Happy Hour, Way Too Happy - An Alzheimer Journey by Sue Scoggins

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Screen Shot 2013-02-19 at 7.27.50 PM

Ok.  So it's not at the Royal Sonesta in New Orleans or at BJ's in historic Pasadena during the Super Bowl.  Seriously, I found this Happy Hour to  be so cute and funny.  Volunteers!  They are so great!  Once a month this couple comes and provides entertainment for happy hour.  He sings.  She plays the piano.  The pretzels and O'Doul's are passed out.  Non-alcolholic wine is poured for the ladies.  It's just so cute.  (Call me demented.)

Remember, Jerry is in a facility that is for assisted living folks.  That means, most of the residents are fairly independent and require only a little help.  Jerry is in a locked memory care unit in the back.  It's not locked because it's a prison.  It's locked for their safety.  They get an extra special amount of care.  They cannot do for themselves.  (Seriously.) They cannot brush their teeth, feed themselves, dress themselves..they cannot even sit on the potty.  Yet, they still have an essence of "self" and  are treated with dignity and respect. They are family.

For happy hour, the residents in the memory care unit are brought in with the assisted living folks in the front.  It works out great and there seems to be no judgement at all regarding anyone's capabilities.  It's a beautiful thing to see such acceptance.

Back to today's happy hour.  When the entertainers said they were going to do love songs....I thought I was going to gag.  Not again.  Sappy love songs!  Don't you know what you're doing?  But, as Jerry drank his O'douls and I snuck a swig, I could hear the "others" singing.  I could hear Andy Williams', "Moon River, wider than a mile.  I'm crossing you in style someday".  These people were singing along.  (at least some of them.)

It's not your ordinary happy hour.  While the activity director put the brakes on a wheelchair and the nurse replaced the oxygen tank for someone who had run empty....she gave her a kiss on the forehead..and continued to sing along...with those bluesy love songs...."The more I see you...the more I want you", written by Harry Warren and Mack Gordon and Stardust, sung by Nat King Cole.

Guess the reason I didn't get all weepy sad was because Jerry never much cared for those romantic songs.  Now, if they had sung "Alabama's fight song" I suppose he would have responded.  But, as it was....I was perfectly ok with his drinking his O'Doul's and staring at me.  I just couldn't help it when "I'm in the Mood for Love" began.  I looked into Jerry's eyes, sarcastically raised my eyebrows and stroked his cheek and sang.  I saw a slight grin.  I think he caught it...for a second.  I could just see a slapstick comedy coming on.  But, I refrained myself.

There was a time, though, that was the "pièce de résistance".  The perfect moment when one of the crotchety elderly women yelled, "DO YOU HEAR A THING THAT THEY ARE SAYING?"  It was a moment to remember.

No pun intended.

Real

I once heard a radio psychologist suggest that we should not write when we are fatigued, hungry, angry, (something else, I forgot). Well, .......

People have said that I will have extra jewels in my crown.  Don't know about the jewels in the crown...I don't want them.  It's getting too heavy.

There's a country band that comes to Jerry's place once a month.  It's Jerry's favorite ole timey country music.  After such a great "respite" I thought I'd go and dance with him tonight.  BAD IDEA!  He is so pitiful.  Don't know whether to be happy or sad.  When you see these beautiful people…besides the smell of urine, the food drippings on the top of the shoes, the bruises on their faces from falls, the glazed eyes…..what else can I say….I try to see what positive that I can.

Jerry is still beautifully handsome…very skinny…but handsome.  His eyes are still radiant blue…but they see far off in the distance and they are "wanting".  Tonight, he was completely unaware that I was sitting by him….I was sitting on the wrong side.  I should have been sitting on the left.  I am so grateful to these talented people who give of their time to bring these tunes to these forgotten folks.  There is a "mean" fiddler and a blind bass guitar player with a great sense of humor, the woman with a velvet voice and then there is the man that slides on his steel guitar. They smile bravely and joke but there is one singer who insists on playing the old woeful whining songs that bring the room to a downward spiral.  It takes two Orange Blossom Specials and a Good Ole Mountain Dew to get the hands clapping again.

