Assisted Living. Reality Smacks Me in the Face - A Mindful Approach to Dementia & Psychedelics
Our return home to Vermont is about two weeks away. Our Vermont daughter has generously volunteered to spend the nights at our house while I am away for a week with our other daughter in Toronto. We decide to push up our return by several days so Henry can have a chance to get re-oriented to being back home before I leave for the week.
Before putting these plans in place, Henry and I considered the possibility of him staying where we were, within the same community just outside San Miguel de Allende in Mexico. If so, it would be in the assisted living area, not on his own at the house rental. The assisted living area is more like efficient apartments, but still there is oversight and all needs like meals, laundry, emergencies, and help required are available. There is a fine line between assisted living, semi-independent living, and being at an all-inclusive hotel. After all, Henry can continue to do daily laps in the thermal pool, massages are available, as is yoga and a full-vegetarian menu as per his request, or he can enjoy pizza night at the café and go to neighbors’ homes for upcoming Easter week invitations.
But no. Henry thinks about it despite the continued winter weather in Vermont. He’s ready to go home. So we had proceeded with our planned return. That all got upended unexpectedly.
I wanted to be sure to get the results of the recent evaluation done by the psychologist in the same area where Henry has been going for PT twice a week. He already knows the psychologist and feels comfortable with her. An appointment has been set up. Due to changing our departure to a closer date, the appointment is just one day before departure. Actually, it is after our check-in time. I’ll decide to do the check-in after I get back from hearing the results.
Henry, based on his request, had an evaluation a few weeks back to determine if or how Alzheimer’s has progressed. I have been mentioning the appointment to go over the results on several occasions. I now have the habit of communicating important information several times over several days prior to what the information corresponds to. This gives me an indication of Henry’s interest or lack thereof. Even though he was the one that wanted the evaluation, now about three weeks after it, he shows no interest in knowing the results. I go on my own.
Over the course of three months, both Henry and I have been to see the person-in-charge: a delightful, welcoming, and kind person, constantly on her cell phone as she manages and arranges things for the fifty people she feels directly responsible for. For Henry, she has arranged services like twice-weekly PT and the evaluation requested by Henry. Initially, she gave the two of us a tour as well as a second one when our Vermont daughter visited. The person-in-charge showed us apartments that had two bedrooms with a shared living room, or just one bedroom. Each had a generous outside space that I envisioned as a potential garden patio. It wasn’t so bad, and it was conveniently located next to the pools, café, and community areas.
Our daughter said a firm NO to this idea. It was too depressing walking down the dark, dreary corridor. Adding to that feeling was a photo of each person, their name written below the photo on each door as you passed by, evoking unsettling questions of who lived in each room and what condition they may be living in behind each door. I agreed. What was I thinking?
I get ready to hear what the person-in-charge will relay about Henry’s evaluation results. Instead, she gets on her cell—of course—and calls the psychologist who assessed Henry. I ask if she can put it on speakerphone rather than repeat to me what the psychologist says. It seemed more efficient and direct. I asked if I could record what was being said. Permission given.
So there on the old wooden table lay two cell phones, one on speakerphone, the other recording what was being said. I saw the humor with the setup but also the flexibility and humanness of going with the flow and responding to needs as they come up. That is an essential quality both Henry and I appreciated by being here. Basic kindness and humanity overrode process, procedure, and protocol.
The recording was high quality enough to be sent to our daughters and Henry’s siblings: another recording that could be shared to communicate the status of Henry’s Alzheimer’s condition; describe its progression in a professional way.
At the end of the half-hour, when the conversation was coming to a close and all my concerns and inquiries were given time and space to be held with respect and care, the-person-in-charge asked if Henry would prefer to stay in Mexico in the community, swimming daily and enjoying the pleasant weather. I was slightly taken aback by the unexpected question but replied that I would ask.
The-person-in-charge assured me that everything would be alright; they would take good care of Henry. He would be accommodated in the area I visited with our daughter. There had been changes, she informed me. The ground floor is now being used for assisted living, while the residents who are further along with their dementia journeys have been moved to the upper floors. Maybe it wouldn’t be as depressing as I remember.
