Advice to an Alzheimer's Caregiver Partner Newbie

I am often asked, "What would you tell someone who just found out that their spouse or parent or friend was diagnosed with Dementia/Alzheimer's?"

My thoughts to myself, as I gather my about to be given "advice," is that there is a world of difference between a person's spouse and a person's parent. The relationships are different. The intimacies are different. The experiences shared are different. The way in which care will be delivered, both the caregiver's and the caregivee's needs are and will continue to be different.

With your parent, the relationship began when you were first born. It may have been an easy relationship or a difficult one. You had no choice as to who that parent would be and short of acting out and/or running away from home, you had no control over that relationship. Usually, the parent leads and the child follows. The parent has the power and the child has none.

It is said that the most important part of the parent/child experience is the child's slowly working to leave the parent and become independent. If you can do this successfully, the parent and child relationship can begin to move more towards one of friendship and mutual respect.

With your spouse, you elected to begin the relationship. There were the things you had in common, interests and experiences shared, and hopefully, the growth over time was two-sided. The passion and lust grew into love. The partnership was forged in a way that was negotiated, supported both your needs, your partner's needs, and the needs of your children if you chose to have them.

If you are lucky enough to have a successful union; you learn to live with the give and take, the shared responsibilities, the negotiations, and by taking the good with the difficult to provide a meaningful day-to-day way of spending your life.

I have discussed the two most important types of relationships one can have with another. But also one must look at friend and other family relationships as well. I'll not talk about this here but you can think through that on your own.

When Dementia / Alzheimer's come into the relationship with your parent, the responsibilities of "who is in charge" changes. With your spouse, the partnership slowly dissolves into a one-sided managed situation.

I have thought carefully about the differences if only because the day to day "advice" I would give for dealing with the situation, most likely would be defined or suggested by your relationship to the person who has received the diagnosis. I will not go into the types of thinking necessary for any of the different relationships but tailor my comments to anyone dealing with being part of the caregiving team created to support the diagnosis of Dementia/Alzheimer's.

But one more digression first. Most advice that I could give will seem trite. The person receiving the advice will most likely feel that I do not really understand their situation. For the information I might share to become real, the person must learn it, feel it, accept it themselves. One cannot tell another what to think let alone how to feel or what to do. One can only advise.

Hopefully, hearing some of this advice (and much of it is what I read about or have been told by others over time) will "light up" again once you have had time to process it, experience it, understand it, really need it. If you decide to own it as your own, then it will feel less banal and more applicable to you.

RESPECT the person. No matter what changes they go through. Find a way to help them continue to keep their "personhood" even as their abilities fail.

Be aware of the RIGHTS of the person diagnosed. As possible always respect their rights to be who they are, to make decisions for themselves or at least to participate in making those decisions, to live their lives in the ways they choose. Also be aware that sometimes and/or eventually, their rights must be disregarded but always must be done ethically, with love and respect, and only in their interests (not your own) for safety and health reasons.

BE PATIENT with the person. Their processing and understanding of the day to day activities of life, both mental and physical, are changing. The cognitive abilities are slowing down and/or the connections are no longer as easily made and eventually no longer exist.

CONTROL ANGER, as best as you can. Imagine that the person diagnosed is slowly living life backwards, losing what they have learned, and once again becoming more of a child. But what complicates the matter, is that they are becoming a child again but in an adult's body with an adult's worth of experiences and knowledge that will be at a wide range of various and changing levels of availability to them. How you would treat a very young child as they grow with wonder at the world around them is similar to how you must treat the person who is slowly losing this wonder.

REALIZE IT IS THE DISEASE, not the person who you are continuing to love and trying help. If they get angry with you, it is the illness. If they strike out, it is the illness. If they need you to repeat something for the hundredth time, it is the illness, not the person!

BE FLEXIBLE. As the diagnosed person's needs change, so must their environment change. Every day might need a different approach to almost every possible activity: toileting, grooming, eating, dressing, spending time, sleeping, etc.

