It was a normal spring morning and Maria was with the farmhands milking the cows. Ron went round to finish the chicken pen they planned to set up. They had explored the local market about the viability of poultry products, particularly eggs. Ron had asked engineers in to build a suitable housing for the poultry farm. He was there with the men making sure that things were done according to his specification.
Then one of the farmhands drew Ron’s attention. ‘Mr Mackintosh! Mrs Mackintosh has passed out!’
‘Oh, not again. Where is she?’ he answered, feeling flustered.
‘With the cows, sir,’ said the farmhand.
Ron took out his mobile phone and called the emergency service. This had happened three times within the same week. At the hospital, the doctor had serious concerns about Maria’s mini-strokes. There was only one thing on his mind: vascular dementia. But he had to do more tests to confirm the condition. He had shared his thoughts with Ron and said he wouldn’t conclude until he got the results of Maria’s brain scan.
He explained further: ‘Mini-strokes are sometimes triggered by damage to the brain cells. Someone diagnosed with vascular dementia may lack the ability to think clearly, plan, or remember simple words. Symptoms may depend on the particular part of the brain that has been damaged. The condition results in problems understanding speech or finding the right words. This condition becomes worse depending on the severity of the strokes encountered. Sadly, someone who suffers from vascular dementia can deteriorate rapidly each time they experience a stroke. A vascular dementia sufferer encounters problems with planning or organizing, making decisions, and solving problems. They have difficulties following routines and are slower in thinking and reasoning. They have problems with concentration, including confusion and disorientation.’
Ron had seen all these symptoms in Maria. Lately she forgot simple things like the children’s birthdays and their wedding anniversary. She looked surprises when Ron bought her bunch of flowers and a card. ‘What is that for?’ she asked.
‘Today is our anniversary,’ he had reminded her.
‘Oh, thank you, honey. I totally forgot,’ she said, disappointed in herself.
Ron was saddened by the current state of things. What the doctor said frightened him. He had said if it was confirmed that Maria has got vascular dementia, then Ron should prepare himself to cope with the situation.
Ron’s nightmare was yet to come; the doctor had more bad news.
‘I am afraid the brain scan results show there has been damage in the brain. It is severe enough that Mrs Mackintosh is definitely going to experience symptoms of vascular dementia along with Alzheimer’s,’ he said.
As Maria listened to her fate, tears gathered in her eyes. Ron held her hands and said, ‘We are all in this together. I’ll be all right.’ He planted a passionate kiss on his wife’s forehead.
The doctor gave the couple some leaflets about dementia. ‘It is important that Maria stays active and continues to do the things she enjoys.’ He said it was ideal to encourage her to stay mentally active, playing puzzle games like sudoku; that would help improve her communication and memory a bit longer. ‘Professionals advise that you use past life experiences to communicate with your wife, as she may remember past events better than current events. I will refer her to the dementia department; they will support you and Maria to get through this journey,’ he said as he wrote a discharge letter.
Ron had to work the farm with the hired hands, but Maria on her good days would help with milking and other chores she used to do. Ron made sure to remind Maria to take her medication.
She was in a good mood and was working with the cows. Ron needed someone to pick up something from their little farm office, but then the phone rang. ‘Mr Mackintosh?’ The woman’s voice on the phone was frantic.
‘Yeess, how can I help you?’ replied Ron.
‘Your wife is walking barefooted along the road towards Gravesend,’ said the woman, sounding alarmed.
‘Oh, my God! She was milking the cows when I left her,’ Ron said, feeling frustrated.
‘She does not seem all right, I asked her where she was going, but she did not answer me. That’s not like her at all.’
‘I will be on my way now. Thank you,’ Ron said and jumped into the jeep he had bought for the farm and sped by way of the dirt road towards town. Soon he saw her walking briskly along the road, lost.
He stopped in front of her and walked towards her. ‘Where are you going, Love?’
She stood and stared at him.
