Nevertheless Dementia, We Persist

(Short story 4451 words)

“I want a cat.”

Lynne had persisted about getting a cat over the past few weeks, unlike many requests that flash by briefly and are quickly forgotten. I hoped this one would be one-time flash by because a cat would arrive with loads of baggage.

Lynne is my 54-year old daughter who lives in a compact one-bedroom apartment in assisted living. Over the year-and-a-half years she’s lived there, her random requests for a pet would fill a petting zoo such as hedgehog, parrot, dog, hamster and fish. Unexpectedly, a cat had recently arrived as a persistent request.

I get the requests because I’m her 78-year old dad in my first year as a widower loaded with full responsibility for her care. She focused her blue eyes atop puffy cheeks in a rosy oval face with a wide smile, draped in a bob cut of salt and pepper hair streaked with gold. Her steady gaze exudes strength from her firm shoulders squared back by workouts three times a week. I adore her because she’s cooperative from the beginning when she moved out of her home with three teenage sons, a cat, two dogs and a cat. She enjoys less stress and, incredibly, thrives in that facility mostly because she helps care of the other residents who are at least 20 years younger than other residents. Residents and staff lover her. She laughs a lot. She guides residents to bathrooms. She listens to them when they’re lonely. She calls for staff when residents need help. Staff treat as an equal and request her help with residents. She’s an inspiration to me. My main joy right now is to see her happy by fulfilling her wishes.

Her wishes are usually reasonable, but I’ve also inherited a list of unfamiliar feminine skills my wife used to do. They include replacing the correct cosmetics, adjusting a bra that stabs her in the side, scheduling care to repair nails, finding comfortable shoes for painful feet inherited from her mother. Worst of all, I try to decode a complicated TV remote for video options my wife set up based on her computer-systems-administrator experience. Lynne knows I’m a pushover for ways to obliterate the loneliness of her apartment without her sons to hug. I pride myself on being her heroic dream catcher.

All her wishes aren’t reasonable, but they vanish after brief review, such as a ten-day trek to worship with spiritual masters at Machu Picchu in Ecuador. Others appear reasonable, but aren’t, such as a cat. Her request for a cat gives me a steel backbone.

“Why don’t you like cats?”

For good reason.   

I used to be indifferent to them, but the last one I owned stalked me. They’re my enemies.

Growing up, I was indifferent to our cat named Ziggy. I don’t know why we had a cat. She came and went out the second story window of our house. She would push open the screen window and leave whenever she wanted. When she wanted in, she batted the screen window until it swung wide enough to come back before dawn. She regularly left the remains of birds and mice on the foot of Mom’s bedspread to honor her when she woke up. Mom complained about leftover body parts at breakfast when I was eating oatmeal. Why did we keep it?

She was my sister’s cat, I guess, and Dad was a pushover for my sister. Ziggy’s lair was in her room. Ziggy lived like a deadly cheetah free to stalk the Serengeti Plain while I ignored her like an adult male giraffe.

Mushy me wants to preserve my role as her hero, so I had to fairly consider whether Lynne and a cat are a good match. I’m sure she’d love a cat, if she remembered it. When she lived in her home with her three boys, she had an independent cat named Geraldine after her maternal grandmother. She also had Tucker, a huge hyper-energetic mix of greyhound and Pit-bull and a stray mini-dog her son rescued. She hugged the cat whenever she could, but it escaped and returned whenever the boys or Tucker came and went. Tucker clung to her for attention. Her ex-husband graciously accepted the three pets and the three boys when Lynne entered the assisted living facility. She wistfully remembers Tucker, but never talks about the cat.

I believe she’d love a cat in her room if it was domesticated, never got out and was always available to cure her loneliness. I hate feeling Lynne’s loneliness. It’s most severe when I close the door to her apartment because it feels like a dementia compelled prison cell where she’ on her own. I’ve opened her door and found her stressed, stuck in a t-shirt with one arm inside a sleeve and the other sticking out the neck. It hurts when I pull the apartment door shut leaving her alone even though she says she’ll be fine and ready to get into her pajamas I’m afraid she’ll get frustrated undressing. Or getting into her pajamas, giving up and changing her mind to watch TV, searching for the remote and then pressing a button that doesn’t work.

