Sunday, April 27, 2008


I can't emphasize enough the importance of medication for Alzheimer's patients.

I've written about Aricept at today. The combination of Aricept, Namenda, and an antidepressant (Prozac) worked a near miracle for my mother, and I always want to spread that news. When she came to live with us I also gave attention to her diet and to daily exercise--but neither of these are perfect in consistency or in quality! I have to think that those Alzheimer's drugs (brought to us by God's grace and through His provision for us) are largely responsible for the fact that, against all predictions, Mom has actually shown improvement in her level of processing over the past four years.

Our wonderful nurse practitioner, Diane, has told us that medication is often stopped when Alzheimer's patients are placed in nursing homes. This doesn't make sense to me since studies have proven that people who receive medication are so much easier to care for and enjoy a higher quality of life. Diane said, "If your mom goes to a nursing home be sure that she continues to receive her Alzheimer's medications."

I plan to do that if and when the time comes, but for now Mom's level of functioning continues to allow us to care for her at home.

Tuesday, April 8, 2008

Keep in Step

When all goes as planned, I take Mom for two short walks a day. At around 10:00 a.m., I coax her out of doors for our first excursion of the day. Two times around our big circle drive and back to the house takes about ten minutes, and leaves Mom breathing hard. Mission accomplished!

When I get home from work around 5:00 p.m. we head out for our second walk. Maybe it's because I'm weary by this time of the day, but I always find it more difficult to stay in step with Mom in the evening. It's important that I time my steps to match hers. She leans on my arm heavily, and if we get out of synch both of us have trouble keeping our balance.

Mom is bent, and looks down as we walk. And so I must guide her, or we begin to list from side to side and once again balance becomes an issue. It's difficult for Mom to keep from attempting to stride out ahead to lead the way; perhaps because in our former life she was my guide rather than vice versa. Or, perhaps she is just anxious to get back to the comfort of her chair!

For whatever reasons, I've noticed that when I match my steps to hers and she accepts my taking the lead to plot our course, our walks go much more smoothly.

Isn't that a nice illustration of the caregiver/patient relationship? The caregiver plots the course but must allow the patient to set the pace. And for her part, the patient must be able to accept guidance.

It is my difficulty with allowing Mom to set the pace for the activities of her day that causes most of the small tensions that occur between us. My requests of her--to wash her hands for lunch, or to come to the door to put on her coat for a walk for example--take her more time to accomplish than my "hurry-up" mindset can tolerate with grace. This illustration of the importance of allowing Mom to set the pace was a nice reminder for me. I need to allow her the dignity of moving at her own rate as she accepts the guidance I offer.

Saturday, April 5, 2008

Cup of Coffee, Please!

While clenching my teeth and biting my tongue this morning, I had a flash of insight; maybe because I was multitasking and managed to pray in conjunction with my tooth grinding/tongue holding exercise.

Mother had asked me to get her a cup of coffee. If I had a true servant's heart, such a request wouldn't annoy me, would it?

One of the most difficult aspects of caring for an elderly parent has to do with the reversal of past roles. Mama used to meet my needs, now I'm supposed to meet hers; and this is an ongoing heartache for an only child who was once the apple of her mother's eye. I think I'm still the apple of her eye, but for different reasons. She calls me, "My Linda," and you'd think I'd smile when she says that. I do not smile. The little voice in my head, the one you shouldn't listen to and probably won't hear if you are rightly aligned with the Lord says, "She doesn't give a flying fig about your well being. She only cares for you because of what you do for her."

Back to the flash of insight. It came to me quite clearly, not quite in time to prevent me from grimacing in Mom's general direction but it did cause the sharp retort that had been threatening to spill out of my mouth to be silenced.

The ability to ask for help outlasts the ability to "do" for oneself. Put yourself in your mother's place, and imagine that your thinking processes are compromised as you know hers to be. Getting a cup of coffee is a complex task. You must stand up. While occupied with the mechanics of standing you are very likely to forget why it was that you stood up to begin with. If you do remember your task you then must orient yourself to the room, remember where the coffeepot is kept, and navigate your way across the room. Once having arrived at your goal you must procure a cup, remove the pot from the burner and pour the hot liquid. But wait, it isn't hot. You must use the microwave. The coffeepot won't fit back into its slot and you can't see what is wrong so you leave it stuck at an angle. How to work the knobs on the microwave? And when all of these maneuvers are successful, your mother must then negotiate her walker, a cup of hot liquid and her uncertain balance to get back to her chair. When you respond negatively to her requests for help, you take from her the dignity of being able to adjust to her limited capacity to function by learning a new way to get what she needs--she asks! Behaviors that in the general population would be labeled as "lazy" are, in the Alzheimer's patient, coping strategies developed to adjust to a lowered level of functioning. Your mother is doing a good job. You, not so much.

In our former lives, my mother rarely asked me to "do" for her. I have clear memories of her jumping out of her chair to see to my comfort, to make me a sandwich or to mix up the special frosting I used to like to eat between graham crackers. And if you think these are childhood memories--no. We retained our mom-as-caregiver/me-as-child roles right up to the time of her diagnosis four years ago. So you can imagine, it was quite a shock for me to learn to be a caregiver. I guess most adult children have difficulty seeing the new limitations of parents who have become elderly, and I had somehow managed to judge my mother as a caregiver who was failing to perform her job well. This, despite the rather obvious fact that she was both physically and mentally incapacitated.

I'll get it Lord, I will. Thank You for helping me. And forgive me for my failures to be Christlike in my caregiving of Mom.