Still

The disease keeps moving, whether I am aware or not. Whether I accept it or not. That is its nature.

Its gradual movement creates an illusion of stillness: like the subtle changes in daylight that go unnoticed until suddenly (it seems) it is dusk…or like fog rolling across a lake until the water is covered and the shoreline invisible.

So it is with Dale’s latest changes.

Suddenly (it seems) he is sleeping more hours than he is awake; content to sit because standing and walking are challenges; leaving food items on his plate that he once ate with pleasure.

This transition feels shocking to me, despite the length of our journey and all the signs along the way. As I look back, I can see dusk approaching…the fog rolling in. I can see the gradual movement to where we are now.

But still, my whole being responds: How can this be? How can it be that our daily walks together have ended? How can it be that Dale is no longer my dinner-and-a-movie partner each evening? How can this be?

As I inch towards acceptance, I look up to see that there are guides along our way: hospice CNAs who bathe Dale with skill and compassion; chaplains who sit with us, pray with us; caregivers who bring smiles, experience, and helping hands; fellow travelers who know this place well and listen with deep understanding; friends and family who express love in myriad ways, lifting our hearts and assuring us that we are not alone.

And still, Dale is here…in his smiles and laughter, in moments of recognition and connection, even amid periods of intense confusion and long hours of needed rest. Still. Here.

“Still is still moving to me
And it’s hard to explain how I feel
It won’t go in words but I know that it’s real
I can be moving or I can be still
But still is still moving me
Still is still moving to me.”

From Dale’s favorite Willie Nelson song: “Still Is Still Moving To Me”

Music Lessons

During the early years of Dale’s diagnosis, we participated in a clinical trial at Emory. On the way to Atlanta for an appointment, I realized I had forgotten to pack something and mentioned it to Dale as I drove. He replied, “Well, you’re thinking for two now.”

Yes. It was a new reality. I was adjusting to it.

All the tasks we had shared as two would gradually become mine alone. Planning. Managing finances. Shopping. Meal preparation. Contacts with friends and family. My responsibilities expanded over the years as Dale began to lose the ability to care for his personal needs.

Now there are times of deeper confusion as language, emotions, and cognition are further disrupted. “Thinking for two” is not enough when the disease clouds his. 

So, I “tune in” by listening to his vocal tone. I watch his facial expressions. I notice the sound of his breathing. Sometimes my guesses about his needs are right; sometimes they are not.

It’s as if Dale is listening to music that I can barely hear. My attempts to join him in that music are improvised at best. There are times when I can discern familiar melodies—variations on themes that I know well. “Ah yes,” I think, “this is the music of Dale.” But other times the music sounds completely foreign to me. I have trouble finding the tempo or even the right key. And when I do, the music changes again the next day—or next hour—or sometimes the next minute.

As someone who prefers to have a musical score to read, the near-constant improvisation can be exhausting. I wonder whether I will have enough breath to keep going.

The only way through is to expand our duo and form a band. Thankfully, experienced players have joined ours. There are times when Dale’s caregivers hear the music far better than I do. While I may know “Dale’s theme,” they know the musical genre we are playing now. I listen to their riffs in amazement and gratitude. And when it’s my turn again, I can come in refreshed.

As we play, I learn the lessons of improvisation: Be in the moment. Listen. Match the emotion. Loosen up. Remember that mistakes are to be expected and are quickly forgotten. And as guitarist Joe Pass said, “If you hit a wrong note, then make it right by what you play afterward.” May we make it right for Dale.

More Than

Soon after Dale was diagnosed, we began considering a move to a continuing care community. While I knew the wisdom of this, I remember discussing my feelings of hesitancy with a friend. I said, “I don’t want to move to a place where people only know Dale as ‘that man with Alzheimer’s disease.’” My friend replied, “But if you move soon, they will get to know Dale as he is now.”

That is what happened. The progression of his disease moved slowly in those first years, and the people in our new community came to know Dale when he could fully engage in conversations and share his own story. Many grew to love him and still do, no matter the changes.