If only I could picture the cat climbing into her lap as Lynne lays down the remote and hugs her, I might agree to it. It’d welcome her and she’d pick it up and hug it. Or maybe it’d leap into her arms and she’d talk to her as she walked around the apartment. It’d nestle into her lap purring as Lynne stroke the smooth fur. They’d climb in bed together. It’d curl next to her and keep her warm. She’d wake up with it next to her legs. Why can’t I just shut down my objections and let her have a cat?

Because I can’t easily picture that endearing love fest. Would a cat welcome her? Or would she hide? Run out the door? Pull to get out of her lap? Or am I blinded by my own biases?

Lynne is currently diagnosed with moderate to severe dementia from Alzheimer’s. Caregivers help her with dressing/undressing, showering, hygiene and going to bed. They administer her medications. She eats from a menu with other residents in a dining room, but I cut up her steak because she can’t cut with a knife and fork. They wash her laundry weekly and clean her room twice a week.

I worry she’s declined since she entered assisted living a year-and-a-half ago. My mother needed 10-pound bags of birdseed every week in the winter but eventually her Alzheimer’s dementia declined until I didn’t need to buy it. How long would it be before Lynne couldn’t care for a cat? Then what happens to the cat? It’s not moving to my apartment.

I worry she’s declined since she entered assisted living a year-and-a-half ago. My mother needed 10-pound bags of birdseed every week in the winter but eventually her Alzheimer’s dementia declined until I didn’t need to buy it. How long would it be before Lynne couldn’t care for a cat? Then what happens to the cat? It’s not moving to my apartment.

With all my confusion, resistance and reluctance I’ve stalled by listening, ignoring her, saying I understood and promising that I’m looking into it. She’s persisting and I can’t keep postponing a decision because I have to feel honest with her to keep her trust and welcomes me with a big smile every time she’s sees me.

I guess I’d reached the point where I had to get her a cat or squash the idea. My resistance buckled. “OK, I promise I’ll look into it and if it’s possible, and you really want it, we’ll get you one. But I’m not in favor of it.”

I was immediately disgusted with myself because I was committed to explore it into it despite despising the idea. Objections rushed over me.

A cat imprisoned in a tiny assisted living apartment would bother me. It’d leave everything inside I don’t like about cats: hair, poop, urine, kitty litter, fleas, upchuck, hairballs, shredded cloth and smells. They’re bred to be outside tracking phenomes of cats or pestilence of rats. When the last cat in my family was stuck inside, she turned malevolent and stalked me. I’m not exaggerating.

We bought my last family cat to catch mice who’d invaded our home from a small horse barn. Lynne loved her, especially when she birthed kittens for us. She was not a predator. She didn’t twitch when she watched our dog sniff out a mouse hiding inside our organ. Instead she terrified us for a week by bringing squealing baby bunnies we had to release in the back yard hoping they found their mother. She was malevolently shredded my sleep pattern when we became empty nesters because she’d wake me up to let her outside at 3:30 am every morning. I threw her off my bed, threw pillows at when she pawed the door or yowled until I got up. I installed a pet door in the basement storage room. She wouldn’t use it so before I went to bed I shut her in the storage room with food, water, litter and the pet door. Soon I couldn’t find her before I went to bed. I’m not making this up. Luckily for me she died of natural causes at 19. Even an 11-year-old cat would mean I’d be dealing with it for 8 years. Now I had to see if she could have a cat.

I searched for advisors at the assisted living hoping they’d agree with me.

They loved the idea. Lynne would love the cat and staff would love that. Residents love cats. There’s a catch about cats. The facility requires a veterinarian keep all vaccinations current and regularly tests for illnesses and other pests, like fleas. The staff would care for the cat’s feeding, water, kitty litter, clean dishes, cleaning up after accidents. I don’t know if that would include removing hair from furniture, beds and clothing. Would they charge extra to use a hairbrush to clean up clothes and furniture? Would I start doing that? Staff say they can handle it. And they have a set policy of the additional time added to the care bill, and it is substantial.

