It just happened so suddenly. Volunteer Deb arrived for the evening.  As I was getting prepped for heading out, Mary Ann got up and walked into the kitchen.  Deb was with her, as was I when she fainted.  We got her in a chair, then into her transfer chair.  She immediately popped up again, without the brakes yet set.  We got her to her spot by the little table at which she sits in front of the television.  She stood up again.

This time she responded that she wanted to go to the bathroom.  Deb took her while I was still there.  When Mary Ann came back to the Living Room, Deb said she had been looking for her diamond.  I pointed out that it was on her finger.  She popped up again needing to do something she tried to describe but it just didn’t compute.  Then moments later she popped up again and just stood there needing to do something but not sure what.  She fainted again. Deb, of course, was right there with her hand on the gait belt (Deb is a Nurse).

She popped up again. I asked Mary Ann if I could bring her something when I was out.  That is our code for getting her ice cream.  She said, “garbage bags.”  I asked her what she meant, what garbage bags.  She got angry with me for not knowing what she was talking about.  I asked her if she would sit down for Deb since she had been fainting.  She reacted angrily and sat down.  There was nothing in the air, any former conversation, anything in the immediate or recent circumstances having anything to do with garbage or garbage bags.  She responded as if I was just being difficult on purpose about the obvious matter of garbage bags.

Recently, the hallucination/delusion/dream  mixed with reality has been a constant undercurrent, surfacing at various times.  There have been days when she has had streaming confusion.  While the confusion can come and go in moments, tonight’s move from the mild dementia in the background to blatant and intense problems happened in a more dramatic way than I remember happening before.  Rarely has anyone else seen the dementia on the surface with this level of intensity.

After I left, Deb said there were a number of trips to the bathroom, with some action in the last one.  Then she settled in front of the television.  I asked Mary Ann as I was putting her to bed what she was referring to when she got angry with me about the garbage bags.  She wasn’t sure but she thought it had something to do with our Granddaughter, Chloe.  A couple of years ago we bought garbage bags from Chloe as part of an annual school fund raiser.  To my knowledge there has been no conversation in our household about those garbage bags since then.  At the moment, as I am writing, Mary Ann seems settled in bed.

Last night did not go well at all, so I expected today to have some problems with the dementia. She ate reasonably well.  Bath Aide Zandra came to give her a shower.  Mary Ann was in and out a bit.  She asked me to let the dog in.  There is no dog.  She talked about the tapeworm she is convinced that she has.  She said she sees it in the bed at night.  While she was in and out, it was not overly intense.

She was tired, understandably after last night.  There was a lot of time with her head on the little table in front of her.  She opted for Chinese from the grocery for lunch. Hospice Chaplain Ed came over after lunch for a while.  He asked Mary Ann how she was doing, asked me how I was doing, but most of the time it was the usual conversation that included our various ministry experiences.  He was interested in the Concert we had at church since he is a musician, plays the piano.  Mary Ann had her head down and dozed through most of what was an exceedingly boring conversation to her.

She then napped in the bed for about an hour and a half.  I got in some deck time while she was sleeping.  Tonight while Deb stayed with Mary Ann, I did a little shopping at Penney’s to replace some holey underclothes (it’s a pastor thing) and get a long-sleeved white shirt.  Yesterday’s Concert revealed that I had none that fit me.  Who needs a white shirt when retired?  Levi’s and work shirts (euphemism for hang around the house doing nothing shirts) are all that are needed.  Then I went over to my spot with the best view in town and sat for an hour or so.  I read from Weavings, the Spirituality Journal that comes to the house quarterly.  I watched about as beautiful a sunset as a person could hope to see.  In that spot I can hear birds and frogs and wind in the trees against the backdrop of tires on the Interstate a half mile away.

The deck time and sunset time was helpful.  Lately it has just been a little tougher for both of us to deal with the vagaries of each day’s leg in our journey — nothing dramatic, no one thing in particular.  Having said that, a prayer popped into my mind.  In our tradition there are formal corporate prayers (sometimes called Collects) that are often used in worship.  Many of them have a long and rich history.  There is one used in a worship service called Evening Prayer (also in other services) that is a favorite of mine. Here it is, copied from The Lutheran Book of Worship, p.153:

“Lord God, you have called your servants to ventures of which we cannot see the ending by paths as yet untrodden, through perils unknown, Give us faith to go out with good courage, not knowing where we go, but only that your hand is leading us and your love supporting us through Jesus Christ our Lord.  Amen.”

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Sitting in the transfer chair in front of the television, she just fainted.  I took her blood pressure as soon as I could get the cuff on her arm, the stethoscope in my ears and the cuff inflated.  It measured 80/50.  About five minutes later I took it again.  Then it measured 90/60.  Remember the three weeks it measured 220/120 when I took it first thing in the morning?  Check a few posts back.

I started her on a half of a Midodrine pill three times a day.  I got in two doses today.  And so the roller coaster goes up and it goes down.  Today is the best day in the last four (if I am counting correctly) in terms of Mary Ann being awake and lucid.

She got up in time to eat and take pills before Bath Aide Zandra came this morning. While I needed to help her with all that she ate, she had a good quantity of food. She did faint more than once for Zandra as she was trying to give her a shower.

She sat up in the chair for the rest of the morning.  It was the longest she has sat up in the chair in many days.  There has been no evidence of hallucinations today.  She ate reasonably well at lunch, having a big bowl of ice cream for dessert.

After lunch she sat for a while and began slumping over some.  Soon she got up to go in and take a nap.  She slept until supper.  She ate reasonably well (I actually cooked) and had a lemon bar for dessert.

