Thursday, August 24, 2006

 

After days and days of struggling...

...to get my mother up, keep her up, seduce her, again, in the middle of her day, from naps, suddenly, today, she scared the bejesus out of me by coming up behind me in the kitchen while I was emptying out the dishwasher at 1100. My joy knew so few bounds that I convinced myself this meant I was going to be able to usher her through an "active" day. I was wrong about that. It took only a few spirited suggestions, that she come out with me and supervise weed pulling, that she accompany me to the grocery to buy fresh vegetables, before she said, "Do I have to do something today?"
    I laughed, remembered her note to MFS, and told her, "No, it's not required, I'm just pleased you're up early, today."
    She was awake for most of the day, right through to 0015 this morning, when her light went off, and took only a 45 minute nap. Since "lights out", too, she's been to the bathroom twice and both times we've had extended discussions about her school years and her mother.
    Even now, after all these years, her revivals catch me delightfully off guard.
    We had one interesting smoking episode today that actually began yesterday. We've continued to cue episodes of Northern Exposure, working back from the fourth season. We're in the third season, now. About halfway through one of the episodes, my mother motioned for me to pause the DVD.
    "Where's my purse?" she asked.
    "It's behind you on the hearth, Mom, but it doesn't have much in it because you hardly ever go anywhere and when you do you don't carry a purse anymore. What do you want?"
    "I want to see if there are any cigarettes in it. I want a cigarette."
    I was startled. It's been several months since she's remembered cigarettes, or smoking, long enough to want one. This was especially surprising because she managed to get through our Bette Davis fest without ever "looking for something" or coming right out and mentioning that she wanted a cigarette, despite the fact that she was verbal with her reaction to Jerry Durrance's habit of lighting two cigarettes at once in Now, Voyager. Besides which, we haven't watched anything in the last few days, as far as I could remember, that featured cigarettes. "Mom," I said, "there aren't any cigarettes in your purse. We don't have any."
    "Then I'd like to go get some," she said.
    I didn't hesitate. "No, Mom," I said. "You don't smoke anymore. No one smokes in this house."
    She gave me a sly look. "Oh yes they do," she said. "That woman who visited yesterday, she smoked a cigarette."
    Shades of deeper dementia, I thought, immediately bringing to mind all the journals I've recently read that describe Alzheimer's episodes involving hallucinations of people who "aren't there". I've come to accept and work with her memories of the dead being here, but this was different. We haven't had any company, concrete or the illusory dead, for a long time. "What woman?" I asked.
    "Oh..." she fretted a little, "you know. I can't remember her name but I can see her plain as day. She smoked a cigarette out there," she motioned toward the dinette.
    "Mom, no one was here, yesterday, besides you, me and the cats, and none of us smoked a cigarette in the dinette."
    "I know. It wasn't us. You know who I mean..." she struggled some more, "she sat at the counter and had a cigarette."
    Ding, ding, ding! I realized to what she was referring, astonished at her memory of it. Yesterday, one of the episodes of Northern Exposure we watched was A-Hunting We Will Go, in which Ruth Anne, who has just celebrated her 75th birthday, is scolded by Ed for smoking a cigarette, who believes it will endanger her life, of which he thinks she has little left. When Ruth Anne smokes the cigarette she sits at the counter in her store. In response to Ed, she launches into a lengthy explanation that she started smoking when she was a child, rolling her own. Her habit continued through a high point of three packs a day during the Eisenhower years. She had, since, cut back severely on her own. She "now" smokes no more than one cigarette every other hour and has no intention, at this time in her life, of "going cold turkey". I remembered this scene almost verbatim for a couple of reasons: First, I was surprised to see cigarettes being shown on this show; second, as the scene played out, I held my breath, waiting for Mom to not only begin "looking for things", but, since the word "cigarette" was verbalized, to be aware of that for which I expected her to look. Nothing happened, though. The scene played out, my mother never flinched and our day proceeded without further mention, by words or pantomime, of cigarettes.
    Until today. I guess the scene's defense of elders smoking made a slow but solid impression on Mom, to the point where, this afternoon, she 'remembered' Ruth Anne sitting at our counter yesterday (which doesn't have chairs, by the way), smoking a cigarette in our house.
