I had two calls from Alz center nurses last week. I was just leaving a work-related evening reception event at about 8:30 p.m. Wednesday when my cell phone lit up. A night-time call, for some reason, gives me pause. The nurse said staff had just noticed that Mom had a swollen jaw. They had been trying to get her to drink some juice, and she rejected it. That’s when an aide noticed the swelling. The staff members didn’t know what the source of the swelling was, so they had lined her up to be seen by the visiting physician the next day. I asked what time he would be there so I could try to visit at the same time and possibly assist with the exam. It could be anytime from 1 to 2:30, the nurse said. I was concerned that Mom had a rotten tooth that was abscessed and would need to be pulled.
I showed up the next day at about 1:10. The doctor was in already, and I tracked him down to see when he would see Mom. He asked me to wait about 15 minutes. I went over to the program area and found Mom sitting on a couch, resting her head in one hand, very drowsy. I pulled up a chair and sat as close as I could to her. I patted her arm but she didn’t acknowledge my presence. I just kept my hand on her arm and sat. I tried to look at her jaw, but her head was hanging forward and I couldn’t see any definition or lack of definition in her jaw. She eventually opened her eyes and began to slowly turn and let her head fall toward the middle of the couch, with her feet toward me, her knees bent. I rubbed her leg and felt a tough spot, so I lifted her pants up to her knee to touch the spot, which was on her upper front calf. I couldn’t tell if it was a bruise or a rough patch from previous skin problems. I tried to pull down her pant leg and she stopped me and said, “Oh, no. Oh, no.” She pulled it back up. I think she thought I was going to try to take her pants off.
She turned sideways and rested her head on her two hands, together as if in prayer. She was so tired. The doctor came and nudged her and tried to talk to her. He called her Mrs. Caldwell, and I noticed he called another patient by her last name. So respectful, but probably the only person who addresses the residents that way. Mom knitted her brow and fussed a little as he started lifting her head. I went behind the couch to try to grab one of her arms, but the doctor said he got to feel the lump on her right jaw and, as he suspected, she had an infected salivary gland. He said the gland was probably backed up with fluid, the result of food particles getting stuck in the mouth. Shortly before he came, Mom had slid her finger into her mouth and ran it along her right cheek. He said that further convinced him that it was her salivary gland. I asked if it hurts. He said it might be inflamed. He prescribed antibiotics and said she could be given a pain reliever if staff thought it was needed. I figured Mom was tired because she was a little bit sick with infection. After the doctor moved on to the next patient, I got up close to Mom and put my arm around her. She made sleepy sounds like she was just a little annoyed. She reminded me of a child. I hugged her and kissed her cheek and left her to nap.
The next day, a nurse called me during the day to tell me Mom had gained five pounds in a week. The nurses were going to monitor her weight weekly. Mom’s legs have been puffy for years, and sometimes there is more swelling, or edema, than other times, and they thought that could be one source for the gain. She has been a little lethargic, perhaps because of her infection. They weren’t alarmed, but they wanted to let me know it’s a change in her condition and something they’ll be watching. I appreciated the call. I think they are choosing to err on the side of telling me things now, which is what I want.
These events followed a visit last Tuesday that was very enjoyable. Mom was in the program area, resting on a couch she was sharing with an older woman resident I didn’t recognize. This resident was wearing her nightgown and looked very cozy. Mom eventually stretched her feet out and put them on this lady’s lap. And the woman patted Mom’s feet. It was a sweet moment. Mom was in a good mood, making pleasant conversation. Meanwhile, this new resident told me she is hard of hearing and suggested I write her a note. I pulled a gum package out of my purse and wrote on it, “What is your name?” She wrote her name in a shaky but classic script. I wrote, “Do you have any children?” And she wrote her name again. But she told me she had a daughter. It turned out I was visiting during an emergency drill so I helped coax Mom into one wing of the program area, where all residents and staff were gathered until an aide could account for everyone. While we were assembled in these close quarters, Mom encountered her boyfriend, Mr. Beard, and the two of them began walking around the perimeter, holding hands. She was busy with him, so once we heard the all-clear to end the drill, I slipped away without saying goodbye.