A Trip to the ER

As our LAN line and cell phones rang one after the other last night, we figured something big must be up. And it was. KS called Tracy at 7 p.m. to let her know that Blanche had tripped and fallen after dinner. She hit her head and her knee and as a precaution, KS called the ambulance and had them take her to Waterbury Hospital. The emergency room. On a Sunday night. In the pouring rain. Did I mention on a Sunday night? In the pouring rain?

So we sat with Blanche for about five hours. She was in great spirits. She kept saying how happy she was to see us and how nice it was that we could all be together. She had x-rays taken on her knee and a CAT Scan on her head. It was all good. There was nothing wrong with her. But yikes, it was a long wait. Toward the end, Blanche really wanted to leave, so she started to methodically fold the blankets and sheets that were covering her. It was quite interesting to see the level of concentration she exhibited as she folded first the top blanket, which she then placed at the end of the bed and then the second blanket was folded, and also placed on top of the first blanket.

By then she was down to just a sheet covering her. Tracy kept telling her to leave the sheet alone because all she had on under it was a johnny coat. So she would stop for literally one minute, then pick up the sheet, defiantly stare at Tracy and start to fold it again! It was fascinating to watch. Tracy finally just got up, and unfolded both blankets and placed them back over Blanche so she had to start all over again. At least that bought us time so she wouldn't be just lying there practically naked waiting for the doctor. And it was freezing in the room she was in.

We watched several sets of people come and go. As each one would leave, Blanche would make a comment loud enough for all to hear. She was very nosy. It was also interesting to see her out of her normal surroundings. While she was in good spirits, she literally could not complete a sentence, which was really frustrating to her. She kept telling Tracy she had something to tell her, but she couldn't remember what it was. Tracy told her where she was and why she was there, but she did not respond to that at all.

Interestingly, when we first got there, a nurse came up to Tracy and said that Blanche seemed very confused. Tracy explained that Blanche has Alzheimer's and the nurse said he knew that!? Okay, then, why was he surprised she seemed confused? We couldn't quite figure that one out.

When the doctor finally came, he asked Tracy if in her opinion, her mom was acting normal. Tracy said, "absolutely" and the doctor was satisfied between that answer and the CAT Scan results that she had not suffered a head injury.

So, we were curious as to what would have happened if KS had not been able to reach Tracy. Apparently, the ambulance would have taken Blanche back to KS, so that's good to know.

Hopefully, it won't happen again anytime soon.

Trying to Make Sense of It

I just got off the phone with my dad's geriatric doctor. I figured if I write down all my thoughts right now, chances are that I would remember more of the conversation. She said it is her feeling, and that of the consulting doctor, that my dad's lack of motivation is being caused by his dementia and not his depression. I can understand that, but it doesn't change my opinion about the need to increase his depression medication.

I told her that I understood her reasoning. However, given that my dad cannot take Aricept because of his past bleeding ulcer issues, and they won't give him Numenda because that's only prescribed in cases of severe dementia (that's correct - that's what she said), I think that a slight increase in his depression medicine might give him some added motivation and wouldn't it be worth a try?

Ruling out Aricept and Numenda rules out the popular Alzheimer's/dementia medication that I'm aware exist. In fact, Tracy's mom is on both of those and I don't consider her dementia to be severe. Maybe I just don't know enough yet about the illness or even the differences between Alzheimer's and dementia.

If I compare Blanche's behavior to my dad's, it's hard for me to see the similarities. Blanche has bouts of paranoia, she makes things up, and she forgets everything a minute after it happens. My dad has not exhibited any paranoia, but he does seem to forget everything a minute after it happens. He does make things up, but not in the same way Blanche does. She tells us of visits she's had recently with her husband, who has been dead for six years. My dad just seems to think he's doing things like he used to do. It's very confusing, but I guess if I re-examine what I just wrote, my dad and Blanche do exhibit similar behavior...

Well, as I was writing, the doctor called back. Hard to believe! She actually gave me a referral to an experimental study that is ongoing at Yale University's Department of Psychiatry. It's an Alzheimer's/dementia study. I think it might be the same study that Tracy and her grandmother participated in when her grandmother was about 95 years old in 2004 or 2005. If I remember correctly, they went to Yale periodically and participated in testing. There were some instances where Tracy's grandmother actually tested better than Tracy did! I better check with her on that to make sure I'm not making that up!

And she then said that if we choose not to participate in the study, or if we do participate and it doesn't seem to help, then they'll bump up the depression medication! After all that. She also said if they do bump it up and it doesn't seem to make a difference, they can always reduce it. That seems to make sense to me, but I still don't get what harm there is in bumping it up now. I think I want to believe the increased medication will help, when I'm hearing these doctors say it won't because my dad is like he is because of the dementia, not the depression. I think we still have to try.

