Dementia, the Back Story

Wednesday before Thanksgiving.  Serious cold weather arriving perhaps driving temps into single digits. 

Because I have been spending an inordinate amount of time working on my next column, I have a lot of ground to cover to catch up.  I’ll begin where I left off with Clare’s suggestion that I consider signing up for hospice services.

The word “hospice” suggested end of life to me and that is why my initial reaction to Clare’s mentioning it as a possibility for Carol was to want no part of it.  When first I realized how serious Carol’s illness was and at that time someone mentioned hospice for her my mind jumped to final arrangements.  I even got in touch with a neighbor whose husband had recently died suddenly from a heart attack to talk with her about whom I should be talking to.

About final arrangements.

For Carol.

Because of the suggestion of hospice.

My original understanding, perhaps from media sources, was that hospice  was a prelude to summoning the undertaker, a transition period when a dying person was made comfortable.  At the time, hospice was first suggested to me for Carol I heard that to be eligible the individual had to be diagnosed as having some six months to live.

Thus the thought that I should be thinking about arrangement.

My neighbor said she would put me in touch with the funeral director she had worked with.  I said fine.

I didn’t follow up, nor did she get back in touch.  Perhaps she was waiting for me to take the initiative to proceed with preliminary discussions.

It was wise of her to wait on me because I was not ready so to do not only because of my  obvious emotional resistance to the idea, but because despite Carol’s cognitive issues she was quite obviously in good shape physically, a fact routinely confirmed by the medical professionals who on occasion saw her.

That is all background to Clare’s bringing up the idea.  She made it clear, however, that I was not to concern myself about that six month mortality requirement.  I now know that Medicare requires an assessment of eligibility in order to pay for the services hospice provides.  Exactly what the basis for eligibility is remains a mystery to me, but it certainly does not involve a six month prognosis.  Once eligibility is established it is reviewed periodically.

In any event, having understood that my old understanding was wrong, and  because Clare emphasized the services that would be available to us at no cost I agreed to at least explore the idea and Clare said she would set up an evaluation session to determine if Carol was, in fact, eligible.

Hanna, a nurse from Heartland Hospice came the day after I called.  She did the usual check of vitals, talked with Carol, I imagine to get an idea of cognitive functioning, saw that Carol’s right arm was held stiffly to her side and resists having it moved, which makes dressing and undressing a bit of an issue, none of that coming as a surprise to me, of course.

Hanna had me,trace as best I could remember the onset and progress of the disease.  She inquired about what help I was now getting.   She then announced that Carol was eligible for hospice, verified that I wanted to enroll her in it, which I did, as I now understood that hospice is a kind of Medicare funded insurance program.

Got this difficult topic started.  Will continue next time with the nuts and bolts.

Sunday night, the end of the four- day Thanksgiving weekend.  Watched less television tonight because Poldark’s season ended last week.

The most important service hospice offers is that Hanna will visit once a week.    I am  happy to have regular visits from a medical professional.  I checked with Chronic Care, Clare’s practice that has been supervising Carol’s medical condition, to ask about coordination with hospice.   It seems hospice is now in charge but that Chronic Care will check in every three months to verify that Carol remains eligible.

Although I do not now know, nor care particularly to find out what criteria made Carol eligible, I cannot imagine why she would lose that eligibility.

Some miracle improvement perhaps?

One should not try to find rational answers to the rules established by insurance companies, private or governmental.  Just go with them.

Besides Hanna’s regular visits, hospice will also send someone to the house whenever a situation warrants an immediate intervention, and that too is a comfort.

Hanna is a case manager, so all issues and services flow through her.  Medicare, through hospice, pays for Carol’s meds, and Hanna will need to stay on top of keeping me supplied since they are dispensed in a fifteen day supply as opposed to the 90 day supply my employer based insurance provides.  She will also put in orders for  care items, such as hygienic items, or liquid thickener, that I have been buying but will now come to me cost free

Also available from hospice are relief aides.  Since all hospice services are paid for by Medicare, I could save considerable money by replacing my current relief aides with ones from hospice, but  I declined to do so because I am well satisfied with the ones who have been providing that service for me for quite some time, a year or more, and I did not want to go through the process of working with new individuals.

I did contemplate replacing one aide to save that expense, but Hanna informed me  that hospice aides only provide bed baths, which my current aides provide.  They would not give me the block of free time I need.

Whether or not there was any truth that shaped my original foreboding about hospice for Carol,  I am relieved and pleased to see that hospice has turned out to be so supportive without any of the negativity I had associated with it.

I had been handling this situation pretty much on my own.  I now feel that although the disease will continue to do what it does, a support team now has my back and will be there to help me deal with whatever difficulties will inevitably arise.

Friday night, wind howling outside, snow already on the ground.  But at least the phone has stopped ringing, Election Day having come and gone.  This is not the place to chew over the results, just glad it’s over.

Welcome distraction from  all the political noise came from  reading the reprint  of an article from the 2007 issue of The New York Review of Books. The article was a review of books about the founding of Jamestown.  The reviewer was Edmund Morgan, one of the main secondary sources for my dissertation and I was always immensely impressed not only by his scholarship but the clarity of his prose, a pleasure to read.  Reacquainting myself with him was like getting back in touch with an old and valued friend.

This morning as I stood next to Carol’s bed, she said in the most plaintive tones “Steve.”  At least my memory now some eighteen hours later tells me that was her tone.  I can recall her expression, but I hesitate to label it lest my emotions intervene, but I will say it looked troubled.  About what, of course, I have no idea.  I believe I had just said my usual good morning and perhaps started, as is my wont, to chatter about the breakfast menu she would soon be offered.

Hearing my name, in whatever tone of voice, accompanied by whatever facial expression, in whatever circumstance, however everyday or not, whatever the context , always provokes a strong but ambivalent response.

On one level, I am pleased my name is still in her memory.

On another, I have no way of knowing whether she associates that name with me as I stand next to her.

I tried to clarify that point.

For her.

And for me

“I’m right here,” I say.  “Steve is right here, as he always is.”

She does nor respond either verbally or with a change of her expression.

I go on chatting about the upcoming breakfast, the usual toast, breakfast sausage, juice, a fruit of some variety.

I suppose one day I will no longer hear her call my name.

I’m not going to dwell on that unpleasant eventuality.

Better to think about the weather.  Will I be snow blowing tomorrow morning?  I have no place I have to go this weekend, nor do I expect any visitors, so the weather is no great concern.  I’ll just listen to the wind and let it lull me into sleep.

