Sheltering In Place

As I write this, I am currently “sheltering in place” as our city, and most of the world, is experiencing the pandemic of COVID-19. It’s given me a lot of time to reflect on aspects of Alzheimer’s caregiving that I hadn’t fully appreciated before. This pandemic is unprecedented in my lifetime, and I am sure we are all learning a lot about ourselves.

The closest I ever came to this experience during the time of Harvey’s diagnosis of Alzheimer’s disease was during the ice storm of 2014, affectionately (?!) called Snowpocalypse here in Birmingham, Alabama. For those of you outside of the area, shaking your heads and laughing at the crazy southerners who can’t handle a little snow, let me tell you what happened.

No one saw it coming, not even our revered weatherman. In the space of 30 minutes, our roadways were covered in a layer of ice and were unnavigable. Scenes of automobiles by the hundreds, abandoned on highways gave rise to the term Snowpocalypse. People were stranded in their cars or walked home long distances.

I was stranded at my office. Hearing about the crisis on our streets, I decided to stay put. But Harvey was home, alone, now four years into his disease. I called him frequently, telling him that I was unable to make it home. I had a neighbor go over and check on him and offer companionship. I was able to make it home late the next afternoon.

If Snowpocalypse had happened just one year later, when Harvey required in home care, it would have been disastrous! Our caregivers wouldn’t have been able to make it in, or back to their homes. I quake at the thought of Harvey alone in that stage of his disease.

Of course it does no good to worry about the “what ifs” of the past, but today, with this pandemic creating havoc in our lives, I can’t help but imagine what it would have been like had this been happening just a few years earlier.

I am a physician, and I would have had to continue to work. I wouldn’t have been able to ask for time off to stay at home. Would paid caregivers have been willing to come into our home? Would I have been willing for paid caregivers to come?

How would we have managed social distancing and worsening isolation? His respite care facility would have closed, and he wouldn’t have been able to go to the gym. He wouldn’t have been able to walk dogs with the neighbors or have friends visit.

Harvey had three medical emergencies requiring trips to the emergency room during the last year he was home with me, and the staff there relied heavily on me at those visits. Would I have been allowed to accompany him? As physician to my vulnerable patients, would I have put myself in harm’s way to be by his side? Impossible questions. No right answers.

If this pandemic had occurred during the years that Harvey was in memory care, I wouldn’t have been allowed to visit. Would he have despaired over not seeing us? Would we of him? How would our family have managed to feel secure that he was well taken care of? And what about those times that he was admitted into the geriatric psychiatry wards? Not being able to see him then would have devastated me and our daughters.

I know that as I was doing all this hard imagining, these scenarios are the current reality of people living with dementia and their caregivers right now. I spoke with a friend just yesterday whose sister with dementia is in the hospital and cannot have visitors. That is crushing!

I hate to leave you hanging here for another week, so I’ll follow up tomorrow with a few ideas that might be helpful. Please feel free to share, privately, or in the comments, how you and your loved one are coping.