Monday, October 24, 2005

The Steep Decline

"There will be a steep decline," said Claudia K., the neuropsychologist who has analyzed Mom's dementia for a year and a half.
"With Alzheimer's Disease there's a slow steady decline like this," she said, drawing a line inclined down at a 45-degree angle. "But with Lewy Body people tend to stay on a plateau for a long time and then go into a sharp decline."
Since that pronouncement a year ago, we've been on the lookout for this sharp decline. There have been serious medical crises--the broken hip, the allergic reaction and swollen tongue, the pulmonary embolism and pacemaker implantation. But Mom has made amazing come-backs from each of these hospitalizations.
Another factor making it difficult to notice a decline is her fluctuation in mental acuity from day to day. One day she is sleepy and can barely talk; the next day she's agitated and very talkative, reporting vivid dreams; the next day she's normal.
Today, however, I was stunned by her condition when I arrived at 3:15 pm. Perhaps because I've been out of town, I was unprepared for what bad shape she was in. I saw the steep decline.
She was nearly asleep in her recliner, snuggled in the flowered velour blanket, with the curtains closed and the lights out, but she quickly talked to me when I arrived. "Oh, is tha' you, Anne? Than' goo'ness you're here."
Her words were slurred together; her eyes opened but closed again.
"Yes, I'm here. Would you like to go out and get some French fries or an ice cream cone?"
I had a few errands to run, and I thought I would take her with me as I drove about town. I had imagined stopping by and immediately leaving with her. No way. I sat down in a chair opposite her and stared: her eyes were closing again, and she was slumped to one side, not sitting straight forward in the recliner.
"I see you're sleepy. Oh, you got your hair done this morning--you must be tired from that."
"Yes... was exhausting. The girl too' forever, washing my hair, rinsing, pu'ing i' on rollers, pu'ing me unner a hairdryer."
I decided to take Mom out anyway, mainly because I needed to make a deposit at my credit union. We started with a trip to the bathroom; then she demanded her "Kuhner's," which I finally succeeded in interpreting as V-8 juice.
She held up amazingly well while going to the dry cleaners, a gas station, and two banks--as well as polishing off a butter pecan ice cream cone. The hardest part was transferring her 120 lbs. from the toilet to her cheelchair or vice versa.
After she was out in the car riding around, while managing the drips from the ice cream cone, she seemed okay. Her speech was not slurred. The steep decline seemed to be a thing of the past--except that I noticed my own shoulder muscles were sore from lifting her. I was exhausted.
Speaking of a steep decline...

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