Tag Archives: Alzheimers

A Blessing

Nursing homes can be expectedly awful.  Nursing homes can be unexpectedly wonderful – like how the Nurses’ Aides dress Mom so that her clothes match and carefully comb her hair.  She looks better coordinated and more kempt than when she was in Assisted Living and dressing herself with Alzheimer’s eroding her ability to do so.

There is a certain little old pillow that stayed in her closet in Assisted Living, and which I put in her closet in the nursing home.  It’s nearly as old as Mom herself – ninety years old – because it was hand made for her by my grandmother when she was a little child.  I thought a time would come when that little old pillow should go onto the bed although I think she has forgotten the significance of it (and almost everything else.)  But she has been sleeping more and more as she loses the ability to talk or even smile.  Two afternoons ago when I visited her, she was in bed, comfortably asleep, with the head of the bed raised somewhat and extra pillows to help prop her up – with the little old pillow tucked over her shoulder for her head to rest on. God bless those Nurses’ Aides.


Music is something people remember and respond to when almost all else is lost.

Yesterday there was a singalong at my mom’s nursing home.  It is at least a weekly event, when a lady brings sheet music and song word books and plays the piano in the downstairs event room for those residents who get there on their own or who are brought by the staff.  The songs are golden oldies like “Red Red Robin,”  “Grand Old Flag,” “Sidewalks of New York” and others familiar to these folks from their youth or adulthood.  Wheelchair-bound and more or less feeble, a couple of the residents knew just about every word of every song by heart and could sing along.  Other residents wordlessly enjoyed the songs.  My mother seemed pretty far out of it, half asleep and nearly motionless.  But I noticed one of her hands gesturing in time to some of the songs.  And she took her foot out of the wheelchair’s footrest and put it on the floor and tapped her toes for “Alexander’s Ragtime Band.”

The End of the Day

My mother has been failing slowly all year.  Then she had a health crisis in the summer. After two ambulance trips to the emergency room and a five-day hospital stay, crisis turned into catastrophe and landed her in long term care in a nursing home in Georgia.  Since she is ninety years old and has had Alzheimers for years this was not exactly a surprise.  It grieved me, though, and I think it grieved her while she still had hold of that part of her memory,  that she couldn’t return to the wonderful assisted living facility where she was safe and happy for four and a half years. But there was an up side:  no more reason not to bring her to Houston. I was able to get her to Houston and into a reputable facility called the Treemont.

As soon as the first mildly cool front of the year blew in, I took my mother on what may have been our last walk together. She was in the wheelchair she can never again not use.  I pushed her on the sidewalks around the grounds of the Treemont. We looked at the flowers and acorns, leaves and oak trees.  I plucked a morning glory flower from a bed of ground cover.  She held onto that little purple flower all the way back into the building and upstairs to her floor.

She’s in worsening shape.  Last night, it was all she could manage for me to push her to the end of the hall to look out the window at the clear cool sunset sky. She told me she wants to go home.  I have no idea if she meant Assisted Living, or the modest little house on Mayfield Drive where she lived for f thirty years, or the farm where her family lived when she was a child.  She is hardly articulate.  I told her that she is very sick and has to be where nurses can take care of her day and night.  And then I prayed with her, because now her once and future home is the nearer presence of God.  May she get there in God’s good time soon.

thanks, Mom

My mother saw me fly in a sailplane exactly once.  That was when I drove her up to the  Mid-Georgia Soaring Association to see gliders and see me launch and land in a demo ride with one of the club pilots in an ASK-21.   Mom declined a demo ride for herself, but really liked the whole idea and has been totally supportive ever since – even now.  Eight years after that summer soaring day, she has moderate Alzheimer’s and can’t remember what we said three minutes ago nor  remember the house she lived in for thirty years until three years ago – but she still likes the idea of me flying gliders.  Today I called from Texas to wish her a happy Mother’s Day where she lives in Assisted Living in Georgia.  I told her that I’d had a wonderful flight an hour and a half long this afternoon with an instructor, knocking off rust from the years when I had to be inactive in soaring.  She enthused.   Thanks, Mom, more than I can say.

