What Is Daily Life Like With Alzheimer’s
This is an excellent question, and one I’ve considered often in the last decade-plus of working with such folks.
First, it depends upon the stage of dementia: mild, moderate, or severe.
In mild dementia, it seems to be like being a functional alcoholic’s day, as far as cognition goes. You’re able to do what you need to do, but some little things get missed, such as your T-shirt is on backward, but you don’t notice, or you can’t find the sugar bowl, so you start taking apart cupboards and end up going without coffee and the kitchen is a mess. Later, you swear you did not do that. You have no memory of doing it, and the more another person argues that you did indeed make that mess, the angrier you get. You did not. He or she is lying.
The whole day goes like this—close to normal, but not quite. Routines are easy, but anything new is more difficult. And, if asked about someone or thing from earlier in the day, you may or may not remember the event. By the end of the day, you’re tired of thinking, but your brain keeps throwing up odd thoughts and ideas—things like, “I can’t find the car keys. Someone must have stolen them! I need the car keys.” You may wander, rummage, pull things out of drawers for a couple hours, at the end of which you may be unable to tell anyone what it was you were searching for. Even more telling, you may not have driven a car for the past five years.
During moderate dementia, each day is more moment to moment, and routine is your friend. Anything that is routine is easier for you to experience. Breakfast, lunch, dinner—that’s how your day is scheduled. But something out of the ordinary, like a doctor’s appointment, can throw you. You may balk at going, at getting dressed and getting in the car and going. There’s so much mental stimulation involved in such a nonroutine event that you prefer to stick to what you know: breakfast, lunch, dinner, and maybe sitting in the sun, watching the world go by.
Activities like taking a shower can become difficult for you. If you think about it, a shower is an event that is very high in stimulation of all sorts. The bathroom is very separate from your normal living space—usually hard-edged and cold-seeming. Then you must take all your clothing off—that’s just a lot of stimulation itself, and the memories loosely associated with nakedness are also fraught with stimulation. The shower makes noise, the temperature difference is apparent, there’s soap and shampoo and the scrunchie thing, water in your eyes, your ears, the space is confined, and by this time someone is usually in there with you, “helping,” which is just weird, no matter how much you understand and accept that you need help. It’s one diagnostic sign of moderate dementia: You may start to not like to be washed and clean—shower or bath.
I remember a gentleman in the facility I worked at in Washington state. He was new and hadn’t been showered at the hospital, so on his first full day, the aides gave him a shower. He spent the rest of the afternoon in tears because, “They threw me in the corner and pelted me with rocks like a piece of trash!” That’s what he felt like. Another woman would walk up and down the corridors but stay far away from windows, saying “There’s Indians out there! They’re going to attack!” It took a long time to figure this one out. She would pace and pace and could not sit still, always talking about Native Americans shooting arrows at us. Finally a nurse asked her if she had been hit by an arrow. Yes, she said. Where’d they get you? Right here, and she clutched her low back: Arrggghhhh! It hurt so much! Going through her medical history a bit closer, we discovered she had been in a car accident years before and suffered a low back injury. She’d been telling us for weeks what was happening to her, but not in a way that made sense to us. To her, it made perfect sense: It felt like an arrow in her back. And who used arrows? American Indians.
You are losing words, but it doesn’t matter much since those around you ignore that loss and fill in the blanks. Sometimes you cannot understand what someone else said, like he is speaking a foreign language, and this can make you automatically refuse whatever is being spoken about—that, too, makes a certain amount of sense. Someone babbling to you in a foreign language and making “Come with me” motions is someone to view with suspicion, don’t you think? Moderate dementia is usually the longest part of the disease, which is why I’m spending so much time on it.
The slow slide into severe dementia is sometimes difficult to spot as far as an actual line of demarcation, but one sign is sleeping more and more often. Even during formerly pleasurable activities, such as familiar and enjoyed music, the damage to your brain is so profound that the stimulation is not enough to keep you awake. You sleep, perchance to dream, but we don’t know. We know that damage to the areas that are usually lit up like a Christmas tree during dreaming is profound, but since we don’t really understand sleep or dreaming, it seems rather cruel to take someone who doesn’t do well in new situations into a sleep lab and wire his brain for sound and color, stick him in a tube, and say, “Don’t move.” So we don’t know. But that is one of the things I’ve always wondered about; it seems to me by the time you are in severe dementia, the difference between awake and dreaming is invisible.
