Sunday, January 6, 2008

December 2007

December was a very challenging month for my mom and Nana. People with dementia act out in unpredictable ways. It is difficult for those living with them to remember to not expect rational behavior. My Nana has begun to hide things. She sneaks. She yells. She looks for people who have long been dead. There is no logical explanation. It is so critical to remember to not take the outbursts personally. Even if one knows this logically, it is difficult to ignore when someone tells you that they do not like you and want you gone from their home. Both my Nana and my mom sound severely sleep deprived which cannot be helping. The conversation about perhaps selling the house to get long term care for Nana has thus far been avoided. I find myself morbidly waiting for the event that will make everyone willing to talk.

December 12, 2007

For the past few days, Nana has slept most of the day. But she was up to play the piano with R last night. And she watched some television with me tonight. Nana really needs to use her walker now. R, M, and I keep reminding her to use it. She admits now that she does need it. Since I tell her that I need to use my walker all the time, she does not seem to be resisting the use of it as she was before. But she does forget to use it sometimes. And sometimes she loses it altogether.

December 16, 2007

Last night Nana and I had some problems. There was an ice storm going on so it was very cold outside. Nana kept opening the kitchen door and going out on the porch. No matter what I said to her, she kept opening the door. I was really getting cold. After more than an hour, I finally put my large walker in front of the kitchen door and sat on it. Nana was very angry that I would not let her keep the door open. Finally at 3:45 AM I thought that she went to bed. So I went to bed too. When M came at 8:00 AM, she told me that Nana had lost her rings. Nana said that she hid then in a pocket. M searched for a long time, but she did not find the rings. When A came tonight, she searched for the rings too, but she could not find them. During dinner, Nana changed her story. She said that she put the rings on a napkin, and then she blew her nose. So A thinks that Nana threw the rings away with a napkin. A took a bag of garbage out of the garbage pail out doors. She said that I should tell M to go through it in the morning, and any other garbage in the house. Nana has decided that she does not care if the rings have been lost or thrown away by mistake. She said that they were not worth much. I do not think that is true. But it would not do any good to argue with Nana. Now Nana is asleep since she did not sleep last night. Each day bring something new.

December 18, 2007

R was here this afternoon. He went upstairs and found Nana's rings in her jewelry box. He also found that Nana had turned all the lights on upstairs. For the time being, I have put the rings away in my room. We have all been in a tizzy for days trying to find the rings. Nana kept changing her story about where she had put them. She had us going through the garbage looking for them. We are really glad that the rings have been found.

December 20, 2007

Last night I was up all night with Nana. At 5:30 AM she came to find me in the bathroom. She said that I needed to take the little girl home. I finally went to sleep at 6:00. I slept through M’s visit to fix Nana's breakfast. Thank goodness M understands that sometimes I just need to sleep. Nana does hide things all the time. This morning I found a plastic bag full of cut vegetables in the silverware drawer. Not knowing how long the bag had been out of the refrigerator, I had to throw it all away.

Last night and tonight A2 has been washing the curtains and windows in the living room. The last time they were washed was when I did it in 1974. Housekeeping has never been of much interest to Nana.

December 21, 2007

Last night Nana and I were up all night. At 5:30 AM she told me that I had to take the little girl home. When I asked her what little girl, she got angry and walked away. Tonight while I was watching TV I fell asleep. Since I was up all night, I should not be surprised. It was 11:00 PM when I awoke. I heard a noise upstairs. Then Nana came down the stairs. I asked her what she was doing upstairs. She said that she did not know. I do not know how long she was up there. She must have gone up after I fell asleep. I told her that we did not go upstairs anymore because we could not walk very well. Then she walked quickly, without her walker, into the next room. She was not a bit hesitant. Obviously I have known that she sometimes went upstairs, but this is the first time that I ever saw her coming down the stairs. R suggested that we put a gate on the stairs when he found her rings upstairs. But she gets really angry whenever she is thwarted. My computer is right next to the stairs. She has already tried to destroy it twice. She has also threatened me several times. I am an easy target because I am here most of the time. It is a difficult situation.

December 23, 2007

The past few days have been difficult. Nana keeps waking me up at night. Last night was the worst. I did not sleep at all. Nana came into my room at 7:30 AM to continue berating me for something. She was still going strong when M came in at 8:00. M tried to get Nana to go into the living room by promising her coffee and breakfast. Nana came back to tell me that I had to move out because I would not co-operate with her. She said that it was her house and she did not like me.

