Alzheimer: A Carer's View

This is my summary account of the events that took place in the year 2024 while living with and caring for a sufferer of Alzheimer's disease [Stage 6].

Beautiful Personality

The one for whom I care has always had a wonderful positive personality. She has a selfless sense of caring for the other above herself. She is never scathing. There is not the slightest trace of acridity within her being. Her life endeavours are for social justice, equal opportunity and the demise of disparity. She loves to read and can do so to great depth in both Portuguese and English. She sings spontaneously both the classical arias and popular songs and often breaks into the wordless mouthing of Latin-American rhythms. She has always been a career lady and so has never had the time to learn how to cook. However, strangely, she loves to wash dishes after a meal. She also used to keep her apartment meticulously clean.

Since the onset of her illness, she has had diminishing social contact to the extent that she now focuses her 'selfless concern for others' on her little Maltese terrier. Unfortunately, this has not been a positive thing. If not prevented, she will give the dog the kind of food that is definitely not good for it. At first, she would give the dog little bits from her plate at meal times. This extended to her getting a small plate and placing up to half the food on her plate on it for the dog.

One day, I gave her her plate of vegetable salad for lunch. She immediately put half of it on another plate for the dog. I told her that dogs don't eat vegetable salad. So she flushed everything she had put out for the dog, plus her own portion, down the toilet and said she was leaving. She tried to leave the apartment, but the door was locked. At 12:00 she finally ate another plate of food. She cried a little afterwards, denying that she had thrown food down the toilet. This was out of character. I remember the first time when she simply placed her whole meal plate on the floor for the dog, leaving nothing for herself. On another occasion, she gave all of her lunch time plate of lasagna to the dog, which was definitely not good for the dog because it suffered quite a dose of diarrhoea afterwards.

Over the years of her illness there have been literally only about 3 or 4 outbursts like her reaction to the above food for the dog incident. She has freaked out occasionally but it is very rare and always precipitated by frustration. I remember only one occasion when she angrily refused to take her medication saying that it tasted horrible. Eventually, I managed to get her to take the medicine. I recorded only one other occasion when she flushed her medications down the sink. She took a second lot that I offered to her with a small cup of Coca-Cola and then went to bed. For all the rest of the time she has lived in tranquillity.

Eccentric Behaviour

Quite early on, she started to sleep in her day clothes. She simply didn't take off her day clothes to go to bed. She seemed to think this was normal. During the daytime, she frequently spends a long time trying on all the clothes she can find. She frequently puts on several layers of clothes. At times she has been found wearing up to 7 layers of clothing with up to 14 knickers at the same time with an extra bra on top of her cardigan. And we live in the tropics. I have to persuade her to strip off these extra layers to be comfortable.

Around September 2024 her behaviour towards people in the street started to become somewhat inappropriate. She says to any man in the street such things as: "You are a wonderful man..." and speaks to any woman as though she were her best friend. She shouts: "Arri Égua!" at other women across the street. This is a colloquial expression from the Interior, which may be best translated as "Hi bitch!". It is an expression that only very familiar women might say in friendly banter. She waxes at length on the beauty and cuteness of every child she sees in the street.

While in our apartment, she seems to have developed a fear of the outside world. This is demonstrated by her drawing the curtains in the lounge during the day and switching on the light. She also closes the storm shutters in the bedroom.

She still reads extensively from the books in her large home library, which is good. However, she always reads aloud, including every punctuation mark. She also, very annoyingly, reads aloud all the subtitles or banner text from television films and news broadcasts. This makes it very difficult for me to actually hear what the news readers and reporters are saying.

