If I hadn't seen it before, almost three years ago now, the Omi's recent behavior would give me quite a turn.
Her doctor did warn us that her behavior was likely to be "variable" as she got on in years (now almost 98), but it was still hard to anticipate that it would compete with that of a two year old for inconsistency. One has to conclude that there are good reasons why institutional caretakers find it almost irresistible to manage with the assistance of medications that take off the edge.
In any event, the last time we went through the routine of non-response, incontinence and general resistance to efforts to ameliorate the situation, there was a good excuse--a bout with pneumonia which consumed a lot of energy for a while. As the doctor also explained, the human body has only so many energy packets and when most are dedicated to fighting an infection or some bug, there's little left for the normal routines of daily existence.
This time around there's no apparent illness or injury that accounts for the current condition. And, although I recorded the first on video tape, thinking quite honestly that the last hours might have arrived, it seems wiser this time to make a verbal record, since the video recording (with sound) isn't very good at representing the response of the observer/caretaker (me). There might just be some value in that for others who have yet to go through a similar experience.
The current event started a couple of weeks ago when we were starting to run out of the pain medication the Omi had been taking (with no change in the dosage) for over five years. Since renewing the prescription was taking some time, it seemed like a good chance to see if the medication was actually needed for pain. After a couple of days it became apparent that it wasn't. There was no increase in complaints about pains which, all along, seemed to be prompted more by psychological stress than any particular physical action, or inaction.
On the other hand, while there were no complaints about pain, there was a marked increase in physical activity, a new concern in getting new clothes and adjusting those that no longer fit, accompanied by pointed conversations of monetary assets and who owned what property. Indeed, one of those conversations started out questioning my ownership of our house and moved on to the assertion that I would have to get a lawyer because she was going to inherit the property. Which sort of made it clear that the Omi was having another role-reversal incident in which I became her mother and she became me.
Such confusion has arisen periodically. I'm used to it now, but at first it was very disconcerting to have a role-reversal, which has been present for a very long time in practice, verbally realized in this manner. Since I assume that such events are not unique, it strikes me that it must be very stressful for familial caretakers to be suddenly treated like strangers. Though I, for example, actually remember my grandmother (she was very young when her only child was born), being mistaken for her was strange, to say the least. It was difficult to know how to respond, especially since I am fully aware that the Omi never liked her mother. Or, at least, never had a good word to say about her in the last 60 years.
The increase in physical activity and apparently better balance when walking, accompanied by whoever answered her summoning bell (a regimen established to prevent further injury from falls), resulted in several independent sorties from and to the bathroom when no-one was looking or the response to her signal wasn't rapid enough. Rapid response had been a requirement for some time since she made it quite obvious in conversation with friends and strangers that she really resented being dependent on others and, indeed, "forgot" at least once or twice a week to signal a desire to walk around on her own. Indeed, whenever she perceived that she was not being attended to, she was in the habit of setting out on a stroll, even if she'd been asked about a desire to do that just five minutes before.
Actually, there was one minor constant in her behavior. It was almost certain that whatever offer of assistance or provisions she rejected (and she routinely rejected ALL offers the first time they were made), would be demanded within five or ten minutes. This was actually progress from my perspective, since it had been the Omi's life-long habit NOT to ask for any benefit or service and then to resent that it hadn't been offered. In other words, she expected everyone around her to be on the constant look-out for what she might want. Then she could pretend that she didn't want anything at all and be condescending in accepting the suggested service or gift. A delay of five or ten minutes until she would act on a suggestion is actually better.
At the beginning of this past week, after other members of the family had departed from their visit and only the spouse and I were in attendance, she took one of those solitary excursions to the bathroom and when I remonstrated with her, yet again, for risking a fall, she told me flat out that she had been accompanied by someone other than the only two people in the house. When I accused her of lying, she rejected that assertion and claimed that she had been accompanied by her dog. What's significant to me about this exchange is the rapidity with which the lie can come forth. Where most questions have to be asked three or more times before it is apparently comprehended and elicits a one-word answer, the lie just pops out. That's been apparent for some time and suggests to me that, if there has been some brain damage from a series of small strokes, the perversion of the truth into a protective lie must reside very deep in the brain.
