Be True to Your Teeth or They Will Be False to You

Sometimes a decision about care for Mother almost overcomes me.  Right now we are struggling with her oral hygiene.  Basically, her teeth are rotting out of her mouth.  She has been in assisted living or in the nursing home for almost two and a half years, and now we are seeing her mental decline manifested in a new way.  She tries to brush her teeth, the staff try to help her and we try to help too.  When she will let us, we floss her teeth and help her brush.  I put on the gloves, trying to not get bitten, and I am as gentle as I can be.  The problem is that she is constantly eating something sweet, and the brushing and flossing is just not adequate.  Every dental appointment reveals more cavities.   This time there was even a crown missing - apparently she swallowed it.  Teeth will have to be pulled.

The dilemma comes for us when once again we have to decide what it best for her quality of life.  How much money do we put into dental work that may be in a tooth that has to be pulled in a few months?  How will this affect her diet and one of the few pleasures she has - eating?  Can she tolerate the dental work?   Just going to the dentist for a cleaning is a major event.  It takes two people to get her there, and we have to hold her hand and reassure her.  She becomes fearful and exhausted.

Sometimes I wonder if I am up to this task.  A friend said to me today, concerning her parents, that she thought she knew about these things, but she is discovering that she knows nothing.  I empathize with her.  I sometimes feel that I don't know what to do or how to do it.  Watching a parent die of Alzheimer's and dealing with the terrible, slow decline is horrifying.  At each step there is one more element of decay to deal with.  I am helpless before it.  I just keep taking one step at a time and try to keep moving in what I think is forward motion.

Going Home

Without a doubt the hardest thing we have had to do so far is making the decision to move Mother to  assisted living and then to the nursing home.  Leaving the home she loved was absolutely wrenching for her and for all of the family.  Her home was more than just a house and a piece of land.  It was and is who she is.  Her identity is rooted in that soil, distilled into that water.  Her spirit was fed by every tree and animal and bird in the woods and meadows.  She walked the woods and fished the pond.  She chopped the wood and cleared special areas for sitting and communing with nature.  She planted her garden and made a home made swimming pool out of boards and black plastic that the grandchildren thought was better than any pool they had ever seen.  She taught her grandchildren about God and about nature in the woods.  She roasted pork loins over an open fire pit she built herself.  At 70, she was on the house putting on new shingles.  She never wanted to be gone from her home.  She even wrote a song about her home in the woods.  Sometimes we thought she might love that place almost more than she loved people.  It has been everything to her.

Now, she often doesn't remember it at all.  If you ask her where her home is, she names her childhood home. She can go months without talking about it.  But when she does, I once again experience the ache and the gut wrenching feeling that I have somehow betrayed her.  Yesterday when we visited she grabbed our hands and asked to go home.  She said she had to get out of that nursing home and go home.  I told her I really wished I could take her home, but I just couldn't.  Then she held my hand, leaned forward and said. " Pleeeeeeeease.  Oh pleeeeeeease.  I am so homesick."  My heart shattered into a thousand sharp fragments. My heart was broken, but I heard myself saying, "It is too late.  We can't go.  I wish I could take you, but I can't."  The look on her face pierced me through.  I comforted her with hugs and told her that my sister looked after the place.  I assured her that we put the light bulb in the well house, swept the porch, and  cleaned the house.  She smiled and said okay. That was it.  The thought of home was gone, and today she was happy.   But my heart still aches today.  I can't get the look on her face as she pleaded with me out of my mind.  I would give anything to be able to restore her to her home and her mind and her life.  It is a bitter heart ache, and I mourn for her loss and for the pain we share together.

It Happens

Mother has adjusted fairly well to life in the nursing home.  Occasionally she asks about her house, but most of the time she asks where she is.  She just can't remember where she lives.  And as sad as that is, sometimes these everyday forgetting episodes take a funny turn. 

Last week when I visited was one of those days when Mother didn't know where she was or who the people around her were.  Her solution to not knowing is to give the people she lives with the identities of people from her past.  I think for her it is a comfort to have old friends and long-dead relatives "living" there too in her mind.

One of the residents who wanders constantly was in the sitting area with us.  She tried to move furniture and pushed the coffee cart out from the wall and was carrying on a conversation with someone.  She approached us and told us to "come on" or we would be late.  She then walked across the room and walked directly into the wall!  Poor thing!  She wasn't hurt, and she came back and sat with us and talked about so-and-so not coming and something about a cash register not working.  It was nonsense, but she expected an answer.  I replied, "Well sometimes that just happens."  She looked at me and yelled, "S- - t happens!"  I said, "Yes, it does."  She yelled it again, got up and wandered out into the hall.  Mother then proceeded to tell me which "family" member she believed the woman to be and said, "She doesn't know anything.  She has lost her mind." 

Sometimes you just have to laugh.  I think maybe the woman spoke for everyone who has Alzheimer's that day.  It happens.

Eating Daisies

From time to time I find the progress of Mother's Alzheimer's disease, just too much to think about.  Last week as I left the home after visiting her, I found myself in tears.  It is usually the small changes that make me weep.  I think it is because I expect the big changes - incontinence, forgetting, having trouble walking - but the small changes are like a slap across the face.

The leaves have been so beautiful, and I thought I could share some of them with Mother.  She has always been an outdoor person and loved the trees and the fall colors.  I walked the backyard and chose the most perfect yellow and red leaves I could find.  But it was one of those days, and when I showed the leaves to her, she yelled, "Cookies!", snatched them from my hand and had them in her mouth in a split second.  I was stunned, but managed to get the leaves out of her mouth.  Silly me, I tried it again.  I held them away from her and pointed out the colors and pattern, and within a second they were in her mouth again.  Once again I got them away from her and went and found a cookie for her.

Eating the nonedible (paper, dirt, flowers) is called pica, and it is a disease.  In Mother's case, it is a result of the Alzheimer's.  Last year she began to eat flowers from arrangements in the home.  This summer, I had to stop taking her flowers because she was eating them. This is what made me cry.  Mother loved flowers.  The last few times I took flowers to her, she cried and kept saying "how beautiful."  Now that is gone.  Of course I can take artificial flowers, but it is not the same.  Alzheimer's is stealing even the small pleasures of beauty from her.  I weep.  I rage.  But that part of her remains stolen.