‘Get into the car, sweetheart; we must go home,’ Ron said calmly.
‘Home? I am going home. Mum will be angry for staying too long with, Emilia,’ Maria said.
‘Maria, we are going to our home at Vigo. You left home an hour ago, and we must go back,’ he said, trying to reason with her.
‘Really? Vigo? Where is that?’ she said, looking very confused. ‘I live at Walpole Road in Walthamstow.’
‘No, Maria. You live at Vigo, and we have a farm,’ Ron explained, distraught.
‘Let me go,’ Maria said, resisting.
‘Maria, It’s me you are talking to. Who am I?’
‘I know you from somewhere, but I can’t remember.’
‘I am Ron, your husband. Please get into the car. We must go home.’
She looked at him, puzzle, but sat down in the passenger seat.
Ron was devastated. He knew there would be a time when his wife might lose her memory completely, but he hadn’t thought it was going to be so soon. Tears gathered in his eyes. What has happened to my beautiful wife? he said silently.
Ron took his wife home and stayed with her the rest of the day making sure that she was fed and took her medication. As advised by the doctor, Ron put on a love song CD, ‘You Are Always on My Mind’ by Coker, and it played all evening, songs they both knew which had been their favourites during their courtship. They were relaxing, and it took them back in time. They listened in silence until they retired to bed. In bed, Maria remembered her husband, turned to him, and said, ‘I love you.’
Ron responded, ‘I love you too. Good night, sweetheart,’ and kissed her passionately.
The following morning was bright and warm. Maria looked through the window over the field. She felt good and after her usual morning chores decided to do what she normally did: supervise milking the cows and do some office work, taking deliveries and arranging pickups. She was surprisingly fine after yesterday’s episode. Life went on as normal apart from her forgetfulness; she forgot things and felt frustrated when she struggled to remember the day.
‘Maria, you must be getting ready for your doctor’s appointment now,’ Ron reminded her.
‘What are you talking about, Ron? I don’t have a doctor’s appointment today. It’s Monday morning at nine!’
‘Love, today is Monday, and its seven o’clock now, so you should be getting ready,’ Ron said calmly.
‘Silly me, I thought today was Sunday.’ She hurried into her bedroom and began to get ready. What have I become! I can’t even remember the day of the week, she thought, wiping away her tears.
Ron had got the jeep ready to take Maria to her appointment at the doctor’s surgery, at the outskirts of the village. ‘Have you brought everything you need, love?’
‘Yes, I think so,’ she said, looking through her shoulder bag. ‘Oh no, my glasses!’ she cried.
Ron knew exactly where to find them. He went back inside, looked in the corner of the sofa, and hand them to her. ‘Come on, we are running late,’ he said and led the way out.
‘Thank you, honey. What would I do without you?’ They drove in silence until they got to the surgery. Maria told the doctor how she had struggled to remember most recent events and how that affected her mood, leaving her frustrated and depressed. ‘I even forget to take my medicines, Doctor.’
‘You may have to ask your husband to take charge of your medication,’ he responded. ‘It is very important that you take your medicines at the right time and at the right dose.’
Ron nodded and said, ‘I’m already doing that.’
‘Good,’ the doctor replied
Doctor Freeman checked Maria’s notes and suggested another brain scan. He wanted to know the state of the brain again and what impact it might have on Maria’s health and well-being. He said he would set up the date, and they left for home.
‘I will be cooking dinner tonight. Ron. You have been doing everything. I think I can manage a fish pie for us for tea,’ Maria said, feeling excited and able, but Ron was not taking the idea lightly. He must supervise Maria’s activities lately. He stood in the kitchen, keeping company, and watched her every move without her knowing that he was there to ensure her safety.
After mixing the needed ingredients, Maria stuck the tray in the oven, closed it, and went to the lounge, where she sank into the sofa. Ron turned the oven on and timed it before joining his wife in the lounge she forgot to turn the oven on.
