Tag Archives: elder care

The Mind: An Amazing Piece of Bio-Electronics


First, let me say I am overwhelmed and humbled by the response to yesterday’s post after being “Freshly Pressed” on WordPress.com. I found it hard to breathe for a couple of hours yesterday morning, because it suddenly dawned on me that, wow, a lot of people have been and are in similar situations. We need support. We need to feel heard and we want to talk about our loved ones. So, please feel free to send me any personal stories you are comfortable sharing, or suggestions for upcoming posts. I know that a single day as Freshly Pressed does not an Oprah-worthy blog make, but I do hope you will continue reading and sharing stories. We can all help each other.
Thank you,

Lucy

Long ago, when I was a student at UNT, my Abnormal Psych professor  was explaining what was then known as Multiple Personality Disorder. He said, “The mind is one of God’s greatest gifts. Look at what it will do to keep us functioning.” At the time, his statement made some sense to me. Over the years, however, it began to make more sense as I realized some of the security work my mind had managed in order to keep me going. Then, a couple of weeks ago, I was reminded what an amazing bit of bio-electronics we humans possess when I witnessed dramatic changes in my father after he fell, hit his head, and ended up in the emergency room.

It’s important to note that for the last two or three months my father had gotten to the point where he barely spoke. When he did speak he rarely completed a sentence. This change has been emotionally challenging for me because it’s been so dramatic. Back in the day, dad was a master of the English language, and during the last few months, I couldn’t even piss him off enough to make him talk. Frankly, as anybody who’s ever known my father will attest, he never shied away from expressing his anger. Never.

Anyway, I believe it began during the wee hours  of Monday, April 4. My ringing cell phone woke me up from a dead sleep. Initially I didn’t answer because I really just wanted a good night’s sleep. Then, I realized the only calls that ever come that late at night are either drunk dials or bad news. Of course, it had to be bad news. So, instead of listening to the voice mail message, I called back the number on caller I.D.

“Autumn Leaves.”

“Oh hi. Um..I’m Lucy…somebody called..I’m Mr. Parker’s daughter.”

“Oh Lucy! I’m here with your father. He fell and hit his head. The ambulance is on its way to take him to the hospital.

“Oh! Umm…Do I need to go, too?”

For a few minutes, the caregiver dealt with a very sleepy, uncertain, and not-so-bright daughter trying to wake up enough to understand what was going on. Eventually, I apologized profusely for my dimwittedness and said I was on my way to the emergency room to meet my father.

JHP, JR. letting everybody know he is okie dokie.

It may have been her professional wisdom that kept her from describing the scene. I don’t know. Honestly, I’m glad she didn’t warn me about what I would see when I got to him. I was also thankful for my father’s poor vision because it meant  he couldn’t see the change in my expression when I saw him covered in blood with a blood-soaked turban-like bandage wrapped around his head. His face was covered in blood. His hands were covered in blood. His shirt was covered in blood. All I could say to him was, “Hey Dad! It’s Lucy. I’m here. Wow, you sure made a bloody mess.”  Thank God he saw some humor in my less-than-graceful entrance.

Dad was happy to see me, but he was sleepy. The lights were bothering him because, not only were they really bright, he just wanted to sleep. He was also annoyed by people talking loudly and RNs calling him “buddy,” otherwise he said he was fine. This was surprising considering his appearance. He ended up getting about 20 staples in his head. All the tests came back okay, no concussions or broken bones. And I had a chance to flirt a little with a doctor and a muscle monkey RN. Of course, Dad gave me the evil eye for it because I was doing it on his time.

“Dad, next time you want to work on introducing me to a nice doctor, try a dinner party, not a head bashing, OK?” Thankfully, he was again able to see the humor.

All in all, it was only about four hours and a few office supply jokes before he was back in his own bed, and we were done with it.

Actually, no. We weren’t done. We weren’t done at all. The most amazing thing was about to happen. Talk about throwing me for a loop!

I visited dad later that day after I took a little nap, and every day after that for about a week. The first visit, he was understandably tired. Still, he wasn’t in any pain, but he was surprisingly alert. He was coherent. He even talked in complete sentences.

The next visit, he was still surprisingly alert. He was still coherent. He was still speaking in full sentences. Okay? Wait. As I was able to set aside the worry, my brain started to function again and I began to catch on. He was speaking to me…in full sentences…for the first time in a couple of months. Granted, it still took a while for him to form the sentence in his head and then send it out his mouth. And, yes. It took me nearly 24 hours to realize that I was once again having full conversations with my father!

