Symphony in D mentia
By M on Wednesday 18 October 2006, 23:55 - Journal - Permalink
Andante
Roberta, our case manager, called me to express her 'concerns' about my
mother. Apparently she has recently received 'incident reports' every week,
which have related mum's resistence to help and aggression towards both the
nurses and the care worker, Gail. On top of this, Roberta is worried that mum
is losing weight and getting dirtier. Apparently there has been a report that
the bathroom is in severe need of cleaning.
I respect Roberta: I think she is one of the few that seek what is best for the
'patient' rather than looking for the best way of doing their job. During a
pause in her litany of problems surrounding my mother she admitted that she did
not have any solution, and then began again by saying that perhaps mum would be
better in 'another environment'. She was having difficulty saying all this, but
I was deliberately not helping by being an active listener. I had automatically
gone into negotiation mode. I wanted her cards on the table. When she paused to
ask what I thought I replied along the following lines:
- None of these issues were new to us
- We (the family) talk about the issues every few days
- Yes, mum would be better fed and cleaner in a home
- She would probably also be much more disorientated
- Dad would have to be 'dealt with' too, as they are inextricably linked
It was ironic to me that Roberta had homed in on nutrition and hygiene as
problems. Were these not the two aspects of life that I had flagged as top
priority way back when we started?
We concluded the talk quite satisfactorily, in my opinion. Roberta would fund
another companion for a second day. Dad could go to day care twice a week. One
of the companions for mum would take her out for a long outing each week, and
another worker would go into the house and do some cleaning. This, I think, is
a step in the right direction.
The slightly uplifting closing theme prepared me for the next movement.
Allegro
I dropped in on mum and dad and showed them the paired photos (1961 and
2006), and several others taken at the latter session. I also took several of
their wedding photos over to show them. Mum really enjoyed the whole thing. She
did just as I had imagined - running a thickened fingernail from one face to
another, answering 'me' when I questioned her about the woman under her finger,
'mine' when I asked her about the four children and her husband. I said that
'he', pointing at the photo of dad, was 'him' pointing at dad himself, sitting
next to her at the table.
'Oh, no!' she said.
But over time we perhaps got her around this objection. Yes, there was the old
man sitting next to her and her children in a more recent photograph. She could
see it, but how had that been done? For a minute I thought she was going to
accuse me of 'photoshopping' the image, but she seemed temporarily willing to
accept dad as her husband.
Dad and I then left for a hit and run attack on the supermarket. We were in and
out of the mall in twenty minutes. Dad kept saying how grateful he was for the
photographs (he thinks this will finally convince mum that he is hers). He was
equally grateful for the shopping and the mere fact of my being at the house.
Having another member of the family there temporarily defuses some of their
disagreements. I dropped dad back at the house, put all the new food in the
cupboards, and laid out dinner for the two of them. That was my work for the
day done, and it was time to relax.
Adagio
I moved on to Greg and Regan's place for dinner. I gave them updates on the
first two movements of the day. Cassy read her current favourite book (Dr Dog)
to me, and we had a glass of wine with the meal. Cassy said:
' I know what Granddad's favourite subject is.'
'What's that,' Greg asked.
'The war.'
Greg then reminded me of a story about dad. I will be writing it down for
posterity later tonight because it contains an incredibly strong, almost
surreal, cinematic, image that I cannot get out of my head: a lone airman is
calmly walking down the runway of a Belgian airfield that has just been strafed
and bombed by the Luftwaffe. On either side of the runway Spitfires have been
parked in rows. Every one of them is burning violently. They had all been ready
for combat: armed and fueled. The flames are tearing high into the air and
their combined cloud of black smoke is smothering the sky. Walking slowly
between the two rows of flaming aircraft like this is a near-suicidal act of
fearlessness or recklessness.
Andante
On the way home I drop in again on mum and dad, to leave their copies of the
photographs. Both of them have gone to bed, but dad answers the door quite
quickly. He's been unable to sleep because he is distraught about mum's denial
of the marriage, he says. We stand together in the kitchen. He is wearing
shortie pyjamas and nervously running his fingers around the elastic waistband
of his shorts. He needs to make sure that someone else knows what he's going
through, so I let him talk for as long as he wants to. One revealing little
fact that emerges is that the day mum got lost she and dad had had an argument
and he had walked away from her - or she had refused to follow him home.
In the end I have to say that we all know what mum is like, we all know the
problem, but none of us has the solution.
'Ah yes,' says dad. 'That's the...'
'Sixty-four thousand dollar question,' I say.
'Exactly.'
But he's got things off his chest and goes to bed a little calmer.

Comments
I think, sometimes, the "solution" is exactly what you did...just listened. You can't change their reality (separate realities lived in the same house, obviously) but, you know, silent acknowledgement, well, I think that is a time honored "therapeutic technique", is it not? It isn't only those we can easily label "demented" who are incapable of resolving or obsessing over conflict, too.
Seems like you are including more tiny detail that causes your descriptions to jump out off the screen: "...nervously running his fingers around the elastic waistband of his [pyjama] shorts." I was immediately reminded of "the marriage bed"...and how this one area, the sometimes quiet, sometimes volatile resolution to many a marital conflict, might loose it's soothing properties when the couple becomes older and each is dementing. No wonder lots of older couples sleep in separate beds, or bedrooms.
As well, I couldn't help but think that the lone airman strolling the Belgian runway is still apparent in the lone husband "strolling" through the daily disavowal of his relationship to his wife. The only difference, perhaps, is that it's easier to suck up any possible fear and act recklessly when you know the situation isn't going to repeat itself endlessly. The activity of country to country war always ends (even though the urge to it doesn't), so you take the risks in stride (ooooh...nice pun, there, completely unintended). The resolution to the activity of person to person conflict on a demented field, though, is much less assured.
Thought provoking post.