Perhaps lying is alligned with impulsive behavior in general. I do think it's possible that much of the Omi's behavior has been impulsive (as opposed to considered) for a very long time and that what's happened recently is that the responses to impulses as well as suggestions (impulses from outside) have simply been delayed.
In any event, about 4:00 AM Tuesday I heard a huge thud and thought, incorrectly, that it had come from upstairs which I immediately checked and, finding nothing amiss, I rushed to the Omi's room and there she was, in the dark, lying on the floor where she had obviously fallen after using the commode. Her explanation for her position, heading away from her bed to the other side of the room, was that she was trying to turn on the reading light by her chair, perhaps because she hadn't found the one by her bed.
Anyway, since nothing seemed to be broken and no evidence that she had even hit her head, the spouse and I lifted her into bed. Later in the morning she rang her bell and I helped her to the commode, since she didn't seem up to walking to the bathroom. Then, she barely seemed up to walking to her chair. Or, at least, she was resistant to being helped to move in that direction and made herself into a dead weight--a trick I am used to from three years ago when being weakened by illness didn't prevent her resisting being "helped" into or out of the bed. It's a back-straining trick, I can tell you and also strains my temper. So, when I finally had her settled in her chair, I told her this wouldn't do and she answered quite clearly, "You're right, it won't do."
Having refused breakfast on Wednesday, she allowed herself to be fed chicken and rice soup at lunch. And, later in the day, she ate a chocolate cookie with a cup of coffee. And at dinner she ate a small portion of what we were having at the table and finished a chocolate pudding. Since her back seemed to be sore from the fall, I gave her some medicine for pain. The night was uneventful though I obviously slept lightly and was awakened at least five or six times by sudden sounds on the monitor. (A monitor in her room lets me hear even uneven breathing. I didn't hear her get up and fall on Tuesday because I had already got up to write downstairs).
Thursday I was able to maneuver her to her chair and assist her to the commode several times, though the sheets needed changing because of some incontenance during the night. Mostly she was unresponsive through the day and not willing to drink or eat. She did take her pills and a little liquid and allowed herself to be fed a chocolate pudding.
Friday again started out with a wet bed, a change of sheets while she sat on the commode and then, having been returned to bed, the announcement, later in the morning that "it is wet." In other words, although apparently unresponsive and almost comatose, she was able to direct a change of the sheets yet again and, as I was arranging the plastic mattress protector, her hand reached to help smoothe it out. All evidence, in my mind, that attention hadn't left her entirely. Also, she did respond with a "good morning" to my initial greeting, almost before she caught herself.
Since two loads of laundry seemed enough for one day, the spouse went and got some adult diapers, which would keep both her and the bed drier.
It doesn't seem to have been needed over night and, indeed, there was sufficient bladder control yesterday to make use of the commode when I sat her on it. Putting on the diaper seems to cause some distress (scrunched up face and one or two "ows") but no active resistance or dead weight (how do people do that?).
Having taken almost no food or drink during the day, she did accept a cup of water, which she held in her hand and drank on her own. Then, as I prepared her for the night, she asked if I couldn't "help her" but wouldn't specify in what way. I suspect, but can't prove, that she wants help in dying now, while she's still aware and can keep track of how it goes. This would be consistent for her periodically expressed desire to have the crematory people come to take her away. Indeed, over the last six months she's spent many a day apparently waiting to be picked up and taken off. When a visitor has arrived during those time, she's always been disappointed that they weren't coming for her.
I used to think that this expectation grew out of her experience as a ballet dancer in multiple operas where the heroine dies most spectacularly and with lots of pomp and circumstance. Explanations that that's not how it happens in real life don't seem to register.
Anyway, that's were we are at now. No response to my greeting this morning, but she did take her pills with water before going back to sleep.
That's actually a normal pattern, so there's no clue as to how the day will proceed. Just wanted to get this down before I forget. Forgetting is not a matter of age, by the way. I noticed the same thing about my awareness of the development of the first two children and took to writing things down about the third. Those writings are lost. Perhaps in the age of the internet my musings will fare better.
