Saturday, June 3, 2006
I still don't know why that emergency room story...
...discussed in the immediately previous post, was on my mind last night. It remains so today. I have, though, been doing some more thinking about it and want to post some afterthoughts.
This experience causes me to consider that dementia, at least those states in which long term memories become present reality, needs to be considered when working with or treating the demented. Those of us whose brains work "normally" are quick and agreeably oriented enough to, for instance, immediately register the difference between a gynecological exam and what might be the memory of a past, abusive sexual encounter. We don't need coaching to suppress a distressing memory in order to cooperate with an unrelated but potentially evocative procedure.
Interestingly, the same night as the previously posted experience my mother had a demented (yes, she had developed vascular dementia previous to the transfusion experience) flashback (questionable, though, whether it was a genuine or created memory) that I had to negotiate before she would allow herself to be tranfused. You can read about it in this paragraph, if you care to.
I'm not sure how successful a heightened sensitivity to demented creativity within the present moment would have been with the woman discussed in the previous post. I remember that my maternal grandmother had never had a pap smear, thus, I assume, never had any gynecological testing or treatment, until she was screened for admittance to the nursing home wherein she spent the last months of her life. By the time the nursing home became necessary, though, she was so far into her particular dementia (probably Alzheimer's but we'll never be sure) that she spent most of her time in a fetal position and was inarguably dead to the world. Although I can't be sure, I doubt that she was even capable of being aware enough of any present moment to connect it to a past incident. Speculating from this, my guess is that it is not uncommon for many Ancient women alive today to not have experienced any gynecological exams until a full medical work-up becomes necessary in one of "today's" medical facilities. My mother has had plenty of gynecological exams from middle age on but this is because she has been under the auspicies of military medicine, for which preventative testing is a hallmark.
At any rate, dementia can obviously be a tricky road to negotiate when having to medically treat the demented one. The treaters can never be sure from where the demented one's responses are generating. One of the aspects of dementia that renders it especially tricky is that simple calming techniques aren't necessarily going to work. I think it might be advisable for studies and observations to be made in order to determine how to work with the demented perception even when the contents of the perceptions aren't clear.
Regarding my mother's present, yesterday was a strange day for her, thus for me. Her body seems to be a bit stressed and I can't yet determine the cause. We'll be going in for both a CBC and a BMP on Wednesday. I'm especially curious about her renal results. I'm wondering if her kidneys have progressed in their failure to the point where we're entering a new phase. I've considered, on a daily basis, administering furosemide again over the last few days because I'm wondering if she's retaining torso fluid, although her feet and legs remain fine and I can't determine, from the appearance of her belly and face, whether she needs it. I'm being especially careful because furosemide is particularly apt to knock the wind out of her when she's not feeling well. Her thirst has been tricky so, overall, it's fair to say that she is, again, "running a bit dry", but I've been pushing fluids in food as well as cups and she seems to be doing okay. Her allergies are bothering her, lately, which is no surprise. She did some hacking yesterday but, again, it was impossible to tell whether this was caused by torso fluid retention or sinus drainage. She hasn't been gasping for breath, though, or indulging in lots of mouth breathing. Her spirits have been middling, she's been slightly weaker than usual and she's been insisting on lots more sleep than usual, too, over the last few days; thus, she's been a bit hazy when awake and definitely not interested in movement. I've been allowing this, even though I have to fight myself to do it. I'm not yet considering doctors, per the advice in Sick to Death and my own instincts. Unless her blood tests tell me she's building up to a crisis, I think we'll sit this one out at home. I'm hoping she's just going through a cyclical slowdown and will rev up or, at least, plateau soon. One step forward, two steps back time, I guess.
I haven't gotten around to updating The Dailies yet for yesterday. I'll probably do that later. As well, I need to start compiling a two month report for her doctor for the occasion of next week's blood draw (I didn't send a report last month...just wasn't into it and everything was more than fine, anyway, which would have been obvious to the doctor from the test results). I also plan to experiment with a different template for this journal...not too much different, just some changes that keep the archives from diconnected floating on short post pages. As well, I've decided to fast today and possibly tomorrow and detox myself with a variety of cleansing teas. I just feel like my body could use a good flushing.
Later.