    My hard memory of this scene, though, allowed me to rally a quick, firm counter attack. Upon realizing that it was triggering not only Mom's desire for a cigarette but a self-righteous attitude about her right to smoke, I decided to face it head on. First, I explained who "the woman" was and where she had actually been, on our television set. I triggered the episode and the scene as an audio visual aid. Mom nodded her head approvingly as it played. I'd expected not only this but also that she was going to use Ruth Anne's defense as her defense for being allowed to smoke today. Thus, I launched my third wave. I reversed the scene after it had played once. I paused it and went through the entire history of Mom quitting smoking while she was in the SNF in late August of 2004. I was honest about all of it: That she had forgotten that she smoked and that I took advantage of this in order to encourage her health to improve. I explained to her that she does smoke, on occasion, when we visit MCF and her family, usually three times a year or so, becase they smoke. I told her I don't refuse her cigarettes when she is surrounded by smokers. I didn't mention that I ration her cigarettes in a variety of ways to make sure she doesn't fuck her lungs in one sitting. Finally, I play-paused the scene again and explained to Mom at each juncture exactly why I will not allow her to become a full-time smoker anymore, citing her excellent health for the last three years and telling her that if we introduced smoking back into her life her desire to be "poked and prodded by doctors as little as possible" would go down the drain. I pointed out that Ruth Anne had none of the health conditions that Mom has. I explained, in detail, why these health conditions transformed Ruth Anne's defense into pure folly for Mom. She would, I said, be on oxygen a lot more, be taking breathing treatments again, would probably be experiencing lots more doctor appointments and health crises, would probably be on much stronger doses of blood pressure medication and our life would, once again, be a living hell of recovering from one doctor visit while awaiting another every few weeks, not to mention the emergency room visits. I bluntly told her that the elimination of this one habit was responsible for our vastly improved quality of life and, for this reason alone, I was not willing to reinstate smoking. I added that she continues to forget that she smoked, most of the time, and I'm pleased about this. I brought it home by telling her that, although I work hard to make sure that she is allowed to live her life as she wishes, with two years of evidence under our belts that eliminating smoking has made both of our lives easier and has vastly improved her health and undergirded her desire to "live to be 120", this is one desire of hers I refuse to grant.
    She didn't argue. I could tell by the glare in her eyes that she was not completely accepting, but I could also tell that she understood my reasoning, agreed with it in theory and realized that I was not going to back down.
    After a few minutes of staring each other down, I said, "Mom, I'm not going to reverse myself on this, like I often do on your prodigious sleeping and your preference for a sedentary life." Hoping to place a subliminal suggestion, I finished with, "You may as well relax and decide to continue to let your creative memory work on your behalf on this issue and forget that you smoke. You did it before, you can do it again. If you do this, you will be continuing to do yourself a huge favor."
    She relaxed into her rocker and allowed me to close the issue.
    Twice more, this evening, she "looked for something", but her dementia kicked in both times and she forgot the object of her desire before she could name it.
    Bless her dementia. It can be counted on, at times, to operate in her best interests.
    Well, shit, I'm up longer than I intended, tonight. I'd better set my alarm. I want to be ready in case the miraculous happens again tomorrow (which is today) and she springs forth from the head of her bed before noon. Who knows what surprises lurk in the shadows of demented days?
    Later.

Comments:
originally posted by Deb Peterson: Thu Aug 24, 06:22:00 PM 2006

Gail--Yes, sometimes the dementia can work in our favor! As I read this entry I had a quick mental image of you and your Mom sitting in the living room, you with the remote control in hand, leaning forward a bit as you vigorously explained why she can no longer smoke, and your Mom, rocking a bit, taking it all in, and thinking something like: "My Gail is so smart, and she's pretty, too! I'm so proud of her!" I don't know why I had that image--maybe I'm thinking about times when I've been passionate about something, and my mother has responded more to my passion than to my message. Well, they keep us on our toes!

My mother has been having good days, too. I wonder if it has something to do with the weather? Or with Pluto no longer being a planet?
 
originally posted by Karma: Fri Aug 25, 01:55:00 PM 2006

We should all make lists of television and movies that our parents with AD enjoy.
 
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