Virtual-Doug

The Home

Its her “house.”  I spend a fairly decent chunk of my time there every day, so I thought I would share a few photos I have been taking at the nursing home where my mother lives.  Many, but not all, of the other residents also have Alzheimer’s (or at least some form of dementia).

Back on the 4th of July, the staff decided to serve watermelon to the residents.  As the activities director carried in each watermelon, she stopped at this gentleman’s wheel chair to get his “approval.”  He was once a successful farmer.  He often comes out to the lobby area to look out the large glass windows and watch the world go by.  The day I took the photo, he saw me aim the camera towards him, and he never changed his expression – not even one little bit.  When I showed him his own image on the LCD of my camera, he never changed his expression.

(As always, be sure to click on each photo to see a larger version.)

I often process the nursing home photos in black and white.  The starkness of B&W suits dementia well – it doesn’t make the disease look good.  But, not everything in the home is stark.  Sometimes I am struck by the warmth and love I see.  In this photo, the wife is the resident.  Her husband comes every single day, and spends hours there with her.  I usually see him pushing her wheelchair as they tour the parking lot.  On this occasion, he “helps” her with her coloring.  A long time ago, this man said “In sickness and in health . . .” and he took that vow very seriously.  Color suites this photograph – it is one of love and caring and sharing.

I’ve watched this lady being fed by the staff on a number of occasions.  She is always in her wheelchair, and though she may talk, I have never heard her.  Sadly, I’ve never seen visitors either.  I wonder who put her in the nursing home – I wonder if she ever had a joyful time in her life.  I wonder what is in store for her.  I wonder if she wonders.

One of the best known stories from the Bible is about Ruth and Naomi.  Ruth was Naomi’s daughter-in-law.  When both women lost their husbands, Ruth pledged to stay with the older woman – “Whither thou goest . . “  And that is how I see the Mystery Guest Blogger and Mom.  My mother may not always be able to remember names and facts anymore, but she knows what love is – and she responds.

This photo definitely should be in color.

Blessings

I’ll call him “Jim”, both because that’s his name and because there are so many Jims in the world that I can protect his privacy even if I post his real name.  Jim is an old college friend.  We were good friends – doing all the good things college buddies do, such as finding places in the next county where we could do our under-aged drinking, double dating, and generally screwing around.  As is usually the case, we drifted apart – I went into the Army and he joined the Coast Guard.  Towards the end of time the Mystery Guest Blogger and I lived in Việt Nam, Jim found me.  After finding this blog, and putting a few other facts together, he emailed me to be sure he had truly found me.

We still haven’t seen each other face-to face since my return from Huê, but we swap many an email and the occasional phone call.  You see, Jim is a blessing.

I have written about my mother’s Alzheimer’s on this blog on numerous occasions.  Jim has been a very real and true help in all this – because he has a lot of experience with dementia.  I mean a lot of experience.  Jim’s mother suffers from dementia, but also Jim’s wife has early onset Alzheimer’s.

Yikes!

Each week, I send out something called “The Mommy Report” to family and friends.  I detail what I’ve observed in my mother during the past week.  Last week, I wrote this:

“For some reason, all his week she has been really pounding me with the same question:  “When am I going to get out of here?”  On one hand, I know there is no reasoning with her, yet I find I cannot resist asking “Where would you go, Mom?”  She only mumbles some variation of “I don’t know – anywhere but here.”  I realize this is her emotions asking the question, not logic.  It is tied in with the statement she often makes that “nobody comes to see me here.”  She means that none of her old friends come to see her.  Something in her inner self still wants to connect to the memories, yet she now lacks the threads in her mind to do that.”

Its one thing to read what experts on the disease say, but it has far more impact when somebody you know who is also going through trials writes about it.  Jim’s reply:

This paragraph is very a very accurate description of people suffering from dementia and I have seen it in my wife and mother.  My wife will sometimes ask me "when am I going to take her home" when she is sitting in her own living room that has been her own living room for twenty years.  I too believe it has more to do with disconnected memories than physical location.  Its sad to watch but a classic symptom.  Gets worse at the end of the day when she is "sundowning" (the actual name of a symptom).  And you are right that it is the emotions asking the question not logic.

At the other end of the friendship spectrum is the wisdom of someone I have just gotten to know.  He’s a regular reader of this silly blog.  Though he lives in the western United States, he is Vietnamese.  We had a chance to meet face to face in April during our trip to Huê.  I’ll call him Sam.

