Lord, the trouble about life just now

is that I seem to have all things

which don’t matter, and to have

lost all the things, which do matter.

A prayer for the one who is left

1

9

3

2

I have life;

I have enough money to live on:

I have plenty to occupy me:

but I am alone,

and sometimes I feel that

nothing can make up for that.

Lord compel me to see

the meaning of faith.

Make me to realise

that I have a hope

as well as a memory, and

the unseen cloud of witnesses

is around me;

that you meant it when

you said that you would

always be with me;

and make me realise that

as long as you leave me here

there is something that

I am meant to do;

and in doing it, help me

to find the comfort and the

courage that I need to go on.

1

9

3

3

For confidetiality and privacy the names in this book have been removed. The woman will be refered throughout only as she, her or herself. The first person writ-er will asume the role of the husband of the woman. Any medical professional will be known by there job description/title.

His Book

1

9

3

5

My wife does not know of this letter to you. She must not learn of it. My

purpose in writing to you is to give you a much fuller picture than you

could obtain from other sources, so that my wife can be helped as quickly

and efficiently as possible.

Dear Doc-

tor

She is suffering from three major dif-ficulties, which interact with each other to an alarming extent. She has become introspective, miserable and moody – totally unlike the out going and cheer-ful person she used to be.

Her difficulties are (in no particular order)

Severe pain in her knee

i. Depression

Memory loss

ii. Memory loss

On the 24th April she

had keyhole surgery

at the local hospital

this did not improve

her situation. She

had been told that

this could be the out-

come. Subsequently

she opted for a total

knee replacement,

a provisional date

being arranged for

the 23rd July. On

the 14th July she

had clinical assess-

ment, at which it was

quite clear (I was

there) that she was

depressed and had

memory problems

it emerged that she

had not been taking,

for some time, the

citalopram tablets

prescribed for her

by the doctor for her

depression. The knee

replacement surgery

was cancelled.

1

9

3

6

Since the 14th July she had taken the

correct daily dosage, but there seems to

be no improvement to her depression. It

was a struggle to persuade her to take

the tablets for about ten days, but now

she controls the taking of them herself,

although I clandestinely check.

Severe pain in her knee

She endures much severe pain, but does not appear to take

any of the prescribed painkillers. She has an aversion to tak-

ing any medication. I’ve given up any attempt to persuade

her. In this way I avoid the inevitable “scene” which are so

distressing, not only to me but also to her.

Occasionally I mildly suggest that she should perhaps take

a painkiller inevitably she replies to the effect that she has

just taken one. I know or can establish that her reply is

probably a lie. She probably believes what she says in this

matter.

The pain dramatically curtails her ability to

walk. She has done no household shopping for several

months and rarely ventures outdoors on her own. This all

makes life very difficult for her and me. She is naturally a

very active person. Frustration and despondency are her

constant companions nowadays.

1

9

3

7

D e p r e s s i o n

She has been depressed for at least a year, possibly even for two years or more. Last year in June 2008 she fell down a short flight of stairs, when holidaying with a friend. Result – a cracked vertebrae and much pain with consequences similar to the described above.

After the cancellation, on the 14th July this year, of the knee replace-

ment surgery, she now believes that the hospital is no longer interested

in her and will not carry out any surgery in the future. I try to convince

her otherwise. My efforts are unsuccessful. Whereas previously she

could only speak very highly of the hospital and her experience with the

staff, her views have become negative since 14th July.

9

3

8

1

She can create scenes for no reason other than she take umbrage at something I’ve said or done. More often than not this is linked to memory lapses. During her scenes/outbursts she resorts to the follow-ing sorts of expressions:

I’m not a child; don’t tell me

what to do (or treat me like as one)

Nobodies is interested in me,

Nobody cars for me,

You don’t give a damn for me,

You’re a hateful man,

You make me feel this size (using her thumb and forefinger) ,

You don’t love me,

I don’t know why I

married you,

1

9

3

9

I want my mother and father

In her outbursts she quickly builds she quickly

builds up to a crescendo of

shouting, shrieking and tears.

Unfortunately, I often respond by telling her that she is imagining

things, is irrational, illogical or crazy.I often raise my voice to match her shrieking. I know that such

responses are wrong but it is difficult to keep a lid on my emo-

tions all the time. The situation is not improved when she adds a

bout of door slamming to her verbal tirade and rage.

