She was the traditional Irish Catholic Grandmother, the matriarch of our family. Need I say more? She was a sister, a wife, a mother, a grandmother (many times over), a great grandmother (still going) and a natural caregiver. Her profession in life was as an OB nurse; and it was perfect. She was caring, nurturing, kind, patient and after 8 children of her own, this was all very natural for her.
All her children were all just as individually intelligent and very successful. There are 18 Grandchildren and so far 24 Great Grandchildren. Whether it’s a doctor, a nurse, mother, father, an administrative professional or Director; many in the family have followed her lead in being the exceptional caregiver or working in the healthcare industry. Nature vs Nurture? Now that’s another story. Caregiving and helping others is simply and undeniably, in our blood.
But that’s not all that is in our blood.
There are very few people I have idolized or respected more in my life than I have her. She was the kindest, most caring and gentle person I have ever known (aside from my own mom of course). I remember always dressing to the nines, hair all done up and always, always, always, showcasing her Pink nail polish!
My favorite memory is sitting in church as we sang the service hymns and soaking in every moment, listening to her beautiful voice. I remember a strong feeling of pride as I thought …that’s MY Grandma and snickering with my cousins as she drowned out the entire church choir! (Did I mention she sang Opera and we have beautiful voices in our family too?) Out of respect, when grandma was around, you never raised your voice; you were respectful, good mannered and polite at all times! She was so proud of her grandchildren and it was evident that she enjoyed this time just as much as we did. She was the glue that held every facet of our family together.
This is why, it was especially hard to swallow, the day I walked into her room and she didn’t recognize me.
After the death of my grandfather, my grandma began to experience some minor cognitive deficits. In time and after a very hard family decision, my grandmother eventually moved into an assisted living facility. This was not just any facility however; it was a facility which I happened to be employed by. Her digression seemed to happen pretty rapidly. I will never forget how uncomfortable it was walking in her room and hearing her curse at an aide (I never heard her swear much less raise her voice). When I responded, “Gram, what’s wrong?’ She said, in a very authoritative voice “I don’t know you, don’t call me that!” And then… “The both of you need to get the “blank” out of here.” Just like that, my grandma acted like she didn’t know me and was using profanity! I was just crushed; I was shocked and needless to say, very, very unprepared.
For the first time ever I had my own personal experience with the ugly side of Alzheimer’s disease.
This was a reality I had experienced every day at work. I had seen it a million times. I knew how to interact, what to expect, how to redirect the residents and provided support to families. I understood the disease and what that meant. I knew their reality was a different time and place, but none of that prepared me for having to face all of that with my own grandmother. I was the oldest granddaughter, how could she not remember me?
Long term memory is the last to go right?
I guess I still had a lot to learn.
Even people that work in this environment and see it every day, cannot be fully prepared for the first time there is a personal experience with Alzheimer’s. It hits home hard and all our professional knowledge and reasoning becomes secondary to reality.
It has to be something else right? Maybe an infection or a medication; maybe she had a minor stroke. At that point, even something as a stroke would be easier to swallow then knowing that my grandmother, as I knew her, was gone forever.
These are the hardest goodbyes too. You don’t have time to prepare, because as you are avoiding all the very evident signs, you are covering them up with all the same excuses you have heard your own residents and client’s family members use all the time.
It’s called denial. It is the actually the very first stage of grief. We begin to grieve before they are even gone, because although our minds have not admitted it yet, in our hearts we just know. Acceptance is not an easy thing either. When that started happening to Gram, I suggested all the above things. Maybe she got the wrong medication, maybe they are giving her too much; Make sure she does have an UTI!
Being a nurse for so many years, I’m sure she knew it long before any of us did. Having the experience I have now, I can look back and see many signs that she in fact, was aware something was happening. She did know. The covering up of things, the way she would answer a question with a question, skirting around answers. Now I see it, now it makes sense, but then it was easier for us to just ignore and pass it off as a bad day or a restless night.
I mean it was gram, she was the top of our totem, the leader of the choir, the queen of the family… she would live forever …right?
With everything I have experienced, both professionally and personally, with Alzheimer’s disease and other types of Dementias, I have gained a lot of respect and admiration for the professionals that care for these people, the caregivers, aides, the nursing staff, the social workers etc. The ones that really take the time, to know the patient, resident or client for who they are today…..and they show them the respect and dignity they deserve. That is something that is very hard for a family member to do.
Not that a family member does not respect their loved one, or want what’s best for them. But it is hard to take someone close to you, so much a part of your life and accept them as someone completely different. It’s sometimes impossible. We know who they were before and although they may look the same, they are basically a stranger to us.
I’ve seen many things, very sad things. Like the daughter who told her mother not to eat the steak (she really was looking forward to ) because mom was a vegetarian (although she didn’t remember this) The Mother was so mad when the daughter took the steak away from her, she started yelling and cussing at her daughter. She caused a huge scene in the dining hall. The daughter left in tears and didn’t come back to visit for a very long time. When she finally did return, her mother didn’t even know who she was.
Although it appears to us that our loved one is gone, they are in fact still fully alive in some other place and state of mind. It’s important to acknowledge that they still have a purpose and an identity and all though it’s different it still needs to be nurtured, respected and accepted.
At times, they may digress to a child, or go back to a time and a place that is still very much alive in their mind. They hold on to the clearest of memories and that’s where they chose to stay. My best advice is to try to go where they are, meet them in whatever time, place or world they exist in that moment. If they are holding a doll and rocking it gently back and forth to put it asleep and she believes it’s your father and that’s it’s a real baby. Don’t tell her it’s not; don’t try to reason with her, it will only cause unnecessary aggravation. If they ask the same question over and over, dont say “You already asked me that” or “I told you the answer five times already!” Meet them where they are. If you have to repeat yourself ten times, who cares, what does it hurt? Dont be angry, they really dont remember asking you the first nine times. Don’t try to orient them to your reality. That rationalization is only for you and that’s okay. However, while you have the opportunity to just be with them, just go where they are and join in the conversation, go with it and just enjoy the moment for what it is. It will be hard I know, but the moments are gone all too soon.
I snicker to myself now when I think of my grandma cussing at those aides! I think of how many times she probably wanted to say those things in life, but as a good Catholic and proper gram, she never did and it all came out when her filter was lost. It’s so funny now and makes me laugh. It’s a great memory, you tell them Gram! HA!
As I got my nails done the other day, I asked for Pink nail polish. I never wear pink; I’m more of a red girl. When Pink came out of my mouth, I went with it. I lived in that moment with my Gram, I savor those memories and I’m happy that I have them, all of them.