Friday, July 28, 2006

 

"When she was good, she was very, very good, and when she was bad, she was horrid."

    Mom just went to bed. Early, for her, especially for the last couple of weeks, since she's been arising at 1300 or later. It's typical for her to mention around this time, "I think I'll head for bed."
    In order to make sure she doesn't spend almost all day in bed, at this point I typically distract her with an alternate activity, or two, or sometimes three: Could be a conversation catalyzed by me questioning her about her past or her attitudes; maybe a round of Sorry (usually not Scrabble or Brain Age this late at night) with the Big Band cable music channel providing a bubbly ambiance; reading aloud; episodes of one of the television series we have on DVD; possibly a short, light movie, if I sense that she's far from being dead tired and I think she's got it in her; sometimes, so I can gauge if she simply needs to move a little or she's really to-bed-tired, I'll put her through a short round of her informal exercises. Always, well, almost always, as you'll see, before I allow her to head into the bathroom she gets her nightly leg rub down; if it isn't already on, I trigger the Big Band Channel; the combination of mental gaiety and physical repose can always be counted on to create a reverential alpha state that usually provokes "I wonder" conversations or silly, pleasant chatter between us.
    Sometime late this afternoon, though, I reached into my Caregiver box and came up empty handed. From that point on I hovered in a quiet background vigil, turned the television to TCM's Festival of Blondes, which I knew would hold her attention, made sure, in the manner of an aloof English valet, that she got her dinner, her pills, went to the bathroom on time; I performed some niggling, distance-producing chores like cleaning out the microwave (a piece of salmon exploded in it two days ago), finishing off the laundry and folding it in the utility closet instead of in the living room, anything that I thought would give me enough "space" to buck back up into a pleasant demeanor before her inevitable first attempt to go to bed, so I had the wherewithal to keep her up for awhile. Doing this seemed especially important tonight because, although she was awake by 1330, just about 12 hours, it took a half hour of coaxing to get her hand over the edge of the bed for BG measurement and bathing went so slowly that when I placed her breakfast in front of her I noticed it was almost 1500.
    At 2300 straight up, on the heels of an Andy Hardy movie, she said, "I think I'll head for bed."
    "Okay," I said. No argument. I didn't look at her. Peripherally I could see her head swivel in my direction expectantly. I knew she was wondering what little stay-awake tidbit I had up my sleeve tonight. When I didn't meet her gaze, she turned away and fingered the coffee cup on her dinner stand.
    "Have you finished it?" I asked.
    "Oh." She leaned over to look into the cup. "Yes."
    "I'll go ahead of you and turn on the lights. Your pajamas are in the bathroom hanging over the edge of the tub."
    There was a short but significant pause before she quietly said, "Okay."
    I stood and headed out of the room. Before we were able to meet in the hall, as we usually do, I was in the kitchen setting up the dishwasher.
    I waited for a minute then entered the bathroom and began helping her pull her knee brace, pants and underwear off, still refusing to meet her eye to eye.
    By this time she understood that I'd pulled a curtain between us. "I can do that," she said. She always says this when she understands that I'm distancing myself.
    "If I let you do this, I'll have to stand here and watch you to make sure you don't get tangled in your clothes and you'll be a lot slower about it than I am. I want to get to the point where I can pretend I'm alone in the house as quickly as possible, tonight."
    She stopped her attempt at self-maintenance and let me divest her of everything below the waist. I pasted her toothbrush, reminded her to brush her teeth "really, really good, longer than 30 seconds," and left the bathroom, telling her I'd meet her in the bedroom.
    When I arrived, she was seated on the bed groping for the oxygen cannula. She looked at me.
    I could tell she had something on her mind. Finally, I returned her look.
    "We forgot to rub down my legs."
    "No," I said, not roughly, just matter of factly, "I didn't forget. I can't touch anyone anymore tonight unless I have to. I'm caregiven out. I couldn't even pet the cats, tonight. [Which is true. When Mr. Man crawled up on my lap and rubbed his head against my hand, I moved my hand away and told him, "I can't pet anyone right now. I'm the one who needs to be petted tonight. You want to do that for me?" He slid off my lap.] I'm sorry. I know it's good for you. I just can't."
    "That's all right," Mom said. "We'll do it tomorrow."
    My eyes returned to their oblique study of the floor. I adjusted her cannula, administered the last of her pills and water, kissed her, murmured, "Good night, I'll see you tomorrow." I turned. Before I left the room I said over my shoulder, "I'll be up for awhile. You're going to bed earlier than usual, tonight. If you feel the urge to come out an hour or so from now and do some late night visiting, please stay in bed and read. I need to be as alone as I can, tonight."
    "Okay," she said.
    I've been fighting this caregiven-out feeling for a few more than a few days, now. I thought I'd won. I've pushed myself to interact with her on a cheery level; taken advantage of her heightened alertness to bolster both of us with riveting movies, both comedies and dramas. Wrapped myself in her world, even took an exhilarating stab at trying to explain one of its mysteries to her. I've worked hard at thinking positively, acting forthrightly. Realizing before I retired last night that today might be a particularly acute day, I pushed myself to arise very early and headed to the barber's for a haircut, then colored my hair, hoping that would allay some of my need for wrapping myself up in myself. It rained off and on today; I made sure I wandered our yard in it while she was napping, hoping it would wash away some of my need for strictly me time. While I was out there I even petitioned any passing gods for a small gift of peace and tolerance to keep me from treating my mother like an unwanted distraction.
    Now, I'm thinking, Wednesday birthday? Oh god, I don't think I have it in me to celebrate anyone, not even my mother.
    Sometimes, I can't hold it back any longer. Sometimes I've got to pull my need for isolation around me and hope for the best until I've absorbed it into me and can reach out, again.
    Sometimes, nothing works until I'm working, again.
    At these times I think, as I did today, "What would be the harm in putting her in a facility so I can have a few days off?" Then, I remember that today, during one of my bad days, even though I allowed her to steal a little more sleep than usual (which she'd probably steal in a facility without anyone batting an eye), she was well taken care of: She got all the liquid she needs so she won't become constipated; she got the sodium she needs (she's needed more than usual, lately, because she's been sweating from the heat); she received a skin stimulating bath; she was lotioned down in the morning so her skin won't dry out and start to crack; her underwear was changed in a timely manner so she won't get a rash; she ate well, if a little starchy (I only had the energy to throw a pot pie in the microwave for her dinner); she received all the meds and supplements she needs and none she doesn't, and everything was administered with thought and care; she spent no time wondering where she was and who the people were with whom she came into contact; most importantly, for half the day, anyway, she engaged in meaningful, if light, conversation with someone with whom she's bonded, allowing her to know she matters and for the other half of the day, even though I pulled away from her, I did it here, within earshot and eyeshot of her, so she was never "a stranger in a strange land" [Exodus 2:22], doubting whether she could count on random acts of kindness and community.
    This is why I say, even at my worst I take better care of her than anyone else could. And, of course, my worst never lasts forever; it usually begins to dissipate as soon as I give in to it. Chances are, sometime tomorrow I'll recover my ability to be close to her, again.
    Later.

