Tuesday, April 27, 2010

Spring

I just love the first signs of spring...
The trees and flowers are in bloom, the weather is getting warmer and My Mom is riding shotgun again.
She had been sleeping half the day away all winter. I figured we were experiencing a new part of aging. I warned others if you tried waking her before noon it was like rousing a bear. Well, the analogy wasn't too far off. She appears to have been hibernating during the cold months!
Twice this week she was up and fully dressed with the sun -- catching me quite off guard I'll admit. I took a quick trip to Atlanta Friday. A friend and I left for the airport at 6 am. I told our caregiver if she arrived any time before 9 that would be fine -- it should have been.
I had a text message at 7 with the following: "Good thing I got here early. She's up and dressed in at least 50 layers of clothes!"
Murphy's Law, right? She must have heard me leave the house or something. Mystified by the whole clothes layering phenomenon, I've spied on her to figure out how it works.
She shuffles over to her shelves. (I keep clothes out in plain site specifically so she can still dress herself.) She eyes a "favorite" sweater and puts it on. Once it's in place she seems to forget about it. She eyes another favorite and puts it on... The cycle continues until she either a.) somehow manages to layer them all, which seems to have happened Friday, or b.) I catch her in the act and remind her that we have to take the pajamas off first. It really is pretty funny, but not as entertaining as riding with her in the car.
I can't tell you how much I'm enjoying having her back on outings again. She rides kind of low in the seat observing everything and anything passing by. Sometimes she'll read every sign, sometimes she gives commentary on people, sometimes we talk about life.
I've mentioned it before, but it doesn't hurt to say it again. There's something about being in the quiet cabin of the car that helps her focus. We have our best conversations in the car. She's almost lucid in the passenger seat. In the past few weeks we've been to a horse show, out to eat with my sister and her family, even just grocery shopping and every time the real treat is talking in the car. It's like I have my real Mom back as we travel from point A to point B.
She's full of life and jokes. She has renewed energy. A little too much energy some days. The trip to Atlanta was to find a new horse. I'm not positive yet that it will all work out, but as an activity last night, I asked her to give the new horse a name. She studied the pictures for quite some time and finally said, "I tell you what," her eyes glistened as she concocted a plan, "let's take a little ride and go see him!" She was so excited at the prospect of going on an adventure. "That would be awesome," I said, "but he's not here yet. He's still down in Georgia."
My Mom contemplated the news for about a millisecond. "Okay, then let's just go for ice cream!"
Like the flowers throughout our subdivision, she's definitely come back to life after a long dormant winter. "Sounds great!" I answered, confidently relying on her fleeting memory. At a few strokes before midnight, it was no time to be running around town.
Instead, I enjoyed watching her enthusiasm just at the thought of once again being on the go. She's definitely blossoming again and I suspect, we're going to make it through at least one more season.

Monday, April 12, 2010

When You're Smiling...

My Mom smiles at everyone and everyone smiles back. She really brightens a lot of days.
So there's nothing I wish more than that she had better teeth.
Sadly, what should be her 'pearly whites' are more witch-like these days. I'm not being mean. She's visited the dentist quarterly for as long as I've been alive, it's absolutely not her fault.

She spent the first six years of her life in Scotland where they never used fluoride. The damage from those early years was insurmountable for any human, and any dentist. The first time I stepped up as advocate for my aging parents was with a secret call to the dentist. I told Dr. Magar I'd pay for tooth whitening and he could tell her it was covered by insurance. She is such a beautiful lady, I didn't want her to miss out on the latest technology that may help recapture a little sparkle. That saint of a dentist personally took my call and spent a good half hour explaining that although he'd be glad to take my money, no whitening on the planet would work. My pretty hip Mother, it turns out, had already requested whitening on her own and received the same answer. She suffered from a 20-some letter condition that I no longer recall, mostly a direct result of poor dental care as a child that caused premature discoloration and eventually decay.
There was no way around it. Her teeth and gums would be the first features to betray her age and beauty. Her failing brain would soon after prove too unpredictable to do anything about it.