~~~~~~~~~~~~~~~~~~~~~~~~~~~Sunday
Forgot to mention that a half piece of bread with butter and jam went down well on Friday. But, after that, she's not been willing to take any food. This morning, the first swallow of water went down without trouble. The next caused her to choke and cough.
The adult diapers are working well, especially now that I've learned to put a new one in place before removing the old. Something I should have remembered from many years ago--removing the covering triggers a flow.
A sponge bath this morning elicited no reaction and no resistance to being moved around a bit either. Sometimes her fingers tug at the pajama, the covers or even an eye lid, but these movements seem not purposeful. When her eyes are open, there's no recognition of me as a person--but that's been the case for a long time now. For months and months I've been a stranger and, in a moment of apparent clarity, the Omi explained that she had forgotten she was ever a mother. Not surprising since she never behaved like one. (When she got her first dog after moving to Gainesville, I realized she treated it just as she'd treated me as a child. And when it got to be too much trouble, she had it put to sleep. The current one, too, was destined to be dispatched when she was unable to put out it's food.) I. obviously, simply got shunted off to be taken care of by other people--her parents, her housemates, boarding schools.
While I've concluded that she's always lacked impulse control, I wonder how that fits in with planning ahead. It probably doesn't. Rather, it probably accounts for a life full of actions that were later regretted--and for having relocated on average every two years before this last decade.
* * * * * *
Monday update---
Not very variable yesterday. The Omi was largely unresponsive but looked to be at peace. She made one effort to speak, but gave up after four or five words and went back into her closed eyes, mouth open state. When I changed her diaper, she did lift her leg somewhat. So, it doesn't seem like she's comatose.
The spouse is going to looking into the acquisition of a coffin today, as the Omi repeatedly requested. She's never forgotten that he did that service for a neighbor about forty years ago and wanted to have the same done for her. A strange kind of jealousy, if you ask me, only wanting something because somebody else had it. But there it is--it's a pattern that probably accounts for frequently not liking what one's actually got.
That's sort of to be expected if you taylor your desires to other people's tastes.
7:00 AM
Quite talkative this morning--telling me she can't walk. Which I guess was meant to explain why the diaper was half undone. She is, however, able to raise and lower her legs and when I helped her to sit up to drink, she propped herself on her elbows. So, not as helpless as one might be led to think.
I told her she would have to eat something today, since it doesn't look like the end is nigh. Also reminded her of that fellow in New Orleans who went nineteen days without food or drink and survived. Since the Omi has never been a consumer of a lot of liquids, dehydration is probably not as great a risk as for some.
Before she had her fall on Tuesday, I had been warning repeatedly that if she fell, she would probably end up confined to bed and that she probably wouldn't like that. Perhaps I was wrong about the last part.
11:30 AM---
Well, the Omi ate about a 1/4 of her usual portion of hot cereal cooked in milk for breakfast and, after a morning nap, awoke to observed that she is doing OK. She wanted to get up to use the commode and I made up some chicken broth with an egg of which she consumed a whole bowl. She likes being fed. So, variability persists.
7:30 PM---
Chocolate pudding in the afternoon and mashed potatoes in the evening, plus a couple of cups of tea are a pretty good sign that the appetite is returning. Also, orders are being given. Whatever the problem was, other than a head-strong determination that the end was going to be willed, I don't know. All I can keep repeating is that's not how it works.
When the eyes are clear, skin color is good, all the senses are functioning and a person can eat and drink without any problem, it's unlikely that the end of life has arrived.
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Wednesday, September 21
Yesterday was a fairly "normal" day, other than the Omi prefers to stay in bed most of the day. She consumed a bowl of hot cereal, with milk and butter, for breakfast; chicken soup with rice for lunch, followed by a chocolate pudding. In the afternoon, there was tea (three cups) and a bit of cookie which she partook of by herself from a tray. Dinner had to be fed to her, even though a small potato dumpling with chicken sauce should have been tempting. More pudding served as a chaser and then, of course, more tea before she settled down for the night.