Speech is limited. You may have a full thought in your head, but only one or two words come out, if any. Caregivers learn to listen for the first two or so words and try to discern what the thought is from there, because that’s usually all we get. Eyesight is odd; you don’t know what it is you are seeing. My current furthest-along-in-Alzheimer’s resident recently did not recognize a puppy. She saw it, she gazed at it, I placed her hand on it, but she looked at her hand and not the puppy, and there was absolutely no engagement between her and the stimulation provided. She no longer hears music, which is a shame, because she loved music her whole life long. We still play it for her, and we still put on her favorite musicals, but there’s no engagement anymore. She does not hear or see any of it other than perhaps a fleeting spark of memory, now gone.
In severe dementia, everything is moment to moment. Routine means nothing anymore, because there is no past or future, only now.
And then you start your last slide into end-stage dementia; you sleep 23½ hours out of 24, and when you are awake, you may as well be dreaming. You do not meet anyone’s eyes. You do not react in any manner to much beyond very painful stimulation. You are almost gone. We try to feed you, but you don’t seem to know what to do with the food in your mouth, and you may choke, which could result in aspiration pneumonia—never a good thing. Your urine output drops, peristalsis decreases, and your body temperature may rise. And as your organs start to shut down, you sleep, and sleep, and sleep, and slip away, very peacefully. You’re gone.
That’s what Alzheimer’s-type dementia is like.
– Jae Starr
Why did everyone go from loving Ronda Rouse to hating her?
It is easy to like a dominant fighter, and Ronda Rousey used her Olympic level judo to beat all of her opponents to great effect. The statistics speak for themselves. She won her first three amateur fights by armbar in the first round. Then she proceeded to win her first seven professional fights in the exact same fashion; an armbar in the first round. I haven’t checked, but I’m 99.99% sure that no other fighter has dominated in such a way (same technique, same round).Then she fought Miesha Tate for the second time, who managed to make it to the third round with Ronda, but still lost by armbar. Her next four fights she won in the first round with a variety of finishes (KO (punches), another armbar, KO (punch), and a knee to the body).
She was always a rather fierce character, as you might expect from an elite fighter. She didn’t mince words, she was outspoken, brash, etc. And all this time, she was really paving the way for women in MMA. She was a big draw. I for one, as a former judoka, loved seeing such high level judo in MMA. It was awesome to watch.Now to the casual observer, this is amazing to watch and read about. A fighter, dominating in such a way, with 75% of her victories with an armbar and 92% of them in the first round. That kind of prowess attracts attention in any sport.
And thus a hype machine was born. The UFC promoted her more than almost any other fighter at the time. Due to being paid proportionally to how much money she brought in to the UFC (revenue at the gate and in PPV buys), she was the highest paid fighter in the UFC. She was a Big Deal.
But to the more hardcore fans , there were aspects that went largely unnoticed. Chief amongst them: her division (bantamweight) was weak. The combined record of her opponents at one point was something like 1-7. Most champions will fight fighters coming off a winning streak, with mostly wins on their record. But there simply weren’t (and still aren’t) many female mixed martial artists at a high level at the time. Rousey was an Olympian, with a strong work ethic and a desire to win, and she climbed to the top, but arguably it was a relatively shallow climb.
As for why she is facing such a backlash now, in the last year or two she was getting extremely arrogant. All elite fighters have confidence in spades and the mental aspect of combat sports is paramount. You have to believe you’re going to win. But there is a very fine line between confidence and arrogance, and Rousey went deep into arrogance. She got too big for her boots, was apparently surrounded by yes men, was told that she had ‘elite boxing skills’ to go along with her judo… people got swept up in the hype around her and I think she did too. She was in movies, countless interviews on television, etc etc… it must be hard not to let all of that get to you.So by the time she fought Holly Holm, she was saying things like “I believe I can beat anyone in my division with one hand”. Arrogance. And yes, you can argue she’s just talking smack and trying to hype the fight to get more buys… but personally, I don’t think so. I think she got swept up in the hype. Being told your boxing skills are elite when you’re about to fight perhaps the best female boxer ever..! Some of the video footage of her shadow boxing in particular drew great criticism. On the pads she looked a bit sharper and faster, but in the Octagon it was never crisp and clean. Her win against Bethe Correia (supposedly a hard hitter who frequently won by punches), was essentially just her charging Correia down, eating a few punches, pinning her to the cage wall, and overwhelming her. There was no finesse, no head movement, no neat footwork or evasion. Bethe wasn’t actually a hard hitter, and Ronda just ate those punches, apparently because she wanted to prove that she wasn’t just a one trick pony. Not exactly champion level tactics.
I don’t think people ‘hated her all along’. I for one liked watching her fight at the start. But as her personality started to show and her arrogance grew, it was harder and harder to like her. It was also hard to hear people talk about her like she was some kind of god, when under the surface you could see that she wasn’t as great as she was being made out to be. And it was oh so satisfying to see such a masterful fighter like Holm dominate her completely and knock her out in such a spectacular fashion, ending her reign and proving just that.
