Friday, November 24, 2006

Dead or Alive?

I entered my mother's room at about 4 pm for my daily visit.
Instead of sitting in her recliner as usual, she was lying on her side in her bed, under a blanket.
Odd, I thought. I've never found her before in her bed in the daytime.
"Mom, hi, I came to see you," I said, but she didn't respond.
That kind of nonresponse happens about once a week, when she is really out of it. Usually she opens her eyes when I arrive or at least says something without opening her eyes.
But this time she was absolutely silent and immobile.
I touched her cheek, and her face was cool. I started to panic.
Is she dead or alive? I couldn't see any movement of her chest with breathing.
I reached for her hand and took her pulse: thank goodness, there was a staccato bit of pulse, though not regular.
I thought about calling 911 but decided to ask one of the staff members to take her vitals first.
I rushed to find someone.
"Could you just take her vitals? She's nonresponsive, and I don't know if she's okay."
They did so, and everything was fine. Her pulse was 60 beats per minute; her blood pressure 145 over 84. Her temperature was 98.8.
But she was still immobile, lying in the bed in a fetal position, completely unresponsive.
"She must be completely exhausted from being out for six hours for Thanksgiving," I said. "Did she sit up for breakfast or lunch?"
They didn't know how she had been in the morning; she had sat at lunch but eaten very little. She hadn't had her 4 pm meds because the medication nurse hadn't been able to wake her enough to swallow the pills with applesauce.
"We thought we would just let her rest and not take her to dinner," they said.
"No, she has to get up," I said.
I pushed and pulled her up, into her wheelchair, and she mumbled a few protests. Good! At least she was communicating.
I got her to the toilet and wheeled her into the dining room, to her place at the table. We managed to get her to swallow two of her pills, but decided not to do the calcium or the evening Tylenols.
She wouldn't eat anything, but finally I got some French fries out of her refrigerator, left over from two days ago, and microwaved them. She ate ten or twelve of them, mechanically, with her eyes closed. She ate one bite of pumpkin pie.
I'd been planning to give her a shower, but there was no way. I just changed her to her nightgown and put her into her chair, asking the staff to put her to bed in an hour or so.
She was pretty much a vegetable.
This is how Lewy Body patients vary from day to day.
One day she can be alert and talkative, the next frightening close to no brain function at all.
It was a sleepy day like none I have ever seen before. Apparently her brain was exhausted, needing deep rest to recharge itself.

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