Friday, January 6, 2017

The Tantrum

When my mom was diagnosed with Alzheimer's disease, I approached the news the way I have approached things for many years of my life--as an academic. Read up on it. Find out about it. Ask questions. Google it. Observe.

The three best resources I found on Alzheimer's were "The 36 Hour Day" by Nancy Mace, "Creating Moments of Joy" by Jolene Brackey, and the blog Alzheimer's Reading Room, which is a nearly daily wealth of information and tips about the disease and caregiving. That's a trio of resources I recommend to anyone who has a family member with the disease.

From all my reading I thought I was aware and prepared for each stage of the disease, including the times when the person becomes difficult or anxious. I forgot about the difference between intellectual readiness and emotional readiness. You can know that something is coming, and how it's going to be, and research every detail of it in advance, but it doesn't prepare your heart for the emotions of the event.

I knew that eventually my mom would forget who someone was in the family. When that first person was my dad, to whom she has been devoted all my life, I cried. Couldn't she have forgotten some other relative first? Why the most important person in her life? It hit me hard.

Yesterday dished up another milestone: I saw my mother in a full-blown fit of obstreperousness and hatefulness. And I was included in those who were the brunt of it. I knew her caregivers had dealt with some tough times, and the nurse at the hospital had told me that morning my mom had been combative and had yanked out her IV. But personally I'd not seen anything more than grumpiness from my mom; she usually is happy to see me and sweetens up and calms down when I walk in.

So yesterday morning after I arrived at the hospital, the nurse wanted to check on a dark spot she had glimpsed on my mom's backside. She asked me to help get my mom to allow that.

And there it all began. When I asked my mom to let the nurse take a look, her face twisted up and she immediately went into a full-blown tantrum. I was shocked. "I will not." "Leave me alone." "Get out of here."  Her body was rigid and there was no way, nohow, that my mom was going to comply. Not with anyone.

I tried logic with an explanation of why the nurse needed to see the spot, voicing what might happen to her health if it got worse. I tried getting stern as she used to do with me when I was a kid. I tried the word "Please." Each of those was a mistake. They made her even madder. I should have known from the reading I've done. Leave well enough alone and come back later. It's not that urgent. But I didn't.

The nurse and I briefly conferred and decided it didn't have to happen right now. Mama was in a pout, and hearing us talk about it made her even madder. She pinned me with a hateful glare--something I have never, ever in all my life caught from her. My beautiful, always-professional Mama had turned into a horrible person, and I didn't really understand how that had happened, nor why I couldn't change it.

And then I confess, I deepened my error of trying to use logic and words. Once the nurse was gone, I leaned close to my mom quietly and asked, with some emotion, "Mama, why are you being so ugly? I have never seen you do this before. When you were a doctor and you asked a patient to do something, you expected them to comply. Now you are the patient, but you won't let the medical people do what they need to do. I don't understand that."

Oh, that just made her spitfire angry. And maybe sad, too, now that I think of what I saw. She glared at me. If looks could kill, I would've been dead on the floor. She was wordless again for a moment, but oh-so-angry.

That's when I felt the tears start to flow. I moved away and sat down on a chair in the corner, sniffling. It was all just so awful. The nurse returned, and we discussed the situation, with me crying and telling her this wasn't like my mom, and that she had always been such a professional woman. Better to talk in front of someone than behind their back, right? Oh, my; I was so dumb! Not smart to do this in front of an Alzheimer's patient in full rebellion.

"Stop talking about me." My mom hollered. "You get out of here. Both of you. Just get out. Go talk somewhere else. Leave me alone." Her ability to articulate her thoughts, which has been diminishing over the past year, was suddenly back in full force. And at high volume.

The nurse and I looked at each other and agreed silently that we'd move out into the hallway.

And now I am left licking my wounds. I've always been able to work my mom around to acquiescence and cheering up better than anyone, even through this whole disease. No more. Alzheimer's disease takes your loved one away, and that's sad. But I think what is even sadder in this moment, is that I'm understanding that it not only takes them away, but it can turn them into someone else, someone quite monstrous. And frankly, I want to flee far away when she gets like that, to pretend that it's not happening and my mom can't become monstrous. It's easier to bear up with a mom who has always been kind and helpful and professional and is now quietly fading, than it is to bear up with a mom who is now wailing and roaring and shouting aggressively for me to get out.

I don't have any other thoughts right now. Just dealing with the heartbreak.

