Monthly Archives: August 2013

…”That’s what I’m here for”

Posted in August by

“Can you come here for a minute?” Miss Cathy called out the familiar refrain.

I’ve heard that phrase as a preface to many a request in the last three years.

“Can you help me hook my bra, I can’t seem to get it on.” (Which usually means it was on backwards, inside out or both and is followed with a litany of expletives of how much she’s always hated being ‘busty’)

“What day is it?” (She asks this almost daily now, which is understandable for someone (anyone really) who doesn’t have a job, deadlines or have to rely on a schedule or clock any longer. But what I find troubling is that there are days when it’s after dark and she can’t distinguish whether it’s day or night)

“How much is four times twenty?” (This usually happens when she’s trying to count money)

“I can’t find a can of soup in the pantry, can you look and see if we have any.” (The pantry is stocked full of canned, paper and other goods that she can never seem to ‘find’)

“This TV is messed up again, I can’t get it to work right.” (This usually means that she’s pushed the wrong button or any number of random buttons on the remote causing the TV to either shut off, switch to DVD, Video mode or have to reboot itself after so much activity)

“Did I take my medicine? Is it time for me to take my medicine?” (Since I’m in charge of dispensing her meds I can usually remember if she has and if not, looking at the weekly pill dispenser easily solves the problem)

“Can you dial (insert the relative or friend’s name here) for me?” (Unfortunately she lost the ability to remember telephone numbers she’s known by heart for decades along with the loss of her short-term memory)

And so on and so forth, that’s just a sampling of what she asks and what she needs, not all at the same time and not everyday (Thank God) but so goes the dialogue and familiar ways and days of living with Miss Cathy.

“Can you come here for a minute?” she’ll ask.

“Of course”, I reply, “that’s what I’m here for.”

Advertisement

Another day, another Doctor: Pt. Vl

Posted in August by

“That other doctor didn’t know what he was talking about”, Miss Cathy said, after Dr G decided to reject the suggestion of adding a statin to her daily medications.

“He was just generalizing, he didn’t know me.”

“Well, yes he did”, I piped in, not so much in support of the vascular surgeon she just saw so much as defending doctors in general.

I sat there feeling as if I was under attack for (“heaven for fend”) not only suggesting but also encouraging her to go the doctors and specialists we’d seen in the past several weeks and months-regardless of the outcome of their findings.

Believe me, I understood her frustration after schlepping to more than six doctors in a two week period with no hard diagnosis but what she couldn’t (or wouldn’t) appreciate was the fact that answers are not always guaranteed when you have questions for a doctor.

Sometimes they just ‘don’t know’ and the best they can advise is to monitor the situation or seek a second (or third) opinion.

“In Dr M’s defense”, I continued, ”He was just making a recommendation. He did say that the final determination would be up to Dr G so I wouldn’t just dismiss him. He was looking out for your best interest.”

“Yeah, well….”, she said dismissively, “I can understand that too but I don’t want to take anymore of that medication.”

“All dem pills!” began her familiar retort, followed by, “I don’t see why I have to take’m.”

And so the broken record continued…..

“I’m gonna die anyway, like everybody.” “Nobody is going to live forever.”

Apparently the good doctor and I were to be subjected to all her greatest hits.

Before my ears started to bleed I said, “Then stop taking all of them, don’t come to the doctor and you’ll be dead that much quicker.”

“Will that make you happy?” I asked, not quite rhetorically but not expecting an answer either.

“No, not all of it” she said thoughtfully, “I’ll take some of it, but not everything.”

“Well, actually, that’s the problem, you see, we’re here so the doctor can make the ‘call’ on the medications, it shouldn’t be up to you to decide what you take and don’t take.”

“What’s the point of having doctors if you’re not going to listen to them?”

My question evaporating into the sterile, antiseptic air in the examination room as Dr G closed his notepad, having already said that he wasn’t going to make any change in mom’s meds (or get in the middle of our “George and Martha” act) then got up to leave while Miss Cathy looked around, not for an answer but for her purse and cane before wobbling off to the phlebotomist.

And so ended the appointment, just “another day, another doctor”.