Be SELFISH. Most people will be taken back by this term but I maintain that if you do not take care of your SELF, you will not have the energy or health to give to another. Find ways to relax, to refresh yourself, to get away for a short period of time, to make sure you visit your own doctor as needed, to enjoy yourself as you can.

ASK FOR HELP. This is a difficult one. First of all, it does not mean that you are weak or not doing a good job. Second, finding ways to involve other people who love you and love the person diagnosed is not easy. Everyone else had a life and most are oversubscribed. But there are ways that others can help to lighten your day-to-day.

YOU CAN DO THIS, what choice do you have, really. Hopefully, with support from family, friends, your religion if you embrace one, your therapist, your neighbors, a group of people in a support group or online chat room ... you can find a support system that works for you. You will be strong and find resources to keep going. Love will help. Kindness will help. Being good to yourself even though you are devastated will help.

YOU ARE NOT ALONE. So many others, in the U.S. over five and a half million are living with Dementia / Alzheimer's. Sixteen million people are in addition to their own self, providing care.

WAXING PHILOSOPHICAL: It will "GET BETTER" ... but sometimes better is not on this side of life. We all will die. For some of us, it will be easy, quick, and/or unexpected to die. For others, it will be anticipated, slow,  and/or very painful to die.

Usually, the parent wins the race to death. With a spouse, one or the other will win the race. Interestingly, the person diagnosed with Dementia does not always win the race! For everyone, we will grieve the loss of someone we love. Talking about death helps, in the long run, to ease the mystery of death. Conversations with the person dying and being there for and with them helps.

The biggest mystery of life is death. We think about it and fear it from the first time, as a child, we begin to have intelligent thoughts. Hopefully, its mystery also allows us to live a meaningful, fulfilled life with respect, love, and understanding for others.

YOU CAN DO THIS!

INTERNATIONAL DAY OF PERSONS WITH DISABILITIES 2018

Welcome to

INTERNATIONAL DAY OF PERSONS WITH DISABILITIES 2018

especially in this post as it relates to those diagnosed with Dementia, Alzheimer's, and the other diseases associated with Dementia: 

Alzheimer's, Vascular Dementia, Lewy Body Dementia, Parkinson's, Frontotemporal, Creutzfeldt-Jakob, Wernicke-Korsakoff, Normal Pressure Hydrocephalus, Huntington's Disease, Mixed Dementia, and Other Causes

These are some of my thoughts in relation to my friend Kate Swaffer's current post on the progress we are making in the world with regards to understanding, diagnosing, and supporting those with Dementia.  CLICK HERE TO SEE KATE'S POST. Opens in a new window.

I always feel a little traitorous in making the kinds of comments which follow as I DO NOT want to undermine the good work going on of making things better for those diagnosed and for those who love those who have been diagnosed with Dementia. I do not want to ignore the progress that is being made. In my own experience, when Gregory (my 41 year life partner) was first diagnosed in 2003, the stigma of the diagnosis was still so strong and so little known about it.

But having lived through 12 years of Gregory and my journey with Dementia, most likely Alzheimer's, I cannot let go of what went into making the middle and end stages of the disease manageable, tolerable, safe from harm, as close to normal as we could get it, and the struggles we worked through. P.S. We did not SUFFER!!! Hate that idea! We worked very hard and our life was filled with love and life!

I always said that Gregory was not a VICTIM of Alzheimer's but rather a HERO! Recently I have been able to say that BOTH GREGORY AND I were not VICTIMS but rather HEROS! As in all things, it is better when there is more than one working together to deal with any life threat.

HOW WONDERFUL AND HOW MUCH WORK HAS GONE INTO: "The World Health Organisation" .... stating .... "Dementia is one of the major causes of disability and dependency among older people worldwide"(2018).

AMAZING AND SO MUCH PROGRESS THAT: "It also now defines dementia is a condition causing acquired cognitive disabilities."

ALSO SO TRUE THAT: "as dementia progresses, our disabilities are likely to become more obvious, although this seems to be the lens through which dementia is still being viewed (late stage)."

