Thursday, July 09, 2009

Are You A Good Day, Or A Bad Day?

The first time I saw my mother after the initial drop off at the assisted living center was last Tuesday when I took her to a doctor's appointment. It was her first meeting with the new doctor and I wanted to be there to fill him in on her medical history and to get a sense of the new guy.

She was fine the entire time. A bit zombie-like, but she knew who I was when the doctor asked. He basically said that her memory is shot. (I know it but it still doesn't feel good to hear someone else say it.) He also said that a recent study was published that asserts Aricept and Namenda have no real effect in postponing the effects or improving the memory of people suffering from dementia.

As my brother and I are both anti-pill, I suggested that we back down off the Xanax (anti-anxiety) to only once a day. That being at night so she could sleep. We decided to stay on the Aricept and Namenda for now and wait for the next generation meds to come out. Although I think mother dear is probably beyond help at this point.

I saw her on July 4th and it didn't go as well. When I walked in, she was standing in the lobby crying. I hugged her and asked what was wrong. She was discombobulated, her mind going in all directions until she told me that someone had pulled her hair. I asked who, and she said the man who cleans the walls. I reported it to the staff. It could have been a staff member, another patient, or just in her mind. I don't know, and unless someone sees it happen, we'll never know.

I took her to her room and tried to get her to relax on the bed and take a nap but that wasn't working. She wanted to walk the halls and for me to go with her. We ended up out on a swing in the courtyard until it was dinner time. My brother and I have decided to strategically arrive about 1 hour before then so it gives us the opportunity to leave without any fanfare while her attention is moved to the eating process.

Not this time. I just couldn't get her to go to the dining room. I was trying to redirect her there over and over. An attendant tried to help with no success. Then it happened.

Me: Why don't you follow me? Let's go into the other room.

Mom: [Angry.] I'm not going anywhere with you.

Me: Why? What's the matter?

Mom: Because you're always mean to me!

I looked at the attendant and shrugged. As quickly as Mom got angry, she moved to her normal mood. I considered that she may have thought I was the "hair puller." I eventually got her to her seat and scooted out when they served her soup and a sandwich.

I was pretty shaken up and told my brother what had happened. He went up the next day and said she was a lot better than what I'd seen.

Tuesday was when I planned my next visit. I had decided to ask them to put her back on the Xanax in the a.m. so it would keep her calm during the day. Unfortunately, I had a client schedule a last minute conference call and I didn't make it.

Wednesday I received a call from my Mom's nurse. We talked and she expressed concern that Mom was having trouble adjusting. She seemed nervous, and was routinely heading out the door. I understand she wanders out the door a couple times a day. She isn't eating well, either. The nurse said they'd put her on protein shakes and suggested that we go back on the morning Xanax. I told her I agreed and was going to mention the same thing. So she's back on that.

I went up that afternoon and Mom was fine. I sat on the swing with her for an hour and relaxed. I brought a television up for her room to give her some distraction. With nothing to do in her room, she paces the halls and eventually heads out the door.

She went to eat dinner without much coaxing and that was that. My brother goes up tomorrow and I'll probably go up on Sunday so we are seeing her every other day.


Greg said...

I'm so glad there's a swing there. I remember that she likes a swing.

I thought the same as you about the hair-pulling. It could just be a childhood memory she's re-living. There's a resident of my Mum's place who often thinks she's a child in war time again, about to be evacuated to the countryside, and scans the faces of anyone visiting in case we are her new foster parents.

I'll bet your Mom's outburst about you "being mean" made you feel awful. However, it's too easy to imagine that our Moms are still rational and then attach an outburst like that to the huge guilt we're carrying with us for placing them in a Home. I'm always fighting that.

I'm glad you and your Brother are managing to get over so often. I wish I'd placed Mum closer to my home, but there were good reasons at the time why I wanted her near our other relatives.

citygirl said...

There will be good & bad days like these and there's sometimes no way to avoid or help them. When my mom was having a bad day (and she also would direct them right at me like your mom did), I would feel like crap for days after.

I'm not a big fan of pills either but my mom had to stay on anti-anxiety pills or she would have given herself a heart attack or stroke because she was so wound up. After the first year or so, I think we weaned her off them because she was settled in the home and she was losing the wind in her sails. She didn't seem to want to "fight" anymore. She had moved onto the next stage.

I also felt a little kick in my gut when I read that the doctor said your mom's memory was shot. It's something YOU KNOW but when you hear someone else say it, it still hurts.

I totally agree that Aricept has no affect on postponing the effects or improving patients.

Interesting about the hair-pulling man. It's quite possible she dreamt/imagined it or it was another patient. My mom told us one day about a visitor she had in great detail - her long-deceased sister!

Keep going to visit. Keep your chin up. It's really great that you/your brother are getting there as often as you do. My siblings and I did that and I think it really helped mom overall plus it lets the staff know that your mom has someone watching out for her (not that you like to think that way about the staff but it's something that crossed my mind).