Trip to Kaisr

Atria wanted her to see her doctor because she is having more angry periods late in the afternoon and they were concerned that she might have a urinary tract infection.  I decided to make her a late morning appointment and then we would go to lunch (because they are also concerned that she is losing weight...she has lost 10 lbs since March).

Unlike our last trip to Kaiser, she was in relatively good spirits and kept up what was not exactly a lively conversation, but what passes for a conversation with her these days.  The only thing was that it was about 90% based on fantasy.  At the restaurant, for example, she wanted to know if her brother was going to be there and how she had not seen him in a long time.

She asked several times why she needed to see the doctor and each time I explained to her that they were concerned about some of the things she does when she's angry (she stole a walker and refused to give it back).  She insists she had never done those things because she doesn't remember them.

Sitting in the waiting room, while I was checking her in, she started talking to the man across the aisle from her, thinking he was her sister's husband and when I said something she asked if I was Barb.

The appointment went as expected -- other than listening to her heart, the doctor never touched her, my mother said everything's fine and we were told to let her know how the change in medication goes (fortunately, no labs were required this time).  At least the doctor agrees with me--Atria is worried because she is sleeping so much.  But she's 98 for Pete's sake!  It is of no concern to the doctor at all.

I took her to IHOP for lunch, because I knew she would eat something laden with calories (not, of course, because I wanted something rich and gooey).  We had the new Hawaiian rolls French toast, which I've been seeing advertised and which looked so good.  It also turned out to be the cheapest thing on the menu, if you didn't add any eggs or anything else with them.

It was one of those cases where things look a lot better than they taste.  I love Hawaiian rolls and thought how much better would they be slobbered with strawberries and topped with a big dollop of whipped cream. 

But they were a disappointment.  Regular ol' pancakes would have been better, IMO.  She did, however, eat the whole thing and so at least got a nice dose of fattening calories, which is good for her weight loss.

When they cleared away the plates, she put both her hands on the table and noticed that she was not wearing a ring--she usually wore two, but they have been gone for many months (I suspect Marge took them, but Marge is long gone now).  Then she picked up a spoon and said that at least she found one and told me to put it in my purse and take it to the car.  She wasn't convinced when I tried to explain that (a) it was not a ring and (b) if I took it, that would be stealing.

When the bill came, she insisted on paying, so I charged it to her credit card, though when I asked her if she wanted to sign the bill or if she wanted me to sign it she said "I don't know.  I wasn't even there."  So I signed it.

One of the things that dementia has done to her brain is that she is no longer able to follow something like "look at that pink car."  There was a pink car that was coming up to us as we stopped at stop sign and I pointed it out to her (there are so few things that I can say to her that I think she will understand).  I said "look at that pink car there" and pointed to the right.  She looked straight ahead and said "yeah."  I pointed out to her again that the car was on our right and was pulling ahead of us  She kept looking straight and never did see it.

On the ride down I tried to point out to her the famous "bird car" which I saw coming up on the right about a block ahead.

But she just can't process those directions fast enough and missed it.  On the way back, I drove down that street again, PARKED to take a photo and then, given sufficient time, she did finally see it, though was uninterested, so it was hardly worth it--except for me, getting the photo.

I dropped her back at Atria and she never looked back. I think before I got the car door closed, she had forgotten I was ever there. 

I have 2 days off now, since I don't go every day any more and Wednesday is her Alzheimers Buddy's day with her.  I'll be back on Thursday, when I have an appointment with the director of the memory unit to go over her "plan of treatment."  Whatever that means!

Honoring Mom

Ned was going to arrange things for a Mothers Day brunch with my mother, which is always difficult to do because of not knowing exactly when they are going to feed them lunch...and you can't call ahead to arrange things because if she actually answers the phone, by the time she hangs the phone up, she will have forgotten what you were calling about.

We got to Atria as she was finishing her lunch and we sat with her while she polished off a big strawberry dipped in some sort of pink frosting.

While we were sitting in the dining room, Tom called and he talked with me and with his grandmother, but his kids were busy with their other grandmother so I didn't get to talk with them.

Ned, who is one of the very good guys, had brought all the brunch food, so we took her out of the memory unit and down to a patio in the regular part of Atria, which she claimed never to have seen before.

There are some perks of dementia.  For one thing, you don't remember what your stomach has done and so though she had finished her lunch, she ate another one, which is fine because she hasn't been eating lately. . .

...and you get lots of points for giving her a card, which was brand new every time she picked it up to read it.

 It's also possible for someone with dementia to eat "just one" stuffed egg four different times!