This afternoon I went out for therapy. When I came home Nana had left her walker in the hallway so that I could not get to my room. She was in the living room feeding something to poor Fluffy. When she heard me moving her walker so that I could get to my room, she came in and grabbed the walker and would not let me pass. I can only stay vertical for a short time. I really needed to get to my room so that I could lie down. Nana finally moved when I yelled at her. Asking nicely does not help. But yelling really takes its toll on me. I finally made it to my room. Then I heard Nana in the kitchen. She was banging dishes and pans around. I heard her in the refrigerator. Then I heard her try to turn on the stove. Thank goodness A2 came in then. She finally convinced Nana to go to the living room so that she could cook her dinner. Nana insisted that she wanted eggs. I guess that is what she was trying to cook.

Tonight Nana went upstairs twice. I tried to convince her that we do not go upstairs anymore. She just ignored me. When she came down the second time, she was looking for Pop. She accused me of lying to her when I told her that Pop was not here. I stayed in the living room, but I could hear Nana slamming doors. Nana continues to be very angry. I am not sure how much longer I can keep going without sleep. Nana does not seem to need sleep any more.

December 28, 2007

Yesterday I needed to leave the house for an appointment before M arrived. When I arrived home, M told me that there were boxes all over the kitchen floor. I learned later that Nana had also tried to take my computer apart again. Nana told M that she does not like to be left along. I try to leave the house only when M or A2 will be here, but it is not always possible.

Sunday, December 23, 2007

November 2007

November was a challenging month. What happens to a family when some members feel it is time for long term care while others are not yet ready to discuss the possibility? I write from Colorado and am relieved that there are others who are near to Nana who must make these decisions. In her October 31 email, my mom finally confessed “I am not sure how much longer the present arrangement will work.” The responses from our family were varied. Some family members remain unwilling to discuss the possibility that things have changed. Other family members proposed solutions to people who perhaps were not ready to hear them. Is it time to sell Nana’s house so that the financial resources are available to pay for her long term care? What would this mean for my mother who currently lives with her in the house? These were and are difficult conversations. Nana has her good days and her good weeks where the family can postpone these conversations. But the day is coming, inexorably, perhaps not this week, or this month, but soon.

November 1, 2007
I had no solutions for my mother, no answers. There are so many days where I selfishly think, I am so glad that I am away. I sent her the following:

Hi Mom, I wondered when someone would finally say this "I am not sure how much longer the present arrangement will work." I can sense and imagine from your emails how challenging it must be to live in this situation day in and day out. I am sorry for how difficult this is and has been for you. Cathy

My cousin, oh how I admire how direct she is, cut right to the heart of the matter. If Nana needs full time care, how will the family pay for it? Behold her solution.

J, Please know that I am not attempting to minimize how difficult it must be for you with Nana. I am also interpreting your message as a cry for help in this situation. However, there aren’t a lot of options for Nana right now. Based on discussions with my mother, it sounds like Nana cannot afford 24 hour care in her house. So, the next move from here is to place Nana in a nursing home.

If Nana goes to a nursing home, the house will need to be sold to pay for her care. Nana will need the equity in the house to get into a nice facility. If you spend all the equity on in-home care, most facilities won’t accept Nana as a Medicaid patient. She will end up going to a state facility, and I really wouldn’t wish that on anyone.

So, please be clear, are you asking for the family to start looking into selling the house and moving Nana to a nursing home?

My mom found my cousin’s email upsetting. I think in part my mom wanted some sympathy and support and was a bit shocked to get hit with such a dramatic solution. Many emails followed about money and the realities of the US health care system.

Finally there was some shared understanding.


November 3, 2007
D, even if I were young and healthy, I could not supervise Nana for twenty hours a day any more. Since Dr. L said that Nana should not be alone, and since you say there is no money to provide additional home care, then I guess that the house needs to be sold so that Nana could go to a nursing home. Is this a decision that the family should make? Or is A the one to make the decision because she controls the finances?

My cousin replied:
I think that you and K and my mother need to have that discussion. I don’t think it’s a decision that any one person can make.
I think if Nana is a danger to herself (or the house) when left alone, you should have that discussion as soon as possible.
I can set up a conference call if you all can’t be in the same location. Please let me know if I can help.

November 5, 2007
Last night A was here for about an hour to fix dinner for Nana. She does not think that Nana needs supervision 24/7. She seemed unconcerned about Dr. L warning that Nana should not be left alone.

November 16, 2007
A2 told me tonight that she thought that Nana had a good week. She felt that she enjoyed getting her hair and nails done today. Tonight Nana showed me her fingernails and said that she chose brown polish today. I told her that brown polish looked nice.

