Saturday, September 5, 2009

The Move

Friday we moved Dee Dee out of our house. Brian moved her things up to Gardenview while my mom and I took her out to lunch to break the news to her. All in all, she seemed to take the news remarkably well. She didn't say anything as we drove there, except to comment in a disparaging voice as we pulled up, "Oh. This place."

She said nothing as we entered. I walked her back to her room to get settled while my mom handled the paperwork. As we walked through the halls, she seemed increasingly sluggish and drowsy. I was almost worried she might collapse - her head was hanging so low and she was slouching tremendously. Several nurses and staff people greeted her, cheerfully welcoming her back. It was as if she didn't even hear them. She didn't raise her head or acknowledge them in any way. Then after one nurse left us, Dee Dee jerked her head up and started talking with me. At which point I realized the sluggishness was an act. She was determined not to talk to "those people."

Now, Dee Dee has several personality modes which I've had the privilege to get to know over the last few months. There's sweet Dee Dee, funny Dee Dee (she has an amazingly sharp wit still), agitated Dee Dee, ...and scheming Dee Dee, which is one of my new favorites. In scheming mode, Dee Dee is upbeat and smily, and revels in sharing her clever ideas to trick the people who are thwarting her desires. This Dee Dee first showed up while trying to trick her home health caregivers into letting her out of the house so she could go to the lake on her own. And Dee Dee was in full scheming mode this afternoon.

As mom and I were organizing things in her room, she started grinning as she explained to us the clever plan she had devised to escape and meet me back at my house. I can't say I fully understood the intricacies of the plan, but it included some of the following elements: 1) telling everyone it was storming outside to fool them (since it was actually a beautiful sunny day); 2) crumbling the bag of homemade cookies I brought for her into tiny crumbs; 3) collecting all the shoes she could find, including those on her roommate's side of the room; 4) sneaking covertly into the hall and scoping out exits; 5) jumping onto a delivery truck in the rain so that no one would notice her; 6) meeting me back at my house later this evening.

She was clearly not happy to be back at Gardenview, but she was channeling her dismay in a way which by far easier on Mom and me than we were expecting. There were no scenes, no tears, no physical struggles... only cheerful schemes to escape.

My mom stayed with Dee Dee several hours this afternoon, and reported that Dee Dee even brightened a little at dinner when she recognized several faces in the room. When my mom left her this evening, settled into a recliner in a common lounge area, she was cheerful. Mom reminded her that my aunt would be coming up to see her tomorrow, probably in the afternoon near lunchtime. Dee Dee asked her, "So, if I'm back by 11:30, that would be soon enough?" Clearly she is planning to escape tonight, but be back in time to visit with her daughter tomorrow.

Needless to say, Mom made sure before she left here that the nurses got Dee Dee's "wanderguard" bracelet set up, so she won't be escaping tonight. However, I wouldn't be surprised to see her tomorrow and hear all about her nighttime escapades around the town.

Thanks to all of you who have been praying for us throughout the day and sharing words of encouragement. Many of you have expressed concern that I shouldn't feel guilty, so let me assure you that I really don't. I feel very sad that we can't keep Dee Dee with us any longer, but I truly believe this will be the best situation for our family and ultimately for Dee Dee as she needs more and more care (even though she will never admit it).

Thursday, September 3, 2009

At a Crossroads

Man, what a crazy last couple days.

Tuesday night was great. Dee Dee got up just twice to use the restroom, but otherwise slept through the night. We all thought, "Great, looks like we're set!"

Then last night happened. Dee Dee was out and about all day long. No naps. We gave her the Trazodone to help her sleep. So she went to sleep at about 9:15. We knew she was going to sleep through the night again.

I was gone until a little after midnight, but when I got home Dee Dee was awake for the night. She'd only slept for about an hour and a half. Diane (Michele's mom) spent the night on the couch and took care of Dee Dee most of the night. Dee Dee was very concerned because she knew that if she didn't keep one bare foot on the tile floor, she would die. So that episode took over an hour and a bunch of cajoling and creative thinking to get her to her recliner. And so on and so forth. Several times she threatened Diane that if she didn't do what Dee Dee said, she'd yell and wake up the whole floor.

