Monday, September 29, 2014

Downward Spiral

     She asked me about the dishes again yesterday.  "Are you taking dishes to work and not bringing them back?"
     "No," I reply.  "You have the same amount of dishes, give or take a broken glass, as you did when I moved in here three years ago."
     "I know that when I buy dishes...I should have twelve."
     A few moments later: "Do you think someone could have a key and is getting in and taking them?"
     She actually doesn't get all the way through this sentence before I interject, "No, Nana, no one has a key to the house."  Now I'm frustrated because I don't know how many different ways to tell her she's not missing any dishes; I have to practice my self-restraint to tell keep myself from saying to her that she's being paranoid.  So I try a different strategy:  "Call David & Leslie and see if they have any ideas."
     She doesn't.  So when David comes by to pick her up for dinner I tell him, "She's concerned," do not say "paranoid" because she is standing right there, "about her dishes again."
     Yes, again.  This is the third time she's asked me about dishes in the last month or so.  (Although in the past year, there were a few scattered times she believed she was missing Tupperware.)  I've lived with her three years -- the same amount of dishes exist.  Why now is she so...concerned about them now when she never was before?
     Dementia -- there really is no logic.

Monday, September 8, 2014

The Obsession: Part II

Hearing stories from other people whose elderly relatives developed dementia, I gather that weird or unusual obsessions are part of the disease.

I've mentioned "the pills" before.  Well, this one is to do with the kitchen.

I've been living here with my grandmother about three and a half years.  All serving items (plates, bowls, etc.) have, for the most part remained the same in that time, with the exception of a few new mugs and a few "OK to throw away" containers.

Last week or the week before....

My grandmother:  What happened to all the silverware?
Me:  What do you mean?
My grandmother:  I had [insert number of] forks.  Some aren't there.
Me:  I'm sorry, I don't know what you're talking about.

This goes on for a little bit.  The self-restraint is hanging by a thread, and I flippantly say, "I guess someone came in and stole them."
My grandmother: They must have because I had [however many] of each and now there are only [less number than however many].

This past weekend....
My grandmother:  Are you taking glasses to work and not bringing them home?

[Okay, pause....I can't even begin to describe the absurdity of this statement.....resume]

Me:  No.  There are the same number of glasses in there as there always are.
My grandmother:  No, some are missing.  I had...just a minute.  [She goes to check to tell me just exactly how many are missing, like she can remember the exact number of each type of glass she has, but gets sidetracked by something else and forgets about the whole thing.]

(I realize that last bit is a little callous, but please permit me a little blazing honesty for a moment.  My self-restraint is temporarily broken.)

I checked a few minutes later, not mentioning the conversation, just looking.  All the glasses are there.

I don't know if this one counts as obsessional technically, or paranoid.  Either way....oy.  And since I don't remember to ask in the moment, because I'm too busy being stunned by whatever absurd question has been thrown at me: "Jesus, please allow me your strength in these moments.  Amen."

How Not to Kill Your Grandmother

I've become quite familiar with the emergency room.  How old is mine?, you ask -- she'll be 82 this month.

Last November (it was forever ago and it was yesterday) was our first visit.  I get home from work to find the house slightly amiss.  I walk around cautiously calling for Nana, praying I don't walk into a room and find her on the floor.  Her car is still in the garage, but her purse is gone.  I assume she's at the neighbor's. What really nags at me is the sight of my work number lying on top of the microwave, like she had the intention of calling me. I call Uncle David and Aunt Leslie to make sure Nana isn't with them (leave a message for both) before going to knit/crochet group.  Aunt Leslie calls me back while I'm at group.  She had gone to the house after she got my message.  She went to the neighbor's but the neighbor said she hadn't seen her.  Leslie went across the street to another neighbor's -- they happened to see an ambulance come pick up Nana.  So I go home.  We discover the hospital Nana'd been taken to.  The story finally comes out that she felt short of breath so she called an ambulance.  By the time the ambulance had arrived, she knew she had called them, but she couldn't remember why (a recurring theme with these ER visits).  It was determined she had a pulmonary embolism.  This visit marked the commencement of me being charge of her medicine.

The second visit is a Saturday.  I had planned a lovely day at the zoo with a friend and her son (me complaining is another common theme with these ER visits), but Nana said she woke with a pain across her chest.  By the time we even leave for the ER, Nana is no longer in pain.  We're at the ER -- a long, drawn out process, especially for the complaint of chest pain -- they run their tests.  Nothing is wrong, but they admit her overnight for observation.  During this visit, I discover that she and her one friend had chili dogs the night before.  The woman probably had indigestion.  This visit taught me that should Nana ever complain of chest pains in the future, I should ask more questions before jumping in the car.  (Please, for your sake and mine, do NOT state anything along the lines of "Better to be safe than sorry."  Really not helpful.)

The third visit I wasn't privy to until I came home from work.....thank you, Jesus.  She went in, nothing wrong, sent her on her merry way.  

Let me interrupt here to say, the thing about these ER visits, there's always the thought of "Is this the One?"  There's the worry regarding whether or not this one's very serious, like the first; whether this will be the last one because it's the one she won't come back from.  That thought is always there nagging.

