Tuesday, April 28, 2015

Let the Little Ones Come...

Mom and our oldest grandson, Daniel, when he was 2. 
When they are in a comfortable environment with people who have become familiar to them, small children may exhibit wonderful empathy for an elderly person with dementia.  I love the photo above of my mother with our oldest grandson back when he was just two years old.  Daniel was a laid-back toddler and usually happy to oblige loved ones who wanted to cuddle.  I love the expression on his face here; he looks kindly indulgent.  One of his little hands rests on Mom's wrist, the other mimics her pointing at a feature in the book, and he is gamely looking at the story detail she is pointing out to him. He is, in short, ministering to my mom, who had invited him to sit on her lap.

Daniel's little brother, Logan, who is now exactly the age Daniel is in the photo above, spent time with Mom yesterday afternoon.  I'd brought him out to bake cookies with Grammy (me), but as soon as he arrived he announced, "I'm goin' in to see Roof. (My mom's name is Anna Ruth, and the kids are instructed to call her "Grandma Ruth," but "Roof" is Logan's abbreviated form of her name.)

No one had asked Logan to visit Mom, but as toddlers, both my grandsons have been delightfully uninhibited by any need to distance themselves from disease-related behaviors.  It isn't that they don't notice dementia symptoms, but more that small children are governed by a compassion that spurs them to find a way to communicate.  Logan strutted into Mom's apartment, and when she didn't look up he said loudly, "HI ROOF!"  Mom responded with delight.

Now, Logan is very different from his brother, and does not give hugs unless 1) they are his idea and 2) the hug-recipient is his mother or father.  But he has a precious empathy for his great grandmother nonetheless, and he surveyed her appraisingly, hands on his hips. After a few moments of thought, he attempted to entertain her with some dance steps, but Mom soon lost interest.  And so he ran to his toy cupboard and said, "I need a game that Gamma Roof an' me can play togevver."

I was at a loss; Mom isn't very interactive, and Logan wasn't going to sit side-by-side with her in the chair with a book as Daniel once had done.  As I hemmed and hawed, Logan decided to take matters into his own hands. Turns out that in his mind, a good game was one in which Logan displayed talent and Grandma Ruth's attention did not waver.

He chose a box of magnets and metal connectors and sat down with them at the foot of Mom's chair.  "Look at 'dis, Roof!" he said...and he proceeded to create amazing sculptures and then hold them up for her to admire.  Whenever her attention seemed to fade he would stand up, say her name, and redirect her to attentiveness; it reminded me very much of how I used to speak to a class of first graders when their attention wandered.  The amazing thing about Logan's interaction with Mom is that although he had to work hard to keep her engaged, he managed to do so for nearly 30 minutes.  I'm astounded that two months short of his third birthday, Logan had the fortitude to sustain a social-type interaction with her for a longer period of time than her Alzheimer's has allowed since--well, since the last time Logan visited.

Sometimes, parents may feel they are protecting their little ones by preventing them from contact with elderly relatives, but young children are uninhibited by fear of of dementia-related behaviors. Of course the interactions must be closely monitored, and you wouldn't expose a child to angry or violent behaviors. But when the child is given a measure of control over the situation and the dementia patient responds with smiles, the results can be heartwarming.

Friday, April 17, 2015


If, when this journey through my Mom's Alzheimer's is done, I ever begin to think I made it through via good planning, hard work, and my exceptional caregiving skills--someone needs to just knock me upside the head to gently set me straight. 

In truth, I have bumbled through by praying day by day and sometimes moment by moment, and the Lord has just been very gracious to my mother and me.  I'm too bleary eyed right now to remember and record a complete list of the ways our challenges have been met over the years, but the most recent bears sharing.

A week ago I was stricken quite suddenly with a painful case of strep throat followed by debilitating flu-like symptoms. I was unable to enter Mom's apartment, and felt frantic. Our backup caregiver could not be exposed to my flu because her husband has COPD, and my daughter is newly pregnant and has two small children.  Since Mom's recent UTI she had required high maintenance caregiving of the sort my husband was unable to provide; she had become completely incontinent and worse, had lost motivation to make those important trips to the bathroom to change her clothes after an accident.  She would not get out of her bed or her chair without physical help.

