The Foreign Service Journal, January-February 2016

THE FOREIGN SERVICE JOURNAL | JANUARY-FEBRUARY 2016 55 Through the Iona support group I learned of Iona’s Wellness and Arts Center, which Zandra joined on a part-time basis in December 2014 in an effort to break out of her growing isolation. She connected well with the staff and other center participants. We were gradually increasing her hours when she had a serious wandering episode last April, walking from Bethesda to Silver Spring via the Capital Crescent Bike Trail. After a 911 call, Zandra was found safe but oblivious. It was apparent I could no longer leave her alone, and I knew I could not care for her at home—even with the help of health care professionals. Through Iona, I contacted Arden Courts in Kensington, Maryland. This is a 64-unit facility catering exclu- sively to dementia and Alzheimer’s patients. Zandra is doing well there. She is unafraid and oblivious to the world that she has lost—the only mercy Alzheimer’s has granted her. Zandra is not the first FSO to live out her life at Arden Courts, nor will she be the last. Some Final Thoughts Helping Zandra manage her descent into Alzheimer’s is the hardest emotional challenge I have faced. It is much harder than our son Sam’s autism. There, we reaped accomplishment. Alzheimer’s, by contrast, is an exercise in achieving a controlled crash. Drawing on the support of friends and support groups is essential to recognize and manage the inevitable stress buildup. Short breaks for respite are very helpful if they can be secured. Alzheimer’s onset is exceedingly hard to detect. I can only recommend that if you or others notice memory loss, mood change or the beginning of mental rigidity, consult a neurolo- gist. There are some useful precautionary steps you can take regardless of whether Alzheimer’s ever becomes a concern. These include: have a joint account—insurance checks will come to the policy holder; take out long-term care insurance; secure a power of attorney; have a will, and update it frequently; have a medical directive. If you get an Alzheimer’s diagnosis and have not taken these steps, do so immediately before legal competency becomes an issue. Also consult a lawyer to deter- mine if you need to set up a special needs trust for the benefit of the Alzheimer’s patient—you can’t guarantee you’ll die last. Zandra has made a remarkably smooth adjustment. I think it helps that her form of Alzheimer’s has caused her to steadily withdraw into herself, although her steady loss of connection to me is painful. She is always comfortable in my presence when I visit, but there are now times when I am not at all sure she knows who I am, and I know the day is coming when her memory of me is gone. n