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#24 Indulgence

Compromise is key to a healthy relationship. Whether romantic, familial or otherwise, nobody gets their way all of the time, except for maybe the family poodle. Am I right?

If you’ve been in the care game a while you’re probably shaking your head right now. Those of you caring for folks with dementia or Alzheimer’s definitely know: while good in theory, this old adage ain’t holding up in reality. Mr. Stefson will not change out of his pajamas for lunchtime, thankyouverymuch! Grandma Mary will eat her dessert before her meal just like they did back in the 60’s when nobody cared about artificially manufactured social norms and rules! And Granddad Bill will eat four pieces of bacon every morning, despite his hypertension and high cholesterol, because goddamn it he’s a grown man who can feed himself and he’s going to continue to do so come hell or high water, no matter what some quack tells him to do.

There are any number of things that will make your loved one inexplicably happy even if (especially if?) they are detrimental to their health or well-being. While you should never sacrifice safety to placate an unhappy individual—such as allowing them to drive or walk outside alone when they are not safe to do so—certain concessions can be considered.

Assess the pros and cons by relative weight. If I allow Dad his two scoops of ice cream (with whipped cream and hot fudge) after dinner, how happy will that make him? How angry or sad will it make him if I don’t? Will his health be put in jeopardy by allowing said ice cream sundae say, once a week? How about three times? Four? How likely is it I will cause “death by sundae”?

As caregivers, we are often scared out of our minds. This person—in many cases, this parent or grandparent or person quite a bit older than us—has unwittingly put their life in our hands. We try to follow care by-the-book. We enlist nurses and traveling doctors and home health aides to help set The Boundaries, to diligently enforce The Rules. Said patient should spend x amount of time reading, x amount of time on arts and crafts, x amount of time on memory-enhancing games and x amount of time on physical activity. They should also eat a well-balanced diet and refrain from too many sweets, and they most certainly should not imbibe in alcohol.

Why the hell not?

This was the question my friend Sarah eventually asked herself when her mother Carol began eating Klondike bars by the handful. Carol, at seventy-six, had early-onset Alzheimer’s that had advanced to a critical state. She had always been thin and walked every day—weight was not a concern. The hang up was that Carol had Type 1 diabetes that had to be carefully monitored. She had done an exemplary job of sticking to diet her entire life, staying well within the boundaries of safety. But now, legally blind from the disease, unable to read or enjoy a television show, mind riddled with confusion and anxiety, limbs not functioning on their own, the mere mention of a sugary freezer treat brought utter joy to Carols’ face.

The last memory I have of Sarah and her mother, Carol is lying on the couch. She asks why she is lying down when everyone else is sitting. Sarah tells her that’s a good point, omitting the fact that five minutes earlier Carol herself had asked to lie down. She raises Carol to a seated position, arranging her hands in her lap.

“Well, what are we going to do now? Sit around and stare at each other?” She squints anxiously toward the door, and sighs.

“How about a Klondike bar, Mom?”

Carol smiles dreamily. “Well now, I think that sounds like a fantastic idea. And I think I might like to have two.”

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