Reflections on dementia

by The Curious Scribbler

My mother was never considered to be suffering from Alzheimer’s disease.  Indeed her death certificate (for she died, a week ago, aged 94) has a slightly farcical ring about it.  Her certified causes of death are Hypertension, Old Age and Memory Loss.  It reads as if she just forgot to go on living.   More likely vascular dementia played a part.  Abnormalities of this sort were detected in a brain scan about seven years ago, and her final years were marked by a number of TIAs (Transient ischaemic attacks) or mini strokes, from which she usually physically recovered, though there were new lapses in memory and ability.

But what is more striking than what she lost is what she retained:  an iron certainty that she was right, and that the only way of doing things was her way.  In my last blog this certainty applied to the control of the items on her overbed table and to her method of achieving quality control on her diet of chocolate buttons.

Here she is five years ago in another white-knuckle account I wrote then:

Shopping for my elderly mother: The quest for the perfect toothbrush                     13 February 2007

I have searched every chemist in town for a small-headed Maclean’s toothbrush like the worn one I have been compelled to carry around in my handbag for the last week.
Eventually I go to the dentists’ and queue to ask if they have any of these toothbrushes (this is where Mummy says they come from, – but because they are no longer on visible display she did not ask for them when she went to the dentist last week). They sell me an OralB small-headed toothbrush which is very similar to the Maclean’s one. The assistant has worked there for eight years. She is quite definite that they have never sold Maclean’s toothbrushes.

I took the toothbrush round to my mother and handed it to her.
She gazed at it and laughed merrily.  “Ha,Ha, ha, ha, ha, ha.” She chuckled.

 I couldn’t muster such a cheerful peal however hard I tried.
She drew breath and laughed again.
“What,” I asked calmly “is so funny about it?”
“Oh, I’ve never seen one like it!” she replied.

I point out its similarity to her present Maclean’s tooth brush, which I fetch from upstairs. The small head is exactly the same size. The handle has one blue flash rather than three diagonal stripes. The handle, she says is very long. She has never seen such a long toothbrush.

I hold them side by side:  once you subtract the packaging, the two toothbrushes are exactly the same length.
So now we come to the bristles. This new toothbrush has the tufts of bristles cut on a slight diagonal so that they are longer at the front. The toothbrush she has just started using has them cut square. The manky brown-stained ex-toothbrush in my handbag has alternate pairs of long and short tufts.

But I can tell, it is not, and never will be, satisfactory. I tell her that the assistant at the Dentists’ says that they never did stock Maclean’s toothbrushes. She shakes her head emphatically with a knowing grin. She knows when she is being told a whopper.

 ***********

Was this a symptom of dementia?  Or was she just being herself?

 

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A Degree of Dementia

by The Curious Scribbler

She is awake in her chair and watching the TV.  The sound is off.  If it were on she would not hear it.  She is deaf.

On her table is a substantial stack of broken fragments of chocolate buttons.  There is also a pool of tea.  The lipstick which always props up the chocolate-smeared emery board is particularly heavily smeared with chocolate.

I tackle the problem.

“You look in a bit of a mess here,” I say.  I point to the buttons.  “Do you want these?”

“No,” she replies, “they are old ones.”

“They are only broken” I say, “You are throwing away perfectly good chocolate.”  But I collect a paper towel from the bathroom and clear up the heap of mauled chocolate.  I wash the lipstick case in warm water and return it to its place.  She seems accepting rather than grateful.

The situation is worse than I thought.  A layer of milky tea has spread across the table, soaking under the lizard from Lanzarote, the Chinese serpentine frog on a lily-pad, the birthday cards from me and from my sister-in-law.  I pick each up and wash the table with more paper towels.  A j-cloth would be handy but Health and Safety regulations in the Nursing Home determine that only disposable materials may be used for cleaning by us amateurs, the relatives.  We don’t even have the use of a drying up cloth or a washing up brush in the kitchen for fear we might spread contamination.  As a result all the personally owned mugs become rimed with tannins, brownish in their crevices.

The tea on her table derives from my mother’s obsession with placing her empty mug on its side when it is finished, or in her words “dead”.  It is not invariably completely empty when she makes this decision.

As I clean I pause to speak distinctly and slowly in her ear.  “This- happens- because- you- insist-on putting- your -mug -down-on-it’s-side.”  I say.  She hears the words.  “Possibly,” she replies, “ but I have found that it is best this way.”

When I am done, I water the flowers, restock her mini fridge with six packets of Cadbury’s Giant Chocolate Buttons, and her cupboard with three bottles of Maple Syrup.  Dementia likes sweet flavours.   She has long taken maple syrup on her porridge. Now she demands it on her soup and pureed meals as well.  One of the nurses is pregnant, nauseous, and cannot bear to feed my mother this mixture.   She delegates lunch and supper feeding to other carers.

Poor old lady you think, unable to feed herself.  But she is able. She simply elects not to.  That is what the carers are there for.

Her room tidied, I sit down on the bed beside her.  My gorge rises.  There on the table is a new stack of nine or ten chocolate button fragments.  With her right thumbnail she is deftly prizing two fused chocolate buttons apart and discarding the pieces.  Little wonder many are stuck together.  All day she sits with the bag tucked down beside her thigh.  The buttons become warm. They stick together.  She refuses to have them placed on a plate or little bowl on her table.

“You-are-breaking-your-buttons-again.” I state clearly.

“Yes, these are not suitable ones,” she replies, “they are old.  I must throw them away.”

There is a response on the tip of my tongue.  But I confine myself to telling her that she would never have allowed a child to waste food in this way.  I, as a child, was not allowed to leave the table until I had eaten everything on my plate. “Waste is anathema to me.” she used to say.