As her condition evolved, I noticed that the rate at which we consumed toilet rolls had increased geometrically, until I was now buying a 40-pack every week. I discovered that, apart from their normal use, she was using toilet paper for drying her hands [as opposed to using a towel], drying dishes [she loves washing up], cleaning the floor in the kitchen and bathroom, wiping up spills, plus a host of other uses. Furthermore, she placed toilet rolls in strange places, including her handbag, in her wardrobe, on her dressing table, in the kitchen storage cupboards, on the sideboard in the living room and even in clothes drawers. She asserted that towels were not clean enough for drying things. Also, after using the wash basin, she throws lots of water over the tap to get rid of germs and thereby flooding the marble surface surrounding the wash basin. On the other hand, she repeatedly washed the lavatory brush and placed it in the toothbrush holder alongside the toothbrushes. I kept removing it. The last time, I found it in the cutlery drawer in the kitchen. I removed it and hid it. Thus her sense of hygiene has become somewhat inverted.

One time, I caught her eating a plastic leaf that had fallen off an artificial rose plant used to decorate our living room. When I asked what she was doing, she gave me a completely disconnected answer "These vagabonds have nothing in their heads". Another time she was complaining that what she was eating was too hard to bite. She had taken a chicken nugget from the freezer. Yet another time, she complained that what she was eating tasted horrible. She had a round tablet of soap in a cup of the same diameter and was trying to eat the soap with a tea spoon. I have caught her also eating wild flowers and leaves she has gathered from the roadside gutter during our walks, which I shall describe later.

The only physical eccentricity she has developed is a very lopsided walk, in which she leans towards the left. But this she has gradually corrected.

Her disposition now is thus very different than the stable sharp-minded Federal Judicial Analyst that she has been all her working life until this present condition developed. Her geriatric doctor likened the effect of the disease upon her as being somewhat like somebody high on cocaine. Despite this, I receive a lot of pressure from her brothers and other relatives to have her take cannabis oil, which they assert to be the miracle 'cure' for her condition. They have all been beguiled by various self-authorised influencers on social media [especially YouTube] who have a financial interest in promoting and selling the stuff. Her geriatrician was most emphatic that, particularly in her case, cannabis oil would be most detrimental. It would make her even 'higher' and take the sharp edge off her mind, the use of which in reading and conversing keep her very happy.

I must emphasise to the maximum that the eccentric behaviour described above is the very antithesis of the impeccably mannered professional that she formerly was. It's a total reversal of personality. Notwithstanding, she herself — her character — is the same as it has always been. Her inherent consideration and empathy; her total absence of antagonism or hostility; her overt benevolence and generosity. This is what she always has been and still is. The disease hasn't altered this in the slightest. For this, she is still every bit as worthy of the highest respect.

Our Long Walks

Until 2014, she and I were in a weekend running club. Each Sunday, we would run all the way round a lake — a distance of 18·3 kilometres. In 2022, when she was diagnosed, her geriatrician said that we should continue with regular exercise but that running was not advisable for people our age because of the propensity for falls and pulling ligaments. We therefore mapped out and followed a 3 km walk, which we did each Saturday and Sunday, with the little dog we acquired in 2017.

All was well until she started to become obsessed with gathering large amounts of small wild flowers and foliage from the roadside gutter, which is invariably full of dirty rubbish and is where the neighbourhood dogs do their poos. She brings them back home and spends ages washing them with the tap running all the time thereby consuming an enormous amount of water. She would invariably block the kitchen sink and the bathroom wash basin. I suspect that she put the foliage she rejected into a plastic bag and flushed it down the toilet. This was probably one of the major causes of the blocked toilets.

One day, we went for a shorter walk during which we nearly lost our little dog. She insisted on walking the dog herself on its leash, while at the same time insisting on pulling dirty plants out of the roadside gutter. While she was so doing, she let go of the dog's leash. Our little dog ran across the road, totally oblivious to the traffic, to confront another dog. It's pure luck that we still have our little dog. After only about a minute, she remembered nothing of the incident.

