Redirection or Meds… or No Meds?

I asked a question on a forum this week about redirection.  Redirection is a commonly used tactic for misbehaving toddlers – and also those with Alzheimer’s.

After our return from a wonderful respite weekend, Mom was experiencing her typical post respite confusion.  She kept telling me about the “man on the phone” – we’ve heard that before J  – who was telling her she had to go to the hospital.  She had also decided that the daffodils next door were actually “food” and we needed bring them in and cook them.

As usual in her post respite confusion, she laid things out on the bed so she would be ready to “go” – purse (empty), nightgown, sweater, hat.  She walked around the house telling me about “the man” and “the food”.

As she talked, I did my typical and said, “Hmmm, uh huh”, every so often.  When asked specifically about the hospital I told her I hadn’t heard anything so we would have to wait and see and when asked about the “food”, I told her they weren’t quite ready yet or it was too cold to go out.

After posting my question on the forum, there were some excellent suggestions about music, TV, taking a drive, etc.  Some I had used before, some Mom doesn’t go for or is too far into the disease to do any longer but I read along because you never know when you’ll find something that hadn’t come to mind before.

Quite a bit of what was posted involved drugs.  Drugs to calm her down, drugs to help her sleep…  You see, lots of folks with Alzheimer’s get very agitated to the point of distress, anger, crying, even violence.  The meds can help not only the patient but also make the caregiving a little easier.

But  Mom, soon to be 95, has never taken medications.  Given that her overall health is excellent and in general we have calm, quiet days, I hesitate to give her anything because of some wandering or because she takes a while to settle down after I’ve been away.

After years of watching my daughter go through various epilepsy drugs and dealing with the side effects they caused, I don’t feel the need to control Mom’s current behavior with a medication.  When I compared my daughter’s hyperactivity (prior to meds) to what I call Mom’s agitation (she wanders about the house and talks to me or asks me questions), a few caregivers didn’t understand how I could compare the two. 

I do see the similarity because any problem in the brain comes down to neurons firing – or not.  In the case of epilepsy, they are firing when they are not supposed to fire and setting off a brainstorm.  In Alzheimer’s, sometimes they are firing correctly, sometimes they are firing and causing disjointed thoughts or old memories, and sometimes they are not firing at all.

At this point in time, as long as I am calm and settled, it seems easier for Mom to settle.  She’s happy – she is still able to smile so it’s easy to see – and her quality of life is good.  So do I really want to take the chance of side effects before an intervention is necessary?  I think not.

“I can do all things through Christ who strengthens me.”

Some caregivers of Alzheimer’s/dementia loved ones scoff at others who profess their faith in the midst of their very difficult situations.  I’ve described these positive, faithful people before as seeming to walk on clouds all the time.

While I’m not constantly professing my faith, it is ever present in me and my earliest recollections when I was little involve believing that God will take care of me.  In the big old house that I grew up in, lightning and thunder were often the subjects of my prayers for help.  To this day, if I am feeling scared of a storm, I say that same little girl prayer and the calm settles over me.

There have been times in my life when I let myself drift and fears would jump into my life.  Sometimes it took awhile and God would be practically hitting me over the head to get me to turn around but ultimately I would realize and run back to His embrace.

Recently, my daughter was upset and I missed the queue.  A drug company is being sued because an epilepsy drug, taken by pregnant women with epilepsy, has caused birth defects.  While I now believe she was feeling the sorrow for those women, my reaction was that people no longer accept the responsibility for their decisions.

My reaction may sound strange but again, it all comes back to my faith.  Each time my daughter was pregnant, she continued her epilepsy drugs and took additional drugs because her seizures always increased during pregnancy.  We were told of the potential issues of those drugs but the concern was to get her through the pregnancy and what would be, would be.  She was blessed with two beautiful boys who are now 13 and 10.

My oldest daughter, on the other hand, decided to have a second child and did everything right.  In spite of sinus infections and allergies, she followed all the rules so she would have a healthy baby.  It wasn’t too be and alone at a regular checkup, she learned there was no longer a heartbeat.  She was devastated and for her, there was the question of why.  She, and others, did everything right and lost their babies and her sister took all these terrible drugs and had healthy babies.

These are the times when my faith jumps back in.  I lost a baby soon after my oldest daughter was born and both of these daughters lost a baby early in their pregnancies.  With each loss, I could easily see that God knew we, individually, were not ready for another child at that time in our lives.  At the same time, we learned the lesson of cherishing life.  It’s interesting to note that a few years later, totally out of the blue, my oldest became pregnant.  I fully believe that, although it took her awhile to settle into it, God knew that it was time and we now cannot imagine life without our little Hurricane.

