jmgoyder

wings and things

Easter Saturday, Parkinson’s disease and a picnic

Today, Ming and I picked up Anthony from the nursing home, took him out to my mother’s place, picked her up, then went down to the foreshore near her home for a picnic. It was a perfect day, sunny, but with a breeze, so we grabbed some takeaway (sushi and chicken rolls) and managed to find a gazebo right near the water. Now that Ming’s back has half healed from his second spinal surgery, he insisted on doing all of the maneuvering of Ants in and out of the car and the walker/wheelchair we recently bought, and, except for when we picked Ants up, he was pretty mobile – bonus!

After our main food, my mother and I went to the nearby shop and bought ice-creams for dessert, two banana paddlepops for Ming and me, a magnum for her and an ice-cream sandwich for Ants (he loves these). We were surrounded by seagulls of course and Ming, like a little boy, loved chasing them away.

Then we went for a long drive around the estuary until we got to a semi-hidden beach where Ants said he wanted to have a swim. Having never swum in his life, this was a funny request, so we simply drove back slowly, dropped my mother off at her house, then headed back to the nursing home.

On the way back, Anthony became even quieter than usual, knowing, I guess, that the outing was nearly over, so I turned the car radio up and the three of us bopped a bit, with Anthony tapping his leg and Ming complaining that the radio station was too mainstream and that Ants and I had no taste – brat!

Once we had delivered Ants back to the nursing home room, and got him comfy in his armchair, he was showing signs of fatigue, confusion and the kind of misery that sometimes hits him when we depart. He loves the way Ming and I banter, so when we leave him, despite turning the television on for him, I can see how the silence of our absence hits him. I can see it in his face when this happens because he raises his chin a bit, sort of defiantly, and gives us a glare that is a mixture of love and grit.

He knew that Ming and I were going to a barbecue tonight at a friend’s place and that it would be just as impossible to take him to this as it would be to have a swim in that beautiful ocean. Usually I don’t tell him about these social occasions, so that he doesn’t feel left out, but this time I had to in order to explain why we had to go.

If it weren’t for the various photos I’ve taken over the last few years, I probably wouldn’t see as clearly how much Anthony has deteriorated. The photo I’ve included here is from a bit over two years ago when we were still able to do the restaurant thing easily. Back then, he was more upright, more mobile, more able to eat using a knife and fork, more vocal, more himself. Now, going to restaurants or to people’s houses for a sit-down meal is very hard because, with PD, he is only able to focus on one thing at a time (one voice, one activity, one sound), so the picnic idea was much easier.

When we picked Anthony up this morning, the nurse-in-charge said he had become aggressive again, punching out at the carers, and swearing (totally out of character), so I promised to have a word with him and I explained to her that it is part of the dementia engulfing the PD. She nodded in understanding but when I mentioned it to Ants he just muttered that he had to fight because he is often kidnapped.

I am sad, yes, but no longer ‘tragified’ because what would be the point? This is only going to get worse, not better, so the four of us just have to accept this and do the best we can (I include my mother in this foursome because she is a rock and very much a part of our own little family dynamic).

DSCN1244

51 Comments »

A very quiet house

As many of you already know, Ming lives in an old shed we began to renovate for him years ago (before Anthony went into the nursing home). It has been a very long process but also very exciting. Once it was finally finished, with a new paint job, lino on the floor, windows put in, electricity connected and his bed moved out there (around six months ago) he began to sleep out there regularly. But it wasn’t until recently that he moved all of his stuff out of his old bedroom (in the house) to the shed. Then, two days ago, he moved our old refrigerator in there too so he now has that and a microwave, so he can be (sort of) self-sufficient when it comes to meals.

Ah, meals, yes – a contentious issue for Ming and me. You see he has always been extremely fussy with food. No, let me rephrase that; he has always been extremely FUSSY with food! Let me exemplify. As a newborn, he wouldn’t breastfeed or take a bottle without our coercion (Anthony’s confidence that he’d had this problem with calves, and he could fix it, was unfounded and Ming actually lost some of his scrawny birth weight in his first month of life). He simply wasn’t interested in any sort of sustenance full stop. That first summer of his life I had to actually syringe water/milk/custard/mashed banana into his sweet, rebellious little pursed lips. It was an absolute nightmare.

