It's A Red Flag Day

March 30, 2010


Many of Dad’s lifelong habits and routines are starting to drift away. For more years than anyone can count, he was an avid fisherman. Rising more mornings than not, he would be out on the water with his hook in place before dawn even made its arrival. Over the last several years, he gave up fishing altogether.

25 years ago, Dad would put on his running shoes and run to the gate (1 mile each way). 20 years ago, he would jog to the gate. 10 years ago he would walk to the gate. In fact, up until a few years ago he was still walking about half that distance daily. Up until a couple of months ago, he would walk to the end of the driveway (it’s rather long) to get the newspaper every morning. Now he doesn’t bother trying to do that. It’s as if it is too much effort to even go that far. Some days, it’s too far for him to go from the bedroom to the dining room.

Part of this is physical and part of it is mental. With mental illness, it’s very easy to slip into a depression. Days go by without tending to normal grooming habits. It has now become common for Dad to go days without showering or shaving. On rare occasions he won’t even get dressed. But when he does, he puts his bathrobe on over his clothes if we are at home. It isn’t unusual for him to wear the same clothes 5 or 6 days in a row. After repeated battles, I no longer argue about it. I just wait for a morning he comes to the table in his pajamas and robe then I go grab them up and throw them in the washing machine while he is having breakfast. He refuses to buy new clothes even though many of his are old and stained. He says he won’t get enough wear out of them so why buy them. I’m not even going to try to argue with that…

Mom’s lifelong habit of arranging and rearranging is still alive and well. Unfortunately, it’s because she is Manic. She hates being in a wheelchair, she hates being tied to her oxygen (The Leash) and she hates being told to take her meds or to eat. She wants what she wants… when she wants it and can be rather a handful until she gets her way.

She is getting more and more forgetful every day. At least 3 or 4 times a week, she doesn’t know who I am. Tonight, she asked me how long I have worked for them. When I replied that I moved here back in November, she wanted to know if my husband and children missed me. I gently reminded her that they were with me here. “That’s right… that’s right… I knew that,” she mumbled in a confused state.
After careful consideration, I have come to the conclusion that her confusion is sometimes induced by stress. Today was a bad day for Dad, as Mom calls it “it’s a red flag day” (referring to the caution flags used on the beach to warn you about being in the water). He has been argumentative and has picked at least 3 fights with her that I know of. He is not feeling well and his mood today reflected it. Here’s hoping, for both their sakes, that tomorrow will be better. And if it’s not… we will deal with it.

Every Day Tasks Are Getting Harder

March 28, 2010

Some days are harder than others, know that and remember that. It can be very difficult to interest a demented mind. Sometimes, while the interest may be there the will just isn't, or worse yet, simple tasks have become physically or mentally impossible. Don't get frustrated, just keep trying. Anything you can do that stimulates the mind is a good thing. Anything you can do to stimulate the demented mind is a great thing!

Mom wants so desperately to be able to do all the things she used to be able to. Little things like arts and crafts, which she adores, have now become too difficult for her. Her hands shake violently most of the time (possibly related to Essential Tremor), making it impossible to do a lot of things. She finds many things physically impossible and others are just too much effort.

Dad, on the other hand, has no will to do anything. He is far more content to sit staring at a muted TV for hours on end. His self-imposed jobs around the house are gradually becoming more difficult for him to complete. If he begins to unload the dishwasher, for example, he may get sidetracked mid-task and completely forget what he was doing. He will then begin to load dirty dishes into the half unloaded machine. Or wander off absently forgetting to close the dishwasher door.
Last night, after dinner, I began loading the dishwasher while he insisted he was going to do it (he's still bandaged so he isn't supposed to be doing it). He immediately came to the kitchen with the few remaining dishes and informed me, "I have been loading that thing for over an hour. I don't need any help. Now move!"
I stepped aside and watched him turn 2 half full glasses of Coke and ice upside down in the dishwasher before he realized he had forgotten to empty them first. Within seconds, he grabbed the liquid dish soap and was going to pour it in the dishwasher. "Hey, Dad," I said, handing him the right stuff. "Why don't we use this instead?"
With a sheepish grin, he did it correctly before leaving the door open and wandering off into the other room. I followed him to do our nightly routine of cleaning his wound and changing the bandages. When we were done, he announced he was going to clean the kitchen and started to rise. I pointed out it was all already done. He replied, "Guess it's time to go seek a horizontal position." I wished them a good night and reminded them to call me if they needed me for anything. And as I was leaving the room, I saw him walk over and sit down in his recliner. Just that quick, he forgot he was going to bed.