Back on July 1st, as part of a post about my mother, I wrote:

But - - true confessions - - -  I do find myself a bit depressed on occasion . . .
Maybe – just maybe – its because I have seen my own future, and I don’t like it.

Sam wrote back to me:

The last sentence could be as well as mine and billion of others’ confession too, since it’s the utmost truth of our being as a human. For some reason, I’ve felt long time ago, that it’s God’s call for me to console and comfort the living, especially the elderly, to prepare for them the next journey of their spiritual eternal life.  Of course, you’re just a few years older than I am, so anh Doug is not the “elderly” yet, that title is belongs to our parents, but as anh Doug’ve said “have seen my own future”  and so do I. Even Jesus was shaken in the garden before his  death and prayed to our Father to take the bitter cup (of death) away, but still - he carried out the  Father’s will. Each time I read this, it gave me more strength and full of love.

Finally, there is this blessing – from my mother.  In the past few weeks, I have discovered she likes to “rough house.”  You know what I mean – the kind of things kids do when they’re bored.  They poke at each other, swatting away just to break the monotony.  From what I understand, as the mind dwindles, the soul likes physical touching.

And so this blessing – my mother in unreserved laughter as we rough house.

Thanx to the MGB for the photo.

Chow Time

My mother has an excellent appetite – so much so that I tease her about being hungry all the time.  However, I did wonder if her Alzheimer’s might inhibit her ability to feed herself.  During some of the darker times in the recent past, she couldn’t distinguish a knife from a fork.  Recently, I arrived at the nursing home at lunch time.  I stood behind her for awhile – she didn’t know I was there until I made my presence known.

I watched as the Certified Nursing Assistant served her lunch.  Mom scolded the aide for cutting her meat with a curt “I’ll cut it myself.”  And – sure enough, she did.  I have an idea this has happened before as the aide didn’t bat an eye, but I also noticed the aide cast a glance towards Mom as she cut her meat.

(As always, click on each photo to see a larger version.)

I think the bib is a fairly new thing – I had noticed food stains on her clothes before, and I assume the staff thought it was time for a bib.  She not only doesn’t resist the bib, but when it fell down off her shoulders, asked me to put it back on her.  She did a good job of  polishing off most of the Swiss steak (with mushroom gravy), scalloped potatoes, and spinach, then enjoyed her dessert of banana pudding. 

The dining room is a wholesome place.  Mom sits at the same table for every meal – not because the staff seats her there but because that’s where she is used to going.  She walks to every meal herself with only a reminder from a staff member.  There is some social interaction at the table with some of the other residents, but its not what most of us would call “stimulating conversation.”  The lady you see in the center of this picture if Mom’s roommate, though I doubt either know each other’s name.  The roommate is still very upset that there is somebody else in “her” house.

I visited at lunch time another time too.  It was hard to stifle a giggle listening to her long and loud complaint that she has “been here for hours.”  She just clucked away as if her time was being robbed by inefficient people who were causing her to be late for a meeting to decide the fate of the world.

But, the dear reader will also understand I didn’t have the courage to differ with her.  She is, after all, Mom.

The Birthday Girl

She turned 91 Sunday.  I had mentioned it to her all week long, and I think there was an element of anticipation in her.  She was looking forward to something, even if she didn’t know exactly what was so special.  It was only a matter of a few months ago that she told everybody she was 100, yet today the concept of “birthday” and “age 91” is a bit difficult to grasp.

When the Mystery Guest Blogger and I came in the front door of the nursing home, one of the staff members told us there had been a mini-celebration of her birthday as part of the residents’ daily activities, but Mom was expecting more.  We were “more” I suppose, and that is good.

Its not a birthday without flowers, presents, and cake.  We brought the whole shebang in with us – even sang “Happy Birthday” to her, and she was all smiles.  Frankly, she was at the sharpest I had seen her in a long time.  She wolfed down a large portion of rich chocolate cake – and smiled when we teased her about spoiling her appetite for dinner.

(As always, be sure to click on the photos to see a larger version.) 

Like a kid, she dove into opening her presents, but some things don’t change.  I remember as a kid that she would chide me to be careful opening presents to be sure I didn’t tear the paper, then she would fold it neatly so she could use it again.  She isn’t quite that neat today, but she still folded the wrapping paper after the gift was opened.  She “oooohd” and “ahhhhd” appropriately as she examined her new treasures, just as she loved the flowers her daughter sent. 

