Another care conference

I had a quarterly care conference with staff members at the Alz center last week. Mom lost 13 pounds over the last three months. Isn’t that amazing? She walks so much, but she apparently is also eating only between 50 percent and 75 percent of her meals. I guess her restlessness makes it difficult for her to concentrate on sitting still for meals. But she enjoys 100 percent of her snacks, which I think is funny. She can be mobile and enjoy a snack, which is often also sweet – a cookie, a jelly sandwich, sometimes a peanut butter sandwich. On Fridays, when ice cream is served after lunch, pretty much 100 percent of the residents enjoy the snack for the day, Mom among them.

Mom also occasionally participates in activities. She recently even sat in on a crafting session, which took the activities director by surprise, because Mom hasn’t done that much lately. Part of Mom’s problem is she doesn’t necessarily know how to perform the task at hand – painting, or coloring, or assembling puzzle pieces, or whatever it might be. And she doesn’t take well to being given instructions, either. She is well-known for that character trait.

She still spends a lot of time with Mr. R. Interestingly, though, he is making rounds to other women – something that I thought had stopped. I certainly don’t mind this, and apparently Mom doesn’t mind, either. They find each other and hang out a lot, but they also spend time apart. One staffer told me Mom will sometimes hold hands with a female companion, as well. She likes companionship of all kinds, and I am glad she is able to find that wherever and whenever she needs it. It’s really so sweet to think about residents just enjoying the comfort of holding another’s hand and resting on a couch, or taking a little stroll.

Mom apparently is having trouble finding her words – not new, but apparently she shows some frustration about it. If something is troubling her, she might describe a problem using words and phrases that are very hard to decipher. But if someone on the staff responds with kind attention and offers some comfort, Mom responds well to that, too. I was glad to hear that. For the most part, she is super pleasant. “She’s a joy,” the nurse said.

The nurse also went through the list of Mom’s medications and I learned for the first time that she is taking a blood pressure medication. I had never heard this. Typically, in care conferences, we discuss meds related to the disease and mood. But the nurse was going through every detail on this day, she said, just because. She looked through Mom’s chart and it appeared that Mom’s previous facility started her on this drug without telling me, probably when her behavior was really disruptive for those two weeks between assisted living and the move to the Alz center. I said I didn’t really see the need for her to be on that – I had never heard that her blood pressure is high. So they are looking into it. By now, I would imagine her BP is normal, considering how completely content Mom is. Call me crazy, or mean or, I don’t know, LOGICAL, but I don’t see any point to controlling the blood pressure of a woman with Alzheimer’s disease.

I visited Mom after the care conference, and found her with Mr. R in the program area. She had her leg hoisted on the arm of his chair, which cracked me up.

A relaxed Bonnie. She also had her sleeve pushed up because her skin was itchy.

I visited briefly with her. She said a few interesting things, including: “Where are the three little girls?” Could that possibly be a reference to her three children? And, “I was waiting for Emily. She was sweeping the floor.” I later looked behind me to find a housekeeper mopping a floor in a distant room. This reinforces my theory that at least sometimes, the things Mom says are observations of the world around her. The best thing she said, though, was upon my departure. I said, “I should leave now; I have to get back to work.” And she said, “Did you brush your teeth?” For someone who misses having a mom, that was a delicious little reminder of days gone by.

12 comments so far

  1. Gemma on

    It may seem counterintuitive right now but if Bonnie’s BP is high, it could lead to stroke — a whole other load of issues. A reason to give her meds? IF it’s high, that is. Just sayin’…

  2. Julia on

    this post is great. sounds like your mom is doing well; nice to see a bit of distance is settling in between her and Mr. R and that she’s enjoying a bit of friendship with other folk too.

    love the picture. she does look calm and content. she’s pretty and the loss of those 13 pounds has etched some nice definition into her face. i can see where you get your good looks from. 🙂

  3. momsbrain on

    Gemma: I do know that high BP could lead to stroke. I guess I am of the mind that I’m not convinced a stroke would make her any worse off than she currently is. I used to be much more defeatist about all this than I am now, but I still am driven in part by the fact that there is no good outcome here. I don’t want her to have a stroke – I know I might appear to, but that’s not what I want. I just feel weird about preventive medicines in general for someone with advanced dementia.

    Julia: Thank you for all of the nice things you said! I spent much of my life thinking I looked like my dad, but lots of people think I look like Mom – especially as I get older.

  4. sayte on

    My 92 yr-old mom recently told 55 yr-old me how to brush my hair every night before bed. It was a nice, warm feeling & nice to know that I am still a child to someone!

  5. margaret massey on

    I agree with you about unnecessary medications. Thanks for speaking out on that. It can be a vulnerable position to take.

    I get perplexed when the doctors work on life extension measures for my mom, who has a terminal disease and has been miserable for the last three years.

    It’s interesting that for the most part it’s not socially acceptable in our society to allow a space for death to happen if it seems preventable by any means.

    It’s eerie to me to think about what the future will look like, as the population with severe dementia rapidly increases.

    If I were in a similar situation, I would prefer that my family did not interfere to extend my life (or let a doctor do so) unless I asked explicitly for that.

  6. patwhite67 on

    I so enjoyed your March 25 blog about your wedding. Congratulations to you and Patrick on your anniversary and the happiness that you enjoy together!
    Thank you for sharing the wedding photo with your mom. Am glad you can laugh about what she said about helping. I laughed too as you told it in retrospect.
    I have appreciated your most recent blog about your mom’s medication. I too agree that if a medication is not needed, it should be omitted. This last trip to VA I requested a list of my mom’s medications. It took some doing, since the nurse had to hand copy it off. She was not allowed to just make a copy, she said.
    That was a nice photo of your mom, so relaxed. As I hear more about the caring at the Alz Center, I am so impressed with the overall attention and care that residents receive.
    I so loved hearing your mom’s advice to brush your teeth! She still knows you are her little girl.

  7. momsbrain on

    Sayte: It is nice to have parental attention at any age, I think. Thanks for commenting!

    Meg: I took Mom off of Lipitor several years ago, too, because I felt controlling her cholesterol was not particularly useful. I do worry about appearing to want to hasten Mom’s death. That’s not it, and I think most people in our circumstances get it. I just don’t want to needlessly prolong a life just for the sake of prolonging life – as you said.

    Pat: Thanks for your supportive comments! And it’s true, the Alz center provides very good care, and I feel so lucky still that I found this place for Mom.

  8. JenniferJayhawk on

    Your Mom looks amazing! I love that picture. You are doing a great job with your Mom. As the saying goes “It is what it is”. We all just do the best we can with the cards we have been dealt.

    Take care.

  9. JudyDearing on

    Oh your mother looks so comfortable there with her leg up!
    As for medications, I recently asked Chrissy’s doc to hold off on the Crestor. She has taken it for over ten years – eats everything and literally no exercise, so I thought maybe a baseline might seem appropriate. He agreed. I also am aware of the stroke possiblity. In three or four months I’d like to have the nerve to ask about her blood pressure medication. Chrissy is 86 with late moderate Alzheimer’s and on Namenda and Razidyne.

  10. momsbrain on

    Jennifer: I’m glad you like that photo. I think it’s funny. And she does look good these days. And you are so right, it is what it is.

    Judy: It is such a balancing act to try to do what is best with regard to medications – including those that support memory. I’m glad your doctor supported your request about the Crestor.

  11. Jeff on

    I remember all of us sitting that way at one time or another in the chair in the living room that faced the TV. Funny.

  12. momsbrain on

    Jeff: I still sit that way sometimes!

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