Dementia News | Newsodrome

Dementia News | Newsodrome

Repeat, Repeat, Repeat

March 26, 2010

Dad gets to worrying about something and he can't let go of it until we find a way to resolve it to his satisfaction. For the past week or so, he has been worried about a prescription cream he uses. The tube was getting low and he didn't want to run out. I called the pharmacy and ordered more. A couple of days ago, I picked up the cream and brought it home. I put his credit card (which is used for all their prescriptions), the receipt and the cream into his hand as soon as I walked in the door. I made sure he put the card in his wallet before going to the kitchen to put away groceries. Dad called and reported his credit card missing so many times last year that they finally told him if he lost it again, he would have to wait until a specific date to get another one.

So here's the way today has gone so far...
Everybody slept in this morning (Mom and Dad were up A LOT last night and I was up with them) so breakfast wasn't fixed until about 11:30. While Dad was waiting for the pancakes to get to the table, he urged Mom to eat repeatedly. She and I both pointed out that breakfast wasn't ready yet, so she couldn't very well eat. He finally excused himself to go to the bathroom, mumbling that we were ganging up on him.
After 15 or 20 minutes, I went to check on him and found him in his bed asleep. He heard me and immediately struggled to his feet and made his way across the room to the door. He staggered when he went to stop in front of me. I caught him and held him til he was steady. "I think maybe I should lie back down for a while," he said shakily. "I'm a little dizzy."
I helped him back to bed and offered to bring his breakfast in to him. He passed his gnarled hand (the uninjured one) over his face and told me he would really appreciate that.
I went to the dining room and pulled out the bed tray I keep handy for times such as these. I put everything on the tray and picked it up while explaining to Mom that Dad wasn't feeling good so he was going to have breakfast in bed today. She nodded approvingly, "Good. Good idea. He's not himself today."
And as I turned around, Dad announced we were being silly. "I'm fine. Really. Sorry to put you to so much trouble, Sweetheart, but I've changed my mind. As long as I can sit at the table to have my meals, I will know I'm alive. Today, doesn't seem like a good day to die..." He ate his breakfast without incident but I could easily see he wasn't feeling well.

After breakfast, he went to Richard and told him he needed more cream. Richard explained that I had gotten him some a couple of days ago. Dad handed him the almost empty tube and asked if he would please take care of it. Richard of course came to me. And I of course went straight back to Dad. "Dad, I picked that up for you a couple of days ago." I was very cheerful about it, "Remember? I came in and gave you your credit card, the receipt, and the cream."
He instantly replied, "NO, I don't remember anything like that." He took the empty tube from my hand and led me to his bathroom. He showed me where it goes and pointed out emphatically that it would be right there if I had given it to him and it wasn't so obviously I was mistaken. Rather than argue, I took the tube back and announced I would go call it in and pick it up this afternoon.
As I entered the living room on my way to the phone, a thought flashed through my mind. I stopped at his desk and opened the drawer where he keeps his receipts. Rifling through it I couldn't find it so I closed the drawer and went to turn away. When I did, I saw the end of the tube poking out from under a book on the desk.
"Found it!" I yelled, heading for the bedroom.
Dad met me halfway down the hall. "Oh shit, Sweetheart. I am so sorry. Where was it?" I told him and he shook his head. "I'm sorry. I guess I forgot again."

After lunch we went through our routine of him telling me to get done in the kitchen and just let him clean it up. Normally, I would do exactly that, but he can't get near water with his bandaged hand. He is lost without his regular chores. He grumbled for a while but I managed to convince him he just can't load the dish washer. Sulking, he went to sit in his recliner.

