One of the clearest places to see the progression of my husband’s early-onset Alzheimer’s disease is in his ability to take care of himself.

In the beginning of his dementia journey, Tony had no problem in taking off his clothes, taking a shower, picking out what he was going to wear for the day, and putting those clothes on.

Although we don’t think about it too much because it becomes so automatic, this process really is a series of decisions that must be made. It requires what is known as executive function in our brains.

The Cleveland Clinic defines “executive function” as the skills that we use to manage everyday tasks such as making plans, solving problems and adapting to new situations. It combines three main skills: working memory, cognitive flexibility and inhibition control.

When Tony was diagnosed with Alzheimer’s disease, his executive functioning had already begun to slip, but it was still able to help him with everyday tasks.

As his disease has progressed, I’ve had to step in to help Tony when he runs into problems.

Initially, it was picking out his outfits and making sure he had everything he needed to get ready. Then it was supervising as he got dressed to make sure he didn’t get frustrated or skip a step.

Then it was helping him with his showering. This is also where things started getting challenging.

Somewhere along the line, and I’m not sure exactly when it happened, Tony became more difficult to deal with when we were doing this daily routine.

We used to have a set way of doing things, and I was careful to be consistent with the cues I gave him when it was time to take off certain articles of clothing.

Sadly, Tony often got belligerent and would do things like take his T-shirt off and then smack me repeatedly with it. At first, I thought he was kidding around, and he might have been. But then it started to be neither loving nor playful.

He’d also do things like back me up and shove me into the sink. Ouch. I’d do my best to stay calm, but sometimes that was impossible to do.

During the worst of it, I’d wind up with fingerprint bruises up and down my arms where Tony would grab me and squeeze as hard as he could.

This wasn’t a sustainable situation, and when I had to have breast cancer surgery for the second time in 2024, I knew that I wasn’t going to be able to handle that and Tony’s care.

That’s when I was able to get some help. Our friend Andre, who also happens to work for a caregiving agency, stepped in to help.

I gladly gave up that duty, and Tony had someone else to get angry with each morning. Andre got the same responses, but he’s a lot bigger than I am and better able to handle them.

Then we discovered that the reason Tony had been so hostile was that he was in pain. The addition of pain medication made a huge difference. I wish I had thought of that sooner. (That suggestion came from Tony’s dementia doctor through the Medicare GUIDE program.)

Showering still isn’t Tony’s favorite activity, but even with Andre he’s become less aggressive.

Still, when Andre came down with a nasty virus right after Thanksgiving, I was terrified. I haven’t had to bathe Tony for more than a year.

Imagine my surprise and relief when Tony let me give him sponge baths each morning. I wasn’t about to try the shower again. True, he still isn’t super happy about taking off his T-shirt, but at least now he isn’t trying to beat me with it.

Since I’m sure he doesn’t remember our previous experiences, we’ve had to come up with some new cues to get things done. We’re a work in progress, but he hasn’t once pushed me, and once he figures out what I’m doing, he’s been impressively compliant.

That said, he does babble the entire time, and it sure does sound like he’s telling me off for putting him through all of it, but I just reassure him in a calm voice that I understand and that we’re going to be OK. I say this to reassure myself, too.

Despite all my fear, we really have been OK. Now we just need Andre to get better.

• Joan Oliver is the former Northwest Herald assistant news editor. She has been associated with the Northwest Herald since 1990. She can be reached at jolivercolumn@gmail.com.