Monday, October 16, 2006

From Heaven to Hell

"Get the hell out of here," Mom yelled at Bethlhem, who had come into her room to help Meselech take her to the bathroom.
Bethlhem is the sweetest person in the world. She has a deep Christian faith and her fiance is a missionary with Global Team. I can tell these words hurt her feelings, even though she knows the residents on this floor are mentally less than competent.
Both she and Meselech are from Ethiopia, working as caregivers with elderly persons who have dementia. Their job is to give care and take abuse patiently, no matter what.
Everyone's nerves are on edge today because of the death of Rosemond early in the morning, but of course Mom and the other residents have not been told about this.
"You're late!" Mom complains angrily when I arrive at 3:45 pm to visit her. "You said you'd come at 2 pm, but you didn't come until 4."
"Sorry, Mom," I say. "I was here in the morning, so I didn't come as early this afternoon."
"Tell these people to get out of here," she fumes. "I don't want them. I just want you to take me to the bathroom."
"Get out of here!" I tell them jokingly, with a smile on my face.
That's when they tell me what she had said a few minutes earlier.
"Mom, why did you say that to Bethlhem? You like her," I cry.
All those earlier reflections about transcendence, Bach, and praising God are now replaced by the grim reality of Mom abusing her patient caregivers. My heart aches for Bethlhem being told to go to hell. I love her at least as much as I love my mother.
"Maybe she thought you were a man, Bethlhem," suggests Meselech. "She kicks and fights any man who comes in here."
"Look at me, Evelyn," says Bethlhem, bending down to Mom with a smile. "Do I look like a man?"
"No," says Mom. "I guess I shouldn't have said that, but Anne was late coming here."
"Emily too said a bad man came into her room last night," smiles Meselech, referring to another resident.
"Well--" I begin, thinking that there's always the possibility of a real predator.
"No," says Meselech, reading my mind and confirming that Emily is another one who has dreams and delusions.
My discomfort is extreme because the real problem is racism. Mom has a recurrent dream that a "bad man" or "black man" comes to her room and harms her.
As far as I can tell, it started when she had a male Filipino physical therapist a year ago who teased her and prodded her to stand and walk and progress in her physical strength. She began referring to him as "that bad man," and then any man she saw became that man, if he had dark hair and skin.
In the hospital last month, she fought off a male attendant (African-American) and the two men trying to give her a CT scan; she kicked, bit, and scratched them.
Now back at Ocean View Assisted Living, she continues to rail at any dark-skinned man who says hello to her; she says he stole money out of her purse. She has hit and kicked the male caregivers.
This morning when I took her down to have her hair done, she was upset about this man again.
"That bad man came into my room again last night," she began.
"Oh dear," I commented, wondering how to shut her up.
"He hit me and did all kinds of terrible things to me!" she continued dramatically. "I was so scared I didn't dare yell for help." She didn't quite use the word rape, but the implication was clear.
"Mom, you go ahead and yell," I said. "Of course you should yell if someone comes and hurts you. But I think really it was a dream."
"No, it was not a dream!" she said angrily. Part of Lewy Body Dementia is the inability to distinguish between things that happen in dreams and in real life. When she wakes up, she is sure that the events of her dream really happened.
In the morning I just handed her off to the hairdresser, dreams and all.
But now I am sure that seeing Bethlhem triggered this "bad man" delusion in Mom's mind.
What a bad sign of her decline that now seeing either a man or a woman with short hair and dark skin can cause Mom to shriek and strike out.
Ten years ago she would never have said anything impolite to a dark-skinned person, but then she rarely encountered anyone but Caucasians, living in her home in Boulder, Colorado.
Now she and the other white people in their 80s and 90s on her floor are cared for mostly by new immigrants from places like Ethiopia and the Philippines. These old folks lived most of their 90 or so years during times when extreme racism was widely accepted. Their personal histories have not prepared them to be accepting of people regardless of ethnic background.
Whatever acceptance they learned late in life has now been erased by Alzheimer's or Lewy Body Dementia or vascular dementia. The thin veneer of acceptance is peeling away and the deep racism remains.
There is only one African-American on the floor, Verma, whose genteel southern manners are offended by any profanity uttered by residents like my mother.
I am stumped by how to handle this situation.
"Mom, you can't yell at people like that. You can't say 'Get the hell out of here,'" I tell her, but I'm pretty sure she won't be able to remember this tomorrow.
Perhaps I should just drop the subject with her, apologize to Bethlhem, and remind her that Mom is non compos mentis--crazy.
Nevertheless, there are relationships here. The caregivers interact all day long with the residents, each with their own personalities, abilities, and disabilities. There's a lot of affection on both sides, so a breach of this sort does hurt.
It's hard even for me when Mom says something mean. I try to remember that her brain doesn't work well, but discounting her words is counterintuitive.
Oh well, just another day in the life of the Reminiscence Neighborhood--good training for the rest of life's interactions, where harsh words boomerang about and much forgiveness is needed.

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