On another day, we went on our 3km walk as usual. She gathered her large pile of leaves and small wild flowers from the roadside gutter where dogs do their poos. She even picked flowers by reaching into people's gardens and from the flowering bushes planted by the local authority. She brought all this home and spread it on the dining table. There she sorted it as she wanted. Then again, there was water running for ages and ages as she washed this filthy stuff in the kitchen sink.

The next day I decided not to take her and the dog on our usual 3km walk because of the difficulty caused by her insisting on gathering flowers and plants. But I eventually had to relent and just let her gather ever greater amounts of foliage. I tried to surreptitiously hide them when she wasn't looking and rely on her short memory for her to forget all about them. Then I would hide them under other rubbish in the bin. This problem is on-going.

On another day, on arriving back home from our 3 km walk, she washed the flowers she had picked from the gutter as usual. Then she offered me one. I had my hands full so I couldn't take it from her. So she ate it. Then she gave our little dog some other flowers to eat. Of course, the dog didn't eat them. Another day, while on our way home, we visited her mother. She made a mess of her mother's apartment with what she'd gathered. Her mother commented about her strange behaviour. We left without the foliage. Her mother's carer had to clear it all up.

Things Disappearing

She has a propensity for making things disappear by 'putting them away' in places that make no logical sense whatsoever.

I always keep my small wallet in the back pocket of my trousers. One day, I discovered that it was missing. At first I thought I had become the victim of a pick-pocket while shopping. My wallet contained official identity cards, debit cards and medical insurance cards and other official cards; both hers and mine. I was in despair. Some time later, I found them all spread out on the sofa.

I always place my laptop's plastic dust protection cover on top of it to keep the dust off while it is not in use. One day, this dust cover disappeared. I couldn't find it anywhere. Noticing an extra bulge where there shouldn't be one, I found the laptop's dust cover stuffed down her bra together with a tea towel and a rolled up Moroccan place-mat.

The television remote controller is a favourite at disappearing. One day when this happened, I mounted a police-style deep search of the entire apartment. This was all to no avail. I simply couldn't find it. The following day, it appeared on the dining table. It wasn't there before. She knew nothing about it. The apartment was a total mess with clothes, tablecloths and other objects having been 'put away' into ridiculous places. Another time, the garage door opener controller disappeared. I had to embark on another police-style search and eventually found it in the pocket of her leather jacket hanging on the bathroom towel rail. On another occasion, the funnel for the coffee filter papers disappeared. I found it in the bathroom cupboard. My glasses also tend to disappear from where I keep them hidden behind the computer monitor. This happened one day, while I was taking a shower. I found them at the back of the second shelf in the fridge. This took me an hour of searching the apartment to find them. I can hardly see, let alone read, without them. I had to wait 20 minutes for them to warm up sufficiently not to re-fog.

She is an avid consumer of toilet roll. She uses it for drying her hands, dishes and cutlery. She also spreads it on the dog's bed. She then puts the partially used rolls 'away' in every kind of illogical place. One day, she took lots of toilet rolls out of a 40-pack and distributed them in unknown places. I had to hunt them down and put them back together in the pack. She kept washing the lavatory brush and placing it 'bristles up' in the toothbrush holder. The last time, she put it in the cutlery drawer. Another time, the handle of the kitchen tap disappeared and was eventually found in a storage cupboard.

Disrupted Nights

One night, she wouldn't get in bed, even though she'd taken 25 mg of quetiapine. She just sat on the bed looking at her hundreds of photos and holding conversations with the images of the people therein. I went to sleep in the spare bedroom, but I kept checking on her from time to time to see if she had got in bed. At 01h05 I saw her still sitting on the bed conversing with the photos, although it appeared that she had been in the bed for at least some of the time. I was concerned about what she may do if I did not keep an eye on her. I managed to sleep a little. I awoke at 06h25. I made breakfast for her then I went back to bed and slept until past 9 AM.

