In His Time

In the months before she was diagnosed with Alzheimer's ten years ago, my mother was in crisis.  I spent hours in prayer for her and helped her every way I knew how.

Mom's disease had already progressed further than we knew at the time. The devotions I wrote for her and the prayers I prayed seemed to bear no fruit; the opposite seemed true because Mom resented my interference in her life. This sort of response is not uncommon for new Alzheimer patients; it is hard to accept the need for change, and the confusion of early dementia exacerbates fear and shades perceptions.

Mom suffered a terrible fall the first winter after we brought her to live with us.  She broke her collarbone and then, sent home from the hospital to recover, suffered a cold that turned to bronchial pneumonia. I thought we were going to lose her, but instead the Lord brought healing.

For several years resentment toward me simmered throughout most of Mom's responses to my overtures.  She hated having to bathe, take a walk, or go to bed just because I said it was time to do so, and her Alzheimer's made her forget that she had lost motivation to do these things on her own.

This past year I put the devotions I'd written for Mom into book form, and matched the readings with the hymns she loves. Though my name is on the cover of the book, Mom's Alzheimer's has now progressed to the point that she doesn't realize that her daughter wrote this devotional.  Last night I was in her apartment emptying trash cans and removing dirty dishes when she said, "Just listen to this wonderful devotion..." and she proceeded to read aloud words I'd penned, encouragement the Lord had provided just for her.  She closed with the Scripture reading at the bottom of the page and looked at me. "Isn't God good?" she demanded, as though daring me to state otherwise.

Not waiting for an answer she looked back at her devotional.  "Now I will sing the hymn that goes with this reading," she said.  Tears ran down my face as I listened to my mother warble Just as I Am, and my heart warmed with the Holy Spirit's presence.

During the early years of Mom's Alzheimer's, my heart ached from her rejection of the Lord in me.  She thwarted my attempts to help and said things that hurt my heart. I forgave her but I didn't think she would ever accept the blessing God had offered her through the anointing He gave me on her behalf. I couldn't see the use of having spent so much time in fervent prayer for my mom when those prayers seemed to have no impact on the course of her disease or her heart toward me.

But tonight it was as though God whispered to my heart, "You see? I heard your every prayer."

So often, the Lord asks us to trust in Him when we can't see where our paths will lead. When a loved one is diagnosed with Alzheimer's there is so much fear and uncertainty, but I am here to tell you that it is safe to place your trust in our God. At the time of Mom's diagnosis I never would have dreamed that the love and prayers I offered on her behalf then would bear fruit for her ten years in the future; I didn't think Mom would survive that long, much less still be able to think clearly enough to sing and to pray.

But God knew.  He always knows.  Blessed be His Name! 

For the remainder of the month of November and throughout December, my mother's devotional, Beautiful In Each Season, has been reduced to the lowest prices allowed by Kindle and Createspace, both eBook and hard copy formats.  This is a wonderful time to supply copies of a large print devotional to shut-ins, nursing home residents, and care recipients.

Pray in All Things

I suppose all mothers have pet bits of advice that, over time, become ingrained in family lore. "Wash behind your ears...put on clean underwear (in case you have an accident, the EMT's won't be appalled by you)...don't fidget in church..."  A small portion of my counsel to my children has been stellar, the greater part nonessential, and some downright ridiculous.

However, I stand by one of my oft-repeated instructions, first utilized in that moment of terrified desperation every parent feels when their teenager slips behind the wheel of a vehicle for a first solo excursion. When this transition came for my 16-year-old daughter I shouted one last word of advice after her rapidly retreating form: "PRAY IN ALL THINGS!"

This has become the customary parting phrase for me each time my adult children walk out the door; "I love you, call me when you are home safe, pray in all things!"

I have realized that although my "shouted advice" version of this counsel may be unique, the familial example of praying in everything did not originate with me. This was brought home to me recently when I delivered my mother's supper plate.  Mom loves macaroni and cheese. Her plate featured a generous portion of this favorite dish, and there was also a half sandwich and a cup of applesauce.  Mom began eating the mac and cheese with relish, inserting little comments of appreciation between bites. "This is so good...so creamy...I love this." After a few moments the timbre of her voice changed and I heard her pray, "Guidance, please Lord, for when to stop eating the macaroni and to pick up the sandwich."

My Alzheimer's mom truly does pray in all things. When faced with anything unpleasant she closes her eyes and prays aloud, "As you will, Lord, as you will." And with increasing frequency as her Alzheimer's progresses, I hear this repetitive prayer, "Guidance please Lord, guidance." 

A friend recently asked me how Mom was doing, and I replied, "You know for how little she has left cognitively, she continues to do amazingly well."  Understand that Mom often thinks I'm her granddaughter, sometimes believes she is in a facility rather than in our home, and recently mistook gas pains for labor pains (she told me it would be time to have the baby soon). Her Alzheimer's diagnosis was ten years ago and she is 90-years-old, but she somehow manages to function pretty well within the familiar environment of her little apartment. 

When I heard Mom pray about how she ought to proceed in eating her dinner, I realized why she is able to continue to manage as well as she does despite the confusion of Alzheimer's; the Lord has not departed from her. The Holy Spirit is described in Scripture as counselor and teacher, and He has not abandoned my mother.

When Mom inquires of the Lord, He does indeed provide her with help.  Following her prayer for guidance during the incident described above, she paused in her compulsive intake of the mac and cheese and appeared to be listening. She then picked up the sandwich with her other hand and began alternating bites of sandwich with forkfuls of the irresistible main dish. 

