memory care

I am really getting close to drop kicking the nurses at the facility my Grandma is at. To say they are patronizing would be doing a disservice to the snooty help that looks down their noses at you (if you're like me, and arrive in baggy jeans, no makeup and barely managed bedhead) at fancy pants stores to browse. I went to visit Grandma today and found her in the wrong wing trying to find her room and determined to get enough money for bus fare. She would not stop talking about Qunicey Avenue in Kearney, where she grew up, and that she just got back from church and Grandpa went to the funeral of a friend who'd died but she couldn't attend and she had to go to her grandparents house and she was very upset that she couldn't remember the name of a certain street. She got on a tear about this, two of the care managers said she'd been trying to get bus money all morning, which is not common behavior for her. Yeah, she has dementia and gets very forgetful but she usually just keeps asking where I live, how far away it is from her, or the ages of my children. I felt she was getting agitated because she wouldn't stop with the talk about Kearney and bus money and she kept trying to get me to give her another quarter for the bus ride. One of the care managers came in and, I guess, tried to placate her by lying to her but I don't feel right doing that. She has dementia but that doesn't mean she's dumb. She usually can see the logical fallacies in what the people who try to calm her down by lying are saying. I tried to explain again and again that we were too far away from Kearney and that it would cost a lot more than .50 to take the bus there. I also kept mentioning, in as gentle a manner as possible, that the people she wanted to see were no longer living. But it makes me feel so bad for her, I don't know if that's the right tactic to take, if it's hurtful to keep telling her these people in her family are dead, but I just can't lie to her, it seems condescending and disrespectful. Okay, I will lie when she wants a drink, which I'd give her but she can't have it with her medications, and tell her that the ginger ale/apple juice/grape juice she's drinking is wine. That will calm her down and she never questioned it. But we only used to do that when she came to my house or went out to dinner with us. It didn't seem like a lie that can need others piled on to perpetuate the myth.

I asked one of the care managers to call the nurse because my Grandma, who's had anxiety forever and has been taking ativan for at least 30 years, has a prn (she can get another ativan when necessary) and since I see her regularly and she isn't like this regularly I thought the situation might warrant it. The nurse comes in after awhile and I'm immediately thinking 'oh no' because the first impression did not go over well. There is one nurse on staff there who is excellent, she's attentive, empathetic, not full of herself, basically everything you want in a nurse. This nurse blew in looking more like she'd be one of those scornful women looking down her nose at me at Barneys. I explained that my Grandma wasn't usually like this and she seemed agitated. Her response was that I should redirect her by taking her to town hall for the activities that were going on there. I told her that my Grandma is agoraphobic, for the most part she won't do public stuff, aside from meals, unless she's with a family member. So she doesn't really redirect by being put in social situations. So then the nurse gives this smarmy smile and sits down across from my Grandma and starts lying to her; saying that we can't go to Kearney today the buses, trolleys, what have you, none of them are working and I just sit there hating myself for just sitting there. But even the lies won't steer Grandma off of needing the bus fare to go to Kearney so the nurse goes on about how my Grandma's family loves her very much and she doesn't ever have to worry about money while she's living there. The rates in benign neglect are going up to close to $200 a day, mind you. The nurse then tells me it's a part of the disease and that giving her another ativan won't cure her, that she's only to have that when she seems agitated. My Grandma isn't an Alzheimer's patient that, when she's agitated, is going to get violent or pull down her pants or start screaming obscenities, all of which I've seen happen before. I told her that I'm aware that it won't cure her and tried to explain what I thought of the situation; that .5 ativan twice a day for 30 plus years could make it sort of ineffective when she gets extremely anxious and won't stop wanting to get that bus to Kearney and keeps wringing her thin hands and hanging her head on her chest with a sigh when they tell her she is unable to get the bus today. She was exhausted but she couldn't give up her thought of needing to get to Kearney and I just thought that the extra ativan might be enough of a push to get her in bed to nap before lunch, which she usually does anyway. My Grandma is so flipping polite, even in her exhausted, anxious state she wouldn't think of letting me help her into her bed to rest because then where would I sleep? And this is when nurses and other staff will say they have a room right down the hall from her. Seriously, I can wind up leaving there feeling like I have Alzheimer's.

Something that I've been told before by nurses in the field of dementia care is that it's often harder on the family than the patient and that the patient won't remember what's happened, those episodes of extreme agitation or anxiety but I don't know that I believe that. How can they know that for sure, it would seem to me those episodes could become a palimpsest, that she doesn't quite know what happened but a trace of dread remains. I hate seeing her so upset like that.