Just another WordPress site

Category: Uncategorized

  • How Many Dangers Don’t We See?

    There are many dangers for Grandpa. It is impossible to eliminate all dangers but I try to make a measured judgement about what should be done about those I see. There is little that can be done about the danger of him falling, but he isn’t allowed to drive or play with fire. Beyond the obvious “not allowed” activities, most other possible dangers are handled on a case-by-case basis, usually with oversight.

    But then there are the unnoticed dangers.

    Grandpa often forgets why he went to the bathroom. Usually he goes in to use the toilet and when he arrives begins to do something else. A common impulse is to fill up the sink with water. I think this is an old memory impulse from when he used to shave with a razor. Since he no longer has a razor what begins as a shaving usually ends up as a face washing and hair combing. It is a harmless activity so when I catch him fighting with the sink drain trying to get it to stop up the sink I help him and then leave him to his splashing in the water.

    That was the beginning yesterday. Grandpa went into the bathroom, opened and close the medicine cabinet, then turned on the water and began to fight with the drain. I helped him stop up the drain, watched to make sure he wasn’t going to leave the water running indefinitely and flood the bathroom, and once he stopped the water and began his splashing I left.

    A little later I decided I had better go back and check on him again to make sure he wasn’t getting into any trouble. First thing I see is Grandpa fiddling with his electric razor which is plugged into the outlet beside the sink and is now half dangling into the sink full of water. First reaction is Aaiieee! Why didn’t I see that one coming! Next is quick intervention, first unplugging the razor from the outlet, then carefully elevate the razor back out of the water.

    Grandpa wants to shave. First I convince him that he should empty the water out of the sink before he shaves. Then I take off the plastic head cover and shake out what water I can. It doesn’t look like much water got into the device. I dry it off, and since it is battery operated (when not plugged into the wall) I switch it on. Electric shaver still works. I give it back to Grandpa and let him shave.

    While he shaves I think about the outlet right next to the sink. It was only in the sudden moment of near electrocution that I noticed the outlet was not a Ground Fault Interrupt outlet. According to code (and any safety concious individual) electrical outlets in bathrooms must be GFI so that if there is ever any problem no one is electrocuted. Time to replace the bathroom outlet.

    How many other dangers are right under my nose that I can’t see?

  • Shadowlands

    Last night Shadowlands was on TV. The actors were good, the story was sad. The subject, something to think about. I suppose first it made me think about life in general, about all the pain and grief in life. Second it made me think about my present situation. Lewis, tending the dying, faced with a life slowly (or not so slowly) slipping away.

    All of our mortal lives are measured by death–we live a span and then we die–but we don’t face up to this in our daily living. We so often live our lives as if it were not really a breath. But when you tend a dying person you see life compressed. The end is not far off but very near. The fragility of life, and its shortness is vivid in a way not seen elsewhere.

    On the one hand this strikes me as a valuable instruction. We are all to number our day’s aright. To recognize the shortness of our lives, and the futility of our self-centered planning, is good. To recognize and accept our humble state is wisdom.

    At the same time I believe the reaction that says “This is not right” is also proper. Nature has been corrupted–It isn’t right for life to be so. Our life was subjected to futility, and in tending the dying the futility of this life is put in stark relief–both our inability to save others, and our inability to save ourselves. The thought that “This is not right” reminds us that this life is not what we are looking for, and that we are still waiting for what will be. Properly, when we look at death it should remind us that this life is not what we are living for, nor what we are longing for.

  • I was Talking to the Little Dog

    Around Grandpa one has to become accustomed to non-sequitors and free flowing activity. The protein plaque builds up on his brain as Alzheimer’s progresses and it becomes an increasing struggle for his brain to function. Two results of this are the failure to properly process information, which leads to non-sequitors, and the inability to follow a course of thoughts and action, which leads to free flowing activity. These two problems are very, very, common in his daily life. It is at the point where they are more common activity than normal environmental interaction (whether with people or objects)

