jmgoyder

wings and things

Monday 9th June 2014

Today I went into town just after lunch to spend the afternoon with Anthony at the nursing home. This has become the ‘norm’ now because a few weeks ago it just became too difficult to take him out and about or to the farm on a regular basis because of mobility problems. Over the last several days Ants has been quite content to just have me in a chair next to him with my arm around him, watching Judge Judy, Dr Phil and, if we are lucky, a good afternoon movie.

I usually stay from around 1.30 – 4.30pm (my new routine) and it beats the hell out of my old routine of taking Anthony on outings, or home, then being unable to manage. Even at the nursing home, I have been told not to lift, move, or even shift him in his chair, because he is now strictly classified as a 2-person lift.

This afternoon I entered Anthony’s room with wine and olives and my usual ‘goodies’ and he was asleep in his armchair. Usually I wake him up, but he looked too peaceful so I just sat next to him and quietly ate all of the olives. Suddenly a nurse entered the room to take his blood pressure because he had been asleep all day. He woke up but only slightly and the nurse and I struggled to get one of his arms free from his jumper because he was so limp and ‘out-of-it’. Well his BP was 190/110 – very high. This, and the fact that I couldn’t really wake him up enough to say goodbye when I left to go home, alarmed me a bit.

On the way back home to the farm, I allowed myself to think that Anthony might be dying. But my thinking of this possibility could not translate into a coherent thought because I cannot imagine him not being here. Despite the difficulties of home nursing, the transition to a nursing home, and all of the mini-traumas in between, I have not yet been able to imagine life without Anthony in it.

My father, Brin, died of a heart attack on this day, 36 years ago. He was only in his 50s.

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Resting

I’ve had a wonderful rest from blogging (as in NOT reading, writing, commenting, replying) and, despite the inevitable guilt, it has been great to concentrate on other things.

Like my navel!

IMG_0069

That’s Gutsy9 by the way.

Life here has become too busy to sustain blogging every day so I’ve decided to post once a week instead of once a day. Again, I really appreciate the support and friendships formed with other bloggers but I simply can’t keep up.

I think, too, I have oversubscribed to blogs in general and, especially to those that deal with grief. The kinship and support exchanged with those bloggers continues to sustain me but also makes me sad. I can hardly cope with my own sorrow about Anthony, so reading about the grief of others is very hard – too hard for me at the moment. For those of you who I have become close to, we have each others’ emails so we can still keep in touch. Please feel free to email me on juligoyder@gmail.com

Years ago, when Anthony was younger and still milking his cows, he would have a mini-rest after lunch and that would sustain him for the afternoon ‘shift’. He would have a solid sleep for around ten minutes then get up again, full of energy!

The memories, all mish-mashed now into the present, are sometimes heartbreaking for me, but not for him, thank God. He is okay; my husband is okay; he is being well looked after in the nursing home; he is warm; when he is confused, the nurses reassure him. And tomorrow, I will go in and stay with him for the afternoon and ask him if it is okay if I lie on his bed while we watch TV ….

Resting.

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Holiday

Ever since I began blogging, in November, 2011 (I had to go back to find this!) I have been amazed by the generosity of strangers, the friendships formed by commonalities, and the understanding when certain bloggers, like myself, just can’t keep up with those amazing, yet tenuous, friendships.

The fact that WordPress has gone a bit AWOL in terms of this blog (yes, I have contacted the Happiness engineer people) has actually given me time to reflect on what I really want to do here, on this blog:

1. Reading: Keep in better touch with blog friends, but don’t feel guilty if you can’t.
2. Writing: KISS (keep-it-simple-stupid!) – also, keep it short.
3. Photography: Learn from others.
4. Personal: If you are having a difficult time with the whole life thing, and you can’t blog, that is absolutely fine.

I so appreciate all of the blog support I have received from friends, relatives, bloggers and family, but I just cannot keep up at the moment and feeling bad not to have even answered comments! So yet another blog break is in order, so I can spend more time with Anthony and write my soon-to-be famous novel ha!

Nothing dramatic – just a little blog holiday.

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A bit like the weather

At the nursing home, Anthony was up and about this afternoon at about the same time he was in bed yesterday. He was lucid, mobile, vocal and quite jaunty.