Monday night.  Carol asleep.  The dog snoring.

Winter arrived over the weekend.  I woke up to a snow covered driveway Sunday morning.  Only a couple of inches so I didn’t think it would be much of an impediment for me to deal with on my way to the store for Carol’s muffin and my Times.

I was wrong.  Underneath the thin layer of snow was a coating of ice.  I could not get past the end of the driveway where it grades up toward the road.  At that point, the car just slid sideways.  I tried a number of times giving myself more of a running start each time until I managed to sit on the edge of the road.

On the edge.  Not on it.

It would be criminally stupid to back onto the road without stopping to make sure the way was clear.  As it turned out, it wasn’t.  Cars coming one at a time from north and south.   When finally the way was clear I tried to back onto the road.  But lacking traction I went nowhere.

There was nothing to it but to put the car back in the garage, fire up the recently repaired snowblower and roll it out onto the driveway.  It managed to take the snow off and just enough of the ice so that when next I reversed out of the driveway I could get up to the top of the driveway, pause, and then onto the road.

Which itself was covered in snow and ice.  The four and a half mile drive to the store and back took at least twice as long as usual, as I kept my speed down to between 35 and 40.

Which almost seemed a bit too fast.

But I was dealing with conflicting pressures.

I did not want to leave Carol much longer than usual.  But I also didn’t want to risk an accident.

Now, I’ve been dealing with these roads in this kind of weather for sixteen winters.  Ordinarily, I am confident and comfortable.

Not this time.

Because I could not permit myself to get stuck or worse. Carol was alone back in the house in bed.  She cannot get out of bed to the phone, nor would she be able to use that device if it were within her grasp.  I would not be able to call her, nor would she be able to summon help if she needed it.

As usual, I know I was not being rational in that my concern for Carol was exaggerated.  Short of my being rendered unconscious, I would be able to summon help for her.  Yet, I still found myself tense as I navigated the ups and downs and curves of the road.  I was especially alert to the occasional oncoming car who might not be as careful or as experienced as I and so a head on collision was not beyond possibility.

I pulled into the parking lot outside of the store, a little surprised that there were several other cars there, more than I would have expected on a bad weather day.  But this is northern Michigan where people are not easily deterred from going to where they want to be.  I bought Carol’s muffin, and the Times, exchanged pleasantries about the early winter with the clerk as I checked out and drove back still much more carefully than usual.

Not a bad thing.

And I was more than usually happy to get back home to ask Carol if she missed me.

I don’ remember what she said.

It doesn’t matter.

Tuesday night after a troubling day.  Carol continues dealing with accumulated phlegm, resulting in much coughing and a gurgling sound as though she were drowning.

It was worse yesterday, much worse.  At one point, I gave her a little water, thinking, hoping, that it would somehow do some good.  What it accomplished was to cause her to spew out a mixture of the water and the phlegm.

This was worrisome.  I didn’t know if something serious was going on.  I checked her blood oxygen, found it to be 98%, a very good reading, but I wanted more support so I called Chronic Care and spoke to a nurse.  She asked me the color of what was spewed.  Clear, like water, I said.  Any sign of fever.  No, I replied.  And then, since this was someone I had never spoken to before, questions about the history of this problem, which I recounted to her.

By this time, Carol seemed to have settled down somewhat.  Less coughing, little gurgling.

The nurse said she would look into seeing what else could, or should be done.  A little later,Chronic Care called to say Clare, the nurse practitioner who usually sees Carol, wanted to come tomorrow morning.

Pizza supper that evening with Ryan was almost as usual, except Carol had little appetite and dozed off without eating much.

The next morning at breakfast, she ate with better appetite.  Still some sounds coming from her that I did not like.

Clare arrived, checked blood pressure, listened to her lungs, announced they were clear, recommended I begin again to give her Claritin, which I had stopped administering a while ago when the problem seemed to have mostly disappeared.  Clare said it would be good to suction out the phlegm but that cannot be done in the home.

Then, she said, she wanted to have a serious talk.

About hospice, its advantages.

I listened and agreed to an evaluation.

But there is much more to be thought about and written about on that subject, so as it is beginning to get late, I’ll tackle it next time.

The new normal for winter driving and perhaps a newer still version upcoming.

Thursday afternoon in the community library, where I have not been for some time.  As I turned onto the road leading to this building I passed on that corner the site for the new library, and there I saw that construction had started perhaps trying to get a head start before winter sets in.  That new facility will certainly be a boon to our community.  The library in its own space will be able to stretch itself with more shelving, a community room for speakers, and so forth.  On the down side, perhaps, will be the students at the new charter school now occupying this building will not be able to walk to the library as they now can, and that lost of immediate contact and familiarity with a library is not inconsiderable.

This morning Clare, the nurse practitioner who comes every three weeks or so,  checked Carol and found her  to be in fine physical shape, and she also remarked on Carol’s apparent cognitive improvement.

Which accords with my own observations as well as those of others who have seen Carol over the past weeks.

It seems, then, we have settled in to a period of relative stability.  As I am a creature of habit, although one who deals with unexpected changes, good or bad, with decent equanimity, I am content to ride this period out for as long as it lasts.

However, on the way out today, Clare asked me if I had plans for a trip to New York in the coming months.  She recalled my aborted intent to attend my grandson’s bar mitzvah last April, thinking that transporting Carol to the respite facility had turned out to be too expensive but now with her wheelchair, she could  more easily, less expensively, be transported in a van supplied with a lift.

Perhaps so.  But I explained that travel arrangements, and the costs thereof, were only part of the problem.  My continuing hesitation was emotional, and frankly I don’t know if I am ready for a week’s separation.

Which I know, on one level, would do me some good.

But on another, I imagine would be difficult.

Would I feel guilty that I was somehow neglecting my responsibilities?

I don’t think so because no doubt I would have taken care to be sure she would be well attended to in my absence.

Would I think nobody else could replace me?

A ridiculous thought.  Three times a week I leave her in the care of my relief aides.  True, those times are for only a few hours.   Yet, all three aides do a fine job. In that respect, I am eminently replaceable.

But, and this is important, those hours do not include potent emotional periods of going to sleep, rousing in the morning, and in a counter intuitive way, that period of sleep when I lie within a couple of feet of her, when I have held her hand before stretching myself out, and taken her hand upon rising and greeting her in the morning, when during the night I have heard her breathing, or moving about in the bed.

