Looking Back

What will YOU say at the end of YOUR life?

Will it have been worth it?    

Never Underestimate a Person with Dementia

Around and around she went!  When she first was admitted to the dementia unite at the nursing home, Abbie was able to walk. In fact, she could hardly sit still. She was like a jack in the box at mealtime. She rarely slept through the night. She was on a mission, going to Who Knows Where. She did not seem particularly disturbed by her own wanderings even though there never seemed to be an end to her journey.

Her only child, daughter Karen, visited her each and every day. It was clear to everyone that Abbie did not even recognize Karen, yet Karen remained steadfast. "I'm giving her back the loyalty and care that she provided me when I was a child." she said.

Days and years passed. Abbie eventually started falling so she was given a wheelchair. People of any age can have a hard time learning how to maneuver a wheelchair, but Abbie had determination and she figured it out. She started wandering about on two wheels. Shuffling her feet as she propelled herself forward, she would wheel herself around the facility in what seemed to be a surprisingly consistent pattern.

I was Director of Social Services at the time, and I could tell time by her. Abbie would wheel herself to my doorway, speaking to me in a language that I could not understand; the language of Alzheimer's Dementia. Inevitably she appeared at my office each day promptly at 11:55 a.m. and then again at the change of shift at 3 p.m. Every day without fail Abbie was right on time, although she did not wear a watch and was assumed to be totally confused and disoriented.

One day we received the tragic news that her daughter had died in her sleep. She never had a chance to say goodbye to her mother.

All of a sudden Abbie changed her route. She started showing up at all different times in different places. She was unpredictable. She now mumbled constantly. Her words were not intelligible, but she was clearly repeating the same thing over and over again. One day I sat with her and I finally grasped what she was saying. I was amazed. 6-7-3-4-2-4-6.... 6-7-3-4-2-4-6... ad infinitum. I went to her medical record and, sure enough, she was repeating her daughter's phone number over and over again.

Everyone had just assumed that her daughter would pass from her life and she would never know the difference. Abbie taught us otherwise. We ultimately offered her comfort in her grief and could only assume that she might have been able to understand and receive it.

If you know someone with Alzheimer's Disease, the best thing you can do is to treat them with respect and dignity. They are trapped inside a body that seems to not understand because it can't communicate whether it does or not. Assume the best. After all, if you were that person, isn't that how you would want -- and need -- to be treated?

Care Manager Reverses Alzheimer's Diagnosis Decision

My client, we'll call him Walter, sat through an intensive three hour interview with his new doctor. I was impressed with how thorough the session was. After all, this was one of the reasons I referred Walter to this particular physician.  

Walter, at 90, holds a PhD in Electrical Engineering. His mind is beyond active! He has worked all over the world during three different wartimes. Top secret research has been his specialty. When he moved to Arizona he brought over 400 boxes of books with him. He believes in God and the angels and extraterrestrials. He forgets all about himself while making his mission his obsessive center of focus. He doesn't care what anybody thinks of him. The clock is ticking and he needs to complete his mission before he leaves This Place.

Before I meet with new clients and their families, I ask them to sketch out some basic goals to get a head start in preparing a customized plan of care. At our initial meeting, Walter was prepared. He had typed up five pages of goals!  

Most people want help preparing meals, cleaning the house or getting to church. Some need help getting out of bed in the morning... or need inspiration to face each day. Walter had five pages of goals related to complex and continuing research with his ultimate goal: To find a way to save human civilization. He had already met with the nearby Hopi Elders to learn their thoughts about how they have survived since the Dawn of Time. 

Sounds far out, yes. Walter was far out. But he was clear as a bell. He was brilliant beyond brilliant. Some people are so intelligent that they just don't handle the mundane things very well. 

When the doctor created Walter's initial file, the diagnosis of COPD was first and "Dementia: Probable Alzheimer's Type" was secondary. I was floored. Granted, the interview was all over the place because Walter was trying to teach the good doctor about what was important in his Great Scheme of Things. I could see where the doctor was coming from. The doctor remained firm in his opinion that Walter was fighting severe dementia.  

This is where a Geriatric Care Manager can come in very handy as an advocate. I took Walter back home that day and, with his eager cooperation, we completed a Mini Mental Assessment to determine the level of his "dementia". The tool assessed him in 30 different areas of cognition. His final score on the test: 29 out of 30. Early in the process I asked him to remember three things -- Pencil, Shoe, Watch. At the end of the test, when I asked him to recall the three, he missed the shoe. That was the one and only point Walter missed. 

On our next appointment we presented the doctor with the test results and he agreed that it was appropriate to remove the dementia diagnosis from Walter's chart. 

Click here for the Folstein 30 question MMSE assessment.  This 10 question format, a much simpler assessment, is available for people who have higher degrees of dementia.

A man is not old until regrets take the place of dreams.  