To me, Dementia resembles the unpredictability of the weather, about which you can do nothing. The other day, a tree was uprooted and fell down during a storm; the next day it poured with rain; the next day it was bright sunshine; and today it is a bit of both.

There is nothing anyone can do about weather fluctuations – nothing. Forecasts can be wrong and often the weather will change drastically from what was expected to something totally different. A storm may shove a sunny day aside and vice versa. And there is nothing you can do about it. Nothing.

Dementia is like this in so many ways. One day, at exactly 10am, Anthony might be able to answer the phone and have a coherent conversation with me; the next day he might be unable to do either. Despite the careful timing of his PDD medications (just like I used to do at home), sometimes he has a huge appetite and other times he has forgotten how to eat. Sometimes he can almost run, using his walker and other times he can’t even take a single step and we have to get the wheelchair.

With over ten years of nursing experience up my sleeve, and a PhD about Alzheimer’s Disease, you would think that I’d have more understanding of the kind of nuances that occur when Dementia has climbed onto the back of another disease like Anthony’s Parkinson’s. And yet, every day is a surprise for me – sometime wonderful, sometimes awful, and sometimes in-between … a bit like the weather.

So what do you do when the weather isn’t what you expected?
You accept it of course, because you have no choice.

[Note to blogger friends: I am still not receiving email notifications of your posts so have been using the WP Reader. This is a much better way for me for the time being but I am not keeping up with you all and I apologize].

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Bedridden

Today, Ming and I took my mother out for lunch for Mother’s Day and we had a lovely time together, and we all mentioned Anthony but the logistics of getting him into that crowded restaurant were too difficult, so we didn’t include him.

After lunch, Ming and I went to the nursing home. Usually, when we visit, Ants is out in the sunshine, or still at the communal dining table, or sitting in the armchair in his room. But, today, for the first time ever, we found him in bed, with the bed-rail up. Ming and I briefly watched him from the doorway; he was nearly asleep, but not quite, his eyes were vacant and wide, and his tongue was lolling, and he was extremely confused.

I sat right next to Ants and stroked his head, while Ming looked through a couple of boxes of photos of Ants when he was young (which I have kept in Anthony’s nursing home cupboard for ages) and, for the first time ever, Ming was really interested.

But Anthony was terribly blank and his speech was incoherent and, even though I know he might be a lot better tomorrow, I caught a glimpse of the inescapable future when he will be bedridden and unable to communicate.

I am totally gobsmacked by my mother’s capacity to love and visit this son-in-law of hers who is just a bit younger than her. When, as a teenager, I fell in love with a man twice my age, she must have been totally alarmed and who wouldn’t be? He was 41! Long story short, it took many years for it to all work out with Ants and me, mainly because he respected (and was terrified of) my youth. But when we finally got married, my mother embraced him with her whole, beautiful heart, hesitantly to begin with, cautiously and protectively, and now totally.

Anthony is approaching, in a slow and confusing way, the next phase of all the diseases he suffers, mainly Parkinson’s. I visit, or take Ants home, or out, every day when I can but I fluctuate and am not very organised (i.e. yesterday I brought him home for the day then felt like I needed a crane to lift him from chair to wheelchair to car – it was terrible and I wasn’t physically strong enough and, all the way back to the nursing home I sobbed silently, because I had become impatient with him with my “JUST PUT YOUR LEFT FOOT FORWARD, ANTS!”)

Even though I can already see that I have written a rather convolutedly emotional post here, I want to thank my mother so much for helping me care for Anthony now that he is in the nursing home, for visiting so often, and for loving him. Thank you Mother.

But when he is totally bedridden and asks for you and not me we may need to have a bit of a discussion!

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Parkinson’s Disease Dementia and FEAR

I don’t think many people recognize, and acknowledge, the kind of fear that a person with any kind of dementia can experience. Anthony has PDD but can still vocalize his fears, especially after the sun goes down (Sundowner’s syndrome).

About 15 minutes ago, I rang him on his new phone and he actually picked up (doesn’t always remember how) and he was frightened and utterly delusional, thinking that he was at his brother’s house and that a storm had destroyed it, and asking me to come and rescue him. His words were garbled and frantic. I tried to calm him down, then told him I would ring the nurse but he said I wouldn’t be able to get hold of a nurse because of all the workmen were around and it was dangerous.

