My mother succumbed to Alzheimer's at 89... now my siblings and I work toward understanding and prevention.
Wednesday, February 27, 2008
Not Getting Any Attention
When I arrived to visit Mom, she was sitting in her recliner in her nightgown, covered with blankets, her eyes closed. I always kneel on the floor and put my face in front of hers to talk with her.
"Hi, Mom! How are you?" I asked cheerily.
"Poorly!" she said, opening her eyes a little.
"Poorly? Why? What's been happening?"
"I'm not getting any attention," she snapped back, accusing me.
"Oh, I see. But Connie was here today. She took you downstairs to listen to the music," I argued.
"Yes, but I just want to see you."
"And you got a bag of popcorn to eat while you were there," I continued, having already had brief report from Connie.
"Yes."
"Well, I don't think you are doing so poorly," I said. "You look good to me."
After a bit more chat, I broke the news to her:
"I'm going to visit Ellen and check on her," I said. "In Connecticut, where she's in college again."
"So you're going to leave me," she commented.
"Yes, I will be gone for a week. But Connie and the others here will take good care of you," I continued.
I fussed over her, gave her some grapes, put some sugarless candy from the cupboard into her candy jar.
I wrote a check for a cash advance to Connie, so she can pay her property tax and not lose the home she bought a year ago with her husband, now unemployed. I'm paying her for the next 15 weeks. We did this on about December 1 too. She offered to visit Mom more often, because she needs the money, but I said no because Mom is running out of money. Her monthly income doesn't cover the cost of living at Sunrise. She needs an extra $2-3,000 per month from the money she has from selling her home in Boulder, but that amount is running low now.
I left typed notes with phone numbers and contact information to reach my sister and brothers on the door and in the offices of the Reminiscence Neighborhood and of the medical supervisor.
Then I left.
I will try to visit her tomorrow before leaving for the airport, but realisitically, I don't expect that to happen.
Tuesday, February 26, 2008
Can I Live With You?
Connie, the private caregiver, was with Mom, as she is on Tuesdays 2-10 pm and Wednesdays 5pm - 1 am. I greeted them both. Mom was sitting in her recliner watching the musical Annie on her television.
"How are you?" I began. "Did you have your dinner tonight?"
"Yes, but I'd like to come up to your house for supper," Mom said. "Can I do that? Can I take Connie and live with you? I don't like being here. I'd rather be with you."
Wham--all these demands, when I was doing a very brief visit and preparing to leave for a week to travel to the East coast.
"Well, Connie can't live at my house. She has a husband and two kids. She doesn't want to leave them," I began.
"But I could live with you," she continued.
"Well, I don't think that would work very well. I'd have to be there all the time to take care of you and cook three nice meals a day, like the ones they give you here. I couldn't take you to the bathroom all day and do your bath every night. I have to teach my classes," I tried to explain.
"Oh! Well, I guess you can't. Then I want to go to the Chapter House where my mother lived," she said.
"That's in Colorado, a long way from me. I'd have to move to Colorado, and I can't do that."
She pretty much accepted these realities, once reminded of them.
But her initial joy over her new plan--moving in with me--was so touching. I felt bad that actually I am planning to be away for a week... she will be abandoned, from her point of view.
Wednesday, February 20, 2008
In Search of Song
Hearing singing on the first floor at 4 pm, I rushed her down to hear it, but the 3 pm weekly program had just ended.
We got popcorn and the local newspaper and returned to her floor.
Then I helped her to walk 100 feet with her walker from her room to the dining area. She can still walk pretty well, but I stand with my hand on her back to make sure she doesn't lose her balance and fall backward. I pull the wheelchair behind me because sometimes she walks fifty feet or less and has to sit down.
For several months I wasn't making her walk--she walked only once a week or less with Connie. But now I am trying to make sure she continues to walk, so she won't forget how and so her turned in feet will straighten out a little.
I left by 5 pm, saying as I always do, "I'll see you tomorrow at 2 pm."
I used to say the actual time I expect to arrive--maybe 4 pm or 11 am--but now I always say "2 pm" and she feels secure in this.
Tuesday, February 19, 2008
Popcorn
Her residence has a popcorn machine in the lobby, and whenever she passes it, she demands some, though she often can't remember the word.
"I want some of that candy," she will say.
For a couple of years, she wasn't allowed to eat popcorn because her swallowing has become less competent; her potential for choking is great. But because she loves the popcorn so much, I gave in and started letting her have it again.
I think she'd rather die by asphyxiation from popcorn than never have it.
I came to visit her briefly even though her private caregiver, Connie, came today for 8 hrs.
I wheeled her down to the first floor, got her some popcorn, and wheeled her right back to her own floor, where I handed her into the care of Connie.
She was content with that, though at first as always she had demanded to be taken to my house.
I succeeded with my plan.
Monday, February 18, 2008
Knocking Things Over
"How's everything?" I asked a caregiver, cheerily.
"Well, okay... she did knock over her V-8," Claudia began.
"At the dinner table? On purpose?" I asked.
"Yes, we had to change the tablecloth, and then she poured out her water on the table too."
