Sunday, April 12, 2020

April update. Dementia and the elderly toddler


April 12 

I have a hard time answering people when they ask how Rob is doing.  I sooooo appreciate their asking (so don’t stop), but I have a hard time knowing exactly how to answer.  I want to be real.  To be honest and truthful and descriptive – so that others understand this disease and what our life is like.  However, I do not want to merely sound like I am whining about things or complaining about symptoms that are out of Rob’s control. I don’t want t sound like I am angry with him or throwing him under the bus.  But I do need to attempt to be real and honest about his symptoms. There is a fine line to walk between complaining and explaining.  It is one of the reasons I have not started a Caring Bridge page, and also why I do not update this blog as often as I should. 

But…here it is, already April, and I said I would try to keep everyone updated more often. 

In mid-February we upped Rob’s antidepressant.  It was an immediate relief from the negativity, the curtness, the misguided anger, the constant criticism and complaining, and the general hatred of everything and everyone.  What a relief!  Rob is still confused, but at least it is a happy confused.

His cognition levels have declined substantially. He is much more confused. He has a difficult time knowing what is going on around him or understanding a conversation.  Combined with a constantly fading memory, he has a hard time.  He has a very difficult time communicating – partially because his cognition level most often about that of 3 or 4 year old – but also because he slurs his words or talks in circles.

Because of his difficulty swallowing, I have been making him smoothies for breakfast every morning for the past 2 years.  For the past month, every morning he asks me “what is for breakfast?”  I try to make him exercise his brain, so I answer with a question, “what do I always make you for breakfast?”  Some days he will again ask me what is for breakfast fifteen to twenty minutes later.  We will have our normal morning routine, and just as I am leaving for work, he will ask me if I am going to work.  His questions are very repetitive, and they are all things that he knew a month ago.
In the past 2 weeks, he has rapidly declined. He repeats the same phrases over and over throughout the day.  Last week Thursday (April 9), I was tempted to tally up how many times he said the same phrases.  It is almost like he wants to have a conversation, but he doesn’t know what to say, but it is also as though his OCD/repetitive actions include repeating the same phrases.  Quite often, he is simply repeating the same thank you phrases.  Thank you for making smoothies.  Thank you for cutting my hair (I cut it 10 days ago).  What is for dinner? Thank you for cooking. There is a bird. I see a robin.

During the past 2 weeks, our daily conversations follow along these lines. I get up, do devotions, clean the kitchen, check my email, say goodbye to Heidi, then go in our room to get him ready for the day.  He will be dead to the world snoring, but when I walk in the room, he panics and throws the blankets around, “Issssittt sshhshshwer im?” (Is it shower time?)  Yup. He jumps out of bed – but doesn’t have his balance yet and often weeble-wobbles into furniture and walls, then sits back down and takes his socks off while I get things ready for the shower.  He will eventually stumble into the bathroom while I am running the water to get it the right temperature.  Some days he will say “I’m not going to church today” even if it is a weekday.  Other days he will go about his normal routine and into the shower we go. Yesterday he took a tumble in the bathroom doorway, and was in such a hurry to get up, that when I helped him up he started tipping over backwards the other direction.  I’ll have to watch that more from now on.  Into the shower we go, and “thksssss frrrrrr hrrcit” (Thanks for the haircut).  Again…it was 10 days ago…I appreciate that he is grateful!! For sure!  But it is like he doesn’t know what else to say.  He knows that when he gets in the shower, he says thank you for the haircut.  Sometimes, he thanks me 2 times for the haircut in one shower.  Most of the time, we shower with little to no conversation. Somedays he complains about things or asks what I am making for breakfast (smoothies, remember?).  Turn off the water, puts the towel on his head, and “thkkkssssss agin hrrrrrrcit” Yup. 

We go through the morning routines of getting ready. He will often ask about breakfast while getting dressed, or complain about a certain pair of sweatpants.  I need to hide them so he doesn’t drag them out and complain about them!  I move to the kitchen, make his smoothies, pack my lunch and work bag, then I make sure he is ready for the day.  I remind him if it is a Meals on Wheels day or tell him what his lunch options are in the fridge.  He turns the radio on to the Christian station (loudly), puts on his Carhartt vest (he is always cold, so he wears a shirt, a heavy fleece pullover and a carhartt vest with wool socks and slippers for inside the house) and he sits on the couch with his smoothie. Once I know he is good to go, I take off.  Some days he will not have anything to say.  Some days he will say “thkssss frrrr ssssssssmmmmmmmthsssss” (thanks for the smoothies) 3-4 times before I leave the house.