Irrational concerns?

Yes, but who ever said irrational concerns were irrelevant?

Maybe I need to take such a trip once and see how well I and she do.  If successful, it can be replicated.

I do need to find out.

But dealing with the impending winter comes first.

Come spring, we will see.

The library is very quiet.  I might be the only patron now here.  Time to pack up and head home.  As I start to close my laptop into its case, I look up and see kids, maybe eight or  ten years old, lined up under the supervision of a teacher about to march out of the library and back to their classroom.  For all the advantages the new library building will offer, I will miss seeing these young people, their presence surrounded by books somehow suggesting hope for the future.

Monday night before election day.  Political robo calls kept my phone ringing with  increasing frequency all weekend and into today, the last call arriving well after supper.  As usual my caller ID alerted me to these calls and so I didn’t bother getting up to answer them.  But I noticed that my voice mail was not picking up the calls, and then I remembered the scheduled power outage starting after midnight and into Saturday morning.  When the power came back, my answering machine had defaulted to its off position.  I switched it back on just in time to catch another call.

That power outage somehow also seemed to have fried the motherboard in my new desktop.  At least that is what the Dell tech diagnosed as the reason the unit would not power up.  A Dell technician will install a new motherboard on Wednesday, so I’ve been told.

The falling leaves have opened up my view of the  East Bay again, a sliver of water more gray than blue now visible.  Some trees haven’t defoliated yet, so the view will get better in the next week or two.

Which also means that shortly I will be looking out over a blanket of snow as winter is knocking at the door.

It is something over a year since I started keeping this journal and posting weekly blogs from it.  I began it for several reasons including sharing my experience both with others in my situation as  caregiver, but also all those who are aware of, but have no direct experience with, the growing number of older people sliding into dementia.  From  more personal motivation, I need to be writing on something, and this serves that purpose.  And finally, as a writer, I always consider publication, and so this material might become a book down the road.

A less obvious consequence of my regular writing about our situation is that it forces me to think about it rather than just react to it.  I believe that is a valuable byproduct.  Caregiving responsibilities can be exhausting.

But they can also become through repetition rather mindless.

And that is not a good thing.

Not for the recipient of the care, nor the provider of it.

On that reflective note, which had never occurred to me before it just popped into my head I will close this session with one last thought.

As a writing instructor for many years, I always encouraged students to think of  writing as recursive.  Reading what one has just written often enough leads to another idea, one that would not have occurred to the writer had he or she not been writing.

It is good to understand that as a writer.

But also as a tool for the caregiver.

More than writing about our everyday activities, or even the problematical situations that arise and must be handled, when I sit down at my laptop I open a door into my mind, and perhaps most importantly, my feelings.  It makes me more self-reflective than I usually am.

And that, too, is a good thing.  That is what in hindsight I see is precisely what I was doing in the first section of this post, delving into how I felt, and feel, about taking time off from my caregiving responsibilities.

My wonderfully gifted wife placed a quote attributed to E.M. Forster beneath her email signature.  It is an apt closing quote: “How will I know what I think until I see what I say [write]?

Writing as an act of discovery, as a way to open the door to thoughts and feelings.

Monday night after a pretty good day.  Carol laughed more than usual, sometimes at something she heard, sometimes at something humorous in her head.  Ryan joined us for a pizza supper, and he noticed the increase in her good humor.  And she ate three slices.

Got some positive responses to my second column for the Record Eagle, one in which within my 550 -600 word limit I attempted to deal with the mystery of the inaccessible thoughts that Carol clearly contemplates in silence, a kind of daydreaming although far more focused than that from the look on her face.

The responses to my column, and the fact I have undertaken the responsibility of a regular gig writing for the local newspaper leads me into what I have been thinking about which, for want of a better word, I will term the schizophrenia of my life now that Carol has seemingly settled into a stable period, and my caregiving routines are well established so that each day is pretty much laid out for me in terms of what I have to do and what space is available for things I might want to do.

Prominent in the latter category is my life as a writer.

I have always found time to write, no matter what else was going on in my life, what other responsibilities demanded my attention, or bright shiny object lured me away.   Maybe that is why I almost always write late at night when the house is quiet and all chores have been attended to, and distractions would have to be sought.

Or maybe it is just a matter of my natural biorhythm favoring that time frame right before sleep.  In any case,  from day to day I must be writing on something,

So that is the schizophrenia I am talking about.  Of course, I am using the term metaphorically to suggest that I am, in a certain sense, two people.

I am Carol’s caregiver having assumed those responsibilities thrust upon me by Carol’s disease, a burden I quite willingly have undertaken in spite of the demands, emotional and physical, that it places upon me.

And the other me insists on reasserting itself by retaining the interests and activities that have always been constants in my life.

Pausing now having set up this dichotomy to let these thoughts percolate for a while before attempting to flesh them out.

Tuesday night.  Sat on the edge of Carol’s bed holding her hands with my left hand while with my right I stroked the head of the dog who had come by for her share of my attention.  Now both are asleep.

That Currier and Ives domestic scene, husband, wife, dog at bedtime, of course, belies the complexity of our situation  But it is a moment of calm if not serenity, and a good way to end the day.

So I will leave it there for now.

Wednesday night after a Halloween day during which, predictably, no trick or treaters came to the door.  We are too far out of town and there are simply no kids around here, hardly anybody much under sixty.  Just in case, I had bought a bag of small Three Musketeers, which I have begun to share with Carol.

I’ve been exploring the idea of the two of me, the one who takes care of Carol, and also runs the household, something we used to share, and the other me with my carry over interests and aspirations.  Among the latter is my writing career, which I have been at for about half a century, and am not about to give it up now.

As for the first, as Carol’s caregiver, after two years I have become pretty well used to it, and for the most part it is now routine.  For her part, she seems to have settled into our routine as I have.  Most activities go smoothly.  She still, as she did earlier this evening, calls my name, and I assured her, as I always do, that I was right there.  I continue not to know for a certainty whether she equates my physical presence with my name.

But my name, and associated memories are stored in her brain, and provides me some comfort, small as it is.

I suppose there is a next step when it might well become clear that I have in all ways left her memory and at best I will be no more than a figure like anybody else who attends to her needs.

I can’t say that I am prepared for the transition to that stage.

