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[gennimom]

Yeah. My SIL, who lives next door to them, takes them to their appts now. Pop had his first chemo treatment yesterday. While GD was talking to Pop about it on the phone, for some reason I just started crying my eyes out. It brought back the memories of my own father and his treatment. The only difference is, we thought my dad had a chance to beat it. Pop can only delay it a little.

[mended_drum]

My mother recently had cataract surgery (and now has 20/20 vision for the first time since she was in junior high), and when the nurse was checking her vitals, the three of us had this conversation:

Mom:  Where's the good-lookin' doctor?  I want him.

Nurse:  Which one is that?

Mom:  Now, you know which one.  The one with the nice hair and the nice butt.

Me:  Mom!

Nurse:  I know which one you mean.  But his partner is a very good doctor.

Mom:  That's not the point.  If a man is going to be poking me with something, he's better be good looking!

Me and Nurse:  <giggles>

Mom:  What?  I know what I said.  And it's a rule I've followed my whole life.  Good looking men may poke; ugly men may not.

[gennimom]

MD, I can see the nurse sharing this story with her office mates later, and they'll all be rolling on the floor with laughter! Elderly parents can be as bad as kids sometimes!

[compdoc]

Mended_drum, My dad is the one who would say something like that and, yes, the nurses will laugh, perhaps for days. But it won't hurt anyone and they will remember your mom when she comes back and... It's really a good plan that your mom has, after all, so...

However, I sometimes think my parents are trying to get our goats when they do stuff like this.

[gennimom]

And sometimes they mean it.

My dad, when asked if he was Catholic because he had 7 children, replied that no, "just passionate Protestants." He couldn't have been out of his 40s at the time.

All children in range nearly died of embarrassment though.

[barred_owl]

I think I'm glad that my parents were never very forthcoming about things related to sexuality, having heard these stories now!

That said, a friend of our family, now deceased, had a "fling" while she was in a nursing home.  Apparently, she (a widow) met a man there and the staff had a heck of a time keeping them apart.  They'd go to our friend's room, only to find her gone in the middle of the night--but found her down the hall in the man's room, in bed with him.  I guess it just goes to show that you're never too old for that sort of thing!

[compdoc]

Yes, it can be a little disconcerting. But my parents were very upfront about sexuality all my life, so it's nothing new to me. The nurses, doctors, PTs, etc, however, find it new and disconcerting/funny.

[reener06]

I have a question about "re-orienting". My mom is suffering from Alzheimer's which has progressed rapidly in the last 6 months, due in part to chemo treatments for lung cancer (yeah, not a good year for us all around). She is growing increasingly confused and confuses information about my siblings, my dad, etc. For example, she was sure my Dad sold our old house w/o telling her and she wants to go home. She also forgets that many people close to her--her brother, her parents--are dead. When this began, I upset her accidentally by mentioning the death of a friend and decided it wasn't worth her emotional upset to "correct" her when she states that Uncle L is alive or her mother is sleeping in the next room.

But...I have 2 sisters, both nurses, who keep correcting my Mom about every large and small error she makes. One sister insists we need to "re-orient" Mom. I'm not in the medical field, but I thought reorienting meant letting Alzheimer's patients know, for example, that they already ate breakfast so it was time for lunch or something to that effect. My sister says we need to reorient and tell her for example as she did recently, that her brother was dead. Which upset my Mom greatly and she had a hard time believing it. What is the point of this? I want to protect her from as much emotional trauma as possible--I should think she is already confused enough, and this isn't helping. But my sister insists we need to do this.

Any help understanding this is much appreciated. And yes, this is my annoying, bossy older sister who I have I hard time listening to, so I'm also trying to see if my problems with her are getting in the way of me doing what's best for my Mom.

[2much2do]

I just went to the Alzheimer's association annual conference, and heard a really great presentation by an occupaitonal therapist named Teepa Snow.  She used a model that referred to "gems", and discussed what to do and what not to do at different stages.  I found it very helpful for my Mom - it really explained how to help her and when to leave her alone.  Basically, reality orientation is fine in the early stages when they might remember, but later, she believes that you don't correct and don't lie "oh, your brother just left".  You restate their question, and then ask them a question about the topic.  It was a fabulous, non-confrontational approach that seemed to be very respectful. Now, I have the same problem you do - how to get my siblings to buy in.  But this powerpoint gives all the basics, and should help them "see" your Mom in a different light.  (I'm not sure I did the link right, but you can cut and paste it into a web site)

http://www.pinesofsarasota.com/Teepa%20Snow%20Gems%20of%20Caregiving.pdf

She also used some very powerful group experiences that helped people clearly understand how the client might feel.  The best one was, to a roomful of mostly professionals at the end of the day.  "What if, when you were ready to leave here, we told you that you were going to live here now?  And, when you said you needed to get home to your kids and families, we said that they weren't there.  And when you said the conference was over, we said 'Oh, that conference was 20 years ago.'  Would you believe me? Would you get upset? Might you try to call someone for help, or become belligerant?"  And, all of a sudden, it became very real that when the clients or family members think they are in a different time, they are as sure of it as we are sure that it isn't that time. Anyway, I hope this is helpful. 