This morning was cheerful, perhaps because the sun is shining. She got up to use the commode and stood and took a few steps. There doesn't seem to be a physical problem, only a new level of fear since she fell last week.
I've prepared a summary letter for the local doctor, inviting him to make a house call and see his patient for himself. It's being edited and will be delivered to the office later today. Allegedly, the doctor doesn't do email, but he does make house calls. So, we'll see.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
September 22---
Well, it turns out that it isn't enough to sign up with a primary care doctor. If you're not sick and don't make regular visits to the office, they discard the records. At least that 's what the local doctor claimed until I pressed him. Then he admitted that the files were in storage. But, since he no longer makes house calls (this is now 2005 and not 2003) and he's going out of town next week, he really can't be bothered and suggested we contact a Hospice association in the area.
Which seems like a reasonable solution, since they'll plug her into their medicare program, do an evaluation and then, when the time comes, issue a death certificate without having to call law enforcement or the Medical Examiner.
Someone is supposed to come tomorrow. There doesn't seem to be any urgency. The Omi ate a whole eight ounce serving of hot cereal cooked in milk and made tasty with a pat of butter and cinnamon/sugar. Then she drank a cup of tea by herself (cereal has to be spooned into her).
Arms and legs are quite active. It wouldn't surprise me if she got tired of being in bed in the near future. She appears to tire easily, but that may be an act. Don't mean to seem heartless, but, unless I am grossly mistaken, the signs of an imminent demise don't seem to be there. She's just always liked being catered to and cared for.
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September 24
Nurse Fran from hospice came as promised and we are all signed up to get a weekly visit from a nurse (to take the vitals), respite workers if we both need to get a way for a while, and someone who will "pronounce" her when it becomes appropriate.
The appetite continues fairly good. In addition to her morning cereal, she consumed two containers of baby fruit medleys, a half piece of bread with butter and jam, and a bowl of mashed potatoes with grave. Tea and coffee in half cup servings. There seems to be some difficulty actually putting lip to cup--so, a lot of dribbling. In the evening I just gave her tea with a syringe, but I don't think she liked that very much.
I'll have to plan better and make sure she's still propped up when tea time comes around.
I can see why people get hospital beds. Trying to do things in a bent-over position is quickly painful. I have to remember to kneel. Since she's still willing to get out of bed from time to time to use the commode, I'm not keen on having a mechanical bed.
The Omi's interaction with the nurse was interesting. She wanted to know where she had met her before--a conversation starter she's picked up lately. Told she'd never met her, she wanted reassurance that the nurse had nothing to do with me. Also, as she was being examined (blood pressure, heart, lung, etc.) she looked quite distressed and seemed glad to have us leave her be when we went off to sign a bunch of papers.
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September 27
Yesterday was, on the whole uneventful. Efforts to remove her depends garment were entirely successfu but the pajama top only got unsnapped. So, the sheets had to be changed again though the cut-open plastic bag actually worked good at protecting the mattress. So, I think I'll stick with those rather than getting another pad with a plastic back.
A social worker made a visit to inquire about additional help we might need. I might take them up on an occasional respite worker while Puddy is away. They have to be scheduled two weeks in advance, so it's not help that can be gotten on short notice. Omi expressed no interest in this visitor.
She'd had her normal breakfast and a small amount of prune juice so about mid-day a sit on the potty was successful. I used to think that the nose gets used to noxious smells, but have been noticing that they actually recur on their own when the occasion is long passed. So, I wonder if that's one of the lingering negatives of the rescue operations in New Orleans that will stay with people, along with the horrendous images, for a long time after they return home. A plug-in air freshener does do a good job, however.
We had some conversation. At bedtime she told me she was going to die and earlier she wanted to know how long she was going to be as she is now. While I don't have any answers, I did point out that the latter is somewhat up to her. She can remain mostly uncommunicative, or she can talk and make it easier to care for her. This morning, when I moved her to the potty, she made herself stiff as a board and hooked her foot around the chair leg. When I remonstrated that this habit of making herself stiff was not helpful, she wanted to know what she could do different. The transition back to the bed was a lot easier since she made an effort to support herself. Perhaps the reason her ballet career was cut short was because she could not be partnered. Any effort to move her prompt immediate resistance.