Most of the residents who have cats are confined to their rooms. Lynne’s consistently rated as one of the most active participants in group lectures, exercises, games, trips and musical performances. She attends a women’s strength workout three times a week where she shoulder-presses 50 pounds, more than anyone else according to friends and classmates who encourage her. She puts on workout clothes hours before she is picked up to attend. She helps staff during activities and games. She’s still highly verbal with conversations. She laughs a lot. She notices residents who need help or are alone and helps them or alerts staff. Friends take her out for meals and walks. I love to be with her. I take her to Dick’s Burgers fast-food shop to get milkshakes where her boys’ work. We shop together. We travel for three-day family visits. I see disaster for the cat. If Lynne keeps the same activity schedule, the cat would be lonely and unloved much of the time with nothing to do but sleep.

I see disaster for Lynne. If Lynne became attached to the cat, she’d stop her activities. Research shows residents who exercise, socialize, sleep, and problem solve live longer and happier lives. Research shows living with cats also improves people’s health, contrary to my experience.

Another problem is Lynne stresses about things. She repeatedly asks, “Is it workout day?” “Why isn’t my friend here yet?” “I can’t get my zipper to work.” “I can’t find my black jacket.” She stresses about lost clothes that later show up in the laundry or in someone else’s apartment. With a cat, would her stress level go up? “Did I feed it?” “I can’t find my cat. Did it get out?” “Who will take care my cat while I’m gone?” “I think something is wrong with her. She’s acting strange.”

On top of those changes, it would be expensive. Why would I want to pay extra expense for those problems? I could say, “It’s too expensive. It’d cost thousands of dollars a year and jeopardize your sons’ inheritance. It’s unacceptable. I forbid it.” I might imagine saying that, but I could never do it. It’s too mean for me. I want her happy. I keep searching for another solution. I found one. It offended her.

I proposed a toy companion cat. They look like cats and the hair feels like fur. They purr, blink their eyes, simulate cat movements and meow. They’re used in dementia facilities because residents are intrigued by them and care for them. Some residents treat them as real. Even residents who know they aren’t real still cling to them. People treat stuffed animals as if they’re alive. I apologize to a humongous Santa my wife bought at a charity event when I stuff him back in his garbage bag until next Christmas. However, Lynne instantly refused the idea. “You’re not serious, Dad?”

I dropped the subject, but still searched for options. I shared our dilemma at a birthday party Lynne’s friends gave her who gave us an option.

A good friend of hers loves cats to the point of volunteering at a cat rescue shelter which met her highest ideals of sheltering unwanted cats and placing them for adoption. She loved the idea of getting a cat for Lynne. In fact, she already had one in mind. Lynne had a well-informed advocate. She invited us to visit the shelter for a tour and to meet the director.

The rescue center website was encouraging. It described a small non-profit sanctuary for unwanted cats that were rescued with a commitment for permanent care. The cats are rehabilitated and observed to see which would be better maintained at the facility or make good candidates for adoption. The shelter provides a formal process for adoption with a fee, including a promise to accept cats returned from an unsatisfactory adoption for whatever reason. They had good community ratings and worked with local officials who rescued cats.

Lynne’s friend calmed a lot of my fears because she puts cats first. She’s volunteered there weekly for years and suggested options which she would discuss with the director. Lynne could volunteer regularly. The staff would watch her care for the cats to see if she would be able to volunteer with her friend. If she and a cat became attached, we could work out an adoption. Lynne and I agreed we’d make several visits to see if would work. Lynne’s friend was so excited I got anxious she and Lynne would get thrilled with the first cat that wandered into Lynne’s arms. I tamped down her ecstasy by confessing my objections and biases. She understood and she agreed to alert the owner and arrange for her meet with me alone.

The day of the visit we dressed Lynne in old jeans and a throwaway shirt that could be shredded. Before we left for the sanctuary, the Director of Care for the assisted living facility requested to see me, briefly.

She’d observed Lynne’s first hallucination when her TV showed an outdoor scene with moving clouds. Suddenly Lynne visualized her room full of clouds. The director had alerted staff to watch for more hallucinations and said at this point they’re not making any recommendations, nor were they alarmed. It’s a common symptom. I asked for a hug. I was not prepared for hallucinations. My mother didn’t have them to my knowledge when I managed her care at assisted living facilities. Alzheimer’s disease regularly stuns me even with my long experience watching my mother. I didn’t say anything to Lynne.

We drove an unfamiliar route to the sanctuary address that took long enough to question whether it would be worth the trip. I had the wrong address and we had to ask three strangers for the right address. They voluntarily complimented the shelter for the good things it did for their neighborhood. It’s in a small two-bedroom house blended into the neighborhood with clearly posted welcoming signs and several parking spaces. On the left side several small sheds designed like cabins and two-car garage sized building.

