Saturday, 24 September 2011

"I wonder how he is

this morning," my father says as he comes out for breakfast.
I do not need to ask who he means. The woman in charge of the nursing home 'phoned last night. It was almost 9pm. She had finally gone home but wanted to talk to me. She did not ask for my father.
Normally, if the conversation is about his brother, he is consulted. We have a telephone extension by his bed. It means we can both listen at once.
This time time he said, "It's someone from the nursing home. She wants to talk to you." I thought he would listen but he put the extension down.
The Director, as she is titled, was letting us know that my uncle is back in hospital. He has not been sleeping. He is, she says, exhausted. He has had two more small "heart attacks". All that would be worrying in itself but he is also wandering at night. He has lashed out at the staff. The previous night he had tried to break the window in his room. He thought he was in a chemist shop and was trying to get out. Three days ago he thought he was at Heathrow airport and he had lost his passport.
At times he seems lucid but it comes and goes. He persists that he wants to "go shopping". Why? He needs "knives and forks". Apparently he has visitors coming and the nursing home has taken the knives and forks away.
My uncle has been taking sleeping medication for more than twenty years. He could not sleep when my older cousin was ill. By the time of my cousin's death my uncle was addicted. The nursing home will not or cannot give him the same quantity of medication. Even if they did he would not sleep well. He has not slept well for all those years.
He has told them and told us he wants to die but he is also afraid someone is going to kill him.
The admission to hospital is to see if they can actually view the frontal lobe damage we all know is there. It may give them some help in deciding how to handle him. The nursing home says sedation is "the last resort". He is a "walking chemist shop" now. True.
He is also distressed. My father is distressed. The fact that he did not listen to what was being said is an indication that, while he is deeply concerned, the technicalities and the practicalities are beyond him. He simply does not want to know those things.
My uncle does like his new red shirt - or he would seem to. He apparently snatched it back when one of the nursing staff tried to put it in a drawer. Perhaps that is something.
Sedation may be the last resort but, if he is so distressed, I am beginning to wonder if it might not be the kinder option - or would it? This sort of old age is a terrible thing.


Donna Hosie said...

I'm so sorry to hear this, cat. Old age is the cruelest fate of all.

jeanfromcornwall said...

Your Uncle sounds to be in a similar state to that of my Father in his last months. I don't know if the medics used sedation, and if they did, whether it had any great effect, given that he was on a shedload of pills anyway.

There is a lot being said in the UK about how it is wrong to use a "chemical cosh" to keep old people with dementia quiet, but the folk who look after them deserve protection from the worst of the violent behaviour, and if the mental distress can be eased then it cannot be all bad.

It is a very difficult situation where there are no right answers. I send you my sympathy.

catdownunder said...

Thankyou both - a Prof of Gerontology once told me "the biggest problem with old age is that the rest of us have not yet experience it". I think he may have been right.

JO said...

I think medication to deal with distress is absolutely valid. It's not a matter of sedating him to make life easier for those around him, but of easing his unhappiness.

All of which echoes what Jeanfromcornwall says. (But at least he is still comforted by red!)

widdershins said...

Oh dear ... this is one of those situations where no-one wins ... my sympathies too ... I hope you have folk around who can give you hugs, as many as you can possible want and then doubled.

catdownunder said...

Thankyou Jo, Widdershins. I may have less qualms about sedating the severely distressed than some people. I once taught in a school where there was a child - in another class - who had severe epilepsy. They were trying to keep the medication at a level where the child could "function" but the child was severely distressed most of the time. Eventually the on-site doctor made the decision to up the medication. The child in question was less alert - but much, much happier. I think these things have to be worked out on an individual basis not according to some policy or other!

nicobulus said...

sad to hear about your uncle; unfortunately we know very little about how old age affects brain function and it's distressing to witness the effects at first hand. I agree there are no right answers, which is so sad. All the best Cat.

BTW - I've completed my ride from London to Paris for the Alzheimer's society in the UK. About 70 of us made the trip and raised over £100,000.
One of the biggest obstacles to understanding dementia is that research into this mystifying illness only receives about 1/8th of the money that goes into cancer research.