Yesterday was a Christmas to remember. For a while I thought I was living "A Christmas Carol." Unlike Dickens's plot, I was not seeing the ghosts, my aunt was. Unfortunately I don't know the whole story that went on in her head.
In Psychology, schizophrenia is one of the most severe disorders. The patients may experience delusions and/or hallucinations. My aunt would not be diagnosed with schizophrenia because of her age and on-going dementia. However the existence of delusions and hallucinations is all too real. For the past 6 months I have witnessed her delusions, being in a reality that exists only in her mind. The fact that these thoughts and false beliefs are expressed out of the blue is one of the things that is trying my physical and mental state as I try to care for her.
The purse/ money delusion
She is "normal" most of the day and is napping. I think that she will be down for 2 or 3 hours, and I sit to read or watch a movie. In the next 30 minutes I hear her getting up and is stressed out that she left her purse on the bus. Her purse has her identification and passport. She has also "left" her purse at some one's house after a party. I cannot erase this thought from her mind with rational thoughts. She may want me to do something or she will may just sit there anxiously looking out the window worrying about the lost purse.
It has been a long time since my aunt deals with money. She is not aware of how things are purchased or who buys the things. Yet, the money delusion will surface randomly, similar to the purse. With the money, she has forgotten where she left her money. She may start looking for it or ask me to look for it.
Daily chores delusion
She has delusions that relate to house chores. Every night, after she finishes her dinner, she will ask me if she can fix me something to eat. While the thought should normally be appreciated, it is frustrating. We go through several meal choices that she can cook for me and I say no to all of them. I explain that she has trouble walking, standing, and cannot stand to do these things. "Yes. You are right," she will respond. Five minutes later, I am offered another meal choice.
She recently told me that she was going to heat up some water to take a bath. This is a delusion to the Nth degree. Heating water for bathing takes her back to ancient times in Mexico, when I was a kid. That was the norm, heating water in the winter for bathing. She is not a lover of bathing. The fact that she mentions bathing tells me that all is not pleasant in Pleasantville.
Yesterday as she was walking back to her room, she almost fell as she tried to bend to wipe a spill that was not there. She also wanted to get a mop to clean "it" up. On another occasion she side-stepped a "spill."
The Hallucinations
Sometimes they scare me until I get my bearings. A few nights ago, I took some oatmeal to her room in the evening. I sat on the bed as she ate. Without raising her eyes or making much about it, she said, "Who are the two women in the window?" In another instance she had been in bed less than 30 minutes when I heard her call out. She was sitting on the bed pointing to the hall asking, "Who are those two children looking at me?" In both instances, I did turn to see if anything was there, hoping there wasn't. To soothe her mind, I went to the window and checked and closed the door so that the children would not stare.
Yesterday's hallucinations were the most intense since I have been here. The first "visitor" was a little girl. From her chair in the bedroom, she saw her standing outside the front door on the porch. I asked who it was and my aunt said that she could only see her from the waist down. On her way to the kitchen, she pushed open the bathroom door to check that the little girl had not been locked in there. When my sister came to visit, my aunt asked her about the little girl, worried that she could be run over by a car. Later she smiled and waved at "her" in the hall.
When she was having the afternoon coffee (I needed wine by then), she looked past me into the hall and smiled. I asked who she was seeing and she said, "Roberto Vidales." I don't really know who this was. With that name there was a half-brother of my aunt and his son. "Roberto" did not stay long. The only other unusual thing this evening was that my aunt did not have any supper. This is unusual because she has always been concerned about sleeping on an empty stomach. This is a diabetic concern.
She went to her room ready for bed early. I told her that I would be in to give her cold medication later. While I was in the living room, I heard her talking to someone. I muted the TV and listened. "You are going to be alright. There is no need to cry, tears are sacred. Why don't you lay your head on the pillow. Do you want me to bring you some water or some milk? Just lay your head down for a while. The body needs to rest and you can rest laying down." I go into the room and see her pillow at the far side of her bed and she is looking in that direction. "Maria" has come to visit. I don't know who this is/was. In reality my aunt id looking toward the piled comforter and blankets on top of a table. Since I could not get her to lay back, I took the pile of stuff out of the room and told her it was time to sleep. She was still asking for Maria and I told her that I took her to another room to sleep. My aunt continued talking for a while and then she fell asleep.
Reality
These delusions and hallucinations affect my aunt's reality. She tries to bend down to wipe a spill that is not there, or she wants to get the mop. She gets up without one or both slippers. She may get up to get a glass of milk for one of her "visitors." These are real actions that she takes or tries to take and the reality is that she may not be capable of these and harm herself. These are actions that need to be monitored. Another reality is that she gets upset that I do or not do for "her reality."
Right now, although she is napping before she eats lunch, I am vigilant listening for the sounds of her trying to get up. She has forgotten how to work the electric recliner and will try to get down instead of asking for help. I or someone has to be vigilant because she does not ask for help. She will struggle to get up from a chair or struggle to carry a glass of water, while she tries to hold on to the walker. Someone has to be vigilant to make sure that she swallows her pills and does not toss them to the floor. Someone has to be vigilant that she not feed the dog from the table, in turn making the dog sick, vomiting. When she goes to the bathroom, I check to see that there is not something that needs mopping or cleaning. I also have to see that she pulled up her diaper all the way.
The reality is that my aunt needs to be in a nursing home. While that reality will be devastating to her, in short time, another reality will set in to erase the hurtful one. I hope. I know that I am at the end of my ability to care for her.
It is what it is.
Joe V
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