This post is another in a series of my Facebook posts from 2015 related to caring for my mother. It’s really hard for me to re-post it without shedding my own tears. Those who are walking alongside a loved one struggling through the various stages of Alzheimer’s will probably relate very well. By the time you realize that the momentary lapse of memory is something more than the natural aging process forgetfulness, hints at “forgetting time” or how to tell time have already begun.
My Momma was in about Stage 5* of the disease when I first started noticing the decline in her ability to measure time. By my calculations, with a further decline in her ability to measure and understand the progression of time, I believe my Mom is somewhere approaching the end of Stage 6 of her journey with Alzheimer’s.
[*Note: There are several scales professionals use to stage dementia. I use the 7-Stage measuring scale to personally assess where my mom is in the disease’s progression.]
Facebook Journal Entry – October 5, 2015
Momma watched with fascination as Brenda, the visiting nurse practitioner, set up her computer at the dining room table in preparation for Mom’s annual Medicare visit. Nursing technology had changed quite a bit since Momma worked as a nurse, though she shared that she was one of the first RNs at County General Hospital to be trained in how to use a computer in the very early days of computerized charting.
Momma’s rich history as a nurse came out in many of Brenda’s medical history questions with her answers oftentimes couched in the verbiage of one who is an experienced medical professional. When asked about surgeries, for example, Mom’s description and recollection of an eye surgery to correct glaucoma came out in medical jargon as “bilateral iridectomy for angular glaucoma.” Stories from her 27 years of nursing were easily shared.
“Mrs. Boyles, when is your birthday?” queried Brenda as she gently guided Mom to return to the task at hand. Momma’s eyes darted back and forth as though she was trying to capture that piece of information from some corner of her mind. I wanted to help Momma, but knew I shouldn’t. “January the 17th,” Mom replied about a minute later. Typing Mom’s response, Brenda further asked, “And what year was that?” Seated across the table from me, Mom’s brown eyes were imploring me to answer that question. Mom’s eyes pooled with tears with the obvious recognition that this was something she should be able to remember, but she could not.
Nurse Brenda then informed my mom it was time for a “little memory test.” I felt as though someone had stabbed me in the heart as I observed the look of sheer terror in Momma’s eyes. Surely she was recalling her first memory evaluation completed earlier this year in April – one that I made the mistake of telling her about in advance, resulting in her needlessly worrying about it and obsessing over it for many weeks. Mom knew she had struggled with answers to that exam, but told everyone that she had “passed with flying colors.”
Today’s unexpected exam was much like the previous one. The nurse gave Momma three words to remember: captain, baby and sunrise. Momma repeated them, but warned that she didn’t do very well on this part the last time. The nurse gave her an encouraging smile, then handed her a piece of paper and a pencil and asked her to draw the face of a clock on it. Momma’s eyes lit up as she recalled acing this part of the exam last time. Years of taking pulses and using a watch with a sweep second hand had clearly given mom the advantage of a skill stored in her long-term memory bank. Momma relaxed and smiled, then took the pen in hand and began drawing her clock face.
This time was different though.
This time Momma had to struggle as to where to place the numbers. This time she didn’t even realize that she could reference the watch that had been on her wrist since her nursing days. Which way did the numbers go? Several belabored minutes later, Mom had drawn her clock face. A little skewed, but acceptable. Brenda now asked her to draw the hands at 11:10.
This time, Momma couldn’t do it. After a minute of trying to figure it out, the nurse offered a further hint by restating it in a different way. “Ten minutes after eleven.” Mom worked at it several minutes longer, growing more fidgety and agitated as the seconds ticked by, then handed the nurse her paper.
It wasn’t 11:10.
If Mom looked defeated then, she was even more saddened when she couldn’t recall the three words the nurse had mentioned prior to beginning the clock face exercise. She pondered some more, finally coming up with “baby,” but nothing more would come to her tired mind.
The sweet home health nurse left us with written results of her visit, some paperwork to review together, and took with her the documentation of Mom’s advancing memory loss – documentation she would share with Mom’s primary physician.
Sleep didn’t come easily for Momma that night. In the wee hours of the morning, I heard Mom stirring in the room next to mine, so got up to check on her. The light was on in her room and the door was open a crack. I peeked in and saw my pajama-clad momma sitting on the edge of her bed. In her lap was a pad of paper. In her hand was a pencil. Slipping into her room, I sat with her on the edge of the bed and placed my arm around her. Her brown eyes began to weep. My blue eyes joined hers.
I looked at her paper. Momma was practicing making clocks.