I was resting in my room tonight when R came to visit. I did not see him but I heard his voice. He had Piper (his dog) with him and I heard Fluffy barking. After R left, I went into the living room to talk with Nana. She did not remember the visit from R and Piper. Then she said that she used to have a brother named R. When I told her that her brother's name was B, she did not remember him at all. So one minute she seems fine, and the next minute she is very confused.

November 22, 2007
A took Nana and me to D’s house for Thanksgiving dinner. Everything was delicious, and the company was the greatest. A3 and E drove down from Boston to join the family. D2’s new puppy Rosie made the rounds with a greeting for everyone. Then she slept peacefully during dinner. D2 seemed happy to have E to play with before dinner. E was very tolerant of a little boy so much younger than he was.

Yesterday we had a surprise visitor. Barney's son S came to spend the afternoon. He brought Nana a huge bouquet of beautiful flowers. Unfortunately Nana did not remember him. But then today at D’s house, Nana kept asking me who I was. On the way home in the car, she kept saying that she did not see me at D’s house. Nana seemed to have a nice time there anyway. She went to sleep as soon as we got home.

November 26, 2007
M told me yesterday that Nana talked about our Thanksgiving dinner. She said that it was at D’s house, and that A drove her there. So sometimes she does remember things.

Tonight when I returned to the living room, I discovered that the green waste basket that is usually next to my chair, has disappeared. I do not know what Nana has done with it or why. Maybe I will find it tomorrow. Life here is always full of surprises.

Monday, November 5, 2007

October 2007

My Nana is getting progressively worse. Her need for full time supervision is growing. My mom is finding it more difficult to be the only person responsible for spending 20 of 24 hours watching over Nana. I do not know how she has done it this long. It seems that my Nana no longer needs to sleep. She wanders and creatively rearranges furniture in the night. She sneaks her own food to the dog, Fluffy, who is becoming so fat she can no longer easily go up and down the stairs to leave the house. It would be funny if it were not so sad. And yet, even with all this, there are moments of relative lucidity. A moment when she remembers having had great skill at the piano; skills that are now sadly lost.

Next month's post may be heartbreaking to assemble. The Doctor's Halloween warning that my Nana needs 24/7 care may force my family to have difficult conversations and perhaps to make some hard decisions. Already the emails are flying back and forth. More in the last few days than in most months up to now.

October 1, 2007
Today Nana had a quiet day. But she keeps giving poor Fluffy her cookies.

October 11, 2007
Last Friday after Nana had her hair done, A2 took her out to dinner for Chinese food. A2 said that she was very happy at dinner time. When they came home, Nana went right to bed. Two hours later she came into the living room and asked me when some one would come to fix her dinner. When I told her that A2 already took her out for Chinese food, she did not remember.

Each day Nana goes out on the porch several times to get the mail. Even once she has given it to me, she continues to go outside to look for the mail.

Nana does not seem to notice whether it is daytime or night time outside. She often says good morning to me even if it is dark outside. Tonight she went to bed early. Then she came into the living room to ask me what she should do next. She often asks me what she should be doing. Sometimes it is difficult to find an answer. I used to suggest that she go to play the piano. Yesterday she began to tell me that she does not like to play the piano anymore because she knows that she can't play it the way she once did. I feel sad about that. Before she did not seem to remember that she once played the piano very well.

October 15, 2007
This morning M turned our heat on for the first time this fall. It has been so humid in the house that it was very difficult to open the basement door. Last weekend it was 89 degrees. This weekend it was forty. This morning the house was 65 degrees. It is much more comfortable at 70 degrees.

Whenever Nana hears me in the kitchen or the bathroom, she comes to ask me what I am doing. She is also moving furniture around again. She moved the chair where I sit when I first come into the house. Getting into the house takes a lot of energy for me. Once I am inside, I really need to rest for a few minutes. Then last night I could not get back to my room from the living room because she had left her walker between the dining room table and the big organ speakers. It took me a while to find a place to move the walker out of the way so that I could get back to my room. I was very thankful to finally reach my bed so that I could rest.

October 20, 2007
Tonight for the very first time, Nana became very angry with A2, Nana demanded her dinner. A2 told her that she had already eaten her dinner. Nana did not believe her. Nana often forgets that she has eaten shortly after a meal. Tonight Nana could not be convinced. So A2 asked me if she could give her another dinner. In the interest of peace, I agreed. After her second dinner, Nana asked for more coffee and cookies. That was her third cup of coffee. She will probably up all night again.