Getting ready for dinner tonight, Dad asked if it was time to set the table (we go through this routine daily). I said, "Sure." "How many people are here tonight?" he asked. "Four." I replied.
He wandered into the dining room and promptly came back to the kitchen.
"How many people are eating dinner tonight?"
"Four."
He got forks from the drawer and back to the dining room he went. As soon as he reached the table, he cleared his throat loudly. "How many people tonight?"
With a hidden smile I answered "Four."
Once the forks were in place he returned to my side. "What else do we need?" he asked in a stage whisper. "Knives and napkins," I replied, watching him gather the knives and shuffle to put them in their place.
When he returned to the kitchen he asked, "What's next?"
I told him he could go ahead and put the glasses on the table which he set out to do but as he opened the cabinet to get them down, he turned to me and asked, "How many for dinner tonight?"
I smiled at him and said, "Four." He looked at me with sad eyes and said, "Damn, I knew that. I'm sorry, I guess I forgot again." And off he went.
This continued until I had dinner on the table and we were getting ready to sit down. I realized there were no napkins. I didn't say a word about it, I just went and got them and put them on the table. Then Mom asked Dad if she could borrow his knife (she didn't have one) and so on. It is all part of our nightly routine.
When dinner was over I quickly cleaned the kitchen while Dad insisted he could do it. And I insisted that he would be able to as soon as the bandages come off in a few weeks.
Then I sat down to bandage his hand. The entire time I was unwrapping, cleaning and re-wrapping, he was telling Mom to eat her dinner, take her pills, etc. It has been a day of repetition, a day of confusion. But on the bright side, tomorrow just might be a better day.

Some Days Are Not Good

March 24, 2010

Today has been utterly exhausting. I woke up to the freezer door standing wide open (obviously for quite some time), food on the counter, 4 or 5 dirty dishes and a quart of milk had been consumed. I got the kitchen righted and took Jordyn to the bus stop and headed home. I managed to get 1/2 a cup of coffee in me before I heard the wheelchair above my head.

Mom woke up with a vengeance today. Ravenously hungry and determined to make herself pancakes, she WALKED into the kitchen. She turned the burner under the cast iron skillet to high and went across the kitchen to mix up the batter (which she sloshed all over the counter). She turned around and reached overhead to pull down the cooking oil, then poured a more than generous amount into the already hot skillet. In a flash, the oil was smoking and popping. I hurried to remove it from the heat. Meanwhile, Mom fills her coffee cup with half a cup of water and bunch of half & half and puts it in the microwave. When the timer goes off, she puts it on the counter and dumps a spoonful of Community (absolutely nothing else will do) Instant Coffee into it... the volcano that erupted everywhere was intense. I may have to tell Jordyn about it because it would be a great science project. While I cleaned up the mess, Mom fried pancakes.

Once things were stable in the kitchen, I sat Mom at the dining room table with her mountain of pancakes ( she ended up polishing off 8 small pancakes!). I began my Wednesday morning routine of filling their weekly pill boxes. It was more time consuming than usual because I had to make new med lists for them both as we have had several recent medication changes. By the time I was finished, they were done with breakfast and ready for a nap. So, I helped them get settled and disappeared downstairs to get a few things done.

Lunch time rolled around and I headed up stairs to fix them something to eat. They were already in the kitchen and Dad was pulling everything he could get his hands on out of the refrigerator, Meanwhile, Mom was stirring a pot on the stove. They were making there on lunch. I checked on Mom first and saw she was making oatmeal. When I turned to Dad, he grabbed my arm and pulled me as far from Mom as he could.

In a resounding whisper, he told me they had "decided to get a bite to eat because Mom got dizzy in the bathroom and closed her eyes then fell". He had apparently helped her up and encouraged her to lie down and rest for a bit. Having worn himself out, he stretched out beside her. They just forgot to let me know until now. For the 1,000 time I reminded him how important it is for him to let me know when one of them has an accident or an incident so I can assess the situation. A delay of the time it takes to get help could mean the difference between life and death.

Once everyone had had lunch, I left them alone again, at Dad's request, for a while. It wasn't very long before I heard them make their way back to their bedroom. When I checked on them, they were both sound asleep. A couple of hours later Dad decided he wanted to pick some Daffodils for Mom so he put on his slippers and quietly shuffled out the backdoor. He made his way to the hill that leads down to the lake and stepped right over the barrier.