She was awake mostly all day again today, so I don't know where she's getting the energy. Maybe she's built up an immunity to Trazodone after one night, or she has a super-power where she gets energy from sleep aids. Those are about the only possibilities that seems logical to me at this point.

For the first time today, I got to witness agitated, insistent, paranoid Dee Dee. She has historically saved those mostly for Michele, Diane, and Ace. It was quite remarkable. She really didn't want Jennifer, our home health worker, to be in our home. She kept on dismissing her, making up all kinds of stories about why she needed to leave. I was Dee Dee's only recourse. "Brian, you don't understand. She needs to go, because we're leaving."

But Dee Dee, I need to go back to work. We're not going out to lunch. She'd shake her head in frustration and say "Brian, would I lie to you? Would I? You just have to trust me!" while she grabbed my arm tightly. This went on for about a half hour until I really did have to go back to work. The afternoon went on in a similar vein until Jennifer left.

Basically, we're back to where we were before the hospital episode. She's not sleeping through the night. Getting rid of the urinary tract infection doesn't seem to have helped her dementia. And she's getting more and more irritated with her family, to the point of physical resistance sometimes.

At this point, it looks like Dee Dee is going back to Gardenview tomorrow. Tonight will be an adventure, but we're taking it in shifts. I've got First Watch. But even if things go perfectly tonight (we're upping the sleep aid dosage by 50%, per the doctor's suggestion), I don't think it will change the outlook.

By the way, I'm not upset by Dee Dee getting upset with me. I fully expected those kinds of episodes when I signed up for this. What cracks me up is that when we went out to dinner tonight, she brought up out of the blue how unhelpful and irrational I'd been that day.

So some things she remembers just fine. ;)

Tuesday, September 1, 2009

Coming Home Today

Michele and I had some good talks yesterday with everyone involved, concerning where Dee Dee should go once we check her out of the hospital. Except for Dee Dee. We all know what her opinion is. ;)

The psychiatrist made his opinion clear: Dee Dee should be going to a nursing home. His concerns, though, were pretty much exclusively for our family. It would be too much. She's not sleeping through the night. We're not equipped. It's only going downhill from here. Think of your children. Etc.

I wasn't there for this, but he interviewed Dee Dee for about a minute before he came out and talked to Diane and Michele. He started off by saying that when a patient has Alzheimers, but then Diane stopped him. Dee Dee's doctors had never used that term for her before, apparently. The psychiatrist said he was referring to a broad spectrum of elderly dementia symptoms and then continued.

So clearly, I need some more info on Alzheimers. Does it just refer to elderly dementia? Or forgetfulness? Or what? Or does it even matter?

I think Ace and Diane's concerns were also for our family. Because they know how tough it's been the last week. And Michele and I agree. If last week is the new baseline, our home is not the place for Dee Dee.

However, there are a few main reasons we all agreed to take her back here today:

1) Gardenview has a room available now, but Dee Dee would only stay there temporarily until another room opens up, in maybe two weeks. We remember that last time she changed rooms at Gardenview, Dee Dee was pretty confused. So it makes sense to wait a couple weeks before she goes there.

2) The urinary tract infection is being treated, so she might be less confused than she has been the last week.

3) She's been prescribed a sleep aid - Trazadone, I believe - that should help her sleep better. Warning: one of the possible side effects is confusion. Yikes! But in theory, if she's sleeping better at night, she'll be safer and we'll be saner. It'll be interesting to figure out what time to give her this pill at night. How long does it last? How fast does it knock her out? Or will it just make her groggy but still awake?

4) If things are obviously not better over the next couple days, we're raising the white flag. Dee Dee goes to Gardenview and we go back to taking her on outings just like we did before.

So that's the plan. Michele and I are planning on sleeping in shifts tonight. The thinking is that we can each get a few hours of uninterrupted sleep rather than more hours of fitful dozing.