There are times when I still feel that longing for others to know Dale as more than a man with Alzheimer’s disease. Any new medical situation is where I sense it most acutely. There are usually only a few seconds to say the most basic things to the staff as we walk into the examining room: “His language comprehension is mostly gone. You will have to show him what you need him to do.”

However, I want to say: “This is Dale Sessions. He has been my beloved husband for 35 years. He is more than his disease. He has a story.

Dale is a man of courage and compassion. As a minister, he was not afraid to ‘rock the boat’ when advocating for issues of social justice. He was a chaplain who cared for people with the disease he has now…a pastor who walked beside many in times of illness and death…a skilled counselor with people suffering from mental illness and addiction.

When Dale asked how you and your family were, it wasn’t perfunctory; he really wanted to know. He was genuine and had little patience for pretense. As a friend put it, Dale could tell ‘chicken s*** from chicken salad.’

Dale loved to tease and laugh. He still does, although you may not be able to understand his jokes. Music fed his soul and continues to. He cared and loved deeply. He still does.”

Of course, outpatient medical offices are not set up to hear people’s stories. They are equipped to treat whatever the presenting problem is, and I am thankful for the expertise of those professionals. I am also thankful for care providers who treat Dale as a man who is far more than his disease.

As I write this on the eve of his 81st birthday, I am filled with memories of Dale’s story and deep gratitude for all that he was and is. May he know tomorrow—and each day—that we are happy he was born. May he know each day he is dearly loved.

That Which Abides

One morning several years ago, I noticed Dale’s wedding ring and another ring on the bedside table. Assuming he had just forgotten to put them on, I took them to him. He stretched out his hands, showing me that he had two other rings on them. I held up his wedding ring and pointed to his left hand. Nothing registered. I showed him my ring and how the two matched. Still no comprehension.

This precious gold ring—the one I had placed on Dale’s finger during our wedding ceremony—had, to him, become just another ring.

Clearly, the disease was on the move, cutting a wide swath through Dale’s brain, destroying long-held memories and separating meaning from things. Spoken words were becoming just sounds. Beloved possessions, simply objects. With no access to key parts of our story, the ring’s significance as a symbol of our union was gone.

During this same period, it seemed that I, too, was beginning to disappear from his awareness. He stopped saying my name, and no longer recognized it when others said it.

Who am I to him? I wondered. Who are we to one another if he no longer understands the concept of “spouse”? What is a marriage when I alone hold our story, remember our wedding, understand the symbolism of our rings?

Although who I am to Dale is not always clear to me, this is clear: Love—the reality we celebrated 35 years ago with an exchange of rings—still IS, no matter what Dale calls me or what he remembers from day to day. It does not live in the symbols that once had meaning to both of us. Love is embodied in our actions. Every day.

We continue to encircle one another with it, despite the destruction caused by this terrible disease. Love is expressed not only in my caregiving tasks but in Dale’s own actions and responses.

It is different these days. Sometimes disease-related confusion creates barriers. And sometimes my patience wears thin. But love still IS, and it is expressed in both new and old ways: A clasp of the hand. Patience when either one of us has to wait. Willingness, on his part and mine. Shared laughter. A look of recognition. A smile.

Concepts fade away. Symbols lose meaning. Love is what is real. Love is what abides.

“When you put these rings on each other’s fingers, they become symbols of your pledge to one another…that you will encircle one another with your love, your care, and your protection, that whatever happens, you can depend on one another…Your ability to give yourselves to one another is not perfect now, but you will learn to give yourselves more and more, until the gift is like the ring, continuous and whole.”
                                                                                      From our wedding ceremony, June 2, 1985

Inscription

One morning two years ago, I found Dale staring at a plaque he had received in appreciation for his work as a mental health chaplain. He had already lost access to much of his long-term memory and was losing his ability to read. I had no idea what meaning the inscription might still have for him.

He finally said, “That says ‘Dale Sessions.’ It’s supposed to be me. But I’m not. I’m supposed to be me, but I’m not.”