Long story short, he survived on the bare minimum for years. During toddler years it was crackers and orange juice and sometimes butter, but nothing else. Eventually I took him to a naturopath who did some magic and he got a bit of an appetite but he is still (at 20) one of the most unhungry people I have ever come across. He just doesn’t seem to have a normal appetite reflex thingy – a weird anorexia? Mostly, he doesn’t think to eat, meals are haphazard and then suddenly he will eat four steaks in five minutes.

Needless to say, Anthony and I gave up when he was a kid and just let him ‘graze’. And now that he isn’t a kid any more, he either rejects meals I prepare or says he isn’t hungry. So, a few weeks ago, Ming and I made a decision that has actually saved my sanity (and probably his). When it comes to food, he fends for himself. He buys and prepares his own food and I am not to interfere.

Well, since I don’t eat that much anyway, this has come as a bit of a relief. But it is so hard to let go of 20 years of trying to feed the brat and let him fend for himself.

But it’s so weird and so quiet now and it only hit me tonight. With Anthony now in the nursing home, and Ming in his shed, there is no need any more for me to buy, prepare or cook food for others, so there is no sound of something simmering on the stove or in the crockpot and, because there is nobody in the kitchen any more, the television is off, it is very quiet.

All those years ago, when I first met Anthony and his mother and family, this was the noisiest house I had ever entered – loud voices, radio blaring, eggs and bacon sizzling, kettle boiling, Aga thrumming, dairyhands eating, and big, boisterous Anthony yelling for more toast-and-marmalade please.

So now, with all of that fading into history, and Ants in the nursing home, and Ming in his shed, and food no longer being something any of us share any more, the house is deathly quiet and strange and a little bit unfamiliar.

46 Comments »

Taboo topic: poo!

We all do it but, after the age of around 4 or 5, it becomes a bit taboo to talk about poo. It is an intrinsic part of everyday life but is clothed in secrecy. In nursing homes and hospitals, however, the activity of the bowels is all-important: “Have you used your bowels today, Mr Smith?”

Years ago, when I worked in a hostel for multihandicapped (I don’t know if that is the politically correct term any more; suffice it to say that all of the residents were people with both intellectual and physical disabilities), we had a chart in the shared bathroom in which we had to record daily poo production in cups. Don’t get me wrong – we didn’t use cups, but we had to look at what each person produced and imagine how many cups it might equal.

As a nurse and/or care-giver, you get so used to poo that cleaning it up becomes more of a tedious than a revolting job. At least now there are plastic gloves and pull-up adult nappies which makes things a lot easier on the carer and the sufferer.

I don’t want to personalize this into an Anthony-and-Julie situation here; I just want to speak generally in a way that kind of (hopefully) demystifies this particular type of incontinence and makes it easier to cope with.

The first time it happens it is, of course, humiliating and ghastly for the poo-victim and quite frightening for the carer. Above all, do NOT make the person feel worse than they already do. The next thing you need to do is to remain extremely calm and pragmatic. Just do what you have to do as quickly as possible and try to remember your 5-year-old poo jokes. The ability to hold your breath, and the invention of room deodorizer, are good additions to the situation.

My point: being able to use your bowels means you are still a living, breathing, eating, functioning person, so pooing is a very good thing. So rejoice in the poo! Don’t be afraid of it! It is normal!

It can also be a great conversation starter: “Remember the time when you ….?” Raucous laughter may sometimes accompany these conversations, which is a hell of a lot better than misery.

Just saying…. it might be you one day.

69 Comments »

Parkinson’s disease and paranoia

Well I was wrong about Anthony not remembering last night’s incident. I just spoke to him on the phone earlier this morning and he said ‘they’ are doing terrible things to him and that last night he decided to fight back. “I wanted you to come in and see they are testing me.”

I tried to explain that the staff were just trying to put him to bed, but he wouldn’t accept that and so I said Ming and I would be in this afternoon. He said okay in a tired, defeated voice.

Since then I’ve been looking at various articles about Parkinson’s disease (PD) and Parkinson’s disease dementia (PDD) that discuss paranoia and psychosis in the latter stages of the disease. The fact that Anthony remembers last night, and still maintains that he is somehow under attack, indicates that paranoia has well and truly landed on our doorstep.

