Wife's care for former Greensburg doc, Alzheimer's patient a 'labor of love'
The 90-year-old doctor lies on the wicker couch, covered with a white blanket, alone in the bright sun room.
His wife of 46 years walks in and gently places her hand on his nose.
“Your nose is so warm, boyfriend,” Aida Spino says, her cheek almost touching her husband's. She tells visitors: “If it's cold, I know I have to move him.”
Dr. Pascal Spino's eyes remain closed. He looks peaceful, surrounded by tall houseplants in this corner of his colonial home in Greensburg. The retired pediatrician who once cared for hundreds of children doesn't react to voices around him. Alzheimer's disease has shattered his once-brilliant mind.
As he slowly fades, his wife tends to him round-the-clock. Like an estimated 664,000 other caregivers across Pennsylvania who watch over people with Alzheimer's, Aida Spino has put her own life on hold. At 81, she believes she has a responsibility to care for the man who helped her rear four children and who put a roof over their heads.
“It's a labor of love,” Spino said.
Spino, a petite woman born in Guatemala, bathes her husband. She feeds him. She holds his hand. When she tires, she doesn't stop. She simply takes a shower to regain strength.
“It's almost like — how should I say it? — it's almost like a devotion that I have for him.”
Sibling's loss defines future
Pascal Spino grew up on Wood Street in Greensburg's Hilltop neighborhood, the son of Italian immigrants. The call to become a doctor came when a baby sister, Pascqualina, died as a result of complications of a virus, most likely influenza.
Spino's family was too poor to afford medication.
In his teenage years, he took a job cleaning the offices of a local doctor. He saw sick children and wondered what life would be like had his sister survived.
“Pat told me he didn't want to see more children die,” his wife said.
Spino went to college, earning his medical degree from the University of Maryland in 1947. The young physician completed an internship at Children's Hospital in Pittsburgh before establishing a private practice in Greensburg. He spent most of his days at work, said Aida Spino, who married him in 1966 and worked in the office on Maple Street.
Spino charged $3, perhaps $4, for patient visits. He kept a broom in the office and often swept the front entrance.
“You could call him any time, any day, and he would always be available,” said Annette Poole, 65, of Hunker, who took her sons, Jeff and John, to Spino's office. “He lived right above his office complex, and if you called him in the middle of the night, he would meet you in his pajamas, in his robe and his slippers. He always made you feel that your children were his only patient.”
Spino never hesitated to jump in his car in the middle of the night to drive to the home of a sick child. The parents inevitably would ask how much they owed for the after-hours call, and Spino often charged nothing extra or nothing at all, according to his wife.
“Promise me you'll buy them some shoes,” she said he'd tell the parents.
Spino was the pediatrician for the couple's children — Pascal, Gerome, Camille and Marco.
If any of his patients had to be hospitalized, he'd go see them in Children's Hospital, an hour away. It wasn't rare for him to ride along in the ambulance.
Spino sold his practice in 2006 and officially retired two years later, his wife said, showing off their home's den where Spino spent hours reading and reviewing patient records. Medical books, knickknacks and cards from grateful patients fill the bookcases.
A bout with the flu around the time he closed his office led to pneumonia and other complications. Afterward, his wife said, his health was never the same.
Aida Spino drove her husband to Oakland, where doctors at the University of Pittsburgh conducted a battery of tests. The evaluation required Spino to stay in the hospital. His wife, concerned about leaving him alone, slept in her car for two nights.
“He was afraid to let go of me,” she recalled.
Doctors eventually concluded that Spino had Alzheimer's disease.
From dapper to decline
Spino spends most days in the corner sunroom, where he can watch birds from large windows. His wife takes him for walks, talks to him and calls him “boyfriend,” “Patti,” or “Dr. Spino.”
Every two weeks, she takes him to get a haircut. She worries that if she doesn't feed him — yogurt, ice cream or his favorite blueberries — he won't eat.
During the past few months, Aida Spino said, she's noticed a decline in her husband's health.
His illness controls everything, she said.
Often, he calls her “sweetie.” He no longer says her name.
“As the days go by, you see the different stages of the disease, and you realize how bad things are,” she said. “You know what's so sad? He was always so dapper and putting on a suit. He wouldn't know the difference now.”
Alzheimer's experts say those changes are normal, because the illness has no timetable. Tasks that once appeared simple become difficult. The stigmas associated with Alzheimer's, coupled with lack of awareness about the disease, commonly prompt caregivers to isolate themselves, said Clayton Jacobs, vice president of programs and services for the Pennsylvania chapter of the Alzheimer's Association.
“When we see people we care about changing, the immediate reaction is to provide care,” Jacobs said. “So often, we hear spouses saying, ‘I don't want to burden anyone.'”
Aida Spino said her daughter wants her to consider placing her husband in a nursing home.
“I can't do that; this is my obligation,” she said. “When you love somebody who took so good care of you, you return the favor.”
On a corner table in the sun room, Aida Spino has placed two glass angels and figurines of Mary and Joseph. She believes angels watch over her husband. When death comes, she said, she wants to be holding his hand.
“I've made a deal with God,” she said. “Don't let him go when we're not together. I've been a good girl, so I just want him to give me enough life to take care of him.”
Luis Fábregas is a staff writer for Trib Total Media. He can be reached at 412-320-7998 or firstname.lastname@example.org.