If It's Not One Thing, It's Your Mother

I went to Atria yesterday to let my mother know that Peach had died.  She was shocked because she hadn't remembered that she was sick.  We talked for a long time and I told her I would be over today for lunch.

There was no answer when I knocked on the door, which always scares me.  I let myself in with my key and she was lying on the couch.  I checked to make sure she was breathing and as I sat down to wait for her to wake up, her eyes opened and she groaned.  She was more out of it than I have ever seen her.

She wasn't in pain, she wasn't nauseous, but she was completely confused and very anxious.  She knew she had to be doing something, but she didn't know what.  She says this a lot, but it was worse than usual this time.  She told me she hadn't eaten.  At first she said she hadn't eaten in 3 days and then she said that she had not eaten since she moved into Atria and had not been in the dining room.  When I told her she had been there for 2-1/2 years, she was amazed.

I checked the refrigerator and saw that she had eaten half the piece of pumpkin pie I had left for her, so told her that she had eaten something, at least.

She told me about "the nice girl" who comes every day to find out if she has eaten and that she said she would bring food, but she doesn't know if she ever did.

I sat and listened for almost an hour as she told the same story over and over again about her confusion and about how she would wake up in the middle of the night, convincing herself that she had to keep from telling me any of her fears because it would bother me and she didn't want to be a bother.  Apparently her biggest fear was running out of clean underwear (she still has 4 pairs in her drawer)  

I definitely learned what it's like to be a therapist, as I just let her talk and talk and talk, though she was making no sense.  I had the feeling that what she really needed was some kind of anti-anxiety medication, and it made me angry yet again (I get angry about this a lot)  that no doctor has given her a baseline mental health exam, though I have asked each doctor who has seen her to do it, and she has no relationship with any doctor. 

Her primary care physician is mine and I chose her not because I thought she was such a wonderful doctor, but because I could e-mail her.  I have written here more than once about the difficulty ... impossibility ... of getting an e-mail account set up for my mother, which apparently even God can't do.  My doctor is a numbers person.  She keeps track of all of my numbers -- lab numbers, blood sugar numbers, heart numbers, but she has never asked me personal questions and is not a person I would turn to for a talk about something bothering me. But since I haven't needed more than that I haven't tried to find another doctor.  She's been my doctor for about 10 years.

I tried to contact the patient services person at Atria, but she won't be in until Tuesday.  I just wanted someone to TALK to to find out what was the best course for her.  Is it time to move to assisted living care level, where she stays in her apartment but someone comes in to check on her meds and make sure she gets to the dining room every day, and just be a daily predictable person she might come to rely on?  I don't know.

Then I came home and wrote to her doctor, who is out of the office until Monday, of course (I got a return message to that effect).

Of course all this is coming about at exactly the wrong week for me. I have four doctor appointments myself this week, three with the eye doctor (one of which is my cataract surgery on Friday) and another with an audiologist to get the process started for hearing aids.  I also have my first work day at Sutter on Monday.  And after my surgery, I'm not going to be able to drive until the doctor gives me clearance.  So even if the doctor thinks my mother should see someone -- her, or someone else  -- I may not be able to get her there.

At one point I told her that I thought maybe the severe deterioration in her dementia seemingly overnight might be a reaction to the news about Peach.  She didn't remember and was shocked all over again when I told her Peach died.

She finally calmed down enough that I could make sure she got to lunch and during lunch she improved a lot.  I also made sure she had a glass of wine, which I thought would relax her (and it did).  But when we got back to the apartment, she said she was dizzy and wanted to lie down.

I picked up her dirty undies and brought them home and will return them to her tomorrow.

I am very worried about her.

Suspicions confirmed

After I left Atria yesterday, I wondered if my mother was really sick or if it was an excuse to avoid a social gathering.  The last time she was nauseated was the day I was going to drive her to San Rafael for lunch with her friends to celebrate her birthday.

I posted a note on the dementia support group on Facebook and have found countless other people who express the same feeling, that their loved one always gets sick when a social occasion is approaching.

When Tom et al come up for Christmas to spend a couple of hours with her, I won't tell her.  I'll just let it be a surprise. No time to get anxious about it.

The Thanksgiving that Wasn't

Thanksgiving didn't happen the way we planned, but was very nice anyway but without my mother.

