Gram Notes

Hi everyone,
  Gram continues to be her happy, positive self. We brought in a hospital bed for her a few weeks ago, because she seemed to like sleeping in one when in respite care. She does the same thing here-when settling in for the night, or a nap, she smiles and smiles! When asked if her bed is comfy, she says, "OH, yes!" so there's an endorsement.

We may have zeroed in on a better sleep med, Risperidone. Gram can have one to four tabs each evening. Usually it is 2, so that is good that she is not needing the max dose all the time so  far, and we have some options left there. This is about the 5th sleep med we have tried. Some have made her more agitated instead of calmer. We were told to watch for that, as it can happen often in older people. We have had some wild and very interesting nights, but they are much more predictable  now.

Mom has had some recovery of the use of her feet/legs and her ability to stand and pivot to a new seat. For a couple of weeks now, she went back to how she was before Mary's birthday. That was the day when her legs suddenly did not support her at all. We have not been walking, but just being able to transfer means she can get the heck out of bed, use the bathroom, get a GOOD shower in the tub (with a shampoo!), get to the table, use her rocker that she loves, and so on. It is amazing how important this one ability can be.

The last 2 days, Mom has been very tired, however. She was not able to respond well to prompts of 'wake up", "let's go, Kokomo!" and all our other silly morning rituals. She just curled up more compactly in her blankets, and ignored me. Sometimes she would say, "No, no, NO!" and grab blankets back from me. I like that spirit.

When this happens, I work on getting some breakfast into her by serving it in bed. We got a hosp. table with the bed, so I put that over her, bring in the coffee, toast, yogurt, oatmeat---whatever we are having that day. Most days this inspires her to participate, but it did not work the last 2 days. She could have cared less about her morning cup of coffee, which she generally loves. I tried Ensure with a straw in the bottle, and that is the only thing that got a positive response. She was able to swallow that. I think the delivery method, using a straw and keeping the mouth sealed, helps her to swallow. She did not do well with yogurt, applesauce or other foods presented on a spoon. If she allowed this food into her mouth at all (sometimes she did not), it sort of just sat there. Choking risk became an issue, so I quit trying to spoon-feed her if she did not swallow initially

On Wednesday, I kept at it until we finally got up and dressed. However, Mom had difficulty staying awake in her chair. He head was down most of the time, and it took a lot of prompting to get her to eat. She wold sleep unless I made a lot of  1-to-1 interaction attempts  It got to be so that I was pretty much standing on my head to get her to interact and eat. After a while, I asked if she wanted to lie down, and she said 'yes'.  So  that is what we did. Mom had an afternoon nap, and we got up again for the evening. She did eat a small dinner, and then went to bed for the night.
Strangely, she was pretty restless, so we worked our way up to 4 Risperidone tabs, her limit.
Then next day, Thurs., as I have mentioned, she was very sedate. This morning, although she is not up out of bed yet, she has showed signs of being more chipper and 'with it'. Yay!
I  need tot wrap this up and get us going, but not before I wonder aloud again about the strangeness of ALZ. At school, we dealt with a lot of brain issues, traumatic brain injury, strokes, congenital brian abnormalities, cortical blindness. In my experience, brain functioning was fairly static, staying the same over time. We tried to access other parts of the brain for basic skills, by programming and repetition. With ALZ, functioning can seem lost, then magicallly reappear the next day. Our nurse, Niki, explains to me: "It's not a linear disease". That is my new mantra for the week.
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Our trusted expert in geriatric/dementia care, our sister Kathy Fallon, says that there may come a time when Mom is just tired of eating, or just not interested any more. She also may forget to swallow, in which case, continuing to try to feed her will eventually induce choking.

I figure that she can choose to sleep or not, eat or not,, and so on.  If you have other feelings on this, let's talk about it.

Alrighty then, talk to you later!
Love from the Home Office,
Annie and Gram