We came home after brunch.  Ned had to get to work to help his friend Jon at the university's Whole Earth Festival and it was time for my after-brunch nap.  Sadly, while sleeping I missed a call from Jeri.

Walt offered to take me out to dinner, but Mothers Day is such a hard time to find a restaurant without a reservation, so I just planned to cook dinner here at home.

It was a quiet Mothers day but I felt loved and maybe my mother remembers that she is loved too.  If not maybe she'll find her card and read it again, for the first time.

Cloud of Pain

I don't remember the last time I had any sort of major pain.  I have been fortunate in that regard.  It probably was 2003, when I had my bike accident and dislocated my shoulder. But the thing I remember about that time is that when you are in that much pain, it's like you are living inside a cloud of pain, oblivious to everything around you. 

Looking at my mother today, that's all I could think of.  She was in this big cloud of pain and nothing outside the cloud registered with her.

Of course she was not wearing her splint.  They've taken to calling her "Houdini" for how quickly she can get out of it.

The wrist was much more swollen and discolored and every little thing that touched it, or came near it, caused her to cry out in pain.  I think if she could have taken a pill to end her life then and there she would have.

And of course she doesn't know why it hurts.  And she can't understand that the splint is to protect it so that she can't accidentally brush it against anything (she told me she didn't know anything about a splint and guessed she didn't have one).

I told one of the aids today that I have noticed a significant decline in her cognitive functioning recently and she agreed and said "sometimes it comes on suddenly."  At 98, that's not surprising.  I suspect that even after the wrist has healed, she will have taken another step down from which she probably won't recover.

Today was her appointment with the orthopedist and we had to check in an hour early so she could get an x-ray.  Of course I couldn't stay in the room with all the rays flying around, so I don't know how much the manipulation of her wrist to get four shots hurt her, but I suspect a lot.

Then back to ortho to wait for her to be called.  Her official appointment time was not until 2:50, so we had about 45 minutes to wait and after about 40 minutes, she had to go to the bathroom.  This was my first time with bathroom duty for her and getting the wheelchair into the ladies room was almost impossible and with her unable to understand such commands as "hold the bar while I move the wheelchair" made it even more difficult.  I finally got her to understand she should hold onto the metal bar while I moved the wheelchair out of the way, but then she couldn't understand that she had to lower her body to the toilet.  Trying to manipulate her I couldn't help at brush her wrist several times and each time she let out a mournful groan.

I suspect this is something I will get better at doing.

They finally called her back to a room and the certified physician's assistant came in. I have to admit I'd never met a medical person named "Sundance" before!  She was very sweet and very patient and said that it was a bad break, that they had aligned it well in the ER and that it had shifted a bit, with all the splint on/splint off-ing. 

Said that she couldn't put a cast on her herself, so she called the wonderful Arthur, who got her all decked out in a bright green cast.

She was already picking at it before he'd left the room, but he assures me that it is solid and she won't be able to remove it.

I'm not convinced and I'll be curious to see what I find when I check on her tomorrow.

We dropped her back at Atria and I decided to let the aid take her to her room.  She was totally lost and confused and didn't know why I was there and I told her I'd see her tomorrow. 

I came home to take my now-normal post-Atria nap.  Unless she tears the cast off between now and next week, she won't have to return to Ortho until next Friday.

I was back at Atria today and found her in the community room, no splint on. I got her back into her apartment and, with great pain, put her splint back on. The swelling in her wrist is worse, and it's more painful to try to slip the splint over her arm. I tried to impress upon her that it would not hurt if she would not keep taking the damn splint off! She said she understood and then, as I sat down, she started to remove it again. I know she can't remember and I just don't know what to do to help her.

I was back at Atria today and found her in the community room, no splint on.  I got her back into her apartment and, with great pain, put her splint back on.  The swelling in her wrist is worse, and it's more painful to try to slip the splint over her arm.  I tried to impress upon her that it would not hurt if she would not keep taking the damn splint off!  She said she understood and then, as I sat down, she started to remove it again.  I know she can't remember and I just don't know what to do to help her.

I don't know if the orthopedist is going to put her in a plaster cast (and don't know if she can remove that or not) but nobody can do anything until the swelling goes down...and it is more swollen and bruised now than it was 2 days ago.

I came home and, as usual, took a long post-Atria nap.  I seem to need that to come down after the frustration of visiting her these days.

This is how I ended yesterday's entry:

We finally got back to Atria and helped the aids get her settled in bed, though I will be interested to see how they found her this morning.

This is how I found her room.

And this is how I found her in the community room.

