Several weeks ago my mother, in her eighth or ninth year of Alzheimer’s Disease, and 63
rd year of
marriage, began wielding knives and trying to stab people, verbally threatening to kill my father, throwing dangerous glass objects and screaming bloody murder at her own image in the mirror—“I DON’T WANT YOU HERE, GET OUT!!!” My brother and I finally intervened and had her temporarily hospitalized in a
psychiatric ward, hoping we could buy more time for her at home through stabilizing her on the right meds, and getting Dad more help. We chose a modern, upscale hospital in a New Jersey suburb that came highly recommended, and where we had a personal connection with the presiding geriatric psychiatrist on the unit. My
parents are fairly well off and have excellent insurance. By all measures, this should have been among the best our health care system has to offer, or certainly several notches above The New York State Asylum for Idiots (referring, I believe, to the staff, not the patients.)
My father and brother brought Mom to the ER, as planned, to get a few simple medical tests out of the way as part of the Admittance procedure. Seven hours later, my dear, traumatized, 85-year-old toddler-mother was covered in bruises and black and blue marks; they had knocked her out on Ativan to make her easier to work with, then waited until she was awake to have five people hold her down while they shoved a catheter up her; presumably, a urine sample was vitally crucial at that moment for an extremely agitated and frightened, sobbing and screaming Alzheimer’s patient.
It was not an auspicious beginning, and right away Dad began declaring this to be “the worst mistake I’ve ever made,” conveniently forgetting that the home scene had begun to resemble a bad Hitchcock film and my brother and I were fielding up to 10 calls a day from him in the heat of battle.
The ER torture chamber was only the beginning of surviving two weeks of madness, on all sides. On Day Two, the geriatric physician ordered an x-ray and CAT Scan of Mom’s G-I tract, based on the
inaccurate report that she had been vomiting repeatedly for several days. She had thrown up once in the ER, but not since. My
brother almost
threw up in the ER just watching her ordeal. The x-ray was normal.
I arrived on the scene a few days later and met with her psychiatrist, who told us the precise dosage of Seroquel he was prescribing. I was naturally concerned when the nurses delivered something different and showed us their written orders; we didn’t know if the doctor had neglected to update them or had changed his mind about the dose and neglected to update us. It was even more disturbing when we called him to clarify and heard, “This mailbox is full,” and couldn't even leave a message. Eventually I figured out that most of the other patients there were alone much of the time, and he probably wasn’t used to dealing with families that actually pay attention to little details like when and how much powerful anti-psychotic medication our loved one is receiving which Dad will be responsible for administering once she gets out.
It dawned on us early on that we were in charge of Mom’s basic needs and care, alerting the nurses when she needed to use the bathroom or be changed, monitoring her meds, and providing her three meals a day from the outside, because she eats very few things anymore, only specific items that the hospital couldn’t provide: matzo-ball soup and corned beef from The Kosher Nosh.
Dad had to persuade the nurses to allow him to administer the medications using his own, special method: a base of vanilla ice-cream topped with a layer of whipped cream, then the crushed pills, followed by another layer of whipped cream and topped off with chocolate syrup. Some of the nurses let him do this and it was easy, and my mother ate it in five minutes. The mean Nurse Ratchet, however, insisted on doing it her way, which was to attempt to force a single spoonful of whipped cream into my Mom’s mouth against her will, escalating her agitation and resistance, and requiring about a half hour of struggle, frustration and anger.
My brother, a psychologist, observed with bewilderment as various social workers and psychiatrists did “intake interviews”; my mother hasn’t uttered a logical sentence in several years, except by accident, like the other day when out of the blue she looked up at Dad and said, “Your nose is worse than mine,” and the day before it was, “Your face is Christian.” My brother kept waiting for either Rod Serling or Allen Funt to step forward as he listened to these professional conversations:
“How are you feeling today Mrs. Sobel?”
“I have no fish.”
“Do you know where you are?”
“You can have the fleigels, and if you need more tomorrow, somebody can help you plisselage.”
Every morning the names of all the patients were listed on a chalkboard along with the name of their nurse for that shift. I was very pleased to see, when I first got there, that Mom’s nurse had only been assigned
one geriatric patient that day; one-on-one care, I thought, that’s pretty impressive. The only glitch was that I stayed with Mom for the entire day and didn’t run into this particular nurse even once. But at least she was listed on the board, and that counts for something.
Like many Alzheimer’s patients, Mom has an aversion to and fear of water and so has not had a bath or shower in over three years, and instead we have had an aide gently sponge-bathe her. The hospital’s compassionate idea was to force her into a shower immediately upon arising, regardless of her morning mood which is often not her friendliest time; not surprisingly, it required three psych nurses to restrain her, as we stood outside listening to her heart-wrenching, blood-curdling screams, kicking and spitting, emerging 20 minutes later covered in fresh bruises up and down her legs, and collapsing in my father’s or my arms with deep sobbing and tears. This would be a scene we would have to endure often, matched only by the diaper-changes, which she was also not overly fond of, to say the least, and had mastered the art of clenching her buttocks to avoid being cleaned up.
The good news about Alzheimer’s, of course, is that within a fairly short time, these daily incidents would be quickly forgotten and, as the new meds regime started kicking in, within a few days Mom was mostly back to her smiling, sunny self, initiating wonderfully inane conversations with everyone she passed in the hallway and playing duets with me in the piano room. She would play single notes in perfect 4/4 time as I improvised, and we sang Tumbalalaika and Rock of Ages together. She and my father danced as I played the Anniversary Waltz.
However, after two weeks of this routine, my Dad was completely battered and worn down from all the stress and anxiety, and had contracted bronchitis. Mom was sleeping through the night and mostly calm during the day, apart from the horrible hygiene events, and the psychiatrist let us know that there was not likely to be a pill to cure that. So my Dad decided it was time to take her home, and we had the official discharge meeting with the staff; they all gave the go-ahead, providing the M.D. checked her out, because Mom had been coughing and complaining of a sore throat. But with everything seemingly in place for a discharge the next day, I headed back to my home in Virginia.