TyTip: Carry your own version of a “Cathy Clutch” (a tote bag filled with all of your loved one’s doctor’s files, paperwork, a notebook and pen for taking notes and film from any/all exams or tests, plus their identification, medical and insurance cards) to all of your doctor’s appointments, you’ll never know when you’ll need something!

TyTip too: Type up and print out a list of your loved one’s medications (be sure to include the dosage(s), what the medication are used for and what condition they are to treat) as well as medicines they might be allergic too

Your “Medications List” can be attached to medical forms and can also be handed directly to doctors and nurses who may inquire about your loved’ ones medications as well.

Having this document will save you a ton of time! Don’t forget to update your list whenever there is a change (addition or removal) of a medication or change in dosage

Another day, another Doctor: Pt. V

Posted in August by

“Yeah”, Miss Cathy said, agreeing with me as if I’d been serious when I’d said, “From your lips to God’s ear”, this in response to her saying that “I could die before her”.

”Nobody’s time is guaranteed in this life you know.”

She continued as if we were really having a conversation about mortality instead of verbally sparring with each other.

The fact that I’d just ‘wished’ an early death on myself to get away from her completely going over her head.

“You don’t have to be a certain age to die.” She said, quite please with herself, looking to the doctor for a visual ‘high five’ as if she’d just ‘nailed it’ with her observation.

Dr G was sitting between the two of us, poor man (Switzerland between France and Germany) awkwardly trying to find some neutral place to gaze upon.

“Oh my God!”, was all I could think. “Shoot me, shoot me now!”

“Mother” I interrupted her before she could continue gloating about the possibility of my early demise.

“I was being facetious.”

“You know what” Dr G said, having found a safe spot near the door to focus on, “I’m not getting in the middle of this one.”

Miss Cathy shrugged and changed the subject.

“How is my cholesterol count?” She queried, showing no signs that she’d forgotten the other subject at hand, which was whether or not to add a statin to her daily medications (which total 12 pills at last count…..8 in the morning and 4 at night).

“All medications have side effects you know.”

Dr G opened up what is turning into a volume of notes worthy of a JK Rowling’s novel and after a careful review said, “Last time we checked it wasn’t that bad at 218, which isn’t too bad, but the LDL was 107 which is spectacularly good…so on second thought I’m going to say ‘No’ to the Lipitor.”

“Her protected cholesterol is really so good that I don’t want to do it.” He said to me.

“Yes”, Miss Cathy said, as if she was being vindicated that she was right all along (when actually she wasn’t right so much as just argumentative and stubborn).

Another day, another Doctor: Pt. IV

Posted in August by

Squeezed onto a faux banquette that must have been intended for a toddler, I tried my best to sit quietly in the corner and not listen to Miss Cathy and Dr G debate the merits and side effects of statins, focusing instead on my ‘happy place’ (which at the moment was anywhere but there).

As part of my (self assigned) duties as ‘caregiver’ I’ve trained myself to be as unobtrusive as a butler (or how I’ve perceived one to be), fading into the background after I’ve chauffeured her to the appointed destination but available if need be.

I do this so that Miss Cathy can feel free to have whatever exchange she wants with whomever she’s meeting with, without a care or thought as to what I may think (and believe me, this works just fine for someone as self righteous and self absorbed as she is….she could give ‘two hoots’ what I think or how she’s being perceived…..I’m just saying).

I will say though, it’s hard to listen to the same questions and answers over and over.

But, they are her doctors; her meetings and appointments so the focus should be on her, I’m just the ‘transporter’.

And this works out just fine for the most part; at least it does on the days when she’s lucid, heaven help us all on the “off Alz days”.

I try, let me emphasize the word ‘try’; meaning I make and attempt or effort to do something (like keep my mouth shut), so my objective is to ‘try’ not to interject during Miss Cathy’s exchanges unless she’s misspoken or given the wrong answer to a question (and I do not hesitate to jump in when her health is at stake).

It’s my (self assigned job) to give factual answers and to fill in the background for whatever the doctor may have asked, hopefully without any sarcasm or added editorializing on my part.

But, it’s not easy to sit idly by when (I know) she’s fudging the facts (insinuating that she’s exercising when she’s not or being faithful to whatever she’s been told to do) or being obstinate (which is usually any statement that starts with “I’m not” doing, taking, making, reading, eating, or ingesting).