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Screen Shot 2013-02-12 at 10.00.37 PM

Jerry was rather unresponsive tonight which brings me such sadness.  I think he was even hallucinating but I couldn't tell. There was no dancing. Oh how I wish I could hear a cohesive word come from his voice.  We held hands tonight...all four of them, his and mine.  His hands are so soft.  If there was anything that use to get a rise out of him…it was foot stomping country music.  When the Orange Blossom Special was over, he got so excited that he gingerly rose to his feet and walked to the front of the room amongst the singers.  He had no idea where he was going.  It was so pitifully sad but a smily type of sad.

Ok….now that you are probably crying.  I'll stop. I realize this is sad.  People say this is cathartic for me.  Yes, it is.  However, it is real and I am not the only person to experience this.  There are many.  We will cry.  We will be blessed.  We will be stronger in time.

Now, I think I'll go eat some toasted raisin bread with extra sugar on top....along with a gin and tonic..then go to bed.

Re-energized for Year Fourteen - An Alzheimer Journey by Susan Scoggins

As a caregiver, consistency in routine seems to keeps things working at their best.  VIsits twice a week, once during the week and one weekend day, keep the time with Jerry pretty positive.  We used to have lunch dates, but because of his declining state, I now go just after lunch, around 1:00.  If the weather is nice, I still put him in the car and we drive around town to see his favorite waterfront, the birds and the boats.  If the weather's too cold, we head to the facility dining room, which is white table cloth, and have a coke or coffee and a cookie.  (I'm always prepared with cookies or peanuts.) After months on end, my mental energy tank begins to run low, so I've found that I HAVE to get out of dodge for a couple of weeks a year to refuel. I can feel myself sinking, my paintings lose their energy and so do I.  Luckily for me, my son lives in California, so it's the perfect escape.  In our 41 years of marriage, Jerry and I rarely left each other (accept for his business travels.)  I wasn't one for girls weekends and he wasn't one for guys golf trips.  I suppose you could say that we were stuck to each other like amyloid plaque and brain cells (not funny).  The first time I ever left Jerry for over one night, was a year and a half ago.  He was at the facility and I went to a two week art school in the mountains.  We both survived.  Then, last spring, I went to Santa Barbara for a week of intense painting.  It was wonderful.

Capitola By the Sea  20x24 oil on canvas

Capitola By the Sea

20x24 oil on canvas

January and February are overcast and dreary in the Carolinas.  That type of weather in Alzheimer world is a recipe for depression.  So over the last few weeks, I went back to California.  With my paints neatly packed, a rented car, and US 1, I drove through Carmel and Big Sur, then ended up in Pasadena with my "old same", my son, Mark.  He's good for reenergizing me.  We worked on a new website, created a new art video, played great music, laughed and celebrated being together. It was a beautifully crazy fun time.  And even though I felt the need to call Jerry almost every day, just like in the old days, each day, his nurses who are well versed in knowing how to make the families feel good, would say, "He's fine.  He danced with me today."  This trip was the perfect thing to refuel my emotional and mental energy tank so that I could go back to him.

Refreshed after two weeks, I walked into the facility curious if Jerry would know who I was.   The aide had him back in his room, bathing and dressing him, shaving and putting all his "smell good" on.  When he walked out, I melted as usual.  He put his arms out, but he did not know who I was.  (He gets lots of hugs from everyone who sees him).  I wrapped my arms around him, pulled away and told him it was me.  Hugged him again and laid my head on his chest.  As we walked down the hall, I could tell he had a happy countenance. His eyes had a brightness to them.  Even though he didn't know who I was, he knew he was with someone who made him happy.  We wandered down the hall to the living room but he wasn't content staying at the facility.  WIthout words, I could see he wanted to go.  This is our routine...go, get in the car, and drive around.  He knew.  He knew who I was.

