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Arthur Ramm cried six years ago when the doctor said he had Alzheimer’s. But he adjusted. “I’ve got to live with it. What else can I do? I’m a happy man. My caregiver makes me happy, with her smile and her pearly white teeth.” Evelyn Ramm, she of the pearly whites, gets a huge break on days she puts Arthur on the van to day care.

Eight days

When George placed his wife in Bon Secours, the staff advised him to stay away awhile and let her adjust.

Eight days have passed and George can't stand it a minute longer. On four hours' sleep, he is wired with anticipation. He sails past the gift shop, the beauty shop, the ice cream parlor and punches 491 into the code box that opens the dementia wing.

Lucille's face has paled, her hair has lost sheen and chunks of it stick up as if she just rose from a nap.

She frowns at George, confused. He practically yanks her from the chair and blankets her with kisses.

"What a good girl you are. Want to give me a hug? Did you miss me? I missed you."

Lucille slides her hands up his arms and into his short-sleeved shirt, hanging on for support. Gradually she relaxes and summons her old expressions -- snippets of word and gesture that keep her connected.

"Yeah, yeah," she says, smiling. She winks.

The staff invites them to the patio for a sit-down hula, and George bubbles with excitement. When Lucille's father was in the Navy, she lived in Honolulu and learned authentic hula moves.

"She'll love this," George says. "I should have brought a Hawaiian shirt."

On the patio, they sit on plastic chairs, blue leis draped around their necks. A 45 rpm record player cranks out lilting songs.

"Huki huki huki hukilau," sings the woman on the record.

George undulates his arms to the music. "Put your hands out. Put your hands out. Hula, hula."

Lucille scrunches her nose as if she just stepped on a slug. The hula holds no interest; only George does. She smiles, rubs his hand and grabs his face.

He's crestfallen that she won't hula. "Usually she would at the drop of a hat. She's not at all doing well."

The battery on her watch has stopped and George fusses with it a few seconds before dropping her hand. "What's the difference?" he says.

He guides Lucille to her room. She walks stiffly and leans backward.

His thoughts stray to the talk he had with his children before putting Lucille in the nursing home.

"I told them she isn't going to last long. I think that's what scares me."

The renegades

"YOU'RE SO lucky," people at support group tell Evelyn Ramm. Arthur still dresses himself, converses rationally and is compliant as a lap dog. Put him in a nursing home and he'd outperform some of the staff.

But Evelyn can barely stand it.

After her disastrous first marriage, the man who brought sharing and kindness into her life has retreated into childhood. With his Swiss-cheese memory, Arthur latches onto something and gnaws it to shreds.


“YOU’RE SO LUCKY”

"You're going to bump your head on that shelf," he says as they take their seats at the breakfast table.

"No, I'm not," she says.

Two minutes later: "You're going to bump your head there."

"No, I'm not."

Two minutes later: "You're going to bump your head."

"I've been doing the same thing for 27 years!"

"Well, this time you might bump it."

Her face flashes with irritation, then softens into laughter. Another day with Arthur has begun.

An 80-year-old retired nurse, Evelyn is known at support group as the Drill Sergeant because of her upright bearing and gruff jokes about whipping her 82-year-old husband into shape.

Adult day care is her salvation. For six hours, she can exercise, go out with friends or just collapse.

She got up at 5:30 this morning, made cereal and toast, laid out Arthur's clothes and reminded him to shave, always keeping an eye on the clock. No way she's going to let him miss the 8 o'clock van that represents her freedom.

By 9:15, Arthur has taken his seat at Lealman Adult Day Center. The precision and know-how he relied on as an accountant have long since abandoned him, but only the human spirit counts here, and Arthur is a star.

He helps the staff serve breakfast. At one table, a low-functioning man fiddles with a collection of moveable locks, keys and door handles. Arthur serves him an English muffin and whispers conspiratorially:

"He's practicing to get out of here."

Arthur holds up a dollar bill and the cover of Time to Rubye Wysinger, a former school administrator saddled with lousy eyesight. He demands she read them, then demonstrates his own visual acuity by reciting the lunch menu off a blackboard 50 feet away:

"Roast beef with gravy, mashed potatoes, corn."

He removes his glasses. "I can read it without these. These are just to protect me against women."

Rubye chuckles: "It must be hard. You are so irresistible."

As people dance around the room to exercise music, Arthur grabs Julia Slaight's wheelchair and pushes her into the crowd. They joke about forming a club, with T-shirts.

"We should call ourselves the Renegades," Arthur says.

"No," Julia says, "the Used-to-Bes."

Next to Arthur sits Lucy Kasheta, a fidgety 82-year-old who lives alone and thinks her memory is just fine. Her daughter, Carol Ross, joined Cheri Whitaker's support group after Lucy lost 80 pounds and started accusing people of stealing things.

This is Lucy's first day here and she's not happy. "I have other things to do at home," she tells Arthur, as if he could grant her permission to leave. Through the morning, dance music, card games and a TV tuned to The Price Is Right catch her fancy.

"Would you like to come back?" Carol asks when she picks her mother up.

"Now and then," Lucy says, shrugging to mask her enthusiasm. "It's up to you."

BACK AT the Ramm house, Evelyn takes a walk, runs a few errands and relaxes until 2:15, confident that Arthur is enjoying himself.

Evelyn turned to day care because Whitaker kept pushing it at support group. It was heartbreaking the first few times. "I would come home and cry. I didn't know what to do with myself. I felt so alone. But it turned out to be a big break.

"When I hear other people at the group and what they are going through, I thank God I have Arthur," Evelyn says. But without day care three days a week, "I don't think I could stand it."

The days he stays home, she lets him sleep.

