Since this phase of Mom’s life has unfolded, the psych major in me can’t help but find some fascination in her condition. (I have a BA with Honors in Psychology from NYU). Often, when Mom can’t find words for what she wants to convey, she speaks in metaphors. Boats loom large in her metaphorical vocabulary. When she first got to rehab, she was very happy and thought she was on a cruise ship. Later, when her paranoia was in full swing, the thieves were trying to steal our boat.
Before her dementia became evident, another metaphorical term was established: “Home.” Shortly after my father died in 2004, all my mother wanted was to go home. Florida. Hallandale. Her apartment. I arranged my schedule so I could take her back.
On the appointed day, I flew down with her, shlepped her luggage, picked up the rental car and drove to her place. As we approached her block, I told her to smile, she got her wish, she was home. She drew a breath and sobbed “I’m in hell.”
Resisting the impulse to punch her, I took a deep breath. I had jumped through all these hoops to get her back to her beloved apartment, her home. But it finally sunk in; she didn’t want to just go back to her place; she wanted to go back in time, to the life she used to have. “Home” was a metaphor for the life she had loved but could not reclaim.
Late last week, once Mom returned to the psychiatric hospital, my brother went to see her. She was glad to be there; it was better than the rehab center (which had gone from cruise ship to den of thieves in a matter of days). She asked my brother if he was going to see Dad while he was there. “Dad’s HERE?” he asked. “Who do you think is driving the ship?” Mom replied. This little exchange had me giggling for the next couple of days.
Bob and I went away for the weekend; a Saturday night concert in Asbury Park, a hotel stay in Lakewood followed by a dolphin watching cruise out of Atlantic City on Sunday. Just another little respite for the terminal caregiver.
I called the hospital on Monday to see how Mom was doing. They were glad I called. Mom had wanted to speak to me over the weekend and they had called my home number rather than my cell (how many times does one have to clarify contact information?!). The nurse taking care of Mom said she was “doing great” and they thought she might be released mid-week. The psychiatrist confirmed this prognosis.
Then I spoke to the nurse from Emeritus who had gone to evaluate Mom that morning. She found her to be profoundly confused. Mom told her that I had been in accident and was in a coma. The nurse assured her she had spoken to me recently and I was fine. Mom insisted it had just happened. I thanked her for the information and asked if she thought Mom had a chance of returning to assisted living. “I’d like to see her a lot more stable.”
I went to visit Mom so she could see I was OK. I got caught in a huge traffic jam and arrived after visiting hours, but was permitted to see her anyway. When I got to the floor, Mom was in a group session. She lit up when she saw me. Going by the comments I heard from her colleagues, Mom had been crying and upset that her “sister” was critically injured. I introduced myself as her daughter, Tracey, and let one and all know I was quite all right, despite the hour sitting in Paramus traffic.
We went to Mom’s room to chat. She had been collecting items in little baskets. I looked to see if they’d given her any of the clothes and personal effects I’d brought her. I couldn’t find much in the room. She remarked that she didn’t even have a tube of lipstick.
I went to the nurse’s station and asked about her stuff. They kept her suitcase locked up in a hall closet. Could she have her make-up? She couldn’t keep it in her room, but she certainly could use it when supervised. I handed the cosmetic bag to her and she smiled broadly. “That’s what I meant to pack!” Okay, good. You can have this whenever you want it, Mom. It’s yours. Just ask the nurses.
She fished out a tube of lipstick and put it on without a mirror. She brightened. She picked a bright fuchsia color, which complemented her tie-dyed tee shirt.
Her confusion was obvious, but she was calmer. Her thoughts were even cloudier than usual. This is doing great?
Today, I called the Alzheimer’s Hot Line. The woman I spoke to listened patiently and sympathetically. She heard my concerns and frustrations. She recommended I reach out to the caseworker at the hospital to see if we could talk about Mom’s next steps. Maybe she and/or Mom’s doctor could recommend an appropriate “Plan B” facility.
I called the caseworker at Holy Name and voiced my concerns. She said she had spoken with the doctor this morning and he was still looking at releasing her mid-week (today is Tuesday). I asked where they proposed to send her and if they felt she was stable enough to return to assisted living. She said they would coordinate with Emeritus. She also said that there was another facility I might consider, and it’s at the same address as Emeritus. They take only memory impaired patients, many with psychiatric issues.
Speaking with the referred facility, they sounded appropriate, but they don’t accept Medicaid. That means that when the money runs out, Mom would have to move again. Not acceptable. So Emeritus is the better choice. I’ll just have to talk to them about moving Mom to the “memory” side of the building and the associated costs.
As I was writing, Mom called me. She’s upset. There’s trouble. Mike was shot. Who’s Mike, Mom? “My husband to be.” He’s dead. She saw him. They don’t want to keep him in a casket. She’s exhausted, her back hurts and her mouth keeps sticking together. Okay, Mom. I’m going to call the desk and ask them to help you.
I called the nurse’s station and told them my mother was in full-blown delusional mode, that she believes a man was shot and killed, that she needed some water and probably needed to lie down for a while. I was thanked for the heads-up on Mom’s condition and assured they would act on it.
It is possible that “Mike” being shot is a metaphor for the death of this particular delusion, but I wouldn’t bet the ranch on it.
How can a woman who is so clearly in distress be defined as “doing great” on track for imminent release? What kind of metaphor could be applied here? Kicking a can down the road sounds apt. But if I have anything to say about it, that can isn’t getting kicked anywhere until I know it will land safely on a comfortable shelf.