Archive for June, 2010|Monthly archive page

Care conference and a haircut

I took a vacation. And apparently, that led me to take a little vacation from thinking about Mom. And writing about Mom. And that is OK.

Two days after I returned from a visit with my sister’s family in California, I attended a care conference with staff members at the Alz center. Mom has lost 6.6 pounds in the past three months but still weighs plenty so there is no concern about the loss being detrimental to her. She continues to like snacks and usually finishes her meals with no problem. A nurse had told me the day before that the medical director would like to lower Mom’s Zoloft dose by 50 milligrams per day. She is on a high dose, and he would like to see if she can manage with less. The staff will be monitoring her mood during this process. I am in favor of reducing her drugs as long as she remains content. I have never been against giving her drugs to maintain a stable mood, but I am OK with the philosophy of reducing meds when it’s possible. Looking at her pharmacy bill, I do believe she might also be off of Aricept, the memory drug. I have favored taking her off of that for about a year, so it does not surprise me if it is considered useless at this point in her illness.

The activities director said Mom’s mood fluctuates, and seems directly related to how much attention she is getting from her gentleman friend, Mr. R. Staff try to get them to sit together for meals, which helps Mom focus on eating. It turns out Mr. R is not the one-woman man some say he is. When Mom is not around, he will still cuddle with another lady friend. The staff said that when Mom comes upon this scene, she will sometimes just stand there until the other woman goes away. “Her territory is marked,” a staffer said. The activities director’s concern is that Mom is less social with others now that she is so focused on Mr. R. She can still initiate conversations, but she is less likely to do so with other residents. She also participates less frequently in group activities. Mr. R never participates, so the two tend to sit and watch from one of the distant couches in the program area. Everyone seems to know there is nothing we can really do about this. But it is there, as a bit of a problem. Mom is content most of the time. Even when her mood darkens, she is not combative or aggressive. Just sort of grumpy.

My sister and I talked during some long hikes we took together about her next visit here to Columbus, and what it will be like to visit with Mom if Mr. R is on the scene. I initially said I am afraid to take Mom away from him for fear that it will upset her and/or make him cranky upon her return, or both. But the more we talked, the more I thought the benefits of taking Mom out somewhere with Laura will outweigh the risks. Though there might be a rough patch, it will pass. That is one good thing about this disease. Most bad feelings go away, or are forgotten, or both. I talked about this a little bit with the staff. I will do a practice outing in the next few weeks to see how Mom does with separation from Mr. R, how she is on an outing (I suspect she will enjoy a Bob Evans lunch) and then how the transition back to the center goes. I choose to be optimistic that it will all be fine. I want to do what’s right for her. And there is no reason an outing can’t be the right thing.

While I was in the building, a nurse asked if I might be willing to get Mom to the beauty shop for a haircut. She was on the schedule and staff had twice tried to get her into the chair, to no avail. Even Mr. R tries to help with this, but Mom won’t go for showers or haircuts these days even with his encouragement, apparently. I agreed to give it a go. I found Mom wandering in the lobby, which was a lucky break. I called out, “Bonnie,” and she turned around and we had a big hug. I popped my head into the beauty shop and asked the stylist what she wanted me to do. She needed just a couple of minutes to finish up with her current resident. So Mom and I walked toward the program area. When we got there, I could see in the distance that Mr. R was in an embrace with his other girlfriend. Mom spotted them, too. She pointed in that direction, and seemed to want to go over there. I put my body in front of hers and just physically redirected her back down the hall toward the beauty shop. I think she was so startled by my insistence that she quickly forgot what was on her mind.

We got her seated in the stylist’s chair with no problem. When her head was tilted back, she said, “I just had a baby.” I said, “Uh-oh, I think I know what that means.” The stylist sort of chuckled uncomfortably. I thought it was gas, not poop. But I wonder, too, if the sensation of being tilted back just gave Mom a weird physical memory, because there was no sign that anything else had happened. It was an interesting brief moment. I told Mom to savor having her hair washed because that feels so good. She did seem to relax. The stylist did a nice, quick haircut, just trimming up around all of the edges and leaving enough for Mom’s curl to show. She gently blew Mom’s hair dry on a low setting. Mom did great, just sitting there and occasionally asking the stylist’s name or trying to otherwise make small talk in her own way.

After the cut, she and I sat on the couch in the lobby and a few staff members came by to admire her beauty.

Mom and her brand new haircut.