What does the first day of a long prison sentence feel like?
I remember my first day because it was my worst day. I was sentenced to life in prison on September 25, 1995 and about a week later was transferred from the San Diego County Jail to RJ Donovan Prison for intake into the state prison system. The morning of my transfer a deputy came to my cell and told me that I was “catching the chain” to the pen. I had just made it to sleep as my cellmate and I had stayed up late playing chess and talking. He was a 19 year old 1st termer headed to the joint with a life sentence and every night he would ask me a gang of questions about prison life. I felt compelled to answer his questions in as much detail as possible because I knew he didn’t understand the danger he was headed into and he needed all the help he could get.
As I got myself together my cellmate sat up on his bunk, wrapped his arms around his knees and watched me like a child would watch a parent. My heart went out to the little dude because he needed more guidance than I ever could give him. I started to remind him of some of the things we had talked about but the deputy came back to get me. He told me to state my name and booking number then turn around and cuff up. I complied and when I turned back around to cuff up, my cellmate was sitting there crying. I will never forget that look of hopelessness on his face and I can only imagine the look on mine. I told him to keep his head up and I walked down the stairs with the deputy. Right then I said a prayer for that kid because as bad as my situation was, he was someone who had it far worse than me.
We got to the holding cell and there were about 20 others waiting to catch the chain also. They call it catching the chain because we’re all chained together as we go to the pen. The single file chain of men made its way outside and it felt good to walk around a bit and breathe in that crisp morning air. As we loaded onto the bus the deputies unchained us from each other, but we were left shackled at the waist and ankles. No one said a word on the bus and my heart was beating so hard I could hear it. The ride to Donovan took all of 20 minutes as the prison is literally within eye sight of the county facility from which I was transferred. The sun was just coming up as we pulled into R&R (Receiving & Release) at Donovan.
I couldn’t wait to get out of those handcuffs and leg irons; being shackled up like that is something I could never get used to. As soon as we walked into R&R I saw someone I knew from the county jail and he was all smiles as he asked me how much time I had. When I told him 25 years to life his eyes got big and he took a step back, as if I had some kind of virus he didn’t want to catch. His response surprised me. First it made me feel nervous, then worried that everyone else would respond to me the same way. He didn’t know what to say and neither did I. I tried to ease the awkwardness of the moment with small talk about my appeal but no matter what I said I couldn’t escape the growing despair in my gut; and that was only the first day.
We made it out of R&R around noon and got back on the bus to go to the “4″ yard. We pulled up next to building 16 and unloaded straight into the dayroom. Once inside, we walked into a gauntlet of correctional officers who immediately started yelling and telling us to shut the f*** up and not ask them for anything because we had nothing coming. After being strip searched and yelled at for about 30 minutes, we all had to sit and wait to be interviewed by the gang coordinator. While we waited, I heard familiar voices of people I knew who had caught the chain before me, asking if I needed anything. At that point I was so depressed and downtrodden that I didn’t respond verbally. I just shook my head.
After my interview, I walked upstairs to the cell where I’d spend the rest of the first day of a life sentence. I stepped inside and the sound of the cold steel door slamming behind me ricocheted around inside my skull, making me dizzy. I just stood there in shock. I remember wanting to scream but when I opened my mouth nothing but sobs came out. I was devastated. I heard people calling my name on the tier but I couldn’t speak. I closed my eyes hoping to find some relief, but what I saw in my mind’s eye were all of the horrible choices I made and the faces of the people that I hurt in the process. I thought about the times when I coulda, woulda, shoulda, taken action to stop this nightmare from happening, but it was way too late.
Looking back, it was as if I was on a runaway train to prison and every choice I made accelerated my imminent arrival. When I finally opened my eyes and looked around the filthy cell, there was nowhere to run and nowhere to hide. I felt like the most worthless piece of crap ever known to mankind. My life had just hit rock bottom and I couldn’t see any way up or out. That was by far the worst moment of the worst day of my entire life.
What’s It Like To Be A Street Prostitute?
I was high as a kite when I got in the car and now I’m higher still. Every time things go right and you get a normal guy, not a nut, a cop, a non-payer, it feels like the world is your stage. Money, control, drugs, dudes, drama, excitement, attention, sex, nightlife “love,” glamor — I slam!
The dude is high too. Like me, he’s relieved he didn’t get robbed or stabbed or attacked by unseen accomplices, what used to be called the Murphy. Sure his wallet is lighter and he risked arrest and having his car impounded. But he got away with it — and doesn’t even feel like he cheated on his wife since it was just oral sex.
