Repeating Ourselves

By Kathryn White

Mark caught the yellow plastic ball with his left hand, bounced it a few times against the floor of the court, held it out to serve, then paused a moment. He looked at me, “Who do I serve it to?”

I smiled. The question was familiar. I’d answered it half a dozen times in the last hour. “Either one, Mark. Either one.” 

An estimated three million Americans have been swept up into the pickleball craze, but in this quiet rec center in Lakewood, CO, you won’t experience the fast-paced frenzy that is typical in other pickleball settings. You’ll find a moderately paced game—punctuated by laughter and paddle bumps—played by an assortment of people living with Alzheimer’s disease, along with caregivers and friends. We’re playing a simplified version of the game born here in Colorado.

When Georgi and Mark moved to the Denver metro area half a dozen years ago, they signed up for pickleball lessons at their neighborhood rec center. Mark, despite his Alzheimer’s diagnosis, was able to pick up the game just fine alongside Georgi, and the two enjoyed the fitness and friendly competition. As time went on, though, it became difficult for Mark to keep track of the game’s rules and complicated serving and scoring system. Georgi wondered about simplifying the game. Could you leave out the cognitively complicated parts, and still retain the fun and fitness elements? Absolutely, said their instructor and pickleball ambassador, Chris Beal. Georgi and Chris set out to devise the simplified version you’ll now see in action at Whitlock Recreation Center in Lakewood.

During a recent session, it occurred to me we’re practicing more than pickleball at these weekly gatherings. We’re practicing patience and flexibility, and we’re working on accepting and responding positively to whatever comes our way. If a player loses track of the score, we don’t worry; an estimate will do. If a caregiver needs a break for a phone call, they haven’t broken a rule by walking right off the court; we can play with three until they come back. For someone who’s moving a little more slowly than usual (physically or cognitively!), the two-bounce “rule” easily expands to three. And we repeat ourselves.

When Mark asks who he should serve to, his brain is pulling an important memory fragment from a version of pickleball where it actually did matter. But the last thing he needs in that moment from me is a long explanation about why it used to matter and how it no longer does. The second-to-last thing Mark needs from me is a frustrated response that signals he’s forgotten something important or that I’m annoyed by something he’s said or done. I remind myself: smile, answer, keep the game moving.  If this were my son’s soccer game, the referee would be holding her arms out, palms up, saying, “Play on boys!”

I’ve noticed for caregivers with a newly diagnosed loved one this requirement to diplomatically repeat ourselves can be one of our biggest adjustments. It doesn’t feel right. The practice of circling back to the same answer to the same question—over and over and over again—yields a frustrated knee-jerk reaction. It runs contrary to everything we previously understood about social courtesy. If someone needs me to repeat myself, it means they weren’t listening, right? In conversations untouched by cognitive decline, this can mean the person hasn’t respected me enough to pay attention. How do we switch gears and accept this new requirement to diplomatically repeat ourselves when everything in our lives up to this point, and so many other interactions we have with people, doesn’t work this way? Caregivers bring a variation of this struggle to nearly every session of the support group I facilitate, and it comes up weekly at simplified pickleball.

But how, exactly, do we get from frustration to “Play on!” in those tense moments with loved ones? One answer came in a recent caregiver support group: most of what humans communicate comes across through our tone of voice, facial expression, and other body language. The words we say matter, but not nearly as much as we think. For me, this translates onto the pickleball court as 1) walking a little closer and making gentle eye contact, 2) using a friendly tone of voice, and 3) repeating the exact same answer I gave earlier, or perhaps replacing it with a simpler variation.

When my mom was still around, I came to think about this retraining process as learning to listen and respond in layers. What do I notice about her mood or tone of voice as she asks a question again? Is she disoriented or agitated? How can my body language convey reassurance and safety? As the disease progressed, and as I visited more often to give her husband respite, her most common questions revolved around where Dave, her husband, was. “Now, where’s Dave?” “We’ll see him after lunch, mom.” I’d hold her hand; she’d relax and smile.

The pickleball court has become a great training ground for putting this idea of a layered response into action. We’re having fun and the game is moving. A long explanation doesn’t fit here. I field Mark’s question trying to mirror in my response his own spirit in asking. Mark isn’t frustrated. He’s genuinely curious. In his world, he’s not repeating himself. Can that be my world too? It’s an easy question and I have the answer. Today it can be that simple.

Mark picked up the ball that had rolled out of bounds. He walked back toward Georgi, reaching out to hand her the ball.

“Your serve, Markie.”

“Oh, okay.” He held the ball up to serve, then paused for a moment. He looked at her, “Who do I serve it to?”

She smiled: the question was familiar. “Either side, Markie.” 

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