The plan had been to take dinner to her so we could have a family thanksgiving together in her apartment and she wouldn't have to leave Atria (which seems to scare her).  This was Ned's idea and better than mine, bringing her here to share Thanksgiving dinner with us.  Ned and Marta were bringing mashed potatoes, green beans and rolls; I was cooking the turkey and stuffing and making the pies.

My mother had never been particularly interested.  I had hoped the idea of having a family dinner would have pleased her, but she had been particularly blasé whenever I mentioned it, merely saying "well...whatever you want."

In the morning, hoping to help her remember that we were coming by in the afternoon, I brought the pumpkin pie, and a floral arrangement for the table.  I sat and talked with her and she said that she was feeling sick to her stomach.  Jeri called and we did a facetime chat and even that didn't help my mother.  She said she felt like vomiting.  It was obvious we needed to cancel our plans.  She said she was going to bed, and I left her lying on the couch looking miserable.  I will go over there today and see how she's doing.

Dodie

The visit with my mother was nothing out of the ordinary.  I finally remembered to break it to her that her friend died last week.  I wasn't sure how that would go and if she would have to be reinded of who Dodie was, but she didn't need reminding and was shocked and saddened.  I told her I had no information on the cause of her death and she said, somewhat wistfully "maybe someone will call me," so I let her other friend know that it was OK to call.  I couldn't guarantee that it wouldn't be like breaking the news all over again, but her friends were concerned about the effect of telling her over the phone and I think that will be OK now.

She's developed a new "thing" -- reading her watch.  She can be at times obsessive about it and seems to have trouble each time trying to figure out what time it is.  She obviously doesn't need a watch, since she has no place to be, but having it on her wrist is important to her.

The weather continues to be a big topic of conversation.  Today she asked the usual question "is it hot outside?"  I told her that no, in fact it was cold (about 59).  After that each time she looked outside she would tell me that the sky was so blue but somehow it looked cold.

I've read some new things about Alzheimers / Dementia in the last week.  One was a list of ways to tell if a person has dementia or Alzheimers and with I think one exception, it described my mother to a T.  The other was a book written for caregivers (as in people in an assisted living facility who care for dementia patients) about how to enrich their lives, how to handle difficult situations, etc.  So much of the situations discussed sounded so familiar.  I sure wish I could get her doctor to do a baseline, but that would involve getting her to a doctor and that's not likely to happen until her required annual physical since it takes an act of God (literally) to get her to agree to see a doctor.  But next time I'll try being more insistent.

Back to Normal

First visit with my mother following our cruise.  I took a selection of post cards to tell her about the trip, figuring that eventually I will make a selection of the best photos to show her.  She didn't seem to remember I had been gone when she opened the door, but then she did and, of course, it took many retellings but that was OK.  We had things to talk about.  And she laughed a lot when I told her about Walt getting left in the bathroom of the bus.

But the best part was going to lunch.  Robert joined us.  He is a regular at her normal table but came in late today, as did we, so we were at a different table.  Her whole demeanor changed when he arrived.  She was back in flirty mode again.  She has always needed a man in her life to flirt with. The two of them are good for each other, he can't hear much and both of them have dementia, so they speak the same language.  Robert's dementia was particularly bad today but somehow they were able to enjoy a conversation. I was amazed that she greeted him by name.  I didn't know she knew ANYONE at Atria by name.

While they were chatting, I was talking with Carol, a woman I hadn't met before, but who has been there not quite a year and says that "Mildred is my favorite person here."

Loretta came in while we were lunching. Carol told me I should see Loretta and my mother trading barbs when they are together.  I told her that I had and that they were even better when they had a little wine with their meal.  Loretta is starting to get that 'Atria look' that all the older people with dementia seem to get (my mother included) where they have completely lost interest in their appearance.  In addition to wandering around looking for a friend to eat with, I noticed that she had not brushed her hair and her clothes were "askew."  My mother is frequently like that when we go to eat.  It seems a good way to tell the ones with dementia from the ones without is to check their hair.  Robert's normally well coiffed white hair stood up in back like Alfalfa's.

But all in all it was a good visit.  I dreaded getting back into the Atria routine, but it wasn't at all depressing, and she desperately needed underwear washed.  I don't know what she did in my absence.  She had told me she would wash things by hand, but doesn't remember now whether she did or not.