For several nights in a row, Nana has been up all night. She comes into my room every hour to ask me what time it is. This morning at 5:00 AM I found the kitchen door wide open again. On Thursday night, Nana created a situation in her mind that required her to solve a problem. There was no problem. She just thought that there was. Then she decided that she could not solve the problem, so I must solve her problem right now. I told her that I would talk with her about it tomorrow. She totally ignored me and began again to tell me what the problem was and why I needed to solve it RIGHT NOW! Again I told her tomorrow. Again she told me to fix it RIGHT NOW! More and more, Nana wears me out. When M comes in the morning, I go to sleep. At least I can get two hours of sleep then.

October 26, 2007
Fluffy has spent the past two nights out doors. She is so fat that she can't get up the steps to get back in the house. The first night it was very warm outside. And even though it rained, she must have found the dog house because she was dry when M went outside to bring her into the house. Last night she was outside again, but she found a way to get inside around seven AM. She was all wet when she came in this time. Nana dried her off with a few kitchen towels and then she began using flannel sheets and trying the give them to me as mine after they were wet. Fluffy ate her dog food in the morning as usual. But she has refused to go outside since she came in this morning. She is having a lot of trouble walking. She is much too heavy. It hurts her to walk. Nana keeps feeding her cookies. M, A2, and I have tried to stop Nana from giving her cookies, but Nana is very sneaky about it. She pretends to eat a piece of cookie, and then she puts it down on the floor for Fluffy. If we catch her at it, she denies EVER feeding Fluffy a cookie. All day today she accused me of poisoning Fluffy. If something is wrong with Fluffy, it must be my fault because I hate all animals. So Nana decided that I could not live her any more. I called A to see if she could take Fluffy to the vet this evening, but she did not want to do it. I am not sure what to do it Nana persists in her determination to get me out of her house. She was really angry about it this afternoon. I was glad to be able to leave the house to go to S’s house for a while. When I came home, M had been able to calm Nana down, But she had not been able to get Fluffy to go outside. Perhaps Fluffy will feel better tomorrow.

October 31, 2007
Dr. L saw Nana yesterday. At the last minute the doctor's office changed the time of the appointment from 4:30 until 8:00 AM. A took Nana to the office. M met A and Nana there. She stayed with Nana so that A could go to work. M was a good person to speak with the doctor because she is with Nana each day. Dr. L said that Nana is fine. He said that her heart is very strong. He said that she should come back to the office in six months. Today the office called to say that Nana's blood test was fine. They are sending a copy of the blood test results to Dr. G. M told me this morning that Dr. L said that Nana should not be left alone. I only leave Nana alone when I go for therapy or to see a doctor myself. I try to make my appointments to co-inside with the times that A2 is here, but it is not always possible. Most days I am with Nana twenty hours a day. She often wanders around all night. I am not sure how much longer the present arrangement will work.

Saturday, October 27, 2007

September 2007

The signs are getting stronger that Nana will need full time care and supervision soon. It is difficult to understand dementia. The people dealing with it keep trying to find the logic behind the words or actions when there simply is none. I was struck, as I was putting these posts today, at how similar the content of my mother's emails is to some blogs I read written by new mothers. The focus is on eating, grooming, and sleep. I was struck also by how lucky we are to have these wonderful women A2 and M who come and care for my Nana each day. While the grandchildren (like me) of my Nana have scattered across the country, many of her friends and the friends of her children have remained close. Some of these friends of the family (e.g. J) who will come to help keep the house going. I do not know how my family would cope without this community.

September 1, 2007
Nana and I both slept well for two nights. Tuesday night no one slept. Late that night Nana was obsessed with finding her mother. Nothing I said would convince her to go to bed. She kept wandering around the house. Around four AM I heard her upstairs. When M came in the morning, I asked her to check on lights upstairs. It was dark when Nana went up there, so she must have turned on some lights. M found lights on in every room. She also found the ceiling fan running. In each room she found some of Nana’s clothes on the floor. I do no know what Nana was really doing upstairs, but I am thankful that she made it up and down again safely.
Tonight I made some soup. After I ate, I put the pan in the sink to wash. I left the kitchen for a few minutes. When I came back, the pan was gone. I finally found it on the floor in the living room. Nana does not know why she put it there.

M will be away for the three day weekend. She will be back on Tuesday. A2 is due back on Tuesday night. I miss them both when they are not here.

September 5, 2007
A2 is back from vacation. M was wonderful while she was gone, but taking care of Nana plus the house is just too much for one person. It was great that both of them were here today.

The bad news is that Hurricane Felix hit Nicaragua head on. A2 and M are both from Nicaragua. One of A2’s daughters is there now visiting her grandfather. A2 hopes to contact her daughter tonight.

Nana was glad to see A2 tonight. Nana asked her for food as soon as she arrived, even though she came early. But Nana is well fed every day. In fact some of her long pants are too small for her now. But she feels fine. She just can’t remember things.