That’s when I have to take the “Hoke” hat off and put my caregiver bonnet on before my chauffeured ‘busy bee’ can verbally run too far afield.

“Why don’t you just give it a try”, I interjected, exasperated by all the pointless back and forth.

“We’re here after all, if all you’re going to do is question and then end up doing what you want to do anyway we could have just stayed home!” (Yeah, I know…not very ‘faded into the background’ of me)

“Yeah, well…what do you know, you’re just a layman, too!” she said.

“You’re not going to be the one taking the medication.” (Touché!)

“I know”, I said (and she was right)

“But I am your caregiver and I’m with you 24/7 so I can see the benefit of what you do and don’t do…what you take and don’t take.”

“Yeah well…” was her response, her voice trailing off in defensiveness.

“Whether you believe it or not, we’re all on your side here, nobody is trying to make you take anything that’s going to be harmful to you.”

“That may be, but what do you know”, she sneered, unaffected by my attempt at a kumbaya moment.

“Besides, nobody lives forever, you might drop dead before me.”

“From your lips to God’s ear”, I said.

Another day, another Doctor: Pt. lll

Posted in August by

One of the benefits of having Dr G as Miss Cathy’s Geriatrician is that it’s like ‘one stop shopping’ when we go to see him.

Whenever there is a problem or question (and mom has many) we see Dr G first, and if he doesn’t have the answers he’ll know the appropriate specialist who does.

Case in point, we were back after about a month (it felt like longer) of schlepping around from one new doctor to the next, to discuss their various findings.

The good news was that (other than not remembering what day it is) mom is basically ‘fine’ (a very subjective word these days but considering the alternatives, we’ll go with ‘fine’).

Dr K, her new neurologists, added Namenda to her daily medications, Namenda is a dementia drug that is thought to work well in conjunction with Aricept (which she’s been taking since her diagnosis in 2010) to help sustain memory and issues of confusion.

One of the other specialists she saw was Dr M, a vascular surgeon. I took Miss Cathy to see him regarding the five ‘episodes’ of fainting that’s she’d had over the course of the last three years to get to the root (hopefully) of why they were happening; was it a stroke? Were they seizures? Up till now nobody could say for certain.

He determined that the problem was not the blood flow to her corrated artery (so the ‘why’ and ‘how’ of the episodes is still unresolved but luckily there haven’t been any recently).

After his examination the doctor did recommended Lipitor or it’s generic equivalent to help reduce the possibility of a stroke given her age and all she’s been through.

As we sat with Dr G in one of the (very small, very cramped) examination rooms, he went over all the notes from the other doctors, the things put in place and their recommendations moving forward.

There was a little debate (more between Dr G and himself than with either of us) as to whether or not to put mom on the cholesterol-lowering drug.

Dr G said that while Lipitor is a valid recommendation his concern was Miss Cathy’s various other health conditions; diabetes, Alzheimer’s, high blood pressure and anxiety. So he wanted to be careful that any new drug introduced into her system wouldn’t have either a negative effect or counteract the effectiveness of a current medication.

It seemed at first that he was considering adding the ‘statin’ to mom’s meds and said as much.

Miss Cathy’s response was, “I don’t want to take that. I’m taking too many pills as it is.”

I sat in a corner of the room on what looked like a banquette built for a child or as an afterthought next to a small sink and supply cabinet. There was barely enough room to contain my ever expanding ass and irritation as I eavesdropped on their tête-à-tête.

Dr G smiled and said, “Of course that’s what you say about every one of these pills that we give you to take, so lets just consider this for a minute.”

‘Points’ for Dr G! It may not sound like much but that was one of the rare time that he didn’t just acquiesce to her protestations…..we might just be getting somewhere today.

The Meds discussed in this Blog Post were:

Aricept: is used to treat confusion (dementia) related to Alzheimer’s disease. It does not cure Alzheimer’s disease, but it may improve memory, awareness, and the ability to function. This medication is an enzyme blocker that works by restoring the balance of natural substances (neurotransmitters) in the brain.

Namenda: is used to treat moderate to severe confusion (dementia) related to Alzheimer’s disease. It does not cure Alzheimer’s disease, but it may improve memory, awareness, and the ability to perform daily functions. This medication works by blocking the action of a certain natural substance in the brain (glutamate) that is believed to be linked to symptoms of Alzheimer’s disease.

