Lunch Today

I decided to tell the story of lunch today, to give a snapshot of life . . .

“Would you like some lunch?” I asked Grandpa after I came back from my bike ride. “Are you hungry?”

“Are you hungry?” Grandpa repeated back to me.

“Would you like something to eat?” I asked, rephrasing the question.

“Yes, I would,” he said. “But not just anything. What do you got? Some of the stuff you feed me I wouldn’t give to a cat.” (He didn’t get that last sentence so clear, but I managed to decipher the gist of what he meant.)

“All sorts of stuff,” I answered evasively. “What do you want?” I typically try to avoid giving Grandpa a run-down of choices because he can never remember them all, and often if given a definite selection he will simply decide they all don’t sound good enough. (If you’ve ever had a little kid who didn’t want anything you offered him for lunch, you know how that goes.)

“Well I don’t know,” he said. “What have you got?”

“Lots of stuff,” I said. “Imagine that you could have whatever you want–what would you pick?”

“Well, that’s not very nice,” Grandpa said.

“Okay, would you like soup or sandwiches?” It is key to keep the question always an either/or and work down to a final selection through a process like twenty questions. I do the same with breakfast, where the first question is hot or cold and then work down from that point. Not only does this help eliminate confusion by limiting choices and what he must remember (though he still can get confused) it also reinforces a sense of inevitability–what you eat has to be hot or cold after all–which helps to avoid the situation where he decides nothing is good enough.

“Yeah, I guess I’ll have that,” Grandpa said.

“Soup or sandwiches?” I repeated.

“Sandwich sounds good.”

“Would like you tuna fish or grilled cheese?”

“I’ll have the Dur-guh,” Grandpa said, pointing at a spot on his pants.

“Grilled cheese?” I prompted.

“No the other one.”

“Tuna fish?”

“Yeah, that sounds good,” he said.

“Okay, I’ll get you a tuna fish sandwich in a little bit.” I turned to go.

“Now wait a minute,” Grandpa said. “I also want a . . . I want . . some nu-hunn and . . . and . . .”

“I’ll get you some drink too,” I said.

“Yeah, okay,” Grandpa said. “What are you going to have?”

“I’ll get you something good,” I said vaguely. Grandpa always wants to drink coffee, but since he has stopped eating well I try to get him to drink as much nutrient drink as possible and typically limit his coffee to two cups when he first gets up in the morning. I buy the “plus” variety of store brand nutrient drink which means in 8 oz. there are 350 calories. However, Grandpa has no clue what “nutrient drink” means and if asked what he wanted he would always say “coffee” so I generally try to keep the issue of drink to simply “yummy and tasty” without getting into particulars.

I made Grandpa his tuna sandwich and cut it into quarters and stood the quarters up on their ends on his plate. As Grandpa’s ability to eat has deteriorated I have altered how I present his food. There was a time when he wanted to eat everything–including sandwiches–with an implement. At that time I switched him over to always using a bowl and spoon because he couldn’t remember how to use a fork properly and if he scooped from a plate he dumped most of the food on his lap. When he was using a spoon I would cut the sandwich into bite sized pieces. Now he is having difficulty figuring out how to use any implement I cut the sandwich into quarters and stand the quarters up on end so they are easy to see and pick up, because if a quarter of a sandwich is laying down, Grandpa has difficulty getting his fingers around it.

After I changed Grandpa’s diaper I put him in the wheelchair and moved him out to the kitchen. Eating the sandwich started out with difficulty. First he thought to pick up the entire plate, and I prompted him that it might be better to pick up the sandwich instead. Then he made moves to pick up several quarters at once, and I suggested it would be better to take one quarter at a time and I rearranged two quarters of the sandwich, demonstrating. Finally, everything clicked together in his mind and he picked up a quarter of the sandwich and started eating. He finished off the sandwich without any further trouble.

“Would you like some potato chips?” I asked after he finished the sandwich.

“Yeah, I guess that sounds good. I would like that,” he said.

So I got out the nearly empty bag of potato chips.

“But only . . . only give . . . just a . . .” he said.

“You only want a little bit?” I said.

“Yeah, the bag is almost . . . not much.”

“Oh, you don’t need to worry about using them up,” I said. “There is a another bag.”

“Oh, okay,” he said, visibly relieved.