Monday, August 31, 2009

Still in the Hospital

Dee Dee is still in the hospital, but doing fine. The sedatives they gave her in the ambulance took a while to wear off, but as of last night she was walking around and chatting normally. She no longer has back pain, which tells me it was mostly just pain from not being situated in the hospital bed correctly.

The reason she's still in the hospital is because the doctor wants her to have some more physical and occupational therapy, and he also wants to get a psychological evaluation. I think the psychiatrist was there with her as of this morning - we'll know more soon. I was hoping to have her back with us yesterday, but it was not to be.

I'll be visiting her later on today to check on her, but I'm starting to hear murmurs about her not coming back to our house when she's released. I haven't spoken to any doctors or to Ace/Diane yet, but I think there may be concern that unless the mental issues get better, our house isn't the best place for her.

I have high hopes that if the increase in dementia was caused by the urinary tract infection, she will become more coherent over the next few days. I would also add that I don't think her having more dementia affects her staying here per se. If she wants to talk to me all day about how she got married at age 15 and has parties at night with her brothers and sisters, that's fine by me.

But I also see that if the mental issues cause her to crawl around on the floor and zonk out for hours in our foyer, that's probably not the best situation.

So we'll see how things develop. As always, I'll keep the blog updated.

Saturday, August 29, 2009

To the Hospital

Michele and I just got back from Missouri Baptist hospital, where Dee Dee is spending the night. Diane was with her when we left, and Ace is probably heading there at some point, too.

(By the way, Ace took her to the doctor on Friday and did indeed find that Dee Dee had a urinary tract infection. So Roxana was correct in that guess. We started her on antibiotics last night, and in fact she seemed not at all combative or agitated last night.)

Dee Dee is mostly fine. She's pretty alert. X-rays and MRI (or maybe CT scan?) came back negative. She's complaining about back pain and won't/can't walk. If she had walked for the doctors tonight, they would have sent her home with us, in fact.

We were hanging out at home today while my mom and dad took the girls to the movies. I was getting ready to take Dee Dee to White Castle when I find her on the floor in her room, sitting up. She's scooting across the floor. I rush over to her and offer to help her up. She strongly discouraged me from helping her up and said she just wanted to rest.

Alright - I can't help someone up who wants to stay on the floor. But instead of resting, she scooted into the hallway and then laid down for a few seconds, then sat up and scooted more, then laid down, etc. All the while she just told me she was fine - she just needed to rest.

She eventually scooted to the front foyer on the hard-wood floor and laid down on her back, eyes closed. It really looked like she was asleep. Her breathing and pulse were normal. But we couldn't wake her up for anything. Michele was yelling into her good ear and got no response.

When we tried to help her up, she strongly resisted. Her eyes were closed and she wasn't talking, but she definitely wanted to stay right where she was. It was the strangest thing. Whenever we tried to cover her up or hold her hand, she strongly waved or kicked us away.

Eventually, after consulting Ace and Diane and the on-call doctor, we called 911. They whisked her away. As they lifted her into the ambulance, she was yelling at the EMS guys to leave her there. All still with her eyes closed.

Once in the ER, Michele tells me they had a normal conversation. She was a little groggy from the sedative the EMS guys gave her (to get her to calm down enough for an I.V.) but otherwise seemed normal. They ran a bunch of tests over the next few hours, but they all came back negative.

She's complaining of back pain. At one point she said that she hurt her back falling out of her chair in her bedroom. But then later she said her back was fine until she had to lay so long in the hospital bed. So who knows. Nothing's broken, though.

The next step is to get her to walk. Michele and I are worried that once she's checked into the hospital, there might be a slow recovery. That's what happened in February when she went to the hospital for a bowel impaction and then got dehydrated and wound up having to spend weeks in a nursing home.

We'll keep the blog updated as we learn more.

Friday, August 28, 2009

"The Party's Over"

Michele here. I haven't posted in quite a while - since it stopped being fun to talk about how Dee Dee was doing. As Brian has been documenting, she has been growing progressively worse.