So, we're going to see my dad's primary care doctor tomorrow. I'll do some research on this study at Yale before then and see if I think we can do it. Then I may just tell the doctor tomorrow to tell the geriatric doctor that we want to go ahead and increase the depression medication.

Long Overdue

This new post is long overdue. I'm not sure what happened to July. It just came and went so quickly. There were several visits to Blanche, the most recent being last Friday. She was very happy to see us and actually said my name. She hasn't said my name in a long time, so it was a nice surprise to know that at least on that day, she remembered who I was. She talked for awhile about how much she likes Kensington Green and how long it took her to decide that was where she wanted to live.

As for other things, her hair was dirty and the handicapped seat in her shower had two piles of nicely folded, dry clothes on it, leading us to believe that the shower had not been used in some time. We unpacked everything from her clothes hamper. Just can't get her to stop doing that. We found her underwear, tucked away in her nightstand and returned it to her dresser. My big find of the evening was the 24 bingo balls hidden away in her bathroom! What a find! I initially thought they were those oversized gum balls that I ate too many of when I was a kid. Glad I didn't try one because I'm sure it would have broken a tooth!

Cleo is good, although she probably needs to be checked out by the vet. She doesn't seem to be able to eat the dry food anymore, so we've been bringing moist food for her. We can't give her the cans because Blanche cannot monitor that and there would be smelly, open cans all over the room.

On another front, I took my Dad to the geriatric doctor on Wednesday and his dementia is worse than it was six months ago. He told the doctor that it was 2005. He also told her he goes out everyday, takes my mom shopping, and jumps in his truck and drives to the beach a couple of times a week! Interestingly, that is exactly what he was doing in 2005, but he doesn't do that anymore. He NEVER gets out of bed unless we make him. The doctors told me there is a great deal of overlapping with depression and dementia and it's hard to distinguish one from the other. I just know that I wanted them to increase his depression medicine to maybe give him a little motivation and I'm waiting to hear if they'll do it.

Living like this is taking such a toll on my Mom. Since she doesn't drive, she relies on my brother and I for everything. And she has to deal with my Dad and his depression and his dementia 24/7. She's handling it as best she can, but I know she is overwhelmed sometimes.

And to all of those health care professionals out there, please heed this word of advice from an average person. PLEASE do not tell elderly people that they should go to daycare! Why would a professional say that repeatedly to an 80-year-old ex-Marine? To him, daycare is a place where helpless little kids go when their parents have to go to work! I actually got the doctor alone and asked her to say "activity center" or "senior center". How hard is that?

I'm trying to stay positive because my mother needs that from me. But it's so hard. This is my Dad - my hero. He's the guy I followed around when I was a kid. It was me climbing the ladder right behind him to fix my grandparent's roof. It was me hauling the wheelbarrow full of stones into our backyard to extend the usable area of our yard. And now it's me taking him to the VA, getting him into a wheelchair and making sure I understand what is going on. It just sucks. And there's no nice assisted living facility waiting for him when the time comes and we can't take care of him at home. There's the VA hospital in Rocky Hill and I have no idea what that place is like. So that's where we are with all of that.

Keeping up with Medical News

There's an illness that is similar to Alzheimer's and I think it's important for those of us with aging parents to be aware of it. Check out this link for a disease that has many similar symptoms of both Alzheimer's and Parkinson's. The goods news is that it is very treatable once diagnosed. It's called Normal Pressure Hydrocephalus, or N.P.H. for short.

Read the entire article at the link below.

http://www.kauz.com/news/49629637.html

I also posted this to my Facebook page. I just wanted to make sure it gets as much exposure as possible.

Visitors are a Good Thing!

So in recent weeks, Blanche has had visits from several friends, her roommate from nursing school and a cousin. It's always nice to hear that because in part (and perhaps selfishly), it takes some of the pressure off Tracy given that we were the only two people seeing her regularly for quite some time.

I sometimes wish I could create some type of pamphlet that Tracy and I could give to people to prep them for a visit with her mom. It is so interesting to me that in some cases, not all, Blanche's visitors feel sorry for themselves because they feel as if they have lost a friend and that makes them sad. Well, yeah? Think how Tracy feels. It's her mom who has disappeared right before her eyes, yet still lives and breathes and exists in this world! People are funny like that I guess. The closest I can come in comparison is the person you may know (because we all know at least one), who doesn't go to wakes or funerals because it's too hard on them. Really? What about the people that are burying their loved one? Do you think it's hard on them? Do you think perhaps they need your support at such a difficult time?

Anyway, now it's my hope that the people who have gone to visit her will continue to do that as regularly as they can, at least through the summer.

The other thing that has surfaced because of these visits is that I think the assisted living facility should have regular communication with the family as to how their loved one is doing. Tracy never hears anything about her mom from the facility. They only have about 25 people living in the secured area of the facility. They should be able to generate a report that keeps Tracy apprised of the activities her mom participates in (or addresses the issues if she doesn't participate), the people who come and visit her, and just the overall state of her well being. Sending out something like that just once a month would be a great comfort to Tracy and I'm sure many other families as well.

