Managing Trust with an Expedition Woman

Cindy trusts me. One touching, memorable moment when we were hiking the American Discovery Trail provides proof of this. I messed up as navigator by taking a wrong turn onto a jeep road, high up along the Carson Range in Nevada. Fortunately, from that open vantage point I could see where we were going wrong and adjusted our course, bushwhacking down to a lower jeep road which headed us back towards where we needed to go.

Finally heading down from the Carson Range

At this point I was upset with myself for creating extra mileage on what was supposed to be a more leisurely day. I kept apologizing to Cindy and swearing at myself. Cindy, meanwhile, was as calm and unperturbed as could be. She finally interrupted me with:

“I’m not worried. You’ll find the way. You always do.”

While grateful for her trust in me, I also realized from this comment that the Expedition Woman had trust in herself. She was confident I would find a way and that she could handle whatever route I used without much bother.

Unfortunately, one particular moment on our more recent Pacific Crest Trail journey revealed how Cindy’s trust in herself has eroded. We were taking the tram up from Palm Springs to near the top of Mt. San Jacinto, an elevation change of 8,000 feet. Cindy clung to me for her dear life. We have been on many gravity-defying roller coasters in the past, yet here she was terrified on a relatively tame tram ride. Her fear related directly to distrusting her ability to handle what is going on around her.

The shower has turned into our laboratory where I work on managing trust. I used to have a hard time getting Cindy into the shower, because of her apprehension for cold water. I made sure the water was hot before getting her in, then used a version of the “repeat three times” rule. Before she climbed in I would tell her not to worry, the water would be hot. After she climbed in I would comment: “Isn’t the water nice and warm?” After we climbed out I would reflect on what a nice, warm shower just took together. All this was to the point of building her trust. I recommend this “repeat three times” approach for any caregiver trying to overcome the apprehensions that spring from Alzheimer’s.

We now negotiate a new obstacle with the shower; Cindy does not trust her balance climbing in or out. I handle each in different ways. I do not wait long before lifting her up and over the lip of the bathtub to stand in the shower. She may have greater trust that the water will not be cold now but, combined with her lack of balance, that is enough of a disincentive to prevent her from climbing in on her own. However, I do not help her out of the shower beyond holding her hand. Eventually her desire to get out will cause her to trust her balance enough to do so.

Each tactic for climbing in or out of the shower serves a purpose. Recently we attended a Christmas party on a cold, blustery evening. Leaving the party Cindy froze (figuratively) on their stone stairs, distrusting her ability to climb down them; the wind and cold only made her paranoia worse. I had to act or she would have frozen literally as well. I picked her up over my shoulders and carried her down the remaining stairs, having gained her trust in our “shower” laboratory.

The Alzheimer’s mind adapts well to what normal people would view as indignities, such as being assisted in the bathroom. However, I cannot imagine a life stripped of all dignity, particularly for an Expedition Woman, which depends largely on trusting yourself. In the interest of dignity I make little compromises in our daily living tasks. I hold her cup when full, but allow her to hold the cup when she is focused and the cup not full. I feed her with fork and spoon, but look to get finger foods for her to eat. I lift her into the shower, but wait for her to climb out on her own, even if that leaves her standing in the tub for a while.

Addressing both apprehension and indignity as a caregiver hearkens me back to my former role as navigator for our wilderness adventures. I strive to manage Cindy’s trust in both herself and me as I attempt to “find the way” towards living with Alzheimer’s.