AND YES: "This is relevant, in light of the global campaigns to make our communities 'dementia friendly', as what we want has little to do with being friendly, and everything to do with inclusion, and therefore access, including access to adequate health care, and disability support including rehabilitation (cognitive and physical).

AND WHAT AN IMPROVEMENT TO QUALITY OF LIFE AS: "People with dementia have definitely become empowered, and are working together locally, nationally and globally to ensure dementia is not only listed on websites as a condition causing disabilities, it is a condition where we will, at the time of diagnosis, be provided with adequate disability assessment and support to maintain independence for as long as possible, not just assessment of our Activities of Daily Living (ADL's), and which will also include rehabilitation."

WHAT STILL SO GREATLY CONCERNS ME, HOWEVER: Is that Dementia is incurable and increasingly causes the acquired cognitive disabilities to get in the way of quality of life, including independence and safety and the ability to successfully function on a day to day basis.

WHAT BOTHERS ME STILL: is that the caregiver partner without the diagnosis is often discounted out of concern for what the caregiver partner with the diagnosis goes through. I do not believe one can win the "which is worse" prize in this contest. As we used to kiddingly say, "On a scale of horrible to horrible, it is terrible for both of us." But with love, understanding, respect, and educating oneself, one can persevere and prevail. 

The joy outweighed the sorrow and the laughter outweighed the tears!

ALSO, I HAVE NOT COME TO GRIPS: in dealing with the "rights" of the person with Dementia. It seems to me that sometimes those rights must be forfeited (only, of course, if done with the person with Dementia's best interests always in mind.) A key factor here is that those rights must not be removed too soon or if they can be improved with compensation and support and definitely with trying to keep the person involved in those decisions if they are still able.

LATE STAGE DEMENTIA IS AN INEVITABILITY:  and as a "world," on this World Day of Persons with Disabilities, we are doing still such a terrible job of making the Late Stage Dementia Journey as comfortable as possible for those diagnosed, as well as for those who love and care! 

YES, WE NEED TO CONTINUE WORKING ON MAKING CHANGES ON THE STIGMA AND INAPPROPRIATE APPROACH TO DEALING WITH THE DISEASE IN THE EARLY AND MIDDLE STAGES: but we cannot assume that those changes will improve anything as it currently exists during the late stages. Therefore, I believe that hand in hand with discussing changes in the diagnosis early stages, at least a "nod" must be present to the difficulties and changes necessary during the late stages.

Family, friends, and many medical and social support services do an increasingly better job helping those diagnosed to keep their visibility and their independence; to accentuate what they are able to do and not the abilities that have been lost; to do so with understanding, love, and respect.

So maybe the best I can hope for is that if the BEGINNING GETS BETTER the END WILL BE MORE TOLERABLE AS WELL?

Behavioral and Psychological Symptoms of Dementia or Behavior and Psychological Changes Due to Dementia

I have continued to refine my thoughts, as precipitated by friend and colleague Kate Swaffer, on 1) Caregiving Teams, 2) Use of labels, 3) SYMPTOMS due to Dementia/Alzheimer's vs CHANGES due to the disease, 3) Use of drugs for symptoms and changes, and 4) Attending to and respecting the human rights of people diagnosed with Dementia/Alzheimer's.

It is a very complex conversation and I am sure it will continue.

• • • • •

September 10, 2018 

Kate,

I have given much thought to your recent posts on BPSD (Behavioral and Psychological Symptoms of Dementia) and the abolition of such. I have attempted to share comments several times, did a little on one of your posts, but for the most part was overwhelmed by the implications you present and therefore I went into “hyper-thought” to try to make some sense of the situation (at least for myself!)

While I agree with you strongly, and join you in your fight for “Human Rights” for people diagnosed with Dementia/Alzheimer’s, I also feel that I need to clarify in my mind what it is that WE (or at least I) am/are actually dealing with here.

First issue—Good vs Bad People and Caregiving Partners:

There are Good People and Bad People. There are good intentioned people who make bad choices and ill intentioned people who think they are making good choices. And there are people on the continuum between the extremes. 