Oh, yes, I've got a new use for duct tape. Just one strip across the front of the depends kept it securely in place and the sheets didn't get wet. Of course, ripping the duct-tape off destroys the depends, but the tabs have so little stickum that they can't be reused once they're undone, anyway. I did hear efforts to rearrange things on the monitor over-night, so I'm pretty sure the duct tape gets the credit for keeping the bed dry.
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September 29
Yesterday the duct tape didn't work all that well. Didn't make it tight enough. so she was able to slip out. But, no time to actually wet the bed, until later in the day when I hadn't duct-taped her anyway. So, one change of sheets during which she had to sit on the commode, not happily but finally compliant.
In response to questions, the Omi told the Puddy that she knows who he is, but couldn't remember his name. Then she added that he's NOT part of the family, rather gratuitously. That she has no family is an illusion she likes to hold on to.
Otherwise the day passed uneventfully. As did the night. This morning she preferred not to have breakfast right away. The Depends hadn't come off and she was able to let me know when she needed to use the commode.
Usual breakfast and some chocolate pudding for lunch. And so it goes.
~~~~~~~~~~~~~~~~~~~~
October 1, 2005
The hospice nurse called yesterday and offered to come by, but there wasn't anything to see. The Omi was more responsive to questions, seemed to understand when told about a phone call from her "cousin" Elfriede, but refused to get out of bed except to use the commode.
Then, last night about 9:30 I woke to the sound of tearing and rustling. So, I went down to have a look and she was busy trying to remove the duct-tape reinforced Depends. She'd also unsnapped her pajama top. I fastened the snaps and told her to leave the Depends alone and go to sleep. Which she did. This morning everything was still in place.
I got her up so I could change the sheet because Puddy was looking for laundry to do. She didn't want to eat then and went back to sleep until almost eleven, when I fixed her cereal with butter and cinnamon sugar. Although she said "Enough" about half-way through, she did eat the whole eight ounces. Last night she had mashed potatoes with sour-cream gravy and finished her pudding, so I'm figuring she's not going to starve. Dehydration doesn't seem to be a problem either. She's drinking her prune juice, water, and tonic. Tea seems to be no longer preferred. When I fix it, she usually has enough with half a cup.
Today, she's been unwilling to get up and spent most of the day sort of sleeping. She's not as alert as yesterday, but not totally befuddled either.
Somehow I get the feeling that time is of no significance any longer. Will see how dinner goes. She's not had her fruit for the day, so that will be the minimum.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4:30 AM a baleful plaint came over the intercom "I'm all wet."
Sure enough, duct-tape doesn't work if the Depends isn't on tight enough--an almost comotose person can wiggle herself out and then, of course, find herself in a wet bed that quickly gets cold when the blanket is lifted to inspect. The heat has been going on at night, so you know we're no longer enjoying summer temps.
The "almost comotose" is obviously an exaggeration. There's no inability to communicate and my repeated assertions that she only has to speak to be heard obviously registered. 4:30 isn't a bad time to get up. So............
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
It being Sunday, it was sort of appropriate for the Omi to have brunch about 10:30 in the morning. But, when it was ready, she announced a need to use the commode and then half-way through the eight ounce bowl she announced "no more." I insisted that since this was brunch she would have to eat it all and she did.
She spent most of the afternoon propped up in a sort of sitting position. When I popped in a couple of hours later, she had pulled the blanket up to her chin--to hide that she had yet again started the undressing process, though the Depends, tabs undone, was still in place. I resorted to a piece of duct tape. Asked, the Omi asserted she doesn't know why she tries to get undressed--that she wouldn't if she did.