Bedrooms

George drags into support group all haggard and coughing. Since he moved Lucille to the nursing home, he has lost so much weight that he's disappearing into his pants.

"I haven't slept in three nights," he announces.

"What are you doing here?" Whitaker asks as the others treat him like Typhoid Mary and playfully back their chairs away.

Whitaker hugs him. "We still love you."

Phil Germaine eases his chair closer to George. "I'll move back, but I'm not going to kiss him."

"I wouldn't miss this for the world," George says, "even if I make you all sick."

George is walking testament to Whitaker's warning that nursing home placement is often hardest on the healthy spouse. The daily grind goes away, but the ache sets in.

"Are you lonely?" Whitaker asks.

"Oh, yeah."

"How are you dealing with it?"

"I visit her in the morning and the afternoon. I talk to the kids over the telephone. The house is pretty big. You rattle around in it."

The Hoffmans used to sleep in separate bedrooms because Lucille snored so much. Now that she's gone, George has moved back to the smells and touch of her bed.

THOUGH WHITAKER says the nursing home phase can be worse than death, Gil Nichols doesn't buy it. Dick died three months ago and she misses him every day. Someone -- she won't say who -- recently questioned why she keeps coming to support group. What good is it for a widow?

Gil has stewed on it for days.

"I want to ask a question," she blurts out. "Do you think I should keep coming to the group?"

She bows her head and shakes as support cascades over her.

"I don't want you to leave!" cries Millie Gundlach.

"It wouldn't seem right without you sitting there," Jack Grable says.

"I do want to come here," Gil says.

George makes it unanimous: "You better come, or I'll come get you."

DAYS AFTER dragging himself to the meeting, George lands in the hospital with raging pneumonia.

The phone rings. Whitaker has hooked up a speaker phone at support group, and 11 voices jabber at him at once: Get well, hurry back.

Ruth Mooney -- they call her the Pantyhose Lady for an off-color joke she told -- shouts a hello.

"Is that you, Ruthie?" George yells, rallying now. "Save me some pantyhose!"

He gets out of the hospital the next day, spent but ready to move on.

'We'll fold!'

THE GROUP is about to be tested. Their leader -- their teacher, cheerleader, advocate, nurturer -- is leaving the Alzheimer's Association.

Cheri Whitaker cannot stand her life. She is lonely and depressed, and her mother offers only sadness and pain. Whitaker needs a change, a big change, or she is going to explode.

Her medications made her feel lousy, so she stopped taking all 14 of them, including pills for heart problems, high blood pressure, depression and anxiety.

She moved from her mother's apartment to a motel. Now she has turned in her notice without a new job in sight.

And the group?

She plans to lead it as a volunteer, maybe bring in a cofacilitator who can give her a break.

She churns inside when the meeting begins, planning to drop her bomb at the end. Plastering on a yeoman smile, she makes her way around the table.

George has recovered from pneumonia and looks chipper. "I wasn't sure I was going to make it. I realize I wasn't eating my three squares a day. I found out I have to do that if I want to be here, and I want to be here."

Cliff Lee is having trouble with his 76-year-old wife. Betty squirrels pills in her mouth for hours and spits them out when Cliff isn't looking.

Whitaker suggests hiding pills in applesauce, yogurt, ice cream -- anything sweet -- but Cliff says Betty roots through the applesauce with her tongue and finds the pill as surely as a princess with a pea.

Last week, Betty vomited brown stuff; the ER doctor said it was dried blood.

"It looks exactly like dried-up coffee grounds," Whitaker tells the group. "If that ever happens to your loved one, it means there is internal bleeding."

Cliff has a heart condition, and rushing Betty to the hospital has left him exhausted.

"Let us give you a week or so of respite," Whitaker pleads. Betty would get care, Cliff would get a break, the association would pay.

"I don't know how Betty will handle it."

"Right now, we aren't concerned about Betty. We are concerned about Cliff Lee. You need a good 24 hours' rest."

Cliff won't commit. He steers the conversation back to medicine the doctor gave Betty to coat her esophagus.

"He told me to have her swirl it in her mouth and swallow it. You think you can explain that to Betty? She doesn't know how to swallow. It makes me a nervous wreck."

Whitaker bores in: "Are you going to let us help you before you leave today?"

Cliff fends her off and the discussion moves on.

WHITAKER LEANS stiffly into the table and smiles and smiles. She rambles, unable to get to the point. Puzzled faces greet her monologue until George figures it out.

"She's leaving."

"Yes. I'm resigning," Whitaker says, her shoulders slumping.

"How come?"

"Don't ask. I'm not leaving the group. We will continue together."

"We'll fold!" cries Millie.

"No!" Whitaker says, almost shouting. "You are not folding it up."

"Not without you!" Millie says.

"You have to be practical. The one thing I don't want is this group breaking up."

"It's going to," George says.

"If there's any assistance you need, you are to call this office. Cheri is not the organization. The Tampa Bay Alzheimer's Association is helping you. That is their mission."

Evelyn Ramm, the group's Drill Sergeant whose cool reserve never yields to sentimentality, grabs Whitaker around the shoulders.

"We love you," she whispers.

The meeting is over but nobody wants to leave. Whitaker ignores the hubbub, taking one last shot to prod Cliff to get help. She clasps her fingers as if in prayer and bends toward him, begging him to put Betty in an assisted living home.

"This is going to make you sick. You leave and you go straight there."

"I can't. Friends are watching Betty. I said I'd be home at 3."

"They won't care. Go straight there."

At the other end of the table, Jack and George puzzle over Whitaker's announcement, wondering how much longer she'll stay. Evelyn comes up.

"We'll do the best we can," she says. "We have to."

     
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