How caregivers provide care is also on a continuum of good to bad, informed to uninformed, appropriate to inappropriate, etc. These continuums affect how people diagnosed with Dementia/Alzheimer’s are treated and how the care they receive is given.

There is a difference in care given by family and friends vs paid caregivers. There is a difference in care given when the person diagnosed with Dementia/Alzheimer’s lives at home or lives in a memory care facility. How a person receives care differers greatly when they live alone, have no family or have been ignored by family. 

I know that based on the experience of many relatives, the care given in many memory care facilities, is unconscionable and with little respect for Human Rights and more for the facilities convenience, but that does not condemn all such facilities!

Finally, the nature of those diagnosed with Dementia/ Alzheimer’s and the nature of their family caregivers, will determine the reactions and changes and response to being part of the caregiving team. Caregiving teams which are used to RESPECT will most likely continue to operate with respect. Those teams which were ARGUMENTATIVE, DEMANDING, and or INCONSIDERATE will most likely continue to operate in that way.

Second Issue—Good vs Bad Labels:

While labels can be harmful, I believe that they are also useful and necessary. Some say that we should not have to categorize or label and that the labeling itself is part of the problem. I believe that labeling and categorizing can be part of the problem but it is also part of the way in which the human mind comprehends, deals with, and makes decisions with regard to the every day complexity of life!

I believe that labeling must remain flexible, open, nonjudgemental, and subject to careful, continuing scrutiny and the willingness to change.  STEREOTYPING, NO, but understanding our life through categorizing and labeling is how we all make sense out of complicated issues as well as helping us to make every day decisions.

Third Issue—BPSD A Good Label or Bad Label?: 

Using the term BPSD (Behavioral and Psychological SYMPTOMS of Dementia) does MIS-REPRESENT many of the NORMAL HUMAN REACTIONS that people diagnosed with Dementia/Alzheimer’s experience and present. There are changes in behavior which take place, which most likely reflect the confusion and frustration, memory loss, and especially with the loss of language which comes with the disease. I believe that early in the disease, many behaviors incorrectly considered symptoms really are “human nature.” 

But I also believe that at times Dementia/Alzheimer’s DOES have symptoms, especially as the illness progresses, as cognition and language are compromised, as the brain is not able to function as normal. Examples of SYMPTOMS of Dementia are loss of language, forgetting, verbal repetition, hallucination, confusion of past and present, eye/hand coordination, difficulties walking, etc. Getting frustrated and angry because of the inability to explain ones needs is a HUMAN REACTION, messing ones pants is a DEMENTIA SYMPTOM. 

Perhaps there needs to be two sets of labels to differentiate? BPSD (Behavioral and Psychological Symptoms) and BPCD (Behavioral and Psychological Changes?)

Fourth Issue— Human Rights and Use of Drugs:

Use of drugs to support people diagnosed with Dementia/Alzheimer’s is NOT ALWAYS BAD! Sometimes the use of drugs is necessary. It can be beneficial when used after all other options are exhausted, when used in the person’s best interests, when using the lowest possible dosage, and when being monitored carefully.

The first line of inquiry must be finding out the source of desire, need, confusion, frustration, discomfort, or pain. This is especially difficult and time consuming, but absolutely necessary, especially when the person no longer has use of language. Not excusing it but rather stating the reality of it.

Fifth Issue—Human Rights vs Loss of Rights:

I am not living with the diagnosis of Dementia/Alzheimer’s, and while I can empathize, I know that I can never really know what it must be like to slowly loose my cognitive and language abilities, among others. So I can only look at them through the lens of my own “normality” not the lens of one diagnosed with the disease! I can imagine but will never really know!

Through my lens, when the person diagnosed with Dementia/Alzheimer’s can no longer use language to express their needs/desires, when their cognition no longer functions in what we know and experience as “normal,” when issues of safety and maintaining health are at stake, then decisions must be made on their behalf, always of course with their best interests in mind. This arbitrarily means a loss of rights for the person to decide for themselves. 