September 6, 2007
Last night Nana and I stayed up all night. Nana was agitated about one thing after another. Finally at 5:30 AM I thought that she had finally decided to go to bed. Fifteen minutes later I gave up and let myself fall asleep. When I awoke at 9:30 AM, the door to the kitchen was open, so obviously Nana had not stayed in bed. When M came in at 10:00, she could not find Nana. She looked upstairs because she had found her there in the past. She was not upstairs. Poor Fluffy was locked in her cage. Nana had even put a chair in front of the door so that she could not get out. M checked the basement because the door was open. Nana was not there either. So I asked her to look outside. She did not come back for a very long time. I was really getting worried when I heard M’s voice. She had found Nana in the back yard lying on the ground by J’s camper. M managed to get her up and on to the porch. Nana sat on the bench while M went to get the walker. Nana did not seem to have any visible injuries. She complained that her back hurt. M noticed later that Nana had one ankle that was a bit swollen. After breakfast, M helped Nana get back to bed. She slept most of the day. When M came back to fix Nana’s dinner, Nana did not eat much. Then she went back to sleep again.

After Nana was found this morning, I called A to let her know what happened. There are no easy answers about what to do next. But I fear that since Nana has left the house once, she may do it again. Thank goodness she went into the back yard. L Avenue is very busy most of the day.

September 8, 2007
Nana slept all day yesterday. Then she slept all night. I stayed awake all night to make sure that she did not go outside again. This morning when M came, Nana said that she was fine. M gave her a shower. Then Nana ate a good breakfast. She slept again until A2 came to take her to the hair dresser. When she came home, she ate a good dinner and then went to sleep again. Tonight I hope to catch up on some sleep. A is going to look for some kind of alarm for the kitchen door. We agree that it would not be safe to lock all the doors in case of an emergency.

September 13, 2007
M comes from 8:00 to 10:00 AM now. Yesterday when she arrived she told me that the kitchen door was open, but Nana was in the house. I was still awake at 4:30 AM and the kitchen door was closed and locked then. So Nana must have gotten up after that. That evening I went out for therapy while A2 was here. When I came home, she told me that Nana did not eat dinner. She kept saying that she wanted to sleep. She usually wants to eat all the time. But the next morning she was fine. M said that she ate breakfast as usual. Wednesday night when I got home, A2 told me that Nana had a lot of energy that evening. She ate her dinner and then decided that she wanted a shower. Usually it takes a while for M to talk her into taking a shower.

A2 also put all clean sheets and blankets on Nana’s bed. Then she did three loads of laundry. The third load was a heavy blanket. She told me that the washing machine would not work. I thought that she had just blown a fuse again. But then I heard the dryer going. So I feared that my old Maytag had finally failed. I told A2 that I would look at it after I had a chance to rest. I am always exhausted when I first come home. Later I was able to get the old machine started again. The blanket had become unbalanced. Thank goodness I was able to get the machine going again. I brought that Maytag up from West Virginia in 1971. It has NEVER needed service. If it ever does give up the ghost, the whole laundry will have to come apart to get the machine out.

September 15, 2007
This morning when I awoke at 7:30 AM, the kitchen door was wide open. Several of my things had been moved or taken apart. So Nana must have had a busy night. I was still awake until 4:00 AM, so it must have been after that time. Maybe M is right. She said this morning that Nana really needed someone to watch her all the time. So far we have been lucky that Nana has not gone into the street. A said that she would try to find an alarm for the kitchen door. But at least we have cooler weather now. Maybe the change of seasons will help.

September 16, 2007
The kitchen door was closed today when I awoke. It is the first time in a long time that it was closed in the morning. Nana has slept most of the day. A2 tried to get her to play the piano, but she did not want to get up. She just wanted to sleep. But A2 did say that she ate her dinner. I tried to get her interested in the television this afternoon and again tonight. One PBS station is fund raising, so they have lots of music programs available. But Nana just went back to sleep again. I hope that does not mean that she will wander around during the wee hours of the night. I am hoping to get to church tomorrow. I have not been able to go because of the heat for most of the summer. But tonight it is really cool. I was even able to turn both air conditioners off this evening. It certainly is quiet all of a sudden.

September 20, 2007
Yesterday Nana had a good day. When A2 arrived to cook Nana's dinner, Nana insisted that they go out for dinner instead. So A2 took her out. When they arrived home several hours later, A2 told me that she took Nana to the Queen City Diner. Nana ate a hamburger and some iced tea. Then A2 took her to a park where they sat on a bench to watch the river and the sunset. After A2 went home, Nana was a bit restless and wandered around a while. Today Nana was very confused. But she did eat her dinner when A2 came. Since then she has slept most of the time.