Visiting Mom

I’m in Georgia again, visiting my mother again.   She’s in better shape than the last time I came this way.  That time she’d had a couple of falls and was in a wheelchair.  This time she’s getting around with a walker and thanks be to God, she’s once more smiling and laughing easily.  Alzheimers or not, good humor makes for good company.  That being the happy case, we never run out of conversational topics.  I can always recycle a topic because she forgets we covered it.

Mom is 89 years old.  All in all, I think she’s had a good life and in part a very interesting one.  She joined the Womens Army Corps during World War II, and liked it well enough to stay in for nine years, reaching the rank of Master Sergeant.

The vital village

Here is a quote I comprehend intensely. It’s from an article in yesterday’s New York Times on line about South Korea’s rapidly growing elderly population and explosion of Alzheimer’s cases.  South Korea has the Confucian tradition of respect and lifelong care for one’s elders called filial piety, but experience is showing that dementia in the elderly erodes filial piety.   Here’s the quote, from a social welfare director named Kwak Young-soon:  “There’s a saying that even the most filial son or daughter will not be filial if they look after a parent for more than three years.” It’s true.  A parent with Alzheimers becomes contrary, illogical, difficult, frustrating, paranoid, heart-breaking and/or crazy-making enough to exhaust the  filial piety of almost any adult child.

In the United States, sons tend to go into denial – insisting it’s not really so bad.  When that fails, sons tend to go AWOL.  Daughters tend to become the designated care-givers and then willingly or not they undergo terrible stress and strain.  I saw very early on how crazy, mad, and bad my mother’s Azheimers made me feel when she was still living in her own home and I went to visit her and try to take care of her and the house.  This is not a good idea doesn’t begin to cover it.  Assisted Living was the only way to go.  It  turned out extremely well for me and for her as well.  If you can afford it and find a good place (those can be big ifs) Assisted Living is a blessed port in the storm of Alzheimers.

This was underscored in a talk given a couple of weeks ago at my mom’s Assisted Living facility, the Gardens at Cavalry in Columbus, Georgia.  The speaker was a geriatric psychiatrist from Atlanta, Dr. Larry Tune.  He told the intent audience of adult children and caregivers that one of the only ways to slow the progression of Alzheimer’s is a structured and highly social environment.  Assisted Living and day care work really well.  An adult child quitting her job to take care of Mom or Dad at home may not work so well.  It turned out that one woman in the audience was in exactly that position.  Dr. Tune radiated concern for her situation.  A  lady stood up to announce that she was with the county agency on aging and wanted everyone in general, and the caregiver daughter in particular, to know about the agency  resources for Alzheimers people and their families.  We want you to know that you’re not alone, the lady emphasized.

They say it takes a village to raise a child.  It takes a village to see an elder with Alzheimers to a good end of life.  This Thanksgiving of 2010, I’m thankful  that my mother has that.

Good enough now

I just had an unusually well-timed emergency.  My mother, in Assisted Living in Georgia, took a fall and injured her leg, after which they put her in a wheelchair since she was unable to safely walk.  As it happened I already had airline reservations to fly to Georgia this week.  So I was with Mom at the doctor, who thought it may be a hairline fracture.  The doctor took X-rays and prescribed Ibuprofen and physical therapy.  The doctor also took her off sleeping pills.  Since sleeping pills can make a person groggy and prone to falls, I’m all for that. Mom got mixed up when the nurse’s aide explained why there was one less pill last night.  Mom took it to be no more Namenda – the Alzheimer’s drug.  I checked up on it for her.  Lunesta is the pill that has correctly been dropped out of the pill cup.  In the meantime, the physical therapist is teaching Mom how to use a walker, which will be safer than walking unaided, and far better than her being stuck in a wheelchair.

Mom is feeling better and more like herself – her Alzheimer’s self, which is chronically forgetful and vague and sometimes paranoid but, fortunately, still appreciative of the natural world.  The dining hall at the Gardens at Calvary has big windows with views of a creek watershed out back, pines and deciduous trees in fall colors, and yesterday at lunch Mom looked out and recited an old scrap of poetry or song:  “The world is so full of beautiful things that we all should be happy as kings.”*  Today she told me that she is very fond of the potted flowers on her porch and waters them all along.  They are artificial flowers but it’s the thought that counts.