"Oh dear!" I said, thanking Claudia for her work in cleaning up the mess.
Another big protest by Mom, a display of her feelings of anger over having to be at this residence and not getting enough attention. It was a hook she has used before; on other days it has caused me to feel upset and embarrassed.
But this time it didn't bother me. It even seemed funny--and I knew it was only because I had arrived so determined not to be pulled into her drama that I still felt calm.
Options: scold her and tell her that I would not take her to my house today because she did that? Or ignore it and take her to my house as planned?
I decided that scolding and expecting her to remember or change her behavior would be craziness on my part.
I took her to my house and gave her the spaghetti dinner (from the freezer, the spaghetti with sauce from her favorite restaurant, The Blue Parrot Cafe in Louisville, near Boulder).
She enjoyed it, and I took her back.
All within the space of an hour, as planned.
Who's the Crazy One?
This is not a fun place to live, not a good stage of life to be in--almost 89 years old, approaching death--but I try to make her happy.
I think that my daily visits and the excursions on which I take her should make her content with her situation, along with the medications. She takes Zoloft for depression and Seroquel, an anti-anxiety med.
She's depressed and irritable, but I keep trying to fix everything for her.
I think, "If I do x, y, and z, she will be content and enjoy her remaining days."
Duh-- it's impossible. She's not going to be happy with her limited, repetitive daily cycle.
She's the sane one, depressed about it all. She's going to be unhappy and tell me about it.
I'm in denial, losing my sanity over trying to interact with her, take her out, cheer her up.
I need to accept reality and stop trying.
For my own sanity, I need to stay away from her or at least limit my time with her to one hour per day. These 5-6 hour excursions are killers. She says things that hook me into feeling bad for her, trying harder to spend time with her and take care of her.
But no matter what I do, she is still going to be gloomy about going back to Ocean View Assisted Living and being just another of the thirty crazy old people on her floor.
What she would really like is for me to take her into my home and spend 24 hours per day taking care of her: meals, bathroom trips, bathing, conversation, excursions, medical visits.
I can't do that, and even the amount of time I'm giving her right now is debilitating to my emotional state and my energy to carry out the other work of my life.
I don't know how people do it who are caring for an LBD parent or spouse in their own home, with or without help.
I do know that all of them sooner or later give up and place their family member in a care facility.
Comments on this subject by Melody Beattie in The Language of Letting Go (The Hazelden Foundation, 1990):
We can learn not to get hooked into unhealthy, self-defeating behaviors in relationships--behaviors such as caretaking, controlling, discounting ourselves, and believing lies.
We can learn to watch for and identify hooks, and choose not to allow ourselves to be hooked.
Often, people do things consciously or without thinking that pull us into a series of our self-defeating behaviors we call codependency. More often than not, these hooks can be almost deliberate, and the results predictable.
Sunday, February 17, 2008
"You Ditched Me"
I found her settled into her recliner in her room. Good! She was done with breakfast, though she looked a bit agitated. Someone had applied lipstick all around her mouth in a sloppy way--I would have to fix that before we left.
"Hi, Mom, it's Anne. Are you ready for church?" I asked, pushing the recliner's control to make her sit up and to transfer her to the wheelchair.
"You ditched me yesterday!" she hissed. "I was going to watch the news with you, how John is winning, but you never came." [Note: she still thinks he's running for President.]
"What?"
"I cried all night. Oh well, it doesn't matter now."
I was stunned and felt tears come to my eyes. Not only did she not remember that I had come yesterday, but she thought I had "ditched" her.
"Don't you remember that we went and got a Nestle's Crunch?" I reminded her. "I came to see you yesterday."
"Oh yes, I remember. But you left without saying goodbye. You ditched me."
I didn't even argue it, just moved her into the wheelchair.
"My back is bare!" she cried, so I adjusted her blouse and sweater to make sure her waist was still covered after the transfer.
"Here's your purse," I said numbly.
"I wish you'd let me have your purse. You have nicer purses."
"Me? You don't like my canvas bags."
"You went away and your never came back. I cried all night--I did!"
I didn't answer. All that time I had given her yesterday, apparently to naught.
"I forgive you now," she continued. "I thought we could all watch tv together, but I just saw it myself, down in the dungeon."
Okay, I told myself, that's hallucination, thinking some place here is a dungeon.
"You said you'd come back, that we could look at it together, how John was winning, but you never did. I cried myself to sleep."
By now we had completed the trip by two elevators to the basement parking garage, and I was lifting her into the car.
We drove silently and without much traffic to San Marino Community Church where a friend of mine, Karen Berns, was preaching today. I turned the classical music up high so there'd be something to listen to. I didn't feel like talking, and I needed to distract her from this track she was on.
We arrived early for the service, and Mom was cooperative during it, nodding her head to the left and right with the rhythm of the hymns being sung.
After the service Karen and her husband invited us to go out to lunch, but I declined. Mom is not patient with sitting in a restaurant; I wouldn't be able to enjoy it.
Instead I drove her to the Huntington Library, just a few blocks away, thinking it would brighten her day as well as mine to wheel through the gardens, maybe take a peek at the Ellesmere Chaucer manuscript.