Cats lived in the main house in the two largest rooms covered with clean linoleum floors. The walls were lined with shelves, chairs and cabinets occupied by cats in spacious wire cages and fluffy beds. One of the rooms had four large kitty litter tubs full of pine wood pellets that absorbed waste and smells. We were told everything is cleaned with bleach at least daily. Cats are housed according to their personalities, their current condition and recent experiences. Some cats were in closed cages, others in open cages and some cats roamed around the rooms. Ill or recovering cats are in separate cages or other rooms if necessary. Cats from recent rescues are in closed cages alone or partnered with cats they lived with before arriving. New arrivals are evaluated for their medical condition, personalities and preferences. Over time each is integrated into the community. They had a cat-patio, administrative office and unfinished room for storage and laundry. The sheds outside were for storage and the back garage was a medical clinic for examinations, illness, surgery and recovery. They had outdoor video surveillance cameras at six locations.

Everything felt like a safe well-managed shelter for Lynne to enjoy cats alongside volunteers. I could hope Lynne would thrive in it.

The director was pleased for the opportunity to learn about Lynne beyond what she’d heard. The director liked the idea making several visits before choosing a cat and who would be a good match. The director knew I was opposed to adopting a cat and I felt obligated to tell her about the hallucination which made me even more reluctant. She thought it might not be appropriate either.

She supported getting Lynne a toy cat companion. She had investigated published information about their role for people in assisted living. She compared toy brands and found they felt like cats and their movements mimicked cats. She warned me some wouldn’t hold up well. “You get what you pay for, so pay top dollar.”

She shared those opinions with Lynne when we joined her and the volunteer in the rooms with the cats. Lynne listened as she sat on the floor with the volunteer. She had to feel like she was on probation or under observation. She looked reserved and hesitant, afraid to make a bad impression. It was supposed to be fun and let cats inspect us.

We stayed most of an hour. One black and white cat climbed into Lynne’s lap and rested. She liked that. Brave, curious cats walked by and allowed Lynne to reach out and caress them. She didn’t try to pick any up even as they walked across her. She was welcoming, patient, happy. An older cat with black and white stripped fur and white booty paws returned several times to see her. She was the one Lynne’s friend thought would be best for Lynne.

Lynne stayed quiet as we toured the facility and headed back to the car. Lynne had done her best in awkward visit and wanted an answer. “What do you think? Can I have one?”

She’d done her best in an awkward visit. Once again I reminded her we’re still working on it and need more visits. I added that the director thinks it may not work, not mentioning that her hallucination, which she knew nothing about, was a factor. I now wish I hadn’t added that. She sat silently in the car for 20 minutes as I wondered what she was thinking and what I could say. Finally, she declared, “I’m not getting a mechanical cat.” Ouch??

After I returned to the assisted living facility, I talked with a counselor about our visit and Lynne’s objection to a toy companion. The counselor thought the activities director might provide a toy companion for the facility and make it available to Lynne. I haven’t verified that yet, and frankly, I’m afraid of it. If a toy companion showed up on Lynne’s floor, she would suspect I played a part in it and would be furious with me for trying to manipulate her into accepting a cat. Instead I sought advice from experts on a website I’d found helpful. It’s the Alzheiner’s.org website called Alzheimer’s connected (https://www.alzconnected.org/discussion.aspx). It is a free message boards through for everyone affected by Alzheimer’s disease.

 I posted a summary about Lynne’s passion for a cat and my concerns. I waited for 24 hours and received thoughtful, experienced responses from people with dementia and caregivers. I felt agreement and not a heartless analytic. They were unanimous against giving her a live cat for her apartment. They added personal stories, including a warning because one cat had an $1100 medical bill. They recommended clever responses for me whenever she mentioned it to create hope we were still looking into a cat without rejecting her idea and then distracting her. Their unanimous experience was their loved ones eventually dropped it and focused on other things.

Many were successful with toy cat companions and nobody reported it was a bad experience. They introduced their automated companions cautiously such as bringing it in for someone else, leaving it at the assisted living facility, taking it in and out when they visit and eventually leaving it. I haven’t followed up with any of those ideas.