If you have any opportunity to enable a caregiver to get away and have a re-energizing retreat.  Please do so.  It will help them go the distance.  Thank you all for encouraging me.

Striped Pumpkins - An Alzheimer Journey by Susan Scoggins

Striped pumpkins.  Today, it was my privilege to take my love for art to the assisted living facility where Jerry lives.  In the morning, I work with the residents in the Alzheimer unit.  In the afternoon, I work with the residents in the assisted living section. When I first began this endeavor, I didn’t know what to expect.  Honestly, I do not expect anything.  That’s exactly what makes the time so exciting.  If I had my own unrealistic, preconceived expectations I probably would get frustrated.  I mean when I brought in pumpkins to paint, one of the residents didn’t want to participate because “That’s not what you do with pumpkins.  That’s not even big enough to make a pie!”   I made light of the comment  and passed out a couple of pumpkins large and small.  These would be corporate pumpkins where all the residents would contribute their artistic skills.

Some of the residents can hardly hold a brush and if they can, they don’t know what to do with it.  But once, I got the brush loaded and placed in their hand, I moved it once or twice and away they went.  The session only lasted about 30 minutes...but it was 30 minutes of smiles.

These smiles may not be remembered for long, but it is the smile of the moment and the more moments of smiles we can have the better.

 

 

We Have a New Roomie - An Alzheimer Journey by Sue Scoggins

It was Sunday and a beautiful fall day.  When I arrived at Jerry’s place, I could see him in the main room where most of the residents “rest” watching tv.  They were watching Andy Griffith.  I could see Jerry actually leaning forward and looking up, as if he was actually watching good ole Andy.  Some of the other residents expect their greeting hug when I walk in the room.  A squeeze makes their day.  Jerry didn’t exactly know who I was at first.  However, I took him by the hand and walked him down the hall to his room.  When I got there I noticed that there was a new bed, pictures on the wall, another lounge chair and a BIG tv.  He had a new roommate.

It was exciting.  It looked like his new roomie might be a good match.  Jerry and I walked on out to the front porch where I had noticed a group of folks sitting in rocking chairs.  What a beautiful family!  His new roomie, I’ll call him Roy, was sitting in a wheel chair next to his endearing daughter and her husband.  I could see the angst of this new transition by the red rimmed eyes.  But, we all stayed upbeat, talked about the country western band that comes once a month, and how Roy loves old movies.  I could see how Roy was trying to be brave......his face would begin to reveal his cry..... he wanted to go home. I’ve seen that face before...many times.  Yet, he knew he had to be brave for his family’s sake.  He was.  Jerry still is.

Jerry’s doggie, Montana, was waiting in the back of the car so we ventured over to give her a pat on the head.  The cool fall day made it possible for her to come for her doggie visit.  By this time, Jerry knew who we both were.  (I think.)  I put the leash around Jerry’s wrist and threaded it through her legs so she wouldn’t pull him and off we went to circle the parking lot.  As long as Jerry is able, we’ll  go for a “tour” around the area.  (This photo above was taken 4 years ago.)  Fresh air and outdoors is in short supply when you are in a locked memory care unit.  Not that they don’t do the their best to keep the resident’s active and get them out....still, it’s not the same as being able to get out whenever you want.  None of these alzheimer patients are able to do anything without assistance.  The residents up front in the assisted living section are able to sit out front whenever they want.  And they do!

Back at the unit, Roy was taking a nap, and the each family member was saying their goodbyes.   Sons, daughters, in-laws, and his granddaughter came out one by one.  All greeted Jerry with empathy and infectious smiles.  Jerry’s face  lit up with a smile as if he  belonged to them.   For them, it was a heavy hearted day but in their heavy hearted ness, they were able to be uplifting.   We’ll be in this together for a long time.  New friends.  A new roomie.  A gold nugget !