As for the carry over Steve, I still read books that interest me, having just finished a slow read of the new biography of Washington Roebling, the engineer who built the Brooklyn Bridge, and will perhaps tonight for a few minutes crack open the next book on my list, Elaine Pagels’ study of how Satan evolved from his brief and sometimes not terribly significant appearances in the Old Testament, primarily in the Job story, to his central role in Christianity, including becoming identified with the serpent in the Garden of Eden.

I continue to subscribe to my usual magazines, read the New York Times online, do my word puzzles, and follow my sports teams.

Most importantly, I continue to write and keep my writer self visible.  Writing a column for the local newspaper gives me an opportunity for regular publication, which most, if not all, writers not only savor but need.  Without publication, most give up writing.  Others continue, driven perhaps by something like I sense is inside of me, persisting without an audience.    I can’t say what that something is, perhaps some ego in believing you have something to say, or maybe just the satisfaction of exercising your skill in your craft, as we all enjoy doing what we do well.  But whatever it is, publication feeds it.

I  think of poor Herman Melville, years after the publication of his Moby Dick marked the end of his viability as a published writer, still at his desk, pen in hand, filling the pages of the manuscript that became his wonderful novella Billy Budd  to be published posthumously thirty-three years later during what became a revival of interest in one of the greatest American fiction writers of his century.

I am not interested in such posthumous fame.  And I’ll certainly settle for considerably less fame.  A little recognition while I am still breathing will do.

So I still market some of my finished work and I am rewarded every once in a while, as recently I was, with an acceptance, this time of a short story.  I have two excellent but as yet unpublished novels waiting for their turn in the  spotlight.

I do not think I will have the time or energy for new fiction, at least not in the foreseeable future, and that is too bad.

What is worse about all of this, is that I can no longer share any of it with Carol.

I have to accept that fact.  Our relationship wasn’t built on our mutual passion for writing.  Let’s just say it was  enhanced by it.

And the solitary version is not nearly as satisfying.

The two of me occupy somewhat uncomfortably the same time and space.  At some point one of those two identities will disappear leaving only its memory like tracks in a frozen path that suddenly stops.

Carol is sleeping noisily , her mouth open.  The dog is asleep on the floor.  My energy is fading so I think I will join them in slumber after I lay out a thread to be continued.

At lunch some time ago, the conversation turned to movies recently watched.  I felt a little envious, and mentioned I hadn’t been to see a film since Carol’s illness became serious, now about two years ago.

“Why don’t you use one of your respite afternoons?” somebody suggested.

Why not indeed?

I go shopping on one respite afternoon, have lunch out on another, and the third is available for necessary appointments, but also for unplanned, or out of the ordinary events.

Such as going to a movie.

Which I would do alone.  And that gave me pause.

One of the things I look to do during my respite times is to interact with other people since my life is otherwise so confined to me, Carol,and the dog.

So I  have my weekly lunch with my guys, and occasionally when I have time after some other errand I will have a sandwich at the old general store where I can chat with Marci and provide an audience for Jim’s endless store of tales, many of them of the tall variety.

A solo movie trip would be different.   I am alone when I shop.  But that is a chore and involves movement and interaction.  It’s true that Carol and I always food shopped together, but I recall eons ago in my first marriage occasionally doing the weekly grocery shopping by myself because doing so happened to fit better into our working schedules.

So doing that now does not feel at all odd.

In a similar fashion, I usually went to my doctor appointments by myself as did Carol before she could no longer manage to do that.

But what I had not done as far back as I can remember is go to the movies alone.  We always went together.

That’s the point, of course, we did enjoyable things together.

After a lifetime lived one way, this new idea of attending a movie by myself is both exciting and off-putting.  I guess those competing feelings make a certain amount of sense.

Off-putting because I almost feel I am abandoning Carol to indulge myself in an experience she cannot share.  I realize by any rational standard that is a ridiculous thought.  It is, after all, my respite time.  I should be doing something I enjoy.  That is the point of respite time.  I do have these three time slots each week when I can leave the house and know Carol is being well attended.

Up until now, I have used these slots for purposes that felt necessary and/or right: shopping, lunch with friends, and occasionally work, as in a writing session in the library.

But never in these two years, have I done something for my amusement alone.  In fact, I cannot recall throughout my whole life ever going to any kind of amusement, be it a film, a concert, a sports event, alone.  I may have, but none come to mind.

That recognition explains why the thought of going to this movie by myself offers an element of excitement.  It will be something new.  There is the outside possibility that I might bump into somebody I know.   But more interesting is seeing the world, for a brief period, as an unattached free agent.

Of course, I know that at the deepest level, I dread that state.  But it will be interesting to experience it for  a couple of hours before sliding back into the now very familiar patterns of my caregiving responsibilities.

And so I will embark on this embarrassingly trivial adventure and see how it goes.

Thursday night, after midnight, jazz from KXKN in my ear buds.

This afternoon during my respite time I drove into town, parked my car in the public garage.  Walking from the parking garage to the theater did not seem right.  In downtown Traverse City on an avenue lined with restaurants and shops, almost everybody else was walking with someone.

Walking and talking.

The only solitary walkers, like myself, seemed to be moving faster as if they were late for an appointment.

Or like me, they had no one to share whatever it was they doing, whether shopping, or dining, or attending to some kind of business..

I found myself picking up my pace to match theirs, even though I was not at all late for the start of the film, which in any event would be preceded by ten or fifteen minutes of coming attractions.

That short walk thrust me into life without Carol.  A small part of me felt a little curiosity, a mix of apprehension but also a bit of excitement as though turning the page into a new chapter.

Having reached the State Theater, I bought one ticket for Redford in The Old Man and the Gun, walked directly in to the candy counter, which seemed a necessary first stop, bought a big bag of M&Ms, corrected the change the volunteer gave me, and then strolled through the doors into the cavernous seating area of this renovated building to a seat in the middle of an otherwise empty row, and settled down, feeling quite strange.

The sparse members of the audience, scattered at significant distances from each other intensified the strangeness.  Redford is an icon, the movie got pretty good reviews, and although this was a weekday afternoon showing, I had expected a larger crowd.  In a more usual movie viewing experience I would be aware, even without conversation, of those around me.  Watching a movie in a theater is essentially a communal affair.  That is part of the fun.

Watching the film, I was engrossed in it as I would have been had Carol been sitting by my side.  As I usually do, I followed the plot and tried to anticipate how it would end.  Would the screenwriters succeed in that difficult task of providing a satisfying conclusion, one that seemed both plausible and meaningful in terms created by the plot?  I imagine other writers of fiction who spend inordinate amounts of time constructing narratives that carry the reader to a good conclusion might also view film narratives this way.  I do pay attention, of course, to the visual elements of film and the acting.  But for me narrative construction is primary.