OMG—assisted living.
Upon arriving back at the house, I did ask Henry if he wanted to stay. After all, there are two snowstorms due in Vermont. I would leave the answer up to him. It is completely his decision. However, based on the information shared with me, I also felt that it would not be fair to put such a responsibility on our Vermont daughter—more care beyond just evenings would be needed at this point.
Yes, he answered without hesitation, he would stay back. Unexpectedly, I felt a very deep relief.
I guess I won’t be checking in to our flight after all.
Assisted living.
It is 2:00 in the afternoon. I WhatsApp the-person-in-charge. Can Henry be settled in by tomorrow noon?
Yes, of course. We are to meet the-person-in-charge at 10:00 the next morning and make the move.
The rest is a whirlwind. Reality really smacked me in the face.
Assisted living.
Just get by, put everything in place. Cancel the flight. Sort what Henry needs. Pack the suitcase. Try to be calm so Henry is calm. Get a good sleep.
Henry asks for his microdose of psilocybin before going to bed. He believes it helps him sleep better. Better sleep is one of the most reported benefits of microdosing, as noted in the new book Microdosing For Health, Healing and Enhancing Performance by James Fadiman and Jordan Gruber. Whether you microdose in the morning or at night—at this point, it may be a placebo effect for Henry. And if it is? So what. All I know is that Henry has profoundly deep sleeps when he microdoses. That would be a blessing on a night like this.
We both wake up in the morning fully refreshed. Both of us had restful sleeps. Thank you, mushrooms.
All is quiet. We enjoy a modest breakfast on the patio. Our last day enjoying the garden as the sun makes its way to warm us. We take the short walk to meet the-person-in-charge.
The whirlwind gears up into full force.
The-person-in-charge shows us three possibilities. Two have an efficiency kitchen and separate bedroom. The third is just a bedroom without a kitchen. Henry chooses the third one because of the amount of light in the room and the adjoining patio. All three choices had piles of old furniture, bed boards, mattresses, and other items scattered about. Maybe it’s a good thing there isn’t a small electric stove or even the ability to cook. Henry stopped cooking a while back anyhow. Also, it’s just too dangerous now. Another relief.
Bed boards are moved, a refrigerator is brought in, the bed is made, the floor cleaned, people swirl about as the room is prepared. It is all a bit much for Henry. He stays in the room with one of the kind assistants to the-person-in-charge before she walks with him to the café to take a break and get a snack. Thank you.
I go to the office of the-person-in-charge. I make a payment, give them Henry’s passport, sign a simple form, and that’s pretty much it. Just like that.
Assisted living.
Henry is going into assisted living. Everything was put in motion less than 24 hours ago. Ostensibly, it is just for the one week that I’ll be in Toronto. But the-person-in-charge recommends I give Henry two to three weeks, three weeks being more preferable. How to break the news? I commit to two weeks away—two weeks of Henry feeling out the new situation.
What is happening?
Then I am driven to our house rental to bring the one large suitcase to Henry’s bedroom in the assisted living area.
I arrive back in Henry’s new accommodation: a large bedroom with a small patio looking out to mountains—or are they hills? No matter. Just get to the unpacking so all is in place before Henry returns. He is already getting disoriented with all the decisions, new environment, and changes. It is also getting hot as midday approaches. I am sweaty and tired and mentally exhausted.
Assisted living.
Can I stay with Henry until I leave in four days? It is a Wednesday. I will figure out a flight for a Saturday departure. Yes, of course.
Yes, of course?
Where in the world can you stay with a spouse who has just entered an assisted living situation? I feel a swell of gratitude.
Relief, again.
I’ll figure it out.
We are back in the room.
It is now afternoon, and Henry is tired. The-person-in-charge calls and, in five minutes, there are several workmen trying to hook up a TV. The large wooden armoire is moved to make room for the refrigerator. A woman is cleaning up after a new cord has been rigged up for the refrigerator. Lots of commotion. And it’s hot. Is there a fan? How about a desk lamp? The-person-in-charge sees that the one light switch is above the bed—that makes no sense. More calls on her cell phone. Off the cell phone. Tomorrow the electrical outlets will be covered, and new ones put in. A fan appears. So does a desk lamp.