    Grandpa wakes up often every night to go to the bathroom. A good trip is when he gets up to use the bathroom, does so, and comes back promptly and gets back into bed–all without turning on the light. Usually a bathroom trip isn’t so good. Grandpa usually can leave the bedroom without turning on the light, but just as often needs to turn it on when he gets back. Obviously having the light turned on is disruptive for me, but worse is that with the light on Grandpa is far more likely to see something that will derail his train of thought and instead of going directly to bed he will start doing something else. Maybe he will see a bit of junk on the floor that needs to go into the garbage. Maybe he will decide he needs to neaten his bed. Or maybe he will decide he needs some toilet paper off the roll beside the bed and he will spend a few minutes carefully folding a few sheets of paper. Or else he will decide to organize the top of the dresser. These are the common derailing activities the slow the process of going back to bed. For me it is very easy to see how his eyes rests on these various objects and he thinks something about them that gets his mind on a different track from going to bed. Usually his derailment doesn’t last more than a few minutes, but at 2:00 AM a few minutes with the light on feels much longer.

    Last night when Grandpa came back from the bathroom he turned the bedroom light on and his eyes fell on a sweater lying on his bed. He picked it up and began to put it on.

    “Grandpa,” I said. “Do you really want to put the sweater on?”

    “I might get cold,” he said. (Which is certainly the thought prompted in his mind by seeing the sweater, but in reality he wasn’t going to get cold in bed.)

    “All right,” I said. When I see him get derailed I generally try to prompt him with questions to help keep him on track but if he insists on his derailed thought I will usually let him go on with it. I feel this better respects his dignity.

    He was halfway through putting on the sweater when the non-sequitor came. “You awake?” He said.

    “Yeah,” I said. “I’m awake.”

    “No,” he said. “I was talking to the little dog over there.”

    “Oh,” I said. There were some objects in the direction he pointed. Perhaps one of them looked like a dog to him. Sometimes Grandpa is clearly mis-seeing objects (or not correctly interpreting what he sees,) other times his statements are so far removed from the reality of the situation that one might wonder if it is a complete hallucination. I presently don’t think Grandpa has visual hallucinations. We all must interpret what our eyes tells us–for normal healthy adults this is an instantaneous process that most of the time we don’t even think about. Not so for Grandpa struggling under the stifling protein plaque killing his brain. He struggles to understand what he is seeing, and compounded with that is a mental detachment. I think these combine to create the seeming hallucinatory occasions. Somehow he saw something that struck him as looking like a dog, and in his mental detachment there seemed nothing strange about such a sight in his bedroom.

    After he got his sweater on he sat down on the edge of his bed and saw his socks beside the bed. So he put them on.

    “Grandpa, you’re getting into bed,” I prompted. “Do you wear your socks to bed?”

    “Sometimes,” he said.

    I let it pass. Ten minutes after he was back in bed with the light out he sat back up and took the sweater off. Sometime later in the night I think he took off the socks as well.

    **

    Another example of derailment was this afternoon. Grandma sent Grandpa to mail two letters. As best I can reconstruct it he went down to the mailbox and saw the empty garbage can there. Then he checked the mailbox and saw the mail had already come. So he took the garbage can back up to the garage. Then, since he couldn’t open the garage from the outside, he went back into the house by the front door and went down to the garage. But now in the garage he couldn’t remember what he was doing, so he took something out of the garage into the house. I heard all of the door opening and shutting and went down to check on him. I found him in the garage with the letters still clutched in one hand, moving a jug of windshield washer fluid around.

    “Need any help?” I asked.

    “I don’t think so,” he said.

    Since he declined the offer of help and wasn’t getting into any dangerous trouble, I let him be. A little later he came up and asked me where he should put the letters. After a little questioning I managed to determine that there was mail already in the box and he didn’t see any point in putting the letters out until tomorrow morning. Perhaps he had a brain freeze and couldn’t figure out how to take the received mail out of the box and put the out-going mail in at the same time and so reasoned that the letters didn’t need to go out yet. I told him he could put the letters by the telephone to go out later. Then Grandpa decided he would go outside to get the mail that had arrived.

    When he came back inside with the mail he saw some specks of dirt on the carpet. So he put the mail down on the floor and got on his hands and knees to pick up the flecks of dirt. I sorted the mail and Grandpa went to take his little flecks of dirt down to the trash can in the garage.