Having refused anything to eat or drink, she accepted the offer of the Sunday paper and actually looked at it briefly before returning it, all folded up, to where I had placed it. (She isn't aware that I can see her from the kitchen). When I went to retrieve the paper, she suddenly asked if I have any money and suggested that, if I did I could get away. I asked her if she wanted money and she said no. I assured her that I had no desire to leave since it's my house and my land. But she insisted that my "friends" (the other people in the house) are bad. When I reassured her that there is no-one here but she and I and the dog and Julian, she said "I don't trust Julian." Since this is a true statement, I merely asserted that he's my husband; that I trust him and love him and that he's proven trustworthy in the forty years I've been married to him. She repeated "forty years" with some astonishment, but her facial expression clearly dismissed the importance of that fact. Anyway, she concluded that she doesn't trust Julian because I'm her daughter--clear evidence that her mind is not totally gone, since that's a well-worn explanation for all kinds of things.
So, being in a somewhat confrontational mood, I told her that I knew full well why she doesn't trust Julian. It's because she doesn't trust any men, never has. In fact, she probably didn't come to love her brother until after he was dead--at barely twenty. She didn't dispute that assertion.
When you come right down to it, although she's trusted women for short periods, her relationships with them, except through the mail over long distance, didn't ever last long either. She doesn't like other people, probably because she doesn't really see them as distinct from herself.
Meanwhile I'd got a note from our doctor in Georgia who suggested that sudden mental changes tend to alert him to some sort of flu or infection that doesn't have normal symptoms in the very old. I was able to assure him that the shifting mental states have actually become the norm since last spring and all the physical systems are going on as before.
Tea in the afternoon was accepted, but only a half cup which she held and drank from by herself. And wiped her mouth when some dribbled down her chin. Supper was just a jar of toddler food, followed by chocolate pudding which she didn't finish because she "doesn't like it." Rejecting food is usually a sign of feeling better. Her whole life, "I don't eat much" has been a mantra, often in the context of launching into a critique of others who are "too fat because they eat too much." I only mention this to make the point that we seem to have a tendency to over-look when people tell lies about themselves. Perhaps because we don't care enough to call them on it.
Think of people describing themselves as "compassionate conservatives."
The end of the day was generally uneventful and I, having been up since 4:30 was glad to retire early as well. Then about 9:30 I was awakened by a plaintiff "I can't sleep" on the monitor. When I went down to inquire as to the reason (other than that it's actually her normal pattern to wake up as night falls), she explained that she was so worried about Charlotte and the three little children and Julian and the cancer. So, of course, I told her that nobody has cancer, nobody's dying and she should just go back to sleep. Repeated that a couple of times, turned out the light and left. And that was that. Not unlike dealing with a little kid's nightmares.
But, this one could probably use a bit of explication because there is some truth in it. Julian had a conversation with her not long ago in which he related that Charlotte's uncle, Tom, has cancer and is expected to die soon. (For some reason, he thought the knowledge that someone else was dying would cheer her up). This bit of information obviously resurrected the memories of our friend Robert's wife, Mika, who indeed had three babies in quick succession and then died of breast cancer, leaving Robert a widower with a huge task. Now, the Omi never liked Mika and held it against her that she died--probably thought she shouldn't have been so reckless as to have three babies. After all, she herself had stopped at one.
In any event, the Omi doesn't like our Charlotte either, probably because Charlotte insults her sensibilities by being heavy and by being nice to her. The Omi does not like people who disprove her assessment of them. So, her supposed concern about something that's not actually happening is fake. But then she's been spinning a scenario about Charlotte leaving and my having to take care of the boys for some time. She's been sure that Charlotte has been about to run away, because that's what she's wanted her to do. That this way of thinking is actually evidence of reason is probably weird. But there it is. If you have the right assumptions, it all makes sense.
Perhaps I'm wrong in seeing a relationship between an old woman's deranged thinking and the way George the Lesser is going on about Iraq, but it sounds familiar to me.
* * *
Well, so we had breakfast at 10:30 and then around noon puddy noticed a lot of activity under the covers and we discovered that she was trying to rid herself of the Depends. When I asked her what she was doing, she said "nothing," so, of course, I called her on it and she challenged me to define lying. Eventually, she decided she needed to use the commode and I helped her get up. Success. Ha.
Then back to bed and no interest in anything to eat or drink. About an hour ago there was whimpering and sighing and, of course, evidence that she had again decided to disrobe (funny euphemism). She claimed she wanted to be able to cry. But didn't know why. So, I told her that her problem was that she was getting bored with being in bed and if that was the case she should just get up. No response.
