Monday, November 18, 2019


When Jim developed dementia, one of the things I missed the most was our conversations. No matter what the daily schedule, we always took time to drink a cup of coffee and talk. Most of the time, our first cup of coffee was in bed propped up on our pillows.

Our first indication that Jim had dementia was the day he couldn’t remember his social security number or his birth date. To forget any date, much less his birth date, set off the alarms in my head.

At first, he still looked and sounded the same. As time passed, he became vague in his speech and searched for words for common objects. He often became frustrated when he couldn’t communicate.

Gradually, our conversations became less meaningful until after a few years, Jim developed aphasia and became mostly nonverbal. He used what I refer to as “stock” phrases. Some of his favorites were “right here, but I can’t find it” or “I have no idea” or “is that right?” and “you’re going the wrong way.” I saw him have conversations with strangers, and he inserted enough “is that right’s” that the person had no idea that Jim had dementia.

After you are around someone with dementia, you are more attuned to the language changes that indicate an underlying neurodegenerative disorder. Subtle changes in speech may occur up to a decade before the onset of dementia, or as in Jim’s case, a short time. Researchers are using speech patterns as a way to identify at risk individuals with mild cognitive impairment (MCI) and those who are in the earliest stages of dementia.

1.      Rambling and Non-specific Speech. People with MCI may use more words than necessary when they speak. Individuals in the early stages of dementia will have trouble finding the correct words, talk in simplified sentences, and make more grammatical errors than normal. Word finding may lead to calling objects by the wrong name, for example calling an apple an “orange.” It can also lead to a lengthy description instead of a word. When they can’t recall the word “book,” they may say, “You know, that thing with words and those things you turn…”
2.      Formulaic Speech. Formulaic speech is a more scientific version of what I referred to earlier as Jim’s “stock” phrases. Using a lot of common phrases repetitively such as “you know what I mean” when a person cannot express what he or she is trying to say.
3.      Weak Language. A person with dementia may start to speak in fragmented sentences and not finish complete thoughts. They stop using less common words and use fewer meaningful adverbs or adjectives.
4.      Not Understanding Written Language. Along with speech problems, persons with cognitive problems may have trouble reading. They might be able to recite written words, or even read a book, but not fully understand what they have read. Jim was a prolific reader and we were regulars at our local independent bookstore. I began to notice that Jim sometimes bought a duplicate or triplicate of the same book. He was reading, turning the pages, but he couldn’t follow the storyline.
5.      Unusually Rude Speech. As language skills erode, frustration can make a person with dementia rude. If the part of the brain is damaged that filters thoughts from being spoken aloud, the brain doesn’t censor what comes out of the mouth. After Jim quit smoking and stores relegated smokers to benches near the entrance of the store, Jim would shake his finger at complete strangers and say, “You better quit that damn smoking.”
6.      Repetitive questions. Individuals with dementia often use repetitive phrases or ask the same question multiple times. When short term memory is affected, they may not realize they are repeating themselves. As annoying as it is, it is best to validate the person with an acknowledgement they have spoken. 

The stage of dementia and the type of dementia affects communication to different degrees and in different ways. It is sad that a degenerative brain disease can so adversely affect a person who was once highly intelligent and a great conversationalist.

When I watch old videotapes of Jim, I realize how much I missed his jokes, observations, and singing during the last several years of his life. But most of all, I missed our conversations over our morning coffee.

Copyright © November 2019 by L.S. Fisher

Tuesday, November 5, 2019

Remember, Remember

When I was a kid, someone gave us a set of the World Book of Knowledge. I was always looking for something to read and found the books much more interesting than the backs of cereal boxes.

Although the books were full of history, science, and various other subjects for school age children, I always started (and usually ended) with the literature section in the middle. The literature section had stories and poems. I memorized dozens of poems and one came in handy this month.