He began questioning me about conversations we’d had 8 months ago and asking if I followed through on some things. He berated me when I told him I did not. He asked about my daughters. That question alone was significant, because he actually remembered them. Better still, he asked about my daughters by name. He asked questions. I answered. He laughed. I laughed. I asked about his head. He got mad at me for worrying. I told him, “Tough <expletive deleted>, dad. I’m gonna worry because that’s one thing I’m very good at.” He laughed because I cursed.

“Dad, this is amazing. You’re talking to me. You’re bitching at me. You haven’t finished a sentence in months and look at you now! I swear to you, if I had known a good whack on the head would get you back for a day or two, I would have done it months ago.” Again, he laughed. Then, he said,

“Really? I wasn’t talking to you? Are you sure?”

“Yes, Dad. I’m sure. Please tell me you see why I’m laughing about you questioning my memory.”

He laughed again.

Yes. The fun did come to an end the next day when his blood pressure dropped and he stared at me from his bed unable to tell me what was wrong, but generally he’s okay. We can still sort of talk, but he’s slowly going back to being nearly silent. It’s no longer the I-fell-in-a-vat-of-toxic-waste-and-became-super-human stuff we had for a couple of days, but that’s okay.

As I’ve recounted this story to professionals, nobody has been surprised by the changes in my father. Apparently, it could have gone either way. The head bashing could have made him worse. Alternatively, it could have made him seem better for a few days, which, lucky for me, it did. I think I was lucky that I had a chance to experience what I call my New Dad again. I’m not so sure he was lucky, though. Even though we were able to talk and argue and laugh and joke and swear at each other, he also re-realized his life is very different. But there was a brief moment when he looked at me the way blind folks look towards you but not really at you. In that moment, I knew he knew I am just as surprised as he is by how well we get along and how much we count on each other, each in our own special way.

“Whodda thunk, Dad? Let’s just enjoy this while it lasts. I’ll be back. The girls will be back. We’ll visit you. And if things change, I’ll still visit you. I’ll still worry that I’m gonna piss you off, and I’ll tell you stupid jokes.”

“Oh no! Not more stupid jokes!”

“Whatever.”

So, this is how I came to realize, once and for all, the mind really is an amazing piece of bio-electronics.

Lucy
Jerome’s Daughter

Advertisements

My First Encounter With Dementia: Daddy Pat (Part I)


Some people may claim they had the best grandfathers in the world, but I really did. Wylie Patterson, aka Daddy Pat, was an old country boy who farmed, worked at a cotton gin, and then went on to work at the Panama Canal until literally 3 months after I was born. He was, and remains, the best man I’ve ever known.

Mommy and Daddy Pat celebrating their 50th wedding anniversary, 1973

To say that I was lucky to have spent so much time with Daddy Pat feels funny to me because of the reasons behind our frequent visits. My mother was diagnosed with colon cancer when I was seven years old. She spent the remaining two years of her life in and out of the hospital, fighting the good fight. Thus, Mommy and Daddy Pat became very important adults in my life not only as grandparents, but also as caretakers. I spent many nights at their house when I was sick so my father could go to work.

It was during these “live-ins” that I really learned about the man my grandfather was. He used to quietly wake me in the middle of the night so we could sneak into the kitchen and eat Mommy Pat cookies on vanilla ice cream. Since he was a man of few words, this was a pretty easy task for him. Others might have called him stoic, but he really wasn’t. He was dear, quiet, sweet, and funny. He was my Daddy Pat.

As I got older and needed less attention, he changed. He slowly became moody. He resisted any and all offers to help with his lawn. He resisted to the point of taking out several of the fruit trees in his back yard. He told me he did it because the trees crowded the yard. Mommy Pat told me he took them out because he couldn’t take care of them on his own anymore and he didn’t want to admit it.

He also became repetitive. He told the same story about cranking up a Model A and nearly breaking his arm. I must have heard the same story about driving the sharecroppers to the fields via a deep dip in the road a million times. “Them older guys knew to hold on. All the new boys would damn near fly out of the bed of my truck!”

Slowly, he became even quieter, less talkative, to the point of near silence. But he always lit up when he saw me. He always hugged me, pat me on the back, kissed my cheek and said, “My girl is here!” (still brings tears to my eyes) Then, he always made sure I got one of the good swivel rockers in their living room. Mommy Pat and I would rock and talk for hours while Daddy Pat sat and listened, smiled and laughed, or frowned and said “Oh no!” (mostly when I spoke about boys)

Then, he’d be back to his old self, or as close as he ever got again. He and Mommy Pat began recounting events during the first weeks and months following my mother’s death. Daddy Pat would say, “Ernestine, tell her about how she’d wait for Joy” (my mother). So, they’d recount the times I stood by their front window, looking outside, for what seemed hours at a time, nearly 10 years prior.