  • Sometimes it is Hard to not Laugh

    This afternoon I looked over my shoulder to see Grandpa with one shoe on. He was standing in the hall putting a tissue box on his other bare foot. Seeing trouble in the works I got up from the computer to investigate. Grandpa was walking down the hall toward the bedroom one shoe on, and one tissue box on the other foot, looking lost.

    “Grandpa,” I said. “Are you going out to check the mail?”

    “Yeah, I was,” he said. “But I think I won’t.”

    “Do you like some help?” I asked.

    “Yes, I do,” he said.

    I try to not laugh at Grandpa, but sometimes it is very hard. Sometimes the situation is so absurd, so completely unreal, that the laughter comes bubbling up. This was one of those times. I very much didn’t want to embarrass him, but seeing him walking down the hall going clump, clump, clump with a tissue box on one bare foot look funny, and the idea of saying, “Grandpa, you’re wearing a tissue box,” was too silly. The ideal solution was to obliqly help him correct the situation without directly pointing out that he had done such a ridicilous thing as putting a tissue box on his foot instead of a shoe.

    “Come here and I’ll give you a hand,” I said, but then watching him became to much and as he walked down the hall I had to turn away and laugh under my breath. When he reached me I manged to regain control and offer him his second shoe.

    “Here is your shoe,” I said. “I think you’ll find this will work better.”

    “I wondered where that thing went,” he said. (It had been right beside where he had retireved his first shoe.)

    When he took off the tissue box I quitely removed it and let him put the shoe on by himself.

    But today wasn’t going to be a good day. A little later I checked on him again and discovered he was trying to put a different shoe inside the shoe I had given him.”

    “I don’t think you want to do that,” I said. “You don’t need that shoe.”

    “But there isn’t a shoe inside it,” he said.

    “There doesn’t need to be a shoe inside that shoe,” I said. “You put your foot inside the shoe.” After I took the extra pare of shoes away and guided him he managed to put his foot inside the shoe and I laced it up. Once I helped him get into his coat he went out and got the mail.

    But it wasn’t the end of his confusion for the day. When Grandpa tries to do something and gets confused or side-tracked he can end up going down a very different (and usually strange) trail. About 15 minutes later I heard him muttering and complaining to himself again and went into the kitchen to check on him. He had taken his pants off and was trying to put his coat on instead. He already had successfully put one leg through an arm hole.

    “Looks like you need some help there,” I said. “How about we swap. I give you these–” I picked up his discarded pants. “And you give me that.”

    “Okay,” he said, and then looked confused over how he might get rid of the coat now that he had his leg through one armhole.

    I managed to keep from laughing, but this time Grandpa laughed. It wasn’t a happy laugh–more like a sad laugh, probably as he realized how completely confused he was. With my guiding he got out of the coat and back into his pants.

    Some people might think he didn’t realize that he made so many mistakes that afternoon. But after I got him back into his pants I asked him if he wanted me to turn on the TV and he said, “Yeah, I guess so. Maybe then I won’t get into any more trouble.”

    It is very difficult to realize you can’t do things without getting into trouble. It’s even worse when someone laughs at you. So I try very hard not to, even when it is funny.

  • The Next Great Adventure

    Life can change suddenly. Sometimes, it does. On September 24th mine did.

    My grandfather has Alzheimer’s. Grandpa P was only officially diagnosed within the past year, but certainly has been suffering with the early effects of the disease for much longer. Within the past year or so the disease has finally advanced to the point that it had a noticeable effect on his daily life, and then it reached the offical diagnosis.

    Once Grandpa’s condition became clear we were forced to consider what plans we should make for the future. Grandpa was becoming increasingly unable to take care of himself, and Grandma wouldn’t be able to take care of him indefinitely. They would eventually–sooner or later–need help. We talked about what we would do at that time and came to the agreement that when Grandma and Grandpa needed more help I was the one best suited to move in with them and provide the additional help they needed.

    But we didn’t know how soon Grandma would need help. In a month? Two months? Six months? Or a year?

    And that is where the suddenly comes into this story.