Survival 1301 - An Alzheimer Journey by Susan Scoggins

One year ago this month, I bought a bike.  The reason this is important is that one of the keys to caregiver success is to exercise. Trust me, this is not to pump me up or give me “kudos”.  This is for you!  So many of the caregivers that I meet are so strong and resilient.   I’ve often wondered how they remain so strong and not so seemingly emotional as I am.  Honestly, I am a female.....an emotional one.....one who wears her emotions on her shoulder and who shares a lot with others.  No pretense here.  I am an open book.

Last July, my lower back gave out.  Jerry had been in his new home for about 8 months.  Each day was a struggle for me, but my game face remained on.  Unfortunately, my body was falling apart day by day.  When the back went out, I remained immobile and in excruciating pain for weeks.  I was faced with a decision.  Either crawl under a rock and die.....or pull myself together and get stronger.

Money is rather tight when memory care facilities are a part of your monthly bills.  So, I really was having a hard time with what to do.  I frequented our local bike shop which is only a 2 mile walk from my house.  The bikes were so exciting to look at.....my pipe dream was to be the female version of Lance Armstrong.  I stewed over it for about a week, when I got a call from my gallery.  Henrietta, my ostrich sold!  Yay!  It was as if she was saying, “Quit procrastinating!  Go buy that bike!”  The thrill of the sale prompted me to run right over and collect that money.  Shortly after that I skipped into the bike shop and paid cash for that bike.

That was the beginning of getting stronger.  The sense of  accomplishment by adding on more miles each week gave me a revived energy and I soon found myself looking  forward in a positive way.  My attitude in dealing with Jerry became stronger both physically and emotionally.  Not that there haven’t been set backs.  After all, it does rain now and then.  But I am here, one year later, to say that my outlook is different, my body is thirty pounds lighter and much healthier.  Tour de France, here I come!

Take it from me, we need this to survive and thrive.   Thirteen years and still counting with my Jerry dearest.  All the more reason to be strong.  It’s what our loved ones would have wanted.

The Diagnosis. Now What? - An Alzheimer Journey by Susan Scoggins

In the past two weeks, I have run across four new families who are facing the new diagnosis of dementia or Alzheimer disease.  Most have been noticing symptoms for a while, but the symptoms finally have gotten bad enough to seek a phyisician’s opinion.  The Diagnosis.  Now what?

Some people wonder what’s the point of getting a diagnosis?  There’s not a cure anyway.  But, having a diagnosis atleast let’s you know what you are dealing with as a new caregiver.  Also, the patient usually is aware that something is happening.  Knowing the diagnosis is the beginning of getting the right tools to cope.

When we first heard the diagnosis we were in shock.  There were no words said.  Just silence.  Soon, the overwhelming emotions began swirl in unpredictable patterns; intertwining  panic, fear, anger, sadness and a sense of helplessness.  At the age of 51, Jerry was declared 100% disabled in a matter of weeks. He was put on short term, then long term disability and life as we had known it...ended.  Step by step we began to pick up the pieces and build a new and different life.

I vowed to be with Jerry until the end. Yet, a fear  of the future kept entering my thoughts....”what if I can’t do this?”  “this could be for twenty years.” “he might be in a nursing home.”  I had to discipline myself not to worry about things that may never happen.  We lived to the fullest and took each day one at a time.  Carpe Diem!

I can think of two things that needed to happen right away.  Simplifying and Securing.   Simplify the surrounding environment.  Secure the finances.  Personally, I like to tackle things head on. Knowing the impending cost of this disease prompted me to sell our family home and become debt free.  We moved into an adorable little cottage type house that was perfect for the two of us.  An elder care attorney set up a healthcare power of attorney so I could handle Jerry’s affairs.  Finances, insurance policies, properties and wills needed to be squared away, so that I could focus my attention on caring for him.