I was not entirely pleased with this film’s ending, but I conceded that given its plot centered on a career criminal’s life alternating between heists and imprisonments from which he would escape, spiced by a late life romance, it would be difficult to do much better.

Back onto the street, I hastened to the parking garage.  I had reason to hurry now because I was nearing the end of my respite time. I had told the aide I might run a little late, but I didn’t want to abuse the privilege.

In the car, almost without thinking I turned for a moment toward the seat where Carol would be sitting to ask her what she thought of the film.

We always shared out responses, not always agreeing, of course, but happy for the opportunity to bounce our reactions off each other.  Often a good conversation would fill up most of the time on the way home.

I turned on the radio and let music fill the vacuum.

Late Sunday night, too late to start anything of substance, so I’ll just mention a couple of things, and then see what I can do tomorrow.

Thing one: a little while ago I held Carol’s hand as she fell asleep.  I have been doing that regularly, and perhaps will have more to say about it.

Thing two: I ordered Carol’s half wrap at lunch on Friday and served it to her that evening with our regular chicken soup plus sandwich dinner.  The sandwich used to be tuna fish.  She ate the wrap with enthusiasm.

Monday night after a pretty good day.  Cleaners came so house is in better shape, and Ryan joined us for a Chinese takeout dinner.  He’ll stop by tomorrow to give me a hand hauling up the heavy storm doors as it’s time to get serious about the oncoming winter.

The main plus today at the end of my long weekend is an opportunity for social interaction and conversation with both the cleaners, who have been coming here for years, and, of course, Ryan.  I need to find ways to combat isolation, so as to build on these people interactions, I am planning on using respite time later in the week to go to town to see a movie, probably the new Redford one.  Maybe even stumble into somebody I know.

Over the weekend Tracy called on Saturday and Danielle texted me on Sunday, and those contacts seem to be becoming regular occurrences.  That eases my mind about the long hiatus each weekend when nobody would know if I were alive or dead.  Not a morbid thought, just a practical one.

I read in today’s newspaper how a woman was stuck in her bathtub for five days because she couldn’t reach a grab bar.  She used warm water for heat, and drank cold water.  For five days until a mail carrier noticed her mail accumulating and  that discovery led to her being rescued from her predicament.

So not morbid, just practical.

That issue shelved for the while, it looks like our lives have settled in to a potentially long, stable period.  Carol’s cognitive issues, if anything, are a touch better, and her physical health remains good.  She is eating well.  Her nose still is stuffed as is mine, but she is not having much difficulty swallowing.

I am a creature of habit and function best within routine, and that is where I am now.  Our daily pattern does not vary much.  In the morning, I transfer Carol to her chair and into the kitchen for breakfast;  then we move back back into the living room where she dozes in her chair, and I do puzzles, or write or attend to correspondence on my laptop; lunch follows for both of us, Carol sometimes still in her chair, other times in bed while I generally eat mine in the kitchen; after lunch on non-respite relief days we follow the routine very much like the mornings with Carol back in her bed after a while in her chair while I again get on my laptop for work, socialization or amusement; for supper Carol is in her chair at the dining room table; after supper, she remains in her chair while I watch a little television  and after a couple of hours transfer Carol back to her bed;  later, usually about eleven, I get her ready for sleep, and once she is settled, I follow  my lifelong habit of writing in a silent house.  Then,  I read for a while lying on the couch where I sleep.  Some time ago, I bought a wrap around your neck reading device with two small bulbs that produce concentrated beams sufficient to illuminate the pages of a book.  Using it, I can read while the rest of the room remains dark.  Reading before I sleep is another old habit.

Thus the rhythm of our lives in a comfortable, repetitive pattern. I, of course, still often feel isolated, legitimately so, but the routine is a great help.

For both of us.

I believe Carol has responded well to the patterning of our lives.  I don’t know, absent any research, whether such patterning is thought to be  good thing for dementia patients, but my observation would suggest it is.

The one moment in this routine that is new and which I most deeply appreciate is my holding hands with Carol as she falls to sleep.  It is now a regular part of our routine.  I sit on the edge of her bed, and take her hand.  She returns the pressure, and usually places her other hand on top of mind,

I  treasure these moments as I sit next to her, feeling the pressure of her fingers around mine, and studying her face as her breathing becomes regular and she relaxes into sleep.  When I am sure she is fully asleep, I remove my hand from her grip as gently as possible, stand up and turn off the lamp  that is behind her bed.

It is a pale echo of how we used to sleep together, but it still provides a sense of physical intimacy that transient as it is, as much as a reminder of a lost past as it is, puts a gentle close to my caregiving responsibilities.

Then, since it is usually not yet midnight, and my bio rhythm perks up at that time, I write.

As I have always done.

This ordering of our lives, into which I mix the necessary chores of keeping food in the house, paying bills, attending to whatever problems the house, inside and out, decides to present,  schedule necessary doctor appointments for both of us, this structure enables me to maintain my equanimity in the face of this most difficult situation.

And it does one more thing, a most necessary thing: it provides regularly recurring time slots during which I can write, as well as to attend to the business end of writing.  I don’t have as much time, or energy for that matter, as perhaps I once did.  But what I have is enough for me to continue practicing what is so essential to my nature.

Were she able, I am sure Carol would agree as she was always so supportive of me in that regard.

Were I to stop, I believe I would be failing both of us.

Anyway, I don’t think I could if I wanted to.

After midnight Sunday night.  I have been busy the past few days working on my new writing opportunity as a columnist for the local newspaper.  It is important for me so to do to maintain the semblance of balance in my life.  The result, though, is I haven’t had as much time or energy for this project, and it is too late to do much tonight. 

I ‘ll  scratch out  a few words  in the hope I can pick up some momentum tomorrow.

As usual I watched PBS tonight, first Poldark and then a documentary on Itzhak Perlman  Nothing unusual in that fact.  What was different was that Carol, in her chair, was in the tv room with me.  Not in her bed.  Or drowsing in her chair in the living room.  But in her chair a few feet away from me, positioned in front of the recliner in which she would sit when we watched television together.