A woman knocks on the door. Henry’s lunch is served. What? Like room service? A healthy, delicious-looking salad and juice—one of the options Henry had expressed. The-person-in-charge gets on her cell phone. A table appears on the patio. Would Henry like to take his lunch outside there?
One by one, people file out of the room. Henry has finished his lunch. All is miraculously in place—well, pretty much—and certainly it is good enough. A perfect time for a nap. Henry falls into a deep sleep for the next hour or so.
When he wakes, I am by his side. I want him to feel my presence. I am here. I want to be sure Henry feels settled before my Saturday departure. Relief.
Henry feels well enough to go for a swim. Water has always been one of our favorite ways of feeling renewed and refreshed, especially healing thermal water. Our pastime in Ecuador, where we met and lived for many years, was visiting all the different thermal spots scattered throughout the country. Henry always wanted to have one—as we do at our little retreat in Costa Rica. And now here, in this situation as well. It is a big source of happiness for Henry.
We put on our bathing suits and walk the two minutes it takes to get to the thermal pools. In true form, the thermal water washes away the emotional exhaustion of the day. We both revel in the warmth as we sit beneath the spouts, the strong outpour giving a natural hydromassage to our backs.
It has been done.
Walking back to the room, I realize the depressing feeling I had during the tours has been replaced by a more welcoming atmosphere—the walls have been freshly painted a serene light color, the lighting has been modernized. It makes a huge difference. Then my gut is wrenched. There is Henry’s photo—probably taken earlier in the day when he went to the café with the assistant. Below his photo, his name. That is my husband of forty-plus years, a photo and name on a door. The same door I walked past two months ago. At that time, and perhaps still, I had lots of generalizations about the people living behind each door. But if I am honest with myself, Henry needs the photo as a reference point since he is not quite sure which room is his. He has joined their ranks.
Shock. Gut-wrenching realizations flood me.
At least the photo captured his smile and the abundant positivity he exudes.
Reality smacks me in the face. Assisted living. A whirlwind.
After dinner, Henry settles into bed. I get onto the computer to get my Saturday flight booked. I go to the list I started earlier that day. I do some online ordering: a pool towel, a toaster, a light-colored bedspread, a few houseplants, and a few toiletries. I also order some of Henry’s favorite food: granola, sourdough bread, honey—to be delivered the very next day. He’ll be all set.
Then, to communicate the enormity of what just happened to our daughters and Henry’s siblings. Lengthy emails are written.
Assisted living.
I am totally exhausted. I am totally relieved. Such a mixture of emotions. Get to bed—it is past midnight.
Mindfulness, cultivated through decades of practice, has brought me to a place that allows an ever-expanding awareness in both sitting practice and daily life. It was not always so, but today, in the midst of all the shock, I wonder where mindfulness practice showed up. Was I able to access it? I don’t remember having the awareness of accessing it.
Looking back on it now, the awareness was one of knowing. The knowing was that I just had to make it through the day. There was a degree of stoicism—just keep doing what needs to be done. Pace yourself as best you can. Protect Henry. Try to maintain and cultivate calm and emotional safety. Just do your best.
Any degree of mindful awareness felt different than it usually did. I can usually pause and make choices with a fuller presence of being. I didn’t feel I had the time or ability to pause, bring awareness, or make choices. However, many mindfulness qualities came through: in the words inspired by the great Buddhist monk and teacher Thich Nhat Hanh, deep listening and loving speech showed up throughout the day. I approached everything with spaciousness, pausing naturally. I was purposeful—paying attention on purpose, in the words of the renowned mindfulness teacher Jon Kabat-Zinn.
Mindfulness showed up seamlessly in the hour of need. Decades of practice came to the fore today. The heart of mindfulness was my companion. And through the heart of mindfulness, my heart kept opening, even in the pain, and my mind more spacious. A stillness. A peace. All is well. Deep gratitude.
Today was a hard day. Today was a needed day.
Reality really smacked me in the face. Assisted living. It has been done.
- Lauren Alderfer, PhD.