A few nights later the disruptions continued to the extent that at 00h20 I went to try to sleep in the spare room. She got up from time to time for the toilet but she didn't go to bed at all: she just sat on it messing about with all the lights on. I drifted off to sleep but still heard her talking and rummaging around. At about 06h00 she came into the spare room and awoke me. I went back to sleep. At 06h50 I woke up and made breakfast. She didn't eat it. I felt absolutely exhausted. I could not concentrate on anything that day.

On Tuesday 16 July, our professional day-carer suggested that I switch off the lighting circuit for the daytime part of the apartment. I started doing this. It worked well, so I continued to do this each night thereafter.

Towards the end of July, I found myself getting practically no sleep at night. She would spend most of the night talking and singing unintelligibly. Consequently, a few days later, her professional day-carer and I took her for a consultation with her geriatrician. He replaced her 25 mg of quetiapine with 50 mg of trazodone [trazodone hydrochloride] at night. The following day, she was somewhat in cloud cuckoo land. That night, she took the medications at 19h30 but didn't go to bed until past midnight. She stayed up messing with clothes and photos and reading books. The trazodone didn't seem to work very well this second night. Notwithstanding, within about a week I was starting to get a reasonable amount of sleep, apart from having to supervise her 3 or 4 half-hour toilet breaks spaced out over the early hours.

On Monday 29 July she took her medications at 20h45 but didn't go to bed until way past midnight.

At 02h40 on Wednesday 31 July she woke up to go to the bathroom. I took her to the bathroom in the utility area. Afterwards, there was urine in the toilet, but also all over the floor and her knickers were soaked. She stuffed a lot of toilet paper into them and went back to bed and slept. At 05h56 I took her to the bathroom again in the utility area and told her to pull down her knickers before urinating. She appeared to have done so, but there was still a lot of wetness on the floor afterwards. She appeared to be dry. Mystery.

On Monday 05 August at 19h30, she took her medications and wanted to go to bed but did not get in. She talked to the people in her photographs. She eventually got in bed and went to sleep at 22h30.

On Thursday 15 August we attended her nephew's wedding. While there, she drank 2 glasses of red wine. Consequently, when we returned from the wedding at 22h00, she went to bed without taking her nightly medications. The next morning she woke me up at 05h30. Practically all the lights in the apartment were on and she was pottering around. I went to sleep in the spare room. I got up at 07h30.

Although the nights were settling down to a kind of routine, I'd become very sleep-starved. At the age of 81, I felt that I did not have the physical resources within me to cope with this situation on a continuous basis. Consequently, on 20 August I decided to message her geriatrician:

"[She] didn't sleep at all last night. She stayed up all night reading a book or talking to people in photographs and singing. The effect of her current medication seems sporadic. Sometimes she sleeps through the night with only a couple of bathroom breaks, each of which takes about half an hour. Other times she is active all night." [The original was in Portuguese.]

Her geriatrician prescribed 10 drops of Melatonin [which could be extended up to 20 drops if necessary] to be taken together with her other nightly medications.

The next night, she took her normal medications at 19h00 and her 10 drops of Melatonin at 20h30. At her professional day-carer's suggestion, I switched off both the lighting circuits in our apartment. She slept from 21h00 to 05h00, at which time, she tried to switch on lights. However, being disconnected, it stayed dark and I was able to continue sleeping. She rose at 05h45, looked at photos and read aloud by the dawn light. She only slept for 2 short periods during the night. Most of the time she was active, walking around the apartment trying to switch the lights on, but I had switched off both lighting circuits. I did not sleep well this night. I was stressed.

The next night, she took Melatonin at 20h30 and slept from 21h00. The next day she awoke to go to the bathroom at 02h15 then went back to sleep until 05h30, when she got up and tried to turn the lights on. She paced around the apartment in the dark until I got up at 06h30. That night at 20h00 she took Donila Duo, Rosuvastatin and trazodone. At 20h50 she took Melatonin. She went to sleep at 21h00.

