Laughter

Little moments of shared laughter go a long way toward making the burdens of dementia endurable for both caregiver and patient. At the heart of the grief of Alzheimer's disease there is a little glimmer of joy springing from the fact that no matter what state our loved ones are in, at least they are still with us. Shared laughter brings that joy to light even if just for a moment.

I love to laugh with my mom. Before she was sick we shared the same sense of humor, and when that surfaces now I feel such gratitude that I still have her with me. Of course just behind that emotion there are tears because she's obviously in the process of leaving me; but for today she's here, and there are opportunities to connect with her still.

On a rainy afternoon in 1980, my mother and I sat in the waiting room outside my doctor's office. I was expecting my first child, and that day we shared the waiting room with a half dozen other women, all of whom were in varying stages of pregnancy. We were not a talkative group and there was silence in the room when a UPS truck pulled up. The driver sprinted to the door, stuck his head into the room and shouted, "Delivery!" He then focused on the startled faces of the group of pregnant women, blushed, dropped his package on the floor, and fled. Mom and I both burst into laughter, and when we realized we were the only ones laughing, the joke became funnier still. I'm not sure why the other pregnant ladies didn't connect the word "delivery" with the imminent arrival of their own special packages, but Mom and I sure did. And why didn't anyone else think the UPS man's obvious embarrassment was hilarious?

Move forward nearly thirty years to a hot July afternoon in 2009. Mom and I were being chauffeured to an appointment by my husband. He had taken an afternoon off from farming, which was a real sacrifice of love for him, and he was not in the best of humors. Mom and I both sensed this and were a little giggly--his taciturn face and abrupt answers to our lighthearted comments were not bringing out the best in us. Mom looked in the mirror and said, "My hair sure does look nice when I'm headed to the beauty shop to get it fixed."

"No, Mom, we're going to the eye doctor," I said.

Exasperated, my husband spoke slowly and clearly, "We are going to the dentist!"

Mom and I both laughed until we cried, as my husband shook his head in resignation. We were indeed headed to the dentist's office for Mom's six month checkup.

Sharing laughter with Mom reminds me of how blessed we are to be together still.

Scripture: "A happy heart is good medicine and a cheerful mind works healing..." (Proverbs 17:22 AMP).

Patient/Caregiver Perspectives

My mother's journals reveal telling insights into how her mind does and does not function. Her journaling may give help to Alzheimer's caregivers whose loved ones are unable or are not inclined to put their thoughts into words. Here is an incident that occurred yesterday, first from my perspective as caregiver and then from Mom's perspective as patient:

Caregiver's perspective:
Yesterday I arranged a little lunch date for Mom, her respite care provider, and me. We ate pizza, chatted together, and Mom enjoyed the interaction. Later in the afternoon I brought Mom a snack of fresh fruit and graham crackers, and a couple of hours later I prepared and served her supper. In the evening I was tired, having shopped for groceries and prepared food for a busy weekend that includes company and a church dinner. I took Mom for a walk during which we chatted about the events of our day. I had returned to my part of the house to prepare her evening snack and sort her night meds when I heard her yelling. I went in and saw that she was was feeling neglected and irritated. "I just thought I'd let you know that whenever anyone can spend a little bit of time talking to me, I certainly would appreciate it," she said. I'm sure I displayed at least a touch of righteous anger. I told her I was busy and went out and shut the door. A few minutes later I brought her the snack and medicine and told her good night. I admit I feel the same anger once again as I write these words; a good portion of my day had been spent in acts of service for Mom and yet in the evening, she concluded that no one cared about her because she felt a stab of loneliness.

Patient's perspective (from Mom's journal entry):
I must have had a little brain glitch. Suddenly I felt need for companionship and conversation so I yelled, "Hello!" until someone came to the door. I told them what I wanted and they just stared at me a moment--turned and left.

An Alzheimer's patient loses the ability to utilize several sources of information simultaneously. Those of us whose minds are still functioning more or less normally don't realize how often we need to think about more than one aspect of a situation in order to draw an accurate conclusion. Furthermore, the dementia patient has lost confidence in his/her own ability to perform the simplest of tasks, but retains the ability to ask for help. Thus, the disease causes a cluster of symptoms that in the general population could justifiably be labeled "lazy" and "self-centered." It is up to the caregiver to recognize these behaviors as being clinical effects of the disease. When the only information the patient is able to draw upon comes from the present moment, then oftentimes those conclusions will be inaccurate.