So then I rang the nurse and told her and she said she would go and check on him and get back to me. There is now an anti-anxiety drug that has been prescribed for these occasions so I reminded her of that.

Now I am waiting for her phone-call. As I wait, I think, with great distress, about how, from time to time, Anthony becomes absolutely terrified at night. PDD and, paradoxically, some of the medications used to treat it, can cause hallucinations, paranoia, confusion of space and time, and fear.

Anthony’s bouts of terror usually only last about half an hour which is the same amount of time it would take me to drive into town and ‘rescue’ him.

When is scared like this, he becomes more articulate despite the fact that what he describes isn’t real. Very soon, I think, he will not be able to talk at all, so it is very important for me that I understand his fear, and try to reassure him. I was in this afternoon, seeing him, and there was no indication he might have one of these ‘episodes’ despite the fact that he was very confused.

I am not just spilling my guts here – I am also saying that if your loved one has dementia but has ceased to speak, they might have the FEAR thing too so your voice on a phone, your visit, your touch, a hug, a cake, a blanket or a cup of tea might just alleviate that.

My heart breaks for those suffering this kind of fear in silence. I just spoke to the nurse and Anthony is apparently okay again and he is being put to bed but what if he is still really afraid? I am so worried, but I won’t be able to see Ants until tomorrow morning by which time he may have forgotten the fear. Oh I hope so.

He is, and always will be, my hero.

[ps. not keeping up with other blogs atm – sorry]

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Ten years ago!

I just found this email draft in my files. I wrote it to Anthony’s doctor and specialist at the time, but I never sent it because I was too shy to be this upfront and personal and, also, neither of them were emailable back then. It gave me a bit of a shock to read my perspective of what was happening to Anthony in 2004, from my new perspective in 2014, mainly because I had lost track of how long Parkinson’s Disease has been part of our lives:

Feb. 2004

[Notes for Drs re Anthony Goyder’s Parkinson’s]

Hello Mike and Robert,

I want to document Anthony’s “condition” before I get so used to it I think it’s normal, whatever the hell normal is. So I am writing to you without Anthony’s knowledge because, from past experience, I have learned that to say this sort of thing in front of him only makes things worse. So this is confidential between you and me. I would hate for him to know that I am this worried and this pissed off.

He presents fairly well to you guys (bravado and all that), then, when we get home and he is back to ‘normal’, he just slumps again. I am struggling with the dilemma of whether to push him to make more of an effort, or to just let him be – ie. I am not sure anymore whether his lassitude, lethargy, lack-lustreness etc. are symptomatic of the Parkinson’s in a physical sense, or if this is a psychological thing – or if this is a side effect of the sinemet.

THINGS I AM NOTICING ABOUT ANTHONY SINCE PARKINSON’S DIAGNOSIS

He has an increased stoop, so much so that he seems to fill more space than he did before and, from behind, he is so bent over that it looks as if he is headless;
His movements are slower – terribly slow; his ability to grasp, pour, reach for, use cutlery, walk etc. – all of these are drastically reduced.
He is exhausted most of the time. He does chores like emptying rubbish into incinerator and long hours of watering garden (switching hoses etc.) but has to sit down often in between all of this. Sometimes he stands for minutes on end outside, looking at the ground. I don’t know what he is thinking.
He seems badly depressed but I’m not sure about this because we still do have a few laughs and great conversations. The main reason I think he might be depressed to the point of needing medication is that he has no energy or incentive or excitement about anything and will not come to watch Ming (our 10 year old) play basketball etc. In fact, Anthony will not go anywhere anymore except extremely reluctantly.
He often doesn’t shave, even if visitors are coming. He wears raggy clothes and he can’t pull his shirts down or his shorts up and doesn’t seem to care. He lies down a lot. He appears morose a lot – I do realise this lack of facial expression is yet another symptom, but sometimes it seems like real moroseness.
He can’t keep up verbally or cognitively with what is going on when Ming and I are having a conversation and he often misses the point of something that is said. This is not terribly noticeable except to Ming and to me. Anthony kind of goes a bit blank or preoccupied and I sometimes have to “translate” what Ming says to him.
Sometimes I may be doing something really mundane like cutting up vegemite sandwiches and he says something bizarre like, “What’s that? Is it meat?” when I’ve only just told him what I’m doing. I do realise this could be an eyesight thing and he refuses to wear glasses, so maybe I’m overreacting – ha.
He has become extremely self-conscious about his appearance (old, bent over etc. – his words, not mine) and avoids all social events.
He will not/cannot drive anymore, except to take Ming to school and pick him up on the days I am at work. The weird and worrying thing about this for me is that he was always car crazy and loved driving but he doesn’t seem to care that he’s lost this. If this is acceptance, fine, but it seems to me that this is a kind of resignation thing. I am not criticizing him – I am worried.
He is ultra dependent on me – my company, my presence. Whenever I go out (except when I go to work), I feel guilty about leaving him.
The drooling thing has nearly stopped, but is still there occasionally. I have always pretended not to notice, of course.