On Saturday 24 August, she awoke at 03h15 to go to the bathroom and did not go back to bed after that. She walked around the apartment trying to switch lights on, opening and closing cupboards and so on. I stayed in bed until 07h30 but didn't sleep fully since 03h30. I was tired and stressed. I made a cup of green tea for her, which she threw down the sink. From then on, for a while things followed a kind of norm. She took her medications at 20h15 and the Melatonin at 21h00, woke up 4 times of about half an hour each during the early hours to go to the bathroom and got up at 06h00.

On Tuesday 03 September at 04h30 she awoke and began to rummage in her wardrobe in the dark until dawn. During the night of Sunday 08 September, she awoke at 04h40 and started messing about. I awoke at 06h00 after going to sleep in the spare room. The night after she stayed up and active until about 02h30. I think that I drifted off to sleep after this.

This continued until Thursday 19 September when at 20h00, for the first time, she refused to take her medicine and threw away the pills I gave her. She said they tasted awful. She wouldn’t go to bed and was active all night, sometimes singing, sometimes talking quietly, sometimes angry. I locked the office [so that she would not be able to cause anything vital or official to disappear]. I then locked myself in the spare room to try to get some sleep.

Her disruptive night-time activity continued throughout most of September. So on Tuesday 24 September at 08h30 I increased her nightly dose of Melatonin to 15 drops. This seemed to improve things.

Please note that after taking the Melatonin, she has to be physically put to bed like a child. She won't just go to bed under her own initiative.

The next night at 03h20 when she went to the bathroom, she only took 10 minutes. I had reduced the water flow in the bathroom by turning down the stop cock. However, on Saturday 28 September she awoke at 03h50 and got up. She then messed about in the dark in the bedroom and lounge. I went to sleep in the spare room at this time. I got up at 05h45 and made breakfast. The situation is on-going.

On Tuesday 08 October I awoke at 06h50. She was already up and pestering for breakfast. At 20h30 that evening she took medications but there was no point in us going to bed because there was a party taking place below. This party [festa] was reasonably quiet from 19h30 until 22h00. Then the sound level rose until it finally went quiet at 23h30. I finally got to sleep I think at around midnight.

I have taken licence to include all this tedious detail here to provide a view of just how devastatingly disruptive this illness is to whoever lives with and cares for anybody with Alzheimer's disease.

Nocturnal Shit Storms

The language in this section is deliberately simple, blunt and vulgar. For this I make no apology because I think that society in general — its government departments & health services in particular — need to be told just what a slavish workload it is that invariably falls upon an ageing spouse or relative. Unlike a health worker — or any other kind of worker for that matter — such a slave-by-default doesn't get paid. Unlike a health worker, he doesn't work an 8-hour shift then get twice that amount off to go home, sleep and do whatever else he wishes. Unlike a health worker, he does not have holidays or days off. But these are only words: they can't convey any real tangible notion of the degree and impact of the ageing carer's perpetual servitude.

Furthermore, if the servitude of caring in such a case falls to a person of working age, then that hapless carer is expected — nay, required by law — to maintain full time employment or be able to prove that he or she has been actively seeking work every day under the threat of State-enforced destitution. This is in flagrant violation of Articles 4, 24 and 25 of the Declaration of Human Rights of 10 December 1948, to which most nations are signatories. It is a situation I endured for almost 40 years in the UK. But that's another story in another place at another time.

At the beginning of August, it became increasingly obvious that she was becoming incontinent. She filled her knickers because she could not get to the toilet in time. Understandably, this caused her much embarrassment. She coped as best she was able, preferring to resolve the problem by herself. But she was gradually but surely losing control of her sphincter and Kegel muscles, which, I am given to understand, must receive on-going dynamic control signals from the brain.

