Why I Am Here, and My 1/3/26 Observations

This letter is a simple reminder, written with care, to let you know why I’m here. People who love you want to make sure you’re safe and supported, so I’m here as your friend, to help when your memory makes things hard. I live here so you don’t have to go through this alone.

To make the most of this time together, we just need a few things to stay clear:

1. Your Safety

• You are not alone. If you feel confused, dizzy, sick, or unsafe, I’m here to help.

• I’ll gently remind you what might be causing it, and we’ll work through it together.

2. Your Happiness

• This is your time to enjoy life.

• If something Needs to be done, write it down—I’ll help remind you.

• If you’re bored or unsure, you can make a list of things you Enjoy—I’ll remind you.

• If there’s nothing you have to do, then just Relax. That’s what this time is for.

3. Your Physically Health

• Your doctors and family are taking care of the medical part.

• I’ll help you follow their guidance and stick to your normal healthy routines, including medications and seeing doctors.

• If you want help with anything specific from me to help around the house, just write it down and I’ll be glad to assist.

4. Your Financial Peace

• Your family is managing your finances—there’s nothing you need to worry about.

• You still have access to the things you want and need.

• I’m not involved in the money, but if you get worried, I’ll remind you that it’s taken care of.

5. If Anything Changes

• We can update this anytime you like.

• This is just a gentle reminder of how we’re making this time peaceful and simple.

Let’s keep it calm, clear, and focused on what matters: your safety, your joy, and your peace of mind.

Observed Symptoms As Of 1/3/2026 (Caregiver-Observed)

1. Memory Impairments

• Noticeable short-term memory loss: difficulty recalling recent conversations or actions

• Repeated questioning within short time spans

• Clear moments of confusion about previously clear topics

• Loss of continuity in thought processes (inability to track linear conversations)

2. Working Memory and Cognitive Load

• Difficulty processing multiple stimuli or complex conversations

• Appears overwhelmed when attempting to reconcile information from multiple sources

• Increased dizziness during moments of cognitive overload or confusion

3. Auditory Processing and Hallucinations

• Auditory hallucinations localized to the perception of an additional person (apparently a version of the caregiver) present in another part of the house

• Reports of hearing actions (e.g., voices, movement) associated with things the caregiver has done before, when the caregiver i sin her presence or not

• Onset of auditory hallucinations was around 7 days ago, just before and after her attempted trip to Wisconsin

4. Balance and Orientation

• Persistent dizziness, especially during or after cognitive strain

• No current reports of vertigo-related nausea, but balance appears fragile

• Dizziness does not appear to be positional or mechanical in nature (i.e., not triggered by standing up or head movement)

5. Hearing Decline

• Recent and noticeable drop in hearing acuity, previously normal

• No prior history of hearing loss

• Possible central auditory processing deficit, rather than peripheral hearing loss

• Tinnitus not reported, but not ruled out

6. Psychological and Emotional Effects

• High historical need for control (former CFO-level executive)

• Increased distress when unable to remember, track, or manage events

• Apparent emotional toll from perceived loss of agency and coherence

7. Coherence and Language

• Maintains general coherence of thought and speech when not actively accessing recent memory

• No signs of expressive or receptive aphasia

• No apparent decline in vocabulary or language complexity outside memory-related moments

Personal Observations and Reasoned Perspective

(Not a medical diagnosis; offered solely for supportive consideration)

In my time living with and supporting Joanie, I’ve observed consistent patterns that lead me to believe the symptoms may be centered around the degradation of functions typically associated with the hippocampus, particularly memory formation and continuity. While I lack formal medical training, the presentation—especially the disconnection between short-term and working memory—suggests difficulty not only in recalling recent information but also in holding and manipulating it in the moment.

Joanie has always exhibited a strong sense of personal control and decisiveness—traits that have served her well professionally. But now, moments of forgetfulness appear not only frustrating but deeply destabilizing, often triggering internal conflict. This appears to create a mental feedback loop: the more she tries to "re-grasp" something that slipped away, the more overwhelmed and disoriented she becomes.

In addition to her executive personality, Joanie has always been highly relational, with family as her top priority—closely tied to her long-standing need for control and personal happiness. As her memory has declined, the natural fading of social engagement has been particularly damaging, both cognitively and emotionally. Social interaction has historically served as a core stabilizing force for her identity and well-being. The gradual disconnection from meaningful relational input is likely compounding her cognitive stress and sense of isolation. While medication may help address certain neurochemical symptoms, the absence of fulfilling social interaction—especially with those she trusts and feels safe with—risks accelerating psychological confusion and distress. Rebuilding regular, low-pressure relational engagement may offer far more restorative effect than any clinical approach alone.

If I may offer a relational hypothesis: for someone like Joanie, who thrived on structure and decisiveness, the psychological strain of memory uncertainty could compound the biological impact. If that strain remains unacknowledged or unresolved, it could plausibly intensify hallucinations, confabulations, or other compensatory perceptions that aim to fill the resulting cognitive gaps.

It seems logical that any clinical intervention—whether pharmacological, behavioral, or environmental—would be most effective when paired with maximum psychological support, including:

• Avoiding any perception of being controlled or disempowered

• Offering meaningful ways to restore or simulate agency

• Providing non-threatening help that preserves dignity

If this balance isn’t struck, I worry that even effective medical treatments might struggle to outpace the psychological distress being generated.