Dementia Grief – Unspoken Feeling, By Richard R. Blake

Journal Entry – November 18, 2017

Thelma makes a sound, an unintelligible attempt to communicate. I smile looking into her eyes. “Tell me what you’re thinking,” I ask. “Let’s talk some more about what your day has been like.”

Thelma laughs a combination grin and giggle. Our eyes meet as Thelma smiles in a warm, self-satisfied way. I gently touch her hand.

Her eyes close. I quietly watch Thelma rest, her face relaxed, peaceful, tranquil, and serene. I find paper and pen and begin to write.

Her eyes open briefly. She watches my pen as I scribble words on the page. I tell her, “I’m painting with word pictures, as I create your portrait on my paper. She seems to like this idea. Her face shows a kind of curiosity, love, and acceptance. I have come to understand that our inner feelings do not always have to be expressed vocally. Thelma’s eyes and her smile say it all.


I understand it usually takes about two years to work through the stages of grief. It isn’t often you can share this grief together with your loved one. Thelma and I are traveling that journey together, one day at a time.

I am learning new lessons all the time as I relinquish Thelma’s care into the hands of others while I deal with the apprehension and anxiety that accompany the uncertainty about the future of this journey.

I am getting a better understanding of the truth that God never intended for us to walk alone and that our times are in God’s time. I am learning to be willing to become vulnerable and to respect the feelings of others as well.

I am finding a new closeness to Thelma, as we share quiet moments, allowing our mutual feelings blossom into a joyful hope. I continue to accept the process of death and the conflicting feelings of loss and the agonizing dread of that day.

I draw strength from our assurance and the blessed promise of a wonderful life awaiting us in heaven in the presence of the Lord Jesus.


Questions to Ponder:

  1. Can you identify with Richard and Thelma’s unspoken sense of communication?
  2. Are you familiar with the book “The Seven Stages of Grief?”
  3. At what stage are you in on this journey as a caregiver?
  4. Do you understand the term Ambiguous Grieving?
  5. Are you familiar with “Palliative Hospice Care?”

More Questions to Consider:

  1. Do you have a Health Care Team?
  2. Are you officially designated as a decisive health care proxy for your loved one?
  3. Are you familiar with the term Health Care Advance Directives?

The 60-Minute Health Literacy – common sense approach to informed decision making By Jo Kline, J. D.,  


Reviewed by Richard R. Blake

Preparing for Decision Making – Managing the Long Range Treatment of Multiple Chronic Conditions

In her new book “The 60-Minute Health Literacy” attorney and bestselling author, Jo Kline, J.D. provides the reader with the practical tools of managing health care decisions for yourself or a loved one. Kline describes health literacy as “the tools and resources needed to make informed decisions regarding preventative, routine, emergency, and end of life care.”

I found the Index of decision-making dilemmas and the medical profile forms, as well as the chapters on The Building Blocks of Health Literacy, Palliative Care, Assembling a Health Care Team, and Keeping accurate Paperwork, especially helpful.

As an aging senior and designated as the durable power of attorney for health care for my wife, an Alzheimer’s patient, I plan to keep my copy of “The 60-Minute Health Literacy” within arm’s reach of my desk for easy reference at all times as I put into practice this “common sense approach to informed medical decision making.”

In today’s complex world of modern technology, advanced research in medicine, new life-sustaining pharmaceuticals, and artificial means of life support Jo Kline’s “The 60-Minute Health Literacy” is important reading for every senior adult, caregiver, designated executor or guardian.

A complimentary copy of this book was provided for review purposes. The opinions expressed are my own.

Providentia Publishing, West Des Moines, Iow978-0692955062, $ 14.99, 2017, 80 pages





Dementia Grief – A Unique Experience – From My Journal

An entry from my journal – Saturday, May 13, 2017

by Richard R. Blake

Dementia Grieving

Today I talked to a bumble bee. Well maybe not a real conversation, I talked. He buzzed. I directed him to the red colored nectar in my humming bird feeder. Never once did I see his wings stop. I wondered if he, as I do, ever experienced shortness of breath. He left me to ponder this as the sun peeked out between the clouds in an unpredictable pattern above the trees.

I continued in my reverie as I relaxed in my pre-father’s day gift, a “slider rocker” stationed on our deck enjoying the peacefulness, and the stunning back drop of trees that surrounded me.