Some days Mom can read, and other days she can’t – that seems to be related to whether she is having a good day or a bad day.  Today was a good day as she read the cards that had been mailed to her.  The MGB and I brought only a few gifts and cards for her – the rest came from her other children.

But the capper was her chance to talk to each of her kids.  She did well – her mind was sharp and she talked easily, though I did  a little prompting before each call so she could remember her children’s names.  But once she had the name in her mind, she did very well from there.

In case you are wondering why she is in bed, that just seems to be the place she prefers.  Its not that she in “in” bed – she is there usually fully clothed with no covers on, watching television.  There are two chairs in her room (including the rocking chair from her home), but she prefers the bed.  She enjoys looking out the front window, watching people come in and out of the building.

At other times, I have written about the sadness associated with Alzheimer’s.  Her birthday was an oasis of fun in the middle of all the sadness.  Happy birthday, Mom.

The Mom Report

Its been a month since my last Mom Report.  On May 27th, she had just moved to a new nursing home and the changes were rough for her.  Things seem to have settled down a bit – but that only means the disease continues to progress.

I visit almost every day.  There is no doubt she enjoys the visits – and yes, she knows who I am even if she doesn’t always remember my name.  Deep inside, she knows I am her son, that I love her, and that she is cared for.  If she can’t quite fill in the details, so what?

There is a stark simplicity to the visits.  In a strange way, I have grown used to the simplicity and even grown to embrace it.  I don’t have to try and come up with some new and brilliant conversation starter – I can talk about the same things each day.  Most visits consist of entering her room, encouraging her to go for a walk, sitting in the lobby watching people come and go, acting silly while we swat each others hands, then a goodbye, during which I call her a “little short thing”, and she laughs.  Simple.  Easy.

I’ve spent a goodly part of my adult life resisting being categorized.  I’ve resisted being categorized as a “typical” Vietnam veteran, meaning someone who is rather pathetic and a loser.  I’ve resisted the stereotype of being a police officer as being a brute who loves to intimidate others.  I’ve resisted the stereotype of a Christian being a Bible thumper.  The categorization I am resisting now is that of being the “typical” adult child of an Alzheimer’s victim.

Of course, I’m not really sure I know what that stereotype is.   Generally, it seems as though I am supposed to be an emotional basket case – maybe wracked with guilt at having warehoused my mother in a nursing home.  Our local daily newspaper did a story  on the topic (in fact, they wrote the story at the very same nursing home my mother is in).  The two adult children interviewed for the story speak about the difficulty in making the decision to put a parent in a home.  But, I feel no such guilt.

I just don’t.  I didn’t work at it, nor do I think I am denying it.  I just don’t feel guilty.  Nor do I mean to say that other people shouldn’t feel guilty.  I don’t.

Yes, I am bothered sometimes by talking with my mother with the knowledge that she once possessed a feared intellect.  I used to laugh when I described her as my intellectual foil – the one who never gave me a break.  She was smart, she used her brains, and she wanted her son to lead his life the same way.  She taught me to cherish good books, and to think critically.  Today, I dare not ask her what she ate for lunch – only if she enjoyed it.  That takes the pressure off having to remember anything.  The fact remains that my visits are a touch of sadness woven into the fabric of each day.

I enjoy taking photographs of her.  I’m not so much interested in recording a sampling of her life so we siblings have something to peruse after her death, but rather an attempt to describe her condition in a deeper sense than just using words.

But - - true confessions - - -

I do find myself a bit depressed on occasion.  Maybe its the fact that the visits are a time sponge.  Maybe it’s the fact that there is other work involved in caring for her, such as paying her bills. Maybe it’s the unspoken dread of the inevitable phone call.

Maybe – just maybe – its because I have seen my own future, and I don’t like it.

But then again, maybe the title of this posting is incorrect.  Maybe it should be “The Son of Mom Report.”

The Mom Report

When we’re born, we have nothing.  True enough, the logistics of toting an infant around are daunting – the little 12 pound bundle of joy requires about 30 pounds (or more) of “stuff”, such as diaper bags, formula, baby carrier, blankets, and other gear.  As the child gets older, the amount of “stuff” declines.

