Monday, August 27, 2007

Confusion


The universe is just what is. But as human beings, we impose story on it. We arbitrarily decide that something 'began' at a certain point and 'ended' at a certain point. That's how we tell stories. It's hard for me to do that sometimes--especially with endings. I distrust endings in stories. But there are certain easily identifiable narrative endings in our experience. Death is the obvious one.

The problem is, the narrative only has shape afterwards. Up until we die, there are only events, some predictable, some not.

I'm acutely aware of that right now. Last night I got a call from the Assisted Living where my mother lives. She wouldn't eat her dinner or drink anything and an alert aide* took her back to her room and took her vitals. She had a temperature of 102. Last week they finally managed to get a urine sample from her (she kept dumping them out--it was clearly difficult for her to keep the point of this whole exercise in her mind) and she has a urinary tract infection. It's probably the cause of some increased confusion of late. So they put her on antibiotics.

If you're curious, the most common causes of transitory confusion in the elderly are:
  • dehydration or failure to eat
  • medication
  • diabetic reactions.
  • heart problems
  • infections
  • urinary alterations
  • hypothermia or hyperthermia.
She takes almost no medications. She eats well. So when a week and a half ago, she climbed into the van that had arrived to take someone else to dialysis and could not be convinced that she didn't need to go somewhere, they tested for infection. (Things are so much different now. I remember nursing homes when I was a child--scary smelly warehouses of old people with a TV blaring too loud in the common room. When someone was confused then, they tied them to the chair. Do I remember that? I remember I tried not to look at the other people living there when we went to visit my great aunt because I was afraid. Did they test for urinary tract infections when someone got more confused? Particularly someone like my mother, who was already confused?)

So they called me last night and told me that if she didn't respond to acetaminophen, they'd have to call the EMTs and send her to the hospital. Just like babies run fevers that would kill an adult, the elderly tend to run lower fevers than younger people, and 102 degrees in a 92 year old woman can signal a life threatening condition.

I'm trying to impose narrative on all this. What does it mean? What do I do now? What could it signify for the near future.

Well, right now, her fever is gone, she's back to normal this morning--whatever normal means for a 92 year old woman with dementia. But she's eating and talking to people. I can imagine her, back downstairs in the dining room in her ancient blue cardigan. (She only wears blue anymore.) And there's no narrative to this moment except the pattern we will see, or think we see, when at some point, we look back at all this.



*Bless the women who tend my mother. Who watch over her. Who tell me when I call to check at 11:00 at night, 'You get some sleep, honey. We'll call you if anything comes up.' They take care of her for minimum wage. And they tease her and talk to her and keep an eye on her. All I can say is thank you.

5 Comments:

Anonymous Anonymous said...

Maureen - Glad to hear your mom's fever is down. This must be a tough time for you. I can't relate yet, but I'm starting to get a taste of it with my mom, as you know. It's a very odd feeling watching someone get dementia. For me, it's like standing on the outside watching the destruction of a normalcy taken for granted. And my mom was never all that sane to begin with. But I still feel very distant. Perhaps my subconcious way of dealing with that which I cannot change. At any rate, I'm sorry you are going through this. - Michelle

August 27, 2007 10:03 PM  
Anonymous Anonymous said...

I've been doing work for a non-profit that helps the disabled, and I've met some wonderful caregivers. I also heard tales of the brutal lives some of these people had with their past 'care.' So, I have a strong sense of what you're talking about here. Glad your mom is being well taken care of and is surrounded by wonderful people.

August 28, 2007 9:38 AM  
Anonymous Anonymous said...

Sorry to hear about all this...let us know if we need to walk some dogs or cook you guys dinner or just buy you beers!

August 28, 2007 9:50 AM  
Blogger Responsible Artist said...

Reading this days later and hoping she's out of trouble.

(25 years ago we knew to look for infection when someone's personality changed or they got more confused. But that took aids who knew the residents and paid attention and I know that many homes, then and now, have high turnover.)

August 29, 2007 11:24 PM  
Anonymous Anonymous said...

We first had concerns about my brother after confusion that was caused by a uniary infection (he also probably wasn't eating). The infection was treated, andhe started to eat, but he did have the beginnings of dementia (mood swings)after the problems were taken care of.

His memory wasn't bad unless you were paying close attention, but he appears to have taken a turn for the worse this month. In the week that I was out of town he couldn't remember that I was gone out of town to take one nephew back to college and go to his other nephew's wedding.

Levin

August 31, 2007 10:07 PM  

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