The roses weren't blooming, but I pushed her wheelchair through groves of huge camellia bushes and trees.
"I want one of them," she said, so I picked up fallen blossoms as we walked; she had a lap full of various kinds: luscious magenta, striped pink and white, single-petal red with huge stamens.
We spent maybe an hour there until she demanded to go home and we started back. I got her a butter pecan ice cream cone and myself mint chocolate chip.
On the way back, traffic stopped: I forgot that people would be driving toward the beach on this holiday weekend. Though I left the freeway to take city streets, our driving time was still doubled; as we neared her residence it was almost 4 pm.
"Now let's go to your house," she said, unaware that her six hours with me today was the limit.
I sat there with my hands on the steering wheel unsure how to explain to her that she was returning to Ocean View Assisted Living.
"No, the sun is going down," I finally said. "It's time to go back to Ocean View."
She started to argue with me, but I put my hands over my ears as I drove. It was just too painful to listen to more demands. We drove into the parking garage.
"My back is bare," she screeched as I eased her from the front carseat into her wheelchair, but actually it wasn't bare. I had carefully pulled the blouse and sweater down before the movement. "I hate you!" I thought to myself. "You say this even when your back is covered and warm. Your demands never stop."
"I love you," she said to me as if she had read my negative thoughts. "Thank you for everything you do."
I didn't answer. Somehow the correct reply just would not come out of my mouth.
I arrived home at 4:15 pm and, just like Friday, required more than an hour of rest and reflection before feeling able to start any other task.
Spending six hours with her exhausts me.
~~~
I made three decisions:
1) I will not take her out of Santa Irena again. Not to Women-Church in Claremont next week, not anywhere.
2) She will stay on a narrow track: her residence, church, my house--well, maybe 2-3 more P.E.O. meetings before I pull that plug too. That's all she really wants: to be at my house or her residence or church. No use taking her to the Huntington when what she really wanted was to sit in my kitchen.
3) I will go on a diet for time spent with her, limiting it to one hour per day. I just can't handle these longer days.
Saturday, February 16, 2008
Traffic Jam
I was planning to attend a meeting of EEWC (see link: eewc.com) in Claremont starting at 4 pm, a drive that takes one hour on the 10 freeway on a Sunday morning or afternoon but two hours or more on a weekday afternoon if one leaves at 2 or 3 pm. At that time all the traffic is flowing east.
I planned on leaving at 2 pm, just in case, and visiting Mom from 1 pm to 2 pm before leaving. However, I didn't manage my morning activities well enough to get to Mom's residence by 1 pm.
At 2 pm I faced a choice: skip visiting Mom and make sure to be on time for the meeting at 4 pm, or visit Mom and trust that traffic on this Saturday afternoon would be about the same as on a Sunday: light.
Reason to skip the visit to Mom: yesterday I'd put six hours into her, so I could take today off.
Reason not to skip Mom: yesterday I'd been impatient with her about her refusal to take her meds, and she had cried. To make amends, I should visit her.
Guess which one I did.
When arrived, planning to spend just half an hour and leave at 2:45 pm, she was hysterical: "Thank goodness you came! I called you and told you I want to go to your house."
"We can go to my house, but we will go out and get some ice cream," I answered.
Then my favorite caregiver, Marnie, often in charge of the whole floor, told me she had been robbed at gunpoint two days earlier. I needed to listen to her story in all its frightening detail rather than rush out saying, "Later!"
Finally I took Mom out in the wheelchair to get a Nestle's Crunch and a banana. Then we returned and I left her in the dining area eating the treat.
"Bye--I'll see you tomorrow morning so we can go to church," I told her.
By now it was 3 pm, and I settled into the minivan for a pleasant hour-long drive with Prairie Home Companion on the radio and a Snapple iced tea to drink, travelling 70 mph. I was glad I had taken time for the visit.
But five minutes later traffic halted: there was an accident on the 10 freeway near the 5.
I decided to maneuver around it, taking the 110 to the 101 to the 10. Traffic flowed well for ten minutes but then it slowed to 30 mph and stayed there.
Frantically I switched to all the traffic reporting channels but no accident was happening ahead of me this time. I had to conclude the situation was normal--SNAFU.
For the next hour I maneuvered from the 10 to the 605 to the 210, hoping there'd be fewer cars and a speed of 60-70 mph, but it took me an hour and a half to get only as far as Azusa, still fifteen minutes away from Claremont.
I fumed and fretted: was this normal for a Saturday, as it is for weekdays? Or was the heavy traffic caused by the three-day weekend--people driving to Las Vegas or to Big Bear for skiing?
I was 45 minutes late to the meeting. An hour trip became an hour and three-quarters.
Now I really regretted having taken time to visit Mom. Once again, I had taken care of her by throwing my own commitments off.
But at least she knew I cared: I had not skipped a day.
Friday, February 15, 2008
A Perfect Storm
But that's what I do every two weeks. I started taking Mom two and a half years ago, then decided to join in order to keep taking her. It's her one outing besides going to church and going to my house, a vestige of her former life, seeing these P.E.O. sisters.
