Since caring for Mom I have had many people ask if Mom was ever combative, argumentative or had escaped from her home. Mom was never combative, could be very argumentative and did escape 4 times. Combative natures can stem from basic personality, fear, some meds, pain and total confusion. Those who cannot process fear and confusion early in the dementia process can strike out at loved ones, caregivers and strangers. Some, in their earlier lives, were combative in nature and do not be surprised if that continues or worsens for awhile. Do not take it personal. Words, actions, delusions that are out of line, make no sense or are very hurtful are all part of the minds deconstruction. The brain is loosing its filter, bits at a time, eventually triggers will all just melt away. Fear creates agitation and that sets up the scenario of the escapes for those who can still walk. Mom was very adept at finding the front door but not the bathroom, 20 steps away. I would find her pacing, walking into a room, standing and staring, not knowing what to do. If I placed a chair where the front door was, she did not see the door. Agitation in the brain creates the need to carry items from room to room, never really resting anywhere. It is in this stage that family members would need to remove all valuables, breakables, decorative items that may look like food and all cleaning supplies from their reach. I had a locked cabinet where all household chemicals could be kept as well as all meds and toiletries. If they have a pet now is the time to begin to monitor how they interact with them. Moms kitty, Honeygirl, became afraid of Mom at this stage. Mom would open 4-5 cans of food and put out 4-5 plates of food, then yell at the cat to eat. Honeygirl spent much of her time behind the couch and under Moms bed. Depending upon the situation it is time to move the pet to another home in the family. As much as Mom did not know what to do with the cat, she was aware when the cat was out of her sight. Moving the pet, is a hard thing to do but it will lessen the agitation for the loved one and save the pets sanity. Before I moved Mom to Reno, NV her driving became an issue. She backed into cars, took out the guard gate once in her community and ran into the planter at the guard gate. By far the scariest thing was her trying to exit a running car, still in drive. She almost ran herself over, as she pulled over to park. In front of her dear friend, Ruth, she ran the car into the ditch, half hanging out of the car. She also left the Eugene, OR airport to take the Hwy 126 home to Florence, OR but somehow did not make it home until 9:30pm. Instead of turning right out of the airport, she turned left, then drove and drove into the farm country to the North. Her pastor, friends all called and said something is wrong and she needs her kids. Early in the disease, it is easy to be fooled into thinking they are ok. They are defensive, make excuses and end up with you wondering why you doubted then in the first place. Do not be fooled. Their filter on who is safe, who is dangerous is gone, losing things is constant and another source of agitation. The saddest part of this disease is the stage where they are aware of the memory issues. They make endless lists, pile up items they dont want to forget, write down loved ones full names and any other pertinent information they may want to recall. Eventually, it will not matter. One of my favorite items from Mom, was a birthday card she gave me in 2010. I know she tried to write my name but the spelling was off. She did write Happy Birthday Love, Dona Even her own name was misspelled. Her escapes usually meant she was looking for something. It is my opinion that need to look is actually the brain knows that something needs to happen and since, the mental ability is compromised, the physical is still ready, willing and able. Walking for hours is easy for them. As the disease progresses the need to go somewhere/anywhere becomes very strong. Mom walked out of her apartment into the night and did not return home until early morning. She could not find her way back. It was a warm July night, but in the process, fell and fractured her right arm. It was then that moving her to an apartment for seniors was done and her front door opened into a hallway. Sometimes she would walk the hallways, carrying a fly swatter, knee highs and a winter coat. Dignity is everything, they cannot protect themselves so all means of keeping them safe, dressed and clean is primary. Toilet habits will change drastically, they may not want your help but staying with them is important to make sure all is finished. Brushing their teeth becomes an issue too. Mom does not wear glasses, no hearing aid and has all of her teeth! Dentures would make it easy but the double sided toothbrushes, (PetSmart has them) work wonders. They do the tops and both sides of the teeth all at once. I brush Moms teeth as much as I can, give her gum and also softened apple slices to sweeten her breath. Sleep habits change too, days and nights reversed, gross motor skills, (walking, rolling over) begin to decline, eventually the fine motor skills go as well. Holding a spoon, fork, pen, plate, glass is not possible. Depth perception changes and why so many fall as they age into dementia. Mom nearly missed chairs, steps, ran into walls, missed her bed, the list is long. Since confusion and delusion take over, the brain goes to total fear. Since Moms attention span is about 3 seconds to maybe a minute it is easy to distract her with laughter, music, holding her hands and singing to her, changing her frown to a smile, every time. It is as though the body and brain are in reverse and unlearning all physical skills once learned from babyhood. Laughter is the key, touch is the key and a smile still unlocks a door deep within her. Call it muscle memory but I think she does know at some level just what a smile means.
Posted on: Sat, 06 Dec 2014 02:47:10 +0000
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