Early dementia or…

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Early in the flight I heard the stewardess checking on the dietary requirements of the passenger in front of me. “Hello, Mr K, I’m confirming that you requested a vegetarian meal?” “No no,” he said, “I didn’t make any request.”

“Are you Mr. K? It says on your ticket you need a vegetarian meal?”

“No no, I didn’t make any request.”

“Okay, can I bring you a vegetarian meal? Will you have that?”

“No, no. I don’t want vegetarian.”

“Are you not vegetarian, can you eat meat?”

“Yes, anything is okay”

“Would you like me to cancel your vegetarian meal and get you a normal meal then?”

“Yes, ok”.

Half an hour later the lunch cart came round and a different stewardess asked, “Pork or chicken?”

“I can’t take that”, he says, “I’m vegetarian!”

And the stewardess says, “Did you request for a vegetarian meal? There’s no sticker on your seat for a special meal. Ok, let me check with my colleague.”

As she goes off to check (thus delaying MY lunch), I was incredulous at the behaviour of the chap. Was he forgetful or plain bad at communicating or a sociopath out to create trouble?

So Lucky!

Mom had to visit the Emergency department one night, as she wasn’t doing so well and needed something stronger than oral antibiotics. Fortunately, the hospital was working well, and we were being seen by a doctor within half an hour of arrival.

He was a young doctor, and even if he wasn’t, he spoke as though he was very young and haven’t seen much of the world. After we told him what the problem was, he turned to the electronic record and was apprised of Mom’s multiple issues.

“Wow!” he breathed, “Aunty* has been through a lot! Do you know how lucky she is to be alive? The condition she had, you know, many people die of it. She’s quite lucky!”

I couldn’t stand it. “Well,” I said, “we take good care of her. And you’re lucky we’re not suing the hospital for missing the condition in the first instance.”

Young man, it may be your first time seeing us, but we’ve been to the hospital countless times, and if we didn’t know better, Mom would be a lot worse off.

Having said that, I’m very pleased with the treatment at this hospital for Mom all these years. Whenever she’s admitted, I get daily updates from the ward doctor, a medication check-up call from the Pharmacist on duty, and a post-discharge follow-up call from the nurse. Most times, things go right. Yet, I believe more than ever that the patient and family must take overall charge and not leave it to the “professionals” alone. Patients are living longer and with more complex and complicated conditions. We just have to help ourselves.

 

*Aunty is a generic way for addressing older women by respectful younger folk in our region.

What is a Snack?

Mom lost a lot of weight earlier this year, when she was hospitalised for an infection. Of course once she got home, we made reparations. She had 3 square meals with morning and afternoon tea! We overdid ourselves, though, and she has become a bit too round. Especially since nowadays she mostly sits around not doing much.

In the last year or so, a lot has changed. Although she can still find her way around the house and brush her own teeth, she is getting increasingly more forgetful and confused. She brushes her teeth three four times in a row, because she forgets that she has just done so. Afternoons become mornings, and nights are times to toss and turn and change the bedsheets. A son becomes the husband, and a grand-daughter becomes a strange girl who stares at her. She’s also searching, searching; for what nobody knows.

One blessing is that she considers the live-in helper her own special friend. They get along so well, and the helper can always make Mom laugh and giggle. But sometimes nobody can help Mom settle down and sleep when it is time to sleep. If it gets worse, I will have to consider sleep aids.

When talking to Mom, one never knows what she will say next. One moment she is wise, and the next she struggles to understand our words. She can still read, she automatically reads signs and labels. But I think she can no longer fully grasp the meanings of words.

Mom, would you like a snack?

What is A Snack?

Well, something like a biscuit or some food. Are you hungry? Would you like to eat something?

Oh, I don’t mind if there is.

I feel she is going adrift. Losing her anchor, losing sense of time. What is this place? What shall I do? Who is there? Where is my friend? Is it time to eat? Is it time to shower? I want to lie down. Why wouldn’t they let me go to the room and lie down? Why must I wait? I need to find my thing. 

Hazy Update

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I’ve been meaning to write, just didn’t get organised enough to do so. Some ideas don’t bear closer scrutiny, and fall by the wayside. Anyway, here’s an update of sorts.