I saw that Mr. R’s lady friend was being encouraged to get her hair done, so I considered the coast clear to return Mom to the program area. We went back there and over to the couch, where Mr. R was sitting alone. Mom leaned over and kissed him. I told her she could sit with him and I could go back to work. Then, out of the blue, the other woman appeared. She had refused to have her hair done. She and Mom exchanged a few words – cordially, as far as I could tell – and then the other woman walked away. Mom seemed a little confused, but I managed to turn her attention to Mr. R and I walked away. I had been at the center for almost an hour and a half – much longer than I expected on a Wednesday morning. When I was ready to turn the corner toward the lobby, I looked back, and Mom seemed to have forgotten I was around. That was just how I wanted it.

73 years old

Today, June 6, is Mom’s birthday. She is 73. She has been struggling with Alzheimer’s for at least six years, we estimate. Who knows how much longer before that she might have been showing symptoms that we didn’t yet understand. I always think of her as a young patient at the Alz center, but she is not the youngest.

Patrick came with me to the Alz center today to have a very small party with Mom. I wanted him to come along. We didn’t bring any gifts, just a container of double chocolate brownies. I have seen so many of Mom’s belongings disappear. I didn’t see any point in giving her any new gift that would likely wind up in someone else’s room. I thought about a stuffed animal, but she isn’t really carrying dog/cat around anymore. I thought about a lipstick, but four or five previous tubes are long gone. I thought about a new bracelet to replace the lost eight or ten bracelets that used to be her trademark look. But that fashion statement obviously is no longer important to her. So I settled on brownies.

When we arrived, she and Mr. R were in a distant corner of the program area. She was on the couch, and he was in a chair next to the couch. We walked over and I said, “Hi, Bonnie. It’s your birthday! Happy birthday!” And she said, “Really?” And she stood up and hugged me. While we were hugging, when I started to pull away, she gave me an extra strong squeeze – perhaps the first time in my life she has ever done that. I introduced Patrick to Mr. R. Mom asked Patrick his name. But she seemed to recognize him somewhat. She seemed interested in him, for sure. The last time he visited, Mom said she didn’t recognize him.

We pulled two more chairs over to face Mom and Mr. R and opened the brownies to have a snack. Mr. R declined to take one. I handed out small pieces of paper towels to serve as napkins. Patrick and I each had two little brownies. Mom ate at least one. Then she started fiddling with the container. She couldn’t quite figure it out.

I noticed Mom didn’t have any shoes on. She said she couldn’t find them. She had a Buckeyes Football T-shirt on, and I said, “Buckeye Football.” She said, “What’s that?” And I said it’s a popular sport at Ohio State. It didn’t register. So much that I say seems to be meaningless information to her, really. I left to look for her shoes. I found her two pairs of Crocs tucked in a little night stand in her room. I know if she ever really lost her shoes, a staff member would find them. Everyone seems to know that Mom wears Crocs. Patrick said that while I was gone, he asked Mom if she had any memories of past birthdays. She said there was a boy once. He asked if that might have been her sister. He said she sort of appeared to agree with him that that could be the case, but then she started talking about something else entirely.

I finally had remembered fingernail clippers, so I trimmed Mom’s nails. She picked at her chin, and told me the hairs there were bothering her, so I plucked a few. If it hurt, she would yell out somewhat dramatically. “You sound like a cat,” Patrick said. And then every time she winced as I plucked, he would growl like a cat along with her – even if she didn’t. It made us all laugh. As we all sat around together, she did ask a few questions. She asked what I’ve been up to lately. But she didn’t seem to absorb the answer. She asked Patrick what his job was. He said he works with people with disabilities. And that he used to be a teacher. A little while later, she asked him, “Are you a teacher?” She laughed at some things he said. She said it was nice to see old friends. I could tell she was enjoying the concept of the visit even if the content of our conversation was somewhat lacking.

The birthday girl laughed and smiled a lot today.

After about 40 minutes, I said we had some shopping to do and should probably get going. Mom seemed to take the news just fine. I kissed her goodbye and Patrick hugged her goodbye. I shook Mr. R’s hand. He was very friendly today with me and with Patrick.

On the way out, we ran into Penny the nurse and had a chat. She said Mom is essentially off the list of residents who get showered. She used to not like having water on her head, so then staff kept shower water below her neck. Eventually, though, she rejected having any water touch her body at all. So she gets a thorough wash-up at her sink each day. “All the parts that need to be washed get washed,” Penny said. She said it appears to be a disease-related phenomenon. Mom is not the first resident to reject the shower and she won’t be the last, Penny said. And on Mondays and Wednesdays, staff members and Mr. R try to convince Mom to go to the beauty shop to have her hair washed. Sometimes it works and sometimes it doesn’t. Her hair looked fairly clean today, and very curly. Penny also said that when Mr. R is showered, Mom paces around, looking for him. He is her everything, I guess. There will be a care conference in a few weeks, when I will learn much more, I’m sure.