Using the simile that we are once an adult but twice a child, the same seems to apply in the elder years.  Mom needs very little “stuff” now.  She is in a new nursing home now and moving her was quite simple.  She got in the car and I put some “stuff” in the trunk – and that was it.  Later, we brought over a rocking chair, a television, and some clothing, but really, she has little “stuff” anymore.  When my priest offered his pickup truck to help with the move, I smiled as I knew her “stuff” wouldn’t even fill up my car.

(Be sure to click on each photo to see a larger version of the image.)

If you look closely at the bulletin board on the wall, you will notice some pictures on it.  Mom’s house is filled with photographs – photos of her and my father, of her and her children, of grandchildren – even great grand children.  In her photo albums we have at home, there are photos of herself, of her parents, and of her young family.  But that kind of “stuff” is superfluous now.  She can’t recollect the names of her grandchildren, though her own children’s names still bring a smile even if she can’t always remember them herself.

She has had a rough time during this move from the rehab unit to the nursing home.  I have learned that changes in routine are difficult for an Alzheimer’s victim.  While the Mystery Guest Blogger and I were in Việt Nam, her routine was changed, and even though my siblings filled in for us while we were gone (thanx again, Russ, Karen, and Martha) the change threw her off her routine.  We moved her last Tuesday, and by Wednesday, she was totally unable to cope.  She lapsed into a behavior I had seen once before, immediately after her surgery in January.  She lay in bed with her eyes closed, in what appeared to be sleep, then she would “talk” (mostly babbly, but some coherent words) and extend her arm and point at something she was seeing in her hallucinations.  There wasn’t much else for me to do except stand guard over her, hold her hand, and just be there for her to see when she awoke every now and then.

A few days later, the MGB snapped this of Mom and I sitting in the lobby watching the world go by.  She enjoyed the walk, and she tried hard to grasp what she saw around her. Experience has taught me that she will plateau, then in a few weeks, even rebound a little.

When you have a child, you have expectations – you expect your child to “grow out of it” and to grow physically as well as mentally.  We have those same expectations of ourselves as adults – we expect to learn from our mistakes, to earn a good living, and to contribute to the world.  It’s a habit we give ourselves willingly – to always have expectations.

Mom’s only expectations are mine – that she will be treated with dignity and respect.

One does not have the expectation that she will get better.

Alzheimer’s

This is a woman who once solved New York Times crossword puzzles in ink.  Now she is reduced to playing tic tac toe – a child’s game – with an Occupational Therapist who is attempting to keep Mom’s intellect stimulated..  As you can see, Mom lost the game, but she still insisted on placing her X on the board.

(As always, be sure to click on the photos to see larger versions.)

I wonder what goes on inside her confused mind.  She is a long way from being totally incapacitated.  She has no difficulty remembering who I am, though on occasion she refers to me as her husband.  Nor does she forget the Mystery Guest Blogger, even though she sometimes refers to my wife as “your woman.”  She knows she is losing  her mental abilities and that must be scary.  A few days ago, I was with her when lunch was served.  It was good food, but she ate little.  I was mildly embarrassed to do it, but I took a bite of the beef and said silly things like “Yum!  Good stuff!  You want to try this.”  I didn’t want to suffer her the indignity of treating her like a toddler, but could think of nothing else.  A few bites of meat, a swallow of iced tea, then two bites of cake.  After pushing the tray away, she looked at me and quietly said “Maybe its because I didn’t cook it myself.”

She knows.  Oh yes, she knows.

In a strange way, I wish she would get worse soon and spare her the agony of having a mind still perceptive enough to know it is failing.  It must be scary inside that mind of hers.  Very scary indeed.  I wonder if that’s why she is reflective so often, peering out into her shrinking world and wondering what the future holds.

Scary.

The Mom Report: Rehab

When last I reported, Mom had fallen and broken her left hip.  Surgery fixed her up, and she was recovering in the hospital, then she was moved into a rehabilitation facility.  Fortunately, the place commonly cares for Alzheimer’s patients.

Well, this is Week Two for her to be in the rehab center.  The obvious question is:  “How’s she doing?”

The answer is not so obvious.  She is still very confused.  Any conversation with her is an attempt to make sense of what she says.  That does not mean she doesn’t know who I am, nor that  she doesn’t know she isn’t home, but her thoughts are not joined together in any coherent way.  She complains about the place a little, but not a lot.  She isn’t crazy about the food, and I do wish she would eat more.  She does not like the lady physical therapist, but really likes the “nice young boy.”  I noticed the first small signs of depression when she said that she wondered if she would ever walk again.