Consequently, on Tuesday 13 August she started to wear integrated nappy pants. These were very good but they didn't always contain the situation. For example, on Saturday 19 October she had what I can only describe as a literal shit storm and soiled much of the bedroom floor. She had a similar incident on Wednesday 23 October. The next day, Thursday 24 October there occurred two separate shit storms at 08h30 and 17h00.

Another severe shit storm occurred on Friday 22 November. I had to load the washing machine twice. On Tuesday 03 December at 03h00 another such storm erupted, which lasted 20 minutes. She insisted on dealing with it herself. During the following night, she had two such incidents: at 01h30 and 04h00.

On Thursday 05 December at 23h30 she had a shit explosion that spread from the side of her bed, all the way along the corridor to the bathroom. It was by far the largest mess yet. I managed to clear it up. Eva, our little dog, licked up a lot of the mess. Ugh! I put all her clothes in the washing machine. I had to hunt for something for her to wear. I could only find her posh black dress for her to sleep in the rest of the night. All her other clothes had been 'put away' in diverse places where I could not find them without embarking on a police-style house search.

On Monday 09 December at 04h00 there was a significant poop eruption but fortunately all was contained within her nappy pants. On Thursday 12 December I had to take her for a pee several times during the early hours. However, at 08h00 there was yet another explosive shit storm in the service area beyond the kitchen and in the service area store room also. It's now undeniable that she's losing most, if not all, control of her Kegel and sphincter muscles.

On Wednesday 18 December there was another shit storm at 01h45, which took me until 02h20 to clear up. Again, I couldn't find clean clothes for her. She was in bed for only 10 minutes when I had to rush her to the toilet again for a pee. I awoke at 05h20 but stayed in bed until 05h50.

On Friday 27 December at 06h15 another shit storm occurred in the service area beyond the kitchen. I managed to sluice all the semi-liquid material down the floor drain but there remained lots of maize, which obviously passed straight through. I later discovered she had left a large splat of shit in the service area store room. I had to clear that up later.

On Sunday 29 December at 08h10 there was yet another severe shit storm while I was on the john. I cleared up all the shit, including Friday's second lot in the service area store room. I put all shit-laden clothes and floor cloths in the washing machine. What a workload! Later, at 23h45 there was another grand shit storm in the front bathroom. It was all over the lavatory seat. She had forgotten to lift it. I sluiced the front bathroom with 5 buckets of water. I washed clothes and gave her a bath. An enormous task in the middle of night for an 82-year-old like me.

On Monday 30 December at 08h20 the final grand shit storm of 2024 erupted. Fortunately, it was almost all contained within her nappy pants this time. However, I still needed to clear it all up and wash her clothes.

Blocked Lavatories

The lavatory in the service area had been blocked since Sunday 04 February 2024. The plumber I had called at the time said that the only way to unblock that toilet would be to dissemble it completely and take it off the floor. I finally managed to unblock it on Saturday 17 February. It had taken me 13 days to unblock it.

However, on Wednesday 24 July, I discovered that the toilet in our suite bathroom had become irreparably blocked also. The following Sunday 28 July, I spent a long time finding it impossible to unblock the suite toilet.

To make things worse, on Wednesday 31 July at 17h40 I found that she had defecated in the blocked toilet of the main bathroom while my attention was elsewhere. It seems she forgot to pull down her knickers before defecating. Her knickers had disappeared and there were poop stains all over the bathroom floor. She had obviously taken a shower and was clean. I locked the main bathroom from the outside to prevent her using it any further.

On Sunday 04 August at 07h00 I got up and tried all day to unblock the two lavatories using a rubber plunger without success. On Sat 10 August I managed to unblock the toilet in the suite bathroom. It had been blocked for 17 days.

On Wednesday 14 August, even with my dyno-rod lodged in the blocked toilet of the front bathroom, she urinated in it and put toilet paper down. I had to retrieve the toilet paper by hand.

