"In Alzheimer's, the mind dies first: Names, dates, places-the interior scrapbook of an entire life-fade into mists of nonrecognition."
~ Matt Clark
__________________
I had lunch with Gran yesterday. It was a beautiful day here... the kind of day that makes you want to call in sick and go to the park. The sun was shining, the sky was classic Texas, deep blue and sprinkled with big, fluffy white clouds. It's not too hot here yet and the temps were in the low 80's with a slight breeze. A gorgeous day.
As always, I stopped at Sonic to get Gran her vanilla shake and some lunch for the both of us. I usually get her a grilled cheese sandwich or an order of popcorn chicken... anything that's easy for her to eat. She never eats it all but she almost always finishes the shake.
There was a bounce in my step as I walked into the nursing home and waved hello to a smiling Wendy (the receptionist). I smiled at the nurses and the aides. When I walked by the nurses desk by Grandma's room one of the aides stopped me to tell me that Gran had an accident in the bathroom and they were cleaning her up now.
I dreaded walking into her room because I knew what I would find. And sure enough, there was Gran, very upset and cursing the aide trying to clean her up. Foolishly, the aide was engaging her in an argument. I finally told her that arguing with Gran wasn't helping. You would think these folks would know that by now but to be fair, the girl had a tough job. Gran is not an easy person to deal with when she's upset.
But still... what does it take before people understand that Gran no longer has the ability to reason things out like we do? There is very little logic and reason left in Grandma's old brain. Much of what she says and does no longer relies on thinking skills but simply emotions. If she says there are purple fairies flying around in the air farting bubbles, then so be it. Pretend like the fucking fairies are there and move on. What's important is that the fairies are there FOR HER.
The thing is, Grandma knew she'd "done a terrible thing". Those were hre words. She shit herself and knew it was wrong... some part of her was cognizent enough to know that this wasn't right. In fact, this was embarrassing. She tried to clean it up herself and because her motor functions are next to nothing now, she only made it worse. The aide had to come in and help and Grandma did not want help because she was ashamed and embarrassed. But the aide can't let the patients in her care run around with shit all over them so she had to clean Grandma up... she had to be forceful and insistent and Gran did not like it at all.
I deduced all of this in about five minutes. It doesn't take a genius to realize that when someone shits themselves and can't take care of it themselves, it's just fucking embarassing and becuase Gran can't work things out in her head anymore, her shame and embarrassment takes the form of fear and anger and she lashes out.
This is what the people in the medical field mean when they say that we are woefully unprepared in this country for the millions of cases of Alzheimer's which they predict will happen when the Babyboomers become the elderly. The facility that Gran is in isn't a bad one, but our nursing homes are nothing but warehouses for old people and the bulk of the work is done by incredibly underpaid aides who make $10 an hour doing back breaking, mentally exhausting work. Furthermore, they are not trained in how to deal with Alzheimer's patients... as evidenced by the aide trying to argue with Grandma while cleaning her up. The poor girl should know that the ONLY way to deal with Grandma is to calm her down and redirect her.
It's worked for me time and time again with Grandma. Calm them down and redirect them. Calm them down and redirect them. That is all you can do. Sometimes you won't be very successful. But mostly, given a little time and patience, you can be successful in redirecting them and everyone feels better for it.
And this time, thankfully, it worked. I got her out of the room and we sat in a sunny patch in the main area. Grandma was ashamed of herself and while she didn't say it in those exact words (because she no longer can find those words) she did manage to communicate that to me. She knew she had done something wrong. I told her it was okay, she hadn't done anything wrong. "You took care of old people, Grandma," I told her. "You know these things just happen... you didn't do anything wrong."
When we went back to her room the aide that had been cleaning her up came by to see if Gran was feeling better. Grandma called her over and gave her a hug and said "I'm sorry, I love you." The aide hugged her back and we can do nothing but file that away in the folder full of fucked up things that happens with this disease.
We're losing her. Slowly but surely. Grandma forgets who we are on a regular basis now. She recognizes us but doesn't know our names. Sometimes she thinks I'm her daughter. Sometimes she thinks my uncle is "Daddy" and we don't know if she means Papa or her daddy, both of whom are no longer with us. She curses like a sailor and actually hit one of the aides a few weeks ago. The facility now has her on weekly therapy and I only hope that the therapist is more prepared for the realities of this disease than the aides seem to be.
I know that one day she will be able to do nothing but lie in her bed and wait to die. She won't recognize any of us and won't be aware of much of anything at all. Most days I dread this while other days I wonder if it might be some kind of mercy for us all, Grandma included.
A few weeks ago Mom suggested we take some pictures with Grandma while we were still able to. I took a radio up and some of Gran's CD's from the Big Band era. We sat in the sun and listened to Glenn Miller and Frank Sinatra and visited. It was a nice visit and I can only hope Grandma's got a few more of these left in her.