Sixth Issue—Time and Place:

Each of the previous issues and how they are dealt with depends on the stage of the disease, the behaviors presented, and the care location (home or memory care facility.) In a perfect world we would know when and where and how to work with each with every behavior presented. We would have time and energy to understand the needs even when the person diagnosed can no longer express themselves. However, this is not a perfect world. We can only WORK TOWARDS PERFECTION when it comes to helping human beings live the best life possible.

Seventh Issue—Human Nature/Existence—The Same Only Different!

Due my need to clarify, through GRAY and not BLACK & WHITE, how I look at life and the trials it brings to us and those we love, everything I have talked about above, has to do with doing one’s best to live a loving, active, productive, compassionate, respectful (among other descriptors) life.

When any catastrophic illness or experience strikes, whether Dementia/Alzheimer’s, Cancer, suicide, accidental or sudden death, etc; the true colors of the people involved in the caregiving team and in the drama of life raise to the top. Depending on how the team entered the experience, they most likely will exhibit the same ways of dealing with the situation. Sometimes they are able to raise above their usual. Hopefully, everyone will come through the experience (or at times ending up on the other side of life) in a way that respects and supports all players as deserving human beings.

Maybe the solution, based on the thinking that has helped me put this essay together, is to say: 

"Labeling and medicalizing behavioral and psychological symptoms due to dementia, can be harmful and wrong. Many are not really SYMPTOMS but rather HUMAN BEHAVIORAL RESPONSES which are complicated and at times exaggerated due to the nature of Dementia/Alzheimer’s as it progresses.

Perhaps two labels would suffice: 1) BPSD (Behavioral and Psychological SYMPTOMS of Dementia) and 2) BPCD (Behavioral and Psychological CHANGES with Dementia.) 

Also, we must strive to make sure that if solutions are not obvious and at times not available, if the presenting difficulties are not amenable to usual solutions, then: 1) utmost care must be taken to keep the individual’s human rights in mind when making decisions that affect those rights, 2) such decisions must be in the person’s best interests and not those of other individuals or institutions, 3) such decisions must be loving, respectful, and compassionate and reflect best practices and 4) be the least invasive possible.

We should work on looking for better solutions, provide more support to caregivers and staff, increase staffing so time is available to listen and to look for solutions, and provide more time to training caregivers and staff. 

Know that we can only do the best we can do in caring for people who are at advanced stages of Dementia/ Alzheimer’s and we must always be mindful that no matter what stage, they are human beings who deserve the best care possible!!! We must remember to treat them as we would want to be treated!

Rock, Paper, Scissors

Shared by a psychiatrist friend. Something to think about.

Anger, fear and sadness play scissors paper rock with each other.

In the absence of resentment, the sharpness of anger cuts through the blanket of fear; the blanket of fear comforts and soothes the rock of sadness; the rock of sadness hones the sharpness of anger.

With resentment, anger becomes rage, fear becomes immobilizing, sadness becomes despair.

But in the absence of resentment, anger becomes courage, fear becomes respect, and sadness becomes grief.

-adapted from Ernie Kurtz, The Spirituality of Imperfection

-shared by Steve Farmilant

ME TOO

There has been a practice going around on most social media where people are "outing" themselves as having experienced sexual abuse/assault! 

I felt the need to join in to show support to everyone who has experienced it too. Not to diminish rape and other forms of sexual abuse against women, I am pleased it has moved to "people" who have been abused ... but that makes it even sadder (and more frightening) as we begin to understand the scope of the problem.

Whether sexual, physical, or verbal abuse/assault; whether threatened or realized; whether children, teens, or adults; whether men or women; whether individuals or groups; whether towns, cities, or nations - perhaps we have begun to dig down to the roots one of the major problems the world faces today!

Why do people feel the need to hurt or bully others? Why do we need to tear down others to build up ourselves? Why do we feel the need or feel we have the right to take advantage of others? 

