Friday, 19 July 2013

Skywatch Friday –thunderboomers galore

 I have been watching the skies. We've had thunderstorm after thunderstorm. Having faced a drought last summer, it is glorious to have the rains.

I've been attending to a client with dementia. I feed him breakfast and dinner. Leaving his lunch out for noon. I've been there for 7 a.m., returning at 3 or 4:00, to check up on him. He managed his laundry, making it upstairs to the toilet, and watching the news.

Arriving in between a series of heavy storms in the afternoon, I found him in the kitchen, washing pretend dishes. Clearly thirsty, perhaps dehydrated. He was having some sort of episode. He was wearing only a shirt. This isn't the first time this has happened to me. Fortunately, as a 'professional caregiver' (according to Dr. Brian Goldman when he interviewed me for his radio show) I wasn't totally shocked. I've come across the same situation before, when a client who was abusing pain medications and drinking too much beer, met us in his living room wearing only a sweatshirt. Logically, he had soiled all of his pants, and didn't know how to use the washing machine. But that is another story of self-abuse!

With vascular dementia, the blood fails to circulate to the prefrontal cortex of the brain. The thinking part. The lower part of the brain stem, the reptilian brain at the back of your skull, manages to keep on functioning. You carry on breathing, blinking, and the other autonomic functions.

Your long-term memory can work, deeply buried in the brains memory banks. However, you may hallucinate. You may not be living in your immediate reality. My buddy had locked the screen door and wasn't letting me in. The lightning was cracking around me. It was beginning to rain heavily.

It took a half hour of persuasion for him to eventually arrive at the door and unlock the screen. What a relief! The lightning cracks were bad. The area had a total of 490 strikes, according to the radio.
He simply wasn't present. He responded to my talking to him, but clearly didn't know who I was, what I was doing, or what his next move would be. He shuffled closer to the door, but began to drink from the sugar bowl as if it was a cup of coffee. Standing two feet away from me, with the screen door between us, it was as if it was a whole different world he inhabited.

After I fed him, had him drink some fluids, he began to return. It was like he was in a fog.
He cannot process abstract concepts, such as what day it is. But his sense of humour returned, and we figured out that it was Wednesday. He was worried about his pills. The routine is to place
them in an egg cup, and he knows which ones he's supposed to take. With swollen feet, due to poor circulation, he needs to put his feet up three or four times a day. But he's too stubborn to do so!

You can get special socks, which keep the feet from swelling so much (my mother, with lymphedema, and wheelchair-bound father needed them), but his feet were too swollen for the pair he had. I let his son know. He attends an adult day away program on Tuesdays and Fridays, and I will drive him to that today. With his son returning tonight, we made it through the week.
Skywatch 7:2

I tell these stories not to shock you, but to educate. This is what many caregivers have to manage in their daily lives. The Ontario Government, in its infinite wisdom, keeps promoting programs to allow care recipients to stay in their homes, but that isn't right for all families. Not many can afford to stay home with failing loved ones.


The Furry Gnome said...

Very thoughtful. Take care yourself with your care-giving.

Christine said...

oh Jenn this is heartbreaking, there is so much need out there. Our society doesn't put enough focus on the elderly. It's all about the young and the beautiful (and money). We will all get there one day.

Kay L. Davies said...

Oh, Jen, this reminds me of my father, and other patients in the care facility. My dad had Alzheimer's but also vascular dementia. Just dreadful sometimes. But he always recognized my voice. I'd see him turn his head as I came through the door and spoke with one of the staff. I just wanted to run to him, hug him, and cry.

EG CameraGirl said...

I guess you need to stay prepared for just about anything!

Red said...

What you describe is all too real. Many people cannot get irrational through their heads. It's sad that some of these people are still living on their own. Good for you to give some attention to these people.

Anonymous said...

Bless you ~ your are a gem and your photos are excellent ~ Happy Weekend ^_^

eileeninmd said...

Beside being a professional, you must be a very caring person to handle this type of job. I am glad there are people like you around! Have a happy weekend!

Reader Wil said...

How difficult and heartbreaking it is to take care of such patients. How long can they live in their own homes. Your work is very important. In some cases such patients cannot be left alone.
Well I wish you all the strength you need.

Rideau Ferry said...
This comment has been removed by a blog administrator.
Jennifer A. Jilks said...

Actually, I adore caring for this man. He is a delight, most of the time.
I do tell this self-deprecating story of me sitting in the thunder storm as it was humorous after the fact, and is reality for many caregivers, paid and unpaid.

He doesn't live alone. I am providing respite, privately, to this family.
I tell the story, as a patient advocate, since many presume that home care is a possibility, but not the best solution for all families. Some people cannot be left alone.

For this family his living in his own home works well most of the time.
I have refrained from any identifying information, as this could be any number of people in Ontario. We all must be aware.

Martha said...

I stopped by because of the storm photos, but it was the bit on vascular dementia that caught my eye. I live with this every day in my mom. It is a slow and gradual decline, painful to witness. She has been on an oxygen concentrator 24/7 for 12 years.

Jennifer A. Jilks said...

It is painful to witness, isn't it, Martha? My late father had it due to a brain tumour. Even as a non-family caregiver I find it hard. It is best to talk about it, though. You know you aren't alone. You know that there are thousands out there doing this either paid or non-paid. I found writing my book very cathartic.
There are many on-line places for caregivers now. It really helps. Canada's Virtual Hospice where I am a regular contributor. Or the US-based Many are in denial about their situations. I choose to face it, talk about it, share my stories, as it helps.
I write about health issues, and found that is a good place for people to read about senior healthcare. I give articles on end-of-life, what the last days look like, how to tell if a person is in pain.
All the best.

George said...

This sounds like some of the things my mother went through before she died. My Dad, who is going to be 101 next month, is starting to show some symptoms, but he is still functioning fairly well. Your photos of the stormy sksies are wonderful.