Trouble in paradise

I got two calls in three days from a nurse at the Alz center. While I was driving home from work Friday, she called to let me know Mom had been involved in an incident with another resident. He had tried to pull her off of a couch, and she resisted and screamed. And later he tried to pull her off of a bed, and she resisted and screamed. Because the interaction was contentious and in a room rather than out in a public area, the staff couldn’t be sure Mom wasn’t hurt. She didn’t show any signs of injury. The two were separated. The staff members are not allowed to identify other residents at times like this. But I know it was Mr. R. Who else? After they were separated, Mom had an aide dedicated to her for awhile. Mom ate dinner that evening in the dining room near the lobby, on the skilled nursing side of the facility. They decided to inform me mostly because there was a chance Mom had been hurt and because Mom was a victim. I have previously received calls like this when Mom had been the instigator. I felt sad about this news. Even though Mr. R is not my favorite person, he has been Mom’s favorite for quite some time. It’s a shame that that companionship might be a thing of the past. But it seems his disease might be changing, causing this new, more aggressive behavior. And I don’t want Mom to be in the line of fire if he becomes angry. The nurse described Mom as calm and unaffected once it was all over. A rare good thing about Alzheimer’s disease.

I visited Mom for awhile on Sunday to see how she was doing. I found her in the program area, sitting on a couch with her lunch tray on her lap. She had eaten everything. There were some traces of food on her clothes. I got her bib and wiped off her clothes and returned the tray to the cart. Mom sat very quietly, almost frozen. She held her right hand out to her side, in mid air. I thought she might be tired. She didn’t acknowledge me. I talked to her, patted her leg. She just sat, staring. And then she looked at me and said something. We chatted. She smiled. “Should we learn something new?” was a memorable thing that she said. The activity for the afternoon was going outside in the courtyard. I asked Mom if she wanted to come. I helped her stand up. She walked about five feet and found a chair. “That’s what I want,” she said. I figured she might be exhausted. So I kissed her goodbye and went to the grocery store.

Late Sunday night (late for me, about 9 p.m.), the same nurse called again. Mom had been in the shower with an aide – one of Mom’s least favorite things to do. In a show of frustration, she plopped herself hard onto a toilet. Later standing again to finish the shower, she complained about pain in her right leg. Movement side to side didn’t bother her, but when her leg was lifted to the front, she complained of pain. So the nurse had ordered an X-ray. I went in this morning before work. Mom was still in bed while most residents were finishing breakfast. The X-ray had been done at night by a visiting service. No results were available yet. I touched Mom’s arm and talked to her, but she was sleeping. The aide that had been showering her was in again this morning. She said Mom hadn’t moved her leg all night. She also talked about the verbal abuse she takes from Mom during a shower: “You’re ugly. You’re fat. You’re going to die.” These are things my dear mother says to the aide who showers her. On top of the screaming she does. But this aide likes Mom. She told me so, and I can see it.

I visited with another daughter for a little while, who was feeding her own mother. Then I went back into Mom’s room, and the aide was feeding Mom. Or trying to. Mom was refusing to open her mouth for the pieces of grapefruit the aide offered. Eventually, she grabbed a piece of fruit off the spoon and put it in her mouth. “That’s what I want,” the aide said. I asked if I should leave. “I don’t want to make your job any harder,” I said. But she said Mom was eating now and had refused before I came in, so it was no problem for me to stay. “See, Emily’s here. I told you she’d be here,” the aide said to Mom. I sat at the foot of Mom’s bed and rubbed her good leg. She ate the grapefruit and the aide then turned to a plate of biscuits and sausage gravy. I said, “Mom, it’s comfort food. The best kind of Bonnie food.” Mom’s response was inconsistent, but she ate several bites after initially turning her face away from the fork. It was very interesting to see her refuse to take bites because she likes to eat. She eventually yanked her leg away from me. I guessed she was feeling overstimulated. And in pain. The aide got her to take a few drinks of milk. “Are you finished?” she asked. “Yep,” Mom said.

I pulled up a chair and sat with Mom. The aide had put a stuffed dog in the bed with her. “What should we do, Nancy?” Mom said to that dog. Nancy is Mom’s sister. “I’m going home, home, home,” Mom also said. She never says that kind of thing. She closed her eyes and twitched as if she were drifting off to sleep, and then opened her eyes. The Monday morning church service was taking place out in the program area, and we could hear the piano music and singing. Mom pretended to sing along. She also made a few odd noises and contorted her face. She didn’t seem to be in any distress, but she wasn’t her usual pleasant self. I attributed most of her behavior to pain. But I also felt like I was seeing a more demented Mom than I saw just a few weeks ago. I know an injury or infection can change behavior in patients with dementia – temporarily, usually. So perhaps the cheerful Bonnie will resurface after her leg heals. I learned from the nurses on my way out that the X-ray was negative – nothing broken. So Mom just has a couple of serious bruises that need to heal. I’ll be spending lunch hours with her this week until she can get out of that bed.

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6 comments so far

  1. Jennifer Jayhawk on

    I don’t even know what to say Emily. I am in tears reading about your Mom. Obviously your writing skills are once again brilliant because I feel like I was there with you!

    You need to write a book about all of this. You have opened my eyes to so many things that I had no idea about. We all have a different walk with our parents. Ours seems to be more frustrating but still sad.

  2. patwhite67 on

    I am so sorry to hear of the injuries your mom sustained. That she can’t communicate exactly where she hurts makes it much harder.

    My mom was rude to her aides at different times, especially the ones who didn’t normally take care of her. They just took it in stride and laughed it off. But knowing it was my mom bothered me, as I know it does you.
    I’m glad you can be with your mom more during meals at this particular time.

    I will be thinking of her often, praying that she can return to feeling good soon.

  3. momsbrain on

    Jennifer: I am near tears myself at this point, I must admit. Just when I think everything is smooth sailing, something goes wrong. Thank you for your support.

    Pat: I do know this aide in particular doesn’t take any of it personally, but I cringe at the idea of Mom saying terrible things and lashing out, both for the aide’s sake and for Mom’s. Thank you for the prayers.

  4. Megan on

    So sorry to hear things have been rough for you and your mom (and even the not so favored Mr. R) lately.

    Sounds like the staff has been really on top of it. Good you have the time to be there at the time it feels right to get more involved.

    I hope she heals quickly and that she’s able to lighten up again and enjoy herself.

    Take care,
    Megan

  5. Sherri on

    Again, I do learn so much in your blog, and I think others do too. A book does sound like a good idea. I’m sorry Bonnie is not herself these days. I hope her minor injuries clear up soon.

  6. momsbrain on

    Megan: The staff continues to be great. I really like some of these aides and I am getting to know them better when I am around more often. They have tough jobs.

    Sherri: The leg seems better, but her eye infection returned. She can’t get a break. But she’s in a decent mood, so that is a relief.


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