What does this all have to do with my current situation?  It was years in the making but I think God had a plan and as I have listened for his voice and followed his plan, I am reaping the rewards.

We Survived the Super Moon!

Talk about bad timing!  It was bad enough that I scheduled things last week knowing there was a full moon coming up on the weekend!  The things I scheduled though?  Oh my goodness!  A new doctor and a visit to an adult day care?  What was I thinking!

Then, to top it off, I found out that it was a “super” moon.  The moon on Saturday was 33,000 miles closer to earth than usual.  Supposedly the effects would be worse than usual – and they were.

On a daily basis, Mom makes comments that leave you thinking, “Where did that come from?”  It just generally gets more fun around the full moon.  Five days before this last one, Mom started telling me about the man that had been sleeping in her bed, he on his side and she on hers.

That same evening, she went to the bathroom and when she came back out, she looked at me and said, “Is this for real?”  She told me there was nothing in her head.  I don’t know if she thought she was dreaming but she had no idea where she was.  She didn’t know where her bedroom was, where her “supplies” were – she always talks about “supplies” and I guess she means clothes?  She also wanted to know if her husband was here.

The week progressed with lots of references to her husband and her dad and mom.  Where were they, they were coming to pick her up, had I seen them, etc.  She also threw in questions about the dog (our non-existent one) and asked one morning if the newspaper had been brought in but I cancelled the newspaper awhile back because she was no longer looking at it.

The entire week, she was unable to keep track of what meals had been eaten.  Normally she might ask me a few times a week but last week it was all day long.  She would say good morning several times each morning not realizing she had already seen me and she would ask about breakfast.

She made it through the first home visit of her new doctor and he had an opportunity to see her happy but with the dementia dancing around in her mind.  I liked that he talked to her, not me, but he would glance at me sitting behind her to see if what she was saying was real or not.  She pulled out a picture of my daddy and called him her daddy, then brought out the pictures of her daddy and also called him daddy.  She couldn’t come up with any names.  I provided them and the doctor would bring up a name to see if she could carry it forward.  It just wasn’t happening.

I already wrote about the catastrophic response to the adult day care and we continue to feel the effects of that visit although they are lessening.  She spent last week and the weekend packing her things and thinking someone was coming to get her.

The good thing?  She kept asking me if she could just stay here.  My assurances continue each day when she asks the question.  “Yes, you can stay right here with me.”  Mom’s response?  “Good.”

I must be doing something right!

Enjoying a little bit of sun on our swing!

Understanding Viewpoints

Although Daddy died of Alzheimer’s in 1988, I’ve mentioned before that it did not have the same impact on me as it did on my children.  As I’m going through this journey with Mom, I am beginning to understand the different viewpoints from which various people see the situation.

After writing that I wasn’t impacted as my children were, I thought readers may have thought his death didn’t impact me.  Oh, it did!  I cried for days after his death and at times when I would be driving to or from work it would hit me again and I would cry.  To this day, 23 years later, tears will come when I hear a particular song or see a particular scene in a movie – or sometimes it just hits.

My comment was more about the impact of Alzheimer’s.  My children were directly impacted because Daddy was a huge part of their world.  He was the person who accepted them as they were and loved them fully – until the disease caused his life to disintegrate before their eyes.

I, on the other hand, when Daddy headed deep into the abyss that is Alzheimer’s, was in the midst of raising those two children while going through a divorce.  My marriage of 12 years was falling apart and I was devastated by the hurt and embarrassment.  With Mom and Daddy as the example, marriages were supposed to be for life and yet there I was.

From lessons learned in my past, I was determined to make the divorce amicable and allow our children to love freely.  The girls and I helped their daddy move into an apartment so that they would feel it was also “home” and I tried to keep our lives as calm as possible, all the while falling apart inside.

I was lucky at that point to find my soul mate, a man in the midst of a separation and divorce that I would later marry and with whom I would live happily ever after.  Before the happily ever after, though, we went through the worst two years of our lives.  We always said if we could make it through that time, everything else was a piece of cake. 