Lipitor: is used along with a proper diet to help lower “bad” cholesterol and fats (such as LDL, triglycerides) and raise “good” cholesterol (HDL) in the blood. It belongs to a group of drugs known as “statins.” It works by reducing the amount of cholesterol made by the liver. Lowering “bad” cholesterol and triglycerides and raising “good” cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks.

Another day, another Doctor: Pt. ll

Posted in August by

It was evident long before we got to Dr G’s by the way Miss Cathy was acting that it was going to be an ‘off’ day (and I didn’t need to check the cutlery drawer, either).

The ride to his office wasn’t so bad, no rumpling through her purse or rambling about the weather (and thanks to a slight increase in her Lexapro) she’s not as jumpy during the car ride-but that’s probably due more to the fact hat she’s being chauffeured around while she sits in the back seat like her fictional movie contemporary ‘Miss Daisy”.

Anyway, I noticed when we arrived that she was slower than usual getting out of the car, which is hard to imagine since she’s usually moving about as a fast as a turtle and just as interesting to watch.

So, instead of hanging back to see her wrestle with unbuckling the seatbelt I walked ahead, went into the doctor’s office, dropped my ‘Cathy Clutch’ on a chair, signed in for her, then went back to the door to see where she was (or if she was a heap of little old lady bits piled on the pavement).

When I cracked the door open I spied her about fifty feet away from the steps to the entrance at a turn in the sidewalk. For whatever reason she chose to (try) to walk around a garage can (placed near the edge of the sidewalk) by going ‘nearer’ the outside edge of the sidewalk where the concrete was cracked and the slabs were starting to separate exposing some of the sand foundation instead of walking toward the center where it was smooth and unobstructed…that’s “my” Miss Cathy, give her a choice and chances are this is what you’ll get-the road less travelled (because it’s usually under construction).

From the look on her face I could tell she was determined to navigate the crack (as well as the turn) in the sidewalk, the last time I saw her concentrating this hard she was at the ‘Live Casino’ pulling on a slot machine.

She always has her cane with her whenever we’re out in public (never uses it at home) because she’s afraid she’s going to fall.

She was picking at the sidewalk with it as if it (the sidewalk) was moving or there was a snake that she was trying to spike.

At the same time she was engaged in a sort of time lapsed back and forth with her feet, slowly lifting one then the other, tentatively reaching out with her foot before putting it down and starting over with the other in her attempt to move forward, brow furrowed, like a runner trying to navigate a hurdle that’s suddenly been raised on the track.

You might be wondering ‘Why didn’t I just go help her?” or for that matter, why didn’t I help her get out of the car?

Well, the simple truth is that she exercises (her body and her mind) so little that I feel I’d be doing her a disservice by stepping in to help (especially if she’s in a position to help herself).

And I do so much for her already that I have to be careful to draw a line somewhere before total dependence.

Besides, I always check to make sure she’s physically not in danger.

I’m like a parent hiding somewhere that their child can’t see but are able to watch as the young one (‘old one’ in my case) walk out into the world alone (or so they think), I’m there (just out of site) watching to see that she gets to where she’s going (safely) and I’m always there to lend a hand if she needs one.

And more often than not Miss Cathy, left to her own devices, has that steely determination, just like that athlete during a track and field event, to jump her hurdle(s) or in her case, ‘step over a crack in the sidewalk’ and finally cross the finish line, which that day happened to be four steps up to the physician’s door.

Another day, another Doctor: Pt. l

Posted in August by

Today was a day not unlike a lot of other days around here; get up, strategically try to time my entrance into the kitchen so that I can make my morning coffee (in peace and quiet before the deluge of chatter dominate my day), meet Miss Cathy in the living room to take her daily blood stik (since she has type 2 diabetes) turn on the TV for her (only if it’s a bad day and she’s forgotten how to operate the remote), then back into the kitchen to start breakfast.

But looking at the calendar on the wall across from the stove I could see that it was also a ‘Doctor Day’ so preparations (in addition to her daily routine) had to be made to get Miss Cathy out of the door and to her respective physician on time.

