Mitch Shields and his wife Melva cared for her father during his last years as he struggled with Alzheimer’s in an increasingly confusing world. Mitch and Melva spoke to Lake Sun about the burdens and joys of that period.

Mitch Shields and his wife Melva cared for her father during his last years as he struggled with Alzheimer’s in an increasingly confusing world. Mitch and Melva spoke to Lake Sun about the burdens and joys of that period.

Melvin Doral Carroll, known all his life as Doral, lived on a farm and still lived with his wife Milly in his original farm-house at the time of his diagnosis. Mitch, Melva, and their children lived on the same land about 100 yards from Doral. As Doral’s disability progressed, the Shields family and others from Doral’s extended family became Doral’s primary caregivers, especially at night. Home health nurses were used during the day, but one of the families needed to stay with “Grandpa” at night because Alzheimer’s patients often do not sleep through the night. Doral wandered, remembering the various chores needing attention on a farm.

Mitch laughed as he remembered Doral’s determination to care for a cattle herd no longer on the farm. Only one steer remained, and it was corralled at the barn. Doral fed that steer almost a dozen times a day.

The steer had lived its whole life in that barn and when it was time for the steer to be sold, Mitch went out planning to lead the steer from the corral, but it stopped at the gate, unwilling to leave known ground. Mitch struggled, but Doral’s vivid recollection of events and routines in his past saved the day. Doral brought a bucket of feed and led the steer easily.

Melva lost her first husband to cancer in her late 30s as they were raising two boys and a girl. A few years later she met Mitch and wanted him to ask her father for his permission to marry her. Mitch agreed.

Before supper on the evening when Mitch would ask Doral for Melva’s hand, Mitch recalls seeing Doral and Milly sitting in a porch swing holding hands like young lovers four decades into their marriage. That simple pose taught Mitch a lot about Doral that evening. The man’s answer later that evening taught Mitch even more.

“Don’t marry her if she is not your best friend,” Doral began. “If you do marry her, don’t ever go to bed angry. You may pick a fight sometimes, but always make up. You can’t say ``I love you'' too many times, you can’t say you are sorry too many times, and you can’t say you are beautiful too many times.” With that Doral gave his blessing. Mitch said he’s always admired that moment that gave him insight into Doral’s character.

Another insight came from Doral’s description of the Great Depression years. Doral remembered that everyone was in the same boat, but his family didn’t think of themselves as poor because they had the means to help a neighbor in need. Because they had enough to share, they considered themselves rich.

Doral didn’t talk a lot about himself when Mitch and Doral were together, but as the disease progressed and Doral lived more in the past, Mitch saw more and more of the younger Doral. If Alzheimer’s and other forms of dementia have any upsides, Mitch says, it is the ability to learn the details of the person that you may have never been privileged to know.

Doral’s loving wife of many years, Milly, suffered from heart disease and spent her last days in a hospital. During her stay, Doral was taken to visit. He endlessly combed her hair and told her she was beautiful, bringing back in vivid relief for Mitch those memories of the younger Doral’s soul. After Milly passed, Doral’s disease prevented him from processing her loss. He always believed she was still in the hospital.

Melva provided care to her first husband as he suffered from terminal cancer, so she knows intimately about that struggle. She is quick to say she will, “take cancer any day over Alzheimer’s because it steals your soul.”

Melva explains Alzheimer’s steals the essence of what the person was. They become lost, their eyes growing dull. She describes the sadness of looking on as that happens. Melva also talks about the support of family, including her school-age children. They took turns staying at Grandpa’s house during the night after taking his dinner to him. Melva describes the period when he felt no compulsion to eat and would not have attempted to fix for himself, but he would eat when food was placed before him.

Along with the pain of living with a loved one progressing through dementia is a certain wonder at those faculties that still remain. As Doral’s driving capabilities diminished, the idea of simply disabling his car seemed less confrontational. Nevertheless, as lost as Doral was in the present, his past life tinkering with recalcitrant farm equipment bubbled to the top. Doral just found the problem and fixed it. The keys had to be taken away in the end.

Patients with dementia such as Alzheimer’s may be confused by the present world around them and are often more comfortable in the past where memories are still vivid and familiar. No matter how many times a person carefully walks an Alzheimer’s patient through a current reality, the resulting conclusion can be wrong and sometimes humorous. For example, Doral’s dog had been run over on the road, but Doral was convinced a cantankerous neighbor had shot the pet.

After repeatedly going through the situation with Doral in great detail, Mitch and Melva felt they finally had explained clearly what happened. Still they needed to check to be sure Doral understood.

“Do you remember that your dog died?” they asked. Doral said he did.

“And do you recall we saw him dead on the highway?” Doral affirmed he did.

“So, your dog was run over by a car and killed then.”

“No,” Doral said, “It would be just like that guy to shoot my dog and drag him up on the highway to make it look like a car hit him.”

When asked how Melva learned about the disease and strategies to help care for Alzheimer’s patients, Melva said her only resource at the time was the doctor. Doral passed in 2003, sixteen years ago when fewer resources were available. Melva and the family worked out strategies to cope and keep Doral safe and content. Now there is more wealth of information and support for caregivers. Melva cites the Alzheimer’s Association for one and participates in the annual Walk to End Alzheimer’s. Mitch, who now works for Lake Regional Health System, noted the hospital and community support groups dedicated to providing strategies and emotional support to those family members directly involved in patient care. (See Sidebar listing regional resources)

Part of the pain caregivers suffer is the loss of the person they remember, especially because there is no cure. Symptoms can only be managed. Being in the presence of other caregivers facing the same struggle allows people in Mitch and Melva’s shoes to learn skills and techniques needed for care. They also develop coping mechanisms while avoiding a sense of isolation and despair.

Melva and Mitch admit there is a heavy emotional toll on the family as everyone’s life is “put on hold” because of the huge amount of time everyone must give to the care of their patients. But on the other side, Mitch believes it helped the kids grow up faster as they were required to step up and do as the adults were doing. They stayed with Doral for company and comfort and safety.

Mitch and Melva came through those experiences and now look back with the knowledge they provided Doral the best possible life even after he had to move to a nursing facility because of the level of care needed in the final days. That transition presented new challenges, requiring an accommodation. After the death of Doral’s dog, the Shields realized that argument will never win, but redirection works magic most of the time. Quite often, according to Mitch, Doral would demand that the family bring the doctor in to release Doral from the nursing facility. Mitch would tell him the doctor was busy and it would be a few days before he could come. Doral responded calmly.

Alzheimer’s Disease takes the soul of the patient. It traps the loved one in a past they may never have revealed. Yet, in spite of losses and throughout all the sorrow, all the confusion, all the doubt, Mitch and Melva Shields discovered a hidden gift, one they recognize and cherish to this day: They found the real Doral of his youth and his formative years when his character was being forged in the depths of the Great Depression. Mitch says the older Doral would have never talked about himself that much, never made himself the center of the story. The young Doral came back for just a short time and showed Mitch ideals and philosophies about humility and humanity that Mitch will treasure forever.