In that time, my divorce was final and Daddy went into the nursing home.  I moved my children to Kentucky.  I fell in love with the two little ones that would later become my stepchildren but on the day my soon to be husband’s divorce was final, they were ripped away from us.  Mom had a brain tumor which was luckily benign.  We married and shortly after I ended up in the hospital after three bouts of the flu.  I changed jobs and then my daughter was diagnosed with epilepsy.  I could go on and on…

All of this happened while Daddy was spending the last two years of his life in the nursing home.  Two times we were called to the nursing home because Daddy was not expected to make it through the night.  The first time, Daddy’s blood pressure was 30/16 and the nurse asked Mom if she wanted Daddy to receive pain medication because he was moaning.  I’ll never forget Mom, my sister and I standing over Daddy’s bed commenting that he would get the pain medication and the next day he would be up chasing a nurse down the hall.  Well, we knew that wouldn’t happen but sure enough, he rallied and it was another month before the second call and he actually died.

That year held more problems for my new family:  my husband’s broken arm, my daughter’s emergency appendectomy, buying and moving into a new house and my hysterectomy after the very real fear that I might bleed to death.

Please don’t get me wrong here – I’m not looking for sympathy.  The things that happened during those years aren’t any different or more difficult than things that happen to others.

My point – the light bulb that lit up in my head this morning – is that everyone sees the situation from a different viewpoint or perspective.  My little girls experienced Daddy’s decline more keenly because they lived it every day.  It was their life.  I, however, was too caught up in what was happening to my family and managing to keep us going day to day to fully feel the pain of Daddy’s decline.

What made these thoughts swirl through my mind?  The question posed by one of my children, “How long are you going to keep doing this?”  I realize that my viewpoint is now closer to that of Mom’s when she was taking care of Daddy.  My child, on the other hand, is looking from the perspective I had way back then.

Sometimes you just don’t see it coming…

In the past week, Mom has been declared “homebound” by Medicare and her Medicare gap insurer.  That designation was initiated by my call to Visiting Physicians Association to ask that a doctor come to our house to see her rather than taking her to a doctor’s office.  And why did I do that?  Because leaving the house is becoming more unsettling for Mom.

I talked about it in a post in February.  Over the past 10 months, Mom and I have made many trips to the store, restaurants, and more and she enjoyed so much of it.  Recently, however, those trips are no longer enjoyable.  She enjoys the thought of going but the actuality does not meet the expectation.  Quite often, the trips cause disturbing results as her mind gets going with disjointed memories.

Yesterday we visited an adult day care.  I thought that, although she doesn’t do well on trips, that she might enjoy seeing others her age and doing some simple activities –just once a week.  She has enjoyed a visit each month with the Activities Director at our local hospital where I go to the Alzheimer’s Support Group.

We took a short tour through the facility which is a part of the highest rated nursing home in the area.  When asked by the nurse if she would like to join them sometimes, Mom came up with a story that because of this and this – pointing to her head and her chest – a man told her she should just stay home.  She sat quietly while the nurse and I talked and we left.  The visit went without incident but her normal afternoon agitation rose to a new level!

Oh my goodness!  I didn’t see it coming!  Evidently the visit dredged up memories of Daddy going in the nursing home, selling our farm where we had lived for 20 years and Mom moving into my brother’s.  It was obvious that the memories were disturbing – she lost her husband at that time!  My husband and I spent the evening reassuring her and settling her as much as possible.  Her night was somewhat disturbed and today she told me, “I just want to stay home.”  She wanted assurance that I would too and light touches and hugs seem to settle her.

I can definitely understand that a stay at home mom who never drove and therefore spent almost all of her time at home would feel more comfortable at home at this stage of her dementia.

As I’ve said before though, respite is critical for the caregiver.  In addition, those trips to the store and the bank, etc., still have to happen.  Consequently, I’ll ask the help of our Visiting Angel to come in a few hours midweek to give me the chance to do those things while keeping Mom safe at home in her comfort zone.

Our lives change as her dementia progresses but the goal is still to keep Mom comfortable and happy until God is ready to take her home.

The Funny Side of the Mind

The thoughts that float through an Alzheimer’s/dementia mind can be very funny and sometimes the hardest part is keeping a straight face so you don’t cause upset.

Mom used to tell us stories about the things Daddy would say and do.  I know initially it had to be difficult for Mom to accept but when she told the stories, she always conveyed the humor of the situation rather than distress.

There was the time that Daddy was looking high and low for his binoculars and Mom got involved in the search.  They couldn’t find them anywhere!  A few days later, Mom watched as Daddy walked to the sliding glass door, lifted up his binoculars and began to look at the birds.  When Mom asked Daddy where he found them, he gave her a puzzled look and said, “In the closet in the den.”  In his mind, there had not been a search, they were always there!

