Transition time

The social worker at the Alz center ran support group last week. I was talking about Mom hitting someone, and how I am having a hard time knowing what my role might be in trying to be helpful when it comes to her eating problems. I sort of talked on and on about Mom being restless and unable to sit still for two meals that I had been present for recently. I asked about the finger food plan and what that means. I noted that Mom’s weight loss seems to be getting to a point that might make me consider worrying. One thing I don’t have to worry about, the social worker said, is that Mom has suddenly become a hitter. She thinks it was an isolated incident and a reflexive act on Mom’s part, and doesn’t necessarily suggest Mom is going to become combative on a regular basis.

And then, the social worker said: “I think Bonnie is going through a transition.” I think so, too. I don’t know if her definition of transition and mine are the same. Mom’s behavior is changing with regard to eating – that could be a transition. Mom is withdrawing a little bit from Mr. R. That is definitely a transition. For me, it is Mom’s appearance that is telling me she is going through a change. And it bothers me – which pisses me off, because from the beginning I have considered myself completely prepared for the inevitable decline, in all of its manifestations. That I can get bummed out about Mom’s appearance is not something I really want to admit to, or deal with.

For so long, she has looked sort of “normal,” like she could pass for a family member at the Alz center if you didn’t look too close. Not anymore. She is so thin. Her face is drawn. The hunch in her shoulders is more pronounced. Her face is peaceful, but also has a blankness to it. She carries herself a little differently. She has developed a hammertoe from walking around barefoot so much of the time. The whole package that is Mom’s being, though, is transformed. I’ve been trying to think of how to describe it. I think she’s sort of like a house that has not been lived in for awhile. She is vacant. The disease’s effects have moved beyond the brain now. With the brain going unused, the rest of the body is sort of caving in, too.

I have been visiting more frequently lately. Twice, I was there at lunch time, hoping I could help Mom get through the meal. The first time, we had another woman sitting with us. We had a few interesting minutes together before Mom got up.

Other resident: Is there any butter?
Me: I don’t know. Mom, this looks good. Why don’t you try a bite?
Other resident: I need more butter.
Mom: I’m ready to go.
Me: Maybe we can just sit for a minute and eat a few bites.
Mom: Mmm, that’s good (after drinking her milk in one long gulp).
Me: I know how much you like milk.
Other resident: Get me some butter!

Mom wanted to start walking. I joined her, and brought along her dessert, a small cup of vanilla ice cream. We walked, holding hands, and she talked off and on. We went through the lobby and over to the skilled nursing side. We hit a dead end and turned around. We sat for awhile in the lobby on the second pass. I offered Mom her ice cream, which was so melted now that she could drink it. “Mmm, that is so good,” she said after slurping up as much as she could. A little while later, she was ready to walk. We went back to the program area, and I looked for her tray. It was already put back into the cart to be returned to the kitchen. Someone has poured a bunch of milk all over Mom’s plate.

With Mom being put on finger foods, I thought she would no longer have a tray arrive at mealtime. But no, that’s not the case. It is either state law, or Alz center policy, or both, for everyone to get a tray for each meal. So Mom receives whatever might be on the menu plus two slices of bread to make a sandwich that she can take on the road with her. The thing is, she could never assemble a sandwich herself. For a more recent lunch, she was served turkey and home fries. Seeing she had two pieces of bread (and before I had heard about the sandwich concept), I started nibbling on one, thinking that if I ate, Mom would eat. That didn’t work. I fed her a few potatoes by hand. She did respond to that, but she is not really in need of being fed just yet so I don’t want her to get used to that. The aide presenting her tray had given Mom her piece of corn bread and said, “You’ll like this.” Mom did bite into that immediately and then put it down. When she said she was ready to go again, I put some of the turkey between the two pieces of bread and picked up the rest of the cornbread. And off we went.

She held onto my arm as we walked our familiar path. “I think you’re wonderful,” she said. Of course, I just loved that. I told her she is wonderful. We walked, and I would feed bites of corn bread or sandwich to her from time to time. We eventually circled back to the program area, and once again, her tray was already gone. I did take in some Clif bars last week, and will be checking in tomorrow to see if she is eating them.

For so long, Mom enjoyed the pleasure of a good meal. It makes me sad that she is losing the ability to relax and really feel the sensation of the food, the tastes of the comfort foods that she has always loved. She does still enjoy snack time and is especially fond of ice cream. The social worker’s theory is that Mom would do better if she could receive her tray a little after the lunch hour, when things have quieted down. It’s as if the hustle and bustle of mealtime is a distraction to her, and gives her the urge to move around. I don’t know if a resident can receive that kind of special treatment, and I wonder if it could prompt a new set of problems with people who want to eat when Mom eats, even if they’ve just had their own meal. But I like the idea of giving it a try.

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5 comments so far

  1. Terri on

    Hi Em- I can feel your sadness as I read this latest edition to your blog. It is never easy watching someone you love so much decline as you are describing. I have been through it way too many times and no matter how prepared I thought I was, I really was not-if that makes any sense.
    As for your mom getting her tray after things settle down, it is a good thing to try. She may not be able to handle so much sensory stimulation( all the noise of the other residents, dishes clattering and all the movement around her. I hope it works!

  2. Meg on

    Sounds intense. I can’t imagine how I’ll cope with the transition you describe here.

    I’m always struck by how dedicated and attentive the staff seem to be at your mom’s place – that they take proactive measures on issues that come up before you need to point them out, or at least think about them and collaborate with you. That is a wonderful thing!

    Hope I can find such a place for my mom someday, and even more, I hope that the standards go up in all such places, especially where the low or no income people end up.

  3. momsbrain on

    Terri: I am a little sad these days, I guess. Mom has already changed a lot, but the change makes her look so different now. I know I will get used to it. Thanks for commenting.

    Meg: Mom is definitely in an excellent nursing home. Everyone there is great. And Mom is on Medicaid – thankfully, that does not influence how they treat her or how they do anything with any of their residents.

  4. Sandy on

    Haven’t been by in a while, I am with you on the transitions… My mother has been sliding down the slippery slope so quickly it dismays me. You are so lucky that your mom is in a good home and well tended to!

  5. momsbrain on

    Hi, Sandy – Funny, I was just looking at your blog not too long ago, thinking it has been a year since I was last in California. I’d like to get back there, but I don’t know when.

    I’m sorry to hear your mother’s change has been quick. Yet another unpredictable thing about the disease. I hope the family is hanging in there. It’s definitely hard to be a witness to it all. And I agree, I am lucky that Mom is safe and as happy as she can be.

    Take care,
    Emily


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