Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, June 18, 1995 TAG: 9506170019
SECTION: EDITORIAL PAGE: F-3 EDITION: METRO
SOURCE: ELIZABETH STROTHER EDITORIAL WRITER
DATELINE: LENGTH: Long
It's more than OK, in fact. I just called to make sure she was getting along, not wielding any more spoons in a threatening manner (there was this little incident last week), and the nurse told me Mom is adjusting well, smiles a lot, has a best friend, Ruth, who's on a walker. When there's dancing, the two of them get up and do a sort of line dance, side by side.
An aide, afraid Mom might trip up Ruth, had sought to separate them on one of their strolls, Nurse Sandy confided, but she had said no, leave them alone. They're great friends, and they manage that walker just fine between them. Bless the wise woman.
I won't deny the tears Mom's children have shed or the ache that remains when we think about the cruelty of Alzheimer's and its relentless progress: This active, intelligent woman grows increasingly vague and childlike. But I thank God that care givers are figuring out how to actually care for victims of the disease.
Little more than 20 years ago, Mom and her brothers and sister were at their wits' end about what to do about Grandma, who more than once walked to St. Anthony's in her nightgown in the middle of the night and banged on the rectory door, rousting the priests to ask them to unlock the church. Clearly, she was too senile to live on her own. Her children tried a variety of wildly unsuccessful living arrangements before placing her in a nursing home.
Back then, the doctors said Grandma had "hardening of the arteries." But her loss of judgment and urge to wander sound today an awful lot like Alzheimer's. I remember that she wandered from the home - my sister insists Grandma fell in the snow and was found later by an arriving worker - and from then on, she was tied into a chair. She was mighty stubborn and crafty and strong, and she managed to untie the restraint around her lap. Then she was tied at the wrists, too. Within weeks, she was so withered I didn't recognize her when Mother stopped before a broken woman sitting vacantly in the hall and said, "Hi, Mom."
Mother had brought me along to clip and clean Grandma's nails because I had a light touch, and Grandma always yelped at Mom's attempts. I clipped and cried, silently, through the entire procedure, grateful that she didn't seem to notice either activity much.
So, yes, I feel a twist of pain as Mother's conversation grows more incoherent, a sharp stab of surprise when she says something that indicates she is still aware of her steady mental losses:
"Here's your name on your room, I see," I comment teasingly as I tape family pictures by her door. "Just in case you forget."
``No," she responds, startled. "I don't want to lose my name." The "too" hangs unsaid between us.
``No, no," I lie with a bright smile. "Don't worry. You won't."
But it is a real joy, after returning from St. Louis to Virginia, to hear Sandy's good report, and Mother's voice - happy, upbeat - coming on the line. (``Oh, I'm just walking, here," she tells me. "You know, it's not a very big place" - this last sounding not like a complaint, but like maternal assurance: "It's not a very high slide. ... It's not a very big problem. ... You can do it.")
She is in a new Alzheimer's unit, built, rather than adapted, to accommodate its residents' special needs. A spacious common room, bright and pretty, is glassed in on one side, and unlocked doors open onto a large patio surrounded by an attractive - but high - iron fence. The unit is built into a hill, and a small creek runs along the bottom of the slope. Beyond that is woodlands.
Residents with the urge to wander can walk outside or in. Two sides of the common room open onto corridors, where the residents' rooms are, and the the nurses' station is along the fourth - next to the locked door that is the only passageway to the rest of the world.
My sister and I had visited several nursing homes last year, and none was as pleasant as this. More important to Mother's well-being than the layout, though, is the attitude of the staff. We had found this same emphasis on the labor-intensive task of keeping residents as active as possible at the cheapest - but, unfortunately, most physically depressing - home we had visited. Like the home where she now lives, it had a staff-resident ratio of 1 to 5, including a full-time activities director for the Alzheimer's unit.
Other places had nicer facilities and decor, but thinner staffing, and we could tell. "Activities" at one meant one hour of a planned activity a week, plus all the walking that residents cared to do, up and down one long corridor. (``We meet the state requirement, a 1-to-10 ratio," the marketing director told us waspishly.)
Mother does need to walk, but we knew she'd be depressed without the activities she was getting for hours every day at her day-care center: games, singing, exercises, relating stories in the newspaper to memories - none of which she can do anymore without help.
Sad as I am that she needs this help, I am profoundly grateful she is in a place where she gets it.
"Grandma doesn't need us anymore," my brother's younger daughter, Sara, said sadly after returning from one visit the other week. At 5, she had naturally taken on the role of Grandma's vigilant protector, grabbing Mother's hand in parking lots even as her own mom or dad grabbed onto her.
"She still needs us," we assured Sara. It's just that now she needs us less, while we need her the same as always.
by CNB