Bad days
Wednesday was not a good "Tia Day." She was on the floor when I went to check on her this morning. She was disoriented and did not know that she was on the floor. At breakfast, the coffee cup, her usual, seemed to be to heavy for her and she spilled some on herself, but did not seem to notice. I sequestered her in her room because workers were laying new floor to the hall outside her room. She was also told that the bathroom was off limits because there was work there too. I told her that she needed to use the bedside commode. She sees the bedside commode as something for use at night, or during the day. When I went to "unsequester" her, I found her on the floor by the bed. She was grabbing for a rail and missed. Why does she fall?
There are elements of dementia for sure. However, there are elements of stubbornness. A couple of times a week, in the morning, I find her walker against the door as if to block entry. Of course she cannot do that. But, if the walker is by the door, this means that she had to traverse across the room without the walker with only a night-light to show her the way. This afternoon, the walker again was not by her side or near by when I found her. She likes to park the walker outside the bathroom and navigate without. I yell out, "Don't forget the walker." She will grab it with one hand and drag it in behind her. Questions about not using the walker properly result with her response of, "I was just going to..." and "Yes, but ...."
This morning I realized that I cannot pick her up by myself. In all the prior falls, I could tell her to grab my arm and to anchor her legs to my foot. It was a struggle but up she went. Today, She could not hold on and when she begins to pray, "Oh, my God I am going to fall." She is on the floor again. This afternoon, one of the floor workers helped me get her up. With two people, it is an easy task. At 7 p.m this evening she did not know she had fallen. She did not know that she had lunch and was asking for it. She was holding her coffee cup at 5:30 p.m. and asked if she should put on the coffee. Reacting to the workers in the house, she said, "When your mother gets here, she will be surprised by all the changes." I responded with, "If she shows up, I will be surprised and out door." It did not register. These "bad days" alternate with good ones.
Good days
Although she awoke on the floor yesterday, again, it was a good day. Tia was alert and able to carry on a conversation. She did a good job with her bathroom activities. She was aware of the time. Some days she will say that she does not know what time it is and does not check the clock in her room. Last night she had dinner and went to her room. She came back out saying it was too early for bed, and stated the time. She was going to stay up a bit longer. At bedtime, I told her that I would be raising the bed rails. She said okay. (We have experienced bed rails before without success. We quit using them because she would "escape" by making her way to the foot of the bed.) However, this morning all was good. She was in bed and not on the floor.
To Be or Not to Be
The psychologist in me wants to delve into her mind and show her a better way. I would like to teach her survival skills at her age. What is it like to "be" and "not be?" Observing her and wondering how she experiences life, I question mine. If I fall asleep watching TV some afternoon, how do I know that I fell asleep? I can look at the clock. I would have to remember what I was watching that I am not watching now. I would be aware of the body sensations that connect with sleep. All of these things require awareness and cognition.
Tia will wake from a nap, not aware of the passing of time or that she was even asleep. What happens inside her mind when I confront her with reality? She may be adamant that she has not had lunch and is asking to eat. I correct her and show her the unwashed dishes and give her a detailed account of the meal she had 20 minutes ago. Sometimes she says nothing and other times she will say, "If you say so." But what is happening on the neuron superhighway? Did her thought of not having had lunch just go off a mental cliff, or does the thought ruminate for a while? In grad school a professor once asked us to think about your thinking. I can't ask her to do that.
Before her mental abilities deteriorated, my aunt led her life without any questions. Her ways, customs, and beliefs existed. So ingrained were these ways, that in her current mental state, these surface instinctively. This is her "being." When I am trying to help her get up off the floor, or when I am lifting her legs onto the bed, or when I am rubbing ointment on her knees, her primary concern is to keep her skirt down. I will tell her to not worry about the skirt when she is being trampled by elephants, and pull her hand away, but instinctively, her hand goes back to the skirt hem. This reaction occurs both on her good and bad days. A similar explanation could be offered for her objection to using the bedside commode only at night. It does not make sense; it just is.
I have come to accept my limitations in trying to help Tia. If she falls and there is no help readily available to get her up, I will try to make her comfortable and wait. If she is having a bad day, I am unable to make it good. When there was more hope for reason, her old, ingrain ways were unchangable They are impossible to change now.
It is what it is.
Joe V
No comments:
Post a Comment