September 23, 2007
Nana spent several hours this afternoon trying to find her walker. I did not know where she put it. She finally found it after A2 came tonight to fix her dinner.

A2 did not know where it was either. After dinner, A2 spent some time on the porch fixing the plants. Nana went out there with her. She seemed very interested in what A2 was doing.

Once while Nana was still looking for her walker, she came into the living room with four sacred music booklets and her reading glasses. She told me that it was her lunch. When I told her that it was music instead, she left the room and came back wearing her night gown instead of her clothes. So today was a very mixed day.

September 27, 2007
The lights went out on the TV, the fish tanks, the porch light, and the outside lights. J has been here two hours and he can't find the fuse causing the problem.

I also asked J if he knew why S has not been here for six weeks. He said that he did not know.

Nana has been confused and agitated today. I do not know why.

J just came up to tell me that he can't find the problem. I asked if he could rig up an extension cord so that we could at least watch TV tonight, and we could keep the fish alive.

September 29, 2007
A found an electrician to get our lights back on Thursday. He will also work on a plan to switch us to circuit breakers. A also suggested that the new board be put upstairs so that no one needs to go into the basement to flip a switch. In case of more basement flooding, having the board upstairs makes sense.

I have not seen Nana this evening. A lady from my church took me for a regular visit to Medemerge to get my medication for thyroid. It was my first experience with a Physician's Assistant. The young man I saw was knowledgeable and helpful. He even gave me some samples of Provigil. The last time I had to pay for it myself, it cost me $450.00 for a month's supply. So I was thrilled to receive some samples. It was not until I looked at my new Rx's, that I realized that the man I saw was not a doctor, but a PA. For a regular, non urgent visit, a PA makes sense. After I got home, I slept for six hours. But Nana was fine this morning. She got her hair done this afternoon. And A2 fixed her dinner tonight.

Friday, September 7, 2007

Wandering

I mentioned in the August summary that one sign that my dad's mom needed more care than she could get at home was her unpredictable wandering.

My Nana has begun to wander. This does not bode well for the status quo. I believe that hard decisions are coming to my family sooner than everyone would like.

On a positive note, I see from this email that I come by my night-owl tendencies honestly.

September 6, 2007
Last night Nana and I stayed up all night. Nana was agitated about one thing after another. Finally at 5:30 AM I thought that she had finally decided to go to bed. Fifteen minutes later I gave up and let myself fall asleep.

When I awoke at 9:30 AM, the door to the kitchen was open, so obviously Nana had not stayed in bed. When M came in at 10:00, she could not find Nana. She looked upstairs because she had found her there in the past. She was not upstairs. Poor Fluffy was locked in her cage. Nana had even put a chair in front of the door so that she could not get out.

M checked the basement because the door was open. Nana was not there either. So I asked her to look outside. She did not come back for a very long time. I was really getting worried when I heard M's voice. She had found Nana in the back yard lying on the ground by J's camper. M managed to get her up and on to the porch. Nana sat on the bench while M went to get the walker. Nana did not seem to have any visible injuries. She complained that her back hurt. M noticed later that Nana had one ankle that was a bit swollen. After breakfast, M helped Nana get back to bed. She slept most of the day. When M came back to fix Nana’s dinner, Nana did not eat much. Then she went back to sleep again.

After Nana was found this morning, I called A to let her know what happened. There are no easy answers about what to do next. But I fear that since Nana has left the house once, she may do it again. Thank goodness she went into the back yard. L*** Avenue is very busy most of the day.

Sunday, September 2, 2007

August 2007

My mom is beginning to realize that Nana cannot interpret or process rationale thoughts, that there is no advantage to forcing "truth" on her when her brain can no longer interpret the difference. It is so slow this cognitive decline and yet inexorable. From the outside it looks like the time may be soon when my Nana will need 24/7 care and monitoring. My mom, who has difficulty walking, may not be sufficient to keep them both safe. Since she lives it every day I think it must be very hard to see the changes. There are good days and bad but slowly this disease is eroding the woman my Nana was. The wonderful women who help care for my Nana have been traveling which seems to have exacerbated some of the problems.

I am waiting for the event that triggers a more dramatic intervention by our family. With my dad's mom, that event was my Nannie's visit to a stream where she had met with a childhood boyfriend. In her mind, she was still a young lady going on an outing. The path to the stream was treacherous and she fell and broke her arm. However, she kept trying to convince her daughters that everything was just fine. It wasn't. I don't think we are quite here with my Nana but it feels close.

