Thursday, October 4, 2012

On the Home Front

Well, I was going to tell you how Fall arrived right on schedule and how nice the weather has been, which it has.  Right around Labor Day the temperature dropped into the 80s and it's been wonderful for walking and everything else.  But, things have transpired to put all of that in the background.  On Friday, September 21, my mother went to her doctor for a regularly scheduled followup.  I had spoken to him privately about "sundowners" which she has been experiencing for some time and which seem to be getting worse (taking all of the bed clothes off and folding them up, putting her complicated ankle brace on in the dark, talking to people, etc.)....He prescribed Seroquel at that time.  I had the prescription filled but read up on it and decided to wait as it had very mixed reviews.  Since the sundowners continued, we discussed it during her appointment and decided to give it to her beginning that night.

While there, she asked about Gabapentin, which is a medication that a friend of hers said had helped her neuropathy.  This is something we have mentioned repeatedly to her doctor and it was like the first he had learned she had it!!  I was a bit perturbed by that!  Anyway, he said she could try it. On the way home I dropped of the prescription, to be picked up the next day.

So Friday night she took the Seroquel (a low dosage) and slept calmly.  The next morning she was more active and chatty than usual.....more herself, really.  She said she thought it also calmed her anxiety through the day, with the only drawback being that it made her a bit drowsey.  All-in-all at win.  In the meantime, I picked up the Gabapentin and she started that the following day. In a very short time I realized things were happening.......anger, agitation, etc., though I have to say that I've seen this before, especially when she's demanding to go home and stay.  It got so bad that on Monday I "ran away from home".......which proved a big mistake!  I spent Sunday cooking so there was lots of food in the house and I had lot of errands to run, so I excused myself and did them.  I came home around lunchtime and she was out on the front porch and Gabby was out, so I thought he had mistakenly gotten out and she was trying to corral him.  As I drove up, it scared him and he headed to the door, she let him in. By the time I parked and got in the house, she was in her room.  We had a brief exchange and I went back out to get the car washed and finish the errands.  Little did I know that she had become delusional and was imagining this scenario of people in the house hurting her.  There were drugs involved (possibly because of what the medication had done to her) and lord knows what else.  She was still angry and agitated Monday night, which was restless and fitful.  By mid-morning on Tuesday it appeared that she was tiring and settling in bed, so I took a shower.  Allan called as I was getting out of the shower, so I threw something on and we talked.  As we're talking, I hear someone knocking on the front door and my mother is there knocking as hard as she can, looking out the side panel and calling my cousin (who is not there) to come help her.  By the time I get there, she opens the door and goes out on the porch (in her pajamas, night cap, one shoe on and one shoe off).  When I try to approach her, she moves away and as I hold on to the back of her pajamas, she starts hitting me.  So, I move back, fearing that she will fall and really hurt herself.  She calls for help from passersby and then goes into the street.  Someone stopped and kept her attention until I could go in and call 911.  Once they left, she came back onto the porch and we sat there until the police and EMS arrived.  They could not have been better to both Mama and me.  By this time I'm pretty much a mess, too.  Since her heart was racing, they decided to take her to the hospital......I was stunned they would even consider not taking her and I think they realized that.....I don't know how I would have managed her on my own. We were in the ER from about 11AM until finally getting a room at 9PM.  That was an ordeal for me and I can only imagine how my 91 year old mother felt.  Once she was settled and sleeping, I came home for a partial night's sleep.  The next morning she was up and bathing (with the help of a nurse) when I arrived.  She appeared much better, although as the day progressed I realized she was still caught up in her imaginings......thinking the situation would be in the news, there would be a trial and that I was trying to hurt her!  She wasn't so out of it that she did everything possible to get to go home and, sure enough, she was discharged at 5PM!  We had dinner and she stayed up a while, before going to bed and appearing to sleep well.  But, the next day was like night and day....angry, agitated, etc. The following day was quieter and more settled.

The hospital made changes to her meds (including dropping the Gabapentin, which I had already done early on) and told us to see her regular doctor for a followup. We saw him on Monday of this week and they could immediately see a major change in her mental state, by then mostly confusion and major memory loss......and through it all her plea to "go home.....I want to go home!"  It's all just heartbreaking. She doesn't remember her doctors.  She doesn't remember that we were just in NC three weeks ago.  It's amazing that there can be such a change in that short time.  I was becoming more and more aware of confusion, memory loss and how she was appearing to cope......but this change happened over night....or at least over three days. Even today, she saw her eye doctor in the morning and by the afternoon she couldn't remember the details.....she remember we did something, but couldn't remember what.  Add to that the condition of her macular degeneration....she is legally blind now, but she does "see" things in motion, like rain, snow or smoke.  Riding in the car or trying to watch TV really confuses her and makes her feel sick.  It's a dreadful situation and I'm hoping things will settle as soon as possible.

In any case, her doctor recommended a home health nurse come by and make an assessment.  They set those wheels in motion and we were called at 9:30 on Wednesday by Susan, the nurse, asking if she could come at 10AM for the assessment.  She was thorough, friendly, supportive and very gentle with my mother....could not have been better.  From her visit, we have met Michael, the physical therapist, and Florry, the speech therapist.  I wasn't sure what a speech therapist would do, but she will help my mother with her memory and other procedures that might make life easier for her.  I've also received a call from another person whom I haven't spoken to yet so I don't know what their job will be, but I can tell you is that I am so grateful for their support and services, especially since they will happen at home and eliminate the stress and strain of getting to an outside appointment.

In addition to all of the comings and goings of those folks, my mother saw the doctor about her shoulder yesterday and her eye specialist today.  So it has been fast and furious....and pretty much exhausting.  The physical therapist is coming tomorrow and we are hoping to just have some time to rest over the next few days.  While I feel like it has been an ordeal, I can't imagine how difficult it has been for Mama and how frightening is must all seem. I'm doing my best but I have moments of total sadness and emotional collapse.  It's just a difficult time, though I do feel supported by the services provided and the kind, caring people who are helping.

So last night I was going to watch the debate for some reassurance and solace  If you watched and have similar political leanings, you can commiserate.  Cheryl and I "messaged" on our iPads, which was the only solace I received.  I'm sure the President learned from the experience and I don't think it will happen again, regardless of which Mitt he debates; but, boy was that a disappointment.  I think the fact-checkers will disprove a lot of Mitt's rhetoric, but the sad thing is that facts don't really matter.  I read today that many Ohioans think Romney had much to do with the killing of Bin Laden.  Now try to explain that!!  It all defies logic.