With Love and Gratitude

A blessing a day keeps the doc away

You Can't Go to Heaven with Your Roots Showing: A Memory

The geriatric fiblet may be the kindest way to enter someone's dementia world.

The basket: A gift from my mother *
When Her Royal Highness said to cancel her hair appointment, we knew that her heart was failing and she was giving up her battle with the memory thief. 

“I don’t really care how I look anymore, I’m going to die,” she said. The 93-year-old quickly changed her attitude when I countered, “But, you can’t go heaven with your roots showing.”

Always with an answer she said, “You know I never thought of that.”  As I wheeled her into the hair salon, she asked again, “Who is going to care if my roots are showing?”

I said, “Well, dad, for one.  I don’t want him to look at you and say, ‘What is wrong with your daughters letting your roots show like this?’”

She nodded her head, thought a moment and said, “After all those years he traveled with Frank Sinatra, I don’t believe he’s up there.”

This time I told her the truth, despite becoming adept at the geriatric fiblet – a term coined at the 2000 World Alzheimer’s Congress to describe “necessary white lies to redirect loved ones or discourage them from detrimental behavior.”  

I reminded her of the concept of Last Rites in the church in which sins are forgiven through this sacrament.

She asked, “All of them?”

After re-assuring her, she said, “Well, all right then.  They can do my hair, but color only, no cutting.”

This was our first Mother’s Day without our mother. And today her 93-year-old sister left her home, which she clung to feverishly, to enter a facility that she would call home during this last chapter in her life.

Her new role and Berna Huebner

As a sound engineer and consultant for many celebrities, our father traveled often and our mother was frequently part of the entourage. When they eventually settled into the role of grandparents, our father made paper airplanes for grandchildren.  Our mother, on the other hand, retained her desire for elegance – clothes, jewelry, and make-up -- so she always prepared to hold court.  

Or did we foster this by bringing her more new outfits than she could ever wear?  We also made certain there was a steady stream of visitors. And we filled her room with photos of great-grandchildren and their drawings and cards.

Mother was either a fighter or we fought for her. I had conversations with Berna Huebner who taught me the value of believing in those we love and finding ways to help them even when others had given up on their recovery. I remember better when I paint | Alzheimer's Disease 

The hair incident was a red flag. Nonetheless, when I went to visit several days later, and told her that I brought her three new dresses, she said, “Why bother?  I don’t care if live or die.”  She even chased my sister, Lois, from the room at one point saying, “Let me do this my way.” 

But dresses appealed to vanity that remained a blessing. Opening the box, I said, “I wish you told me sooner about living or dying, because now I will have to return all three dresses.”

She perked up. “Let me see what they look like.”  As I took each from the box and held it up for her, this is how she responded.

  • To the black and white flower design, “That’s the one.”
  • To the red flowered dress, she motioned with her hand, Italian-style, while uttering, “metà e metà.”
  • To the Hawaiian dress of bright orangey blossoms, “Halloween”

She decided to keep all three.  And these were the last three dresses she would wear as her children, grandchildren and great grandchildren came to see her, sit with her and say good-byes.

Memory units and fiblets

Through my work I see the various interpretations of devotion – a once a week visit, several times a week visits for outside trips, and brief daily visits. I see the faces of acceptance and denial.

Despite memory units and special training for work with the men and women with dementia, these are too often looked at as the end of the road rather then a transition. Such units are a bridge to help those in their last years retain some dignity – yes, even if we must resort to the geriatric fiblet.

While the ethics of the fiblet is examined by professionals in geriatric care, for many of us it is a mechanism we use to live within the reality of someone whose mind is slipping away.

As those we love age, or even as younger men and women suddenly find themselves affected by Alzheimer’s, it creates challenges. Perhaps the greatest gift we can give is to enter their world – no need to contradict or confront -- and simply live in their reality always ready with a kind word, a smile, and loving touch.

*Flower is from a "Thank you" bouquet to volunteers from our parish priest who delivered her eulogy.

References:  

Geriatric Fiblets - Necessary White Lies or Bad Therapeutic Technique? How to do an ethical query for your own practice, Geriatric Care Management, Spring 2006, Number 2 Volume 16. Cathy Jo Cress, MSW, and Michele Boudinot, MA

Optimal Aging through Research, Gerontological Society of America,November 21, 2014from Symposium: Affirming and Evaluating Creative Expression in persons with Demetia, Chair, Lisa Snyder.

Rita Watson, MPH, was recipient of a 2012 MetLife Foundation Journalism Award in Aging through the Gerontological Society of America and New America Media and a travel grant in 2013.

Loss: 4 Ways to Move Forward and Counter If-Only Guilt (With photo of our Mother at EPOCH where she felt like a queen.)

For Caregivers and Hospice Angels, Self-Care Is Not Optional

Rita Watson, MPH, is an Associate Fellow at Yale's Ezra Stiles College and a columnist for The Providence Journal.

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