She was in pain and didn't understand why her arm hurt.  I've discovered that she not only has no short term memory, she also has selective hearing.  She doesn't want a broken wrist, so when you try to explain that her wrist is broken, she doesn't even hear you.

Since tomorrow is a holiday and it will be two days before Orthopedics will be open, I called the ER to find out what to do.  The Advice Nurse consulted with a doctor and said to bring her back to the ER.  And so instead of writing the article I was supposed to be writing, we were back at Atria and packing up a very reluctant mother to take her back to Kaiser.

We didn't have to wait TOO long in the cast room, but my mother was very irritated that people didn't come right away.  But we were there long enough for me to learn that my mother is really Adrian Monk (of the show Monk), who suffers from OCD.  It bothered her that the sheet on the gurney was untucked and she mentioned how much junk there was in the cast room.  (They think she may have fallen trying to pick something off the floor.  She is forever finding microscopic bits of something on the floor and leaning over the pick it up.  They keep warning her not to do that.  But of course she won't listen.)

The doctor and I talked about what we could do, since she can't have a plaster cast until the swelling goes down.  The doctor finally decided to try one of those splints that you have for carpal tunnel because even if she rips it off, it can easily be put back on again.

When we got that done, we drove back to Atria.  They had saved a plate of dinner for her and I sat with her for a bit (they brought her steak, a baked potato, and a roll, none of which she could eat with only one hand!).  I cut everything up for her and  then said I would be going home.  "Can't I go with you?" she asked.  When I told her that she lived at Atria, she was very frightened that I leave her alone in the place where she eats 3 meals a day because she didn't know anybody and didn't know what to do.  Walt and I ended up staying longer, but finally left and one of the aids promised to make sure she got back to her room all right.

Will she keep the splint on all night?  I don't have a clue.  But at least if/when she takes it off, it will be easy to put back on again.

Update:  They called me (and woke me up) at 6 a.m. to tell me she had removed the splint.  "Put it back on," I told them.

I was awakened by Walt poking me and holding out the telephone saying it was Kaiser calling.  It was about 11 p.m.

The doctor said that my mother had a fall and that she had broken -- I thought he said her rib, but it was actually her wrist.  The doctor said they would call when she was ready to go, but I knew she would be frightened, so we left right away and drove the 30 miles to the hospital.

My heart went out to her.  She was lying in the bed calling out, softly, "help me.  please help me."  She was happy to see me and the first thing she wanted me to do was to help her to sit up so she could help me.  But we wouldn't let her sit up because I thought she had a broken rib.  We had to fight to keep her down and explain to her over and over again where she was and why she was there.

The doctor finally came in with the supplies to put her in a cast while he sent Walt and me out to the waiting room, where we sat with barfing lady, a poor woman who had a barf bag and made horrible vomiting sounds every couple of minutes, as her bag slowly filled up.  It was lovely.  I was very happy when they finally took her into the back to examine her.

I was surprised to go back into the room and see my mother with a huge cast on her arm.  That's when I realized that she had broken her wrist.   

As I told Jeri this morning, my mother is a lovely woman who is very gracious and will do anything for anyone.  When she first saw me, she was scared in pain but the first thing she said was that she wanted to sit up so she could help me.  But when there is something wrong with her, she can be a real bitch.  She hates the look of the cast and the doctor said she had already torn it off once, so they had to strengthen it.  I had to keep her from trying to tear it off.  She still didn't know why she had to wear it or what had happened to her.

We finally got her into the car but first she complained of the cold, then of the discomfort of the car, and then the wait for Walt to pick up her meds at the pharmacy (many, many times), and all the while picking at the cast.  I got into the back sat with her to keep her from ripping at her cast.

We finally got back to Atria and helped the aids get her settled in bed, though I will be interested to see how they found her this morning.  It will probably take about six weeks for her to be in the cast.

I suspect it will be a long six weeks.

Sleeping Beauty

Another step down for my mother yesterday. I went to deliver Depends and bring her a box of chocolates. She was sleeping, so I just settled in and waited to see if she would wake up. When she did she was *totally* out of it, mumbling constantly but I couldn't understand anything she said. She went to the bathroom, then came back in, sat on the bed and mumbled some more, then climbed back into bed to go back to sleep. I somehow think she never really woke up at all.

When I could understand her mumbling, she was wondering where here sister Betsy was and where her mother was.  I think that she spends all of her waking time and dream time thinking of her family, whom she misses so much.

On the "good news" front, they found her glasses, which have been missing for a week.  They said they were "in her room," but nobody knows where.  I had searched the room pretty thoroughly, so I'm impressed that they found them.