In such a state she

cannot be calmed by

me. After her rage

subsides, she will

then bear a grudge

against me, which

can last for several

hours or even over-

night. Quite often

she will apologies af-

ter a scene, when she

has realised what has

happened. I doubt

it she remembers

the frequency with

which these scenes

have occurred.

9

3

9

1

This form of aggression towards me is, I

fear, not so much connected with her de-

pression but arises from the same mental

condition, which causes her memory loss.

M e m o -

ry loss

In retrospect I should have spoken to the doctor more than a year ago. Her memory has been poor and getting worse. This has been particu-larly noticeable in the last six months. A few of her close friends have noticed that all is not right. Let me list a few of the problem areas and, later, a few of the disturbing events:

1.Keys frequently “lost’. Gener-ally located by me – usually where they should be e.g. in her handbag which she has already searched or in a particular draw.

2.Debit cards, nectar cards, bus pass and sev-eral other similar items misplaced.

4.H

eari

ng

aids

“lost

’ an

incr

ed-

ible

num

ber

of

item

s sp

ecta

-cl

es a

lso b

ut not quite

so o

ften

.

5.Unaware of the day frequently. This row hap-pens almost every day. She often asks me, repeating her question within a few minutes.

9

4

1

1

8.Has difficulty in un-derstanding much of our basic financial manage-ment.

9.Gets into difficulties quite often in operating the televi-sion – even though I’ve written down the basic things to do on several occasions.

10.Cannot understand the central heating and hot water system, switches and thermostat.

11.Gets confused with the contents of the ra-

dio times and cannot comprehend the “+1” chan-

nels, although I’ve explained this dosens of times.

12.Toaster, fan heater, radio – has declared these must be broken in fact they are ok she must have pressed the wrong button.

9

4

2

1

6.Handbag cannot be found, though she had it a few minutes earlier.

7.Repeats the same remarks or anecdotes (more than once often) to people. Also rings a person up more than once with the same information or question.

13.Microwave – forgotten how to defrost. She hasn’t used it until the other day since before 24th April – she hasn’t been doing the cook-ing etc.

9

4

3

1

3.Library tickets and a replacement lost, whereabouts unknown.

A few of the foregoing words would be acceptable, I suppose, but so many clearly indicate to me she is ‘in a bad’ way particu-larly when the more disturbing events are taken into account

She has difficulty in remembering

where we have parked the car (I

drive she does not) and also the

time that we’ve arranged to meet

back at it. I had to look for her,

looking for the car on one occa-

sion. Nowadays we usually park in

a multi story car park this confus-

es her more than street parking.

C a r

Park-

i n g

Day of surgery —

9

4

4

1

I discovered driving the home-

ward journey in the car that

she was convinced that she

had been in hospital overnight

and that the day was Satur-

day, whereas in fact it was still

Friday 24th April – about 4pm,

seven hours after our arrival

that morning at about 9am I

could not convince her, over the

next few days, of the error of

her thinking. She told friends

that she had been in overnight.

I am certain she still believes

that she spent the night there.

9

4

5

1

The Cat

She now thinks that we’ve had

the cat for a short period of

time, which translates into 2-3

weeks, whereas we’ve had it

for about 5-6 years. She has

become very protective and,

dare I say, obsessive with it.

Frequently, she worries it if she

does not know its whereabouts

in the house and goes off in

search of it. Searches are often

unsuccessful, as she does not

look in all the obvious places,

when I’ve been able to tell her

or to find the cat for her. A few

minuets later the same pattern of

event emerges again and can be

repeated several more times in

that particular session. Several

such sessions can occur during

the day. Whereas previously the

cat had the freedom to come

and go outside the house via

two cat flaps, now she insists

on keeping it indoors. During a

heated discussion on this subject

recently, she denied that there

were cat flaps in the back doors.

We’ve always had a cat (or cats)

and before her recent ideas there

were no restraints placed on the

freedom except when circum-

stances dictated otherwise.