I'm a member, and she is, and I would take her to the 10 am meeting.
I delayed leaving the house, first typing up the slate of officers nominated for next year. Two meetings ago when they asked for volunteers for the nominating committee, Mom piped up, "I'll do it!" Everyone laughed, but then they said she was volunteering me. I wasn't clever enough to slip out of this trap.
~~~~~
I didn't arrive to Mom's floor until 9:40 am, hoping just to get her purse and wheel her to the car.
No such luck. She was still sitting at the breakfast table in front of a fresh plate of eggs and bacon, her two cups of orange juice and tomato juice untouched.
What I didn't know:
1) The floor was short-staffed today. The lead caregiver, Karen, was late going down to get the food cart from the kitchen because she had to wake and dress a few more residents than usual.
2) Mom had refused to get up at 8 am when Elisa, her caregiver, spoke to her. She had cried and said she didn't want to get up. Elisa didn't get her up until 9 am, then dressed her and took her to breakfast.
3) Mom had eaten her oatmeal but refused to take her meds. Ilse, the medicine person, had decided to try later. Karen had held off on giving Mom her eggs and bacon, waiting until she cooperated with her meds.
As various people were reporting these facts, I decided to take Mom and leave; at least she had had her oatmeal.
"I'm going to get your purse," I said.
But when I got back with the purse and the lighter wheelchair for car trips, Ilse said, "She's still refusing her meds." As if I were supposed to care.
I needed to leave, meds or no meds, but in the same way George Orwell found himself shooting an elephant, I found myself going along with the caregivers who expected me to enforce Mom having her morning meds.
"Mom, take your meds! Good! Now take the next ones," I urged.
"Don't spit them out," said Ilse.
"Mom! Okay, good, now let's move into this other wheelchair."
To Karen, I said, "Why isn't she ready to leave at 9:40? I asked J.R. to put in her chart for today 'No bus rides! She will be leaving at 9:30.'"
"I didn't see any note on her," Karen said.
When I picked Mom up to transfer her to the portable wheelchair, the entire black chiffon long skirt with liner she was wearing fell to her ankles.
"Is this skirt too big for her?" I asked.
"Yes," said Elisa. I'd set it out yesterday with a red sweater with inserted collar and cuffs to be worn to this meeting, but I hadn't thought about how loose the waist might be.
"Oh, I'm sorry," I said, wheeling her back to her room to get a safety pin. Why hadn't Elisa pinned it? Mom's clothes are my responsibility, though. She was 130 pounds three years ago; now she's down to 100, and she was probably 150 when she first wore this outfit. I'd bought some velcro and thread two months ago, intending to tighten the waists of all her skirts, but I'd been postponing this task.
By this time my patience was gone.
"You have to take your meds!" I yelled at her, pinning up the skirt. "You can't refuse them. We'll be late for the P.E.O. meeting."
"Don't be mean to me," she cried.
In silence I pushed her out to the elevator and to the car.
"Why are you mad at me?" she asked.
"Because you wouldn't take your meds," I answered.
"I did take them! They're lying," she cried. "They always say 'that old bag' and won't give me my meds."
~~~~~
When we arrived at the meeting, I put her into the wheelchair and opened and laid out the forty-pound ramp to get her up the entry steps.
She was still whimpering, and I thought she might not recover, but she still had her wits about her (well, some of them).
"Hi Evelyn, how are you?" asked Alva Mae.
"Fine, how are you?" she replied.
After devouring the fruit cup, the slice of coffee cake, the sausage, she fell asleep in the chair, quiet for most of the meeting until the Lord's Prayer.
I put the ramp back onto the steps, wheeled her out to the car, worked to get her into the car, then folded up the ramp and the wheelchair.
As we drove off, she said, "I'd like a Pepsi." We picked up a cheeseburger, milkshake, fries, and Pepsi from McDonalds.
I took her back to her floor, first toileting her. Off with the black skirt, on with some tan velour slacks. Off with the red Sas shoes, on with the black ankle-height ones for walking.
I took her back to the dining room and set her up with lunch.
Back in her room, I ransacked her closet for all the possibly loose-fitting skirts, tossing them in a heap, vowing to take time at home to tighten them with velcro.
I took the four pairs of dress shoes off the rack and hid them in a sack at the back of her closet.
I wrote a note to Laquetta, Queen of the Reminiscence Neighborhood, to have Mom's Individual Service Plan updated with these stipulations:
1) Get her up by 8 am--esp. on Sundays and Fridays when she is going out.
2) Make sure she is served breakfast by 8:30 am; otherwise she will have no appetite for lunch at 12 noon.
3) Use only the ankle-high black shoes.
4) Sundays she has to be ready to leave by 9:15 am. Some Fridays she has to be ready to leave by 9:30 am.
I left the note on LaQuetta's desk and fled to the car, feeling angry and upset about the whole morning.
~~~~~
At home by 2:15, I had planned to get to work at the computer immediately.
But instead I put away the forty-pound ramp in the garage, fed the dogs, and collapsed in frustration on my bed, unable to get up energy to do anything.