My thoughts turned to Thelma. She is fragile now, weighing less than 100 pounds. Attentive to my gentle words of encouragement, I softly urge her to share her thoughts with me. Her smile is my reward. Her way of communicating, “I do love you, Dick.”

In the midst of my loneliness, I sense the quiet gentle whisper of the heavenly father, through the cooing of a mourning dove.  I look up in awe at the thought of His waiting, too, for me to respond, maybe with a soft smile to acknowledge my love, and the awareness of His presence.

The shrill of a redwing blackbird, at the birdfeeder, calling for his mate, became another reminder of the wonder of God’s creation, and of His desire for our fellowship. The bumble bee returned, buzzed at me, flew on by, destination unknown.

I am now addressing the bee as “honey” as I smile – contentedly alone – but not alone. Thelma and I are still sharing the miracle of life, and I want to treasure these remaining days, weeks, months, or years, one day at a time.


Alzheimer’s research and independent studies reveal a relationship of pre-death grief in the experience of dementia caregivers. These studies address issues of ambiguous loss, as this relates to the grief process brought on by stress, the burden of caregiving, and the consequent tendency to develop depression.

Ambiguous losses include the loss of friends, loss of social life, loss of flexibility, loss of aspirations, and the loss of hope. [i]

In the early days of our journey questions by well-meaning friends often threw me off guard. Questions begin with “Are you aware of Thelma’s (implying Thelma’s advancing stage of dementia)?” were asked at social gatherings or in a group setting including Thelma, I became deeply hurt or offended.  How could I not be aware? I lived with Thelma twenty-four/seven.

I tried to cover for Thelma’s inadequacies in similar groups. We both became pretty good bluffers. However, it became increasingly difficult to enter into meaningful conversations as the “breadth” and scope of our world continued to shrink.

I began to withdraw. Soon we were foregoing church dinners for our own private dinner dates at Denny’s, or the “all you can eat buffets.” Our dates often included a quick tour of the Dollar Store or grocery shopping at Safeway. I begin to withdraw.

Getting together with the family has taken on a new dimension.  The great grandchildren’s enthusiasm, high energy level, giggles and laughter bring pure joy. Fast paced conversations, catching up on family news, and lots of delicious food, are all important.  Little by little I am get recognizing a unique sadness, a missing piece, so close to my heart. Thelma is not with us. I miss her dearly.

Now that Thelma is in an Assisted Living Care Facility, I face new challenges. In social gatherings, I am no longer able to include Thelma. I become envious of those couples who sit by side by side with their wives in comfortable conversation, and I am guarded in my conversations with women in the group who have lost their mates.

I try to compensate for these loses by reaching out to others in the community with a sincere smile, a word of encouragement, expressions of appreciation, sharing a current story of ways Thelma can still express her love, her simplest needs, or maybe a humorous observation of how I may have displeased her in some small way.

Thelma’s example has taught me to recognize that there are no strangers in our world, only unintroduced friends.

I am intentional about building a balanced life, by putting an emphasis on the physical, mental, spiritual, and emotional prerequisites of a well-rounded whole being. I keep hope alive by setting new goals, enjoying the natural beauty of Southwest Michigan, the lake, the wonder of the changing seasons, and I try to compensate for the demands of caregiving through the flexibility of retirement, the gift of imagination, and the rewards of self-discovery.

A positive look at these ambiguous losses have given me new hope, challenged me to be alert for opportunities that will nurture emotional stability, spiritual growth, and creativity. I continue to remind myself that caregiving is love in action.


Questions to consider:

  1. Have you found it harder to stay in touch with friends? How has this impacted your sense of loss?
  2. How do you meet your social needs?
  3. How have you built flexibility into your heavy responsibilities as a caregiver?
  4. Do you still have dreams, a “bucket list” for the future?
  5. Did you see yourself in my reverie and observations of the birds and the “honey bee”? Or did you feel, “I think Richard is in serious need of therapy.”
  6. How do you keep hope alive in these difficult days of “grief” over ambiguous loss?

[i] Ambiguous Losses come with Caregiving, Harriet Hodgson

What’s Happening to Grandpa? By Maria Shriver – Book Review

What’s Happening to Grandpa?

By Maria Shriver

Little, Brown, Warner Books, 1271 Avenue of Americas, New York, NY 10020, 0316001015, $ 15.95, 2004,

Reviewed by Richard R. Blake

Deeply Moved – Valuable Insight into the Dread Disease Dementia and Alzheimer’s

I am a grandfather. My wife has Alzheimer’s disease. I can only wish I had read Maia Shriver’s book “What’s Happening to Grandpa?” when it was first published in 2004. I watched as our children and grandchildren struggled through questions I hadn’t resolved myself.