I would have to make sure that she was bathed, dressed and be prepared to answer whatever questions she’d have (usually the same ones she’d already asked but obviously forgotten) depending on who we were seeing and why we were going.

After weeks and months of specialist after specialist we were off to see her “Geriatrician” (think ‘Pediatrician’ for old people) who just ‘happens’ to be her primary care physician, Dr G.

It makes sense; she’s been going to Dr G for more than thirty years so if anybody knows her inside and out (literally and figuratively) it would be him.

I asked Dr G to take on the additional role so there’d be one doctor (and someone she’s comfortable with and can trust) that is sort of the ‘ring master’ of the circus of care.

In addition to being a ‘Doctor Day’ it was(unfortunately) a ‘running late’ day, too. For some reason mom was still in her room watching TV when we should have been getting into the car.

It still amazes me that for someone who asks what day and time her appointments are over and over, when the day arrives it’s a 50/50 chance whether or not she’ll be ready on time, running late, forget all together or sitting on the sofa, purse and cane in hand ready to go hours before we have to leave….guess with all those variables I should use different odds, oh well…back to getting Miss Cathy outta her room.

TyTip: When possible, tell your loved one about appointments outside of the home a day or two (at most) in advance. The less lead time they have, the less time they will have to fret, worry and/or obsess over the upcoming event or appointment AND the less time they will have to ask you question after question (usually the same ones over and over) regarding said event or appointment.

Remember, changes in their routine (no matter how benign we may think) can be very stressful-even scary to a loved one with Alzheimer’s.

A Shadoobie by any other name: Pt. ll

Posted in August by

WARNING: READER DISCRECTION ADVISED

So, there I was, on my hands and knees scrubbing feces out of the beige colored carpet hoping there’d be no tell tale sign of Miss Cathy’s ‘accident’ after I’d finished laboring over the stain, wondering all the while, “How the hell did I get here?”

I’d gotten used to being “Hazel the housemaid” and “Nurse Ratched with the meds” but this….this was something I had no pop culture reference for.

I had to reach back to the seventeenth century and Lady Macbeth’s, “Out, Damn’d spot!” to find something (somewhat) apropos.

Hey, I accept that ‘things happen’ being a caregiver for someone with Alzheimer’s (and lord knows I’ve gotten used to quite a lot ‘happening’ since I’ve been here) but I couldn’t get over the ‘matter of fact’ way that mom talked about what happened.

I don’t know if I was more shocked by what she did or how blasé she was about it all.

Is alittle remorse, regret or (I don’t know) just some plain ole embarrassment a lot to ask (or expect) when something like this happens?

I pondered all this earlier as I gingerly watched my step walking down the hallway to get out of the front door so that I could go to the store for cleaning supplies.

After perusing the shelves I decided on the “Pet stain and odor remover for carpet”, boasting that it “cleans and freshens even the toughest pet stains”.

I figured if it was ‘guaranteed’ to make Fido’s mess vanish then cleaning up after Miss Cathy’s should be a breeze.

Still, I couldn’t get over mom’s straightforward delivery when she told me what had soiled the carpet.

“Oh, that…that’s shit”.

Since she was so calm and she seemed to have no shame or register any embarrassment in her voice I thought there was no reason for me to act surprised (or heaven forbid ‘shame’ her) so I took my cue from her as I continued my query in the best “everyday” tone I could muster.

“Um, how did that happen?”

She told me that she’d eaten too much of the watermelon I’d bought for her and she ‘felt something’ as she was walking down the hall. And that was that, no further explanation of why she didn’t make it to her bathroom.

The only real emotion she registered was being a bit perturbed (with herself I assume) when I told her that she’d made matters worse when she attempted to clean up the mess, that she’d only been successful in leaving a stain (which I was not sure I could remove once she told me she used Windex as a cleaner) and that she’d missed quite a few spots, and that there were still remnants of matter dotted down the hallway.

Thankfully, she passed the ‘smell test’ as I neared her person and I was somewhat relieved to know that she had the presence of mind to put the offending panties in the washing machine after rinsing them out.

So, back down on my hands and knees; spraying, waiting, gently dabbing, repeating the process (time and again), and amazed (and relieved) that the “odor and stain remover” carpet cleaner made good on its promise, I couldn’t help but wonder,” Did she think this was okay?” and “When did taking a shadoobie on the carpet become acceptable?”