 He will also look out the window and tell me if he sees a bird and then try to tell me what kind of bird, but he struggles to come up with the right name.  He likes the mourning doves that frequent our yard, but 2 weeks ago forgot the word dove so now he calls them his morning birds.  If it is sunny, he says, “I like sunny days.” If it is snowing, the same, “I like snowy days.” But some days, he does not say a word, even when I tell him goodbye and to have a good day.  (Or, he will say, are you going to work?)

If I am at work, I don’t hear from him until 3:06, when I get a text “How’s work going today?”  I get this text every day at the same time, even if I am not at work, if I am in the kitchen working from home, if it is a weekend and Heidi and I just left the house to go to the store (and told him where we were going), or I walked outside to get the mail.  No matter what I tell him in my response (I swear I could say there is an angry grizzly bear in my office) he always replies with “okay dokey artichokey big fat blokey smokey” or a combination of those words.  He used to send a “what’s your 20?” text every 5 minutes starting at 3:30 or 4:00 until I got home, but then I explained that I don’t want to text and drive, so he has not sent one in a while. 

If I am working from home, or we are trying to do something (I took a day off last week and drove everyone to Radersburg for a day outside the house), he will repeat, over and over, all day long thanks for the haircut, thanks for the smoothies, I like sunny days, the Bridgers look nice (even when he can’t see them), there’s a cold breeze, etc.  Some days we get upwards of nearly 20 times per phrase per day.  It can be 90 degrees, stifling and a barely there hot whisper of a breeze or 30 below zero and no wind and he will say, “there’s a cold breeze” or “it’s too windy.”

In the evenings, I cannot even walk in the door from work without him asking who I am and what is for dinner.  Multiple times.  He has to eat at 5:20 on the nose. No matter what my answer is, he will say he can’t eat it because it will make him choke – even foods that he regularly eats and can eat with no trouble.  He will thank me again for the smoothies and the haircut.  He chokes a little during dinner, which makes his nose run, so he tries to blow his nose (he really isn’t coordinated enough anymore), then he tosses his used Kleenex on the dinner table where the food is set and we are eating, then always says “I’ve had a runny nose for 4 years!” Or he will start complaining about the neighbors cars as they drive past the window and why they are terrible people because they have a loud car or a sled deck or whatever.  It all comes down to someone waking him up from his afternoon nap and he will hold it against them for the rest of his life. 

Before we even leave the dinner table, he will ask me to change his socks.  I’m obviously not changing them during dinner, but he knows I will change them after dinner, so as soon as we are eating or getting close to finishing dinner, he starts asking about changing his socks.  I clean up the dinner mess and the kitchen, then change his socks.  He will then say “thkkkssssss chin ssssckssss” (thanks for changing my socks) a minimum of 3 times before he goes to bed. 

His watch beeps at 7 and he stands up and says “its pee time”.  It beeps at 8 and he says “itssssss snck time” Last week for 4 days in a row he said, “well, are you going to get me a snack or not?!” um…definitely not with that attitude buddy – besides right now his 8:00 snack is a glass of chocolate milk that he is capable of pouring.  I hope it does not sound as though I am being harsh or mean or unwilling to help him.  I usually do help him…but even the doctors and his old physical therapist and occupational therapists always said that when there are things he is capable of doing, he needs to continue doing them as long as possible. As soon as he stops trying, it is a task he will lose forever.

There are certain tv shows he likes to watch in the evenings.  He won’t watch tv all day, but that’s the only thing I can do to entertain him in the evenings.  His headaches are worse in the evenings, and if he is tired, so is his cognition.  I’ve tried games and stories and used to read him books, and lots of different things, but he is pretty well done for the day.  I try to keep funny movies and outdoor adventure type shows running in the evenings.  About a month ago we watched a Jackie Chan movie, and he always plays his bloopers at the end of his movies. Someone was supposed to say turtle, but they said turkey.  Rob says, “Yeah, turkeys are okay, but they have color vision and something something about turkeys.  I like blue birds.” We cannot follow his thought process, but at least it was happy.