Brian did a great job of recapping last night's excitement, but I have a few details to add. Dee Dee was urgent to get out of the house last night for the family party to which I was not invited. After our little walk in the rain around 2 am (Dee Dee fully dressed but without a sweater or jacket, and me in my nightgown and bare feet), I coaxed Dee Dee into pajamas and persuaded her (I thought) that the party was postponed until tomorrow because of the rain outside. Ten minutes later, she was fully dressed again and headed for the door. She spent a full hour circling the house from one door to the next, trying each one and moving on. I might have considered going back to bed, but she consistently parked her walker and kept trying to leave without it. (This morning she explained to me that there were no walkers allowed at the party.) So I busied myself in the family room and kitchen - making lunches, folding laundry, cleaning out the fridge - so that I could keep an eye on her.

Eventually, she got tired and went to bed, around 4:30. I set myself up on the couch for the night, to be sure I heard her if she got up again. Which she did, at 5:30. She insisted that I come stand in her room and listen to everything she had to say. I cut her off after a couple minutes, telling her I had to sleep. She became extremely agitated by this, demanding that I listen to her. When I asked her if her story was related to the party, she gave me a puzzled look, and replied, "No, the party's over."

I left her room sooner than she wanted and returned to the couch. Over the next hour, she filled an entire notepad with notes about the special telegrams she needed to send to all of her family all over the world (relatives in Norway, Ireland, and Europe, which, to my knowledge, do not exist).

All morning she has been very anxious and demanding of my time. She keeps pulling me into a room where we can talk privately - away from Louisa's ears - and the things she is saying, I have to admit, make no sense. One sentence doesn't follow coherently from another, but each time I interrupt to ask a question, she accuses me of not believing her.

Needless to say, five days away is too long to wait to see the doctor. My mom is calling this morning to see if we can get in earlier.

The woman living in my house bears little to no resemblance to the grandma I remember. She is becoming increasingly self-consumed, demanding, and accusatory. It is so hard to believe when you know the incredibly sweet and selfless woman she has always been. I am praying that the doctor will have medications to deal with these new delusional symptoms. We need a big improvement, quickly, for her to be able to stay here with us.

As for me, my aunt is coming for a visit today, and I am planning a nap for the three hours that Louisa is at kindergarten.

Night Dreams

I'm not entirely sure what's going on, since it's 3:30 in the morning. Michele could tell you better than I could. I don't think either of us will be going back to sleep at this point.

Dee Dee has been up and about for a few hours now. That's not so surprising on its own - she often is just as awake at night as she is during the day. I suppose that makes sense when you take lots of naps and don't know whether it's day or night.

Tonight, though, Michele and I noticed a sound by the front door around 11:00 pm. Michele investigated, and to our disappointment it was Dee Dee trying to walk out the front door. At night. In the rain. On a strange street. Near a busy highway. Without her walker. However, I will give Dee Dee points for being fully dressed and wearing some good walking shoes.

Thankfully, we've got those child-proof doorknob thingies that prevent most people (even most adults, it seems!) from opening them. We've got them on all three doors on the main level. That was a precaution we took early on just in case.

Michele was then up a few times over the next few hours to help guide Dee Dee as she wandered around the house. For extra excitement, she's been trying to do most of this walking without her walker. Yikes! She fell down on our watch that very first night she spent with us and not at all since then. Dee Dee, don't ruin our record! :)

I'm not sure when Michele gave up on sleep, but I gave up around 3:00. I came out to the family room to see what Michele had been dealing with: Dee Dee walking from door to door, trying to walk out, then saying "Oh right, this one is locked." I asked her if I could help her, and she just said "Oh good morning, Brian! No, I'm just dreaming," and walked on to continue trying the doors. She seemed pretty cheerful to me.

As Michele tells me, around 2:00 this morning, in an effort to humor Dee Dee and calm her down, she offered to go outside with Dee Dee. They walked together in the rain. Dee Dee said she was going to a party with her brothers and sisters because one of her daughters just died, and Michele wasn't invited. When Dee Dee got to Highway 141 and started to cross it, Michele brought her back to our house.

We've got a doctor's appointment for Dee Dee this coming Wednesday. Five days away. I think it's reasonable to say that if we can't get her to sleep through the night, we'll have no choice but to bring her back to the nursing home.