I heard him calling me from the top of the stairs a little after 4 o'clock so I ran up to see what he needed. There he was hair sticking up wildly, shirt and pants covered in dirt, debris and grass stains (front and back), a handkerchief wrapped firmly around his left hand as he stood there shaking his head sadly. I couldn't have been more shocked as he told me what he THINKS happened. According to him, as he reached for the flowers, he lost his footing, or got dizzy, or was pushed, or something... and the next thing he knew he was rolling down the hill.

We both knew what was coming next as I looked at the huge tear in the back of his hand. I ran to tell Jeremy to come watch his Grandmother and bundled Dad into the car. Once again, we were on our way to the emergency room. When we arrived I dropped him off at the entrance and went to park. By the time I walked in, he was almost done with registering. "Sweetheart," he said to me, "Who is our primary doctor again?" Smiling, I told him. When they called him back for triage everything was fine until they took his temperature. "Mr. Felker," the nurse asked, "Have you been sick recently?" Immediately, he said no. I jumped in and pointed out that he has had a slight cold for about a week. The nurse explained he had a fever of 101.8. Dad smiled and said he had been running a "little fever" for several days now.

When I asked him why he hadn't told me he said he didn't want to worry me(ARRRRRGH, how can I help them if they don't tell me when things are wrong!!!!!) Whisk, we were taken to an examining room and a nurse breezed in and looked at his hand. There was no way for them to stitch it because the skin had simply peeled back. As we age, our skin becomes thinner and on the back of the hand, there is no fat to anchor the stitches. Next came an intern who decided it would be best to x-ray it just to be on the safe side and after looking at the chart, he decided it would be a good idea to do a chest x-ray too. He explained that it was likely he had "a touch of" pneumonia.

While we waited for the x-ray tech to come get him, the nurse came back in and irrigated his hand with a saline solution. She then pulled out 2 Q-tips. Very gently, she used one to lift up the skin and slid it under the flap. She then put the other one on the outside and began slowly drawing them toward the other side of the cut. "An old nursing trick," she smiled and urged me closer to see what she was doing. She explained that an elderly person's skin can actually curl under itself with this type of injury and if you can get to it within 2 hours of it happening, you can usually use this method to draw the skin back into place. I was amazed to watch her do exactly that. One steri-strip later and a whole lot of padding and bandaging and we were ready for x-ray.

The x-rays came back fine on the chest and on the hand so the nurse brought him Tylenol for the fever. When she approached the bed with it, he wanted to know why he had to take it. When she explained he said, "That's silly, I don't have a fever." The nurse, deciding to indulge him, took his temperature again. He was right, NORMAL.
She smiled and asked him if he had eaten or had anything to drink just before coming in. He said no not before we got here but he had drunk a cup of coffee after we got here. The price of those x-rays make that one heck of an expensive cup of coffee.

Then as I was signing him out, I find out that when I left the room to call Mom and report that he was ok, he told everybody that would listen that I was "a girl he had hired off the streets to take care of his wife." You can imagine the confusion that caused as I had to repeatedly explain I am his daughter-in-law. As we left the hospital, I informed him I would gladly spank him if I ever heard him telling people things like that. He insisted he hadn't... he didn't think. The laughter that followed us from the nurses station finally put a smile on my face.

We got home about dinner time (which Richard thankfully cooked so I could run to the drug store). Lord, the money that gets spent on keeping Dad in bandaging supplies is awful. When I got back, I went to check on Mom. When I walked into the bedroom, she was sitting on her bed, holding her toe with tissue wrapped around it. "Shari, do you know where the band-aids are? Ayla always gets them for me but she isn't here and I'm not sure where she gets them from." I dropped to my knees and removed the Kleenex to find over half of her toenail missing! She had tried to trim the nail and had pulled it off by accident. So, off I went to get bandaging supplies while Dad yelled at her for trying to do something I could have done for her. I almost wished she would yell back at him for rolling down the hill but she didn't and the rest of the evening was fairly uneventful.

10 Dementia Elderly Recommendations

1. Consider buying Long-Term Care Insurance while everyone is healthy.

2. Consult an Elder Law Attorney to get all legalities done right: Durable Powers of Attorney for Health and Financial, as well as Living Wills, Trusts, etc.