Simplifying.  The downsizing was the first thing we simplified.  Smaller house.  Less upkeep.  No mortgage.   We purged everything we didn’t need anymore.  Material things, old clothes, and filed paperwork from the last century!   The only things that we kept were functional and personal treasures.  Ah....it felt so good.  Next was simplifying expectations.  We still loved to go out.  Now, however, we went to restaurants when they weren’t crowded.  We went to movies earlier.  We walked the mall and stopped for coffee early in the morning.  We traveled extensively.  We still went to church, however, the crowds were too hectic, so we entered in the back entrance and slipped in the front of the sanctuary.  Anything you can do to keep active, yet simplify the chaos will enable you to enjoy each other longer.

Hospice - An Alzheimer Journey by Susan Scoggins

Here’s Jerry about 9 months before he entered his facility.  Pretty handsome, huh.  He cleans up good!

Yesterday I received a phone call from our hospice social worker.  She had just been to see Jerry and wanted to assure me that he was being well taken care of.  She arrived after lunch and wondered why the lights had been turned down.  On most days, after lunch, the residents are wheeled into the activity room for rest time.  The TV and lights are turned down low and most of them nod off while sitting in the circle, one next to the other.   She told me Jerry was taking full advantage of it and was sleeping peacefully.

The first time I saw Jerry like that it really upset me.  Seeing a once vibrant man sleeping upright in a chair, surrounded by other sleeping people just looked so pitiful.  (Course, I don’t know why that would be any different from the good old days when he slept on the sofa “studying” the TV.)  I’ve gotten use to it though, and actually get a peaceful easy feeling when I see it now.  Sort of like seeing a sleeping baby.

I asked the social worker about his weight.  She hadn’t checked his weight this visit, but recalled from the nurse, that it was still going down.  I think, at last weigh-in, he was around 140lbs.  Pretty thin for a man of 6’4”.  Jeddy, his aide, had told me that he was eating well but that it was just passing right through him.  The social worker told me that this was called “failure to thrive”.  It’s when, no matter how much the patient eats, the body does not process any nutriments anymore.   They just continue to lose weight.

There is a misconception that hospice services are only for that last six month of life.  Actually, there have been patients under hospice care for years.  What keeps Jerry qualifying for services is his “failure to thrive.”  His condition continues to deteriorate, which makes hospice available for the long term.  I have been so pleased with the hospice workers.  Unfortunately, I have not met them all, but I have met the social worker, nurse, nurse’s aide and chaplain.  They visit every two weeks.  It’s good to have an extra set of eyes on Jerry’s care.  Each time they visit, I get a call and an update.

Just wanted to give you hospice update.  I’m going to see Jerry tomorrow.  For sure, we’ll visit the FroYo place for a cup of frozen yogurt and not worry one bit about the calories.

There’s Still More to be Done - an Alzheimer Journey

For quite some time, I’ve asked God why?  Why is Jerry going through this?  Why is it taking so long?  Why the suffering? I learned quite some time ago that the question “Why?” is something that cannot be answered.  My belief is that when this life is over, we’ll understand.  For now, we’ll never understand the full picture of what God has in store.  For me, I can only wait and abide with Him.  Walk with Him day by day, moment by moment.

It  has now come to the point that we can see that Jerry’s dying is very real.  Up until now, we’ve been able to continue and live the life that God has so richly blessed us with.  But, now has come the time where the rubber meets the road, so to speak.  It’s a lot harder than I thought, but God sustains me.  Pretty much Jerry is not aware of his condition.  He has moments of delight for which I am thankful.  He has security for which I am thankful.  He knows he is loved...oh, so loved.

Still, there is a little fight left in him.  Even yesterday, he clinched his fist loosely and mumbled.  I knew what he was saying...."I’m trying to hold on.”  I held his hand and actually tried to communicate about his leaving.  I asked, “Why?”  He began to cry. I asked, “Are you afraid?”  He said, “No.”   I held firmly and rubbed his arms, “Don’t you know that Jesus has prepared a place for you?”  He heard me and said, “Yes.”  I said, “He’s prepared a place for me too. There will come a time when we’ll have to let go.”  Then, we both cried.  He was aware in those moments.