Shriver’s insights into the mind of a child and understanding of the process of aging, dementia, and Alzheimer’s capture the emotions of the victim of Alzheimer’s, their primary caregiver, and the entire family impacted by the disease.

I was deeply moved by Shriver’s warmth and sensitivity. The unique use of the voice and viewpoint of Kate, a child, make this a valuable educational resource for children, K – 5th grade. The book can also serve to open conversations with older children.

The obvious love and patience Kate develops with her grandfather as she works through her feelings of hurt, sadness, and loss bear evidence of understanding as she takes on the project of savoring and saving Grandpa’s stories by making a photo album to insure that these stories live on as Grandpa’s memory continues to decline.

Sandra Speidel’s soft colored illustrations add a rich sense that creates the same warm feelings through Shriver’s word pictures and give an extra dimension of reality to the story.

“What’s Happening to Grandpa?”  is a wonderful tool for Alzheimer’s awareness, family comfort, and childhood education. Highly recommended.

Book Review: If I Walked in Her Shoes by Susan Salach – A book Review


Reviewed by Richard R. Blake

Caregiving Relationships – Two Perspectives


“If I Walked in her Shoes” is a dramatic novel which captures the essence of struggle faced by families today as a result of an aging population. Susan Salach has carefully created a composite of characters made up with the needs and characteristics of real people she has connected with through bother her personal and professional experiences.Salah’s characters are easy to identify with as they exemplify the dynamics of aging parents and the underlying love that reinforce these relationships common to thousands of families today.

The story begins by introducing Sara, corporate executive in the midst of a flourishing  career, a happily married, mother of two, who suddenly becomes caregiver for her elderly mother, Rose.

A recent widow and independent Rose lived in the family home of over 50 years until a serious fall required hip surgery. Her slow recovery and waning health sound evolved into a progressive reliance on Sara.


Rose and Sara represent a typical relationship created by the needs of the elderly parent and the nature of a dutiful daughter trying to meet the numerous demands of caregiving, a growing family, and a successful career. A sense of guilt, self-reproach, and a lack of sleep frustrated Sara as she attempted to accomplish all minutia of detail at work and at home until she is overwhelmed until she feels her world is crumbling around her. Severe pain, loss of autonomy, and self-sufficiency with no social outlet turn Rose from a sparkling individual to a dejected, resentful, and demanding outsider.


“If I Walked in her Shoes” covers one day detailing the two perspectives, Rose, discontented, aggressive, and lonely, vying for Sara’s attention, while she feels inundated, defensive, and self-protective. Individually Rose and Sara become aware of the other’s situation. They try to see a perspective from the other’s viewpoint and ask the question: “What is it like to be in the others shoes?” or What If, I Walked in Her Shoes?”


Susan Salach helps her characters come to grips with the meaning and basis of family love as the foundation for an ongoing bonding relationship in times of calamity and shifting roles.

Susan Salach’s writing is articulate, her characters genuine and believable, and her plot is engaging. Insightful, enlightening, and heart searching describe this remarkable tribute to caregivers everywhere.



xulon Press, 978-1606476130

As reviewed for Midwest Book Review submitted by Richard R. Blake












Our Journey with Alzheimer’s by Richard R. Blake

Our Journey Alzheimer’s – Journal Entry, October 11 2016

My heart is very heavy today, for Thelma, for Robert, and for our entire family.

Yesterday I tried to explain to Thelma about Robert’s accident. Saturday he was working on his Moped. While doing a test run on Kaiser Road, only a short distance from home, the bike swerved and went off the road. Robert was thrown from the bike directly into a fence post – head on.

The amazingly beautiful October afternoon was shattered when I received the news of Robert’s   accident. A passing motorist witnessed the accident and immediately contacted emergency services. Robert was taken by ambulance to Lakeland Hospital in St. Joseph.

Because of the extent of his injuries, Robert was airlifted to the trauma center at Bronson Hospital in Kalamazoo. That evening physicians performed surgery to relieve the pressure of the swelling on his brain.

Robert was heavily sedated and in an induced coma when I visited him on Sunday. It was reassuring to know that Robert was being well cared for by a dedicated staff.