Sunday, February 10, 2008
Old Folks Say the Darndest Things
I had a big day planned for Mom: church as usual at 9:30 am, then a visit to my house where I planned to vacuum my floors and make waffles with strawberries and whipped cream on them. My sister-in-law Lee was planning to drive here from Malibu after church there with her five-year-old twin daughters, and I knew that Mom enjoys seeing the twins.
After church we wheeled to a market, bought the strawberries and whipped cream, and rushed home, where I vacuumed as she sat at the table eating grapes. Having been awake since 8 am or earlier, she tired of sitting in her wheel chair and fell asleep at the table, slouched in her chair. I kept cleaning and was just ready to start the waffles when she woke and said, "When are the twins coming?"
"I thought they'd be here by one o'clock, but they aren't here yet," I answered. "Are you tired of waiting?"
"Yes, I'm tired. I want to sit in my big chair," she said. "Just take me home. I want to go back."
I paused in my busy-ness and considered whether to convince her to stay so she could enjoy the fun or accept her desire just to take a nap. How soon would they come? Could I set her up to sleep in a chair in the living room and wait for them? Then I got a text message from John saying Lee wouldn't arrive until after 2 pm.
"Okay, I can take you back if you want to go," I concluded with disappointment. All my lovely plans down the drain—like a baby, she needed her nap on schedule and couldn't hang in there for another hour. Because I had given to Good Will the recliner I used to keep for her at our house, there was no convenient place for her to sleep. It would be an effort to get her onto a bed and then get her back up an hour later.
On the way home, she said, "I saw Reynold today. He's here… how about that!"
"Yes, how about that!" I answered. (He died in 2004.)
Back at her residence, I took her to the bathroom, then set her up in her recliner with a cheeseburger and fries and a milkshake because I hadn't really given her any lunch yet.
"Reynold came to see his little sister," she continued, and I reflected on the possibility that he might indeed have visited her.
After eating half the burger and fries, she started choking and coughed some of it back up.
"I'm choking to death!" she said. "I'm choking to death!"
"No, you're not dying," I countered. "You're okay. You just choked."
"I'm choking to death! It's awful to die."
"No, you're okay," I insisted. "You don't want the rest of this? Here, I'll extend your recliner. You can just take a little nap."
"Just take a nap to die," she repeated in a sing-song voice. "Just take a nap to die."
"No, you're not dying!"
"I never died before. It must be fun, don't you think?"
"Yes, maybe," I said, tucking a blanket around her and winding the back of a musical doll to sit on her lap.
"You are my sunshine, my only sunshine," the doll's bright notes began.
Mom started singing the song with it: "You are my sunshine, my only sunshine. You make me happy when skies are blue…."
Friday, February 08, 2008
Off the Hook
Evelyn Frances Eggebroten
Dear Prospective Juror:
Please be advised that a Judge of the US District Court has given the following direction with regard to your service as a juror:
After careful review and consideration it has been determined that you are EXCUSED, EXEMPT, or DISQUALIFIED from jury service. You need not report for jury duty.
If you have any questions, you can contact...
Very truly yours,
Gregory C. Langham, Clerk
by Joann Garcia, Jury Clerk
Friday, February 01, 2008
JURY DUTY!
Then on Jan. 15 they sent a threatening note (fine or imprisonment) because they did not get an answer back within ten days.
So now I have filled out the response form, and I will try to find some kind of proof of her mental disability to enclose with it.
Never mind that she is almost 89 and lives in California, which they might have figured out by mailing it to her address here.
Penalty: Failure to respond and/or non-appearance may lead the court to issue an order to the US Marshal to have you brought before a judge for an explanation as to your non-response and/or non-appearance. Any person who FAILS TO SHOW GOOD CAUSE for non-compliance with a summons may be fined and/or imprisoned.
Imagine the scene: Mom hauled into a Denver court to explain to the judge why she didn't report for jury duty.
I bet she'd tell the judge a pretty good story.
She'd love the attention--and especially the trip to Colorado for the first time since she was brought here in November 2003.
Tuesday, January 29, 2008
Poison Pimples
"Bumps on your chin?" I ask, feeling her chin. "I don't feel any bumps.
"Yes, they have poison in them," she says. "They're on my cheek too."
"The only bumps on your cheek are your cheek bones," I answer, feeling her cheek.
She's always rubbing her chin because the stubble of hair there irritates her. We just shaved it a couple of days ago, so I'm thinking this started with the scratchy hairs there.
"Yes, I think Emily gave me these bumps on my chin," she continues.
"We're going to the doctor, so you can tell him about them," I conclude.
"What are we going to do with the Russian baby?" she asks next.
"What Russian baby?" I ask.
"Roz came home with a Russian baby," she says.
"No, she didn't," I correct her. "Roz got a little dog, not a baby."
Roz does have young cousins in New York who were adopted four years ago from Russia. I wonder if this fact migrated from some storage place in Mom's brain and attached itself to the recent dog information.
After we enter Dr. Chen's office, Mom starts to tell him about her bumps, but now they are pimples and they are on her hands.