She is unmoved by my reasoning.  I am not sure that she remembers what a child is.  I firmly suggest putting the buttons back in the fridge for a while so they will become firm again.

With dignity and force, she refuses. “No,” she says.  “ I find it works better this way.”

Cadbury's Giant Chocolate Buttons

Cadbury’s Giant Chocolate Buttons

 

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What is a Lhasa Apso?

by The Curious Scribbler

Several people have commented on the joyful puppy on the banner of this blog, so the time has come to explain. The picture is of Otto, and Otto is a Lhasa Apso.  In that picture he was three months old.

Now he is over two years and has a full long coat which almost touches the ground.  If he were a show dog it would do so, but in order to be a show dog you need to spend less time getting tangled in undergrowth and wearing off the ends of your hair and nails.

Otto, freshly groomed

Otto, freshly groomed

He has a bath and a major detangle about five times a year, the last bath was for the wedding, at which he wore a little costume to match the groom and the ushers and was the comic turn of the day.

Otto in costume at the wedding

Otto, a Lhasa Apso, attends a wedding

However this picture would give a false impression of the Lhasa Apso.  Inside the flowing hair he is all dog, with an enthusiasm for other dogs, deep puddles, rivers, sticky mud, sand dunes and the beach.  Lhasas are proud independent little dogs who bustle along at a trot or a gallop and appreciate a couple of miles walk a day.

Otto in mud

Otto, A Lhasa Apso in mud

Otto, a Lhasa Apso, in the sea

Otto in the sea

Otto in the sea

 

 

Otto, a Lhasa Apso, in hay field

Otto, a Lhasa Apso, in hay field

In the home Lhasa Apsos like to audit the visitors but having been introduced and added them to their acquaintance list they generally treat them with dignity.  They seldom bark.  For the inner circle of family members a full greeting is performed, much whirling, wriggling and standing on his hind legs waving his paws.   Lhasas are said to have their origins as Tibetan monastery dogs, perhaps as the reincarnation of monks not quite making the grade for Nirvana.   They like to sleep in an elevated bed, or indeed along the back of the sofa cushions will do.

Otto is deeply in love with his cats, Boris and Bertha.  When they were tiny kittens they hissed ferociously at him, and most downcast he would retreat a few inches and lie watching them, his chin on his big fluffy paws.  Within a week they had relented, and were rewarded with much affectionate dog licking.  We felt we should intervene as Boris became quite spikey and wet with saliva.  But when we tied up the dog to give respite from this degree of love, the kitten just marched up and demanded more.  Over a few weeks the licking abated.  When Otto feels the urge he captures a kitten, presses it to the ground and snuffles it.  When the cats choose, they lure him into wild chasing games around the house.

When I was trained many years ago in Animal Behaviour we were discouraged from naming animals anthropomorphically and taught to see their behaviours as purely adaptive mechanisms which further their survival.  Emotions were not supposed to be an animal attribute. Anyone who lives with pets soon doubts this mantra.  The dog and the cat have long contributed to the domestication of man, and have a wide repertoire of endearing behaviours of little other value.  They gain much from this co-existence, for their appeal to humans has ensured their food and comfort for millennia.  Otto, Boris and Bertha have welded themselves into a little multi-species family, in which there is no friction and a great deal of warmth.  When we sit down at the end of the day they expand the group to embrace us too.

 

 

 

 

 

 

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November Wedding

by The Curious Scribbler

My daughter was married last Saturday in the 18th century mirrored Music Room of nearby Nanteos mansion.  Welsh weather can be relied upon to be unreliable, but the showery day brought great clarity to the air and rich tones to the oaks and beeches of the Regency parkland beyond.   Her flowers were a blaze of burnt orange and burgundy.  Raids with the secauteurs to kind friends’ gardens  provided dark red hydrangeas, ice plant (Sedum spectabile),  Garrya elliptica, and the last few surviving  deep purple dahlias to complement commercial flowers in the floral arrangements.  The hedgerows yielded deep red hawthorn berries, sculptural ivy flowers and orange rose hips.

The bride and groom outside Nanteos

The bride and groom outside Nanteos

After dark the party moved on for dinner at the Conrah Hotel at Chancery.    For the table centrepieces we grew our own pumpkins, removed their tops and filled them with dahlias, chrysanthemums, ivy and autumn berries.  Warm white LED fairylights hung in swags around the walls, and when the music started they could be switched to twinkling mode around the dancers.

Pumpkin table centrepieces filled with flowers

Pumpkin table centrepieces filled with flowers

I wrote one of the readings for the ceremony, which was conducted with just the right mixture of solemnity and joy by the Registrar Melda Grantham.  While I hesitate to place myself with the other chosen authors, Mark Twain and Roger McGough, I reproduce it here.  I was immensely flattered that several guests felt it would come in handy at their own sons’ and daughters’ future nuptials.

On Marriage

A marriage starts with vows exchanged
And hatted, suited guests all ranged
To witness you, the gilded pair
Who shortly will descend the stair
With gleaming rings as tokens of
Your freshly burnished vows of love.

To reach this point you’ve both used skill
Negotiating good and ill
Establishing a shared existence
Through compromise and calm persistence.
A complex mixture – Life is varied –
Won’t be simpler now you’re married.

But we wish you all those things
Symbolised by giving rings.
Mutual comfort, never lonely
House or Hovel – warm and homely
Worthwhile jobs and cheerful babies
Dogs, and cats, and chickens maybe?
Holidays in sunny places
Kindly wrinkles on your faces
As the passing years progress
May you want for less and less.

Counsel often comes amiss
Proffered by parents at times like this.
But with the privilege of my station
I offer just one observation:

Happy is not a continuous state
It comes in small parcels and sometimes you wait
Through bad times and sad times or moments of strife.
Keep the happy bits coming
The whole of your life!

©The Curious Scribbler

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