The weather has been mostly hazy. Grey and smoky. The sun, when we do see it, is an angry red ball. There may be one clear day every ten days, when the wind shifts. By my estimate, the forest fires should be done by the end of this month, and November will be better.

Mom is calm and happy. Occasionally we catch her doing something she shouldn’t, like trying to take a bath fully clothed. But all in all, we are managing. Conversations can be amusing or fascinating, or astounding. One example:

Me, holding a banana: What’s this?
Mom: Mango!
Me: No, no! Look again, what’s this? B-a-n-a…..
Mom: Mango!
Me: I know you love mangoes, but we’re out of mangoes. Here, have this banana.

Mom catches on to emotions of those around her very well. She is still sensitive though the words don’t come so easily. She knows who she likes, and who she dislikes. She’s consistent that way.

She’s nice. Affable. Totally accepting of what is. When she says, “I don’t remember anymore”, it is a statement of fact. She smiles as she says it. But she is clear, because underlying that and unspoken is, “Don’t even try to remind me. I don’t remember, and it doesn’t matter.”

Hazy Outlook

The weather isn’t so good in Singapore. The wind brings fine ash particles from the plantation fires that are raging over in Sumatra. Days are shrouded dull grey. It rains and rains – cloud seeding is rumored – but that does nothing to the haze as the particles are just too fine. They should make it rain on the fires, not on us!

And Mom is showing more signs of confusion. I think the lack of strong daylight is interfering with her daily rhythm. Her afternoon naps are shortened; and she demands her bath and dinner several hours before they are due. The lack of sleep adds to her confusion, and for the first time we hear the confused speech associated with dementia. She’s looking for something, anxious about the “renovation”, having to go somewhere, speaking a strange dialect.

She doesn’t smile as freely. Her eyes are wary now.

I hope it’s not a lurking infection. If only the haze would clear up soon.

Election Day

Singaporeans go to the polls today, Sep 11, 2015. It’s very exciting.

Photo from the Election Departments website http://www.eld.gov.sg

There’s been plenty of rhetoric from both sides contesting the 89 seats at stake. The ruling party will try hard to hold onto its 79 seats. There are 8 opposition parties. Yes, Singapore is funny like that. It doesn’t make the fight any less vigorous though.

Will the ruling party win big? Will the opposition make more inroads? The outcome is still hazy. And coincidentally, so is the weather.

http://aqicn.org/city/singapore/central/

Mom is very clear though.

Do you know it’s election day today, Mom?
But you cannot vote. Do you know why?

Mom smiles and says, “Because I am Malaysian.”

I’m surprised she knows. I should ask her who she thinks will win.

Forgotten, in a manner

Mom was admitted to hospital for a brief illness, and I was visiting her.

“Hello, how are you today?”

“Hello. My daughter just went off.”

I wasn’t expecting that. “It’s me. I’m your daughter, Mom.”

She looks uncertain, and then, “No,” she says, “My daughter, she just went over there. Can you go and get her?”

I knew she had an earlier visitor, but hadn’t realized she thought that person was me, or so I hope, if she still remembers she had a daughter like me. So I decided to go along, “Oh, she’ll be back in a while.”

It’s really strange and unexpected.

At home, we never go to Mom and ask her, “Do you know who I am?” We assume all is fine if we get a cheery Good Morning! or Hello! The routine exchange of greetings, the signs of familiarity, the ease with which Mom navigates to her regular chair; surely all is well.

Or maybe the problem isn’t Mom, but me. Maybe I’m forgettable. Really.

I once went back to a workplace after a gap of a year. There were a few familiar faces at work that day, but they could not recall me. “Did you work here before? When? Really? No, we can’t remember you” they said. It gave me a turn and my heart pounded. I had a fleeting thought of “Twilight Zone” and then I wondered if I had caused offense and was being purposely “forgotten”.

On thinking back, I think it could be because I was task focused and did not get to know these colleagues personally, or they were task focused and did not see me. Or the turnover of staff was so high that those who stayed did not bother to keep track and remember those who had left.

Whatever, I think I can accept being forgotten. It’s the forgetting I’d rather not have.