jmgoyder

wings and things

Smiling

This afternoon Anthony was, as is usual now, in his armchair in his room at the nursing home and a bit confused. I put the heater on, zipped up his jacket, put a rug from home on him and changed the TV station to “Neighbours”. Anthony’s hands were cold, so I took the heat bag my friend Jen made and microwaved it for 4 minutes in the kitchen (staff let me come and go from kitchen area now), took it back and put it on his lap, placed his hands on it and put the rug on top.

Anthony was really drowsy – has been all week – but at one point I was able to rouse him (by punching him gently in the shoulder). His eyes were blank until they met mine and I said, “Ants, I love you more than anyone in the world.” Suddenly my eyes filled up with tears.

There wasn’t much response so I tried again, more shoutingly, “Anthony, I just told you that I love you more than anyone in the world, and my eyes filled with tears, and you ignored me!”

Anthony looked into my wet eyes, and his drooping mouth (caused by Parkinson’s disease) curved upwards into a smile. I realize that doesn’t sound like much but to get a smile from this previously jovial person who is now so disabled, is a small miracle. The only thing that annoys me about this smiling scenario is that I have to work very hard to get a smile out of Anthony whereas Ming just has to walk into his room and shake his hand and – BINGO – Anthony smiles – grr!

I’m so grateful for the decades of smiling we did before smiling became an effort for Anthony – not because of sadness but because of how PD affects the muscles of the face. So nowadays I come into his room with a huge smile every single day.

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Routine to the rescue!

I have never been that crazy about routine. As a younger person I had a reputation for being a bit erratic, despite being a nurse and then a lecturer (jobs in which I was never late but always nearly late!) When Anthony went into the nursing home (nearly two and a half years ago), there was a lot of grief, confusion and uncertainty, but no routine.

Now we have a routine and my heart has stopped racing around anxiously. It is so simple and easy and I wonder why I didn’t do this before but I guess the new routine coincides with a noticeable deterioration in Anthony’s mobility and mind function.

For a couple of weeks now, I have been going into the nursing home for most of the afternoon. In Anthony’s bedside cupboard I have lots of snack foods and drinks, cup-a-soups, brandy, wine, chocolates and sometimes I bring fresh cheese and olives.

If the heater isn’t turned on I reach up and press the button, after kissing my husband hello. Then I put a blanket from home on Anthony’s legs, adjust the chair, change the TV station to something I want to watch, move my chair right next to his and hold his hand.

Sometimes (lately) Anthony says, “How do you always know where to find me?” Sometimes he can’t get the words out – they stumble and crouch, frustrated, just above his lips. Sometimes he drools into what we call ‘the dribble rag’ because his swallowing reflexes have slowed down. Sometimes he tries to squeeze my hand in his and there is a small smile.

So I am now in the nursing home with Ants from 2-5pm most days and sometimes from noon. Does this make me a caring-wife hero-type? No! I don’t even understand what has happened to me to make me all-of-a-sudden so attentive! I love him, of course but I hated going into the nursing home for awhile/off and on. Now I actually can’t wait for 2pm every single day.

This routine has really helped me cope.

PS. This new routine means I don’t have much time atm to follow, comment on other blogs but you are all on my radar.

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A new phase

I think Anthony has entered a new phase of Parkinson’s Disease just in the last week or so. Taking him for drives, or home for the morning or afternoon, or out to lunch, or to visit friends/family has all-of-a-sudden, it seems, become something we don’t do any more.

This new phase is partly due to a deterioration in Anthony’s physical mobility, and his current sleepiness. The transition from Anthony and Julie gallivanting off for the day to Anthony and Julie sitting in his room at the nursing home, watching re-runs of Master Chef, has been strangely enjoyable for me.

Today I had to take Ming to town to get the bus to Perth at 8.45am so I thought I may as well go straight to the nursing home and spend the day there. After seeing Ming off, I found myself in an I-can’t-wait-to-see-Anthony-mood (a mood that is capturing me more and more).

So, for the first time ever, I spent the entire day at the nursing home (from 9am – 4pm). Partly, I did this as an experiment to see if I could cope. But my other reason was to see if Anthony would like me being with him in the nursing home rather than going out; he did! I will now plan all of my writing etc. to be done in the nursing home.

I’m not blogging as consistently as before – hope to catch up soon with blog friends.

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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!

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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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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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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….

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True love

My young friend found this the other day. It was created by her brother Nick when he and Ming were little.

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The UFO

It’s been a busy week, punctuated by strange occurrences. For example, as I rode my bicycle home the other day (from my incredibly long 2 kilometre challenge), I took a short-cut across the front lawn and saw this:

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I assumed that it was a cowpat (you know, the stuff that comes out of a cow’s bottom, ordinarily called cowshit but I am being polite), but none of our neighbours’ cattle usually visit, so then I thought maybe the alpacas, Okami and Uluru, had had a pooing competition, but the pile of whatever-it-was was too big to fit either of these possible scenarios, and, even though geese and ducks produce a lot of this kind of thing, they tend to do it all over the place and not in one spot.

Later in the day I told Ming about it:

Me: There’s this huge pile of shxx on the front lawn – have you seen it?
Ming: No, it’s probably your stupid birds.
Me: No this is massive and it looks really weird, like a UFO or something.
Ming: Don’t worry about it!
Me: Would you mind coming out and having a look?
Ming: Grrr – okay.

So I showed Ming and he started to laugh hysterically.

Me: What’s so funny?
Ming: Remember that pea soup you made and forgot to put in the frig and asked me to throw out?
Me: Oh.

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