Nurses Corner

Thursday, March 30, 2006

Back To Alzheimer's Disease

My sister called today with a very unusual request. The request wasn't the problem, it turns out she had a concern that she might have been responsible for our Mother's death.

This is of course, preposterous.

Mom died on Father's Day, 2004. She definitely had Dementia, probably Alzheimer's, though it wasn't completely diagnosed as such. Mom had a problem with her gut, it simply wasn't working correctly. The poor little thing would blow up like a balloon, and subsequently end up in the hospital. At the time she lived in Portland, Oregon.

The last trip to the hospital, the "doctors" kept trying to drag us to the point of euthanizing her. This is a woman that would never go gently into the long night. She was one stubborn old woman. The doctors said she might make it through surgery for a colostomy, but she'd die afterwards because she couldn't perform what's called a "pulmonary toilet." Meaning, she wouldn't be able to follow instructions to deep breathe and cough.
We knew better.

One surgeon told us, "My job is to sell you surgery. This is what can happen..." He was honest and forthright. Knowing Mom would never opt to just cave in and take that dirt nap, knowing she did not want to die, knowing that it goes against the grain of our values to "euthanize" her like a favorite pet...we opted for the surgery.

That stubborn ol' lady showed those docs. She not only sailed through surgery, she "performed the pulmonary toilet" like a champ. The problem that ended her life is those doctors did not send diet and fluid orders to the assisted living home. When my sister left her, she was doing well. When my sister returned 11 hours later, after a much
deserved rest, Mom had been without any fluids or food. 11 hours no fluids, no food.

Long enough to start the spiral.

And, she died.

This is old history...but my sisters worry is not. She wondered if Mom started downhill when my sister could no longer take her on outings.

You see, when folks get Dementia or Alzheimer's, their bodies become rigid. It's not necessarily a neurological problem, rather, it's in self-defense. Their perceptions of the world are altered, and the rigidity is one of guarding the self against injury. Unfortunately some care-givers don't realize this and see it as combativeness.

My sister worried needlessly that she'd somehow caused Mom's decline. She didn't. It would have happened sooner or later.

The point of all this verbage is...if you have a relative with Dementia or Alzheimer's, realize this stiffness is not to annoy you, or to make life difficult for you, even though it may seem that way when you're trying to get your loved one to transfer out of a chair, or get into a car.

They're just trying so very hard to avoid injury.

If you're the caregiver of a person with Dementia or Alzheimer's, my hat is off to you!

Feel free to read Alzheimer's and Dementia materials on my website: http://webnurseonline.com