This experience causes me to consider that dementia, at least those states in which long term memories become present reality, needs to be considered when working with or treating the demented. Those of us whose brains work "normally" are quick and agreeably oriented enough to, for instance, immediately register the difference between a gynecological exam and what might be the memory of a past, abusive sexual encounter. We don't need coaching to suppress a distressing memory in order to cooperate with an unrelated but potentially evocative procedure.
Interestingly, the same night as the previously posted experience my mother had a demented (yes, she had developed vascular dementia previous to the transfusion experience) flashback (questionable, though, whether it was a genuine or created memory) that I had to negotiate before she would allow herself to be tranfused. You can read about it in this paragraph, if you care to.
I'm not sure how successful a heightened sensitivity to demented creativity within the present moment would have been with the woman discussed in the previous post. I remember that my maternal grandmother had never had a pap smear, thus, I assume, never had any gynecological testing or treatment, until she was screened for admittance to the nursing home wherein she spent the last months of her life. By the time the nursing home became necessary, though, she was so far into her particular dementia (probably Alzheimer's but we'll never be sure) that she spent most of her time in a fetal position and was inarguably dead to the world. Although I can't be sure, I doubt that she was even capable of being aware enough of any present moment to connect it to a past incident. Speculating from this, my guess is that it is not uncommon for many Ancient women alive today to not have experienced any gynecological exams until a full medical work-up becomes necessary in one of "today's" medical facilities. My mother has had plenty of gynecological exams from middle age on but this is because she has been under the auspicies of military medicine, for which preventative testing is a hallmark.
At any rate, dementia can obviously be a tricky road to negotiate when having to medically treat the demented one. The treaters can never be sure from where the demented one's responses are generating. One of the aspects of dementia that renders it especially tricky is that simple calming techniques aren't necessarily going to work. I think it might be advisable for studies and observations to be made in order to determine how to work with the demented perception even when the contents of the perceptions aren't clear.
Regarding my mother's present, yesterday was a strange day for her, thus for me. Her body seems to be a bit stressed and I can't yet determine the cause. We'll be going in for both a CBC and a BMP on Wednesday. I'm especially curious about her renal results. I'm wondering if her kidneys have progressed in their failure to the point where we're entering a new phase. I've considered, on a daily basis, administering furosemide again over the last few days because I'm wondering if she's retaining torso fluid, although her feet and legs remain fine and I can't determine, from the appearance of her belly and face, whether she needs it. I'm being especially careful because furosemide is particularly apt to knock the wind out of her when she's not feeling well. Her thirst has been tricky so, overall, it's fair to say that she is, again, "running a bit dry", but I've been pushing fluids in food as well as cups and she seems to be doing okay. Her allergies are bothering her, lately, which is no surprise. She did some hacking yesterday but, again, it was impossible to tell whether this was caused by torso fluid retention or sinus drainage. She hasn't been gasping for breath, though, or indulging in lots of mouth breathing. Her spirits have been middling, she's been slightly weaker than usual and she's been insisting on lots more sleep than usual, too, over the last few days; thus, she's been a bit hazy when awake and definitely not interested in movement. I've been allowing this, even though I have to fight myself to do it. I'm not yet considering doctors, per the advice in Sick to Death and my own instincts. Unless her blood tests tell me she's building up to a crisis, I think we'll sit this one out at home. I'm hoping she's just going through a cyclical slowdown and will rev up or, at least, plateau soon. One step forward, two steps back time, I guess.
I haven't gotten around to updating The Dailies yet for yesterday. I'll probably do that later. As well, I need to start compiling a two month report for her doctor for the occasion of next week's blood draw (I didn't send a report last month...just wasn't into it and everything was more than fine, anyway, which would have been obvious to the doctor from the test results). I also plan to experiment with a different template for this journal...not too much different, just some changes that keep the archives from diconnected floating on short post pages. As well, I've decided to fast today and possibly tomorrow and detox myself with a variety of cleansing teas. I just feel like my body could use a good flushing.
Later.
