M has been discharged from the Memory Clinic many months ago with advice to let her G P know of changes in her presentation.  In some ways it is a relief not to have to watch M undergo more testing.  Any observer would be puzzled by the tests and the point of scoring individuals on a routine set of questions.  Counting back from a 100 in 7’s may have its place in Primary School.  Knowing the time, date and month has less significance when you are retired.  The point I am making is that the tests are culturally loaded and relatively pointless.   Surely the important measure of deterioration is functional capacity.

M has lost all concept of time, place and person in the last few months .  She often gets lost in the house and is not sure where I am; even when I am watching television and she has just left the room where I am sitting.  Making any contribution to the preparation of meals is a struggle and seeing her try to make a sandwich brings tears to my eyes.  More recently she makes a cup of tea loses where she has put it down and has to make another.  I could go on but I hope I have made my point: there is significant decline in her functional capacity.

M retains her considerable intellect when she is lucid.  She still has the capacity to talk a good game and put on a show when required.  She slips into the ‘hostess mode’ when visitors are present: particularly family members.  While others are here she will keep going and collapse for days after they have gone: relieved that the job is done.

If the ‘cover up’ is successful they leave completely in the dark about how she really is.  Some remain in denial and see what they are already convinced of: that she is not so bad and a tired carer is painting a jaundiced picture of things.  I wonder if they ever ponder on what could possibly be my motivation for doing that?

Perhaps the only solution is to let any doubters take over for a week or two by themselves.  This would give me a break and help them to see the reality of M’s current presentation.   They would be shocked by their experience and perhaps show a little more compassion for someone who is here  24/7; respecting his marriage vows and showing his unconditional love for his wife.

Post Script

I left M washing up in the kitchen whilst I typed the above post.  Her activities have extended to packing to go home again.  The white cupboard in the Utility Room has been emptied of her personal belongings.  She has found a birthday card that she believes one of the carers has left for her.  It was sent by her daughter who died a few years ago.  Her conversation is about making sure we do not leave any of our things in her Aunty’s house.  We have now lived in this house for 15 years.

I am not sure how she would score on a Memory Test but her periods and levels of confusion are growing at a pace I did not anticipate.  My first task in the morning will be to put all her packing back where it belongs.  Another early start will be needed in the morning.