As I tried to assimilate the seriousness of the situation, I felt very strongly that it was important for me to attempt to communicate this information to Thelma, even though she is in a state of severe cognitive decline.  Step by step I softly related my concern for Robert, our youngest son.

I don’t think Thelma assimilated the seriousness of what I was trying to relate. However, as I continued to visit with Thelma, dear friends from the Woodland Terrace staff, aware of the situation and concerned for our needs, stopped by Thelma’s room to offer their support.

As I briefly updated these staff members on the details of the accident and Robert’s current status, I tried to include Thelma in the conversation, looking directly into her face as though speaking only to her. Knowing of their Christian faith, I asked Nora to pray. Throughout the prayer Thelma held my hand, strong and steady. My heart was lifted and I truly felt that Thelma understood and was being reassured that the Lord will strengthen us throughout the days ahead.

In preparation for this journal entry, I visited the website and found this beautiful poem. The words of the poem help me realize the importance of my regular visit to my sweetheart, the love of my life, Thelma.

To make me understand.

Let me rest and know you’re with me.

Kiss my cheek and hold my hand.

I’m confused beyond your concept.

I am sad and sick and lost.

All I know is that I need you

To be with me at all cost.

Do not lose your patience with me.

Do not scold or curse or cry.

I can’t help the way I’m acting,

Can’t be different though I try.

Just remember that I need you,

That the best of me is gone.

Please don’t fail to stand beside me,

Love me til my life is done.

Author Unknown




Our Journey with Alzheimer’s – Notes from my Journal – June 28, 2016

“God usually answers our prayer so much more according to the measure of His own magnificence than our asking that we do not recognize His benefits to those for which we sought Him.”              Coventry Patmore


On April 1, 2007 I made this note in my Caregiver’s Journal.

“Today I became a writer.  I had an epiphany – an “aha” moment for me.  I hurried to the car to find a pen. I scribbled a note on the back of my Target sales receipt.  I didn’t want to lose my nugget of wisdom.  Later in the day I grabbed a pen while shaving.  I didn’t want to lose another gem, a perfect descriptive phrase.”

Over nine years have passed since my remarkable epiphany. Two years later in the fall of 2009 I had another epiphany of sorts. I’ll describe it this way: in an excerpt from an assignment in a writing workshop series sponsored by the Bridgman Library, I wrote:

I have a great idea. I know what I’m working on. I just need a push in the right direction and some guidance through the inevitable pitfalls along the way.

 I naively completed a questionnaire stating my premise of writing A Caregiver’s Journey – One Man’s Commitment to Caregiving. I then prepared a time line of weekly goals I needed to achieve in order to write a rough draft of from 35,000 to 60,000 words. I had set a goal finishing the rough draft ready for my first edit.

A lot has happened in the nearly seven years since then. The manuscript was not completed as planned.

The story is still in the making.  Today is a new beginning of another chapter on an unknown story of our journey; a day at a time in a walk of faith with Thelma, an amazing lady.

“…so walk…just as you were instructed…overflowing with gratitude.”   From the writing of the Apostle Paul in a letter to the Colossians.











From my Caregiver’s Journal – A Tribute to Caregivers – Friends, Family, and Community

From my Caregiver’s Journal

November 9, 2015

I am blessed and I speak for Thelma too.

We rely on a group of individuals, caregivers, whom I have come to think of as friends. These friends provide Thelma’s physical needs with a tender touch, a warm smile, and a genuine sense of sacrificial service and love.

Twenty-four hours, seven days each week, they help Thelma through her confusion, comfort her when she is lonely, and tenderly encourage her through her times of edginess, as well as her stubborn moments. They demonstrate compassionate care while monitoring her meals, bathing her, dressing her, making sure her colors don’t clash, brushing her hair, applying makeup, and attending to those inevitable “messy” unmentionables. They show their affectionate concern for Thelma’s comfort.

These acts of thoughtfulness and kindness do not go unnoticed. These friends specifically refer to the faithful team of caregivers on the Woodland Terrace – Magnolia staff.

There are others we think of as friends of Thelma, and friends of Magnolia Court. These are the other residents; some who hover over Thelma in a motherly way, comforting, touching, and affirming; others, as sisters, chatting, laughing, or exasperated, but always loving. There are also the family members of other residents, who, while visiting their loved ones, shower Thelma with smiles, love, and warm acts of kindness.

A core of healthcare professionals, therapists, hospice caregivers, and Woodland Terrace Administrative staff, while regularly serving other residents, offer Thelma, a smile a touch, or a word of encouragement.

