Coffee, Colds and Caregiving

I pour Cindy a mug of coffee, add a spoonful of raw sugar and a splash of coconut milk, then wait for the drink to cool a little. The wait also allows me to assess the best moment to hand Cindy the mug. Each mug of coffee begins a little adventure, an adventure that reveals some of the obstacles for someone afflicted with Alzheimer’s and a few of the virtues a caregiver must adopt in response.

Because Cindy lacks control of herself she distrusts her ability to handle her environment. A defense mechanism of being overly cautious kicks in. I cannot simply hand Cindy the mug of coffee; there is a process we must go through every time. Understanding the need for this process grants me the patience to proceed.

I first hold the mug for Cindy as she takes a few small sips. This assures her that the coffee is not too hot and reduces the chance for spillage once I hand the mug over. The hand-off yet requires a few steps. While keeping the mug firmly in my left hand I use my right hand to insert the fingers of Cindy’s left through the mug (she is left handed with many things). I encourage her to take a few more sips with my left hand still supporting the bottom. At this point she either instinctively moves her right hand to replace mine, or I switch hands and guide her right hand with my left until she is holding the mug with both hands.

Not knowing for sure how Cindy will handle this micromanaging of her morning coffee, I insert a few quips to lighten the mood once she is holding the mug. “Have you seen any good movies lately?” I might ask, or “How does it feel drinking coffee next to a stud?” The latter never fails to draw a laugh, after which I feign being offended, which draws more laughs. At this point Cindy is good to go.

Yet the process has not ended. One of two things can lead to a spill. When Cindy loses focus she holds the mug only by the handle and the mug tilts. Usually this lack of focus leads to her leaving the kitchen as well and the spill occurs in another room. She has gotten used to these types of spills; her mind alienates her from the experience. Once she even cheerfully declared, as I come into a room to see the spill at her feet, that the spill was not hers.

I’m more concerned twitching, the other cause for spillage. Cindy must be either engaged or relaxed with what she is doing or her body twitches. Precisely because she has not lost focus in this situation she knows something is not right when a twitched spill happens. She may frown or even cry.

Both causes for spillage are avoided with a little vigilance. For the lack of focus I simply follow her around or point out that the mug is starting to go limp. For the twitching I grasp or remove the mug for awhile. If a spill happens I draw upon my redundant but effective repertoire of one-liners … or start hugging.

Lately I’ve dealt with this morning coffee routine with a head cold. The early stages and early mornings of head colds are the worst. I can tolerate walking on blisters for twenty miles, but the foggy congestion of a head cold renders me next to useless. There used to be a time when I might be nurtured in this condition, at the least to be left alone. Now I must continue to do the nurturing, even when the fog in my head rivals Cindy’s. When in this condition I alternate between feeling remotely detached from the scene and intensely miserable. I draw upon optimism and perseverance to convince myself such moments will pass.

Understanding and patience, optimism and perseverance, are primary caregiver virtues. I do not lay a claim to a natural reservoir of understanding and patience. Long distance hiking helped me acquire these virtues while in my twenties, but returning to the “real world” over the past three decades drained this reservoir. I am egalitarian by nature and conviction. If my mind enables me to do something the same must be true for others. Treating others as equals usually is a plus … unless it prevents understanding, or tolerance, or patience. I am afraid this has been the consequence for a few of my past students and even my family.

A return to living in the present moment through long distance hiking, for what amounted to Cindy’s premature Golden Years, partly replenished these virtues. Yet there now lies another wellspring for understanding and patience. In the later stages of my life I have been exposed to a few folks with mental health issues, with Cindy of course being my primary concern. As I watch Cindy’s body twitch or the mug she is holding go limp I am reminded constantly that our minds are not all equally capable. As this dawns on me I recall that “those with greater gifts have greater responsibilities.”

Among such responsibilities are understanding and patience. Even my miserable, fogged head condition accepts this. I wish these always were my virtues, I do much better with natural optimism and perseverance, but perhaps my experience now amounts to the caregiver’s karma. In just such a way is the caregiver being nurtured or shaped as well, even when dealing with a cold.