When My Mom came to live with me, my first order of business was to get a second opinion. I was determined to help enhance her smile. Two dentists. Two opinions. Both the same. You can't cap bad teeth or you heighten chances of severe infection. Dentures, in general, don't work with dementia patients. The primary reason, they lose them. It's best to leave the teeth they have in place. They might not constitute a full set, but at least they're permanent.
Now that we mingle regularly with other Alzheimer's patients, I've accepted the dental status. I don't think much of it when I see a tooth missing here or there on our new friends and I've yet to see anyone react terribly adversely to My Mom's lackluster smile. But even though the twinkle in her eye compensates for a sparkle in her teeth, I kept holding out hope that somehow, someday, she could snag a better smile.

Well, the time has come. She's begun losing enough teeth that the only option is to pull them all -- creating a now or never time to try dentures. It's kind of a last ditch effort. Nothing to lose, except, of course, her new teeth if they're carelessly wrapped in a napkin, left on a dinner plate, or I just heard, perhaps flushed down a toilet...
Hoping she won't have the track record of my high school retainers, we thought we'd give it a shot. I expected my heart to be filled with joy at the thought of her getting a great big new smile. I thought I'd be ecstatic. I was wrong.
I'm a wreck. This is by far the toughest decision I've ever had to make as a caregiver, maybe even the toughest decision of my whole life.
We went to see the specialist today. He couldn't have been kinder, sweeter or better with My Mom. She was in a very upbeat mood, all excited about the prospect of getting a smile like mine. In the car, on the way to the appointment, I very seriously explained the situation, including that although she'd get a great new smile, they'd have to pull teeth to make it happen.
"I want a new smile," she said very confidently. Pause. "I deserve a new smile." We had lowered the vanity mirror on the passenger side for her to assess the situation. She looked side to side at her face as we discussed the topic. "Do you think he could shave a little off my nose too?"
(Note to self: It might be time to cut back on the Hollywood entertainment news shows...)
That very vanity was my selling point for convincing our primary dentist that My Mom just might keep the new teeth in her mouth. Wyn has always been concerned about looks, which makes her a better than average candidate for dentures. I felt so confident about the decision as we entered the office.
The specialist met all my expectations. He was kind, gentle and so good with My Mom. It's the most personality she's ever expressed with strangers. Then he said he'd be happy to perform the extractions himself. He went on to say he had done them a lot. In Egypt. Tons of them. My dark mind spun out of control. Where exactly had he accumulated this vast experience? In a torture chamber?
My Mom still has 19 teeth. Who am I to say 'let's yank them all out'? The whole process of replacing the teeth takes almost three months. This decision would leave her gumming-it for a minimum of 10-12 weeks.
The prospect of putting her through that kind of pain practically paralyzed me. It took all the lure of a new smile right out of the equation. Who would decide the price of beauty when it came to My Mother? Not me. I did the only thing I could think of, I deferred the decision to my sister.
She jumped in where I left off. With even more questions. How many teeth would he pull at a time? With My Mom's condition, could she alert us properly if she was in pain? What would she eat? Would she understand the gum look was temporary? That we weren't trying to torture her? Paranoia is a strong component of dementia. She might think we're selling her teeth on the black market or something.
While everyone else in the dental world seemed to only be concerned over the odds of her losing the dentures, cost didn't even factor into our concerns. We only cared about comfort.
Then we analyzed the other side. What if we left the teeth as is? The front one already cracked. Infection and choking on one were potentially serious consequences. But those side effects at least would be caused by Mother Nature. We wouldn't be to blame.
As we prepared to leave the dental office today, I turned to My Mom one more time, hoping the environment would solidify the seriousness of our decision. Honestly hoping she'd show me a remarkable moment of clarity and make the decision herself.
"You can have a new smile, but you heard the dentist. He'll have to pull all your teeth first, to make that happen. Do you still want a new smile with dentures?"
My Mom didn't hear me. She was too busy interacting with her new friends, Dr. Badr and Pam, the receptionist. She went from being the sophisticated woman gazing in the car mirror an hour earlier, to a child, amused over the toy cars, horses and stuffed animals displayed in the office. Pam gave My Mom a little stuffed bear and she lit up. The joy on her face made her current smile beam like a million bucks. "I'm naming him My Boy," she said with such joy. "Oh, I loved meeting you," she gushed. "I'll come back here a lot."
We all laughed at the irony.
"Yes you will," I answered. "If all this goes through, you'll definitely be visiting here a lot."
If only I could be convinced she'll come out of the process with the same enthusiasm.
Seeing her smile at these new people today. Knowing the joy she experiences over a good laugh. Seeing the sad state of her poor little mouth today. It seems worth a shot.

