Today I was reminded…

Care4Mom2

I posted not long ago about waiting for the ball to drop…. 

My DH has been seemingly “normal” for a few weeks. I had started to wonder if it was because he wasn’t in a situation where he had to really use his brain…. He does his normal back exercises in the morning and goes for a walk every day. But most of our evenings are spent watching TV.  That is how our marriage of 35 years has been… So, nothing new there… After he was diagnosed with MCI in 2020, he had consistently done word search puzzles. But that has stopped.

We have two days before the movers come. Yesterday, my DH went upstairs to straighten up his clothes and pack his suitcases. I was packing other things around the house. Last night, I saw where he hadn’t done what he set out to do. His clothes were still where they were earlier and the past week… Instead, he packed things from the bathroom that he was going to need in the next two days. This morning, he again started to pack his clothes, but couldn’t figure out what to do.  I finally had to tell him to go for his walk and that I will do it…

So, I guess I answered my own question… His seemingly “normal” days were because he didn’t have to use his brain to make a decision or to figure something out. So, nothing has changed… I guess I should be happy things have not gotten worse….

M1

Sounds like a classic example of loss of executive function--he has an idea of what he wants to do but literally can't execute it.  Sorry, I know it's painful to witness.  Good luck with the move, keep us posted as you can.

toolbeltexpert

Care4mom2.  We all think we should be happy we are not in someone else's shoes. But here we are,one day at a time. M1 hit it on the head, my dw is walking around dusting with her slipper. I got the dust cloth and spray and tried to give it to her and she said she'd do it later. That's the one thing I haven't touched,dusting.

May flowers

Moving is so hard and brings a lot to the surface of a PWD. My FIL was moderate at the time of their move closer to us, but the idea of packing was so overwhelming for him. He ended up sitting in his office and shredding old files paper by paper, carefully examining each one (he kept everything as far back as the 60s). So packing fell to my MIL who was already in poor health (had stage 4 cancer not yet diagnosed) - and they had a home they shared for 50 years and were pack rats.  We offered to come help again and again but she declined. We finally just went anyway, a few days before the movers and almost nothing was packed. It took 10 of us (children and grandchildren) packing day and night. Poor FIL was just so out of sorts the whole time. He wanted to watch and see each thing that was packed. He was so sure we had left things behind and still did even after the move.

harshedbuzz

The executive function needed to participate in a move is gone by the early stages of the disease. Additionally, some PWD need to move when they may not be bought into the need or when they've forgotten they've agreed to.

IME, doing it behind their back is best if you can make that work. I was fortunate that dad was in rehab when I moved him from his house in MD to an apartment in PA. Mom was unhappy there, so 5 months later we moved them to a home in a 55+ community. We hired movers and my niece and I made the house ready to live in while I put my parents up in a local hotel for a mini-vacation.

Rescue mom

This just brought back some old memories….as others said, this loss of “executive function” where they can’t carry out certain tasks, was very early for my DH with Alzheimer’s. He appeared so “normal” otherwise, or in a brief encounter, others couldn’t believe anything was really wrong.

He said he’d pack his things (as he always did) before our last couple car vacations, but he could not. Nor could he put away his clothes in general, nor clear out garage shelves/areas. He’d say he would, then just stand and stare at it a minute and wander away. Helping with a move was impossible, unless someone stood next to him and directed every step.

He could put a plate on the table if I gave him the plate and pointed to the table. He could fold a shirt if I handed it to him and said fold. But if I just said “set the table” or “pack a suitcase”—anything that took more than one “step”—he could not.

It took me a long time (especially in hindsight) to realize how many things, or actions, are really a series of steps.

As long as he was told one simple step to do, and watched, he could usually do that, for a few years.  As you said, as long as they don’t have to figure things out, or follow a process or several steps….

June45

Not being able to pack seems to be a common theme on this thread.  Over a decade ago, before we knew there was anything wrong, my husband couldn't/wouldn't pack for a business trip.  Executive function was not even a phrase in my vocabulary at that time.  I thought it was laziness.  He was let go from his job later that year.

ButterflyWings

All this is so true. And so sad. I am still realizing the depth of his impairment, in some ways. Like even giving one-step instructions is not a safe bet here since DH is having trouble understanding the meaning of words. I asked him the other day if he needed more jelly on his toast. Blank look. 

Then he scanned his breakfast plate, pointed to the toast and said "this?" I said "yes, that's your toast" - but he had already lost the point of my initial question... so we went through the same exercise with showing him the jelly and once he processed that (I think), he said "no". No wonder it takes him so long to do anything, or he just doesn't try it at all.

***Adding a thought: DH also has had the spatial awareness issues for a long time. Another hindsight, lightbulb moment for me learning here in this forum that many PWDs experience that. So, with packing he thinks things won't fit in a box or in the car trunk that I can easily eyeball and wondered to myself "why can't he see there's a ton of room there?". It makes sense now, that some LOs might have a combination of executive function issues, language comprehension gaps, memory loss, plus spatial awareness challenges -- under time pressure to do a task, making even a "simple" thing like packing -- a nightmare.

Rescue mom

Butterfly is right; as DH disease progresses, verbal instructions—even simple,  one step things—work less and less. He needs to be shown, have it more physically demonstrated or guided. 

Before Alzheimer’s, I just considered “pack a suitcase,” “set the table,” pay the bills, etc., to be one task. I never thought about how many small steps all those take. And for some reason, although I read a lot about “executive function” and how it’s lost, I always had a hard time understanding what it really meant. 

All those explanations on the “official” web sites and booklets never made it clear to me. I thought it was something that applied to corporate bosses, or something people (you know, executives) did at work. The effect on regular daily life never hit me until it hit me.

And June (I think it was) my DH wasn’t let go because sad fact was, he was the boss. But they left him out, kept him away, and worked around him for longer than I knew, until much later. They could see he wasn’t “right,” but he wasn’t totally nonfunctional, and they couldn’t figure out? what to do about it…..in some ways it’s a holy miracle there weren’t bigger work-related problems, or flat out catastrophes.