Since Volunteer Twila came for the evening, I was able to get out for a while and bring back for her a couple of scoops of Baskin & Robbins.  She ate that treat right away.  It was not long after that that Twila left and she went to bed.  She has been down for a couple of hours, either watching television or sleeping.

I have finished the fax to the KU Med Center Parkinson’s Clinic Neurologist and intend to send it tomorrow.  As I finished it, I could describe what has become a pattern for the last three weeks: two days and two or three nights with streaming hallucinations any time she is awake;  then two days and two or three nights of sleeping all the time (day and night); then a couple of days and nights in which she sleeps at night and is awake and lucid about half of each of the days.  Then the cycle begins again.  This is the closest we have come to a pattern in a long time.  It is not a wonderful and pleasing pattern, but at least it provides something coherent to communicate to the doctor other than constantly unpredictable changes.

Last night instead of getting to bed early as I had planned, I checked out some of the Taizé music on YouTube.  I followed it with some Russian Orhodox Liturgical Chant, also on YouTube.  That hour or so was very nurturing spiritually.  Since the snow and Mary Ann’s sleeping through the entire day precluded getting to corporate worship, I needed the sabbath rest more than the physical rest.  Tonight for part of the time I found a spot with enough light at PT’s coffee shop and read the book on science and religion called The Mind of God by Paul Davies.  I mentioned it in a prior post on this blog.  The author does not believe in God as do I, but his approach certainly makes it clear that he does not rule out that possibility.  He seems to be arguing for belief, based on the science, even though he does not claim belief.  My faith is nurtured rather than challenged by what I read.

As I have repeated far too many times, this is a particularly difficult time in our journey.  The Spiritual nurture is a key element in sustaining me during this time.  I am grateful for Mary Ann’s strong faith as we journey together.

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We are still pretty much snowed in.  Actually, the street and driveway have been clear enough to get out.  The main streets are passable according to the television weather folks, but many of the side streets are not   If we did try to get out, I am not sure what we would do and why.  Mobility in a wheel chair is pretty much compromised when there is snow and ice involved, even when shoveled.

We did not venture out today and may not do so tomorrow, although we will try to get to the Evening Service at church.  I am grateful for some meatloaf from the freezer brought by Maureen some time ago.  A couple of baked potatoes and half of a small head of cabbage rounded out supper.   There should be enough leftovers for tomorrow.  There is still cold meat and cheese from a Christmas gift brought over by former members — good people.  As always, I could eat for months on what we have in the freezer, but Mary Ann would starve. 

I am afraid the time here in the house together without break is wearing thin.  Today was an NCIS Marathon on television.  I like the program and find the characters entertaining, at least I did for the first few hours.  I wander back and forth to and from the computer and the kitchen, doing whatever chores there are to get away from the television. 

Finally, I moved to the kitchen to write some thank you notes and watch some news.  Mary Ann popped up and ended up on the Living Room floor.  She did not hurt herself.  As the grumpiness sets in, I found myself resenting the unwillingness to push the button next to her so that I could get there to help.  The video/audio monitor I use keep her in sight when not by her side  was by the computer.   I should have brought it into the kitchen, but I was not going to be in there long.  Taking the monitor from room to room through the day as I go back and forth and plugging it in so that I can see her just doesn’t seem very workable to me. 

I could be more assertive in insisting that the television be adjusted to my taste, but when she is not engaged in what is on television, she is up heading to one place or another, demanding my jumping up to be at her side.  It is far less difficult for me, if whatever is on TV captures her interest. 

It would have seemed reasonable to ask Mary Ann to help with the thank you notes to involve her in something other than watching television.  It is hard for both of us, but especially Mary Ann to accept how much she has lost.  Last year, I tried including her in the Christmas Card preparation.  She simply could not do any part of the task without utter frustration.  Finally, she tried putting the stamps on the cards.  She could not manage to get the self-stick stamps off the backing and then on the envelop anywhere near the spot they need to be.  She just gave up in frustration. 

It is hard to think about how much she has lost after being so talented in so many areas.  It is clearly very painful to her.  I think that what is hardest for her is the sheer boredom of not having things to do that she is able to do.  I am often disappointed in myself that I do not engage her more in trying to do things that mitigate her boredom.  I am so busy trying to entertain myself in between just doing the basic caregiving tasks, that I can’ t seem to bring myself to add more that might entertain her.   I am certainly not proud of that gaping flaw in my caregiving. 

During her nap today I began doing an online Spirituality Retreat using the Ignatian model.  There are different materials for each of thirty-four weeks.  It is provided by Creighton University.  I do not have a very good track record for keeping at such a discipline, especially in my current role.  I am hoping by attaching the retreat activities to Mary Ann’s daytime naps, I might find it doable on a continuing basis. 

The approach is to fold the central focus of that week into all the daily activities so that ultimately, it is running in the background of the retreatant’s mind no matter what he/she is doing at any given moment. 

The first week’s focus is on going through a picture album of the retreatant’s life using the mind’s eye.  The first couple of days focus on childhood, the second couple of days on teen through young adult years and the third couple of days the retreatant’s adult life.  The goal is not just to remember, but to tap the feelings associated with those events and look for learnings that came from them, gifts that both the good events and the bad ones left behind. 

I have some free software called iDaily Diary that I use for journaling on occasion.  There I will record reflections on the pictures that come to mind.  I may share bits and pieces if they are not too private and they relate in some way to the role of Caregiver. 

Enough for now.  It is late, and Mary Ann has been getting up pretty early the last few days.  I can feel the tiredness spreading through my mind and body.  Let’s hope for a good night of sleep. 

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.