It was common to hear statements like this from him during that time. Once when baffled by something I said, he replied, “Well, I know you are a human being, but I am not a human being. I’m just nothing.” Heartbreaking to hear, even when his laughter followed.

Like encroaching darkness, the disease was moving across Dale’s brain, reducing his abilities to remember, speak, understand language, and think clearly. He could feel the losses.

During the months he was making statements about being “nothing,” though, he was living otherwise: helping serve communion at the memory care unit; proclaiming “Hallelujah!” throughout the day; lifting spirits in the community dining room with each entrance.

And now, after many more changes, Dale still IS: happily greeting neighbors and enthusiastically waving at cars that pass. It is Dale who laughs with surprise when I come back into the room and says, “I know you!” or “Thank you!” or “I love you!” He is still connected to others and to life. Changed and changing. But still Dale.

There is continuity amid the changes of this disease: a precious thread of identity that persists despite change and loss. Like the sky’s colors that change as the earth rotates away from the sun—and yet are still “sunset” and still beautiful—Dale still IS—and is himself—amid the changes of his disease.

And as he forgets more and more, we remember him. We hold the versions of himself that he may forget, and love the one who is beside us.

As our caregiver often says, “He is still in there. And he matters.”

Yes. And that’s what matters.

But Zion said, “The Lord has forsaken me,
my Lord has forgotten me.”
Can a woman forget her nursing child,
or show no compassion for the child of her womb?
Even these may forget,
yet I will not forget you.
See, I have inscribed you on the palms of my hands;
your walls are continually before me.
Isaiah 49:14-16

Rivers in the Desert

When we first began living with Alzheimer’s, I looked ahead to a future of loss upon loss: relentless destruction of memories and abilities for Dale; mounting grief and exhaustion for me.

The disease has certainly lived up to its reputation. It has created gaping caverns where thoughts once effortlessly flowed. It has made everyday tasks—dressing, bathing, toileting—baffling puzzles that cannot be completed without help. Grief for these losses is a constant undercurrent and restful sleep is a welcomed gift.

And yet, amid the terrible destruction, amid the unraveling of relationship and shared story, there has been a forming.

A new thing.

Like new skin—imperceptibly created as the old sheds—a new way of being “us” has formed.

This new thing has not appeared merely in spite of, but rather because of what has been lost. Like a seedling springing up from decaying wood, it is nourished by loss.

In the past, our thoughts, ideas, and memories ruled our interactions. They fueled our conversations, created our history, propelled our plans and activities.

But the disease has removed that capacity in us. Cognition is no longer the dominant force in who we are together. Its decline makes space for new ways of being, for the flow of life in the present.

In the present, we simply ARE. We are learning to BE and to love in new ways.

There is a special tenderness as I become the hands for Dale, tending to all that he once did for himself. Laughter and delight erupt spontaneously with things that have become surprises: seeing a neighbor, tasting an ice cream cone, hearing Chuck Berry’s “Maybellene.” Gratitude and awe expand each time we walk outside and the blue sky is completely amazing once again.

I have not stopped missing all that we were together. And there are times when confusion intensifies and builds a barrier between us. But I am learning to give thanks for what is…for the new ways we love.


I am about to do a new thing;
now it springs forth, do you not perceive it?
I will make a way in the wilderness
and rivers in the desert.
Isaiah 43:19

Dance Lessons

Despite how he looks in the photograph, Dale was never comfortable dancing like this. He used to laugh and say that the ballroom dance classes his mother sent him to as a boy never “took.” Still, he was a good sport when it came to my love of dance. And in our dance of life, Dale has been a sure-footed and grace-full partner.

Our “dance” as a couple was not always smooth, especially in the beginning. We occasionally stepped on each other’s toes, broke connection, heard the beat differently. But over the years of our marriage, certain patterns and rhythms emerged: the pace of conversations, the meaning of a certain look or touch, the balance of time together and time apart, the holding of our joys and pain.

As we danced through life together, these small intricate movements became our muscle memory, our own unique choreography, the composition “us.”