I made an appointment and recited, “Remember, remember the fifth of November.” I knew I had said that twice. Unfortunately, I couldn’t recall what I was going to remember. When I flipped the wall calendar to the new month, the fifth of November was a blank square. My PC was downstairs in the safe, and my phone had a dead battery.

I puzzled over the situation. I knew it was about time for my hair appointment, and sure enough when the battery came to life—there it was. This morning when I turned on my PC, I saw the other reminder. I can now get my second pneumonia shot. Well, I didn’t rush into get my shot, but I kept the hair appointment.

Rhyming poetry is a good way to memorize information. It’s how I used to remember how many days were in each month until I worked for more than thirty years plugging in the last day of the month for our reports. I no longer had to say, “Thirty days has September, April, June, and November…”  Then there’s the “i” before “e” poem, although that one is pretty worthless because of all the exceptions.

Being able to remember important events is something all of us strive to do. Life can get so busy at times, that I often think of events after it’s too late. My phone does its best to remind me of everything I need to do. I even have my grocery list on it. I’m not sure how reliable my memory is without all the bells and whistles of my electronic calendars.

Being forgetful is something that concerns me. Alzheimer’s scares me more than any other disease. I shudder to think that an irreversible, progressive disease could erode my skills, erase my memories, and thrust me into a world of confusion.

I can’t imagine anything sadder than not recognizing my grandchildren. If I lost the ability to read or write, it would change who I am as a person.

With Jim, the thing I hated the most was that we had to place him in a Special Care Unit. He was locked inside, and it hurt my heart that he lost the freedom he had risked his life for in Vietnam. That Jim spent the last decade of his life in a faraway place is one of life’s unexplained mysteries. Bad things should happen to bad people not to good people.

The “Serenity Prayer” encourages us to accept what we cannot change. I have come to realize that what-ifs and could have beens only steal my joy, and need to be banished forever. I want to change the things I can, and know that I certainly need wisdom to make that happen.

Copyright © November 2019 by L.S. Fisher

Monday, November 4, 2019

In Remembrance

At church, I sat behind the man who had been our family doctor until he retired in 2012. As we greeted each other, he said, “I didn’t recognize you at first.” That should have been my clue to tell him my name, but I didn’t get a chance before we started singing. After all, we had one family doctor and he had hundreds of patients, so that didn’t surprise me too much.

It was communion Sunday, and our associate pastor quoted the passage where Jesus said, “Do this in remembrance of me.”

As we returned to our seats after communion, doc turned around and said, “Are you still Mrs. Fisher?”

“Yes,” I said. “I remarried, but kept my name.”

“I remember Jimmy,” he said. “Your name is Linda, right?” I nodded. “It’s a shame that you both had to go through that.”

We finished services with a benediction and our final song. As we were walking out, he said, “You know, Jimmy won’t look the same when we get to heaven, but we will know him.”

I could feel tears welling in my eyes, and I said, “I know he will be whole again.”

When I dream of Jim, he doesn’t have dementia. When I think of Jim, I want to remember him as he was before dementia, and sometimes I do. Sometimes, I think of how life changed so drastically when he began forgetting how to remember. He had a phenomenal ability to recall memories, or to reminisce, as his brother Bob called it.

It is safe to say that I think of Jim every day. Sometimes, the thoughts are fleeting and other times they hit me hard. I’ve lost other loved ones that I think of often, but not that I think of on a daily basis. 

This morning, I was going to town and had some anxious thoughts about what the day was going to bring. Then, a song came on the radio that immediately took me back to a different time. The song I was hearing, “Cinderella,” made me think of Jim, strumming his guitar, and singing the song to me. He would sing, “Lindarella.” The remembrance made me both sad and happy.

Throughout life, we find moments we’d just as soon forget, but those little snippets of memory can enrich our lives if we let them. It is our past that makes us who we are today. Who we are and what we do today will be tomorrow’s memories, so we want to make them worthwhile.

Copyright © November 2019 by L.S. Fisher