Thursday, January 22, 2015

Following Up on Auditory Issues

Lyn had her doctor's appointment to follow up on the hearing issues.  Just a reminder, she's been having auditory hallucinations and complains of hearing loss in the left ear.

The doctor said the left ear drum is not inflamed, blocked by wax or filled with fluid.  There was a small bit of wax which they removed.  Visually, everything looks fine but the hearing loss is cause for referral to an audiologist.  They were able to get Lyn scheduled for an exam with an audiologist next week.

The doctor confirmed that hearing loss, particularly on the left side is fairly common in Alzheimer's patients.  She also confirmed that Lyn's having hallucinations.  She praised Lyn for letting us all know when she hears something or someone and cannot identify the source.

The doctor asked if it was time to consider introducing medication to help ease Lyn's increasing agitation and disorientation.  She acknowledged that Mom and Lyn may not be really ready for daily medical interventions but felt it was time to start offering.  Mom has said "No for now."  They will revisit this topic with each subsequent visit.

So our concerns about Lyn's auditory issues have been confirmed and another appointment will be scheduled.

Wednesday, January 21, 2015

Thoughts from a Teen

I decided to ask my eldest a few questions about what thoughts Lyn and her Alzheimer's provokes.  My child was as blunt as ever and I've copied down the thoughts that were shared with me.   Here are the thoughts from the perspective of a young teen:

"I think Aunt Lyn's Alzheimer's is tough on her and everyone around her.  She doesn't always comprehend what is happening or why it is happening.  She also doesn't understand what people are saying.

It's an annoyance because we have to treat her like a child.  We have to use smaller words even in contexts that should be easy to understand.  We have to deal with her mood swings or the fall out from the mood swings.  Her moods and demands tear Grandma down.

I think of Aunt Lyn as another sibling who you have to be extremely understanding around.  I've always felt like she's been more of a cousin or sibling because she never could take a role of authority."

I've never asked before and I'm glad I finally did.  It helps me to understand another's perspective and to realize just how much patience this young person is trying to show when interacting with my sister.  It is not easy and our visits to Mom and Lyn's is very much centered around things we know Lyn can handle instead of traveling and seeing a new thing every day.

While my child understands the limits and tries to be patient, I appreciate that kiddo felt comfortable expressing annoyance.  In return, I thanked kiddo for the conversation and honest expression of thoughts and emotions.

Tuesday, January 20, 2015


Happy Tuesday!

Despite the winter, may a sunny smile brighten your day.

Monday, January 19, 2015

Over Stimulation

One day last week when Mom picked Lyn up from day hab, the receptionist said "she had a problem with her head today."  It took a series of careful question on the way home to determine what was going on.  Mom has to be careful to not plant suggestions in the conversation or Lyn will grab onto that as her answer.

Lyn was overwhelmed.  While day hab wasn't too noisy and there wasn't too much activity, she became overstimulated with what little was going on.  She can't describe what was happening in her brain or how it made her feel other than "weird things."

Day hab does have a quiet room that she can use when she's feeling her brain doing weird things.  Mom spoke with Lyn, encouraging her to tell the staff that she needs a little quiet time.  Knowing that Lyn won't remember this advice, Mom has spoken to the staff to let them know that if she gets like this again, she should be encouraged to take a break from the main room.  The staff at this day hab have been very responsive to Lyn and I'm sure they'll take this little change in stride.

As a side note, Lyn's reporting hearing voices in different rooms now and will go from room to room to see who's talking.  So far, she's not gotten upset about it but does keep looking for the speaker.  Tomorrow, Lyn sees her doctor about the reduced hearing in her left ear and the increase in auditory hallucinations.  I don't know if they'll perform a hearing test in the office or send her to an audiologist.

Correction:  Her appointment is Wednesday.

Friday, January 16, 2015

The Heart Has It

Winter has been bitter in New Mexico this year.  Mom's actually had to deal with more than one day of snow.  The roads have been slick and icy in spots.  On days like those, she really would prefer to stay at home.  To get Lyn to day hab, she has to drive half way across the city, over 15 miles and back.  A few hours later, she makes the same trip to pick Lyn up in the afternoon.