~John Barrymore

We Are All Just Children It Seems

Funny how long it takes us to Grow Up.  It takes our whole lives doesn't it?  I have realized that no matter how old people are (and I've worked with old people all my life) that we are all just children when we are in an area of life that we have never been exposed to.  Learning to deal with a new challenge in life is not much different than walking through the door of your kindergarten class on the first day of school.  There's always more to learn!

We are reminded that we are still children when we get caught up in emotional waves of concern, fear, overwhelm or feeling a loss of control over our life circumstances.

No matter how old we are we are still just children.  If we are blessed we have our parents alive and well for a long time.  If we are really blessed we will know how blessed we are to have our parents alive and well.  I am one of them!  My parents are doing well and I thank my lucky stars when I look at statistics and when I work everyday with people who are struggling to survive and to live.

I am also well aware that it is just a matter of time and the situation will change.  It makes me very thankful for Right Now for what I have, for what we have together as a family.

Look around at all the parents who aren't doing well.  All those who struggle with memory loss; dementia.  All those who rely on walkers and wheelchairs to get them from one place to another.  All those who rely on their adult children to meet their most basic needs on a daily basis.

This Mother's Day (and Father's Day) upcoming, please take a moment to thank your parent for being self-sufficient and healthy.  And if they aren't, take a moment to breathe in and think of ways to help them --- and to help yourself to help them.  You don't have to do it all.

If you don't know where to start, get yourself a geriatric care manager who can make it all easier for you.

It Pays to be Proactive! A Love Story.

Every day I hear many amazing stories in my line of work!  When you work with people and you care about them, you hear what they say with their lips --and with their hearts... and there's ultimately enough fodder for a screenplay!  I speak each one in confidence and with the utmost respect.  I decided I would start posting them here now and again so others can learn from them too:  

ELDERPLANNING STORY

Roy and Angela had been dating since high school.  Same age, same year - both were now graduating college.  On Graduation Day Roy grabbed his diploma in New England, hopped the train and got to Seattle in time to see Angela graduate with honors.  She was always such a smart girl!  And pretty too!   Roy was stalling, however.  Angela had been saying for years that she wanted them to marry as soon as they finished college.  He loved her, yes, but was he indeed ready for marriage?  Children?  Career?  

Everett, WA Depot 1900's

Two days later they boarded the train together.  He was taking her to Chicago for a family gathering.  She looked at him with such admiration.  After all, he was such a gentleman!  She felt fortunate to have such a smart, handsome and chivalrous man at her side.  As they boarded the train she carried only her purse while he carried both of their bags and her bookbag too.  He was so strong!

They settled into their seats, their tickets were punched and the train started moving. Angela ruffled through her bag for a book and some magazines for the long ride.  Roy was preparing to take a nap.  He was a contented man. 

As the train picked up speed, she nudged him on the elbow.  He turned to her as she handed him the latest issue of the Seattle Times.  "Here" she said "there might be something of interest to you."  He gladly took the paper with a nod and began to read.  

'Of Interest', sure enough!  There, on page 3: "Holstein and McFarland to Wed".  He did a double-take.  Sure enough there was a recent portrait of the two of them, Roy and Angela, taken over the holidays the year before.  The article went on to announce that the two would wed in Chicago on the upcoming Saturday.  Roy was taken completely by surprise.  

Angela had taken it upon herself to make all the arrangements. They were married that Saturday in Chicago and have been happily married for 77 years.  

"How can you argue with a woman like that?  And she's been telling me what to do ever since!"  he says with a smile-- and absolutely no regret.  

 Couple Discuss Their Plans

Lizard Chapter 6: HE FINDS US AT OUR NEW HOUSE

Spring was approaching and we were starting to leave the windows and doors open to let the fresh warm are into the house. One day, I guess when we weren't paying attention, Mr. Lizard came right into our house.  He headed straight for the fireplace bricks where he scurried up with his sure-webbed feet and he just sat there like a decoration that you would buy in a southwest novelty shop.  He looked like he belonged there and I was happy to have him back. 

I hoped that Kate might let him stay here with us but when she saw him she said, "WHAT are YOU doing here?"  She was really nice about it but she said he had to stay outside where he belonged.  

She carefully pulled his webbed feet and hands off the cinder block, placed him in a pretty towel and carried him outside where they sat for a little while talking.  I don't know what they were talking about because I went out to the kitchen to finish my breakfast and drink some water. When I came back Kate was inside getting dressed for work and Mr. Lizard was still sitting on the towel on the bench outside where they were sitting.  

Kate went to work and Mr. Lizard stayed in the same place on that towel on the bench for many hours.  Then I guess he left but I knew that he would be back because he told me he would be.  He told me he would come back to see me in a few months.  I liked the thought that I was sure I would see him again. 

Even though I knew he was going back out into the predatory world with lots of risks to life and limb, I just had the feeling that he would be okay and that he would do as he said he would do.