Every day for decades—at least six days every week, except for the coldest weeks of winter—Evelyn walked. And when she walked, she moved! Two miles or more in 30 minutes. I would huff and puff to keep up with her when I decided I had time to join her.

She bought reduced-fat ice cream, two percent milk, salmon, cod fillets, and chicken. We rarely ate beef. She cut back on the sugar in many recipes. The lemonade was artificially sweetened.

One year the doctor was concerned about her cholesterol, so Evelyn decided she’d handle it. She ate oatmeal every morning for a year, whether she liked it or not, and was pretty bitter when her cholesterol levels didn’t budge even a bit.

She was not obsessed with her health, but good health was always a concern. With Alzheimer’s sprinkled throughout her family tree, she worked to protect herself against it.

Today it’s a different story, of course. I am in charge of her health now. I make the appointments. I dispense the pills and monitor her symptoms. I write the lists of questions to take to doctor’s visits.

I even walk by myself now, which I always said I’d never do. But I’ll admit I have just about given up the struggle to cover two miles in 30 minutes.

Giving up?

I hate to say that, because giving up isn’t something our culture celebrates.

We congratulate the octogenarian running marathons.
We celebrate the actors still playing leading roles when they’re approaching 90.
We debate whether the current likely presidential contenders should still be running in their 80s, (and yet polls say most Americans will choose one of them).

The senator from California, age 90, must be told to vote “aye” in the meeting she’s attending. And the former Speaker of the House, age 81, takes a fall, suffers a concussion, and later freezes in front of microphones. Both of these duly elected officials say they’re fine, just fine. Give up? No, the nation still needs them!

Something different?

But Evelyn’s doctors seem to be saying something different. If not “give up,” at least “relax.”

*Dr. Yvette Neirousz, MD,* *TriHealth Women’s Center, Cincinnati*

The blood tests after Evelyn’s latest physical showed elevated sugar levels. I questioned her doctor about it, and she responded, “We need to balance quality of life with the possible treatment. If you want to cut back on sweets, I’m fine with that, and we’ll stay the course.”

I questioned Evelyn’s neurologist about whether to consider hearing aids. (She hasn’t had a test, but I know her hearing is failing.) He agreed that hearing loss can contribute to cognitive decline. But he acknowledged that keeping up with hearing aids at this stage would be a constant frustration. “Two years ago, I would have recommended that you pursue this,” he said. “But not now.”

*Russell Sawyer, MD,* *UC Gardner Neuroscience Institute*

I confessed that sometimes after several failed attempts to keep her CPAP mask on all night, I just surrender and leave her alone. He told me not to worry. This from the man who had insisted on the sleep test four years ago because of how sleep apnea contributes to cognitive decline.

While we were talking, I told him about a friend who had also received a diagnosis of prediabetes and bought a blood testing device to prick her finger and learn her sugar levels each morning. He looked me in the eye and shook his head. “Don’t do that,” he said.

Take it easy

I think each of these physicians, concerned about Evelyn’s health but taking a compassionate look at the big picture is saying “Relax.”

It’s not that we’re giving up. Although the neurologist recommended fewer pills, none of them are the ones he’s prescribing for Parkinson’s or cognitive decline. Her family doctor is vigilant about the blood thinner she’s taking after we discovered three clots in her left leg.

No one is shuffling Evelyn over into a corner to die. But we are admitting reality.

She is suffering from two chronic, progressive, incurable diseases. New changes to her condition, new erosions to what we knew as normal, are coming every week. The doctors seem to be saying, “Let’s not beggar the life you can enjoy today for the sake of extending a demise that’s going to come anyway.”

Good day!

We were hungry after the neurologist’s visit last week. The appointment was at 1:00, and we’d had only a snack for lunch. Evelyn wanted to stop at Wendy’s, one of her favorites. She ate most of a Dave’s single cheeseburger and about half of the mountain of fries that came with her combo meal.

This was late in the afternoon, so we weren’t hungry at suppertime. Later that evening we had some peanut butter crackers and enjoyed an almost nightly staple, a small bowl of ice cream.

At bedtime I leaned down to give her a goodnight kiss and repeated as I try to do every night, “Well, today was a good day, wasn’t it?”

She nodded sleepily, nestled under the covers and wearing her CPAP mask. And I slept pretty well that night, too.