Comments:
originally posted by Deb Peterson: Sat Jul 29, 11:21:00 AM 2006

Gail--It's important for you to periodically step back. It's not only important, I think, but crucial. However you need to do it is okay. I believe that you have to be able to remind yourself and others that you do have needs and feelings. What you're doing for your mother is remarkable and extraordinary. An automaton could not do this, and you shouldn't be expected to bottle up all your emotions like one.

You're right: your mother would never get not only the care but the relationship she has with anyone else. And I think the way you've expressed your own need for alone time is not at all insulting or hurtful to her. I also think that much of the "quality" of her relationship with you is just that: a relationship, an interaction--not merely one person serving another. Having to accommodate you in this way is stimulating to her, it gives her an emotional workout, which is just as good for her as Brain Age!

You're right--what you call "your worst" doesn't last forever, and I hope that just knowing that you do have a voice gives you a boost, Gail.
 
originally posted by Bailey Stewart: Sat Jul 29, 01:46:00 PM 2006

I was always one of those people who needed "alone" time to recharge my batteries. I don't get that now unless I let her sleep most of the time. I know that I shouldn't, but it's the only "me" time I get. I know how you feel, but you're right, she's getting better care from you - even when you're distancing yourself - than she would in a facility.
 
originally posted by Karma: Thu Aug 03, 10:12:00 PM 2006

Augh! I'm having a similar issue with my mom and sleep. She is losing her sense of time, which is part of the disease, so it throws off all of her sleep. My mom's in an ALF, so it doesn't bother me as much as it must you. Losing sleep is what causes a majority of Alz's caregivers to put someone in a facility, according to what I heard at the Alz's Assn. Think about getting some help, because without good sleep, you won't be much help to her.
 
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