“Honey girl, what you doin’ at that window?” Mommy Pat would ask.

“Waiting for mommy to come and get me.”

Daddy Pat would tell me this story over and over again, then he’d look me in the eyes and do something I’d never seen him do before. He’d cry. He’d say how sorry he was that I had that life. He’d tell me he wished he could have done more for me. We’d spent a lot of time consoling each other and it would end with, “You know, you’re my very favorite grandpa?” He’d say, “I’m the only one you know.” Then we’d agree that’s why I only had one, because the other might have felt left out.

This is when I first notice his mood swings. The man who once only showed a level head around me began to cry and get mad in front of me. Mostly, he got mad at Mommy Pat and his son, my sweet Uncle Sonny.  He usually cried about the fact I was so young when mom died or how my cousin Kenny worked so hard to help his mom, my Aunt Helen, through her battle with cancer. Sometimes it felt refreshing to see these new displays of love and grief, but mostly they confused me. At the time, I had no idea what all these symptoms meant. My grandfather was invincible. The thought his mind was failing never occurred to me.

Then I got that dreaded call from Mommy Pat. At the time, I was living in Denton attending the University of North Texas. She called to tell me she had to move Daddy Pat to a nursing home because “he’s too hard for me to handle on my own. He’s not himself anymore, sweetie.”

(continue reading….)

Mommy and Daddy Pat in the nursing home.

He Said WHAT?!


Dementia changes people. It’s that simple. Dementia tends to shut down the social filters in patients’ brains. It gets confusing because some behaviors are affected by changing attitudes that come with age or the justified anger and frustration about their situation, while other behaviors are the result of the death of the social filter. For instance, a once modest woman may speak more frankly about sex, or a typically assertive man may appear hostile or easily set off.  In both cases it may be hard to tell exactly the cause of the behavior. Knowing which behavioral changes are related to the disease can be challenging, especially for those of us who are emotionally connected to the patient.

My sister and I have experienced this confusion with our father’s behavior. During the course of the last few years, we faced my father’s verbal onslaughts with great frequency. Many of these attacks left me bawling my eyes out in my car. My father still had the attorney in his core, so his ability to argue was still working even if he couldn’t always pick the perfect words. Dad could sling some of the most painful verbal assaults with such power that his words could knock you on your ass. I often gave it right back to him, because I couldn’t sit by and take it. These fights tended to be very loud and peppered by curse words I never knew I had in me.

All of this may sound awful to the outsider. That, I understand. What the outsider doesn’t know is that I’d heard many horrible things from my father for years. What I found challenging about this behavior once he was officially diagnosed with dementia was that, in all honesty, my father really never had a filter. I never knew for sure if it was his true personality, only-child syndrome, drinking,or  depression that caused these emotional outbursts. He was never one to bite his tongue, at least not for the last couple decades. As I got older, moving from my teens to my twenties to my thirties, his filter seemed to all but disappeared. Many times he justified his behavior by telling me I was old enough to hear the truth.

So, when we began getting reports that he had been saying extremely inappropriate things to caregivers, there was a run on opinions by every person involved in his case, and even some who weren’t. Those of us who knew him the longest secretly figured it was just him, but we were reluctant to tell anybody for fear of losing the help we so desperately needed. Others just thought he was an ass and said so. True professionals suggested that it was the result of dementia and his inability to control impulses. Would I hear this and believe it? No. I was angry at him and I was convinced he was just acting that way to affect the people around him without concern for our feelings. Occasionally,  I would I fess up and tell the professionals what I then believed to be the truth. “Don’t kid yourselves. He’s just a <expletive deleted>.”

So, my sister and I had no idea what the proper course of action might be. We felt these outbursts were more about him being demanding and inconsiderate; being typical JHP,JR. We had to do something though, and show the caregivers we were making an effort. So, I called dad’s physician, cried, and recounted some of what was going on in the house. Then, I told him my “diagnosis.” The doctor ended up giving my father an anti-psychotic medication that would hopefully bring and end to those undesirable behaviors.