Earlier this week, there was a day of nasty weather and Mom tried to convince Lyn that it was OK to skip a day of day hab.  They could stay home, stay toasty warm and just relax.  Lyn refused.  She insisted she had to go to day hab.  She had to help out.  They were counting on her.  Mom decided the hassle of a drive on a wintery day was less than the hassle of a disgruntled Lyn cooped in the house for the day.

When Mom arrived back at day hab to pick Lyn up, Lyn handed her something and said "This is for you but you have to send a picture to (me)."

This was the reason why Lyn insisted she had to go to day hab.  She was making hearts for Valentines.  A staff member helped with the cutting and Lyn did all the gluing.

I smiled when I saw the picture for a couple of reasons.  First, her face looks so smooth in this picture and almost serene; not a scowl as there often is.  I can still see the downturn in the mouth, but it is a pretty good picture of her.  Second, I am glad that she made something for Mom.  Even if the delivery was brusque, she still put time and thought into it.  I love that she was insistent that this was important enough to drive across the city to accomplish or at least more important than staying home in her mind.  Finally, I love her fashion sense.

Wednesday, January 14, 2015

Happy 44

Today is Lyn's 44th birthday!

Happy Birthday, my dear!  Not to break with tradition, my gift to her will arrive soon.  (Lyn didn't get the procrastination gene from Grandma that I inherited.)

I hope she has a great day.

Here's a special birthday message from a certain bearded friend.

Tuesday, January 13, 2015

How Do You Choose?

Recently, I was asked "How do you choose to place your loved one in a Memory Unit?"  Let me be the first to say that I've not had to make that decision yet and so, I listened.

I listened as the person spoke of the love and commitment for the parent with Alzheimer's, the desire to keep the parent as independent for as long as possible and the fear that the Memory Unit would mean a loss of the parent's quality of life.  All of this factors into why familial care providers often struggle to made the decision to move the patient to a Memory Unit or even to a nursing home in the first place.

If we remove the emotions of the care provider, we can ask a couple of questions that may help the care provider to make a difficult decision.

  • Is the person aware of their surroundings?
  • Where is the person in their life's memory movie?
  • Is the person still functioning independently?
  • Is the person safe when unsupervised?
If we ask "Is the person aware of their surroundings?", we're asking if they can still get around without getting lost.  Are they wandering or looking to go home even when already home?  We are asking if they know not just the city or the country, we're asking if they know their neighborhood or even their block.  How small is the scale of their place?  If they step outside and get lost, if they don't know the difference between a hotel room and a hospital room, if they don't know their current room any longer, they may need more supervision than they are currently receiving.

Think of a person's life as a movie.  Alzheimer's puts that movie into rewind.  This is why it is reasonable to ask where the person is in their personal movie.  There are frequently clues that they will give you.  It may be a statement that seems odd or out of character.  If you were to consider that statement in the context of an earlier age, what age would that match up to?  If that person is in an earlier time, such as their 20's or teens or even earlier, their connection to the here and now is damaged and they may need more supervision than they are currently receiving.

It is important to be brutally honest in assessing if the person is still functioning independently.  Are they still able to pay their bills on time?  Can they tell the difference between scams and real requests?  Can they tell the difference between spam (e-)mail or legitimate business?  Can they still tend to their hygiene needs or cooking?  If they are not, they may need more assistance than they are currently receiving.

Most importantly, is the person still safe when unsupervised?  If the stove has been left unattended, if perishable food has been improperly stored, if household cleaners are getting misidentified, the person is not safe.  If you are considering baby-proofing an adult's home where no toddler resides, the person needs more assistance than they are currently receiving.  Safety trumps a person's desire to stay in their home until their death.

Neurological diseases cause the symptoms we collectively call dementia.  The most common cause is Alzheimer's.  Dementia is not some simple aging of the mind that leaves a person as a sweet but doddering elder.  It is a disease which is causing deterioration of the person's mind and a failing of the person's body.  It is a terminal disease.  Providing a person with a terminal disease with the resources and supports that are needed is showing love and commitment even if that means a move to a Memory Unit.