This morning, however, I had this epiphany.  Even though Jerry’s death is near, none of his know the day or hour.  It could be a day.  It could be a year.  Alzheimer deaths are completely unpredictable.  I realized that, no, there are still things that have to take place before Jerry goes.  God is not finished and there are grand things that must take place first.  Grand spiritual things.  It gave me a completely new perspective.  I saw a much bigger picture...much bigger than just us.

So, maybe that is “why”.  The answer is coming and it will be  far greater than I could have imagined.

Our Thursday Visit-An Alzheimer Journey

I arrived around noon and the staff was walking several of the men in the facility to the activity room.  The activity directors were grilling hamburgers and hotdogs for the men in the unit.  It was their Father’s Day lunch.  NO WOMEN ALLOWED!  The minute I walked through the double doors I saw this long lanky man’s silhouette in the hallway.  They turned him around and pointed.  He came running, eyes gazed past me, but hugging me tight.  He mouthed, “How’d you do that?”  I had to squeeze him extra tight and hold his face to mine so he could see my eyes. We sat Jerry down with a couple of the other male residents and I began helping serve.  It seems to work better to actually participate in the activities, verses observe.  Once finished serving, Sherry (the assistant activity directlor), and I sat down.  She began to feed one of the residents, I held the conversation and made sure the other spoons were making it to the mouth with food actually on them.  Jerry can still hold his burger once I clamp his hands on it.  George, Jerry’s roommate, has to have his food pureed.  The reason being that an Alzheimer patient, in the late stages, looses the ability to chew and swallow.  It was still a positive experience and one that I am now use to.

Once our luncheon was over, Jerry was anxious to “go somewhere”.  I took him back to his room to do “the do” before we left.  Jetti, our lead CNA came with me to get Jerry changed and spiffed up to go out.  I watched as Jetti took care of Jerry.  She helped him brush his teeth and gently guided the cup  to his mouth, saying, “It’s a terrible, terrible disease.”   He depended on her and looked to her for his every move.  We talked about Jerry’s decline.  And George’s too.  She said, “I’m afraid, I’m going to lose several of them at the same time.”  They seem to all be declining together.

In a few minutes, I took Jerry to the car.  I could tell he was so excited because he had a little perk in his shuffle.  His eyes were smiling as we walked arm in arm down the hall. On the way out, he saw some of the other employees.  He had to break away from me to give them a hug.  They love that.  He does too.

We didn’t stay out long.  Just long enough to feel a short escape and while we were out, my oldest daughter called.  The minute Jerry heard her voice on the speaker, he began to cry.  It was only a split second, though, until his attention was elsewhere.  The most precious part was when little 4 year old McCauley spoke.  They had a special bond and use to eat speghetti together. He asked to speak with Papa J.  I encouraged him to continue to talk and that Papa J was in the car next to me.  Little McCauley wanted to invite Papa J to come and throw the football.    It was so cute and I actually think Jerry heard the word “football”.  There is still a tiny connection.  I love the innocence and the unconditional love that children bring.

That’s it for today.  It was a good day.

Is There a Statistician in the House? - An Alzheimer Journey

My son moved to California probably about ten years ago, not knowing a soul.  Through the years he's developed several friendships that have held true.  Recently when I went out there to visit him, he arranged a get together with a couple and their daughter at a local Newport restaurant.  We had a great time together and made an instant connection. Teri and I seemed to hit it off right away.   She and her husband mentioned they'd  be coming to the East coast, so I invited her to come out early to Emerald Isle. FInding out she'd fly into Raleigh, she said, "Hey, I have an old high school friend who lives there that I haven't seen in 14 years.  That would be great, I'll visit her too."  I said, "Come on!"