It’s not like all is well again or can be.  She’s almost 89 years old with Alzheimer’s and an injured hip.  But she’s in a good, caring facility – thank God she can afford that on her teacher’s pension and Social Security – and she’s not in pain.  Maybe what she feels about her situation is similar to what I feel and think:  that all is good enough for now.  Tomorrow will bring what it brings.  And so will the day after.

*Wikiquotes says that a version of this is  by Robert Louis Stevenson’s in A Child’s Garden of Verses.

Beautiful Shore

The office of my mother’s neurologist can be a grim place.  Not the ambiance (well lighted and nicely appointed) and not the staff (cheerful and unfailingly professional.)  It’s the patients and their families facing Alzheimer’s.  Three years ago my mother and I were there.  I knew the gist of what the doctor was going to say and Mother suspected it.  That was a grim afternoon.

A couple of days ago we were back for her to have a follow-up evaluation of how her Alzheimer’s is progressing.  Short answer:  it is – but much less rapidly that would have been the case if the neurologist had not put her on the gold-standard Alzheimer’s drugs, Aricept and Namenda, three years ago.  Mother still recognizes me and we can have conversations.  Circular ones, because she loops back to earlier topics with some of the loops being three minutes or less.  But it’s bona fide conversation and typically pleasant.  She’s a surprisingly happy person, in large part because she lives in a wonderful Assisted Living facility where she has good care, nourishing food, and many friends.  And where there’s a Chaplain.  I like going to Chapel there on Sunday afternoons, like today.  It puts me back in touch with my Baptist-Methodist roots.

As for my end of the mother-daughter relationship, well, it’s true that Alzheimer’s is a long goodbye.  On the other hand, in her case the disease lost no time knocking out some of her dysfunctional circuits, especially her crippling inhibitions.  In some ways she’s a more normal – less crippled – person and mother than she used to be.  She’s in a more invigorating and resilient social matrix than when she was almost a recluse when I was young.  I travel from Texas, where I live, to Georgia, where she’s in Assisted Living, about four times a year for week or so.  Every time I visit, she introduces me to several of her friends and neighbors.  Sometimes more than once to the same people, but they don’t mind. To be brutally honest, my mother’s Alzheimer’s has given me gain as well as loss.

She’ll worsen in every imaginable way if she doesn’t die first.  She could suddenly deteriorate at any time.  For the days of this fleeting week, though, I’ve enjoyed seeing her.  With financial, legal, and practical things squared away after three years of hard work, this time around I have time to visit her and, well, just relax.  Alzheimer’s is not utterly incompatible with people relaxing and even having fun.  We’ve laughed a lot.  Thank  God so far she still has her same sense of humor:  self-effacing and kind-hearted, never mean.  She reminisces, pulling up old memories with startling clarity compared to her blurry grasp on the here and now.  That’s typical for Alzheimer’s people.  I’ve gleaned bits and pieces of her family and personal history that I never knew before.

The neurologist ran late.  Given his intrinsically unpredictable clientele, I was not surprised.  Mother and I had time to sit in the pleasant examining room with its view of a lake and pine trees.  She  sang a ditty from when she was in the Women’s Army Corps that went on for several pointedly funny verses. Alzheimer’s people tend to retain songs even after they lose almost everything else.  Soon she was singing the old popular song “Blue Heaven.”  There’s a line in that one about whippoorwills calling.  She demonstrated a whippoorwill call she learned how to do growing up on a farm.  Then she recollected how her mother, my saintly grandmother, used to play the piano, one old Baptist hymn in particular.   I remember it.  We sang together, “There’s a land that is fairer than day…in the sweet by and by we will meet on that beautiful shore.”   Lord only knows what the doctor’s staff thought about what they heard through the door.  Probably they appreciate having happy patients and families for a change.