In the literature about PD that I’ve read over the years, it is stated by many that symptoms like hallucinations and paranoia are not only symptoms of the disease but may also be side-effects of the medications. What a dilemma! Ants has had hallucinations for years and lately I have noticed them getting worse (not in a disturbing way – it’s usually just dogs in the room) but in terms of frequency.

The increase in hallucinations exacerbates the paranoia because if Anthony thinks a tablecloth is his dessert, or that a dog is sitting on top of his television, or that Ming is sitting in an empty chair, or that a spoon is a lizard or that the polka-dots on my shirt are flies, then it stands to reason that he might also see a nurse as a torturer. Especially if it is late in the evening and he is already tired and confused.

It probably seems harsh that I yelled at Anthony on the phone last night but I have found this to be quite effective in the past when gentle words don’t work. Cruel to be kind I guess and it kind of shocks him into a tentative acceptance of what is going on. Last night he didn’t believe me that the nurses were nurses until I yelled at him. Obviously, if I lived closer than a half hour drive I would have gone into the nursing home, and maybe I should have gone in anyway, but the nurses reassured me on the phone that Anthony had calmed down a bit, so I let them handle the situation and I hoped for the best.

In the past, it has helped Anthony a lot when I have explained the link between PD and hallucinations so this afternoon, when Ming and I see him, I am also going to tell him about how paranoia is also part of his condition. I think if he knows this it will help him cope better with the night time ritual of being put to bed by the nurses.

Time will tell.

The photo is from two years ago with ‘Doc’ (now deceased) on Anthony’s lap, and ‘Jack’ the Irish terrier we got Anthony as a surprise birthday present when he still lived here at home.

IMG_0228

38 Comments »

Breaking nursing home rules!

For the last couple of days, I have brought Anthony home for the day. On Sunday, friends came over to see him/us so that was fantastic but yesterday he opted for a quiet day with just Ming and me. Today, I just went in late (4pmish) and grabbed him to come with me to do a few errands: groceries, returning dvds, pizza for Ming etc.

So, as I was trying to get him to walk to the door and outside to the car, I asked the couple of nurses who were helping us if they liked pizza. Their eyes lit up (as mine do when I hear ‘pizza’) so I said I was going to get pizza for Ming and I would love to bring them some too. Then, a very interesting conversation ensued:

Nurse 1: We’re not allowed to accept gifts.
Me: It’s not a gift – it’s pizza!
Nurse 2: I like pepperoni.
Me: What is the problem? I hate these stupid rules.
Nurse 1: Well, if you give us anything, and we accept it, it could be misinterpreted as bribery.
Me: What?
Nurse 1: No, no (laughing) we know you but the rule is that if we accept any gifts from relatives we might be in trouble because it might seem like the relative is doing it to get better care for their loved one.
Me: OMG but I bring chocolates and pistachios and olives in all the time and share it around. Does everyone think I’m a briberist?
Nurse 2: Of course not! We know you but we just have to be quite careful about this sort of thing, because of the rules.
Nurse 1: I like Hawaiian.
Me: Okay, so when I come back with Ants, I’ll just put the pizzas at the desk anonymously?

Both of the nurses nodded and we all had a chuckle but as Ants and I drove around town doing my errands and then ordering the pizzas, I asked him what he thought about the bribery nonsense and he said, “That’s what it’s like at the school, Jules.” (He always calls the nursing home ‘the school’).

Anyway, I wasn’t taking any of this seriously until we got back to the nursing home. The first thing I did was to place three large pizzas on the nursing desk (nobody was there so my secret was safe). Then I went back to help Ants into his room and chair. I turned his light and television on and then we shared a bit of his own pizza, then I left.

On my way out, I heard one of the kitchen staff quizzing Nurse 2: Where did those pizzas come from?
Nurse 2: I have no idea – they just appeared! But I am really grateful.

As I leapt to the exit door for a quick getaway, Nurse 2 called out, “Have a great evening, Julie.” I just hope that when they eat those pizzas, they also eat the boxes because my fingerprints are on them!

57 Comments »

A strange incident at the nursing home

The week before last there was a Melbourne cup luncheon at the nursing home (the Melbourne cup is Australia’s annual horse race – ‘the race that stops the nation’). I have mixed feelings about this race but that is beside the point of this post.