Perhaps this current amount of attention will help more of us to carry at a mindful level our ability to respect ourselves first, which will allow us to respect others as well. 

I wonder if it will help to realize that even "abuse" functions on a continuum. None of it acceptable but at one extreme an internal signal to be a better person and at the other extreme a form of mental illness which desperately needs our attention?

Sitting Here

Sitting here enjoying the day. Saturday January 9, 2015 ... oops ... no 2016! Snow is falling outside and 3-5 inches is expected. It is 3:33 PM and I have yet to get out of my "jammies" and into the day's clothes. Maybe I'll not!

I love the new work area, I call it "my desk" or "my office." It feels spacious, light, and friendly. I appreciate Gregory when I sit here in what used to be his space and I feel a little guilty but then a voice whispers, "Someone's gotta use it :-)"

I continue to fine tune the organization and order of the condo. Gregory taught me how to be neat. I used to start out neat, then get lazy and leave things around, then they would pile up, then I would push them aside and leave more. Periodically I would go on my "straightening rounds." Do you catch the irony? Making ROUND into STRAIGHT? A thankless and at times hopeless job.

Gregory taught me how to be more orderly if only out of respect for our living together. He helped me develop areas of my own where I could be messy, where I could work in my style not necessarily his. And he had his areas where he could be minimalist, structured, and organized.

Slowly being organized and orderly became the comfortable way for me. It was easier to put things back where they belonged, easier to create "a space for everything to live," and easier to clean up after oneself as one went along. It really did save time, made things easier to find, and harder to loose!

People always tell me, "You are so organized!" My answer is, "I am NOT organized. I am random and spontaneous in how I live. What you see is the outward appearance of what I have to do to survive inside of my chaotic mind and world!" 

When Gregory was diagnosed with Dementia/ Alzheimer's I guess I went into high gear orderliness. It became more important for things to be in the correct place so he could find them. Our life needed to be and became more predictable in those areas we could control. Our motto more strongly (not new but more) became, "Change those things you can and don't worry about those you cannot."

As the Dementia/ Alzheimer's progressed there was less and less that we could control so I became more and more orderly. It definitely bordered on the verge of compulsive but it served both Gregory and me well!

People who visit the condo, even on a drop in basis, are always amazed at how clean and orderly it is. They comment, "Even though there are many things around on every surface, it doesn't feel cluttered or overwrought or fussy."

They comment, "You have created a warm inviting space." "It feels like people live and love here." "You have created magic." "You curate your lives." "You set up common things in a way that turns them into shrines of beauty, love, and spirituality."

Even though Gregory only lives here now in spirit with me, I still love the condo and maybe more than before. While at times I feel lonely being here myself, I enjoy the antics and love of my two cats, Gigi and Emma. I feel safe, comfortable, contented, and if I may say so, when I look around at what we created, I feel like a grown up, successful person. I feel good about my space and I feel good about me.

I miss being able to spend time and share my life with Gregory but I still have talks with him and he talks to me as well. I know he is pleased for my life, my success, and my strength. I know that he is grateful for all I did for him throughout our 41 years and especially during the last 12 since the Dementia/ Alzheimer's diagnosis. I have learned a lot from him about live and about myself. I can continue to honor our union and our love by living my life with love of self, love for others, compassion, simplicity, forgiveness, and patience for myself and for those in my life.

Growing Up Milestones

Being a Gay Man of 70 years, I have not been able to measure my life in milestones as do non-gay men who grew up when I did. In the traditional situation, a man measures his life by his accomplishments and successes but also by family events.

As far as accomplishments, I was able to celebrate completing my BA, MA, and Advanced Certificate. I also earned the ubiquitous ABD (All But Dissertation.) I was able to celebrate the self-publication of two volumes of poetry and the opening of Michael's Museum: A Curious Collection of Tiny Treasures as a permanent exhibit at Chicago Children's Museum on Navy Pier.