Physically, she seems to be doing okay.  They keep her in diapers because she cannot get out of bed by herself and she forgets to use the call button.  She has no pain, but of course, her body has deteriorated somewhat from inactivity and laying in bed.  She gets physical therapy every day except on weekends.  They work her hard, too.

I thought this photo of her reading the art work from some of her great-grand kids would tell you something about her.

I asked her to smile when I took the picture, but before that, she had opened the envelope and I asked her what it was.  Her reply was “just stuff.”, then she started to put it back into the envelope.  I don’t think she was able to link the contents of package with the pictures of her great-grand kids that is on the wall in her room.  Once I made that connection for her, then she took interest in the art work.

Do not interpret what I just wrote to mean that she does not enjoy mail – she does, and does very much.  In this instance, it was her inability to link unusual mail with people she knows and loves.  Regular letters are recognizable to her so she is able to connect a letter with a person, and she talked for some time about letters from two of her friends in Florida. 

I will end with a story to illustrate her mental state.  A few days ago, she told me that “the man” had her walk to the nurse’s station and back three times.  I’m thinking that this is excellent progress in using her walker – the nurse’s station is about four rooms away.  However, there is a different real story.  I was talking with my friend Michele, a lady at church we’ve known since we came to South Texas.  Michele is wheelchair bound herself, and was visiting a friend across the hall from Mom’s room.  Yes, Mom went to the nursing station and back three times - - -  but she did it in a wheelchair accompanied by Michele.

But she still tells me I am a good boy, so I’m happy.

The Mom Report: Broken Hip

I was a bit puzzled as I got off the plane returning home from Việt Nam.  I expected to see the Mystery Guest Blogger waiting for me.  Instead I saw her brother – and he had a hard look on his face.

The MGB did in fact come to the airport to greet me, and brought my mother too.  She had delighted in telling people at church I was coming home.  But, as she walked through the parking lot, she got her feet tangled, fell - - - and broke her left hip.

Now you know why the posts have been a bit scarce since I returned home.

From the airport to home (to drop off my luggage) then on to the emergency room.  I found her and the MGB, then we talked to the doctor about surgery, and I approved it.  The next few days were interesting.  It wasn’t the surgery per se that caused problems – it was how the various medications and anesthesia exacerbated her Alzheimer’s.  The MGB and I took turns sitting at bedside.  It was a bit strange to listen to her talking to imaginary friends and invite them to sit down, and stranger still to hear her talking with my father, who died in 1966.

But, after a few days, she snapped out of it.  Well – “snap out of it” is a relative term, but she did return to almost the same mental condition she was in before she fell.  She is no longer delusional, she is back to just plain confused.  Physically, she seems to be recovering, though it will take a month (or so) of physical therapy to regain full functionality.

Her progress both physically and mentally will determine if she ever lives in her own home again.  Time for making decisions.

I’ll keep you posted.

(Oh  - I took a couple of cell phone pictures, but I don’t think she would appreciate them being put on the web.  Lets just say she doesn’t look ready to be in the Easter Parade.)

A Double Dose

A Double Dose

This will be an interesting five weeks.  The Mystery Guest Blogger’s mother flew in the other day for the holidays and more.  No – I have no problems with my mother-in-law.  She’s a great lady and we’ve always gotten along just fine.

She has been deaf since her late teens – and I mean deaf.  At most, she could hear a rumble or a vibration, but certainly nothing intelligible.  Television is unwatchable without closed-captioning.  A few years ago, she had a cochlear implant.  While that allowed her to hear sound, her brain’s ability to filter and use sounds she has not heard in 60 years makes talking an iffy proposition.  She still relies heavily on lip reading.

Like my mother, she is a widow, though a more recent one.  The two have always been friends, even before the MGB and I were married.  The two moms are mutually enjoying another episode of “Walker – Texas Ranger” on the Hallmark Channel. 

It will be fun to watch them try communicate.  With my mother’s declining ability to remember words, her speech is sometimes a puzzle.  Can my mother-in-law decipher it?  I don’t know, though on the first evening,  I noticed they worked very hard to talk and share.  Its important to both of them to keep on living – and sharing long relationships.