The medication seemed to help. It was hard to tell because, at the time, my father and I were in the throes of how much we hated each other. This was during one of the first extended episodes where he didn’t know who I was. All he knew about me at the time was he absolutely hated me. Mind you, I was not objective in the least. In fact, I was very judgmental and stuck in emotional quick sand. The caregivers did say they saw changes in his behavior. He still had angry outbursts, but his behaviors weren’t nearly as inappropriate as before. I assumed the medication was doing its work.

Eventually, I attended a support group. The guest speaker was Jane Anderson, co-founder of a Texas-based family of memory care facilities called Autumn Leaves. She offered a perspective that helped me better understand my father, his brain, and the disease by explaining the idea of social filters and how they are affected by dementia.

Basically what Ms. Anderson said was dementia kills the brain’s social filters by damaging the frontal lobes. She likened this portion of the brain to the Miss Manners control center. By shutting down “Miss Manners,” dementia led to a lack of impulse control. This means dementia patients are more likely to act out in socially inappropriate ways.

A-HA! This was new information for me. As I listened to Ms. Anderson speak, all these little bits and pieces of this hugely unorganized mess of diagnoses, emotions, relationships and information began to fit together better than they ever had. And I realized something.

My father had been suffering from the effects of dementia far longer than any of us ever suspected.

This knowledge changed so many things for me. I no longer got AS angry when my father said mean or hurtful things. I also learned that I could bite my angry tongue but free my rational tongue. This knowledge made it okay for me to tell dad what I thought of what he was saying. I finally gave myself permission to respond to him rather than to react. I began to have a better understanding that many of these behaviors were beyond his control, and probably had been for years.

Another insight I gained was that some of these “inappropriate” behaviors were manageable through distraction, redirection and staying busy. Eventually, we moved dad to a Ms. Anderson’s memory care facility and agreed to take dad off the anti-psychotic medication. We were pleasantly surprised to see positive changes. As far as we know dad has not behaved inappropriately thanks to proper care, educated caregivers and our better understanding of the disease.

These A-ha moments helped me tremendously. And by helping me, I’ve been able to better help him. I’m a better caregiver because of this knowledge. I’m also a better daughter. Funny what a little information can do for a person.

NOTE:
In honor of JHP, JR, retired Attorney-At-Law, who taught me to CYA, I offer readers the following disclaimer:
Please do not mistake any of the information on My Father Doesn’t Know Me as medical or therapeutic advice. All of the information contained in this site is based on Lucy Parker Watkins’ experiences, personal research and advice she received during the course of her father’s treatment for dementia.

The Best Money Spent….Elder Care Attorney


I honestly believe one of the best decisions my sister made was hiring an elder care attorney. I am not sure where we’d be otherwise.

It was the summer of 2008 when my sister, as Power of Attorney for my father’s financial matters, hired Steve Katten to be our father’s elder care attorney. For a few thousand dollars, Katten has since been on retainer for all matters surrounding my father’s legal life. This means we have assistance with anything regarding my sister’s status of POA, with our father’s taxes, with anything regarding his estate, and then some. Not only do we have an attorney on hand, we have his social worker on our side as well.

Since I don’t have anything to do with my father’s financial matters other than buying things he needs, I find myself taking advantage of the social worker’s skills. Kim Olmedo has a whole host of abbreviations following her name that tell clients she is licensed, experienced, and highly qualified to help them through the obstacle course that is dealing with a loved one’s dementia. I am not exaggerating when I tell you Kim has seen and heard it all from me. She’s heard me give the silent treatment, she’s heard me cry, she’s heard me yell (even when separated by miles!), she’s seen me lose it in public and in private, and she’s even been through some ups and down in our professional relationship. It’s a tough job she has because of the emotional aspect of my role in my father’s life and her role in helping me with it all. So, I salute her for all she has done, will do, and may need therapy for when this is all said and done.

We are lucky, though. My father set up his finances in such a way he was able to give us the financial resources to take care of him in these ways. Not everybody has the money to do this. In that regard we are very lucky. He did plan well. If, however, you are in a position to utilize the resources of an elder care attorney for matters regarding your loved one, take the time to do the research and interview qualified attorneys in your area. I’ve included resources on the Additional Links page that may come in handy.

NOTE:
In honor of JHP, JR, retired Attorney-At-Law, who taught me to CYA, I offer readers the following disclaimer:
Please do not mistake any of the information on My Father Doesn’t Know Me as medical or therapeutic advice. All of the information contained in this site is based on Lucy Parker Watkins’ experiences, personal research and advice she received during the course of her father’s treatment for dementia.