August 8, 2007
Nana’s friend R is staying with us for a few days. She belonged to Nana’s choir at the Dunellen church. This week R sold her house in Dunellen. She needed to have all her belongings out of the house yesterday. It was a much bigger project than she expected. She finally got to our house at 1:30 this morning. She was really exhausted. She needs a day or two to rest up before she drives back to her home in North Carolina. Nana seems happy to have R here. When R finally sat down in a chair in the living room this morning, Nana said “Now the house is calm.” I am not sure what Nana meant by her statement, but she seemed pleased with the situation.

Note: my Nana is one of those women who was comfortable with the idea of auras, premonitions, astrology and palm reading. I suspect that both my mom and my Nana were comforted having someone capable like R in the house and that truly the house was calmer. It is so like my Nana to say so.

August 11, 2007
Nana’s friend R left Friday morning to drive back home to North Carolina. She called tonight to let us know that she had reached Virginia. She will drive the rest of the way home tomorrow. I think that Nana was happy to have her old friend stay here for a few days. R found that closing her house up to sell was a lot more work than she expected. She was really frazzled the first night that she was here. By last night she was relaxed and ready to start on her journey home.

A2 brought her friend M2 here to meet Nana tonight. She will come to fix Nana’s dinner each night next week while A2 is away. M is also going on vacation next week. But she will only be away one week. When she comes home, she will come twice a day for the next two weeks that A2 is away.

August 19, 2007
Nana has been more confused lately than she was before. She often talks with people who are not there. But Nana is sure that she has visitors several times a day. Today she asked me who fixed this house to look just like her other house. Usually she understands that this house belongs to her. But today she did not seem to make the connection. Maybe tomorrow will be better since she had a lot of sleep today.

August 21, 2007
Nana is not having a good day today. At 5:30 AM she awoke me to say that one of her dogs was lost. I told her that she had just one dog. She seemed angry about that, but she left. Then she came in to complain that there was a gang in her room. I told her that she probably just had a bad dream. In the afternoon Nana told M that she fell while trying to get out of her chair. The chair fell on top of her. She said that she was not hurt. That has happened before when she forgets to use the handle to put the foot rest down before she tries to get up. M has been able to convince Nana that she should be using her walker again. Evidently she was having trouble walking this morning. She told me this morning that her hips hurt when she walked. Also while M was here this evening, Nana refused to speak with R when he called. Normally she races for the phone when it ring just in case it is R calling. Maybe tomorrow will be better.

Aug 25, 2007
Nana went to have her hair done as usual today. Then A brought her home. Then M came back for the third time to fix Nana’s dinner. Nana’s hair looked nice and she was happy about the color of her fingernails. M and I told her that she would look nice for A's birthday party. Then about two hours after M left, Nana came into my room and demanded that I go and get her car and bring it home. When I told her that she did not have a car now, she became furious and said that I was mean and nasty. She became so obsessed and so angry that I finally just said that I could not get her car because I did not have the keys and that I could not walk that far. She persisted with the same demands for two hours. Then she decided that I should move out because she did not like me.

Now she can’t find Fluffy. From some of the things she has said, she may have closed the back door so that Fluffy can’t come in. But since it is 80 degrees outside, and I am exhausted from all of Nana’s demands, I think that I will wait until I have had some sleep before I look for Fluffy. I hope that after Nana has some sleep, she will be calm again.

August 29, 2007
Nana seemed fine most of the day. She ate a good breakfast and a good dinner when M came. Then at about 8:30 tonight, she came to ask me when someone was coming to take her home. I told her that she was already home. She left me and came back a few minutes later with the same question. Later I went into the living room. She thanked me for coming upstairs with her. I did not even try to argue with her again. Since then, about every ten minutes, she has come over to ask me if I will stay with her. I have just answered yes. Maybe I should not try to tell her the truth any more. She seems happy if I just agree with her. If I try to tell her the truth, she gets very upset. Maybe keeping her happy is more important.

August 30, 2007
By this morning, I had pretty much decided to agree with Nana whatever she says. She seems happier that way. When I spoke to M this morning, she has decided to do the same thing. Nana’s situation seems to change from day to day. We will see how this approach works.

August 31, 2007
Nana and I both slept well for two nights. Tuesday night no one slept. Late that night Nana was obsessed with finding her mother. Nothing I said would convince her to go to bed. She kept wandering around the house. Around four AM I heard her upstairs. When M came in the morning, I asked her to check on lights upstairs. It was dark when Nana went up there, so she must have turned on some lights. M found lights on in every room. She also found the ceiling fan running. In each room she found some of Nana’s clothes on the floor. I do no know what Nana was really doing upstairs, but I am thankful that she made it up and down again safely.