With my family's history of dementia, I find this evidence of God's continued presence in Mom's life wonderfully encouraging. Once again I've been reminded that the best preparation for a possible diagnosis of Alzheimer's disease in the future is to cultivate a relationship with the Living God in our present. Once we've made the decision to believe in what Christ did for us on the Cross and have asked to be adopted as a child of God, we belong to Him. The confusion of Alzheimer's doesn't cause God to depart from us.

...God has said, “Never will I leave you; never will I forsake you.”

--Hebrews 13:5

If you feel your relationship with the Lord isn't one that will afford you the peace and guidance my mom enjoys, check out this link. 

A Practical Post

I recently received an email from a dear lady who deals with her Alzheimer mom's incontinence. "Do you have to deal with incontinence issues with your mom?" she asked.

Well, yes I do.

My primary ways of offering comfort to fellow caregivers are in the emotional and spiritual realms; this is my assignment from the Lord. "Nuts and bolts" advice is not so difficult to find, but the provision of heart-solace to caregivers is an oft-neglected area of ministry.  However, it occurs to me that those who read this blog regularly might appreciate knowing how we manage the day-to-day caregiving issues that so many have to face. This is not meant to be advice for anyone else; please clear all caregiving procedures with a health care professional who knows your loved one well. 

Bathing--Back in 2007 (where does time go?) I wrote a post entitled Bath Day that you can find here. About the only change we've made in the ensuing years is that I now have Mom wear her Crocs right into the shower and don't remove them until she is seated. After she has bathed she puts them back on so that she never has to walk barefoot on slick surfaces, which, even when she is leaning heavily on me, makes her feel insecure.

Incontinence--Mom wears adult diapers 24/7. I recently found that brands are important; Depends don't work for us, or at least the mid-absorbent pack I recently brought home definitely did not!  We use Sam's Club and/or Wal-mart's store brand. We are so blessed that she has healthy skin that doesn't chafe or get diaper rash easily, but when she does we use Boudreaux Paste, a product whose full name annoys me but is the best I've found!

Medication--Mom takes two Alzheimer's drugs (work out a plan with your doctor), an anti-depressant (I think this is so important for Alzheimer patients), an antihistamine for her severe allergies (most antihistamines are contraindicated for dementia patients, again, check with your doctor), and a cholesterol lowering medication that was prescribed off label for her irritable bowel symptoms (Colestipol/colestid). People who have had Cholecystectomy (gall bladder removal) as Mom has often need a medication such as this, but I've always thought it might also be useful for those who have lost bowel control or have irritable bowel symptoms as well. Let's repeat my litany: check with your doctor! 

Mealtime--Mom very much prefers to be served meals in her recliner.  When she moved in with us I very much felt she should sit at the table with us at mealtime. This became a "choose your battles" issue which I finally allowed Mom to win, and she is much happier.  We have a wooden lapboard that fits across the arms of her chair and a side table to hold her drinks. The chair is leather and has a cloth cover that has to be laundered regularly. But, the key words are she is much happier.

Entertainment--Music from Mom's own C.D. collection plays constantly on the "repeat" setting. It was difficult to find a CD player for her--everyone now uses their MP3 players--but I found a 5 CD changer at Amazon and hooked my iPod speakers to it (WHY didn't the CD player come with speakers?).  Music is vital for Mom's contentment level, and the familiarity of traditional hymns is the most powerful mood enhancer for her. Films that have very little dialogue are best; Mom can no longer follow rapid fire dialogue that characterizes most movies. Bambi is a favorite, and Mom loves the That's Entertainment films. 

Reading material--sometimes people are surprised that Alzheimer patients may continue to read. Mom's short term memory is indeed shot, but in the moment she is in she is still able to comprehend a sentence or two of meaning. She loves the My First Little House books, and is not offended when I offer her beautiful children's picture books, but she also very much enjoys devotionals such as Richard Carlson's Don't Sweat the Small Stuff  and Max Lucado's writings.  She also peers intently for long periods at a daily newspaper, so I guess she retains some meaning or at least a feeling of being a part of the world from that. And, of course, I have her read a daily selection from the devotional I wrote just for her, Beautiful in Each Season.  The selection of music and reading materials depends entirely on the individual preferences of your patient. What did he/she enjoy pre-Alzheimer's? Find straightforward or simplified versions of what was enjoyed in the past. 

Schedule--I've printed her daily schedule on a piece of posterboard and placed it within her line of vision, along with her clock and whiteboard that has the day's date written in large letters. These things help her very much. Further and more detailed information is available in the post entitled How We've Managed Thus Far,

Phone--Mom loves her one touch phone. She can call me any time by lifting the receiver and pressing the key printed with my name. She is still able to read so instead of photos I printed names of family members on each key and programmed the phone with their numbers so that she is always able to reach someone.  When she calls several times in an hour I put a sign on the phone: "Linda is taking a nap, call if there is an emergency." This has worked so far. 

How I cope with "Why has this happened to us?"--A real change in my perspective occurred with the experience I describe in this post entitled Farther Along...

 Further information of the practical sort is available in the post entitled How We've Managed Thus Far. 

I'm praying now for every caregiver who reads these words, and also for your precious care recipients.  My heart goes out to you.  Let's pray for one another as we walk this caregiving path together.