A suggestion that she have tea elicited a "maybe" and when I said that wasn't good enough, she said "yes." So, I went off to fix it and when I came back she announced that she had to get up and did, with just a little help. She's had trouble getting her feet to move for some time--has to concentrate on making them do their thing. But they did. She walked across the room and sat in her easy chair and then, after I had poured the tea, with a little cognac added, she demonstrated perfect hand-eye co-ordination in bringing the cup from the tea-cart to drink and returning it without a spill.
So, it was largely an act. Though I may be proved wrong and tomorrow she might indeed be dead. I did tell her that just lying in bed was not a prescription for hastening the end. And, of course, it's entirely boring for everyone. I'm thinking that perhaps I should restart the alprazolam and see if that improves her mood. She's obviously got no pains, so there's no point in giving her the hydrocodone.
Variability continues.
Brought her to the table for dinner, after she'd sat up for about three hours. When the news came on the TV, she soon pronounced herself "tired" and didn't eat much dinner. She retired for the night without any fuss, though about midnight I was awakened by a ripping sound--didn't seem enough to do any real damage, so I didn't bother to check. Instead, I got up to write up something on nuclear weapons in Iraq. (Seems that a goodly aray in the Eastern Hemisphere has been a goal since John F. Kennedy ordered them taken out of Turkey. Where they are back, by the way).
For some reason the brain go to thinking about people being adaptable to new environments and how you'd think that someone who keeps moving from place to place must be super adaptable. Not necessarily. The Omi seems to be a good example of an individual who doesn't adapt to her environment at all. Wherever she lands, the environment doesn't matter, because she's entirely oblivious to it. Which would explain why she's always headed in the wrong direction. It isn't that she doesn't look where she's going; she doesn't see where she is.
All of these lifetime patterns just seem to be exacerbated in old age.
****************
Yesterday was a no-get-out-of-bed day, except for a very successful session on the commode. Unfortunately, I forgot to re-apply a Depends and the sheets had to be changed later in the day.
My communication that I would be going out in the evening to my monthly meeting was well received, except for the question "are you doing to take the dog with you?" which suggested that it wasn't really understood.
Anyway, she was still awake when I got home about 9:00PM. At 12:30 I was awakened by the sound of ripping plastic. Went down and remonstrated and told her to go back to sleep (she hadn't got the duct tape undone); 5:30 AM another wake-up by the sound of ripping plastic. This time it was almost all off and I replaced it with a new one. Sleep returned for most of the morning until there was a pitiable "help me" about ten thirty. I removed the rest of the Depends she hadn't managed to rip, put her on the commode and then guided her to her easy chair where I fed her breakfast. Sleep seems to have returned.
*************
Friday, October 7th
After a few hours of sitting up the Omi resorted to her bell and demanded to be returned to her bed, where she spent the rest of the day and passed a good night. i say that because there was no ripping during the night and the sleep was sufficiently refreshing to allow her to sit up by herself, get out of bed with just a little help and negotiate the distance to her easy-chair with a minimum of support. Then she had a second glass of juice and consumed breakfast at the regular time.
Still think the Omi is one of those people who never knows when she's hungry and, perhaps as a consequence, doesn't really like to eat. That is, the food doesn't taste good and, if she doesn't actively dislike it, she wolfs it down. If this characteristic had been accompanied by a low level of activity, it's likely she would have continued obese, as she clearly was as a young child. At some point she obviously became hyper-active and hardly noticed how much or little she consumed. Mood swings were probably related to whether or not she'd been eating right, but probably went unrecognized since she never stayed in one place long enough.
Then, of course, during most of her adult life she had someone else cook for her. First, while she still lived at home it was her mother. When she moved out, she hired a house-keeper and/or frequently dined out with friends. During the war and her stay in Austria there wasn't much choice beyond the pap one could concoct out of grains and milk (which she actually likes to this day).
I suspect that one of the most burdensome consequences of being married, when her husband finally came home from the war, was the expectation that she would cook for him. By the time she arrived in Los Angeles, I was old enough to take care of the preparations. So, when she got home from work, all she had to do was turn on the stove and then serve it up.