If you believe that love is stronger than death, and that our ancestors can care about our welfare and even in some way visit us or help us if we ask them to, then Alzheimer’s is a conundrum.  The mother or father, wife or husband or sibling that we knew raggedly fades until in the end there’s a demented and severely impaired stranger in their husk.  When do they really die?  With this question on my mind, I asked a spiritual director if she thought it possible that our ancestors may  partially, or paradoxically, slip into the nearer presence of God before the body dies.  She slowly said yes – that might be.

The truth we don’t know.  I do know it gives me comfort to think of my mother as being already partly in the nearer presence of God and in the embrace of my grandmother while it’s my job to be kind to the person who is still here.  She’s partly familiar, partly strange in a crazy-making way.  She’s heartbreakingly impaired and frustrating to deal with.  And sometimes something shines through her like light through a darkened house on a stormy night with a dark wind twisting the curtains.  The house of her mind is ill-lit by guttering candles of rationality.  The dim rooms of her soul are haunted by gentle old memories and ungentle, ugly paranoid notions.  But through the flailing curtains and rattling shutters and framework falling apart, there’s a gleam of dawn beyond the house, behind the storm.

Making Rounds with Oscar

When somebody may be suffering from Alzheimer’s,  neurologists and geriatricians administer certain cognitive tests.  Some of these tests are devastatingly simple.  One such test asks  the patient to draw a clock face when the time is 2:45.  People with Alzheimer’s are very likely to draw a clock with the short hand on 2 and the long hand between 4 and 5.

I learned this in a remarkable little book.  Making Rounds with Oscar (Hyperion 2010) was written by David Dosa, a geriatrician who works in a nursing home in Rhode Island.   Oscar is a tabby cat who also works in the nursing home. . . a resident companion animal along with several other animals and birds.  (Enlightened nursing home!)  Oscar has a unique talent.   He knows when somebody is dying.  He  goes and stays with them until the end, whether they are all alone or surrounded by grief-stricken loved ones.

This is a helpful, healing book about Alzheimer’s,  the end of life, and the mysterious connections between people and pets.  The savory irony is that Dr. Dosa is not a cat person.   He never gets to the point of doting on  Oscar – but he comes to respect the reality of the comfort Oscar brings to the dying and their loved ones.



The first time my mother and I ever visited the Gardens at Calvary, we noticed a bluebird perched in one of the slender trees on the Moon Road side of the grounds.

Mom was not happy to make such a visit at all.  She was very reluctant to consider leaving her home of many years to move to assisted living.  But the little bird with its bright blue back and rusty breast seemed like a good sign to both of us. There ‘s an old figure of speech—celebrated in at least one big band song—about the bluebird of happiness.

The hope of happiness came true.

For Mom, happiness is having friends and companions and living a place where she doesn’t need to manage all of life’s details by herself.  It makes me happy to know that she’s safe in the care of capable and compassionate staff, in a building that’s attractive, well-designed, graced with natural light, and located beside a stream with trees and wild creatures.

For both of us, it matters that an assisted living facility be faith-based.  One inescapable truth is that people in assisted living are fragile in body, mind or both.  They exist in a holy place, not very far from death, and therefore closer than most of the rest of us to the nearer presence of God.  That truth needs to be honored.  At the Gardens, it is. Vern Jordin is an able chaplain.  I’ve attended his Sunday services with Mom.  The flock is small and fragile;  Chaplain Vern cares for each one of them tenderly.  When Mom’s last living sibling died a couple of years ago, Chaplain Vern sought Mom out minutes after I spoke to the staff in the front office.  He sat with us in the private dining room while the news sank in.  Mom was able to begin to grieve for her brother there, in that sheltered place and time.

Last fall, I finally visited the Greenhouse—the special Alzheimer’s place up the road from the Gardens.  Knowing that Mom may one day need to live in the Greenhouse, I had to see how it felt.  It felt gentle and good.  Now I know not to be afraid of Mom being there in her final days.

This is the third springtime since we first visited the Gardens.  There are still bluebirds around.  My mother and I are happy that she found an unexpected new home at the Gardens at Calvary, thanks be to God.