I do this for drugs but it’s also what I do when I’m on drugs. You couldn’t do it straight because you’d think about the dangers, disgrace, your parents and your teachers. Plus when you’re high getting in cars is fun! You’re dressed up, people “like” you and you’re making a huge hourly wage. You even wonder, in your drug haze, why all women don’t do this.
I look good. I may be hooked on meth, alcohol and cigarettes, I may not have eaten a nutritious meal for a year, I may not have been to a doctor or a dentist for five years, but the long legs with high heels, the emaciated torso and the big hair is stopping traffic. The straight women give me hate looks.
“Your husband will be late for dinner,” I want to say to them but I never have. The worst I’ve done is on a Saturday night when the dates come down my street, I’ll say “hi” to a cute dude I don’t know just to watch Muffy or Mindy or whoever the hell is on his arm lose it and ask him how he knows me. “Honest, I’ve never met her,” he insists.
One time another woman and I were waiting for the bus and I began to worry she thought I was working when I was legit and really getting on the bus. What a shock when the bus came and SHE didn’t get on because SHE was working. Who knew?
How does a nice girl turn out? A broken family and drug habit help but essentially the customers turn you out. You’re walking around the city with no job and no money and monkey on your back and the cars start stopping and pulling to the curb like an X-rated runway. They know your profession before you do.
My first exchange happened on a Saturday night when a guy who noted my high leather boots followed me into the vestibule of my apartment, crouched down and began licking my boot. In less than a minute he handed me money and left. I barely saw his face. The only words we exchanged were the “thank you” he said. I didn’t feel repulsed, sullied or offended– I felt exhilarated. Where are more of these guys? When he drove by in a car a few days later, we both knew the drill.
One of the first cars that stopped for me was a foreigner who barely spoke English. I told him what I cost and he wanted to bargain. I thought, I’ve sunk as low as a woman can sink and you want to bargain? It was one of the few times I got out. Another time, a truck driver tried to bargain with me in a Travel Lodge parking lot. This time I also walked away but he came running after me and agreed to my price.
The guy at the appliance store was one of my first meets. He is physically repulsive — maybe 300 pounds — and mentally repulsive. (“When you and me gon hook up” seems his only line.) But he’s set me up with several repeat customers — I have to do him and his brother in perpetuity — and more importantly he gives me drugs. The first time I got in his car he took me into the basement of his store which was such a dungeon I would have been praying to God if I believed in him. The fear of chainsaws and meat hooks actually cut through my meth high for a minute.
These johns all seem to know each other and more importantly they know other men. Many set up “trees” where they bring me their friends who pay full price while they get a discount or free. Not only is sharing a sex op a “boy thing,” most men have a little pimp in them and want to exploit “johns.”
One guy who drives a Jaguar knows a pharmacist who staged a robbery and has a lot of merch. He even gives the guys he sends me merch to give me. He had polio as a kid and is very short. He is not married. We talk a little; I don’t dislike him. He says he would marry me but someone like me would never stay with one man. He was shot in the face in a holdup recently and his jaw has been reconstructed. It is very odorific and makes sex unpleasant.
Another of my regulars owns a hardware store where we sometimes do it. He pays me every week whether or not he sees me and actually calls it my “allowance.” It is hard to square his fatherly manner with his lewd lifestyle. Another girl he sees sends me her rejects — a group of fat men who can’t ejaculate because of the drugs they are on. She thinks she’s dissing me but I need the money.
Another of my regulars is a big hedge fund trader. I hear he is rich but he pays no more than anyone else. In fact he pays less; he insists on meeting in a hotel room near financial row and deducts the room from my pay. He is also fat. I sometimes wonder what would happen if these fats guy expired while they were with me.
Mr. Hedge Fund has other rich friends including one who actually drops my cash on the floor and orders trades on the phone while I work on him. These guys could never be Sugar Daddies because I hate them. They invite me to meals (right–knowing their plans for my mouth) and on their yachts like I buy their lifestyle if I could just get past this selling sex thing. In fact one guy who pushed the escort thing and forced me to socialize with his friends in a bar crawl that lasted all night, I robbed him when he passed out in a motel. I left the door open so he would think the staff did it.
I also won’t do men in groups because they turn into rapes. You can control a one-on-one situation but you can’t stag parties and drunks. Once at a motel on the edge of town with no phone or switchboard because the office closed down, a whole group of men who knew I was in there broke in and mauled me. I had two choices: do it or do it and get beat up. It was terrifying and humiliating. When you’re outside the law, you can’t go to the police and say “I wasn’t paid.” Your lifestyle is your consent. The guy who set me up in the motel, told me later he went and shot out the windshields of the guys who did it. All I could think was, you knew the people who did this?