Daddy - well into Alzheimer's in the summer of 1985 but still functioning.  At the end of 1986 he went into the nursing home and finally passed in January 1988.

I love the stories, too, of the situations and conversations when Daddy forgot Mom.  There was the time when Daddy walked up behind when Mom was doing the dishes and asked her if she was paid to do that.   Another time, Mom was sitting at her desk paying the bills as she had done throughout her married life.  Daddy walked up and, obviously concerned, said, “Does my wife know you’re handling that money?  You shouldn’t be doing that!”

“Does my wife know” came up another time when Mom had put Daddy to bed then later laid down on her side of the bed.  You can imagine!  Daddy looked at her and said, “Does my wife know you’re here?”  Mom assured him that, “Yes, she does.”

Knowing about these situations with Mom and Daddy probably helped me when taking care of my daughter after her seizures.  Right after a seizure, conversations were fun – think of someone coming out of anesthesia and the things they might say or do.  J  The good news of that situation, though, was that I truly felt my daughter’s love at those times.  She did know who I was and was always so glad I was there.  Unfortunately, dementia doesn’t always provide the same loving situations.

On a daily basis, Mom says or does something that might distress some.  I choose to keep my face straight but look at it from the funny side and I’m lucky to have my husband and children doing the same.

Today I’ve already been told that there is a man that has been sleeping in Mom’s bed – but only at night!  She says that he sleeps on one side and she sleeps on the other.  All I can think is that they must be quite cozy because it’s a twin bed and I hope Daddy doesn’t mind!  J

Just a bit ago, after walking through the house looking at things, Mom came in my office and sat down.  She said, “I appreciate you being here.  Before you came here, it was a mess.”  I know that right now, I’m the “lady who works here”.  J

Decline – Sometimes achingly rapid, sometimes achingly slow…

Mental decline in Alzheimer’s/dementia is the disease.  The other physical ailments that go along with it such as pneumonia are not a symptom of the disease but can, in fact, be the cause of death.  The mental decline, however, is the tragedy of the life lost.

Over the last 10 months, I’ve watched a slow progression of the disease in Mom.  There are times when the decline seems rapid but when you look back, you realize changes were taking place over time and they just didn’t stand out. 

Up until recently, my husband was the center of our world.  Mom was raised in a time that the man of the house was the breadwinner and the wife kept the home and the children.  Her thoughts were all about “taking care” – of Daddy and us kids, of my oldest brother and his family, and finally, although I am in charge, she was concerned about “taking care” of my husband.

Recently, Mom’s world is shrinking.  I’ve often compared her to a toddler but as time goes by, a toddler’s world expands to include more than baby and mommy.  With Mom, it is the opposite.  Her world is shrinking to include just her and me.

In this change, my husband and others are quite often unfamiliar.  The change can happen in a matter of seconds.  I’m sure my brother can identify with that from his time living with Mom and Daddy.  It was at him that Daddy suddenly started yelling to get away from him, that he was going to call the police, that he was going to call his “son” – his son who was actually right there in front of him.  Just seconds before, Daddy had been sitting in the car with my brother and all was well.

This week, the gradual shrinking of her world has become evident.  She yelled at my husband, “You can’t talk to me like that!”, “I have family you know!” and “I’m getting out of here!”  That was just one morning but she has been argumentative with him every day whether he says anything or not.

Yesterday I was the one to set her off and the conversation was hilarious.  Our Visiting Angel arrived and I told Mom that my husband and I were leaving to take our camper for service.  She didn’t comprehend what I was saying even though I kept speaking more loudly and distinctly.  She argued that she wasn’t going anywhere, that she didn’t want to live in that thing, and that she didn’t want to spend money – none of which was at all relevant to what I was saying.  I finally gave her a kiss, told her we would see her later and we left.

Things are changing, sometimes it seems rapid but then again, it’s not.  I’m now waiting for the day that she doesn’t recognize me at all.  It will come; it’s just a matter of when.  Meanwhile, we just keep adjusting to the most recent change.  Now our hallway gate has an extension on it so no more army-crawling soon to be 95 year olds in our house! 

And the fun begins… or continues?

Yesterday was a quiet day for the most part although Mom suddenly turned on my husband in the morning.  It began innocently enough.  Mom picked up her container for her dentures from its usual place and started to take it to her room.  My husband reminded her that it was kept in its usual place so that I could take care of them for her and we wouldn’t lose the container.  That’s all it took!

