Jump to content
Sign in to follow this  
Reality Check 2

Dementia - sometimes humorous, mostly sad

Recommended Posts

I got the best dementia answer today that I have heard in a long time.

 

He is 90, she is 87. Second marriage for both - greater than 35 years. Combined 7 adult children.

 

Still live in their home. Heaven help us - he is still driving to the grocery store. Finally convinced him to quit driving on the highway.

 

They both came in with 2 of their kids today for paperwork, the whole face to face medicare garbage.

 

Delightful couple, really. He dresses up and puts on a tie and jacket to come to the clinic. She is a peach. Cute, forgetful but loving. 

 

No one is mean or particularly physically dangerous.

 

I ask him all the orientation questions. He glides for a bit. 

 

Then I ask - "What street do you live on?"

 

His answer - "The same one."

 

His wife looks at him sideways and then busts out laughing - "Well that was helpful"

 

I had to chuckle. The best dementia question I have had in a while. 

 

Gotta Love Them - I will be them someday..................................

  • Upvote 1

Share this post


Link to post
Share on other sites

if we are all lucky enough we will all be in that positon

 

This is exactly why I choose to do house calls, to help and serve these people as our society simply doesn't know how to deal with them.  I would try all the tricks to keep them in their homes as long as possible but at times the safety has to trump and it is oh so sad when it does.....

 

One of my saddest stories - life long husband/wife(live 70+ years!!), neighbors to my grandparents, have known them since my childhood - wife profound dementia, husband primary care giver, both well north of  90, i was asked to help and did everything possible, but about 3 months later husband has a fall and broken hip, both end up in nursing home, husband passes, wife remains alive and profoundly demented no longer in her home.... just so sad...

Share this post


Link to post
Share on other sites

welcome to my world....

 

the heartbreaker is the calls from family with the reports of the weird and delusional behavior and them asking what can be done to fix it....

Share this post


Link to post
Share on other sites

I used to work as a CNA in a the dementia unit of a nursing home.  There was a married couple who both had quite advanced dementia; every time they turned around they'd forget what was happening by the time they turned back.  When they turned back and saw each other, they'd ask in the most genuine way, "how are you doing, honey?"  They always asked each other with such a sweet and caring tone, like they genuinely cared about and loved each other.  Funny thing is, they were still physically active, constantly roaming around their room and rotating around until eventually they faced each other...  so they would ask this genuine "how are you, honey" every 5 minutes... all day long.  Very sweet couple and a heartwarming story I've taken with me and still think about from time to time.  

Share this post


Link to post
Share on other sites

I deal with dementia in my own family.

 

Got lucky and my grandma with vascular dementia was pleasant and humorous and generally happy. And she went peacefully at 88 from an MI and broken heart after my Gpa died at 90. 

 

My mother in law - not so much. She had mental health issues to begin with and THEN got dementia. Not a happy combo.

She is now vegetative at 83 and still knows how to swallow. Her nursing home bill is approaching $5000 a month with ZERO quality of life. There is no one home but her body won't give up. She doesn't speak or walk or recognize anyone. Bed bound or chair bound - quite literally bound.

It really made me examine Death with Dignity and Assisted Suicide more seriously. 

 

My patients at work scare me and fascinate me and worry me and frustrate me all in the same breath. 

We have such poor legal precedents for families to follow regarding declining mental function and intervention when things have gone too far.

 

I cannot justify how my mother in law requires $5000 a month for care which is roughly $166 per day in a 30 day month. I don't get it. Thus, I am not an administrator......

 

I love it when my folks can stay safely in their own homes with appropriate care and monitoring but cringe and fret and feel heartbroken when their situations are dangerous, unguarded or unmonitored and the options are so few and so cost prohibitive.

 

One cute little Parkinsons riddled 92 yr old fell out of bed and sustained a hangman's fracture. She stayed one night in the hospital. Her husband can't take care of a full assist/full transfer 90 lb woman much less himself. The idiotic hospital rules wouldn't allow for her to go to a SNF or a nursing home because she went home first and didn't come straight from the hospital. My response was not filtered - What the hell does it matter WHERE she is if she has a freaking C2 fracture at 92 with Parkinson's??????

 

So, I realized that I do what I do in frustrating family practice for these folks and hope to find them some safety and dignity.

 

It was all worth it when my 87 yr old lady this morning hugged me, gave me a kiss on the cheek and told me she loved me.  Yep, that is why I do this.

  • Upvote 3

Share this post


Link to post
Share on other sites

I usually dread progression of dementia but it can actually be a godsend for the patient with terrible anxiety because they suddenly seem to settle down when they forget they're anxious. 

 

I recommend hospice now much earlier for many of our patients with advanced Parkinson's disease.  I tell them that dementia is a terminal illness.  Also tell them that hospice is not a one way street and sometimes patients  can improve.

 

I'm never surprised to hear about a patient passing away.  I'm usually relieved and I always do a personal condolence call. 

Share this post


Link to post
Share on other sites

I spent a few weeks in April taking my Mom to the doctor and having testing done that verified she truly has dementia.  She lives in a very small town 8 hours away.  After my father passed away 6 months ago, we could see my Mom slowly going off the rails.  Then we started getting the "Mom calls" from concerned towns people, who reported my Moms memory loss and driving.  Thank goodness for small towns and knowing just about  everybody, even when you haven't lived there for 40 years. 

 

Mom is safely tucked into an assisted living home and she hates it.  It was so sudden for her.  She can't understand why she is not allowed to drive, why she can't live alone anymore, why it is unsafe.  We have the same conversation on a weekly basis.....and I discuss the why's.  She always responds  "Well, why didn't anybody tell me?  What is dementia? Why didn't Dr. X talk to me about this?   She just can't remember anything.  I was just relieved she didn't get lost driving or kill someone in a MVA. 

 

It's hard to see parents in this condition.  My siblings and I have become the parents, and it's okay, another phase of life that affects nearly every human being at some point or another. 

  • Upvote 2

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More