Anyway, when Anthony still lived at home, he organized sweeps with family, friends and farm workers and he loved doing this and was very good at it. Horses were picked, money was collected and lists were made; it was great fun. Obviously he can’t do this now so I did a small sweep with just Ming, Ants and me, but it felt kind of false and feeble compared to the efforts Anthony made over the years. Oh well.

On the phone that morning, he said he had reserved me a seat at the nursing home luncheon so I hurried in to be there in time for the televised race at noon. On entering the very crowded ‘events’ room, one of the staff pointed to where Anthony was sitting. There was no chair for me beside him and I noticed there were no other family members which surprised me a bit, so I squeezed in next to him and sat on his walker. Around sixty residents were sitting around three long tables but there were only a few from Anthony’s ‘high care’ section. Each resident had either a glass of wine or beer and plates of nibbles were placed here and there so people could help themselves. I filled Anthony’s plate and helped another man too and then the race began on the television. Staff lined the walls just as excited as residents and once the race was over, the woman in charge of handing out the winnings did so with humour and I broke it to Anthony that we hadn’t won anything which he took in his stride.

At that moment, Anthony said, “Here, Jules, have some of this – I can’t eat it all.” So I spotted a spare spoon and scooped up a bit of potato salad which was delicious. “Have some more,” he said, delighted, but as I went to do so, someone tapped me on the shoulder. I looked up and saw that it was the nursing home manager.

“Julie, can I have a word with you?” she said, beckoning me to follow her into an adjacent room.
“Am I in trouble?” I said, jokingly, following her.
She turned around and frowned. “I cannot have you eating the food. I have already turned away two families because we can’t cater for family members on this kind of occasion.”
I felt shocked and humiliated and apologized profusely, so she said, “You can stay but don’t eat the food.”
“Anthony said I was invited,” I said.
“No,” she said.

I wanted to cry, I wanted to rant, I wanted to know who she’d turned away but I knew, as soon as I re-entered the events room because I immediately noticed the misery on Natalie’s face (Natalie is a resident in high care and is usually robust and full of laughter; her daughter and son visit every day so we have become friends. Their absence and Nat’s uncharacteristically long face told me what must have happened. I patted her on the shoulder but she hardly responded).

I then resumed my seat on Anthony’s walker, my face flushed with a mixture of embarrassment and rage. Once again, Anthony offered me some food from his plate but I whispered, “I’m not allowed to – have just been reprimanded.” He shook his head, disgusted, as I nervously helped him manage to feed himself. Suddenly plates of dessert came out and one of the staff serving said, “Hey, Jules, do you want some cheesecake?” I shook my head and said, “I’m not allowed.”

Later that week I bumped into Nat’s daughter who was looking glum. Like her mother, she is usually full of smiles. When I asked her what was wrong she told me she had been kicked out of the Melbourne cup luncheon and her mother had been miserable ever since. We had a brief, whispered conversation in which we both decided that it wouldn’t be tactical to complain.

I understand – of course I do – that having to cater for every resident’s family members for a big lunch would pose logistical problems but the fact is that in the nearly two years since Anthony has been a resident at this nursing home, I have only ever met a handful of family members who visit their loved ones, so it’s not like there would have been a crowd.

After the lunch was over that day, I went to the nursing manager’s office to once again apologize and tell her that I hadn’t known the rules. I guess she could see I was nearly in tears so she suddenly turned her usually unsmiling face into a half-smile and said, “It’s okay, Julie, you didn’t know.”

For the first time in ages, I cried all the way home.

Note: I have stopped calling it a nursing lodge and am calling it what it is – a nursing home.

The photos are of times gone by.

A Goyders Dardanup

73 Comments »

A perfect arrangement

Ming offered to pick Anthony up on Monday and bring him home for the day, then take him back to the nursing lodge in the late afternoon. I can’t believe how much this improved the day for me! It was so wonderful not having to make the two trips, each of which takes around an hour if you count the time it takes to get Anthony in and out of the car and then back into his room at the lodge. It was also great fun for Anthony to have his big son driving him around and Ming got to spend time with Ants on his own during the trips to and fro.