    I think Grandma wanted to be able to take care of Grandpa until she was physically incapable–that is, until someone was needed to physically help Grandpa around and perform other labors that she physically couldn’t do. But sometimes we can’t do everything we would like, and by the middle of September Grandma realized she was mentally exhausted and couldn’t take care of Grandpa alone anymore.

    Arlan has been living with Grandma and Grandpa P ever since he went to college. He has provided them with general assistance, but while in college–and now that he is out of college and employed–he couldn’t (and can’t) provide the full time assistance that Grandma needed. So on Sunday September 24th he came home with the message, “Grandma needs you now.”

    So I packed my clothes and computer (the things I use on a daily basis) and left with Arlan that night.

    Such is the beginning of the next great adventure.

    It has been several weeks now and I am beginning to settle in. It will be several months, I think, before I am truly settled in, but at least by this point I have learned the basic necessities of daily life so that every moment is no longer a “new experience” where I must figure out how to deal with it. I now know how to use the electic can opener (trickier than I expected) and the dishwasher (I still think cleaning dishes by hand gets the dishes cleaner, and I would argue it is faster).

    In this change my situation has been turned on its head. Before I lived with all my brothers and sisters in a large rural family. Now I’m living with two grandparents, one brother, and a cousin on the edge of a city. Before dinner required ten pounds of potatoes. Now dinner requires maybe two pounds of potatoes. Before the nearest small town store was ten minutes away, the nearest chain grocery store was twenty minutes away, and downtown thirty or so minutes away. Now the nearest chain grocery store might be three minutes away, and downtown ten minutes, or less.

    Life has also changed in many more subtle ways, but the most mundane are often the ones that strike most forcefully. In the beginning I always thought the amount of food I was preparing for supper wasn’t enough. There was too little meat. There was too little potatoes. Then, much to my surprise, such a small amount was actually more than plenty. But of course. I eat one piece of chicken. Everyone else in this house eats only one piece of chicken. That means we only need five, not fifteen. I needed to keep doing the math to reassure myself that the meals were not about to come up woefully short.

    There is the struggle of adjusting my thinking to the new environment, but there is also the struggle of adjusting the environment to me. Neither of these adjustments has been made completely yet. In matters of adjusting my environment, both me and the people around me must give a little. Growing up in a large family, I was accustomed to structure. Grandma and Grandpa, by contrast, were used to a much less structured environment. So I have added, and intend to add even more, structure to life at Grandma and Grandpa’s while at the same time I have accepted that there won’t be as much structure as I am accustomed to back home.

    In my own personal life I am still seeking my own new balance. I am a person who normally lives on a schedule. Certain things happened certain days, and certain things at certain times in each day. This type of structure in my life keeps me focused so that I don’t feel as if I am floundering around, lost, and with no idea of where I am going or what I am trying to accomplish each day. It also kept me accountable to myself because if I had a schedule I knew when I was supposed to be doing what, and if I wasn’t doing it. I lost my old daily schedule when my life changed and I’m still trying to get my new schedule together. I have a general schedule thrown together, but it takes time to figure out exactly how much time should be spent on each task required during the day, and when it is most efficient to do each job. I’m not there yet. While I wish I were, I realize that by any reasonable measure I am doing well enough.

    But what, one might ask, do I think of all this change?

    I consider it a great honor to be able to help people when they are in need, and particularly in great need. So I am glad to have this opportunity to help my grandparents. But mixed with this is something else, another feeling that springs from the knowledge of why my help is needed. One could say the mortal pall hangs over all of this life, but it stands with particularly visiblity in my present situation. Alzheimer’s at the end is a fatal disease and though it won’t kill Grandpa today or tomorrow there is a very real way in which I feel called to a very long death watch. It’s not something thought about in every moment of every day, but it is a reality that informs everything. It’s not something that we really talk about, but we all know–even Grandpa–that I have come because he is growing increasingly unable to take care of himself. I have come to help him, yes, but then another voice echoes in the silence that I have come to watch him slowly die, his dignity and his mind stripped from him by inches, day by day. Grandpa knows it. I know it. We all know it. It is like that monster that lives in the house with us, which nobody wants to talk about, but sometimes we do, a little.