Introducing a special guest blogger, Patrick Bartmess!

Patrick's mother was diagnosed with Early Onset Alzheimer's a few years ago.  He is his mother's primary caregiver and lives at home with her.

“Cable”

By Patrick Bartmess

My mother’s habit is to watch television while she eats, so our family always shared the kitchen table with a small television set. Even now, at precisely 6:00pm, the hiss of the kitchen TV coincides with the whine of the microwave. During the day she barely pays attention to the TV, and after 7:00pm,she is unable to concentrate on it. The golden hour during dinner is spent watching local news and Wheel of Fortune. It is a source of comfort for my mother because it is one of the events she can depend on and the ritual provides security.

Earlier this year I reasoned that we could save sixty extra dollars a month by turning off the cable and buying an antenna. We have enjoyed the luxury of cable television since it was first available in our neighborhood, so I had forgotten about the woes of spotty reception and weather-related interference.  I don’t like basic cable programming anyway, and since her favorite shows are on network television, I thought we could put up with a little static. What I did not take into account was my mother’s loss of mental plasticity and diminished short term memory.

Normally, if I watch network TV and encounter a moment of broadcast interruption, I chalk it up to bad reception. I expect program interruptions in stormy or windy weather. If I encounter frequent moments of bad reception, it’s slightly irritating but I comfort myself by remembering that I am saving sixty dollars in exchange for my peace of mind.

In contrast, every time my mother views a sudden gap in transmission or scrambled images frozen on the screen, she tries to fix it. It is a reasonable reaction the first time, but since she cannot remember it ever happening before, she reacts the same way every time. My response to her behavior is to explain that it’s just bad reception and we must accept it because we live on the side of a hill, surrounded by big old trees. We usually discuss why we don’t have cable anymore, then we continue watching. Minutes later, when a break in the broadcast happens again, she has forgotten about the previous event so we repeat the discussion. This is the result of her diminished short term memory. It is as if the past events did not even exist. When I try to remind her of the exact moment that the program was interrupted, or a specific phrase I used to explain it, she is unable to recall the memory. It simply was never recorded.

Her brain’s loss of plasticity prevents her from adapting new situations. Obviously, memory is a significant component of the ability to be flexible – if she doesn’t remember that we have cancelled our cable subscription, how can she adapt her expectations to watching TV through antenna? And yet, even when she grasps the concept that weather can now affect our reception, she does not have a response. She is unable to create new expectations for television viewing.

When I am faced with a situation that defies my expectations, I feel fear. This is what my mother experiences when there is bad reception on the TV. One of the events that should provide comfort has now become threatening. Because my mother is still in the early stages of the disease, she is sometimes able to charm her way through situations that may reveal the effects of the disease. However it is during moments like this, when her security is threatened, that the disease is unmasked.

Occasionally during a patch of particularly spotty reception, her agitation level rises despite being unaware of the reason. Even though she does not remember how many times the screen has scrambled, the unpleasant emotions begin to pile up. I believe this is because she has been watching many years of flawless reception over cable and she expects to be able to watch TV without interruption. Because that expectation has been met so many times, good reception gives her a sense of emotional stability and that provides a sense of security. When it continues to be thwarted by forces which she is powerless to understand, she feels out of control. That would agitate anyone. Combined with my own rising agitation at the bad reception and the repetitive conversation, our golden hour has become fraught with conflict.

Saving sixty bucks may not be worth bad reception because it is costing my mother her peace of mind. When I initially accepted the role of caregiver for my mother, I would have regarded the small expense of cable TV as insignificant but I am learning that the comforts to which she has grown accustomed are neither trivial nor cheap. I spend a lot of money, time, and energy to maintain them. Those habitual comforts are important because when they are removed, she does not have a way to create new ways to comfort herself. For example, if the TV signal is scrambled by a storm, I simply turn off the TV and engage myself in a different activity. If my mother’s TV watching schedule is disrupted by a storm, she has neither an alternate activity nor the capacity to create a new activity. For most of us, comfort and security are merely connected by a sense of repetition. For my mother, her sense of safety depends heavily on her level of comfort. At any other time in her life, it would have been absurd to say she needed cable to feel safe, but now I can see that it is worth the extra money to keep her happy and calm. It looks like I will have to turn the cable back on.