9

4

6

1

Somehow she has been unable to remember where all the double (king size) sheets have been put and when remaking the bed with a clean sheet has used single sheets. On one oc-casion she used a tablecloth. She absolutely (and has always done so) insists that I do not help her in this task. Once I insisted that we buy imme-diately a new pair of double sheets. This we did the next time of remaking, she did not remember that acquisition and used single sheets once more. I found the new double sheets, which of course were still in their pristine wrapping.

One day, 2-3 weeks ago, I reminded her that she had not bought

the annual BBC Proms book which is given her much enjoyment

with her musical background. Almost immediately we went out and

got one. Within a week it had disappeared, I queried its absence but

she declared she hadn’t bought one. I searched high and low but

couldn’t find it. I suggested she bought another copy (to her this

would be the first). She agreed and the purchase was made. A few

days later the original book was discovered by pam in one of her

drawers, she made no comment and did not dare to.

B e d

B B C P r o m s

9

4

7

1

My eldest son

He is 51 and lives in London. He visits us on

Fathers Day in June and treated us to lunch – a

regular event. The three of us spend about 6

hours together during the day. After he had

gone, I opened up the convocation with her

about the pleasure that his visit had given

me. It transpired that she did not remember

that he was my son (her stepson) even though she

had been in his company dosens and dosens of

times over about 30years

and that she has on numerous occa-

sions expressed her fondness for him.

She became exceedingly cross with me in her ful-

some way when I insisted that he was my son.

“He’s a nice man, but I’ve never met him before” was her battle cry she did

think that he must be some sort of family member.

The way in which this scene developed still leaves me in a state of dismay. She asked the question – ‘if he is your son who is his mother?” I explained that his mother was my ex-wife, whom she had often met and spoken to at many

Subsequently, I learned from one of our friends

that she had mentioned the “nice man” who

had visited us and taken us out for lunch.

family functions. She immediately became enraged in a berserk way. “I never new you had been married before. If I had known, I would never have married you”. I managed to keep the lid on my emotions reason-ably secure under the circumstances, even though she continued to rage. I have never referred to this matter again – much too dangerous to do so. I was consigned to the doghouse for the next two days – probably a lenient sentence according to her!

Her mother, I understand, suffered from memory problems when she was the age she is now. Apparently there were shouting scenes, but in which direction I do not know. Occasionally she would make ref-erence to her mother’s condition in relation to herself and her own memory. I now think she was being serious, although I never took her seriously. These observations bye her have not been made for many months. I cannot remember the last time (date).

She worked for WHSmiths for

a number of years in its buying

division and then as its chari-

table donations manager after

leaving WHSmiths she worked

for various charitable organisa-

tions including a remarkable

few years at The Princes Trust.

9

5

0

1Her Background

She was always a confident, gregarious and sociable person, who was

fully occupied in her business and recreational activities. The changes

to her are quite dramatic. She had a great success with achieve-

ments regarding her choir I naturally found myself involved, not as

a singer, but as a treasurer and floor manager. As a result I know all

the members very well and never had any doubts about her abilities

to instruct and inspire the choir, although she would express doubts

to me. Her standards were very high, but she had to compromise be-

tween these standards and the capabilities of the choir member.

Des

pite

the

am

ount

of

wor

k,

this

was

a v

ery

happ

y pe

riod

in

her

life

, bu

t in

the

end

it

prov

ed t

oo m

uch

she

felt

she

w

asn’

t do

ing

just

ice

to h

erse

lf

and

othe

rs c

onse

quen

tly,

she

w

ould

fini

sh t

he c

hoir

aft

er t

he

Chr

istm

as c

once

rt i

n 20

06.

In

the

10 y

ears

she

gam

e a

grea

t de

al

of

plea

sure

to

a

grea

t nu

mbe

r of

pe

ople

. H

er

ef-

fort

s w

ere

resp

onsi

ble

for

over

£1

0,0

00

bei

ng r

aise

d fo

r lo

cal

char

itie

s du

ring

th

ese

year

s.

Perhaps the winding up of such a

successful enterprise left a big gap

in her life – bigger than either of us

thought. We filled the gap, of course,

by having more time for ourselves

and for other activities. But some-

how this point in time marks in my

mind the beginning of her memory

problems. I think she may have re-

alised this too, but without properly

understanding what was happening.

I do so hope that, for her sake and mine, you will be able to improve

upon her present condition and help to restore much of her

happiness with which she used to deal with life.

His Book