I'm ashamed to say that in response to the situation I've shared above, I displayed irritation toward my mother. However, the curse of the forgetfulness of Alzheimer's also contains a hidden blessing, because when I returned to Mom's room a few minutes later armed with a snack and a cheerful attitude, all was well between us once again.

Scripture: "Bear with each other and forgive whatever grievances you may have against one another. Forgive as the Lord forgave you" (Colossians 3:13).

Silver Linings

I try to look for the few silver linings to our Alzheimer's clouds. As Pa Ingalls said, "There's no great ill that doesn't bring some small good..."

Here's my latest:
I'm trying to do my Christmas shopping in July this year--a first ever for me. I ordered a beautifully painted sign for Mom that says, "Amazing Grace." When it came I was unable to keep from showing it to her, figuring I'd go ahead and put it up for her now and buy another gift for her to have in December. She loved the sign! She ooohed and aaaahhhed over it and we planned where to hang it. It was the most pleasant interchange we'd had for awhile. I took it back to my part of the house thinking I'd put it up later but didn't get it done. A few days later I took it in to Mom again, and, not remembering that she'd ever seen it before, she had the exact wonderful reaction! I loved seeing her loving it! A plan hatched in my brain--I can multiply the joy of gift giving by presenting this one gift every week or so until Mom wises up to me...and I can then wrap it up and give it to her for Christmas! Talk about getting my money's worth out of that gift...we both get to enjoy it so much more because of Mom's AD! Just a little joy multiplied, but there's my silver lining for the day.

I posted this story at the Caregiver's forum at the Alzheimer's Association's message boards, and one lady commented, "Truly the gift that keeps on giving! :)"

Scripture:
"Be joyful always; pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus" (1 Thessalonians 5:16-18).

The Importance of Intercessors

Those acquainted with grief are aware of how it can lie dormant for a period of months or years only to come surging to the surface at the most inopportune times. This sort of grief tends to creep insidiously to the surface, gaining a sure foothold before we are aware of its presence.

In the midst of a frantically busy holiday weekend, I was nearly overwhelmed with grief over loss of the family traditions that died with my father's physical death and my mother's Alzheimer's induced inability to remember. How could I have forgotten that the fourth is the holiday that I miss having parents the most; how could I have allowed that terrible sense of loss to advance to flood stage before awareness of it reached my conscious mind? Of the catalysts that open the gates for this type of grief, a dear sister in Christ says it's as though..."we’ve been swept onto the Grief Express, bulleted back in time and soul to those first days..." (Melody's blog).

I was doing a fair job of keeping the grief waters dammed behind a determined smile and a busy schedule, when I walked into my mother's room. In a high pitched, little girl voice, she was singing "Let Me Call You Sweetheart," a song she's often told me was sung to her by her father when she was small. I felt her terrible loss of no longer being a little girl whose daddy adores her, and I turned and literally ran from the room. The pathos of my mother's situation had broken the barriers that had been keeping my own sorrows at bay. When I came to myself, I was clutching the kitchen counter, drawing in deep breaths, knowing my blood pressure was too high. I knew I could not cope any longer with the circumstances of my life and I felt desperate to escape. I was actually thinking I'd just write a note, pack a bag, and go to a motel for the weekend. I pulled out my phone and texted three friends, asking for prayer. Almost instantly my body relaxed, my emotions calmed, my thinking cleared. Next moment I received replies from my friends assuring me that I was being lifted to the Lord in prayer.

The remainder of the weekend was not easy, but I was strengthened to bear the weight of the responsibilities I needed to fulfill, and the grief receded. There is no doubt at all in my mind that this ability to cope came as a direct result of the intercession of my faithful friends who know the power of prayer.

Today I emailed the friends who prayed for me and closed with these words: Thanks be to God through Jesus Christ our Lord that we have one another. Thanks be to God for Jesus and His availing Blood, for His forgiveness, for His grace, for His mercy and
help. I praise Him.

Scripture: "Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous man is powerful and effective" (James 5:16).