None had tried visiting a cat sanctuary regularly and several thought the idea was worth trying, especially scheduling a visit when she requests a cat.

worth trying, especially scheduling a visit when she requests a cat.
I said nothing the next two days. The subject never came up. I worry that it will come up again, either on her own, or because her cat-loving friend would call and invite us for a return visit. She called the day before Lynne and I left on a trip that prevented me from scheduling it. I expect she’ll call again, and we’ll find out if Lynne wants to schedule another visit. Or if she never calls, and Lynne asks me why she never calls?

After a month she had not mentioned it to me. She confessed to a friend and colleague, “I want a boyfriend or a dog.” Cats have been mentioned in discussions or videos at the assisted living facility which she and I attended. She hasn’t commented on them.

I even risked bringing it up when we were downtown to meet her tax preparer. We usually treat ourselves afterward at an ice cream shop. I had also been told about a cat café four blocks away. It’s a public café where customers can drink wine or coffee while petting and playing with adoptable cats. While we waited for her tax preparer, I boldly described the cat cafe to her and asked if she’d rather walk to the cat café instead of eating ice cream. She stared at me briefly said, “Let’s get ice cream.” I couldn’t read her reaction, which unsettled me. We had fun at the ice cream store but I wished Lynne could be petting cats and giving me absolution.

I now think her trip to the sanctuary devastated her hopes. I regret meeting alone with the director because Lynne and I usually meet with people together on personal and medical issues. She had accepted me meeting alone, but it must have added pressure. She hoped for the best under their watchful eye as cats curled alongside her. Immediately afterward I had deferred approval and doubled down against her hopes with the heavy authority from the director. Dementia interferes with her dreams and squeezes her genetically inherited independence into tighter and tighter dependence on others. I now believe she stewed on her anger and disappointment in the car until she capitulated. At that point she drew on her fantastic strength to gain some dignity with her defiant declaration, “I’m not getting a mechanical cat.”

I underestimated her strength to move on.

I am disappointed in how I handled the visit to the sanctuary. I rationalize why I didn’t do better. The counselor had pulled aside to reveal the hallucination and I felt it shouldn’t be shared with Lynne. I was immediately busy concentrating on the drive and getting the right address. I could have asked her about the hallucination to understand her awareness. I might even have referred to it in conversation with the director without emphasizing it. It frightened me. I knew nothing substantive. It fortified my objections so, honestly, I took advantage of it. I also could have been more sensitive to Lynne’s resolve.

The next Sunday in church the minister preached on the mental, physical and spiritual importance of an intimate relationship with a good friend. She joked she wasn’t talking about cats, even though they are beneficial pets for human health. I glanced sideways at Lynne. She glared back. She was not forgetting. She ached for a cat regularly but avoided bringing it up or grabbing on to my suggestions. Emboldened by the sermon, she asked as soon as we clicked in our seat belts. “Am I ever going to get a cat?”

Her desire for a cat was back on the prowl. She’d deliberately avoided it, even when I suggested options. She was more resolved than I was. I was the coward.

I needed to be honest. And her question yearned for a final answer. I’d kept bringing it up.

I admitted, “No. I’ve looked into it. Talked with people. I even talked with the general manager about it last Friday and he also said no. I keep looking at alternatives like the cat café, the cat rescue center and arranging to go over to the boys house and walk Tucker once in a while. But ..” I didn’t have anything to add. 

She didn’t respond. I recalled all the times she’d avoided it since the cat sanctuary.

I felt relieved that I’d finally said no. It felt honest. She is too perceptive to use distraction. It was over, not going to happen.

We drove in silence as I sliced across I-5 traffic for the exit to the 520 bridge across Lake Washington. We were headed to the annual Wintergrass bluegrass festival in Bellevue which Lynne convinced was full of celebrated bands and informal jam sessions. The radio was playing bluegrass. Clouds shut down sunlight sparkling off the water and wind whipped up whitecaps. I hated our silence. We were supposed to be headed for fun. I said, “The wind is whipping up whitecaps.”

She hesitated, then firmly said, “I get it, Dad.”

I heard no anger, no resentment, no frustration, no blame, just strength, resolve, resignation. clarity.

I finally got it. She got it much earlier. I felt relieved, even forgiven. I felt she was saying, “It’s not your fault, Dad.”