Tuesday, April 6, 2010

To Tell the Truth?

I've been using real life flashcards with My Mom again. In other words, instead of holding up cards with pictures of objects, I point to the real thing.
It can be an object, like a candle, or a living, breathing being like one of the dogs.
Tonight we covered "plate, cup, bowl, fork, knife and spoon." I wrapped the exercise with my usual final question. "And who am I?" It's always a gamble on whether she'll answer correctly. Sometimes I'm a "really good friend," sometimes "her sister," or sometimes she'll deflect with a crafty "well I hope you know who you are."
Tonight she was spot on. "I know. You're my daughter," she said quite proudly. Upon closer observation she added, "but I might not recognize you for much longer."
Wow, I thought, is she acknowledging her crippling mental disease?
"You're getting fat," she said bluntly, puffing out her cheeks and patting her belly. I can't be offended, she wasn't wrong. I had definitely put on a few pounds lately.
The problem is, she speaks the truth a lot lately and it's mortifying when she does it to other people.

Last year a good friend of the family came to visit. I've called him Uncle Bill my whole life. My aunt raised his wife. Sadly, his wife died fairly recently and he reached out to us as family at the holidays. He came for what I'm sure he hoped would be an uplifting Christmas experience.
Poor Uncle Bill. He walked into the living room with a big smile on his face and embraced My Mom. I could tell she recognized his voice, but had trouble placing him, so I introduced him to her.
"Oh my goodness, I would have never recognized you!" She sized him up, taking in every feature. "Look at all that gray hair."
"Yea, well, I guess we're all aging," he said, handling the comment good naturedly. I jumped in prompting other conversation. A few minutes later My Mom asked who he was again. Same routine:
"I don't even recognize you," she said.
"I know, the hair," Bill said, still trying to laugh it off.
"And you've gained a lot of weight," she added. I could have died.
It's not just weight and hair, she'll critique anything that catches her eye -- which is quite a bit, especially when you consider she only has partial vision.

When I first started hiring caregivers I really worried about what she might say to them, but so far she seems to win them over well enough in the good moments that they, like me, aren't too terribly offended when she throws a verbal zinger.
In fact, one caregiver, Emily, recently relied on My Mom's candor. I'm known for my being a good cook, however, I admitted I wasn't sure about a batch of matza ball soup right before serving. A guy I was dating at the time had put in the special request. I had him try it in front of My Mom and Emily. Truly a recipe for disaster. In this odd family affair, I dished up a bowl for the date, one for My Mom, then started to serve Emily. She hestitated. The date took a sip and said it was good, but that wasn't good enough for Emily.
"I'll wait until Wyn tastes it. She'll tell the truth."
Thank goodness, My Mom loved it, and of course, said so.

Luckily the truth can go both ways, critical and complimentary. She'll often tell me I look nice, or that my teeth look good. Virtually every night, regardless of what transpired that day, My Mom will tell me she "had the best day ever" as I tuck her in to bed. No matter how rough of a day it really was, I know in that moment that's what she believes. And as I close the bedroom door whispering one last good night to my now very content Mother, I leave whatever earlier stress we experienced behind and reflect on how grateful she sounded. In that moment it becomes the best day ever for me too.

Monday, April 5, 2010

Uh-oh....

Guess who's legitmately sick today???
And guess who's finally feeling better and not in the mood to be homebound???
I just made My Mom chicken noodle soup. Wondering if I can sneak out and ride my horse? Maybe if she takes a good nap...

Sunday, April 4, 2010

I'm sick. No I'm Sick....

I'm finally feeling better, much better after a knock down, drag out sinus infection. I was already feeling a little lousy when I wrote the last entry. The minute I hit "post" I realized my foggy brain forgot to add the couple of funny stories about where we used to go as kids when My Mom handed us off, and now all the crazy places she's been and people she's probably met now that I hand her off... I just couldn't pull enough energy together to write a post.

