years old his body just didn't take the medication well.  By 10am he had lost all ability to stand by himself, and my mom made a makeshift doggie area out of rugs, blankets and towels in the living room.  She spent the night on the couch next to him, trying to reassure him that everything would be okay.  By the next morning they weren't, however, and mom had some neighbors help take him to the vet.  After ruling out a heart condition or a neurological problem, the doctor put him on a low-dose steroid and said to keep an eye on him.  For five days Mom's neighbors and friends came over several times a day to carry him outside, and mom spent hours washing and changing the towels when he couldn't wait to relieve himself. 



Beau, taking a nap earlier this week

 On Thursday mom took him to a doggie chiropractor, who said the discs in his back were severely fused and his left hip was especially weak.  He told her point blank what nobody else was ready to say- that if Beau didn't start walking soon, his insides would start smooshing together and he would most likely suffer from organ damage.  I think this really hit home for Mom, who hadn't slept all week.  For the past eight years Beau has been her devoted accomplice, friend, and family member.  He is the best companion she could have found, and his easy, cheery disposition keeps her spirits raised.  They are perfect for each other, and although we both knew this time was going to come, I guess we hoped it would happen later rather than sooner.  I've often said that if Beau could just live forever, for Mom's sake, that would be really great.  If she were fully able-bodied, things might be different, but she doesn't have the ability right now to pick him up or thoroughly give him the care he needs. 

The decision to let him go would be easier if he showed signs of suffering, but the thing is he still looks like a gosh-darn happy puppy and his spirit is just as strong as ever.  When it comes to matters of life and death, I'm a pretty big believer in the Quality of Life question, and since I only see him twice a week I can't say exactly how much Beau's is affected right now.  I do, however, regularly see residents at Dad's nursing home who are completely unaware of their surroundings and are unable to do anything for themselves.  They either exist on Ensure or are spoon-fed pureed fish cakes and honey-thick soup base.  They have fits of rage, terrors and hallucinations, don't recognize their family, and as far as I can tell aren't responsive to compassion, touch or any other outside stimuli.  Their overall Quality of Life is heartbreaking, yet they can go on in this state for months and years without anyone suggesting "putting them down".  For the record, neither am I.  However, as I'm intimately involved with these two beings who are nearing the end, I can't help thinking of how dialectical our values are. 

Beau is Mom's dog.  While I love him dearly, I have never lived with him and don't have the same connection that she does.  I've witnessed a change in her over the past week, and she now seems to slowly be coming to some acceptance that it's nearing the time to let him go.  It has to be her decision, and I trust that she will know how and when to make it. 

Reminders

One of the first things I did when Dad was diagnosed with Alzheimer's was sign him up for Safe Return, a program set up through the Alzheimer's Association. He was registered in their datebase with my contact info and received a bracelet identifying that he had Alzheimer's and to call them if he was found wandering or if something happened to him.  I expected him to argue with me, but he let me put it on with no contest.  I think on some level it provided him reassurance, as well.  I later got him a second bracelet with "Call Daughter Carrie," my phone number, and his medicines listed.  When he did go out alone he was careful to just go around the block, the neighbors were always looking out for him.  Only once did he run into a problem, but unfortunately the bracelet didn't do us any good. 

At the time he had a caregiver in the mornings and I was going over to his apartment once or twice a day to check on him and make dinner.  One afternoon about four years ago I popped in around 4:30p, and when I couldn't find him I assumed he was out for a walk.  I made him a cup of cocoa, straightened up a bit and waited for him to come back.  After 20 minutes or so I left a note in the kitchen, went outside and walked up and down the street.  Getting concerned, I jumped in the car and started slowly driving around the neighborhood, asking anyone I saw if they had seem him.  I went to all the places we had walked together- the lake, Starbucks, the library, even Jewel.  There was no sign of him, and his neighbors didn't know anything.  After an hour and a half of this I frantically called 911 and filed a missing person's report.  An officer met me at his apartment, and I gave her pictures, descriptions, medical history, and guesses at what he might have been wearing.  The officer told me to stay in the apartment and sent six squad cars out looking for him.  Restless, anxious and imagining the worst, I busied myself with calling everyone I knew in the area to alert them what was going on.  My mom and one of her friends came down and started canvassing as well.  It was getting dark and I was boarderline hysterical.  My father had been lost for almost five hours with no leads.  

I was sitting on his kitchen floor at 9:30p in tears, my head in my hands, when I saw the ambulance lights flash out front.  I ran outside to see two paramedics unloading my father from the truck and leading him to the apartment.  I stared, dumbfounded, for a moment before running up to them.  I didn't know whether to laugh, cry, or scream- I think I emitted a sound that combined all three.  Dad's face was wrapped up in bandages but he was walking.  After giving him a hug I asked them what, the fuck, exactly, was going on. 



Dad, after the bandages came off



They didn't have the whole story, but I was able to piece together that Dad had gone outside in the early afternoon, tripped over something and taken a spill.  He was badly cut and bleeding profusely, and fortunately a passerby saw him and called 911.  They took him to Evanston Hospital, where he underwent a CT scan, an MRI, received 13 stitches to his face, and was being held for observation.  He had told them his name and they were able to look up his information and medical history. My phone number was the only one in his records, and I was listed as the primary contact and power of attorney.  Nobody ever called me. This still blows my mind.  I had taken him to the same ER a month before to have a dog bite attended to.  They didn't look at his ID bracelets, and though they knew from his records he had Alzheimer's they just were treating the immediate problem, not the whole person.  I had a heated, lengthy conversation with the head of the ER the next day and the best explanation she could give me was that it was a busy night and they had some new med students working.  I was livid and threatened halfheartedly to sue, but I knew I didn't have the time or energy.  She wrote off the hospital, doctor, and ambulance fees and we left it at that.  I just wanted the nightmare to be over. 

I try as much as possible to focus on the present moment when I'm with dad now, and not think about all we've been through together.  Last week, though, the nursing home gave everyone new standard identity bracelets and gave me the old ones back.  This story flooded into my thoughts, and I was reminded of how traumatic it was for both of us.  Just one more link in the bond he now seems unable or unwilling to break.