As it turns out, Teri brought Barb down to Emerald Isle with her.  Barb's young husband has recently been diagnosed with ALS and I can only imagine what is going through her mind as she contemplates the task before her.  How well I know her fears, her sadness, her questions, her doubts, her strength to stay positive.   She is 49.  I was 46.

Now, some may wonder why these three strangers have come together.  None of us really knew why, but we just followed our instincts.  It didn't take long before we realized that we were all believers in Christ.  We shared our testimonies, our life struggles, danced a bit, ate a lot, and laughed.  We wondered which would be worse… losing your body and not your mind…or losing your mind and not your body?  Both are unimaginable, but this is, and will be, our journey.  Our meeting was divinely orchestrated and we knew it.

One morning, I received an email from Jerry's previous nurse practitioner from Duke, Candace.  Jerry and I truly love her and "broke the rules" by becoming pretty attached to her.  She is a gift to the medical profession.  Anyway, I had not had contact with Candace in over a year.  That’s 365 days.  What were the chances that she would email me on the day that Barb was here?

The next day, while we were all sitting on the beach, I asked Barb who her doctors were and where they would be going through their journey with ALS.  She mentioned Duke.  I couldn't help but tell her how much I loved the Duke staff and how they were a "Godsend" to me.  Then, I mentioned Candace.  Barb, stopped me in the middle of my sentence and said, "Candace?"  It was like a bucket of blessings were poured over us.  Candace will be taking care of them.

Who could have predicted all that?  Who could have orchestrated that this beautiful young girl, just entering the journey of her lifetime, would come to my home?  She came to the  home of someone who has walked a similar journey for 13 years before her.   Who could have used a feisty young man, 3000 miles away in California, who would make a particular friend out of millions of people, Teri, unknowingly arrange a get acquainted dinner that would eventually help a young girl entering this journey and who’s doctor was the same as ours?  (I think that was a run-on sentence.)

Where’s the statistician?  I’m just sayin’.

“And My God will meet all your needs/according to his glorious riches in Christ Jesus.”  Philippians 4:19

Out for Pizza

Kudos are in order for a great  little pizza place, named Paula’s Pizza in New Bern, North Carolina.  The reason I mention them is that they are so accommodating to the Alzheimer residents at Jerry’s home. Once a month, the activity director and her assistant take those who are able on a little outing for lunch.   The residents are patiently lined up in the back hallway, rolled out a few at a time to the bus and taken to their seats.  Those who can walk, sometimes help with the others who are in wheel chairs.  Each resident is loaded with care, wheelchairs, walkers and all.  It's at least a 45 minute procedure.  Once everyone is seat belted in,  they truck on over  to Paula's Pizza for  lunch.

Paula’s Pizza has tables all lined up, ready for the crew to arrive.  The unloading is quite a spectacle, but the restaurant is very accommodating.  Each resident is treated with respect and dignity as their order is patiently taken.  With the help of the staff, it's mind reading at it's best!   Mini pizzas or spaghetti dishes arrive piping hot with little side salads.  While everyone needs their food cut, but most of them can feed themselves with only a little prompting.  Some dementia patients, like Jerry, are able to feed themselves physically.  Jerry can hold a fork but just needs reminding of  what to do with it.  If the food is good, he'll eat it.  (If it's meat and vegetables, he'll ignore it.  Go figure!)

Outings really can't last for much more than an hour and a half.  Scheduling is essential because of routine, bathroom needs, etc.   Once pizza time is over, the activity director pays the bill, while the other staff members begin loading the bus again and off they go, back to their home.

These outings are a welcome change to the daily routine.  It would be easy just to let the residents roam around the halls, day in and day out.  Each new activity brings a little energy to their day.  WORK best  describes the efforts of lining them up, loading them, unloading them, ordering, feeding, loading and unloading again, but it is worth it.  It's important to givie an alzheimer patient as much "normalcy" as possible in their journey.