He gently examines her hands and says, "You don't need to worry about them. I don't think they will bother you tomorrow."
He doesn't say, "There are no bumps here!"
"They're on my legs too," Mom asserts, but again he reassures her.
"Your fingers are purple on this hand," he says, but I tell him we've already discussed that circulation problem with her geriatrician.
"There was a patient across the street from my mother who died of these bumps," Mom continues. "Her name was Cinderella... Paradise."
"What a lovely name," he ventures.
"Yes. You probably think I'm crazy," she says.
"How are things at Ocean View Assisted Living?" he asks.
"Very aggravating," she answers. "Everybody is teasing me because the door to my room wouldn't open."
I don't explain to him that when she wheels away from the table half-way through a meal and arrives back at her room, she finds the door locked because the staff does not want her to enter and try to get out of the wheelchair into her recliner or onto the toilet.
Somehow she next mentions her husband, Kermit, who died in 1993.
"He went to the Colorado School of Mines," she says. I don't say, "No, that was your brother Reynold."
"--and he got a bunch of gold and silver slates and carried them home--" I don't say, "No, that was your grandfather who was accused of highgrading."
"--to his parents, Mr. and Mrs. A.R. Gustafson. They died. They fell from that silver and gold, carrying it upstairs from that place--"
"Oh, they did," Dr. Chen murmurs.
"They thought he was down at the chocolate shop, and I thought, 'Oh, that's sweet.'"
"Yes, that's sweet," he repeats, smiling.
"And I went down there. He had these bumps and I thought I was going to die from these bumps," she continued.
I wondered how long this tale by free association could last, but then she did a quick self-assessment.
"You must think that sounds pretty silly," she said. "You must wonder how a well-bred woman could have a dream like that, but I did. Of course, they were--"
"Do you have a list of her meds?" he asked me.
"No, they haven't changed since you saw her a month ago," I reply.
"How is she doing?" he asks.
"She hasn't been violent with the staff in the last month," I begin. "At least no one has reported to me any scratching or hitting. But when I come in the late afternoon, she is often very upset and crying about something that is a complete hallucination, something from the past that isn't even anything that happened to her. Like one day she was crying, 'My mother lost her baby... Byron and Serena had to walk to get the doctor.' But this happened to her grandmother, and the child Serena who went to get help is her mother. She thinks these things happened to her, but it was before she was born, in 1899 or something. I just try to take her out to do something, distract her, and she forgets about it."
"You're right to redirect her with real activity in the present," he says. "I don't think it's a good idea to try to medicate her for this. Let's just keep her Seroquel at 25 mg once a day. And maybe this time you can come back in three months."
"Oh, good!" I say. These visits are so pointless--I'm delighted to come less often.
"But these pimples," Mom says, trying to regain the spotlight. "You think there's no reason to have them under a microscope and be seen...?
"No, I don't think so," he answers. "I don't see them."
"You don't see 'em? Well, they're there!" she retorts emphatically. "Why do they come? After a night alone, there they are again."
"Well, it's possible," he ventures. "But you don't need to worry about them."
"Positive? They're not positive? Okay, I won't worry.... I was a Navy nurse in World War II," she counters.
"Yes?" he answers.
"I worked very hard to get everybody in the catalog of US News & World Report. And they had these pimples."
"Oh, I see, " he says as I thank him and push her in her wheelchair out of the office.
We go to the lobby to get ice cream, as usual, for a treat. She has a Nestle's Crunch bar and I have an ice cream sandwich.
On the way home, she is reflective: "I guess I don't need to worry so much about these pimples because everybody dies of something."
Monday, January 28, 2008
Running Errands
Sunday, January 27, 2008
Queen of Hooks
But first I had read my Al-Anon day-by-day books for my daily guidance, along with five psalms and a chapter of the Bible.
Melody Beattie's advice for Jan. 26, in The Language of Letting Go, is as follows (in part):
We can learn not to get hooked into unhealthy, self-defeating behaviors in relationships--behaviors such as caretaking, controlling, discounting ourselves, and believing lies.
We can learn to watch for and identify hooks, and choose not to allow ourselves to be hooked.
Often people do things consciously or without thinking that pull us into a series of our self-defeating behaviors we call codependency....
Someone may stand before us and hint or sigh about a problem, knowing or hoping that hint or sigh will hook us into taking care of him or her. That is manipulation.
What are the words, the signs, the looks, the hints, the cues that hook us into a predictable and often self-defeating behavior?
What makes you feel sympathy? Guilt? Responsible for another?
Our strong point is that we care so much. Our weak point is that we often underestimate the people with whom we are dealing. They know what they're doing....
Today I will be aware of the hooks that snag me into the caretaking acts that leave me feeling victimized....
As a result of this reading, I set out hoping to notice any hooks that Mom set out for me and to avoid being hooked.
When I arrive, Elisa, Mom's morning caregiver five days per week, reports that although she got Mom up and dressed in time, the kitchen had not served her breakfast promptly; she had eaten only oatmeal and fruit, without the scrambled eggs and sausage she usually has as well. I speak to the lead caregiver and to Ilona in the kitchen about that, reminding them that Mom has fallen from 118 to 102 lbs. in the past year and that her best meal of the day is breakfast. She often refuses to eat lunch or dinner but always enjoys a full breakfast.