Some days he sits and complains about the people on the shows to no end.  We are watching a hunting show and he started yelling about sleeping in tents and it’s cold and he hates it. (he never hated sleeping in tents before) So I tell him, well, no one is asking you to sleep in one, so you don’t have to worry about it. He yells, “I’m not doin it!” then he starts saying that the guy on the show is a horrible person and a horrible hunter because he shoots a hoyt bow and blah blah blah.  I turn the tv off.  He starts yelling at me something about a snowplow.  “What?” after that basketball game!!” “What about a basketball game?” “AFTER that BASKETBALL game! You did it!” I have no idea WHAT he is yelling about. Then he starts yelling about where I am going to sleep.

I have been having a terrible time sleeping in bed with him.  He takes up the whole bed – sleeping like a starfish – and then spends all night hitting me, kicking me, slapping me upside the head and shoving me out of bed.  I “sleep” on the very edge of the bed as far down in the bottom corner as I can and even then he is violently smacking me. I have a constant headache from clenching my teeth all night (and that’s with a dental mouth guard) and my shoulders are both going bad from balancing on the edge of the bed. So, out of the blue, he told me I could sleep on the couch.  I was in shock.  I had been planning on trying to have a discussion with him about our sleeping arrangements, but needed him to be in his right mind – if he is talking about bluebirds and sunny days and 10 day old haircuts, I can’t have a discussion with him.  I slept like a BRICK.  He said he slept fine because I turned the heated mattress pad way up without me in bed.  I slept on the couch a second night.  MARVELOUS, glorious sleep.  Then he went into this tirade about me sleeping in bed and how he needs my body heat.  So, I lay in bed now…I have to take a benedryl or Nyquil or something or I don’t get any sleep.  He talks at me (usually yelling at me in a whisper) about something all night long.  I can’t hear him or it doesn’t make sense.  One night he woke me up from a dead sleep, calling me horrible names, and accused me of hitting him 3 times in a row.  I was sleeping on top of my arm to keep from falling off the bed…so….??  I can’t be mad at him.  He doesn’t know the difference between his dreams and reality.  OR tv and reality. Or a story he heard one time and reality – OR that it happened to someone else and not him.  
  
BUT….now I’m off topic and in danger of complaining about things he cannot control.  The main point of this was to describe his cognitive declines. 

As I tuck him in, he will either say “thanks for the smoothies” or thanks for breakfast or thanks for the haircut.  Sometimes he will tell me that I need to go to bed right now (he goes to bed at 9, I need to stay up and finish chores, talk to the kids, get on the computer and do my job remotely, etc.). 

He has so many mental lapses.  He can barely have a conversation other than his repetitive phrases.  Sometimes he can try to tell a story, but he starts a story and goes down 8 or 9 rabbit holes and we never get where he started going.  I miss being able to talk to him.  He has no clue what is happening in the world or our lives.  I try keeping him up to speed but he doesn’t understand.  Every day he asks about church, the pawn shop or other places and I keep telling him they are closed.  I mean – Cody is home all day and not at school but he still doesn’t know what is happening.  It would be lovely to have my Rob back so I could talk to him more than “Thanks for the haircut and I like bluebirds.” Or describing what he sees out the window every 5 minutes.  “It’s snowing.” “It was snowing but now it stopped.” “It’s snowing” “It’s sunny, but it should be snowing.” “It’s snowing again but it was sunny.” “I like sunny days.” “I see a bird.” “I like morning birds” “It’s snowing.” “Is it tax season?” (His friend Ray was here 2 times to pick up and deliver our tax paperwork) “Thanks for the smoothies this morning.” “thanks for the haircut”…

I have been working from home more than usual…but when (if) things ever get back to normal and Cody is at school and Heidi is working…I’m going to have to have someone come keep him company during the day.  Companion care, in home care, whatever – he is not able to keep track of what is happening around him. Most days he has the cognition level of a toddler or pre-schooler, but he has the physical limitations of an elderly person. That is the truth of where we are right now.

 

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