Evidently Mom didn’t know who was talking to her.  She told him multiple times that he shouldn’t talk to her that way, that she had “family, you know” and she was “going to get out of here”.  He remained calm and she finally stomped off to her room.

The rest of the day followed our normal routine and just after 4:00 she began her normal wandering about the house.  At the dinner table, she began talking about how she had this pain and that and that the doctor had called her on the phone.  My husband and I reminded her that she has seen the doctor and that he is aware of everything and that seemed to appease her.

Mom went to bed at 9:00 and we followed at 10:00 as usual.  At 12:38 am I woke up to head to the bathroom.  When I stepped in the hall, both Mom’s door and the bathroom door were open but Mom was nowhere to be found!  As I got my key for the hallway door, Steve joined me and we found Mom in the living room on the couch – she had crawled under the hallway door!  AAARRRRRGGGGGHHHHH!

She said she was scared because “they” were going to get her so she had to get out of there.  She couldn’t verbalize who “they” were so I told her to show me.  She was afraid of the sliding doors on her closet in her room!  “They” were going to attack her!

I also found she had removed her Depends – usually she keeps them on – so I got those back on her and got her back in bed.  Then our work began.

We had to do something to keep her from crawling under the door – it’s important to realize that she is 94 and the door is only 12 inches off the floor.  Low enough that I don’t want to go under it!  I know from the forums and my support group that folks with dementia, however, can be very creative if they want to get somewhere.  To get us through the night, we barricaded the area below the door with a gate and heavy footstools that she wouldn’t be able to move.

Although my husband’s comment after being awakened abruptly to find another issue was, “If this continues she’ll have to go in a home”, he later said he already had thought of a way to put a sliding extension on the door.

My job today – get any furniture out of her room that she could possibly move to climb OVER the gate!

I yelled at her...

I hate to admit it but I’m one for full disclosure.  I’ve done it before in the past 10 months but only a few times.  It’s important, I think, for everyone to know that it can happen.

I could say that it happens because she is hard of hearing and doesn’t wear a hearing aid.  That would only be partially true because under normal circumstances I have to speak loudly and directly to her – something I would also consider yelling.  My husband and my children all speak very loudly – I blame my husband’s booming voice for that J - but I typically laugh loud but talk at a normal tone.  It’s yelling for me when I know that there is frustration behind it. 

On Saturday, we put her through the upheaval again of having my 10 year old granddaughter and my 2½ year old grandson, better known as Hurricane, for the night.  As I’ve said in a past post, we must make this work because I’m not willing to give up my children and grandchildren.  They are all in this wonderful stage of life, ranging in years from 2 ½ to 14.

Hurricane and Great Grandma discussing the rain.

Our afternoon was moving along fine even though I forgot to put Hurricane down for his nap.  He was playing so well it just totally slipped my mind!  As we were approaching dinner time, he was still playing well even as I made dinner but he had toys laid here and there about the house.

Dinner time coincides with the typical time that those with dementia experience sundowners.  That time of day seems to agitate them and Mom has a tendency to be on the move then and often watches me cook dinner.

Given that the grandkids were having a blast chasing each other, I asked Mom to please sit down so that they could play without worry of knocking her over.  I also admonished the kids to be careful.

Her compliance didn’t last long and she was up walking down the hall.  Upon her return to the kitchen, she bent over to pick up toys that Hurricane had left there.  They were already off to the side and I asked her to please leave them alone because he was playing.  She then walked around to the dining room where she bent to pick up other toys that were also pushed back in the corner out of the way.

In the midst of making dinner, I once again asked her to please leave them alone!  She groused a bit but turned toward her recliner in the TV room and I stepped back to my cooking.

Twice in less than 30 seconds I had asked her to leave the things alone.  In less than another 10 seconds, I glanced up from my cooking and realized that she wasn’t in her chair.  Sure enough, she was further in the room trying to pick up the heavy lid of the toy box!  I called, “Mom!” several times but it was as if I wasn’t there.  I stepped over and yelled, “Mom, stop!” to get her attention.  I continued yelling when I asked her to PLEASE leave the things alone and just sit down!

I knew it was shocking for everyone when my husband came out to see what was happening and both grandchildren were standing there staring.

I felt so bad but what was done was done.  Mom sat down, the kids continued to play, we ate dinner and the evening went well.  Mom and I even shared a hug after I helped her with her window blind.  Thankfully, Mom’s memory issues help when I make a mistake.  Even though my concerns were for Mom’s safety, I overreacted, and for the children’s sake I have to learn from this lesson.