3. Realize when your elder says and does things that strike you as strange or illogical or irrational ¾ they are! Don't wait and just chalk it up to old age or second-guess yourself. Call the Alzheimer's Association (800-272-3900) and ask for a referral to a neurologist specialized in dementia who will perform a battery of blood, neurological and memory tests to accurately diagnose what type of dementia it is.

4. Ask the doctor about the medications: Aricept, Exelon, Razadyne and Namenda, which can mask and slow down dementia symptoms, keeping a person in the early stage longer. Make sure vitamin B-12, folate, thyroid and depression are checked, which can cause dementia-like symptoms. Have the doctor evaluate all medications for interactions. Optimize nutrition and fluid consumption.

5. Ask the doctor to consider prescribing an anti-depressant for your elder if needed, which will help to smooth out bad moods. And if you need an anti-depressant for yourself-get one!

6. When dementia surfaces, live in your elder's reality of what is true for them at the moment. Don't argue, question, or try to force logic or reason. Agree and use calm non-threatening body language, while you distract and redirect their attention to things they are interested in. Get them reminiscing about the old days, capitalizing on their long-term memory.

7. When illogical demented episodes surface, realize that your loved one may be trying to work through unresolved issues of a lifetime. Validate their frustrated feelings, go with the flow, and don't contradict, which may help them bring some degree of closure to difficult past experiences.

8. Enroll your elder in Adult Day Health Care, if possible, where professionals are trained to manage dementia patients. By maintaining a daily routine and keeping loved ones engaged during the day everyone will sleep better at night.

9. Call your Area Agency on Aging and the Eldercare Locator (800-677-1116) for resources, and attend a support group regularly.

10. Shift your perspective to being grateful for the lessons you are learning, even though they are hard. Celebrate the life that is left and stop focusing on the dying. You are required to make sure your elderly loved ones are safe, that they have good doctors and the right medications, but you are not required to let caregiving destroy your life, nor would they want that for you.

By Jacqueline Marcell

What is DEMENTIA?
Dementia (from Latin de- "apart, away" + mens "mind") is the progressive decline in cognitive function due to damage or disease in the body beyond what might be expected from normal aging.
Although dementia is far more common in the geriatric population, it may occur in any stage of adulthood. This age cutoff is defining, as similar sets of symptoms due to organic brain dysfunction are given different names in populations younger than adulthood (see, for instance, developmental disorders).

Dementia is a non-specific illness syndrome (set of signs and symptoms) in which affected areas of cognition may be memory, attention, language, and problem solving. Higher mental functions are affected first in the process. Especially in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, or even what year it is), in place (not knowing where they are), and in person (not knowing who they are or others around them).

"Dementia" simply means the symptom of a deterioration of intellectual abilities resulting from an unspecified disease or disorder of the brain.

Alzheimer's Disease is one disease/disorder that causes dementia. Many other illnesses or "syndromes" can also cause dementia. Parkinson's Disease can cause dementia. A stroke can cause dementia. Even dehydration can cause dementia.

Many of the things that can cause dementia are treatable, even potentially curable.

If you have taken your elder to the doctor and received a diagnosis of "dementia" you haven't received a diagnosis at all. Unless you know what is causing the dementia you can't begin to treat it's root cause.

If your physician has diagnosed "dementia" it's time for a second opinion. You are probably dealing either with a physician who is not comfortable with the truth, or one who doesn't know how (or doesn't want to bother) to differentiate between all the possible causes of dementia. Either way, a skilled geriatrician or a neurologist who is comfortable with seniors would be a good place to start.

What is ALZHEIMER'S DISEASE?
Alzheimer's disease (AD), also called Alzheimer disease, Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer's, is the most common form of dementia.

This incurable, degenerative, and terminal disease was first described by German psychiatrist Alois Alzheimer in 1906 and was named after him. Generally it is diagnosed in people over 65 years of age, although the less-prevalent early-onset Alzheimer's can occur much earlier. An estimated 26.6 million people worldwide had Alzheimer's in 2006; this number may quadruple by 2050.

The above is provided courtesy of SQUIDOO