And now for the fourth visit: today.  I am woken up at 5am.  "Stephanie.  Get up.  I need you to take me to the hospital."  I get up; I get dressed. I prepare myself to ask questions regarding what kind of chest pains she's having, is there shortness of breath, etc. -- remember the lesson learned from Visit #2.  I walk out into the kitchen.  She has a bag all prepared in case they admit her.  Before I can ask any questions: "Look at that."  She points to her feet.  She has a lovely bruise on one toe.  "I was lying in bed reading, and it did that."  A stubbed toe? I'm thinking.  Well, she's on coumadin [blood thinner].  Fine.  So we get in the car.  I'm so tired, my eyes are watering.  I didn't bring a warm sweater or sweatshirt because I clearly didn't learn a lesson about the ER being the same temperature as the Antarctic.  So we sit there in the ER.  I'm tired, I'm cold, I'm a little angry at myself for not saying, "Let's wait a bit; if it gets worse, I'll take you."  

A nurse finally comes in; this is when I discover that Nana did not want to come to the hospital because of a stubbed toe.  Oh no.  Here in paraphrase is what she told the nurse: "I was reading in bed.  My feet and legs felt tingly.  I looked down and they're blue."  She's showing her legs to everyone like we're all supposed to be impressed by something.  By her legs being blue, she meant the veins had shown themselves.  Like the veins in her ankles and on her feet -- you know, the veins all old people get for whatever medical/scientific reason old people's veins start showing off on the legs and feet -- were all new to her.  Just Saturday she was mentioning how awful they looked, and she doesn't remember it looking like that.  It does by the way.  All the time.

So, in my words, Nana wanted to go to the hospital because she felt new veins showing.  So here's "how not to kill your grandmother" in three easy steps.  Actually, there aren't steps, just three words: don't do it.

I am so mad and so tired, I have to turn my head to the side so she doesn't see tears running down.  I call my mom, who insists on staying informed on every hospital visit, and have Nana speak with her.  Mom wants to speak with me afterwards, but I can't.  I have to step out of the "room" (it's a cubby with a curtain) because I can't not full out cry.  Because that's what happens when one is sick or really upset about something -- you cry to your mother (or mother figure).  And when you don't want to cry, it's just disaster waiting to happen.

The doctor feels her feet and ankles -- good temperature, good arterial pulse, no unnatural discoloration, (she's fine).  He has a quick blood check done -- all well there.

By the time we're ready to leave a few hours later, Nana -- even though she's told everyone there without any prompting why she came to the hospital -- asks me, "Why did I come in?"  All I can do -- very little self-restraint left at this point -- is look at her and say, "Really, Nana?"

I took her home and went to hang out with a friend, which is often three times the worth of a month of professional therapy.  Thank you, Jesus, for Donna.

So the lesson from this fourth visit is like that of the second, and what is that:  always ask questions.  

Stay tuned for another brief post regarding my grandmother's obsessions.

Friday, September 5, 2014

The Obsession and Confusion


     Fantastic.  Now Nana has an obsession with her pills again.
     Friday night -- six days ago -- I went out to dinner with her and David.  I mentioned to David that before Nana leaves, while she's on her trip, some of her medicines will run out, so we'll need new prescription orders.  Of course, Nana is sitting right there hearing this conversation.
     I get home from work yesterday to find she did take her AM medicines, however, on the chart "AM" was circled, and Nana had written "pills not out."  Ummm, what?  I thought perhaps she had taken her pills, forgot she had taken them and so thought I hadn't put them out.
     No, no.  Once again, she was talking about the big bottles.
     Last night from her one friend's house she called asking about [whatever the situation was in her mind that I could not follow] saying her pills weren't out.  She said she'd taken her morning ones.  She said she'd gone back to my room to look for her pills (she's referring to the big bottles, which I keep hidden in my room -- OMW).  When I told her I didn't know what she was talking about, she couldn't remember, but she knew there was a reason she was asking.  She became so mixed up with this one (obsessional) thought, she couldn't focus on my question of allowing me to check her bank account balance online.  She said we'd talk when she got home.
     Me:  "I'll be in bed when you get home."
     Nana:  "Well, you can wake me up in the morning."
     Me: (in my head) As I rush out of the house because, as always, I'm thisclose to running late, and you're half asleep because I just woke you up?  Sure thing, Nana.
     When I put her daily dose out this morning, there was a note: "Please put all my pill bottles out.  You said I'd run out of some.  I'll go refill them today."
     The reply:  "You have plenty of pills."
     I debated expanding on that but stuck with simplicity.
     It's been hard for her to relinquish control of her medicines.  Clearly.  I'd love, love, love to tell her the truth -- that she can't be in charge of them because she'd screw it up and no one would have any clue, and she may or may not die because of it.  But that truth is one of the things for which I must practice self-restraint.  And not telling the truth is HARD for me.


     This morning I find a note from Nana: "Please leave my checkbook out.  Thank you."
     Her checkbook is in her purse.  I take it out to write checks for her; I replace it when I'm done.
     So I pulled the checkbook out of her purse and sat it with the message and wrote a reply:  "Here ya go.  It was in your purse.  ?"

     I'm starting to get worried about her confusion.  Worried that it's getting worse.
     Dear Lord, what do I do about this?