Then I scoot Mom off in the wheelchair, past the medicine giver on the second floor, who protests that we shouldn't leave without her meds. Ilse had arrived on time, 8:30 am, instead of early, and as a result had not yet gotten to Mom and her meds. Usually I stop (if caught) and wait while we go through the med rituals: a squirt of something in each nostril, drops in the eyes, and 5-6 pills taken slowly, reluctantly, with juice or applesauce. But this time I say, "No, we will be late for church if we stop."
It's sunny as we drive to church, and I hand Mom her sunglasses, but she's putting them on upside down; I manage to steer them correctly onto her nose while driving.
"Look at that cute cloud!" she comments. And sure enough, the Los Angeles sky holds dramatic puffs of cumulus for a change.
There's still a handicapped parking spot near the church, so we save time there and sail into our customary spot on the aisle in the left rear of the congregation. Other than some humming and whispering at inappropriate times, things go well.
Her favorite times are when she drops her envelope in the offering plate and when we recite the Lord's Prayer. For some reason she always recites one line wrong:
"Forgive us our debts, as we forgive those who debt against us"--and being out of sync with the congregation on that throws her off for a few lines, until she catches up with "the kingdom, and the power, and the glory forever, Amen." (A few years ago when I took her to the Episcopal Church, they always said, "Forgive us our sins, as we forgive those who sin against us" and I think she's trying to follow this pattern with debts.)
After church, we head for the handicapped restroom as usual, and after placing her on the toilet, I don't hear any liquid trickling, so I replace the Depend and start to pull it up quickly. There's a smell but I ignore it, hoping for the best.
Suddenly, however, I notice a fat length of BM on the toilet seat. Whoa! I check things out, clean up more just emerging, decide not to throw out the newly soiled new Depend, wish I had brought plastic gloves and wipes, hope there's not any on her skirt or my clothing.
Then we head to the church hall with a blood donation station set up, where I am scheduled to give blood this morning. First I give Mom tea with milk and sugar, as well as cookies, while I fill out the form. But they reject me: the iron level in my blood is only 12.2, instead of 12.5 or better, so I can't give blood today.
We leave church, but by now the cute cloud has multiplied and it's raining heavily. We get soaked while getting her into the car. She has been talking all morning about going to my house, but I realize that project is going to be difficult in this rain. Better cancel it, just do errands and take her back to her residence.
"Mom, this isn't a good day for you to go to my house," I begin. "We would get all wet again getting out of the car and going up the ramp to the front door."
"I don't care! I just want to go to your house," she argues. "It's been such a long time since I was at your house." Hook #1
"Mom, you were there Friday. Two days ago. Remember? You met Roz's new chihuahua."
"Yes, I remember, but I don't go there very often," she maintains. "And I just want to see Reynold."
"Reynold is not at my house," I say carefully. I do not say, "He died four years ago."
"Oh, he isn't? Oh."
"If you want to get soaked in this rain, we can try to get out of the car and go up into my house," I concede. "But it would not be a good idea."
"Sunny California!" she says.
"We have to have rain some time," I counter.
After a few moments, she says, "Okay, I guess I should go back to my place." And she begins singing, "California, here I come! Right back where I started from."
I sing along with her until she, suddenly perceptive, she accuses me, "You sound like you're happy that you don't have to take me to your house!" Hook #2
It's true. I had told myself that it rains so rarely in California that I should take advantage of this unusual reason not to have to load her in and out of the car, supply her with various snacks and foods for a hour.
But I do not succumb to her effort to hook me into sympathy, guilt, and the usual Sunday trip to my house.
"Would you like some French fries?" I ask. "Let's go to McDonald's, and we won't even have to get out of the car and get wet."
"Okay," she says. "But I have to go to your house to get the news. John always has the news." Hook #3
"We can stop and buy you a newspaper," I answer. "And we will do a couple of other errands too. I need to buy some dog food."
At Centinela Pet Feed, I tell her, "Here's your milk shake. I'll just be a minute to buy the dog food."
"Get me some celery!" she demands.
"There's no celery here," I answer. "This is just a pet store, not a grocery store."
"If you won't get me celery, then I'll eat dog food!" she whimpers. Hook #4 --poor me.
"You don't have to eat dog food," I answer. "You have French fries, a cheeseburger, a milkshake, and a doughnut."
The rain is letting up by the time we drive back to her residence, and I hope she doesn't notice. I'm really counting on saving an hour by taking her back now, at 12:30, instead of 1:30 or 2 pm.
Inside, it takes a while to clean her up in the bathroom, but at least I have plastic gloves and wipes. I set her up in her recliner with her milkshake and doughnut on her tray in front of her, but she says she's too tired, not interesting in eating any more. I start a DVD that happens to be in her television, about the birth of Jesus. Oh well.
