Saturday, July 24, 2004
It is important for the reader to note...
...that of all my mother's behaviors described in the post immediately preceding this one are daily occurrences. It is not my mother's behavior that created a bad day for me, it was my reaction to all of these behaviors yesterday and my decision to allow myself to play out those reactions. In the inimitable words of Dr. Phil, "And, how did that work for you?" it worked splendidly, thank you, as it only barely affected the tenor of my mother's day, and then only for seconds and allowed me to release some of my built up frustration. In the absence of being able to rely on anyone to care for my mother while I take a vacation which, experience has taught me, will be fraught with concern over whether my mother is being taken care of properly, a bad day can be an adequate enough vacation for me at this time.
I also want to record here that my mother's behaviors and others, many others, are not the sudden consequences of her back injury in October of last year, nor of her blood pressure crash due to medicated dehydration in the fall of 2002. Most of these behaviors such as her short term memory loss and her loss of the ability to concentrate in the moment have been building up since some time prior to the spring of 1997 when I discovered that, although she wanted to buy a house in Prescott, she no longer had the intellectual acuity necessary to participate in the deal and what it required of "the buyer". A few of the behaviors, such as her deciding to sleep away her days, began before this, sometime in 1996, when I was still working and she was staying in bed while I was gone. Loss of her sense of thirst, which undergirded the severe dehydration leading to the blood pressure crash (enhanced by dehydrating medications) started some time before the crash. I only became aware of it when she had the crash. Escalations and additions of other behaviors happened periodically between 1997 and 2000. For all practical purposes she's been as she is now since mid 2000. These behaviors I've described have gone through periods of escalation, plateau and, in some cases, recession, but recession never lasts long, although the plateaus can last for a long, long time, thankfully.
All of these behaviors occur throughout the day in every circumstance including getting her up, bathing her, feeding her breakfast and on throughout the day. To give you a minor example, every time I take her blood pressure with the wrist cuff, which is now averaging three times a day, I have to remind her how to position her arms in order for me to get an accurate reading. She always starts out positioning her right arm as though she's having her blood pressure taken in a doctor's office. Although the reading takes less than a minute, at least once during one of these three daily readings, sometimes more, I have to remind her to support her right arm with her left arm, keep her right arm limp and not move or talk. When she sits at the breakfast table I have to remind her of the best way to approach the chair in order to not compromise her back. It's not uncommon throughout any particular day for me to have to remind her to go to the bathroom.
This time I'm not complaining. It looks as though both she and I are going to have a relatively good, maybe even active (for her) day, even though I expected to be enduring bad day hangover. This time I'm doing what I think I should have done a long time ago in this journal, I'm recording exactly what the day of a caregiver who is involved in intense caregiving is like; the fact that the description has a "bad day" spin is incidental.
You may think I handle all these quirks in behavior that define my mother's Ancient One Days by rote. I don't. First of all, I've never been much of a rote person. Although I've always been handy at repetitive behavior, the reason I'm good at it is that I don't consider behaviors repetitive, even such behaviors as data entry or, for that matter, negotiating my mother's days. Each moment, each requirement, each behavior, each response, stands alone for me and is negotiated as an act separate from and different than any act that may have preceded or may follow it. I think this "gift" of handling what others consider repetitive behavior (I don't even consider typing a series of repetitive behaviors) in the new-moment-by-new-moment way that I have is one of the reasons why I don't have more, many more bad days as my mother's caregiver. As well, I believe this "gift" is the main reason why I am able to handle her care at this stage of the game despite its escalation. It is why, more often than not, I'm glad I'm here and I can say without reservation that I enjoy what I'm doing with my mother, am aware of and take pride in the fact that I do it well and do not look forward to its end, with her, at least. I certainly am not considering doing this again once my mother's gone.
As I pointed out in a recent post, all caregivers give care out of who they are. This is all that can be expected of any caregiver. I know that most people were not blessed with the gift of being able to operate by rote as though they are not operating by rote. I know that many people who received this gift received it over-abundantly and are typically labeled "autistic" [A footnote: One of the exciting recent discoveries about autistic behavior is that it appears as though it isn't a series of rote behaviors compulsively plied after all but is closer to a compulsive inability to have a "normal" sense of past present and future, which, coincidentally, allows those, like me, who are disallowed from rote behavior, to indulge in it. This is a simplistic explanation of recent discoveries, but not inaccurate.].
