There is no pleasure worth forgoing just for an extra three years in the geriatric ward.

— John Mortimer

The family trip is officially over.  Dad is back in his home.  My sister and her kids are flying back to Mexico City.  My brother is beginning a well-deserved recovery.  And, I am home – actually, I never left (more on that later).

The trip was a tremendous success!  I received a short email this morning which read in part, “I think that the trip did Dad a world of good.  By the third day he was talking in complete sentences.”  WOW!  He didn’t even do that when he was fine.  Ok, I exaggerate a little.

Dad’s improvement on this trip leads me to an inescapable conclusion.  Dad has a mild form of dementia, but he doesn’t have Alzheimer’s.  When he’s interested, engaged, properly medicated, AND unafraid, he does much better.  I add the bit about unafraid because I think that it’s possible that he reached a point where everything was too much for him and he had a “break with reality.”  I don’t think it was by conscious choice, but I do think that, at least for a while, he was hiding.  The problem is that by the time he chose to come out of hiding, he’d lost a few steps – quite a few.

Another Casualty of ????

It would be very easy to blame the recession for Dad’s mental state, but like most things in life, cause and effect aren’t that simple.

In business, the way that a business attempts to make money is called its business model.  Underneath that concept is a very simple mathematical calculation; Sales – expenses = profit.  For our real estate business, the successful model is Rent – expenses (mortgage, insurance, wear and tear, etc) = profit.  My dad believed that there was another essential part of the equation – real estate appreciation.  So, he didn’t pay much attention to the rent minus expenses calculation.

During most of my life, we either eeked by (low rent-high expenses=???) or didn’t even manage that.  It made my mother crazy because “someday, we’d be rich.”  In the meantime, we needed to keep the power on and put food on the table and all those other pesky things that keep a family safe and secure.

When the great real estate bubble was growing, Dad was in hog heaven.  Banks were throwing money at him for a while and he’d just take it in – and spend it on non-business stuff – like food, clothing, phone, power.  But as things wound down, loans became scarce and we had a disaster – a little wind storm that closed down a third of our business.  And Dad was in TROUBLE!

Now, he had mortgages for a property value that had just been wiped out by the storm.  For a while, he tried to beat everyone into submission – the insurance company, the city, the contractor – but in the end, he couldn’t put humpty dumpty back together again – quickly.  He needed help but our help was the last thing he wanted, and he unraveled.

Did the windstorm set him up for a disaster?  Possibly.  Did the bursting of the real estate bubble cause his problem?  It certainly contributed.  Probably, it all came together in a most unfortunate way.

How Smart Are We Feeling Today?

In A Bed by the Window, Scott Peck hypothesized that some people may choose to “go away.”  To the best of my knowledge, there’s no scientific study that supports that idea.  Yet, Dad has managed to work himself to a place where he’s cared for and he can choose to come into our time and space and interact.  We’re not discussing Einstein’s theory of relativity, but he (who “he”) can remember for a couple of hours where we told him that we were going.  He had no interest in doing that before he came on this trip to a place he wanted to visit.

Dementia is a very common diagnosis for elderly people.  When an older person forgets the details of everyday life, the presumed diagnosis is some form of dementia.  Yet, when we don’t look any further, we don’t really know what the appropriate course of action is.

I mentioned at the beginning of this post that I never left home.  That’s because I caught a bug that seems to be everywhere right now.  I guess it’s a form of summer cold.  I probably made it worse by pushing to hit my deadline at work and when I got really sick and miserable, I found I couldn’t do exactly what I’d been trying to do.  But I noticed one thing that I think has implications for this whole dementia issue – when I was really sick, I couldn’t think worth beans.  You wouldn’t want me driving or performing any kind of semi-skilled labor.  And it got me to thinking.  Much of what we observe as dementia in the elderly can be caused by diet, incorrect or inappropriately dosed medications, low level infections, or other causes.  Our brains don’t work as well when we’re sick.  When it happens in a younger person, we attach no significance.  When it happens in an older person, it has grave implications.

Dad will never live on his own again.  Part of that is his mental decline and part of it is his physical decline which comes from being unwilling to get up and do stuff.  He doesn’t want to go to exercise class.  He’d rather just sit there.  And when we let him, he continues to wind down, slowly on some days – more quickly on others.  But this trip has taught us a very important lesson.  At least in my Dad’s case, his dementia is related to what attention and stimulus he receives.

Maybe it’s a blessing that he is content.  Maybe we’ll never know whether it is or not.

It sure makes you think.