For the past couple of months, my mother has become increasingly disoriented and wonders how she’s going to get home.
The mind-blowing twist is this: More often than not, when she’s worried about getting home, she’s already there. Inside her own house. Surrounded by decades of familiarity.
At first, I would point to family photographs, and ask her “Why do you suppose this house has pictures of you?”
I was looking for, “Oh, that’s right! This IS my home!”
Instead I got, “That’s strange. I have no idea why.”
My next tactic was to take her to her bedroom where she sleeps at night and retreats during the day when she wants time to herself. It’s her nest. But when she is disoriented, it’s as unfamiliar as Mars. One time, trying to coax her to get ready for bed, she kept insisting that she needed to go home first. So I pulled out her pajamas, hoping for a glimmer of recognition that this was her bedroom.
She brightened, “Oh good! I need to take those with me!”
Then I pointed to the big stuffed bear she likes to sleep with.
“Hey, your bear is already on your bed, waiting for you,” I said cheerily.
Her rejoinder: “Oh! I’d better take him too!”
Score: Mother 2; Me 0.
Since then, we’ve all learned to avoid reasoning and instead reassure her. We say stuff like, “Let’s have supper here. Then I’ll take you home.” By the time supper is over, she’s forgotten the supposed plan and “going home” may not come up again for a few days. If it comes up at bedtime, we might say, “We’re spending the night here, and we’ll go home in the morning.”
Not only does this reassure her, it shows respect for her wish or concern. We resist trying to talk her out of it or discounting it by reasoning with her. We’ve learned that reasoning never works with someone whose ability to reason has faded.
Yes, these are little white lies, euphemistically called “fiblets” in the land of dementia caregiving. The fiblet is a valuable tool-- a kindness that addresses concerns, calms nerves, and helps the person with dementia feel safe and connected with the caregiver. And the memory-impaired are never disappointed by these faux promises, because they never remember them. What does stick is the feeling of warmth and respect.
With my mother's increasing disorientation, we also decided to ramp up care to make it easier for my father to lead his full and active life. Except for an hour or two in the morning when my mother is most “with it”, someone was present to help her feel safe and oriented-- and to assist with the activities of daily living.
And then, on a recent Monday morning, she got into the car and drove away. (We took her car keys away five years ago!) How could this happen? It was a perfect storm of disorientation and mishaps, resulting in what will go down in infamy as The Excellent Adventure.
Here are the seven elements that triggered her escape:
So when my mother, disoriented and unsupervised, climbed into the driver's seat of the Jeep Cherokee, she struck gold. With luck, ingrained habit, and rare executive function, she found the car key, inserted it into the ignition, got the engine started, backed out of the garage, put the car in "Park", got out of the car, lowered the garage door, got back into the car, and drove off.... toward "home".
The housekeeper, at the far end of the house with water running, heard nothing of this Excellent Launch.
This perfect storm was a collision of oversights, improbable events, and numerous coincidences, whose whole was undoubtedly greater than the sum of its parts. Whipping my mother into a frenzy, this perfect storm enabled her to recall long-dormant habits and abilities. It put her behind the wheel of heavy machinery and it shoved her out onto blue highways full of oncoming traffic, multiple lanes, merging cars, and traffic signals, with speed limits high and low, winding through settlements large and small, rural and urban. Her first move out of the quiet neighborhood was one that puts the rest of us on edge: Turning left onto a 50 mph two-lane highway with limited visibility.
Here's the link to Part Two...