I confronted Anthony about some of these things during our recent row (not really a row, just me upset and him defeated) and his attitude was a silence of sorts – an inability to voice what he must be suffering. Ok, fine, and – yes – I do have empathy and 99% of the time I’m fine with this whole situation. But….

Anthony is worse, in most of the above ways, than when he was diagnosed. To me, this indicates that the sinemet is not quite keeping up with the progression of the disease. He is terribly reluctant to take more pills so it would be great if there were a pill with a higher mg content so he wouldn’t feel as if he were taking heaps. Someone has scared him re the fact that eventually he will become resistant to the drugs.

Once again, I do not want him to know I have said all this to you. It is very important that I seem calm and cool to him and I very much regret being upset and nasty with him the other day. Anthony is not a fighter, once attacked. He is strong, he is resilient, but he seems to crumple in the face of adversity. I do not want him to know any of the bad stuff that may be coming, so please don’t tell him.

Thanks

Julie G

It just feels like yesterday….

31 Comments »

Parkinson’s disease dementia and life expectancy

Okay so I googled this today with a mixture of guilt and curiosity. In watching Anthony’s physical and mental abilities diminish over the last year, I have become increasingly concerned that (a) he will become very depressed; (b) his confusion will cause him anxiety; and (c) he will suffer physical pain.

Some of these things are already happening of course but, so far, he is not in physical pain and – remarkably, in my opinion, – is not depressed in any clinical sense. He is plagued by bouts of immobility and incontinence but we have both accepted these aspects of PD. Recently, however, the confusion of dementia has caused us both anxiety. For example, if he is home for the day, he will often talk to Ming and me even when we aren’t in the room. And sometimes, in the nursing home, he will think we are all home on the farm, and can’t understand where Ming and I are going when we leave him.

It is over seven years now since Antony’s PD diagnosis, and just over two years since he has lived in the nursing home. He is sad a lot of the time, mainly because he misses me, Ming and home, but mostly he is resigned and heroic in the way he has accepted now that he is too heavy for a single person to lift (in and out of bed etc.)

As much as possible, I have tried to inject a daily dose of joy into our equation but sometimes that isn’t enough and visiting him yesterday with my youngest brother and his youngest son, although wonderful, gutted me when we had to leave him, leaning on his walker, waving goodbye, with two nurses ready to take him back to his room.

How long will this go on? I catch myself wondering if sudden death would be better than this excruciatingly slow journey into an illness that has no cure, that ends with severe dementia, and that robs us of the energy we once had to adore each other. Of course the love is still there – maybe more than ever – but it is no longer a gleeful, adventurous, exciting love; it is more like a needy, obligatory, remembered love – not quite real in the here and now.

My grief and love for Anthony are in equal proportions and every single day it’s as if they draw straws to see which one will win – usually love, but not always….

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Anzac Day

Today is Anzac Day (fyi http://www.awm.gov.au/commemoration/anzac/anzac-tradition/) so I went into town this morning to join Anthony for the nursing home’s memorial ceremony. Many of his forbears fought in various wars and he has always become very emotional, as his mother used to, on this day of remembrance, so I wanted to make sure he was okay.