I treasure each of these deeds of thoughtfulness as acts of love and friendship beyond what I can extend to Thelma by myself.

I also benefit from many of these same “friends” as they extend, to me, words of encouragement, as they express concern for my welfare, my physical health, and emotional needs.

I am blessed. I am also blessed with a community of friends who demonstrate concern and care. These include our church family, my Alzheimer’s support group, the Bridgman “Writer’s Group” and the many acquaintances who greet us with smiles and conversation while shopping, or eating with friends at nearby restaurants, and many others.

And lastly, my family, my four sons, Rick, Ken, Jim and Rob and their precious families; our extended family, those of my brothers and sisters, and their offspring, Thelma’s aunts, uncles, and cousins and their offspring.

And there is a friend that is closer than a brother; that friend is Jesus. We are truly blessed.

Jan’s Story – A Book Review

Jan’s Story

By: Barry Peterson

Behler Publications, LLC

Lake Forest, California

978-1933016443, $ 15.95, 2010, 206 Pages

Reviewed by Richard R. Blake,


The Devastating Effect of Early Onset Alzheimer’s Disease


Award winning news correspondent Barry Petersen tells “Jan’s Story” and of their journey together in a story of excitement, passion, and of love lost to the long goodbye of Alzheimer’s. Step by step and chapter by chapter he takes the reader through Jan’s journey into each of the “Seven Stages of Alzheimer’s Disease.”


Petersen is open and candid in talking about his feelings of devastation, anger and grief as the brain altering disease Early Onset Alzheimer’s takes control and dominates every area of life in a downward spiral unpredictable and all consuming. He tells of the private agony of loneliness, overwhelming feelings of depression, and the ongoing battle with exhaustion.


The pages are filled with personal experiences, correspondence with family and friends, advice from medical professionals, fellow travelers, and well-meaning acquaintances. In this dramatic story Peterson provides the reader valuable information and helpful hints for fellow travelers on their journey with Alzheimer’s.


I personal gained:


  • New perspectives on the reality of day to day life and the growing sense of loss, a sense of discovery into the little windows of the Disease and the realization of being increasingly alone.
  • Help to cope with the sense of isolation, loneliness, denial and the delusion of normalcy or improvement.
  • The dangers of ignoring a growing awareness of the results of Caregiver stress.
  • How to deal with times when it seems that all dreams are ending.
  • The relief of distraction.
  • And the realization that I am not alone in this journey.


There were times in my reading when my tears blurred the print or when I just stopped reading to reflect on our own journey with Alzheimer’s. Reflective moments recalling cherished memories of those days that pre-date the realization that building memories for “us” was in reality building memories for me.


Resource suggestions and discussion questions are provided for further reading, personal contemplation or for group discussion, ideal for use in a reader’s or support group.


A beautiful story, of love, trauma, renewal, and hope.

Jans Story

All My Belongings by Cynthia Ruchti – A Book Review

All My BelongingsAll My Belongings
By: Cynthia Ruchti
Abingdon Press
P O Box 801
Nashville, TN 37202
978-1426749728, $ 14.99, 2014, 335 Pages
Reviewed by Richard R. Blake,

A New Name, A New Start, A New Challenge

The shame and humiliation that follows the widely publicized court case and resultant imprisonment of her father for the euthanasia of her terminally ill mother left Jayne Dennegee devastated.

In an effort to escape the mounting pressure and trauma of community bias and unfounded judgment Jayne took on a new identity, as Becca Morrow. She legally changed her name and accepted a position as nurse and companion to an incurable elderly woman in California, two thousand miles from her home in Iowa.

Cynthia Ruchti skillfully challenges the reader to come to grips with the reality of the dilemma faced by caregivers dealing with loved ones suffering with a terminal illness or incapacitated by dementia.

Ruchti has a lyrical writing style that is compelling, using a combination of the elements of good story telling, building a plot providing an ample balance of suspense, humor, and heartwarming pathos. Her characters are strong, well developed, and believable. She used the medium of the novel to bring a message of the results of the poison of prejudice, the entrapment of deception, the reward of revealing truth, and the healing of forgiveness.

“All My Belongings” will resonate with readers in the midst of the role and trauma of providing long term care to a loved one. A timely must read for counselors, pastors, hospice workers, and extended care facilitators.

A complimentary copy of this book was provided for review purposes. The opinions expressed are my own.