Then I got sent off to boarding school and I have no idea what she did for meals. The prospect of being able to re-create the life-style she enjoyed in Germany before the war--i.e. hiring a housekeeper and maid--was certainly one of the main attractions for moving on to Chile after only four years (during which time she lived at three addresses in LA and one in San Francisco). Unfortunately, the household help in Chile was unreliable and I have to admit to applying extreme pressure to get us out of there, so I wasn't stuck with taking up the slack. Once in New York, I was sent off to boarding school and then, during high school, cooking and keeping house became my responsibility almost exclusively. My preference. I couldn't stand her cooking and I couldn't stand dedicating half the weekend to cleaning house, when I could do it by myself in a couple of hours after school.
In a sense, taking good care of my aged parent is an act of revenge, a refutation
of the claim that being responsible for another person was just too much work.
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October 8---Nurse Nancy paid a visit yesterday. The Omi greeted her with "And what can I do for you?" When I tried to explain that the nurse had come to look after her, she observed that she wasn't much to look at. Nurse Nancy did not comprehend that none of this conversation was relevant to her visit.
Anyway, the Omi's vital signs were not significant of anything amiss. She spent the rest of the day in her easy chair and had dinner at the table. Today, however, she is refusing to get out of bed. Breakfast wasn't accepted until near 11:00 AM. Of course, the persistent rain may be depressing.
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Sundays, for some reason, are always downers. Even when the children come to visit, the Omi tends not to be pleased. In any event, yesterday was still dreary, after Saturday's flooding rains, and the Omi elected not to leave her bed at all--not even to use the commode. I had said she needed a hair wash and she didn't seem at all keen for that.
This morning there's still the same disinclination to get up, though there's no apparent physical impairment. The prune juice went down well and she "helped" change her Depends by raising her bottom at strategic times.
We'll have to have a sponge bath later in the morning. A hair wash may have to wait. Getting anything washed hasn't been an automatic process for months.
2:30 PM--Tea suddenly seemed attractive after a very late breakfast and she responded to the suggestion that she get up to drink it in her chair by actually getting out of bed and walking across the room with very little help.
She did have a bit of pain medicine just before noon. Changing weather may account for sore arms. Or maybe it's just old age. I have a foot that hurts every morning lately. Before that it was a leg. It's always something.
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Well, the sponge bath got delayed until yesterday--a day she refused to get out of bed and just barely ate her cereal, fruit and a little pudding. Tea went down slowly.
Then about 10:30 at night I was awakened by cries for "help." She explained she was in a mess, but aside from her pajama being unsnapped, I found nothing out of sorts and told her to go back to sleep. More strange noises around midnight when I found her half sitting up trying to dislodge a big pillow from the corner of her bed. Took that away and counseled more sleep. Which worked.
This morning, Wesnesday, was uneventful but also unresponsive. Then, about 9:30 she was suddenly sitting up, obviously ready to get out of bed. She used the commode and then decided to sit in her easy chair for breakfast.
She does that. Spends a couple of days flat on her back and then suddenly she's up like a jack-in-the-box. Took some notice of the dog today.
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Thursday was change the bed day, so I rousted the Omi about nine-thirty and she had breakfast in her chair. Stayed up until mid-afternoon and even had a look at the paper (with her reading glasses).
Otherwise uneventful. Getting in and out of bed is not a big production even though the muscles in the calves are shrinking from lack of use. Need to get her up and down more often.
Friday we had a visit from Nurse Fran with the Hospice. This time she got to see Omi up and communicating--somewhat. Just before the nurse arrived, the Omi had complained of a head-ache (a funny one) and then she said she had lost feeling in her fingers. So, I pinched one and she pulled her hand back and we both laughed about the fact that there was obviously some feeling there.
Shared the story with Nurse Fran. If they doubted my prediction that there was a good chance she would rally, I think I'm making believers out of them. A couple of times now, after getting up or down, the Omi has complained of feeling nauseous. But, it never last more than about five minutes--hardly time to go get a pan.
Posted by Hannah at October 14, 2005 06:00 AM