I did not come to the decision to wheel her into this room this evening lightly.  I don’t want to over analyze this, but it is worth a little exploration.   I was happy to have her in the room with me even though, for the most part, she was asleep.  I say for the most part because at least once she laughed at something humorous in the Perlman piece.  So maybe she was drifting in and out of sleep and processing, as she does, what she hears rather than what she sees. At any rate, I don’t now recall what she found funny, but I am sure that her laugh was in response to the audio from the show, and not from a voice in her head.

I guess having her in the room with me, in front of her own chair, can be seen as an effort on my part to hold onto a piece of our pre-disease lives.  I don’t see anything wrong with that when there really is no better alternative in our situation.  When, as I usually do, I watch television alone while she dozes in her chair in the living room until it is time to transfer to her bed, that separation is a concession to her disease that might ultimately prevail.

But not just yet.  Her presence in the tv room in front of her chair, occasionally responding to some bit of audio is a useful fiction that I intend to continue as a retention of the past because that past unexpectedly recurs from time to time.

Such as this morning when I was in the kitchen beginning to prepare breakfast when from her bed I heard her call, quite distinctly, my name.  I called “What?” to her.

I didn’t expect her to respond, and she didn’t.

But that brief interaction had the feel of our old time normalcy.

“I’m fixing breakfast,” I continued.

As I would have done in the past.  Perhaps she heard and processed what I said.  I can never be sure.  Often when I leave her for a little while such as to run down to the store or the post office, or even across the road to get the mail, I tell her what I am doing, ask if it is ok, and when I return I tease her by asking if she has missed me.

And fairly often she says yes.

So I continue to hold up my end of the conversational possibilities and am rewarded when she picks up her end.  It is well worth doing, not only for her occasional response but for my own head, a way to combat the strong sense that I am living alone.

Wednesday night.  A few snow showers mixed in with rain announce the approach of winter.  A little snow remained on the ground for some hours.  My snowblower is repaired and ready.  Am I?

At my weekly lunch last Thursday, on an impulse, perhaps suggested by Carol’s recent, robust appetite for lunch wherein she happily ate a grilled cheese sandwich, in addition to ordering my usual wrap, I requested a half wrap for Carol.  I always used to get two wraps for us when I was picking up lunch for us.  I did this so regularly that I just had to identify myself when I called and say I was coming by to pick up our usual sandwiches and they would be waiting for me.  As Carol’s disease progressed, a whole wrap began to be more than she wanted, and so I would get her a half.  But the ingredients for each remained the same, turkey in mine, ham in her, lettuce and tomato in both, mayo in mine, thousand island dressing in hers.

Then, even that seemed more than she wanted, and I stopped getting her one.

Until this past Thursday when I ordered one for her, asking Ardy, who runs the place, whether I was right in remembering that when Carol was still eating her wraps she had given up on black olives.

“Yes,” Ardy answered.  “That’s right.”

So I took her half  wrap home, and put it in the refrigerator for another time because the aide had already given Carol lunch.

I look for reasons to avoid cooking full meals seven days a week, so on Friday, reviving an old pattern, I heat up chicken noodle soup from a can, add toast for Carol and a PBJ sandwich for me.  I had intended this time to substitute the wrap for her toast but I forgot.

Until Saturday when I remembered the wrap in the refrigerator and offered it to Carol for lunch.

She devoured it with enthusiasm.

So our new/old normal for now and for as long as it lasts, will include a weekly half wrap for Carol.

It is a little thing, it seems, but a little thing of some importance.  In so many ways, large and small, our lives teeter between what was and what will be, and the best we can do is try to find stasis between those two conditions.  And in that stasis whatever presents itself as a continuation of the old into our new present is welcome whereas any adjustment that denies the possibility of what used to be continuing is most unwelcome.

Perhaps all of that sounds like too much weight to put on a half wrap containing ham, lettuce, tomato, thousand island dressing sans black olives.

But I don’t think so.

And I might even push a little further.  I used to add one of the wonderful, freshly backed cookies to go along with Carol’s wrap.  I still always get one with mine.

So, this next time, I’ll go for it, and get one for her.

This stubborn retention of bits of our past is an act of resistance to push back against the power of dementia to eradicate that past.

The alternative is surrender and I don’t see us doing that any time soon.

Monday night.  Ryan came by for dinner and I retrieved a pizza from town.  Carol, as usual, enjoyed a couple of slices although I reminded her this pizza was not from our beloved Papa Nick back on Long Island.

This morning at breakfast, Carol stopped chewing the piece of toast I had just given her and said quite distinctly, “Steve.”

Nothing more.   Just my name.

I assured her that I was sitting right next to her as always.

She finished chewing.

What to make of this one word, said with so much emphasis.

First, she does not articulate words clearly very often.  When she does it is usually because she is upset about something when she might say “Stop” or just simply “No.”  Those words uttered clearly and with emphasis.  Occasionally, she forms other words, such as “yes” or more rarely a whole short sentence, such as “I like that,” although that last is quite infrequent.

She does talk a fair amount by which I mean she makes sounds in which it is difficult to find recognizable words.

I recognize that losing the power to articulate words is a predictable result of her disease.

None of which brings me any closer to dealing with what she said this morning other than it was an example of a clearly articulated word.

Which happens to be my name.

When I was sitting not two feet away from her.

But to what purpose?  And from what storehouse in her brain was it recovered?

I permit myself to let my spirits be raised by hearing my name coming out of her mouth.  But I also recognize that it is important not to put too much weight on the event.  Perhaps the word is no more than a shard of long term memory. Even so, why give it voice?  It was not said in a tone that revealed its intent.  I can’t say she was troubled and looking for help from that ancient source, the bit of her husband remaining in her brain.

In fact, when well she rarely if ever asked for my help in anything.  She was too damned independent and self-sufficient.  She was more likely to offer to help me.

Has that changed?

Does she now in the throes of her illness feel she needs help?  That possibility pulls at my heart as sometimes a certain expression on her face does as well when that expression seems to indicate if not fear then maybe confusion or sadness.  Or maybe frustration in the recognition of what she can no longer do, she who thought that through an exercise of her indomitable will she could do anything.  She did overcome her fear of public speaking so that in law school she could perform in moot court; she overcame her fear of flying by, well, just boarding the plane.

I know I am over analyzing this one word utterance of my name.

And I haven’t even addressed the perplexing question as to whether she associates that name with present tense me.  Of course, I’d like to think so, but I don’t want to be foolish about it.

And there is no certainty about any of this, just speculation.

Which I will be well-advised to understand is just that.

I don’t even know what certainty I would prefer because any conclusion that can be drawn would offer a mixture of pain and comfort.

