update

The past few weeks have been filled with events. Just to give you a glimpse of the present situation, my mother is home, she's eating well, she's in good spirits and active. I hope it lasts.

My sister came for a visit on the 26th (she lives in Europe). She had suggested I take a few days' holiday, but somehow I could not see myself going off and leaving her to take care of my mother without having been prepared for the changes since February. So I suggested that we go to the seashore together, all three of us.

Before we left, my mother had 2 medical appointments to go to. The first was with the geriatrist that she should have seen last year, and the second, a week later, was with the geriatric psychiatrist that had been recommended by my contact at the other university hospital.

The outcome of the appointment with the geriatrist was that my mother suffered from orthostatic hypotension. He wanted to admit her at the geriatrics ward for an evaluation that would take at least 2 weeks to assess the causes of the hypotension and to see if it was reversible. My sister was arriving 4 days later, our trip was planned for the following week and I remembered only too well last year's evaluation that was supposed to take 10 days and had finally taken 5 weeks. My mother had come back home in far worse shape than when she had been admitted. And subsequently, we had been left to muddle through as best we could, the only help to be gotten by the general practitioner. I told him that we wanted a few days to think about it because of the visit and the trip. He recommended that my mother sleep with her head elevated, that she wear support hose and that she drink lots of water.

We returned home and I wrote to an acquaintance who had just retired in France. Her specialty? Geriatrics. She was kind enough to give me the protocol to check my mother's blood pressure and to chart it, plus lots of information on the condition. Since she was having a few geriatrists and the nurses from the university hospital where she worked for a meal, she asked for many details that she submitted to them as a case study. The input was welcome and she followed through by mailing me lots of literature and some handwritten notes on care. I noted the blood pressure, as I was taking it, and submitted the results to her by email, as well as to the visiting nurse. They did not detect more signs of hypotension. Meanwhile, I was having my mother drink lots of fluids, in case the condition had been caused by the antipsychotic medication she had been taking.

My sister arrived and my mother was relieved of the stress she had been having about the visit and how my sister would react to the changes in her. On the Tuesday, we had the appointment with the psychiatrist. She examined my mother for an hour, then met with me afterwards. She asked if I thought my mother was depressed and I said that since she had been taken off the medication, I did not feel she was depressed. I did feel though that if medication could be avoided, it should. She told me that she did not think medication was needed. Therapy would be of no use, since my mother's analytical capabilities were very weak. She said the problem with food might be caused by some physical condition, like having problems swallowing. This opened up new avenues for me to explore. I'll have to do research on menus that are liquid-based, yet complete (apart from Ensure). My nurse friend from France had hinted that adding egg whites to food would add protein. Lots of research to do in that area for me.

We were all relieved at the outcome of this meeting, somehow, even if the prognosis is not very positive.

The next morning, we were off to the seashore for 3 days. The trip was fun. My mother enjoyed herself and even went for a half-mile walk to the beach. She ate well throughout and declared that she would like to return in Spring.

My sister has now left, promising to come back in January, then in May. We will go off to the seashore again.

This Wednesday, my mother started daycare. It went well. I plan to start her off progressively. For 2 weeks, she'll be going one day a week (from 10 am to 2 pm), then 2 days for 2 weeks. Finally, in a month, if all goes well, she'll be going to daycare 3 days per week.

Since the geriatrist's diagnosis had been that my mother suffered mainly from "no drive dementia" (where all initiative is absent) with a minimal Alzheimer component, I have been trying to keep her busy so that she doesn't head for the bed to sleep. I plan for an activity every day, whether it is the nurse's visit, or the daycare, or the caregivers that come on Fridays. Today, it's an appointment at the hairdresser and we'll follow that up with pizza at the restaurant. Tomorrow, we go to the farm to get maple syrup. For the past week, she's been eating 2 buttermilk pancakes and maple syrup for breakfast. Joy!