We barely noticed when Alzheimer’s disease entered the dance floor. It stood off to the side, an irritating distraction causing us to cling more closely together. But over time it grew loud and bold. Like a drunken party-goer, it rudely broke in and disrupted our dance, requiring us to learn new steps on the fly. It altered the patterns and rhythms that were familiar and dear to us. Its unpredictable behavior now forces near-constant improvisation.

Today there is another threat lurking outside the dance hall, a virus that has the potential to further disrupt, and even end, our dance together.

While I take my cues from Dale’s movements, it is up to me to guide us safely across the dance floor. How do I remain sure-footed when these intruders are intent on doing all they can to cause me to lose my balance? How do I move forward with grace when pulled down toward fear and despair?

There are certain practices that help. Even if I could do them consistently, there would be days I’d be caught off balance anyway. That is the nature of the intruder we live with. Here are some lessons I am learning:

  • Remember to breathe. As one of my dance teachers used to say when we would concentrate so hard that we’d forget: “Breathing is good!” Yes! A deep breath provides needed oxygen and helps me focus and relax into the next move.
  • Warm-ups are essential. Every ballet class begins with time at the barre, where basic steps are practiced and strengthened. I can’t dance with Dale, especially now, without practicing basic self-care (self-love): eating well, sleeping as well as I can, making time for solitude and prayer, exercising, and taking breaks.
  • Be gentle with myself. Improvisation is hard and new steps can be scary. Mistakes are to be expected. It is best—for Dale and for me—if I can forgive myself and keep dancing.
  • Be present in the moment. I can lose my footing by focusing behind with regret or ahead with dread. Also, the present is where Dale IS, and a touch or look can bring us shared joy.
  • It’s no solo act. Leaning into the ensemble that surrounds us—friends, family, support groups, professional caregivers— helps keep me steady and balanced.
  • Look up and smile. Laughing, singing, and (literally) dancing together have always been a part of our life, and they continue to lift our hearts.
  • Focus on what I can control. I can’t control the actions of these two diseases. I CAN focus on my own steps—protecting us as well as I can from the virus and adapting to the changes that Alzheimer’s brings.

Our dance together has been altered significantly by Alzheimer’s over the past 10 years. Much has been lost and the sadness at times can be overwhelming. However, the love that brought us together 35 years ago remains. Our basic connection endures. Love abides and abounds! Thanks be to God!

About this Blog

I have been keeping a journal since my husband Dale was diagnosed with Alzheimer’s disease in 2010. My writing has helped me express difficult feelings, keep track of experiences, and cope with the innumerable changes that unfold with the disease. Recently I began to wonder whether my journal could be shared in ways that might also help others facing similar challenges.

As I reviewed the pages, I saw that I had used many images to describe what I was witnessing and feeling as Dale’s disease progressed. This was no surprise really, since images often come to me much more easily than words. I decided to try telling our story by pairing visual images—my photos—with reflections—my writing.

It is my hope that by sharing this way, I am carrying forward what Dale began when he accepted his diagnosis fully and openly. Because he had Alzheimer’s in his family, Dale had thought deeply about what he might do if he, too, had the disease. He sought an evaluation early, and when diagnosed, faced the disease head-on. He entered a clinical trial that involved brain surgery, not knowing for four years whether he had received treatment or placebo. Until the disease removed the memory of its presence, he told everyone he knew that he was living with Alzheimer’s. He walked bravely with that knowledge, hoping to reduce the stigma of the disease. He has been my hero all along the way.

Dale is now in middle stage Alzheimer’s. His verbal language is very limited and retention time is down to seconds. He requires guidance throughout the day and assistance with self-care. What he doesn’t need help with, though, is finding joy in the moment. He LOVES greeting and being with people, singing, dancing, and spending time with our dog, Lucky Day. Although he no longer has access to the memory of his diagnosis or understands what Alzheimer’s disease is, he continues to be an example of someone living fully with “what is.”

As Dale said in a video filmed in 2015 for a seminary course on dementia that we were a part of:

“Okay, this is it. I don’t like it. I didn’t want it. But I’ve got it. And I’m going to do the best I can with it.”

Me, too, Dale. Me, too.