Monday, April 25, 2011

Easter Monday.....

....and we survived the Triduum, Holy Thursday, Good Friday, and Easter Vigil. Mom did OK at the long church services, including the Stations of the Cross around town; I knew that she's not be able to walk it, so on Thursday afternoon we bought a transport/transit chair, its like a wheelchair that is designed only to be pushed, it has the same size wheels on the back as on the front, its not meant to be propelled by the sitter. Worked OK, I walked faster than I've walked in two years since I wasn't walking with Mom, I was pushing!

Mom wanted to go to bed at 5:30 on Easter afternoon, so that's fine, and she was up a couple of times before 10, and she slept until 7:30 this morning. Morning Mass was fine, the chiropractor was OK, Mom looked a little zippier than normal, did some running around, and then this afternoon we're back into the wander mode thing.

Mom will sit down for a minute, then bolt up and walk to a door, the kitchen, the bedroom, the bathroom, flip lights on, flush the toilet, walk back down the hallway, turn off the light she just turned on, then to the kitchen, flip switches there too, open drapes, wander more, flip lights off and on, wander back to the bathroom, flush the toilet, wander back...its now about 3 and she's been doing the thing for two hours now, added to the wandering is 'we're going to 9 o'clock Mass now'; its like she has no knowledge of past and future as it comes to time.

If you've never seen blank wandering, the closest thing that it resembles is sleepwalking.

Monday, April 18, 2011

Thoughts on learning, cognition, and growing up...

...bear with me here, I'm writing from a spot where I have little experience.

When we humans are children, we probably want to try to experience everything, everything is new, we are learning all the time after our brains stop growing. Take a look at a young child, they will put everything in their mouth; eventually the word 'no' is attached with this behavior, and the behavior stops. That to me is called basic learning, if you're told 'no' often enough, or if you are spanked when you do something that your parents don't want you to do, you eventually get it. But all these 'events' are a function of a learning, experiencing, eventually learns how to go to the bathroom, how to use utensils for eating, what the rules of school are, how to look both ways before crossing the street so you don't get hit by a car; they're all things that we learn to mold our behaviors into appropriate ways to act for the environment we are in.

Look at children in a church, for example; you'll see the behaviors of younger ones and their older siblings and they are different, the older ones have learned that appropriate behavior is to be quiet, move according to cues, etc. This to me means that the child has learned how to suppress reactions to certain stimuli, you still have the stimuli, you just learn how to deal with it, and eventually it becomes second nature; your brain 'filters out' some of the stimuli, and use the other stimuli to do something appropriate.

Its like toilet training perhaps, young humans just let things go and flow, we have diapers for that. Eventually older people 'train' children in the 'ways' of toileting, and it can be complicated, sense the urge, get to toilet, take off appropriate clothing, accomplish toileting and cleaning, put clothes back, wash hands, this kind of stuff.

Dementia, as I see it with Mom, is a condition known by problems with ordering and sequencing, and I think this can be evidence of the breakdown of the 'learning connections', the connections that we learn over time about how to 'accomplish' tasks. I've noticed it with Mom and toileting, most of the time she will understand the 'urge' to toilet, but then things break down, she'll not understand that clothes have to come off to make toileting happen, she won't understand or respond correctly to the 'its all done' feeling, and then she won't accomplish the the cleaning and reclothing part of the task correctly.

I'm sure that this can explain a lot of Mom's other behaviors, there's too much 'unfiltered' stimulation coming in for Mom to understand; this morning at Mass she was really confused, she knew that there were prayer books and song books in the pew ahead of her, but didn't know what to do with them except take them out of the little holder, put them in the pew, and then put them back (just like I've seen with very young children). When she couldn't figure out what the books said, she pointed at the cover of one and read her name in it.

At Communion time, Mom turned to me and said 'do we get one of those things too?', the contextual subleties of Communion and church are now lost on her.

I've got a window open over here, one can hear cars from the highway, but the drapes are closed. Mom heard the cars, went to where the noise was coming from, the window, peered through the drape, then turned to me and asked 'what's this?'. Again, a pretty simple thing for many of us to understand, cars make noise, open window lets in noise.

Things that we take for granted, like a shower, I can see become too much stimulation for dementia people, there's a temperature difference with the tile on the shower floor, you've got your clothes off, there's sounds, there's running water, big temperature swings, running water on a body; those of us with 'full minds' know the stimulation to expect and filter out the the other things that are not important for us to understand during a shower. We also understand the ordering and sequencing of what we do in the shower, its a very complicated place and procedure.

For a little 'self-test', try to do a flow-chart of 'going to the bathroom' for yourself, and then look at what could happen if you get one of the actions just a little bit out of sequence. Like if you forgot to wipe when you're finished, you're looking at a mess, or if you don't remember to get the toilet paper and try to use something else, like your hands, then what happens?

There are times I'm sure that Mom has filtering problems resulting in too much stimulation, and there are other times when I think that Mom just gives up, and filters everything out. Those are the blank times!

Autistic and Asperberger's people have similar 'problems' with filtering stimulation and ordering and reacting, I'm still learning about these 'brain' conditions.

I'd love to see some reactions to my little words from those in the early phases of dementia, as well as people who are caring for elders with dementia.

Wednesday, April 6, 2011

More slippage and a sad meeting....

Mom's slippage is continuing, we're seeing her doctor Thursday AM. I've noticed in the last couple of weeks that about an hour after taking her morning BP meds she gets very relaxed and sleepy to the almost point of fainting, I'm going to mention this Thursday. I'm betting that since we're going in the AM Mom's BP will probably be low, I'm also thinking that cutting the dosage will be something to think about.

We ran into an old friend yesterday at Longs/CVS, Mom and I have know George and Mary for 40 years. The last time we saw them was three years ago at the same place, George drove the car and sat in the car while Mary did the shopping. Yesterday, Mary was there by herself.

They are both 92, been married for 62 years, George was a brilliant meteorology professor and did some of the first work with digital analysis of weather patterns and subsequent computer weather predication, Mary did a lot of volunteer work with churches and distribution of food and clothing to farm laborers. I found out from talking with Mary that the other day George didn't know who Mary was, Mary said that George was totally dependent on her now, he's almost completely deaf, and he's fallen several times with bad effects on his back. Mary didn't know that Mom had fallen also.

The saddest part for me was watching Mom non-react to her long time friend, no expression, nothing. Bland and Blank!