In another instance, ‘I am going to sort out a sandwich for lunch, what would you like honey? Ron asked.
‘I don’t want a sandwich,’ she replied angrily,
‘What do you want then, sweetheart?
‘I said I don’t want a sandwich!’ she screamed.
‘Calm down, Maria. I won’t give you a sandwich. What would you like instead?’ Ron asked, frustration creeping into his voice.
‘Go away and leave me alone; go. I don’t want a sandwich,’ Maria said, still very angry.
Before Ron could finish a word, whack! She had thrown a cup at him, aiming for his forehead, but he dodged the blow. This violent behaviour had never happened before, so he left the room, making sure that he had locked the door, and then called the dementia support team. They advised him to stay calm and said they were on their way. They arrived in thirty minutes and went in to see Maria. She sat looking passive, as if nothing had happened. She could not remember throwing the cup.
They explained to Ron that aggression was a possible symptom of the Alzheimer’s disease and could be attributed to the decline in reasoning abilities, which could cause frustration. They told him there were two options: either to send her to a residential home that specialized in dementia care, or have her stay home where he would look after her. They promised that they were always ready to provide support on how to manage her care at home. They planned to visit the family twice a week to assist with communication and other therapies to improve the quality of Maria’s life. They advised him to always wear perfume that Maria knew was his. This would help her recognize him anytime; the sense of smell can be an effective tool when interacting with someone who has dementia.
Ron listened as they explained the options to him. He thought about it for a while and decided to let Maria stay home; he could not stand the thought of dumping the love of his life in a care home. He made it clear that his wife was going nowhere. The outreach group assured him that he had their support at all times.
It was a hard decision that Ron took. He had a farm to attend to and also a sick wife to look after. As advised by the professionals, Ron decided to get a private carer to visit every morning and evening to help Maria have a wash or a bath and with dressing and grooming. Maria had been neglecting her intimate personal hygiene and would not change her clothes. That small measure of support would ease the current pressure on him.
Emma, Lilian, and Tammy paid regular visits and dealt with issues so that their father could have a break. Ron discussed with Jonathan, Maria’s brother, the idea of buying shares of the farm so that he could help Ron look after it. It was a good idea for Jonathan, so he relocated with his girlfriend and assumed responsibilities as the assistant director. His presence made it a blooming family business.
It was Lilian’s turn to go and take over looking after Maria, She had now permanently settled with a young man in Germany, and they were expecting their first child. She was thirty-five, so she couldn’t do much when she took over. She often sat and cried as she watched her mother waste away.
Maria did not recognize her daughter when she was there and would ignore her in conversation, which upset Lilian. When they were alone in the lounge watching TV, Maria sat smiling at nothing; then at times the smile turned to loud laughter. Lilian had no idea why Maria was laughing hysterically like that.
Then she heard her talking to no one. ‘Stop that, you!’ Maria said suddenly.
‘What?’ asked Lilian.
‘Tyler! You are making those funny jokes again, aren’t you?’ Maria said laughing.
‘Who is Tyler, Mum?’
Maria ignored her question and continued laughing.
‘What the hell are you laughing at, Mum?’ Lilian was growing frustrated.
Maria merely kept on laughing. ‘Oh, you are funny, you!’ she said, wiping the tears that were streaming down her cheeks. ‘That was hilarious,’ she burst out, still laughing.
‘What was hilarious?’ Lilian asked angrily.
Maria ignored the question and went to her room.
Lilian could see the excitement on her mother’s face. She must have remembered something interesting, she thought.
Later that evening, Lilian told her father that Maria was seeing things and that she had mentioned someone called Tyler.
‘I have no idea who that person is,’ he told his daughter.
Lilian went back home feeling very sad. She was sad for her dad because of the challenges he was going through due to Maria’s condition. She had advised her father to consider the other option, taking her to the residential home, but her father strongly objected. He loved his wife the way she was.