I hope that helps -

[stitch]

Reneer, I agree with 2much2do.  It sounds like you are farther along in accepting your mother's current condition than your sister.  Repeatedly reorienting someone to the death of their spouse or other family members is torture.

Perhaps it's time for a family meeting/patient treatment planning type meeting?  At the facility, with the social worker, and possibly the Dr if that's the only authority you think sis will listen to?

Good luck.

[paultuttle]

I just went to the Alzheimer's association annual conference, and heard a really great presentation by an occupaitonal therapist named Teepa Snow.  She used a model that referred to "gems", and discussed what to do and what not to do at different stages.  I found it very helpful for my Mom - it really explained how to help her and when to leave her alone.  Basically, reality orientation is fine in the early stages when they might remember, but later, she believes that you don't correct and don't lie "oh, your brother just left".  You restate their question, and then ask them a question about the topic.  It was a fabulous, non-confrontational approach that seemed to be very respectful. Now, I have the same problem you do - how to get my siblings to buy in.  But this powerpoint gives all the basics, and should help them "see" your Mom in a different light.  (I'm not sure I did the link right, but you can cut and paste it into a web site)

http://www.pinesofsarasota.com/Teepa%20Snow%20Gems%20of%20Caregiving.pdf

She also used some very powerful group experiences that helped people clearly understand how the client might feel.  The best one was, to a roomful of mostly professionals at the end of the day.  "What if, when you were ready to leave here, we told you that you were going to live here now?  And, when you said you needed to get home to your kids and families, we said that they weren't there.  And when you said the conference was over, we said 'Oh, that conference was 20 years ago.'  Would you believe me? Would you get upset? Might you try to call someone for help, or become belligerant?"  And, all of a sudden, it became very real that when the clients or family members think they are in a different time, they are as sure of it as we are sure that it isn't that time. Anyway, I hope this is helpful. 

I hope that helps -

This is really useful.  Thanks!

[reener06]

Yes, thank you 2much2do for that link. I found it really useful and will try to pass it along to at least one sister. Stiche, it's not just one sister, it's 2 and my Dad who are acting this way. Actually, my Dad takes cues from these sisters who are both nurses and older than me. I think one sister will be interested in the powerpoint and get some pointers from that; the other is likely a lost cause. Also, we (there are 7 of us) are spread across the many states, so having us all get together is pretty impossible. I am trying to push my Dad to get in-home care, but he was sick and hospitalized recently, so things move rather slowly. Partly I wanted to make sure that it was worse to reorient her in this way than not do it, as sister insisted we "had" to do this. I just couldn't bear to see my mom in such emotional pain that seemed pointless. I think I am farther along at accepting this, and I'm just going with the flow and taking cues from my Mom; my sisters act more like she is a recalcitrant child who needs to be corrected. Funny, as they are in the medical profession...

Thanks for your help.

[paultuttle]

. . . . my sisters act more like she is a recalcitrant child who needs to be corrected. Funny, as they are in the medical profession . . . .

My mother was a nurse who was trained (in the late 1950s) that elderly people somehow "regressed" back to their childhoods and therefore that the appropriate way to treat them was like children.

When she told this to me when I was a teenager and she was dealing with her mother's increasing dementia, I told her that was a crazy way to think about dementia and growing older.  She didn't appreciate that, but I stood fast.

Think about it: Children have no memories of times when they had it all together as adults, but the elderly do.  Yes, there are times (in advanced stages of dementia) when some elderly people "travel back in time" and act from the perspective of the children they once were, but by and large, in most of the earlier stages, elderly people can remember--even vaguely--a time when they were capable, competent, or otherwise savvy. 

(And that, to me, is the scariest part of growing older and experiencing dementia: KNOWING you're losing it and not being able to stop or slow that process.)

After 25 years, my mother and I have agreed to disagree. 

And interestingly enough, as she grows older (she's 72 now), I treat her like I know she should be treated, NOT as she was trained to be treated.  I think she appreciates the distinction, somewhere deep down, even though on the surface she still disagrees with me philosophically. :wry smile:

[2much2do]

Reener06, I'm glad you found that helpful.  I liked her approach.  I think that one problem with family members who are in health professions is that they have a lot of experience distancing themselves from the individual. 
And, I think that in the case of dementia, what they anticipate in the future can be so painful that they use that separation to make it tolerable.  Or, as in the case of my sister, they are just a jerk.

[msparticularity]

Reener06, I just want to add in another thought here--which is that your sisters' nursing experience is very likely to have had a lot to do with "reorienting" people who are suffering from short-term memory problems--such as after head trauma and similar things. Training for geriatric challenges and dementia is actually quite different, and is not generally a part of nursing education unless the individual has pursued additional credentials in geriatric nursing. The fact that your sisters are reverting to their own nursing experience even though it is inappropriate in this context possibly (probably?) says a lot about their level of denial right now.