Comfort in suggesting we are still in some fashion together, a pale echo of what once we were.

And pain in both the recognition of that paleness and the reminder of what has been lost if this crumb, this utterance, is all that is left.

Tuesday night after my usual shopping day.  Tired, but I want to capture what just occurred, which is a continuation of what I wrote last session.

Carol is now asleep.  I did a simple thing with her I had not done before.

I held her hand as she fell asleep.

I routinely hold her hand at various time during the day. I enjoy the physical contact, which approximates in a faint kind of way the intimacy we used to have, the comfort we enjoyed in each other’s physical closeness.

Typically, when I take Carol’s hand, she seems to squeeze mine.  Sometimes, perhaps, I have tightened my grip on her hand, but other times she acts first.  I do not know if this is a neurological response devoid of any conscious intention.  And her grip can be quite strong in such moments so that I need to exert a little effort to free my hand.

I’d like to think, however, that there is intention in that squeeze of the hand, that she wants to feel my flesh against her, that it provides her some comfort. At other times when I clasp her hand, she brings her other hand on top of mine.  Again, I cannot be sure of intention if any for often enough she holds her own hands together perhaps as a way of staying their wayward motion.

That perplexed and perplexing preface brings me to tonight.

After I had her settled in her bed, I took her hand.  As so many times before she closed her fingers around mine and then added her other hand.

I did not pull my hand away after a few moments as I ordinarily would.  Instead,  I studied her face, which seemed to relax.  Then her eyes closed.  Her breathing moved into its sleeping rhythm.

I waited a bit more.  Then very carefully, so as not to disturb her, I slipped my hand out of her grasp.

She did not waken.

As with her calling my name, I cannot with any certainty analyze this occurrence.

Whatever the actuality, I will assume some level of conscious intention, or if not intention awareness and contentment that I was there in physical contact with her..

Perhaps it is foolish to have such thoughts.

But if so, I don’t care.

Because whatever its source, with or without conscious intention or deliberate response, just like hearing my name in her voice, these seemingly insignificant instances are my reward, the sustenance that feeds my determination to stay the course.

If this is what my job is now, and my pay, so be it.

Note: Both halves of my two part heading to this post are literary allusions.  First Shakespeare, then Melville.

I couldn’t help myself

Wednesday evening after a freakish weather day, more like mid-summer with a thunderstorm and winds, and  another storm brewing outside.  We had a good, quiet day  in spite of the weather, of which Carol seemed unaware.

On Saturday, when it was clear that whatever had caused Carol’s fever the day before was gone, I went downstairs to the furnace room to do my half hour on the treadmill.  Because I am not in great shape, although improving as a result of my new regimen, I strain a bit during the exercise.

On this occasion, when I was breathing a little harder, a morbid thought occurred to me.  What if I had a fatal heart attack?  That thought is not irrational.  I have two coronary stents, inserted some twenty years ago when even though I was asymptomatic a perfunctory stress test revealed blockages.  My genetics also are cause for concern: my two paternal uncles died from coronary disease in their early 70s.  I am now older than they were when they died.  My mother died from a heart attack before she reached 70.  True, my father lived until he was 86 and died more from despair at my sister’s unexpected death than anything else.

I usually don’t dwell on these factors.  When I do, I look to my father’s longevity more than the less sanguine example of my uncles and mother.

But on the treadmill that Saturday afternoon, the possibility of a heart attack presented itself in a particularly vivid way.  I imagined myself lying dead on the treadmill, the machine still  running, my body jammed against the machine’s stanchions.

For three days.

While upstairs in the living room Carol would be in her hospital bed unattended.

Because as I live now, from Friday afternoon when my relief aide leaves until Tuesday afternoon when next an aide arrives, I rarely have  interaction with anybody.  Except for telemarketers of one sort or another, the phone does not ring.  Nobody drops by.  Any contact I have during this period occurs because I initiated it.  I do go to the market every Sunday morning and at least one of the clerks there as well as the manager, is well aware of these habitual visits to pick up a muffin for Carol and the Times if it is available, but I doubt that familiarity would alarm either of them if I did not show up.

I shared this concern with my daughter Tracy.  She said she would make it her business to call every weekend to make sure I was still among the living.

I also talked about this concern with my lunch companions. Brad suggested a digital approach: scheduling an automatic email arriving in my inbox, to which I would respond.  Probably a better strategy than Tracy’s regular call.  She could set up the recurring email, and check her inbox for my response.

Enough morbidity for one night.

Carol breathing very heavily in her sleep. 

I enjoy the sound.

Late Sunday afternoon.  Sitting in the green room, which is our tv room, having just watched a football game.  Carol asleep in her bed in the living room, the radio still tuned to the classical music from Interlochen Public Radio.  In an hour or so, I’ll prepare supper.  Then, I’ll be back in this room for Sunday night television.

Tonight I’ll watch a new season of Poldark on Masterpiece Theater.  Like most of these productions it is high class soap made a bit more substantial by its historical setting. More relevant to me now and what I am about to explore is the recurrent sadness I still experience in watching these shows alone.  In fact, it is not unlikely that I continue to make sure I watch them as a way of preserving a piece of our shared life together, as we always, that is always, watched the PBS shows on Sunday night.

There are two green reclining chairs in this room.

I sit in the one closest to the window wall, the one on the left if I am facing the television.

Carol always sat in the chair on the right.

While watching the game I worked the Sunday crossword puzzle on my laptop during the frequent time outs and half time.  As I did, at a certain point, my laptop, which was running on battery, warned me that I needed to find another power source.

I retrieved its power cord from the living room and plugged it in to the outlet on the wall nearest Carol’s chair.  The cord was long enough for me to sit back down in my chair

Which I did.

I would not sit in Carol’s chair.  To do so would be unthinkable.

How so?

It would make sense not to stretch the power cord across the floor any farther than necessary.  But to sit in Carol’s chair would confirm the obvious fact that never again will she sit in it.  Of course, that is true.  I just don’t want to confirm it to myself.  It is one of many instances where I face the same situation, namely, how to deal with the lingering facts of how we shared space in this house.

In  the upstairs bathroom on the rack next to the tub shower Carol’s towel remains hanging in its accustomed place next to mine.  There is no point in leaving it there.

But I do.

Of course, there are features in the house that cannot easily be changed, such as the his and hers bookcases attached to the dining room wall.  Or her dresser across from mine in our bedroom.  Or her office down the hall from mine.

And so on.