Other issues we are dealing with relate to my parents. My dad suffers from depression and mild dementia. We were able to get him on an anti-depressant about six months ago. I called a couple of months ago to ask his doctor if we could bump up the dose because he was on a very low amount. They told me no because they were concerned he would suffer side affects and since he wasn't exhibiting any side affects, they left it as it was.

Now, despite all my Dad's promises he made in the fall to start doing more, he only gets out of bed when he absolutely has to. And even then, sometimes he'll take my mom to church or to the hairdresser and not even get out of his bathrobe! Even though he doesn't get out of the car, I am literally distraught that my Dad thinks that is okay behavior. If someone told me 10 years ago that my active, lively, strong father would literally have lost the desire to live I would have said they were crazy. But that is exactly what has happened to him. He is the last left of all his siblings and all his friends. He has absolutely no interest in anything and that is so hard on my mom. She doesn't drive, so she relies on my brother and I if my Dad isn't leaving the house.

I'm going to call my Dad's doctor again tomorrow and request an increase in his medication. Maybe they'll listen to me this time.

All is Well

Mother's Day lunch with Blanche was excellent! As we drove up Route 6 headed for the Charcoal Chef, we passed one or two horse farms. Blanche was chattering away and telling us how she drives up this way two or three times a week and pulls over to the side of the road to watch the horses. Excellent! I told her that's a great way to break up her day and she agreed wholeheartedly. She was also telling us how much she enjoys "working" at KS. If that's what it takes for her to be okay with living there, then so be it.

Once again, she was showered, her hair was nice, although it needs to be cut. Tracy is working on that. Apparently, she needs to ask KS to set up an appointment the next time they are offering that service.

Cleo is doing fine. She seems quite happy and not at all upset that she has to live in a memory care facility! Her life is pretty basic - she stays in Blanche's room and she eats, sleeps, pees and poops! Not bad. Tracy and I are responsible for her care. So once a week, we change the litter and make sure her feeder is full. Blanche is good about keeping water in the bowl. However, she still tends to try to give the cat little "treats" such as crackers, hand cream, etc. But we try to keep an eye on that. Since she can't have food in her room, it makes it easier to manage.

Last Sunday we took Blanche to the Heritage Village book sale. I went off and did my own thing, but Tracy told me later that her mom absolutely could not focus. She just kept reading all the book titles and never really seemed to find anything she was interested in. Yet, she used to be an avid reader. Tracy picked out a book for her and she had another one for her because we had been to the sale the day before. I highly doubt she is able to read a book anymore, but that's okay.

When we went back to Blanche's room, what a treasure trove of things we found! Apparently, Blanche has been collecting plastic hair clips. We don't know who they belong to, but there were at least a half dozen on her dresser. Isn't that weird? Also on her dresser was a checkbook belonging to someone else. Tracy immediately brought that to an aide and it turned out that it belonged to Blanche's friend, Celia. Why her family would allow her to have a checkbook in the memory care facility is beyond me, but the aide gave it right to Celia.

We're having a Memorial Day picnic on Monday and we've decided that Blanche cannot join us. We think it would be a challenge to keep her out of her old apartment and we don't want her to think she's coming home. So like on Easter when we brought her with us to my brother's house, we'll take her to picnics that are not at our house. I think Fourth of July is at my cousin's, so we'll bring her there with us.

That's about it for now...

The Compulsive Nose-Blower Strikes Again!

Are you kidding me?! She did it again! We took Blanche out to dinner tonight and even though the napkins were paper and not cloth, AND Tracy gave her a bunch of tissues when we got in the car, it did not matter. With one swift motion, she had squashed a bug on the restaurant window and blown her nose into her napkin! Yikes!

Blanche had been obsessing about a bug on the window at the restaurant. Tracy had told her several times to just leave it alone. Instead, Blanche started looking at a real estate magazine that I had picked up on the way into the restaurant. After pretending to look at it for a moment, she whacked the window and splattered the bug all over the window and the magazine. And then she laughed heartily as Tracy just shook her head.

So, all in all, Blanche was more animated and talkative than I had seen her in quite a while. That was a good thing. However, she seems to have picked up some odd habits. For example, after we had our salads, she took her knife and started scraping up dressing that had fallen onto her place mat. She would not stop doing that, no matter what Tracy said. Finally, she took the knife and licked it and that seemed to satisfy her and she stopped fussing with it.

When dinner came, Blanche did not eat much of it and like always, said she would bring the rest home. Since we can't let her do that, this is one of the only times when it is a blessing that her short-term memory is so bad. By the time we get back to KG, she has absolutely no memory that she had leftovers. One small (and isolated) advantage to the memory issues.

Until next time...