Anyway, I just wanted to clarify exactly what happens on not only a daily but an hourly and, often, a minute-by-minute basis in the lives of caregivers who tend to the declining elderly or infirm. This is not child care and it is not child's play. It takes a different kind of awareness and flexibility typically not required in the raising of children or the normal caring of loved ones. This is not your father's Oldsmobile.
I also want to record here that my mother's behaviors and others, many others, are not the sudden consequences of her back injury in October of last year, nor of her blood pressure crash due to medicated dehydration in the fall of 2002. Most of these behaviors such as her short term memory loss and her loss of the ability to concentrate in the moment have been building up since some time prior to the spring of 1997 when I discovered that, although she wanted to buy a house in Prescott, she no longer had the intellectual acuity necessary to participate in the deal and what it required of "the buyer". A few of the behaviors, such as her deciding to sleep away her days, began before this, sometime in 1996, when I was still working and she was staying in bed while I was gone. Loss of her sense of thirst, which undergirded the severe dehydration leading to the blood pressure crash (enhanced by dehydrating medications) started some time before the crash. I only became aware of it when she had the crash. Escalations and additions of other behaviors happened periodically between 1997 and 2000. For all practical purposes she's been as she is now since mid 2000. These behaviors I've described have gone through periods of escalation, plateau and, in some cases, recession, but recession never lasts long, although the plateaus can last for a long, long time, thankfully.
All of these behaviors occur throughout the day in every circumstance including getting her up, bathing her, feeding her breakfast and on throughout the day. To give you a minor example, every time I take her blood pressure with the wrist cuff, which is now averaging three times a day, I have to remind her how to position her arms in order for me to get an accurate reading. She always starts out positioning her right arm as though she's having her blood pressure taken in a doctor's office. Although the reading takes less than a minute, at least once during one of these three daily readings, sometimes more, I have to remind her to support her right arm with her left arm, keep her right arm limp and not move or talk. When she sits at the breakfast table I have to remind her of the best way to approach the chair in order to not compromise her back. It's not uncommon throughout any particular day for me to have to remind her to go to the bathroom.
This time I'm not complaining. It looks as though both she and I are going to have a relatively good, maybe even active (for her) day, even though I expected to be enduring bad day hangover. This time I'm doing what I think I should have done a long time ago in this journal, I'm recording exactly what the day of a caregiver who is involved in intense caregiving is like; the fact that the description has a "bad day" spin is incidental.
You may think I handle all these quirks in behavior that define my mother's Ancient One Days by rote. I don't. First of all, I've never been much of a rote person. Although I've always been handy at repetitive behavior, the reason I'm good at it is that I don't consider behaviors repetitive, even such behaviors as data entry or, for that matter, negotiating my mother's days. Each moment, each requirement, each behavior, each response, stands alone for me and is negotiated as an act separate from and different than any act that may have preceded or may follow it. I think this "gift" of handling what others consider repetitive behavior (I don't even consider typing a series of repetitive behaviors) in the new-moment-by-new-moment way that I have is one of the reasons why I don't have more, many more bad days as my mother's caregiver. As well, I believe this "gift" is the main reason why I am able to handle her care at this stage of the game despite its escalation. It is why, more often than not, I'm glad I'm here and I can say without reservation that I enjoy what I'm doing with my mother, am aware of and take pride in the fact that I do it well and do not look forward to its end, with her, at least. I certainly am not considering doing this again once my mother's gone.
As I pointed out in a recent post, all caregivers give care out of who they are. This is all that can be expected of any caregiver. I know that most people were not blessed with the gift of being able to operate by rote as though they are not operating by rote. I know that many people who received this gift received it over-abundantly and are typically labeled "autistic" [A footnote: One of the exciting recent discoveries about autistic behavior is that it appears as though it isn't a series of rote behaviors compulsively plied after all but is closer to a compulsive inability to have a "normal" sense of past present and future, which, coincidentally, allows those, like me, who are disallowed from rote behavior, to indulge in it. This is a simplistic explanation of recent discoveries, but not inaccurate.].
Anyway, I just wanted to clarify exactly what happens on not only a daily but an hourly and, often, a minute-by-minute basis in the lives of caregivers who tend to the declining elderly or infirm. This is not child care and it is not child's play. It takes a different kind of awareness and flexibility typically not required in the raising of children or the normal caring of loved ones. This is not your father's Oldsmobile.
