Last night Stacey and I spent the night at the convalescent home. At first things were going well. Dad was in an ok mood. I'll probably get some of the details wrong. It was a rough night.
Some of the nursing staff at this place are very good. Some of them are clueless idiots. One of them showed up to take Dad's vital signs. Stacey tried to gently wake Dad up but the nurse dope got ahead of her and switched on the light. Dad woke with a start and was immediately agitated and angry. He started yelling at us and the nurse to get out. Stacey tried to calm him down but he was having none of it. Junji, his room mate, was having a very hard time last night. He's also a stroke patient and he has a lot of trouble breathing. Sometimes he makes these horrible, rattling noises while he's trying to clear his airway. When Dad hears this it makes him angry. He kept trying to bat at the curtain between their beds. Junji's nurse was moving in and out, trying to do her job. Dad kept yelling at her to get out. He kept saying he was going to have us all thrown in jail. At one point Stacey firmly pushed Dad down onto his bed and practically laid on top of him to restrain him. Dad tried to bite her. The male LVN on duty came in to see if we needed help. When Dad saw him he yelled some more. Lots of cussing. He screamed for help. Stacey held onto him until he wore himself out.
Somewhere in all this I called Dede to see if we could get him a sedative. Unfortunately one wasn't ordered so we couldn't request it. When Dad was mostly calm I went back into the room to try to talk to him. When he was having his fit Stacey told me to leave the room. Her idea was we would play good cop/bad cop and she wanted me to be the good cop. That seemed to work well. She went out to the hall to talk to Dede on the phone while I sat with Dad. He was still angry but too tired to give me much trouble. He was sitting in his wheelchair, hunched over with his head down. After a while I started talking about when I had played the ukulele and sang for him the day before. He had really enjoyed that and yesterday morning I printed out a bunch of songs that he could sing. I told him I had done that. I started listing the songs and then I sang one for him. It was hard because I was crying but I got through it and it seemed to change his mood. I sang about 3 or 4 songs and then helped him into bed. While I was doing that Dede showed up. We talked for a while and then she left.
Dad slept for about an hour, maybe more. Then he woke up and said he needed to use the bathroom. That was one thing that had us concerned. He was peeing a lot last night but drinking very little. Anyway, we helped him to the bathroom but he refused to let Stacey go in to help him use the toilet. Again he was angry. Stacey and I waited outside the bathroom until he was finished. When he cam out he again tried to go over to Junji's side of the room and pull back the curtain. I blocked his path and Stacey and I tried to guide him to the bed. He turned and walked out of the room. Dede had suggested letting him go for a walk when he was agitated because it wears him out. Stacey followed him out and I went back for the wheelchair. Again Dad was angry and yelling. We kept trying to get him to settle down and be quiet because the hallway is loud. Sound really reverberates out there. As we were walking along the LVN and another nurse came around the corner. Dad said, "Ok, I'm going to start hitting now!" and actually lunged at the LVN. Stacey pushed him down into the wheelchair and held him. Since I had removed the leg rests (I had been sleeping in the wheelchair) we couldn't move forward. So we backed down the hall, Stacey almost in Dad's lap, and back to the room. We backed in next to his bed and I sat in the chair and held Dad from behind. Stacey held him from the front. After a while he stopped struggling. He just didn't have the strength to keep fighting. Stacey sat on the bed while Dad yelled at her. She just sat there, not responding. Dad started to calm down but he kept saying nasty things to her. I don't think he was aware that I was right behind him. I started gently rubbing his back. After a while he started to lean forward and got more and more calm. Back rub. Another great suggestion from Dede.
Stacey left the room and I kept rubbing. I started humming Just As I Am. I couldn't remember all the words but it has a sweet melody and I thought it would be a hymn that Dad would like. After a while he said, "Just As I Am". I said, "That's great, Dad. You remembered the song." I sang what I could remember. Then Junji made one of his noises and Dad got a little mad. I started talking to him about how I know in his heart he is a kind and loving person. I told him I know he can have some human love and compassion for the poor man next door who is very sick and having a hard time breathing. I told him stories about all the times in his life where he has helped people who were in need. I kept gently rubbing his back and arms. Then I crawled out from behind him and helped him into bed. He fell asleep quickly. When I went back out to the hall Drew was there. Stacey had called him. By this time it was about 5am.
I talked to Drew for a while. All of us swap stories and tips for helping Dad to stay calm. Drew is very good with him and Dad seems to be less explosive around Drew. At 6am the LVN came to test Dad's blood sugar. No problem, everything went well. Stacey gathered up her things and went home. Last night took a lot out of her and she was very upset when she left. When Dad is in one of his rages his face changes. His eyes go wild and vacant. He says the nastiest things. These episodes always seem to dredge up the worst of our childhood memories of Dad. We know we're dealing with his disease and that this is all he has left but it still leaves us with a sick feeling. I hope Stacey gets lots of rest today.
He'll be in the convalescent home probably until Thursday. Then he can go back to Sunrise and into their Alzheimer's unit. He'll get great care there. His bed will have an alarm on it to alert the staff when he gets out of bed. We'll probably have a doctor prescribe a sedative so he'll sleep through the night. I think we may have reached the point where he'll need stronger mellowing meds. It's a tough balancing act. Too much medication and he shuts down almost completely. Not enough and he goes into these rages and could hurt himself or someone else, maybe a staff person, maybe one of us, maybe another resident.
Oh yeah, we're in the nitty-gritty of Alzheimer's now.
8 comments:
I'm so sorry for all of you.
