Monday, March 2, 2009

Precious

"Linda, Linda!" the Jamacian Nurse called out to us from the nursing station as we passed. There was a strident tone to her voice we had come to know only too well.

We paused. This would not be good news.

We were at Extendicare for Linda's mother's 90th Birthday and had spend the past hour decorating the Events Room on the ground floor. We had just taken the elevator up to Morningside House where her mother lives to bring her down to the party.

Linda's mother has Level 6 dementia and requires constant nursing care. But even then, her behaviour can be so erratic we receive frequent calls for help.

Her mother is refusing to eat, can Linda come over to help? Her mother is fighting with the other ladies at her table, can Linda come over to help? Her mother is refusing her medication, can Linda come over to help? Her mother is refusing to wear her diaper and soiling all the chairs in the lounge, can Linda come over to help? Her mother has fallen again and is very upset, can Linda come over to help?

For those fortunate enough not to be familiar with Level 6 Dementia, patients--

"May occasionally forget the name of the spouse upon whom they are entirely dependent for survival. Will be largely unaware of all recent events and experiences in their lives. Retain some knowledge of their past lives but this is very sketchy. Generally unaware of their surroundings, the year, the seasons etc. May have difficulty counting from 10, both backward and sometimes, forward. Will require some assistance with activities of daily living. e.g., may become incontinent. Will require travel assistance but occasionally will display ability to travel to familiar locations. Diurnal rhythm frequently disturbed. Almost always recall their own name. Frequently continue to be able to distinguish familiar from unfamiliar persons in their environment. Personality and emotional changes occur. These are quite variable and include: (a) delusional behavior. e.g., patients may accuse their spouse of being an impostor. May talk to imaginary figures in the environment, or to their own reflection in the mirror (b) obsessive symptom e.g., person may continually repeat simple cleaning activities (c) anxiety symptom agitation and even previously nonexistent violent behavior may occur (d) cognitive ability i.e. loss of willpower because an individual cannot carry a thought long enough to determine a purposeful course of action."

So we were worried.

But the nurse had a smile on her face.

"Oh Linda, do I have a story to tell you." she nurse said. "Your mother was in a terrible way this morning. Worse than anything we've seen from her."

Linda held my hand.

"She was outraged because her PSW had thrown out some paper napkins she had placed on the seat of her walker. She had this great wad of napkins on the seat and the PSW was just tidying up. I could hear your mother screaming all the way from the Nursing Station.

"Nothing would quiet her until she got her napkins back. So there we were, her PSW and two nurses digging through the garbage trying to find this great wad of paper napkins for her.

The nurse started laughing at the memory. "Oh you should have been there. It was quite a sight, I can tell you."

"What was so important about these napkins," I asked.

"Ah, that is the question, isn't it. We all thought it was just her obsessive nature and were just humouring her to quiet her down. She was so agitated, you should have seen her.

"Well we finally found the napkins," the nurse started walking us down the hall. "Come, come see what we found hidden inside them. She had wrapped it up in all those napkins for safety, so it wouldn't fade or get damaged."

We followed her down to Linda'a mother's room where we found her sitting in her chair, a great wad of paper in her lap.

"Dear," said the nurse, "Can I just show your daughter what we found in there?"

"Of course," Linda's mother agreed.

And the nurse began unwrapping the object from the protection of the napkins.

Inside was her precious possession, kept so safely away from damage that it was almost thrown in the garbage.

The photo of her newest great granddaughter in her 8 year old great granddaughter Natasha's lap.

"Isn't it precious," Linda's mother said, in wonder.

Natasha and Hailey

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It was also my mother's 90th Birthday and we rushed from Linda's mom's intimate family event to my mothers larger celebration at the independent Senior's Residence where she lives, about 6 kilometers away. Distant family members and friends not seen in years had come out for the Party. We talked and laughed and took hundreds of pictures.

And came home exhausted. It's surprising how tiring partying with 90 year olds can be.