Saturday, November 8, 2014

How Can She Grieve When She Has Alzheimer's?

My phone rang about 7:00 pm on October 4th. I was surprised when I answered and my mom was on the other end. "Donna, Elmer fell and they are taking him to the hospital."
I said  "Who is taking him to the hospital?"
"The ambulance."
"Where are they taking him?"
A man's voice, who I thought may be an EMT, said "They are taking him to the North Emergency Center."
I said "He probably should be taken the the hospital."

The man mumbled something about it being too bad and they were leaving now and the neighbor was taking my mother. I didn't want to waste precious time on the phone,  so I said "Okay, I'll meet her there."

I hung up the phone and ran to my car knowing my mother would be terribly confused if she was left at the emergency center alone.

On the way there I  began to think about that phone conversation. Why couldn't I convince them that he needed a hospital? They wouldn't be able to keep him at an emergency care center and they would have to take him in an ambulance to the hospital. Oh boy, he would be ticked off about that! Why is it people never seem to listen to me? What was it that man said? It's too bad for that? No, he must have said it's not that bad, How could it be too bad to go to the hospital?

I parked my car right in front of the building. I noticed there was a fire truck right out front. The rest of the parking lot was practically empty. I walked through the front double doors to the receptionist. I told him I was there to see my step dad and my mother should already be there. He told me to walk right in and pointed to another set of double doors. As soon as I walked in I saw my mother's neighbor standing outside the room. It wasn't a regular patient room. There was no patient. Just my mom and a couple of women from the fire department. My mom was sitting in the corner and looked up as soon as I entered the room. She said "I can't believe he's gone." I looked at the women standing in the room hoping for an explanation. One of them exited the room quickly and returned with a doctor. He said "I am sorry your stepfather passed away." I think I blubbered something like, "What? I thought he fell. What happened?" The doctor explained that he believed it was a massive heart attack and he died immediately and that it was so quick he wasn't in any pain. My mother seemed like a little girl so lost and sobbing. All I could do was hold her and tell her how very sorry I was.

During the following week I had to explain to my mother over and over what happened. She would say, "Where is Elmer? I don't understand why he did that, we got along so well. Where did he go? Why did he leave like that? Did he take the car?

And I explained many, many times, "Mom, he would never leave on purpose. He had a heart attack and died."

"He did?"

And every time it was as if he had just died (again). Was this a cruel joke? How many times does a husband have to die and how many times does a wife have to endure the pain of loss?

I slept in the bed with her in same spot where he slept so she would not wake up and be alone. I thought it would be just for a few nights until she got used to being alone.

One night she grabbed me by the shoulder and yelled "Elmer, Elmer!"
I said "No mom, it's me."
"Where is he?"
"He's gone mom."
"Gone? What happened to him?"
I got up and told her again that her husband had died.

I felt like we were living in the movie Ground Hog Day where the guy had to relive the same day over and over, only this was sometimes the same hour over and over. It was like being in a time warp.

Finally after about a week and a half of explaining this several times everyday she somehow began to retain it and she was doing pretty well. So well in fact, I wondered if the Alzheimer's would make going through grief easier, maybe she would forget her grief. Wishful thinking on my part.

Three weeks after he passed away, she got up one morning and said to me "Where is Elmer?" 
I said "Do you mean where are his ashes?" 
She said "yes." 
"They're in the closet, mom." 
"Show me."
An hour later. "Where did Elmer go?" 
I said, "Mom, do you remember that he passed away?"
"What? He did?" 

This went on all day. After showing her the ashes in the closet about 10 times, she said "Where's Elmer?" I said, "Mom, do you remember that his ashes are in the closet?" She said "Your closet?" I said "No. Your closet." She said "Where is that?"

I felt something was wrong with her. Something besides the Alzheimer's. She knows where her room is, where her closet is, and she gets herself dressed. She was doing well for two weeks and now there was a sudden change in her behavior and memory. I checked her blood pressure. It was high. So I called my sister in law, a nurse, who told  me that when the elderly get a bladder infection it can affect their memory. I took her to the doctor. He confirmed it. She had a bladder infection. This gave me a reason to be hopeful. Hopeful that this was just a temporary setback and her memory would improve with antibiotic treatment.

She took an an antibiotic for 10 days and her memory did improve within that 10 days. She began to understand that he was gone (most of the time). But she couldn't understand what happened to his ashes. Finally we went back to the mortuary and bought a box for his ashes and we put his picture on the front. I put it in the family room on the shelf right under the television. It is now in full view and I think it helps her remember (some of the time). 

She gets more confused in the evening and tends to wonder around the house not quite sure what she is looking for, rummaging through the refrigerator, and dresser drawers. I found out this is called "Sundowning."

Then today, five weeks after her husband passed away, she walked out of the bedroom and said "I don't know where Elmer went."

It's hard to accept the loss of a loved one in the best of circumstances, but when you can't remember what happened, or at times even that the person is gone, how can you grieve? And if you can't grieve, how can you heal from the pain of loss? It's something that we're working through day by day and hour by hour.