I open her newspaper, throw away the ads, elevate her feet, read her a post-Christmas letter from her best friend, Janelle Krueger, formerly dean of nursing at the University of Arizona in Tucson. Well, it's a typed Christmas letter from Janelle's daughter Bunky, with a note in Bunky's hand, and a signature from Janelle as well as Bunky and her husband. Such is communication at age 89 if one has dementia.
There are a few more hooks as she attempts to delay me and keep me with her longer, but at 1:30 pm I finally escape out the locked door into the elevator lobby.
A caregiver, Stan, sees me leaving and says, "You look tired."
"I just did four hours with her," I say. "That's not much, compared to your hours, but it's enough to wipe me out. And I didn't have any gloves or wipes when she had a BM in the church bathroom."
Stan is instantly sympathetic and solicitous: "You should have them with you."
I stop to use the second floor bathroom, as I often do when leaving. My need to close a door and be alone and quiet for a few moments is overwhelming.
Sunday, January 20, 2008
Bougainvillea
But at church today, when I parked her in front of the flowers while I went to sign a list to donate blood next week, she said, "Oh, bougainvilleas!"
She learned this word last May, on Mothers Day, when Bill was visiting and we picked a couple branches of this flower for her at a church in Malibu.
For some reason, she still remembers it today.
Sunday, January 06, 2008
The Last Day of Christmas

It's January 6--Epiphany--and our Christmas tree is still up. I bring Mom to our house after church to enjoy the tree one last day.
"Tomorrow we're going to take it down and clean up this room," I say.
"No, don't take it down," she begs.
When I take her back to Ocean View Assisted Living, she notices that the pretty lights and decorations in the third-floor elevator lobby are gone.
"The Christmas lights are gone!" she says with disappointment. "They threw them away."
"No, they just packed them away in boxes until next year," I explain.
"Do you think I'll be around to see it then?" she asks.
I pause: this is a serious question.
"Well, we don't know, do we? But I think so--you're not sick. You don't have any illness like cancer or anything."
The conversation moves on.
Note on Jan. 27: She occasionally comments, weeks later when we enter that elevator lobby, "Oh, the lights are gone!"
Monday, December 31, 2007
New Year's Eve
Saturday, October 20, 2007
Pity Party
The wheel chair, the lack of memory, the incontinence I can deal with, cheerfully.
Today I brought her to my house; we ate pumpkin pie and played with the dog.
As I started to put the dishes away and prepared to take her back to the car, this was her comment:
"At least you came to see me. Maybe you'll come again some day."
"I come every day, Mom!" I said. "You don't believe that, do you?"
"I guess you do," she answered. "But it seems like such a long time before you come."
It's never enough.
Most days when I leave her, whether it has been an hour visit or a six-hour outing, she says, "You'll come back tonight and put me to bed, won't you?"
"No, I can't come back," I say. "I need to cook dinner for John." Or "I need to grade papers for my class."
"Oh, of course, you need to take care of John," she says, reluctantly recognizing that I have a few people in my life besides her.
I leave feeling miserable, unable to shake the feeling that no matter how much I do, it is not enough. She is voracious.
Saturday, September 15, 2007
My Most Embarrassing Day
Mom had been on stool softeners for several weeks, and I thought the problem of her constipation had been solved. Keeping the right balance of Sorbitol, prune juice, and various foods in her diet was tricky, though--too much vs. too little of one thing or another.
It might have worked out if she hadn't been given Colase.
There we were at the P.E.O. special event for B.I.L.s ("Boy I Love," my grandmother once explained to me, but in 2007 it is known as "Brothers in Love," partly because so few spouses are still alive). We had two B.I.L.s at this dinner.
We had just started to eat the catered Italian cuisine when Mom said, "We have to go now. I feel sick. I don't want to stay."
Fool that I am, I insisted on staying another 45 minutes until we had been there about an hour.
But I began noticing a bad odor. She needs to go to the bathroom, I realized. She may even have had a BM in her Depend.
Taking her to the bathroom in this home was not an option--it was too small to get the wheelchair inside, and there was no bar for her to hold onto while I removed her nylons and Depends.
The odor got worse. I got worried. Mom insisted on leaving.
The ladies were very polite.
Finally we made our excuses and left, wheeling to where I had parked the car.
As I helped her into the car, I realized the BM was outside the Depend--all over her skirt, the wheelchair, the seat of my car.
I drove back to Ocean View Assisted Living as fast as I could.
In the parking lot, I put a blanket in the wheelchair before moving her into it.
Up in her room, I peeled down the Depend and found a mess--all over her nylons, shoes, skirt, the floor. On my clothes too.
Marnie, a kind caregiver, had figured out that something was afoot as I wheeled Mom back to her room and insisted on helping me. She was a lifesaver.
Together we cleaned up Mom and the bathroom. Then I gave Mom a shower, put her in her nightgown, and left her in Marnie's care.
Hindsight: had I known the extent of her problem, I would have left the party immediately when she first asked to leave. Instead we stayed as the odor got worse and worse...
My brother Bill listened to this story and said, "Colase--I use it to have a colonoscopy. It cleans you out fast."
"I didn't know," I moaned.
From now on: no more Colase.