Little Lies…

My life is made up of little lies.

That statement, taken out of context, stirs up a lot of bad thoughts!  Truth is, for a caregiver taking care of someone with dementia, it is a must.

Telling lies comes up often on the caregiver forums.  Some people really struggle with telling lies and there have been long discussions about it.  Those that have issue with it usually base their complaint on their religious or moral beliefs.  I was raised that way and empathize with their discomfort but I believe that God gives us leeway in this situation.  J

I’m not talking about life changing lies.  I’m talking about the little things that are more like playing make believe.  Yesterday, for instance, Mom suddenly asked me, “Where’s the cat?”  I quickly responded, “Downstairs.”  We don’t actually have a cat but if I had mentioned that, it could have set off an unnecessary argument.  Instead, my response was accepted as fact and calmness prevailed.

Quite often the lies follow the same form.  Since our cat went to live with our daughter 14 years ago and our dog died at the age of 17, we have not had a pet in the house.  It is not unusual, however, for Mom to ask about the dog(s) or the cat and I’m always ready with a “downstairs” or “outside” response.

Sometimes the lies are just a lack of correction.  I’m used to hearing Mom talk about having seven children although she only had five.  Five children plus Mom and Daddy equals seven so it’s easy to see the origin of that.  The other day she added a new twist – she told me she had three husbands in her life.  Hmmm… that was a new one.  I just responded with a “Really?”  I’m sure Daddy would understand my lack of correction on that one because it avoided the argument!

Mom and her 5 children - only we're not children any more!

Another recurring lie involves her Depends.  Just this morning when it was time for a new Depends, she balked a bit and said, “I just did that!”  I reminded her that we changed them yesterday and we do that once a day to which she asked, “Do I pay for those?”  My lie in this case is a little bigger.  I told her, “I take them downstairs and soak them and then wash them.”  Hmmm – don’t want to think about that but it appeases her.

I’m sure some caregivers have to tell bigger lies than I do.  When it keeps the peace and makes life calm for both the caregiver and their loved one, I think it is worth it.

Life and Attitude – The 10% and the 90%

I’ve talked in previous posts about keeping a positive attitude in spite of the frustrations involved in caregiving.  It’s a topic that comes up quite often on the caregiver forums.  It’s actually a very HOT topic!

Some caregivers communicate everything in loving terms as if they are walking on clouds all the time.  They love their charges and talk only of the careful and loving ways in which they care for them. 

There are also those of the opposite extreme.  They may be doing all the care in a loving manner but meanwhile they are a pot simmering on the stove and ready to boil over!  Thankfully, they have the forums to spew those horrible feelings they have inside that they don’t express to their charges.

When caregivers from both sides get going on the forums, they quickly stray from the original topic and begin sniping at each other about which attitude is correct.  The truth is that they are both doing the job; they just handle stress and frustration differently.

Me, I’m in the middle.  I am a naturally positive person, probably because Daddy and Mom were positive people.  Daddy, who died of Alzheimer's in 1988 at the age of 71, was known for his "Never Worry" motto.  I really have to try hard to come up with even one instance of him being angry - at least until the AD was in full swing.  Mom was also a pretty happy sort.  There is only one time in my life that I ever saw a tear in her eye - she just wasn't the emotional type.

Maybe because of my upbringing, I fully believe Charles Swindoll’s quote, “The longer I live, the more I realize the impact of attitude on life.  Attitude, to me, is more important than facts.  It is more important than the past, the education, the money, than circumstances, than failure, than successes, than what other people think or say or do.  It is more important than appearance, giftedness or skill… I am convinced that life is 10% what happens to me and 90% of how I react to it.”

On the flip side of my positive attitude is the reality of the situation – something the caregivers all have to come to terms with when caring for someone with any form of dementia.  The reality:  the situation will not get better nor will it stay the same.  It will progressively get worse.  I had an advantage when I took on this challenge since we had been through it with Daddy.  I knew over time I would watch Mom’s decline.

The decline is most obvious when I have both Mom and my two year old grandson together.  Sometimes it’s exasperating but for the most part funny as I try to communicate with either or both and understanding is diminishing in Mom and still slowly building in Anthony.  They both repeat their questions over and over – Mom because she forgets she asked and Anthony because, I think, he didn’t like the answer the first time.  J  Then again… maybe Mom didn’t like the answer sometimes either!