In ways large and small, our living space announces that is serves two people.

To this point, I am content to leave it that way.

I’ve moved into the living room to sit in my usual chair.  Our sofa is in this room  but only one chair, Steve’s chair, which Carol ordered for me along with a reading lamp to stand beside it.  I don’t believe Carol ever sat in it.  Across from me now, though, is her new chair, the tilt wheelchair in which she spends a good chunk of her waking, and not so waking, hours during the day.  To my left is the hospital bed on which she is now rousing from her afternoon nap.

On my way into the living room I stopped in the kitchen to grab a handful of peanuts for a snack.  While in the kitchen locating the peanut jar in the cabinet over the stove,  I was reminded that the shelves in another section of this cabinet were filled with boxes of tea, all kinds of tea, mostly herbal, designed to be a natural cure for various conditions having to do with digestion, as Carol’s stomach was troublesome, and these teas, all of them, are hers.

Very occasionally I feel like having a cup of tea, perhaps as memory reminds me how my father, following his English heritage, drank tea with supper.  He, of course, would not abide tea bags.  His tea had to be brewed from tea leaves.  I’ll use teabags for mine, and among Carol’s medicinal teas is her Earl Gray’s.

Put simply.   I drink coffee, rarely tea.  Carol never drank coffee, which unsettled her stomach, and therefore drank tea.

Tea and coffee.

Carol and Steve.

Sharing space in this house.

Even now.

Although Carol is more like a living memory of herself.

Which I intend to hold onto.

Until perhaps all traces are gone.

Thursday night. Classical music from WSHU in my ear buds.  Carol in bed, but not yet fully asleep. She breathes loudly through her mouth.  I imagine her nose is stuffed.  Nothing I can do about that.

And the sound reasserts her presence.

It’s been almost a week since last Friday when I came home to find Carol ill.  She has been better since then, but the incident has awakened concerns I have been keeping at bay but which now insist on being addressed.

There are two such, intimately related and one or the other will happen: either Carol will predecease me, or I her.  I’ve dealt with the second by setting up a trust, but not in the manner in which it might occur.  That is for another time, perhaps the next post.

The first, which I confront now, involves the prospect of my living alone into old age.

Some people experience a version of living alone as young adults moving out into their own apartment either when getting a full time job or even renting a place while in college as an alternative to dorm living.

I did neither.  I attended a college about a mile from my house and across the street from my high school to which I had walked rather than take the bus.   I spent my undergraduate years in my parents’ house, first walking and later occasionally driving my ’52 Packard to college.   In graduate school at the University of Connecticut, I lived in a private room in a dorm.  That was a small step toward living alone.  Then I married.

It was when that marriage ended that I fully set up housekeeping for myself, renting an apartment and furnishing it with second-hand pieces bought from a colleague who had gone through his own divorce and had the furniture in storage.  I still needed a bed so working in the theater shop at the college where I was working I built a  platform variety of one with a bookcase for a headboard.

So, I was now living alone.  It did not seem difficult because in many ways my life went on in its usual fashion.  I went to my to my job as a professor and administrator.  Part of my old married life continued into my single condition as on alternate weekends I had my two daughters with me.

Of course, this was a difficult, stressful time because of the impending divorce, but I didn’t fret about my solitary status.  I was still relatively young.   My life lay ahead of me and I was going to reinvent myself in my relationship with Carol who soon became the center of all else that whirled around me.

And I was still rooted in New York among friends, colleagues, familiar geography and  close to my daughters as they grew up.

After a while, Carol and I lived together, then married after my divorce was finalized,  and my solo living ended.

Now, however, it is possible that I might find myself in my twilight years living alone in northern Michigan, a thousand miles from what I’ve left behind in New York: two daughters and grandchildren, as well as several very long-term friends.  It is also likely that my daughter with Carol, who is now living six hundred miles away in Minnesota, will wind up someplace other than here.  And although I have lived here for sixteen years, my roots in this foreign territory are still quite shallow, the friendships I have made not yet fully matured.  All in all a very different set of circumstances than I experienced long ago.

A chance encounter put this speculation into focus for me.

The other day I ran into a neighbor on the checkout line in the grocery in town.  My relationship with him falls somewhere between an acquaintance on the one hand and a friend on the other.  Like Carol, his family has been on this peninsula for a very long time although more as hoteliers than farmers.

We chatted a little.  I asked him what his plans were for the winter, a pretty standard topic of conversation hereabout as our winters are long and difficult.  The local population divides into categories of those who head to warmer climes for the whole season, those who leave for a few weeks, and those who stay the whole time.  Carol and I fluctuated between the second and third categories, occasionally traveling to Florida for a break from the snow and cold.

He said he planned on going to Texas to visit a friend, and then to Oregon to spend time with his son.

Why this conversation was more than social chatter for me is that he is roughly in my age group, perhaps a little younger.   His background is, I believe, in psychology, perhaps as a counselor or therapist.  He is also an accomplished painter whose works hang in the gallery attached to the Tavern up the road from here.  He’s a good enough handyman to maintain his family’s rental cottages, he is something of a sailor, and also has a second place in town.

None of which is why I am talking about him.

Rather, I see in him what I might become down the road, living here as a single older man.

In that respect his travel plans for the upcoming winter indicate the freedom of movement such a person enjoys as opposed to the limits on my movements imposed upon me by my caregiving responsibilities.  The question in my mind is whether enjoys is an accurate word to attach to my expectation that I, too, might be as free as he appears to be to deal with the winter as he likes, and more generally, to do what he wants to do when he wants to do it.

Having now years of experience in northern Michigan, I imagine living a solitary existence on this snowbound peninsula with the winds howling in off the waters of the bay and through the less than perfect seals of this old farmhouse would be challenging if not depressing.  So, perhaps should I find myself in that circumstance  I would also travel to visit children and grandchildren or a very good friend at whose wedding I was his best man, a friend who happens to live in snow free Florida.   In warmer weather, I could visit another good friend now in Syracuse, or ones back on Long Island, or even an older friend who lived across the street from me in Brooklyn and is also in upstate New York in Utica.

At this point, however, hearing Carol’s heavy sleep breathing not ten feet away, I cannot even begin to tolerate that thought.

I do not know my neighbor’s story, how he came to be an older single man.  He does not appear to be at all unhappy with his life.  Perhaps he is in a relationship, but I don’t know enough about him to begin to guess about that.

It might be worth talking to him at some point.

But not now.  It is too damned distressing.