On the family front, I celebrated my Bar-Mitzvah but it stopped there. I was not allowed to celebrate my wedding. I was not allowed to have/adopt children. I did not watch my child begin kindergarten or graduate elementary or high school. I did not see my son off to college nor hope that he would join the fraternity I did.  I did not walk down the aisle with the bride, my daughter, on my arm nor wonder when she would make me a grandfather.

Nowadays, Gay men and women can choose to include these milestones in their life. Too late for me but grow up I did anyway and many unique milestones did exist none-the-less. It was just that they were not traditional.

My first milestone was owning my own refrigerator. I.E. not my mother's. I could fill it with the food items I wanted and arrange it in a way that made sense to me. As a child my parents would tell me "Don't "sit" in the refrigerator!" as I stood with the door open contemplating what I wanted to eat. As an adult, just to show them, I opened the door to both the freezer and refrigerator and literally sat on the shelf created between the two.

Another milestone was the purchase of my first car. I was working at University Ford at the time in Champaign / Urbana, Illinois and going to school at the U of I. The sales manager took me under his wing and helped me through the details of purchasing a car. The car was a gold Mustang with an opera roof (they called it in those days: the roof covered in beige vinyl.)

Getting my BA degree. My first job when I began teaching in 1972. Completing my Masters of Education in 1980 and my Advanced Certificate in Administration and Supervision in 1982. These were milestones too.

A big milestone, which is shared with the general population, was my retirement from teaching in 1999.

I share all of this in getting to the point of this blog: Ben, Ken, Alaksh, and Isaac.

Gregory, my life partner was diagnosed with Alzheimer's Disease in 2004. He did well, with my help, for approximately 8 years but then his decline necessitated additional support and care.

The first round of care giving "companions" included Ken and Ben. Ben made the transition to needing a companion for Gregory easy if only because of my having known him since he was a little boy, nephew of dear friends. He was responsible, loving, and very good with Gregory. Their mutual love of music helped them pass the time and Ben's knowledge of psychology helped him deal effectively with Gregory's needs.

While both were great and very helpful to Gregory, Ken was more of an actual milestone for me. Besides being Gregory's companion, he ended up living with us for a couple of months. His lease was up and instead of finding a new place, I suggested he take over our guest room for the few months he had left to his studies.

Being newly from Japan, Ken and I had many discussions about differences in culture. We learned from each other. He offered young, new, culturally different ideas and I offered older, wiser ideas. We often had dinner together and visited various Chicago sites. Ken quickly became more "family" than "companion."

He caused me to think deeply about my culture and discuss/explain it in ways that were as honest as possible and not too stereotypical. We talked about cultural differences including racial, sexual preference (read GAY!,) male vs female, lifestyle, rich vs poor, and many more.

When he was looking forward to applying for his MA, after completing foreign student core courses in Psychology at Northwestern University, he sought my advice. I helped with the application essays. I helped think through the opportunities of the various universities he was thinking of attending.

With his acceptance in Nashville, his assistantship came with a job in which he needed a car. While he had been driving for a long time in Japan, he needed to learn the Rules of the Road American Style including driving on the right/wrong side of the street (in Japan like England driving is on the left side of the road, not the right like in the U.S.)

So I offered to give him driver's lessons and let him use my car to practice and take the test. This opportunity gave me what must have felt like the first father/son relationship I had ever experienced.

He was careful, responsible, and respectful. I was calm, patient, and helpful. So in some ways this was not like the "typical" father/son relationship.

At one point while about to pull away from the condo, we had an argument about how to set the side view mirrors. He tried. I corrected. He disagreed. I disagreed. He said he had "googled" it.

I backed off and said, "Lets look at it together when we get home." I let him practice that day using his mirror adjustment technique which took a certain amount of bravery on my part. We laughed and I asked him if he realized that we had our first father/son argument. I am not sure either of us had thought of it in that way until that moment.

Turns out the "google" had presented a "traditional" and a "current" way of thinking in side view mirror adjustment. Mine was the traditional, he preferred the current. We agreed to compromise using the best of both techniques. So again not like most "typical" father/son encounters.