I was surprised to find that he wasn’t particularly interested. The ceremony was an abbreviation of those held elsewhere, probably due to having to fit it in between breakfast and lunch routines, and the usual under-staffing on a public holiday. I sat next to Ants with my hand on his arm during the service but now that he is so bowed over (partly due to Parkinson’s disease and partly due to his spinal condition) he no longer looks up so I had to kind of hold his head up when the flag was raised.

By 11am we were back in Anthony’s room and he was very wobbly (‘wobbly’ is the term we coined some years ago to describe what happens when PD is in full force; his eyes become glazed, he begins to dribble, and he can’t move, talk, focus without prompting). A nurse came in at 11.10am to give him his 11am pill but none of his meds seem to work like they used to so I had to feed him his lunch using a spoon. Like all of the residents in the high care wing of the nursing home, he has to wear a bib. We bantered a bit (well I did) about me having to feed him like a baby and that garnered a small smile from him.

By 1pm, I wanted to go home to my chores and said so. Anthony briefly rallied asking why he couldn’t come too and (for the zillionth time) I explained that, as it was already the afternoon, he would just get more wobbly and too heavy for me blah blah, and he gave me the usual stony look. I then reassured him that I would bring him home tomorrow morning because my youngest brother is visiting with his youngest son.

Tonight I rang Ants at about 6pm and he answered it (yay!) but I had to shout because he has forgotten that he has to hold the receiver to his ear, despite how many times I have showed him how. I could hear his voice saying ‘hello’ but as if from a great distance, so I yelled, “PUT THE PHONE NEXT TO YOUR EAR!” He finally did so and this was our conversation:

Me: It’s ME, Julie, your wife!
Anthony: I don’t know where Julie is.
Me: I’m Julie – it’s me, Ants!
Anthony: Oh, Jules ….
Me: I’m just ringing to say good night.
Anthony: Tonight?
Me: I’m ringing to say good night, Ants.
Anthony: Oh that’s very sweet of you.
Me: So I’ll see you tomorrow morning, okay?
Anthony: Where are you?
Me: I’m home.
Anthony: Is Mum with you? (He meant his own mother who died decades ago).
Me: No, but Ming is. So I’m saying good night and I love you.
Anthony: I … you … bye….

Next year will be the 100th anniversary of ANZAC day and I wonder if Anthony will still be here. If he is, I know for sure that he will not remember what the day commemorates because once dementia kicks in, it kicks hard and that is what is already happening.

The photo below was taken by Jane, one of Anthony’s nieces, at his 75th birthday party here, over three years ago. He doesn’t look like this anymore.

Anthony listening to speech

LEST WE FORGET.

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Macular degeneration

My mother doesn’t like to be written about because she is very private about her life, but, as I’m not so private, I would like, here, to salute her for the following:

When my mother was just in her 40s, Dad died of a heart attack. Not long after that, she developed breast cancer and had to have a mastectomy and chemotherapy. Then, about ten years ago, she began to lose her hearing. Two years ago, she fell and broke her hip and then, just as her hip had healed, she fell off her bicycle and broke her pelvis and wrist. And now she has macular degeneration and has to have six-weekly injections into her good eye to prevent it from getting worse (I took her today for one of these).

Despite all of these situations, my mother is an absolute inspiration to all of us and is as active now, at 79, as she was when Dad died and before. She will do anything for anyone and her volunteer work is beyond belief. She has more energy and compassion and generosity than I will ever have!

After the car accident, six months ago, my mother and my brothers’ families had to deal emotionally with repercussions, injuries and enormous anxiety and yet she always remained calm and in control and absolutely supportive of all of us. My own pain of regret had nowhere to go except to my mother and she helped me to figure out how to keep going. (AND she visited Anthony on all of the days I couldn’t when I had the rotten pompholyx condition).

This kind of mother is rare – the kind of mother you would dream of having – and it doesn’t seem fair that she would now be afflicted with macular degeneration, but she is. A fact. Life. Age. Hardship.

And what is Mother doing tonight? She is probably going to ignore the pain in her injected eye and work on the scrapbook she will give Ming when he turns 21 next January She has done this for each of the grandchildren preceding Ming and she has done it for my brothers and me when we each turned 50.

She is funny, clever, artistic and an absolute legend. And she is NOT old!
She is always NEW!

My/our mother xxx

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