Wednesday, January 4, 2017

Tending Mama


It's going on 18 hours that Mama has been in the emergency department of this teaching hospital. I had a feeling something was impending, as I had just been reading a post I'd written a year ago about her 3-day stay in Emergency after a trip and fall and bruising to her hip.  At that time I was fit to be tied. Frantic. I didn't understand what was going on with insurance rules, doctor slowness, and the inability to either admit her to the hospital or get her into skilled nursing until she could walk again with her walker. Seriously? A person could spend three days in Emergency Room?  THREE days?

Now I know. Insurance rules were not made for people. So I'm sitting in the recliner that the nurse so kindly swiped and brought to me last night, with my laptop, and waiting. Waiting for time to pass, for her swelling to go down from another fall, waiting for them to somehow get her up and moving so that she can return to the memory care.

I'm glad there's nothing broken. I'm glad that our winter school term has not yet begun at the university level. I'm glad to just sit here while she sleeps, away from it all, yet connected. These are other-worldly times, and they seem a universe away when I'm in the normal swing of my life.

Here are my reflections from last year, when I was so deeply frustrated.

Things I have learned and re-learned in the past 24 hours, listed with some degree of bitterness: 
(1) When an 89-year old woman falls, and no bones are broken, the bruised tissues on her hip can still be just as painful and debilitating as a broken bone.
(2) Forget planning on 12 hours in Emergency Room. You can be there for 2 days or more. I kid you not.
(3) Nurses are worth every penny they earn, and then some.
(4) The hospital does not deliver food or chronic meds to the ER automatically. The patient is not considered admitted when in the ER, so there has to be an order for anything they get, including food. Those things can be forgotten or not even thought of to begin with. And when an 89-year old woman misses her meal, she can get confused and combative. And the hospital staff have no idea why. Spaghetti, people. Spaghetti fixes it.
(5) Medicare requires a 3 night hospital stay first, in order to financially cover care in a skilled nursing facility. A retired person who has worked for our church has Medicare coverage first, church health insurance second. That means that even if you don't need to be admitted to a hospital, but you need nursing care for a few days while you recover, you have to try to get admitted. For three days. Using up a valuable bed that someone who is actually sick can't get. And the days spent in ER don't count toward the 3 nights in hospital. And did I mention that you can spend 2 nights or more in ER, waiting for a hospital bed to come free?
(6) Yes, you can wait 8 hours... or more... for a doctor to show up.
(7) I knew this, but I see it all over again: If you don't have a family member in ER to look out for you and keep pressing people about things, you're sunk. You could disappear into a black hole.
(8) Wi-fi in an ER is a life-saver for family members.
(9) There should be a box of Kleenex in each room so family members can have a good cry.

Tuesday, January 3, 2017

Back in Step


For educators--which both Husband and I are--coming out of Christmas vacation always feels like trying to regain your balance. The richness, the heaviness and the nonstop action of the Christmas season is over now. Both of us had our faculties over to our home for meals, so our house got decorated up to the nines. Despite the fact that we have tried to tone Christmas down to a quieter and less commercial level, the mad dash always catches us sooner or later. If it's not a rush to buy, buy, buy, it's the rush to give time to people we work with and family and friends we care about, to let them know they are loved and appreciated and enjoyed.

But now it's done. Christmas is has been put away and our home looks bare, even spartan. The time spent and travels completed put our work on hold for a couple of weeks--a massive hiccup in the weekly rhythm of the school year. Suddenly we have to re-enter that rhythm, pick up the threads, figure out where we were and make progress again. The school year is still underway and must be completed, like birthing a child. There are big projects and deadlines looming, meetings to attend and lead, and documents to be written. The spirit shrinks back from it, and yet here it all is, bearing down on us like a merciless steamroller. It will happen. It's the stuff of our lives and of our employees' and students' lives, and somehow we manage to get back into it year after year, with varying degrees of the blues providing the emotional soundtrack of spirit.

I really haven't anything philosophical to say about all this. My new year's resolutions have been on the order of "continue." Continue to do what is in front of me. Continue to live with gratitude. Continue to meet the divine appointments that God seems to bring my way nearly every day, those moments of significance and insight that happen between me and others.

Continue.

"Let the love of the brethren continue. Do not neglect to show hospitality to strangers, for by this some have entertained angels without knowing it." Heb. 13: 1, 2.
Continue.