Dear Readers,
When last I wrote, I shared with you my take on how to cope with the loss of a patient — a possibility that every caregiver is exposed to. I'm happy to report that Rawbaw, my kid sister and current patient, is still with us, and as ornery — and witty — as ever.
Chapter 25 will cover a brand-new topic, folks. I took Rawbaw to the Behavioral Health Department of our local hospital in Appleton, Wisc., on Nov. 15, to discuss the findings of intensive testing done there a week earlier to determine the nature and severity of her dementia, and possible treatment.
Her neuro-psychologist reported that her big issues are with the structure of her day and remembering what has just happened or is about to — two big challenges of short-term memory loss. He quickly added that my efforts as her live-in caregiver are covering those bases. (How effectively, I'm not certain, because, at age 80, I'm coping with chain-linked senior moments that approximate dementia, myself!)
As a layman who has observed Rawbaw's behavior for four years, I get the impression that her dementia, as bad as it is, has not gotten measurably worse since I came on the scene. Her psychologist is intrigued by that highly unprofessional opinion. I sincerely hope it has helped him to help her.
He sees our family unit (Rawbaw, Doggie Brooke, and “Slave”) as a functional one, and doesn't need to see her again for a year. Meanwhile, we will pursue a “C.A.P.E. program” of care at home (steps to cope with her dementia that include Compensation, Activity, Prevention, and Education).
The psychologist has recommended that Rawbaw's primary care physician prescribe Aricept and/or Memantine — two meds, used to alleviate some Alzheimer's disease symptoms, that also may be effective with other mental illnesses. This makes sense to me, because our mother had Alzheimer's, and our youngest sister is now coping with it.
But the fly in the ointment is Rawbaw's attitude about psychotropic drugs. She fears that such powerful medicines could aggravate her multiple diabetes-related maladies and/or create new ones. I have no educated opinion about that, and will wait for her GP (general practitioner) to weigh in on the matter.
As I have often said, I don't know where Robin's dementia ends and her natural stubbornness begins. Her/my GP is a wonderful physician, trying to get my sister to eat smarter, exercise regularly, and pursue a comprehensive program of self-care — one that makes consummate sense for a Type 2 diabetic like Robin or me — but Rawbaw is clearly not buying in.
Nor is she willing or able to make the effort to build up her physical strength to take on the rigors of mastering her prosthesis, which she calls her “fake foot.” (As you may recall, she lost her right foot three years ago to complications from “uncontrolled diabetes.”)
What a handful. But before I condemn her, I have to ask myself how uncooperative I would be after seeing my life go right into the dumper in four awful years. I think I would be a real stinker, because my life has been a steady stream of blessings, and a sudden, rotten change-up would probably bum me out, too!
So, here I sit, inclined to focus on Rawbaw's day-to-day quality of life, and resigned to dealing graciously with her unwillingness to be “Patient of the Year.”
I see a lot of Scrabble, card games, and trips to the Burger King in our future.
I must love her something fierce — or be on some huge guilt trip about having tormented her (as big brothers are wont to do) when we were little kids. Maybe the psychologist can sort that out next year.
Whatever.
At least I know I will always have job security as social secretary for an old woman and her funky dawg. Odd as it may sound, there is a certain comfort in that!
—Michael E. Hearons