When I take Anthony back to the nursing lodge he often gets really unhappy and sentimental, and saying goodbye for the evening is sometimes a bit tearful for both of us. But with Ming, this doesn’t happen so that is a real bonus. This arrangement was also great because, having done the two trips with Anthony, Ming didn’t feel he had to spend every minute of the day with him. This can be a bit of a strain for Ming, especially when Anthony isn’t making any sense or doesn’t speak at all.

Anthony and I spent most of the morning in the kitchen while I made chicken and vegetable soup for our lunch. Then he wandered around the farm (wonderful!) until he became too wobbly. Back in the kitchen he watched me make a blue cake while we caught an old episode of Midsomer Murders on the television. The cake wasn’t quite cooked when it came time for Ming to take Anthony back so I surprised him with it on his return. As you can see, he was nonplussed.

IMG_2794
IMG_2796
IMG_2797
IMG_2798

Ming said he will drive Anthony back and forth whenever he can. This is a perfect arrangement.

37 Comments »

Parkinson’s disease and (un)predictability

Unpredictability

There are many things about Parkinson’s Disease (or Parkinsonism as Anthony’s condition is described) that are unpredictable, especially when, in advanced stages, Dementia begins to insinuate itself into the situation. For example, the other night I rang Ants at the usual time of 7pm to say goodnight and he was lucid and loving and asked when I would be in the following day, then last night a nurse rang me and put Ants on the phone and he was terribly confused and didn’t know where he was. And I have heard, from him and from nurses, that at bed time he can become aggressive. Sometimes, when I am unable to get through to him (he is finding the phone increasingly difficult to operate), I’m actually strangely relieved, but mostly I need to say goodnight just to make sure he is okay and to tell him I love him, and hear him say the same. Whenever he is distressed, I find it nearly unbearable as he is a half hour’s drive away, so I can’t just pop in.

Predictability

Anthony takes a lot of medication but the two times of day I notice the urgency of timing are 11am and 4pm. For example this afternoon, I picked him up from the nursing lodge after lunch so that he could accompany me on a few errands. I hate doing this boring stuff by myself and he loves helping me even though he has to sit in the car while I jump in and out at shops, the bank, butcher, post office etc. Now, even though today I was given the 4pm tablet in case we were still out and about, by 3.30pm I could see I would need to save a couple of the errands for the next day or it would be impossible to get Ants from the car into his room. Why? Because he freezes. ‘Freezing’ is a PD term for when the person’s body freezes into stillness, making it nearly impossible to walk, talk etc. Almost without exception, this begins to happen to Anthony at 3.30 so that by the time he has his meds at 4pm he is frozen, but by 4.30 he is again able to move.

The unpredictable stuff makes planning very difficult but the predictable stuff allows me to time visits and outings. It is such a complicated disease.

32 Comments »

Happy

I think feeling happy is a bit different to being happy. Maybe this is because when you simply are happy (because your bank account, love-life, health, job, family and friends etc. are all okay) you don’t notice the happiness; you don’t appreciate it. But when you feel happy, you are noticing the fragile edges, blossoms, and sunsets of whatever happiness is and you are learning how to create it day by day by day.

Today, my happiness was hugging my baby peacock, having lunch at an Indian restaurant with my friend/niece, Jane, buying baking utensils for my new cooking phase, watching TV with Anthony in the nursing lodge whilst giving him the last of the sticky date pudding with lots of thickened cream, knowing my ma will be home soon from Scotland, riding my bike, watching ‘Undercover Boss’ with Ming, and looking forward to tomorrow’s unfolding.

pea 461

52 Comments »

Ageism

Before I entered university life, I worked for around ten years in nursing homes. I felt an enormous affection for elderly people and began to understand the communication value of stories told by people who were in various stages of dementia.

I wrote a PhD, then a book, then articles – all published – and Anthony was so proud of me. We used to talk about the elderly people I’d met, their stories, my theories, and the various drawbacks of life in a nursing home. This was around the same time we got married – 20 years ago.

Little did I know then what would happen to us now, that Anthony would be in a nursing home, that Anthony would get Parkinon’s disease dementia (PDD), that Ming, our son, would become ageist.

Like many young people, Ming has an aversion to old age, but he never used to! He used to be compassionate and kind; now he is either horrified or indifferent.

We had a discussion about this last night and Ming actually admitted to ageism.
“It’s Dad’s fault,” he said.

I went outside and wept.

83 Comments »