The only solution I could come up with was that we might call 911 and send Mom to the hospital, then once the necessary recommendations were in order to satisfy Medicare, to place her at the nursing home we'd toured last month.  I made a list that outlined exactly what needed to be done for Mom and handed it to my poor husband.  He entered her apartment with fear and trembling, only to find she had gotten up for the day without being helped, and had toileted herself, bathed, and dressed. "Where's my toast and coffee?" she inquired perkily.

Overnight she had gone from  having to have physical help to stand and navigate to the bathroom, and returned to independent behaviors we'd not seen for two months.  She had changed her adult diapers by herself 4 times in the night. And she had dressed without being asked to do so, a behavior we haven't seen for over two years. 

While I was too sick to enter her room, Mom's bed was dry each morning and she continued to take daily sponge baths and to toilet herself independently.  A week later, she continues more independent behaviors than before I fell ill, though not quite to the degree that she exhibited that first night.

I'm still recuperating and haven't assimilated all that's happened, but I do know beyond doubt that the Lord has met our needs. The word "miracle" keeps tickling my befuddled brain and I'm not so sure it isn't accurate. 

One thing is certain, the relatively carefree way we have sailed through this most recent challenge has nothing at all to do with me.  I guess I need some sort of a contingency plan, but where does one find a backup caregiver who is trained to do the really heavy duty stuff and is also willing to be exposed to strep throat? 

Better just to keep trusting the Lord.  He hasn't let us down yet.

Wednesday, April 1, 2015

Musings on the Merits of a Yogurt Parfait

My Alzheimer's mom has suffered what is likely a urinary tract infection (UTI), and I've learned about the atypical symptoms that occur in elderly patients who have this condition. Withdrawal, lethargy, and a downward cognitive slide were almost certainly due to this infection, so, heads up to caregivers who haven't yet experienced this: sometimes atypical symptoms are the only ones exhibited by the elderly (which may throw you completely off when you are trying to figure out what in Heaven's name is wrong--they certainly did me!).  Recommended: an informative article about UTI's HERE. 

The Lord helped me out with this one because Mom came down with a cold at about the same time she exhibited the UTI symptoms. I didn't recognize the UTI but I did know that she is a pneumonia risk whenever she suffers a cold, and so we put her on antibiotics. And that cleared up her infection. 

And we all lived happily ever after?  Not so much.

The antibiotic gave my newly incontinent mother diarrhea. Those of you in the trenches of heavy duty caregiving with me understand the devastation I felt over what happened next.  End result: laundry was quadrupled, and caregiving became intensive.

Enter the yogurt parfait.

Yes, I know, this seems an abrupt change of subject (and, in this context, not a particularly appetizing one), but stick with me here.

I reached out for help to our area department on aging and asked for products and procedures to help with incontinence. After some stammering, an intern came up with this information: "There is a good medical supply store 90 miles from your location, would you like directions?"

Not helpful.

I called our nurse practitioner.  "Give her yogurt daily, and if that doesn't help call me back."

This, it turns out, was moderately helpful. Probiotics can help after a round of antibiotics, and yogurt contains probiotics.

I did a Google search for foods that will encourage a firm stool. (Love how Google search histories reveal what is going on in one's life.  When nothing much is going on with me my history has queries such as this: "How tall is the actor who plays Thor?"  Lately, they've read more like this one: "How to get an elderly parent to appreciate me").

Anyway.  Turns out soluble fiber can act like a sponge and help the problem I was desperate to correct for Mom.  And, oatmeal is a good source of soluble fiber.

And, people, I have to tell you that IT WORKED!  A daily yogurt parfait for 3 days and Mom is not only back to normal, she is BETTER than normal. ( Those of you who are in the trenches of intensive caregiving with me will understand what I mean).

Here's the recipe that is helping us--and as always a disclaimer--clear any dietary or medical advice you read here with your loved one's medical professional. What works for one person may not work for another.  This recipe is, for example, too high carb for someone who has diabetes.  Anyhow, here ya' go:

3/4 cup quick oats
2 teaspoons brown sugar
2 teaspoons. lite margarine, melted
3/4 cup fat free vanilla yogurt

Place oats in a cereal bowl, drizzle margarine over, press brown sugar into oat mixture until well mixed.  Add a little more sugar or margarine if you think it needs it. Layer yogurt and oats in a clear glass or cup.  

The oats aren't cooked and I think this makes them more effective as a soluble fiber source.  

Hope this post helps someone today, and to those who plow through these posts not because they need caregiving tips but just because they are kind and supportive people--please keep praying for us.  Love and gratitude to you and to our Lord.