As it would go, My Mom was still completely in "go mode" when I needed life to come to a screeching halt this week. She gets 'jazzed up' as she would call it from being on the go. It's as if someone pumped caffeine intravenously into her frail little body. For two full days now I've desperately needed rest and she keeps acting like she's on speed. We've been hanging out in the living room where I can lay on the couch and keep an eye on her. Every two to three minutes she has both feet off the recliner footrest asking me "are we ready yet?" or saying "okay, let's go." At first I humored her, "Where do you want to go?" I'd ask. Completely buzzed up from all the action she experienced the previous few weeks, she was literally game for anything. The question gave her brain some much needed exercise as she struggled to think up an answer. "Well... you know, there." Not good enough. "No, like where?" I pushed her. Realizing I wasn't budging until she came up with a solid plan, she really put her thinking cap on. "How bout the movies?" she suggested. My Mom never wants to go to the movies, but evidently anything seemed a viable option that day compared to being home bound. Later she added we could go to the store, home, or a couple times even to see her mother (who passed away almost 30 years ago.)

By the end of the second day of feeling lousy I couldn't take her jack-in-the-box behavior anymore. I decided it was time to really push the sympathy route. "Mom, I'm really not feeling well," I moaned. She looked genuinely compassionate. "You should have told me," she said. I could have laughed. I've done nothing but tell her I didn't feel well for over 48 hours. This was, however, the first time I groaned as I said it. That must have been the necessary emphasis to catch her attention. She was always great at caring for us when she was able-minded, the nurturing skills kicked in to gear. "Honey, you should have a good Hot Tottie and be in bed." (For the Scottish, whiskey is the number one cure-all. We use it for a multitude of ailments, starting with teething as a baby.) I thanked her for caring and told her what I really needed was to rest. "You need to relax and stay on the chair for me to do that," I said. She still wanted up and about. "I'll go get you something to drink," she replied, both feet back to teetering dangerously over the edge of the footrest. I desperately wished she could care for me, but the reality is she's much to unstable to wander around on her own. She also wouldn't know what to do or where to find anything once she hit the kitchen. Just to see what she'd do if I accepted her offer, I played along. The reason she doesn't know her way around the kitchen is that she always has an excuse to get out of cooking or cleaning these days when I try and include her.
"Okay a little juice would be good," I said. Sure enough, that did it. The thought of work sent her lazy little fanny plunking right back into the chair. Then she set out to make sure nothing further could be asked of her. Leaning back she now started to moan, raising her head to her forehead. "I'm the one who needs juice... I'm all clogged up." I wanted to say "Are you kidding me?!" but at least she was safely sticking to the chair for the moment.
I let her play sick for a while to keep her planted in the chair, but as this ridiculous sinus infection raged on, I needed her to help herself a little bit more than usual. Bedtime that night proved difficult. "Okay, get yourself into your pajamas," I coached. Pause. "Please, Mom, I'm really not feeling well."
"You're not feeling well? Look at me." She made her voice weak and raspy to match mine, and she even feigned a little fake cough. "My throat, my head," she gave a side look over at me taking inventory to see if she missed any major symptoms, "my chest. I'm a mess."
"I bet you are Sarah Bernhardt." She used to call us Sarah Bernhardt when we were little when she thought we were acting. Evidently Sarah was a contemporary of Mary Pickford or something. All I knew is that it was an insult. Well, what goes around comes around. It was my turn to use the term. My Mom could win an Oscar for this performance. She was as irritated as I used to get for being accused of acting. In fact, she was down right indignant. She sputtered a cough and tried to eek out a few tears. "No one even cares. Here I am so sick and I'm trying to do all this myself."
'All this', for clarification, encompassed putting her right foot into the pant leg of her pajamas. She absolutely looked on the brink of a breakdown over the small task.
And so it went on, for three very long days. Any time I coughed, sneezed or tried to speak, she too cough, sneezed and wheezed -- matching my ailments point for point. I guess looking back, I'm glad she only caught a fake cold. I was concerned that whatever I had might be contagious. Trying to care for her and myself if she was really sick would have been a lot to manage.
(Side note: We're 'both' on the mend this weekend, so I've got her back on the move. Last night we braved a rain storm to go shopping. We bought her a cute new mint green sweater which she'll wear today when we're once again heading out -- this time for Easter brunch.)
Enjoy the spring weather!!