On Saturday 17 August I spent 3 hours removing the dyno-rod from the lavatory in the main bathroom. Even so, I couldn't unblock the lavatory. The dyno-rod made no difference whatsoever. I tried boiling water. Still no difference. I locked the bathroom permanently. I will now wait 3 months and try again. I have no idea what she can have put down there. The next day at 17h30, I finally unblocked the lavatory in the main bathroom. The dyno-rod retrieved a pair of her knickers full of shit and in a plastic bag + a bra outside the bag. The day after she went for a pee, after which I discovered that the toilet was blocked again, but not as much as before. There was at least a little bit of flow.

On Saturday 24 August I flushed the toilet in the front bathroom. It still wasn't completely clear. I left the bathroom open for a few minutes and discovered that she had flushed some old flowers down it that I had to rake out with my hands. I woke up at 15h56 after 2 hours of much needed sleep and the suite toilet was completely and solidly blocked again. She was desperate because she couldn't find any knickers. Perhaps she had soiled her knickers and flushed them down the toilet.

On Monday 02 September I finally managed to unblock the lavatory in the main bathroom. It had been blocked for 40 days! On Saturday 05 October I decided to abandon our suite bathroom because the shower tap had jammed. I moved operations to the front bathroom ready to have the suite bathroom's shower tap fixed. On Tuesday 15 October she tried to flush her plastic covered adult incontinence pants down the toilet. Fortunately there is no way they could be flushed down the toilet. Immediately they hit the water, they swell up so they cannot pass down the toilet. I managed to pull them back out by hand and dispose of them in the rubbish. Later that day, she put a second [clean] nappy pants down the lavatory. I retrieved it by hand.

On Tuesday 22 October I discovered that the lavatory in the service area bathroom was solidly blocked again. On Sunday 27 October I embarked on a vain marathon attempt to unblock this lavatory [again]. The lavatory in the service area remains irreparably blocked. I suspect that she flushed one of the dog's absorbent plastic-backed toilet mats: I saw her pulling pieces of the fluffy absorbent layer off the plastic backing shortly before I discovered the blockage. I decided to lock the service area toilet permanently until I can find time to cap its water supply, remove the flushing tank, unscrew the lavatory bowl from the floor and remove the blockage by hand from the open end of the sewer pipe. I'm not looking forward to this job. It was still blocked at the turn of the year, at which time, despite all my efforts, it has so far remained blocked for 65 days.

Effect on My Health

The stress of coping with a loved one with Alzheimer is very demanding both physically and mentally. It's stressful. Yet, apart from very few instances, my health has not suffered unduly. I think this is due mainly to her calm caring personality, which has not been too much affected by the illness.

However, I am a writer and a programmer. As such, I need to be able to concentrate in order to be able to think creatively and logically for long periods. Stress comes when I have to do this against a background of constant silly singing and questions and calls to pay attention while I am trying to concentrate.

Frequently, she will come and sit at her desk and read aloud at length from one of her books. She pronounces every word and every punctuation mark. I review what I write by listening to an artificial voice reading my text to me through my headphones while also reading it on the screen. In order to be able to concentrate on what I am hearing, I need to turn the sound volume extremely high in order to overcome the distraction of her voice reading her book, which I know full well isn't doing my ageing hearing any good at all.

All this is frequently on top of all-pervading tiredness from the sleep deprivation caused by the nocturnal shit storms. I sometimes think I will have to give up my intellectual activities.

On Monday 09 September 2024 at 21h30 I became dizzy, fainted and fell on the bed. I was fine again in about a couple of minutes.

On Friday 13 September I gave the medications to her at 21h40 and we went to bed. At 22h35 I suffered a sudden intense malaise for 20 minutes.

On Thursday 26 September My blood pressure shot through the roof. I do not really know what prompted me to measure it. I think it was probably caused by the continuous demand for attention without a break. I get to feel intense guilt if I concentrate on something else, even for a minute. That is stressful. I managed to get my blood pressure down by mindfully diverting and dissipating my stress.