Messages With and Without Words

"Today, we're going to trade in the truck and get a car for you!" my husband, Ray, announced, showing me a scrap of paper with the mileage penned on it in his arcane handwriting. It was five months after he was diagnosed with Alzheimer's disease. In a year, he would be gone.

Ray's purchase of the Ford F-150 twelve months earlier delivered a big hint that something was amiss. On a Sunday evening, we decided to keep both his 20-year-old pick-up and his Lincoln Town Car. Monday morning, he went to the county DMV and renewed the two license tags. From there, he drove to the local Ford dealership, where he traded both vehicles in for the brand-new truck, a sharp reversal from our conversation the previous night, and his stop at the tag office.

Cars and driving were high on the list of what brought Ray pleasure. He spoke of past vehicles with a tone and affection similar to how one might recall a childhood pet or past love. As a result, the prohibition of driving was poignant for him, a restriction presented in tandem with the diagnosis of Alzheimer's disease, arriving when he no longer could understand the profound changes afoot. Initiating the trade-in suggested a modicum of acceptance after months of fierce resistance.

The sales team at the dealership welcomed Ray and me. Outside of my hearing, he explained that, due to his health, he could no longer drive. When he told me about the conversation, he laughed uproariously because the car dealers thought he had a heart condition. Although unequipped to describe his actual circumstances, he knew this explanation was inaccurate.

When he saw the Lincoln MKC on the lot, Ray lit up: "A Lincoln for you! You'll love it." While a crossover SUV was not what I had in mind, it was attractive and easy to drive. Moreover, the ride appealed to Ray, whose encounters with cars would now be as a passenger. Most days, Ray could not recall his most recent meal, but the instant Matthew McConaughey showed up on television commercials, he shouted, "Lincoln!" Two years after his passing, I feel as if he continues to look after my interests through the choice of a well-accessorized vehicle.

Perhaps unwittingly, Ray had accommodated his dementia amid his driving habits and in other ventures for many months before diagnosis. He adhered a return address label to his wallet, which I assumed was there in case he lost the wallet. However, one day when we stopped at a gas station, he told me that the pumps didn't work. Belatedly, I realized that the label was in his wallet to inform him of the zip code associated with the credit card. When the monthly charges on the credit card we used exclusively for fuel purchases decreased, I imagined that Ray was spending less time on the road. But our stop at the gas station with the "broken" pump indicated that technology had become overly complicated, so he paid cash.

Ray was a seasoned problem-solver. As a higher ed administrator, he had set up his office suite with adjoining rooms enabling him to hold two or sometimes three concurrent meetings. Because crafting ways to supplement his mental capacity was customary for him, figuring out how to buy gas was a manageable challenge, even with dementia. He also knew to avoid activities that would be overly complex. Once a lively cook who assembled sumptuous stews out of whatever happened to be in the refrigerator, he started refusing my requests to prepare dinner. He turned the task of balancing the checkbook over to me so gradually that I didn't realize that he had stopped participating altogether. My missed observations and incorrect surmises, along with Ray's savvy, contributed to delaying the diagnosis. While I'm grateful that we preserved normalcy for as long as possible, the risks we overlooked give me pause.

My husband was the most resilient person I have ever known. Throughout his life, he tolerated criticism and unfounded personal attacks in deference...