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originally posted by Deb Peterson: Sat Jun 03, 06:24:00 PM 2006
Gail--I was just reading a caregiver blog (I can't remember which one but it really doesn't matter) with a posting about what to do when the loved one is in a care facility and insists on going "home." What interested me about it was that it encouraged caregivers to interpret the word "home" very broadly, and instead of trying to convince the LO of the impossibility of actually going "home" it might be better to understand "home" to mean anything reassuring, and then respond to that understanding. I bring this up after reading your most recent posts because I wonder if this might also apply to body parts and medical exams. I'm not sure where I'm going with this, but your writing about the gynecological exams exciting memories--or even apprehensions--of sexual assault made me think this: that because people like our moms are losing so much (vocabulary, etc.) they need to invest what they have left with even more meaning. So words like "home" and "eat" and "head" and "down there" need to be considered very carefully by us because they have become signifiers of so much more than merely a house, ingesting food or a vagina. Oh boy--maybe I've got semiotics on the brain!
Your description of your emergency room visit is so vivid and reminded me of those I've made with my mother. There's something extra haunting about being in that setting and hearing someone else's distress without being able to see the person. And I also remember bringing my father to an ER for a non-life-threatening problem, at his insistence, and witnessing him progress from lucid to delerious during the 6+ hours we waited. That was when I VOWED that I would never take a parent to the ER again unless I feared something really serious. If possible I wait to go the the Urgent Care place. I know you might not have this option with your Mom's kidney problems--Urgent Care/Walk-In Clinics might not have the facilities. But the fragile mental state is something we always have to worry about in these situations.
My mother has been sleeping a lot, too. I know you're in a different part of the country--here in New England the weather has been very rainy and gray, and sometimes that affects her mood and arthritis. I hope your Mom perks up soon. Take care.
Gail--I was just reading a caregiver blog (I can't remember which one but it really doesn't matter) with a posting about what to do when the loved one is in a care facility and insists on going "home." What interested me about it was that it encouraged caregivers to interpret the word "home" very broadly, and instead of trying to convince the LO of the impossibility of actually going "home" it might be better to understand "home" to mean anything reassuring, and then respond to that understanding. I bring this up after reading your most recent posts because I wonder if this might also apply to body parts and medical exams. I'm not sure where I'm going with this, but your writing about the gynecological exams exciting memories--or even apprehensions--of sexual assault made me think this: that because people like our moms are losing so much (vocabulary, etc.) they need to invest what they have left with even more meaning. So words like "home" and "eat" and "head" and "down there" need to be considered very carefully by us because they have become signifiers of so much more than merely a house, ingesting food or a vagina. Oh boy--maybe I've got semiotics on the brain!
Your description of your emergency room visit is so vivid and reminded me of those I've made with my mother. There's something extra haunting about being in that setting and hearing someone else's distress without being able to see the person. And I also remember bringing my father to an ER for a non-life-threatening problem, at his insistence, and witnessing him progress from lucid to delerious during the 6+ hours we waited. That was when I VOWED that I would never take a parent to the ER again unless I feared something really serious. If possible I wait to go the the Urgent Care place. I know you might not have this option with your Mom's kidney problems--Urgent Care/Walk-In Clinics might not have the facilities. But the fragile mental state is something we always have to worry about in these situations.
My mother has been sleeping a lot, too. I know you're in a different part of the country--here in New England the weather has been very rainy and gray, and sometimes that affects her mood and arthritis. I hope your Mom perks up soon. Take care.
originally posted by Gail Rae : Sun Jun 04, 01:36:00 AM 2006
Deb,
Another curious demented habit in which my maternal grandmother and aunt indulged was always wanting to "go"...someplace. They both became transfixed with the phrases, "We've got to go; I've got to go; Let's go." At that time, the theory was to move them around and this would help alleviate the need to go someplace. It never worked. My grandmother lived long enough so that her dementia deepened beyond this phase. My aunt died while she was in this phase.
I've always wondered where each of them wanted to "go". Your post makes me wonder if perhaps they both wanted to "go" "home", and where, or what, they imagined "home" to be.
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Deb,
Another curious demented habit in which my maternal grandmother and aunt indulged was always wanting to "go"...someplace. They both became transfixed with the phrases, "We've got to go; I've got to go; Let's go." At that time, the theory was to move them around and this would help alleviate the need to go someplace. It never worked. My grandmother lived long enough so that her dementia deepened beyond this phase. My aunt died while she was in this phase.
I've always wondered where each of them wanted to "go". Your post makes me wonder if perhaps they both wanted to "go" "home", and where, or what, they imagined "home" to be.
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