He started out eating the potato chips all right, but things quickly went downhill. Perhaps he muddled up taking a drink from his cup with eating the chips, or maybe he just forgot what he was doing. The end result was Grandpa reaching down to the table top, pinching his fingers together and lifting his empty hand to his mouth, studious holding them to his lips, and gently blowing on them. Befuddled, he realized this wasn’t accomplishing anything, and returned his concentration to the table. After a little bit he rediscovered his cup and picked that up for a drink. Then he set the cup back down–this time directly on his plate of chips–and began pushing the plate and cup around the table.

After he finished pushing his plate and cup around he returned to pinching his fingers together and lifting the empty hand to his mouth, saying, “Awww, shit,” every time the movement didn’t result with food appearing in his mouth. This did not improve, even after I suggested he needed to pick up a chip. At this point I realize that he had (for the moment) forgotten how to eat. For a long time now Grandpa has done a lot of “ghosting” where he–very convincingly–uses an imaginary implement to eat. When ghosting he can be amazingly accurate in his movements–scooping from the bowl and inserting into his mouth–except all is for naught because the spoon he is using doesn’t exist. This can be fixed if you insert a spoon into his hand. The ghost eating will then become real. But as Grandpa grows worse there are times when it goes beyond ghosting to where Grandpa is no longer entirely sure of what needs to be done to get food in his mouth. He will clench his fingers and lift his hand from table to mouth in the vague memory that such is how food appears in the mouth–but it is the faint memory of once remember habit, not something that can turn into the actual deed.

“I guess you forgot how to eat,” I said.

“I guess,” Grandpa said. “Something like that. I don’t know what’s going on.”

So I fed him the rest of the chips, and he was agreeable to opening his mouth so I could stick them in. Halfway through the process he dumped the rest of his chips on the table. Typically, when Grandpa no longer remembers what to do with his meal he dumps it on the table. This has meant that we have ended up with a lot of food and drink on the table. I continued to feed Grandpa the chips while he continued to “feed” himself imaginary things. At this point he had his cup in his other hand, but wasn’t paying any attention to it, so the cup continued to list further and further in his hand until he started unconsciously pouring his drink on the table whilst eating imaginary things with the other hand. I had to rescue the drink from him and clean up the mess. Betwixt and between all of this I was also eating my own lunch.

After I finished feeding Grandpa his chips I gave him back his cup and he managed to eventually finish his drink. For lunch he had: one tuna fish sandwich, a few chips, and 8 oz. of nutrient drink (minus a bit lost in the spill). For Grandpa, this was a very good lunch. As you can see, it is something of a project, and one that is almost constantly on the verge of disaster. Sometimes he has a much worse lunch.

I wheeled him back to the living room and moved him onto the couch. I then went back to the kitchen and began working on a roast for supper. Grandpa began calling for my uncle Joel.

“Joel? Hey Joely! Joel!?”

“Yeah, what do you want?” I said from the kitchen.

“Is that you, Joel?” he called out

“It’s me. What do you want?” I called back.

“I want you to say, ‘Hi, Pa.’”

“Hi, Pa,” I dutifully said, moving about the kitchen.

“Good. How are you doing?”

“Just fine. Everything is good here.”

There was a little more disjointed conversation as Grandpa fretted in a muddled sort of way about the general woes of Joel’s life until he went silent again. Then:

“Gene?” (Grandpa’s brother.)

“Yeah?” I said.

“Go lay down.”

Then a little later:

“Ma? Hey mother? Ma?”

“Yeah?” I said.

“I just want you to know I love you very much, and I wish . . .” he trailed off into incomprehensibility.

I decided all his talking meant he was very lonely and went out to sit with him for a bit before I returned to my work. Shortly after I left him to return to putting the roast in the oven, he fell asleep.

I have a little bit of an uncomfortable relationship with answering for other people because I don’t feel comfortable deceiving Grandpa but at the same time I want him to have an answer. Sometimes it is easier because by the context of the situation Grandpa isn’t trying to be precise and is simply calling a name because he wants someone to answer. Other times it is not so clear. It is a fine line to walk . . . not only for my own conscience sake but also because sometimes Grandpa is cognizant enough to realize that I’m not the person he called for. Today I felt I stepped a little over the line because while I typically answer for “Ma” “Gene” or anyone else in my normal old voice, I–in the spur of the moment–began mimicking my uncle Joel’s voice when answering for him. On the one hand it was a bit funny, but on the other hand it didn’t seem appropriate.

. . . And that is a snapshot of life.