Tonight I made some soup. After I ate, I put the pan in the sink to wash. I left the kitchen for a few minutes. When I came back, the pan was gone. I finally found it on the floor in the living room. Nana does not know why she put it there.

M will be away for the three day weekend. She will be back on Tuesday. A2 is due back on Tuesday night. I miss them both when they are not here.

Saturday, August 4, 2007

July 2007

My Nana continues her slow decline. There are days of lucidity interspersed with days where her knowledge of common things continues to deteriorate. I am so grateful for my mother's frequent updates and yet this process is so sad. Because my mom lives with Nana, she sees the ups and downs more intimately. You can hear (read) my mom's frustration that the other family members are less aware that my Nana will soon need, or already does need, round the clock supervision. These are difficult topics for families to discuss. It is selfish but I am relieved to live 1776 miles away.

July 4
M told us on Friday that she will no longer be able to come on weekends after Saturday. A came on Sunday and brought Nana a cruller and coffee from Dunkin Donuts. I was not here because I went to church for the first time in a long time. Nana told me later that A had come and spent some time talking with her. Time spent with her is more important to Nana than food right now. She can always find a banana or some yogurt if she is hungry.

Nana is sleeping a lot this week. She did not awaken me last night. But she must have been up some time during the night because the kitchen door was unlocked this morning. Thank goodness I do not have to worry about the living room door being open anymore. Nana complained at first when I locked that door and removed the key. But she seems to have accepted that it is necessary now. When I was a little girl, the house was never locked. No one needed to lock doors in the old days. But the world has changed, and so has this neighborhood. Our neighbors in the ranch house next door moved out in the middle of the night a couple of months ago. Even though there is a real estate sign in front of the house, no one has cut the grass, even in the front yard, all summer.

I put the fireworks on TV for Nana tonight. She used to really like watching the Fourth of July programs. But tonight she slept through most of it. I do not blame her. The music was not even very good.

July 13
A tried to take Nana out for dinner tonight after Nana went to the hair dresser. When they got to the restaurant, Nana said that she did not feel well. Once they got back in the car to come home, Nana began vomiting. She said that she was carsick. When they finally got home, Nana refused to get out of the car. She said that she was still sick. Finally A got her into the house, but only as far as the studio chair. I urged A to try to get her into bed where she would be more comfortable and also closer to the bathroom. Nana finally moved to the couch and refused to move any more. So A went home and Nana slept. At 11:00 I found that she had finally moved to her bed. Fluffy was asleep on the floor right next to the bed. Nana is asleep now so I hope that her car sickness is over.

July 14
Nana slept well last night. When A arrived today to fix her breakfast, Nana said that she was all better. She ate eggs and toast and coffee. She has been up and around all day. She also played the piano for a long time. She has not done that in weeks. Tonight when A2 came, she ate a good dinner too. We are all glad that she is feeling better.

July 17
On Monday Nana asked A2 to stay to talk with her while she ate dinner. A2 told me later that Nana’s conversation was logical and that ideas seemed to be clear in her mind.

For the past twelve years I have been going twice a week for therapy. Nana often plays the piano or the organ while I am gone. Sometimes she just sleeps. Today when I got home, she told me that she was upset about being in the house alone. She said that she did not know where I was, even though I told her as I was leaving that I was going out for therapy and that I would be back soon. Today was the first time that she expressed any concern about being alone in the house. Tonight she kept telling me that other people were in the house watching TV in her studio. There is no TV in her studio.

July 26
A2 said that Nana ate a good dinner tonight. Then she went to bed early.

Nana has been having trouble walking. Her sense of balance is not good. She is still refusing to use her walker. She did go out on the porch to get the mail. Then she could not decide what to do with it, so she left it in the kitchen.

July 30
It has been really hot and humid here. Yesterday I pinned my hair up to try to keep cooler. Nana noticed and said that my hair looked nice. So she can see more than she admits to seeing.

We had a thunder storms today where we had thunder for about 90 minutes before we ever saw rain. The thunder was very loud. Fluffy couldn’t find a place to hide where she felt safe. She finally hid next to my bed under a pillow that had fallen on a floor. It is quiet now and she is sleeping peacefully.

When A fixed breakfast for Nana yesterday, she told her that she would be back later to take her out for dinner. When I saw Nana an hour later, she had traded her clothes for a night gown. I had trouble convincing her to get dressed again. But she finally got dressed again and she had a nice time out with A. Nana really needs someone with her all that time. Twice when I have gone out for therapy lately, she has been upset about being alone when I came home.