The Lesser of Two Evils

Sometimes in this journey through Alzheimer's, we are faced with choosing the lesser of two evils.  That was the case this week for me.

Mother's left hand has become even more contracted, and she can rarely open it and it hurts her. The aides at the nursing home have to pry her hand open each morning to take off the brace she wears at night.  She screams.They have to pry her hand open to wash her hand because she keeps it in such a tight grip that her palm gets yeasty and can get infected.  She screams. They have to pry her hand open to cut her nails.  She screams.  They have to pry her hand open to put a rolled up wash cloth in it for the day, and if she pulls it out with her teeth, they have to do it again.  She screams.  They have to pry her hand open to put the brace on at night. She screams.

The doctor suggested botox injections to help her muscles relax and to release the contraction in her hand.  I thought it was worth a try.  But I was not prepared for the process of getting the shots for her.  I explained over and over what was going to happen.  The doctor explained.  Mother looked at her arm, but none of what we said made sense to her.  I held her arm.  My husband held her other hand and tried to distract her.  The doctor placed the needle in her arm, and she screamed bloody murder.  The look on her face broke my heart.  She was terrified and angry.  She tried to bite me.  She was like an animal who doesn't understand that it is only a small sting.  She screamed at the top of her lungs.

After four or five shots, it was over.  She was fine, and amazingly, she had absolutely no memory of the shots.  She was calm and smiling at everyone.  Her arm didn't hurt.  She was happy, and she had no grudge towards me or the doctor.  It was as if she were trying to figure out what we were all doing there.

But in my mind I can still see her face contorted in terror and pain.  I can still hear her scream.  It will take two weeks to know if the botox will help with the contraction, but I don't know if I can put her through those shots again.  But therein lies the dilemma.  Do I put her through the trauma of botox shots or the daily trauma of prying open her clenched hand.  Which is the lesser evil? Which is the more loving? There are no easy answers to most of life, and there are definitely no easy answer here.

Looking at the Mountains

When I was about eight years old, we took a family vacation to the Rocky Mountains with friends.  I loved the whole experience and didn't want to leave.  But as with all things, the vacation had an end point, and we loaded into the cars and headed east.  I was riding in our friends' car with their daughter, and as we headed into eastern Colorado, my friend's father told us to turn around for our last glimpse of the mountains. "You might never see them again," he said.  To never see the mountains again struck me as an impossibility, and being the stubborn child I was, I refused to turn to look.  I knew in my heart, I would see them again.

And I have seen them again.  I lived in them for five years and have enjoyed many visits since that time.  But as I grow older, I do turn and look at the last blue fingernail of mountains as we head east.  I watch in the mirrors and turn in my seat, trying with my whole being to keep my eye on them.  I don't want to miss the last glimpse as the disappear below the horizon.

Mother gets that look in her eye now too.  On some days she will stare deeply into my eyes and say my name softly.  She really looks at my face as if she is trying to memorize each feature.  It is as if she is turning to look because she may never see me again.  I wonder if somewhere deep in her mind she is trying to hang on to every last bit of her memory.  She is trying to emblazon the images into her mind because at some level she knows she is dipping below a horizon and may never see the images again.  Each face, each moment is looked at intently. For Mother, every day is possibly the last day she will remember.

Turn and look, you might never see them again.

Old Lady Fights

One would think that life in a nursing home, in an Alzheimer's unit, would be monotonously the same, but it is not.  From time to time the full moon, or a weather front, or just the dynamic of group life creates an electric moment when all order disappears.

In the nursing home, the men may shout or get rough momentarily with each other, but with the women, it is another story.  They are more like adolescent girls, and they can get quite ugly.  At school, we know that boys may come to the brink of a fight, or they might even throw a punch, but it is over quickly.  On the other hand, a girl fight can be vicious, and the friends of the girls will take sides and join the fight.  It happens with the old ladies too.

In Mother's Alzheimers' unit, many of the residents spend time sitting in the dinning room/ lounge.  Mother has a favorite table in a small adjoining dinning area where she can see the TV and watch the other residents.  Recently, two of the old women were aggravated with each other.  One stood in the hall and threw insults at Lulu.  Now, Lulu is tall and thin, and has had a broken hip, which she will tell you hurts her terribly all the time, but the insults were too much.  She flew out of her chair, well maybe I should say, she hobbled more quickly than usual toward the insult thrower.  She was ready to fight, and went at the other woman as one would a stray dog.  She shooed her away, told her to shut her mouth, and threatened to slap her.

The woman retreated somewhat, but as Lulu returned to her chair, she decided to use an obscene gesture to make her final point.  Unfortunately, as Lulu's finger went into the air, I noticed that it was the wrong finger.  The other woman made a retort, and Lulu made her gesture again. I have to say that Mother had watched the whole thing intently.  Then Mother looked at me, grinned, and yelled," Up your ass!"

I have never heard my mother say anything like that before, but she was smiling and loved being in on the old lady fight.  Mother found some delight in the phrase, the finger and the whole situation and made her response again, only louder.  I suggested that she say something different, but on she went shouting again and again.

Finally, I said,"You enjoyed what Lulu did, didn't you."  She sipped her tea and gave me a wink and a smile.

Old lady fights.  I had to laugh.  The whole thing was hysterical.  Never a dull moment in the Alzheimer's unit.