When Gregory and I took him for the final drivers test, we sat nervously in the waiting room. He returned from the test with a smile on his face. He had passed the test. I actually cried fatherly tears of pride. In him and in the role I had played.

The relationship Gregory and I had with Ken definitely became one of family.

After seeing Ken off to Nashville, Alaksh next came into our life as Gregory's companion. Alaksh was completing his MA in Biology at Northwestern and was Indian.

Similar conversations regarding cultural differences took place. In addition, Alaksh loved to cook and one day a week, he and Gregory would plan dinner, shop, and cook. I would come home from my errands to a wonderful dinner. Most times he cooked "Indian," but also did a mean "Chinese" and "American."

To celebrate the Indian holiday Divali, Alaksh took us to a University Indian Student Association party. We watched various groups entertain and afterwards partook of dinner. One time Alaksh cooked for Gregory and me at his apartment and we got to meet his roommates.

He often offered medicinal and health cures as passed down from his Grandmother. Often he decided that I was like his Grandmother when if fact Alaksh took care of Gregory and me like he was our Grandmother.

Alaksh was accepted for his PhD in Boulder, Colorado. Again I helped with application essays and decision making. Father and Son relationship or at least Grandmother Grandson. Periodically Alaksh calls just to chat and sometimes still to ask my advice.

We miss him dearly and Alaksh too became part of Gregory and my extended family.

Recently, Isaac who is Gregory and my God Son and son of friends Jan and Jake, moved in with me. He was going through a break up with a girlfriend, their apartment lease was up, he was looking forward to quitting his job and earning money as a waiter for a while, and then leaving for Japan to teach and follow his passion for all things Japanese.

Again the father/son but not typical took place. Advice asked, advice given. Wisdom shared, young blood new views offered. Social media and computer expertise shared. Living together expectations most often met. Sometimes, but rarely, heads banged. Meals eaten and cooked together. Part of the difference in this experience is that since January, Gregory has been living at The Lieberman Center Memory Care Unit so Isaac also brought company and companionship to me.

I shared all of this, Ken, Alaksh, and Isaac, as the point of this blog because these three young men have given me a new milestone to celebrate. That of being a mentor to someone younger, much like the relationship a parent has with a child but not fraught with the emotions that usually come with that relationship.

It felt good to have opinions to give, well thought out ideas to share, experiential comments to make. All without total personal investment and being responsible for having raised a child. It felt good to be valued, respected, queried. I love these three boys like sons, but better!

Road Side Entrepreneur

Every Tuesday, Gregory and I drive down California Avenue on the way to his being dropped off for a painting session with Nancy nrosen.com.

Often we see a woman on the west side of the street, sitting at a card table outside her home. On the table she has a number of items for sale like make-up, soaps, and candy. She is what I would call a road side entrepreneur. She is probably not licensed by the city  but her "shop" is OPEN FOR BUSINESS none the less.

For a long while now I have wanted to stop and patronize her shop but when we have enough time to get to Nancy's, often the woman's shop is not set up. When the woman is there, we are usually in a hurry to get to Nancy's and keep going. This time we had both time and the woman's shop was open.

I pulled over, got out of the car and headed over to the table to shop. The proprietor, who hopes to make a few dollars this way is an older, robust, black woman. I mention this because I have always admired the no nonsense, self confidence that I often notice and admire in black women like her of a certain age.

I selected one bar of carrot scented hand soap and five bags of assorted candy. The candy was hard as bricks but I was going to give them to Nancy who loves stale candy so it was a perfect match. My store clerk added up the items and said, "Five dollars, please."

I had already decided before getting out of the car and proceeded to hand her a twenty dollar bill and said, "You know I feel bad that I always miss you when we drive by, so just keep the change. Merry Christmas to you." I was careful with my wording because while I wanted to do something nice for her, I didn't want to insult her.

Before I know it she came around from behind the table, embraced me close in to her ample bosom, planted a loud smack on my cheek (not just an air kiss,) and asked God to bless me.

I don't really know that woman, but I sure do love her! I felt really good for a long time that day.