We'll make it. We're all pretty strong and we work well together. That's huge.
What a difference a day makes. I was there from 2-ish to 10:45. There were times where Dad seemed on the edge but he never blew. He's calmer around Drew. Also the whole place was quieter tonight. Junji is having much less trouble breathing. At least that's how it was when I was there. We'll see how things go for Drew for the rest of the night.
At one point Dad was really wanting some chocolate ice cream. Dad loves chocolate. I checked at the nurses station and there was only berry flavored ice cream substitute and an orange flavored thing. I knew Dad wasn't going to go for it so I went to Ralph's to get him some ice cream. They had individual servings of Ben and Jerry's. I got Dad some chocolate and vanilla for Drew and me. I know it'll mess with his blood sugar but it made him happy and satisfied the chocolate jones. It's a lot like appeasing a toddler.
He really is much better tonight.
What a night - I can't imagine anything so difficult. Just seeing your parent sick and unable to take care of themself is horrid; I can't imagine them being combative as well. It's terrible that you kids have to do what I would assume the staff would do at a place like that. Thank goodness you have each other.
Good luck, Doni. Can't wait till I hear this lightens up for you.
Nancy
You'd think the hospital would have a plan for this. What if he had no family?
--dean
Nancy- It is difficult and upsetting. But one thing we all know is this isn't Dad, just one unfiltered, uncontrolled aspect of his personality. He can't choose to be any other way. At least not when he's flipped. We're all learning little tricks to steer him away from the dark side. Last night I could see he was on the edge. Getting him the ice cream really helped. We've learned to say yes to him as much as we can, even if we're lying about it.
Dean- If he had no family he'd be SOL in a place like that. We talked to another guy last night who's mother fell and broke her hip last Sunday. They've also had a family member stay with her every minute since she got there. The other night Stacey saw a woman parked in her wheelchair at the nurses station. The place was deserted. All the nurses were in a meeting. They had just left here there. She called Stacey over and asked her if she could take her back to her room. She said she just wanted to go to bed. Stacey said she was sorry but no, she couldn't take her but she'd find someone who could help her. She saw a nurse walking by and asked her if she could help this woman. The nurse rudely flipped her hand and said, "NO, I'm OFF." and walked out. Stacey was pretty shocked. The woman looked at Stacey and said, "See? See how they are?" Stacey found another nurse and asked her if she could help the woman. The nurse said no, they were waiting for some report before she could be taken back to her room. Stacey said, "Well, could you tell HER that so she doesn't feel abandoned?" A few minutes later I took a little walk down the hall. This time the woman was yelling, "HELLOOooo!!! Can somebody help me?!!" I asked the same nurse what was going on and she told me they were in a meeting and she had to wait for the report. I didn't walk away which I think made her uncomfortable. She went over and talked to the woman.
If Dad was there without family help he'd probably be drugged up and tied to his bed. Or he would have fallen on the first night and injured himself. On the night that Stacey and I were there and Dad was having trouble I think they were ready to step in and help but that would have escalated things. He would have really blown his top if a stranger had put their hands on him. Stacey was able to put her police training to good use. If I had been there on my own I would have had to have them help me.
Really, you don't want to mess with Stacey.
tvars- when your butt gets real big from watching too much tv.
Have you been able to get a doctor in there to give him mood altering drugs yet?
And yes, they lying to him is the same tactic my friend Karen had to go thru to help deal with her MIL's Alzheimers at this same stage.
What's the name of this place? I want to mention in my will that I don't want to go there.
--dean
Virginia- He's on one of his regular mellowing meds. He hasn't been to a doctor since he came back from Phoenix. Actually, I might be wrong about that. Anyway, he hasn't been prescribed anything new. He'll have a regular doctor that he'll see once he gets back to Sunrise.
Dean- The place is called Community Care. It's on the corner of Brockton and Jurupa.
Today wasn't bad but he was on edge. He really started to get agitated at around 3:00. Then at 3:45 we had a family meeting with the head therapist. She wanted to see how he walked. When we told him that he got very concerned. He thought it was a test and he'd be doing it in front of a lot of people. We had a hard time getting him to cooperate. We all hid down the hall and let Dede handle getting him into his chair. After he walked I wheeled him around the hospital while everyone else met with the therapist. Dad kept saying stuff like, "They're trying to pull a fast one. They're so phony." I had to keep wheeling him to different parts of the hospital to keep him from seeing the conference room where the meeting was taking place. He was getting more and more upset. Right when we turned a corner we saw Drew, Stacey and Mindy in the hall. The meeting had just ended. Then Dad wanted to have a talk in the hallway. We couldn't talk him into going back to his room. Finally we convinced him that we were blocking traffic and as we were moving we just wheeled him back to his room.
When he's on the edge like that it's really hard to get him to cooperate. We have to come up with all sorts of lies. Everyone left after the meeting except for Stacey and me. Dad was so bratty! He was hungry so I gave him a cookie. He bit into it like he was a starving dog. Yeah, ok Dad, very funny. When his dinner finally came he insisted that Stacey and I share it with him. We kept telling him that we were full from lunch. He wouldn't let up. He was all hands, grabbing at things and moving stuff around. The dinner was kind of gross (some kind of corned beef casserole and carrots) so Stacey went to the kitchen to get some cottage cheese. When she gave it to Dad he scooped out a huge spoonful and mixed it with the casserole. Now he had a plate full of disgusting mush which he continued to insist that we share. He finally did finish his dinner.
I left right after Dede got back. It's best to have as few people in the room with him as possible. She's staying with him tonight. Good luck, Dede!
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