Sunday, May 06, 2007

Classic Lewy Body Dementia

A highly animated or agitated day, followed by a deeply sleepy day--that's classic Lewy Body Dementia.
Mom has these about once a week now. A year or two ago they were less frequent.
The other five days of the week she is pretty normal: talkative, perhaps napping a couple of hours in the morning or afternoon (or both) but able to wake up and eat her meals, to calm down and go to sleep at night.
I feel like a researcher, observing her from day to day.
I just wish I were as detached as a scientist. Instead, I get upset by her refusal to take her meds or by her insistence that someone is a killer, that the Filipino caregiver for the Scotsman John across the hall is a "bad boy" who steals her money and comes into her room at night with evil intentions.
Occasionally I succumb to the temptation to argue with her. The only thing more crazy than arguing with someone who's drunk is arguing with a person who has dementia.
Last night I realized that her agitation was probably going to be followed by a sleepy day when it would be pointless to take her to church.
Nevertheless, I got up today and went to pick her up and take her to church anyway. When a people are in a coma-like state, you just don't know how much of their surroundings they are perceiving. A bit of movement and stimulation probably can't hurt.
Sure enough, she was sitting in her wheelchair with her head dropped to one side, barely responding to my greeting, not opening her eyes.
The staff reported that she had been too sleepy to eat breakfast, her favorite meal. At least she had drunk orange juice and V-8.
I went to get her purse and sunhat, then wheeled her off to the car. Usually she holds onto the car door frame and supports her weight a little as I put her into the car, but today I had to lift her, all 105 pounds.
I didn't try to make conversation in the car because she was so out of it, but I did turn on classical music.
"Would you like any Acapulco nuts?" I then tried asking her.
"Yes, I would" she mumbled, so I opened the can of Planter's cashews and put it in her lap. She ate them as we drove.
Pistachio nuts are what she really likes, but she can never remember their name and asks for Acapulco nuts. Cashews are easier to find and soft like pistachios, so sometimes she has to make do with them. I don't give her peanuts or almonds or anything hard to chew.
"We'll go to church and then go to the store to buy a few things and then go to my house," I said
"Got to buy toilet paper," she said.
Wow! I would have forgotten, but she remembered that her bathroom was low on toilet paper and that yesterday we had agreed to buy more today. She was reminding me. I was impressed with what her brain could do even in this sleepy state.
When I got Mom out of the car, I found partly chewed cashews in her lips and front teeth, falling out of her mouth. I wiped her mouth.
In church she sat motionless in her wheelchair, not talking.
When I tried to press the offering envelope into her hand, she couldn't hold onto it or drop it in the offering plate, usually a high point of the service for her.
Unfortunately, it was Communion Sunday. I wasn't going to take her up, but I had to move her wheelchair so others could return to their seats after Communion. When I moved her to clear the aisle, however, she kind of woke up, so I decided to take her anyway.
At the altar I took a bit of bread, dipped it in grape juice and offered it to her, but she clamped her mouth shut at the first taste of it. It dropped into her lap, and I picked it up with a tissue.
0 for 2.
After church I did errands to a bookstore, the bank and Walgreen's. She slept peacefully, slouched to one side in the front seat.
Thinking perhaps I should just take her back to her residence and let her sleep in her recliner, I asked her, "Would you like to go to my house?"
"Yes, I want to go to your house," she said without opening her eyes.
Once there, she continued to sleep in the front seat while I unloaded the car, set the wheelchair next to the front seat and open door, and went to talk to neighbors for15 minutes.
Finally I took her into my house and set a cup of orange juice and a plate of grapes in front of her. She ate them with closed eyes.
I made her cinnamon toast, and she ate it too with a small glass of milk.
"I want one of those pears!" she suddenly demanded.
"They're bananas," I said. "Would you like one?"
"Yes, half of one," she said.
I brought both canned pears and half a banana, but then a close friend called. I talked for forty minutes with her while Mom sat slumped at the table, occasionally demanding to go home. She ate the banana but none of the pears.
"So you want to go back to Sunrise?" I asked her when the conversation ended.
"Yes, take me back!" she insisted.
I drove her back, took her to the toilet, and set her up in her recliner with her feet raised. In her lap I put the church bulletin and the funny section from today's LA Times. She never opened her eyes or mouth during any of this.
Then while I was tidying the room before leaving, she mumbled something. (On a sleepy day she doesn't talk clearly.)
"What did you say?" I asked.
"I want to go to your house," she said without opening her eyes.
"You were just at my house for three hours!" I reminded her.
"I want to go again," she said.
"I have to leave now to go cook dinner for John," I lied. "See you tomorrow."
I fled to a 5 pm Al-Anon meeting before the argument got any worse, determined not to engage in debate with dementia.

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