I could only hope that this was the exception and not the new normal, but if it was a glimpse into the future, unlike Miss Cathy’s memory or cognitive issues (that I have no control over) then at least (in all matters poo related) I was armed with a super sized can to spray away stains from my memory.

A #Shadoobie by any other name: Pt. l

Posted in August by

WARNING: READER DISCRECTION ADVISED

A friend called me the other day while I was in my room so I went out to the balcony to chat.

I call the outdoor space my ‘summer living room’, a place where I can feel free to talk uncensored and without being heard (except, of course, for the neighbors if I talk too loudly).

It’s not that I have anything to hide or secrets to guard, it’s just that being a caregiver there is very little privacy, so I try to carve out what little space I can.

As I walked through the apartment I happened to look down and noticed that Miss Cathy had spilled something on the caret in the hallway right in front of the kitchen doorway.

Earlier I’d heard her in the kitchen rustling around with the kitchen garbage (something I’ve told her time and time again I would take care of because she’s famous for leaving the garbage bags ‘next’ to the can and never taking them out to the dumpster) so I thought it might be coffee grounds or maybe chocolate ice cream that had spilled.

But, I continued on, chatting away, I thought little of it, other than to make a mental note to go buy some caret cleaner later and joked to my friend, “I don’t know what that is, it could be poo for all I know” then I proceeded to the balcony where I spent the next hour or so talking about everything from the Project Runway season premier on Lifetime (television for women-and gay men) to the Anthony Weiner scandal (television for women-and gay men).

After clicking off my conversation I was ready to tackle the stain, which now looked as if an attempt had been made to clean it up but the result was less than successful.

Fearing permanent damage (because it looked like she really rubbed it in instead of lifting the stain out) I went to mom’s room in search of some answers.

She was already tucked in bed for the afternoon.

“I’m going to the store to get some carpet cleaner”, I said. “So I need to know what you spilled.”

“Oh, that”, she answered, as matter of fact as if I’d just asked the time.

“That’s shit.”

Calculating Cutlery: Pt. lll

Posted in August by

I’ve always thought that if Miss Cathy won’t do the things recommended (by doctors, specialists, social workers and mental-health care professionals) to keep her mentally challenged (things like crosswords puzzles, reading, exercising, socializing, or knitting) then she could at least be conscientious of keeping her surroundings organized and clean.

So, putting away the silverware and keeping the drawer organized seemed like a no-brainer to me when it came to keeping her brain stimulated.

One day I asked Miss Cathy to join me in the kitchen for a little tete a tete and quickly realized after watching her struggle that there was more at play then simple indifference to order.

She stood there trying her best to correctly place a spoon in it’s proper place in the drawer and to stand on her feet, laboring the entire time to do both.

After five minutes I simply couldn’t take it anymore and put an end to the task.

The fact that she has so much trouble standing is an unfortunate but direct result of her lack of exercise (the blame for which I lay at the feet she can’t support herself up on for very long) but that’s her choice and I learned long ago to pick my battles (after losing that one).

But her inability to distinguish what goes where and how to get it there in the cutlery drawer is something that she has little to no control over.

Miss Cathy’s brain isn’t firing off the neurons or whatever it is that fuels her ability to problem solve, and as we discovered after consulting several doctors, her brain is also playing tricks with her eyes.

And when she’s having one of those bad days it can affect everything from forgetting how to perform simple tasks, mood swings, to asking me the same question over and over again.

So, now that I know all of this I just remind her from time to time to be conscious of what she’s doing (whether it’s replacing the cutlery, her posture, hygiene or any number of little things) and she either responds or not.

Alzheimer’s is not only about keeping your loved one safe; it’s about learning to respect their limits and boundaries.

And it’s been important to learn that her mood swings, depression and confusion come and go, the same as her ability to put away the silverware.
I always thought that if Miss Cathy could stay ‘aware’ of the little things then one day the big things won’t be as daunting…or so I hope anyway.

As for the cutlery drawer, it’s become more than a place to retrieve eating utensils; it’s a Rochard test, a crystal ball, tea leaves at the bottom of an empty cup whose chaos or order is a glimmer into the mind of Miss Cathy.