The Foreign Service Journal, January-February 2016

54 JANUARY-FEBRUARY 2016 | THE FOREIGN SERVICE JOURNAL diagnosis was premature or whether she sought to cushion the blow. Had the diagnosis been more forceful, we might have dis- cussed whether Zandra should have retired at that point. In any case, she was not ready to give up her career and was confident that her memory loss would otherwise leave her mind intact. Zandra retired in April 2011. She lasted that long only because management at the Board of Examiners appreciated her illness and carried her on light duty until she could get into a retire- ment seminar. Zandra had planned to use her consular skills in post-retirement volunteer work, but would never work again. Her efforts to reach out to the Bethesda Naval Hospital to help families of wounded service members foundered. I recall her great frustra- tion trying to find an entry point, and suspect her Alzheimer’s undercut her understanding of the application process. Zandra did receive a positive response some six months after her retire- ment from the Montgomery Public Library, but by then no longer was interested in volunteering. Alzheimer’s is remorseless, and it steadily hollowed out Zan- dra. In July 2012, we took a cross-country train trip to Seattle. On the second night, Zandra became disoriented. When we reached Bellingham, she suffered her first travel panic attack and could not understand that we were several thousand miles from home. She rallied, but it was a foretaste of the panic attacks that ended her travels two years later. By 2013, Zandra could not understand finances. That year she also lost the auto navigation skills she had honed as a Secret Service agent. In 2014, she stopped driving and lost the ability to use the Metro without assistance. Alzheimer’s also attacked Zandra’s personality. She lost her self-confidence and became cautious and passive. Following conversations became more difficult, and she withdrew socially— even from the company of close friends. She never lost her sense of humor or her politeness, but she became remote and often appeared dismissive. An observant friend said this was a defense mechanism, an assessment I share. Empathy deserted her, although she never knew it. Connections with family members faded, first for out-of-state relatives, then her understanding that she had a son and, finally, her ability to conceptualize our rela- tionship as husband and wife. Finding Resources Through her neurologist, Zandra learned of a Georgetown Neurology Department long-term study aimed at determining if computer-based exercises, home drills and one-on-one verbal exercises with a speech pathologist could arrest memory decline. Zandra entered the study in January 2012 and participated until December 2014. We were told that we would not be informed of the specifics of her participation, so it is impossible to know if she derived any memory loss benefits. But participation gave her great emotional reinforcement. Alzheimer’s is also consuming for the healthy spouse who steadily assumes the role of caregiver. In October 2011, I gave up a retirement job in the Office of the Historian because I could not balance full-time work and Zandra’s needs. I shifted to part-time work at the National Archives’ National Declassification Center. By 2013, I was managing Zandra’s affairs: although she still main- tained limited independence, she was unaware of the extent of her disease and did not realize I was guiding her. Friends could see the toll caregiving was taking and urged me to join a support group. Amember of Zandra’s Foreign Service family (Ambassador Pat Butenis) recommended I explore the Iona Senior Services program, and I entered a caregivers support group in April 2014. Connecting with Iona was one of two critical decisions that will shape Zandra’s continuing care. The other was her decision to take out an American Foreign Service Protective Association long-term care policy, which is greatly easing the burden of long-term care of $100,000 per year. Alzheimer’s Association National Capital Area Chapter (800) 272-3900 www.alz.org IONA (202) 895-9448 info@iona.org www.iona.org Georgetown University Department of Neurology Memory Disorder Program (202) 784-6671 Johns Hopkins Memory and Alzheimer’s Treatment Center (410) 550-6337 The Neurology Center Chevy Chase, Md. (301) 562-7200 www.neurologycenter.com Arden Courts Linda Ryan, Marketing Director (301) 493-7881 linda.ryan@ arden-courts.com www.arden-courts.com/ Kensington Books The 36-Hour Day Nancy Mace and Peter Rabins, 5th edition, 2012 A basic resource on recog- nizing and responding to dementia-related illness. The Theft of Memory: Losing My Father One Day at a Time Jonathan Kozol, 2015 A very personal and honest account of a son’s experiences. —John Collinge Dementia/Alzheimer’s Resources