Saturday, May 12, 2012

A Peek at a Difficult Day


This is not the post I'd planned for today. Today was supposed to be a calm, quiet day spent taking a short walk, reading or listening to an audio book, recording some of Boo's childhood memories, eating lunch outside. Well, you get the picture. Calm and quiet with meaningful activities. Unfortunately, that is not how today has been.

Today is one of Boo's confused, unsettled days. They don't occur as frequently as they once did. Having a regular (not rigid) schedule and feeling safe and comfortable are major helps. Of course, he has prescribed medication that can help him through the rough patches when they occur. On days like today, I try to keep Boo's focus on the here and now. He's easily distracted and easily upset. Consistent, calm refocusing on the present is usually the most helpful thing I can do for him.



1.

First thing after breakfast, I found Boo carefully tucking his bedroom slippers into the small space beside the aquarium in the living room.

“Where are you putting your slippers?”

“Just giving them to the white fish.”

“Ah...” When he gives an off the wall response, I have to delve a little further. Sometimes that's tricky. In this case, he could just want to sit near the aquarium with his slippers off. Or his feet could hurt. Or he might be considering putting his slippers in the tank with the fish.

“Can I look at your feet?”

“Nope. I'm going to bed.” And off to bed he went.

After he was settled in bed, he let me rub some lotion on his feet. There were no red or inflamed spots. His skin was warm and smooth. His toe nails were alright. So, it's probably not his feet. I checked his slippers. They seemed fine also. His blood pressure and blood glucose readings were normal. Who knows? Maybe after a short nap he'll be himself again.



2.

An hour later, Boo yelled for me.

“Aren't we going to eat breakfast? My stomach's growling.”

“We ate some earlier. Are you hungry now?”

“I didn't eat earlier. Maybe you fed Boudreaux my breakfast.” Well, maybe, but Boudreaux doesn't eat cranberry bran muffins and sugar free peach mango yogurt.

“Would you rather have a scrambled egg and a piece of toast or cheese and crackers?” Choices definitely work better than open ended questions.

“I want a salad.” OK, so that's different. He ate a small spinach salad with half a boiled egg, a little shredded cheese, tomato, celery and shredded carrots.

When he finished his salad, I asked if he was still hungry.

“I wasn't hungry to begin with. Are you through feeding me?”

Um mm....I guess so.



3.

“Where's my tiger cat? BOUDREAUX!!!” Amazingly, Boudreaux comes running to Boo when he's upset.

“Don't play with the alligators!”

Time to help Boo refocus on the present. I sit beside him and calmly stroke his hand until he acknowledges me.

“What do you feel? I feel your hand.” Usually Boo will respond appropriately. This time, he started trembling. Not a particularly good sign.

“I bet you can feel Boudreaux.” After a long pause, he finally responded.

“My tiger cat's good. I think he's been in the bayou. He was wet yesterday and there are alligators.”

Before he could get too overwrought, I interrupted him.

“I bathed Boudreaux yesterday before we gave him flea medication and he did great. He didn't mind being bathed at all.” That's probably overstating the truth, but he did tolerate it well.

“Look around you. What can you see?” Because sight is not Boo's strongest sense, I need to begin to reorient him with a different one. Many times he becomes disoriented because he can't see and only panics more when asked to use that sense.

“I see my brave tiger cat and...” He's calmer at this point and can reorient himself.



4.

“Let's exercise.” Boo is generally very anxious to exercise and enjoys moving around.

“Alright. Just a little.” Boo's lack of enthusiasm and lackluster vocabulary are clues that he is having difficulty staying oriented.

We begin with a simple exercise. He stands behind a chair and holds onto the back with both hands. Then he raises and lowers each leg sideways twenty times. This is usually very easy for him and requires little concentration. Today Boo can't stay upright and lift his leg even holding the chair.

Instead, I have Boo sit in the chair and do ankle circles. He can do that, but it requires a lot of intense concentration on his part.

“Done now! Where's Boudreaux?” After ten ankle circles, this was a very abbreviated exercise session. Another sign that Boo is still not himself.



5.

Boo and Boudreaux sit and watch TV for thirty minutes. Well, Boudreaux lounges on top of the TV and Boo watches it.

“HONEY! Where are you?”

“Right behind you. I'm on the computer.” I sent a message to his doctor's office explaining what Boo was doing today and what his vital signs were.

“Are you coming back?”

“I'm right here. I never left you.” Time for a little hand holding and quiet talk.



6.

“It's lunch time. I'm having a salad. Do you want another salad or a sandwich?”

“Oatmeal. I really want oatmeal.” Oatmeal is one of Boo's comfort foods. When he's confused or has little appetite, oatmeal seems to be the one thing he'll usually eat.

“Let's eat outside on the deck. It's a beautiful day and I'd hate for you to miss it.”

“I can't leave Boudreaux long. He needs me.” Although Boo talks to and about Boudreaux every day, he usually understands that he is a pet. This over dependence on the cat is very telling.

“Just long enough to eat. We both need fresh air.”



7.

“HONEY! I need help. I can't find the bathroom. It's been moved.”

We locate the bathroom. It's still about seven feet from the bedroom door. At this point, Boo is so confused that he can't be left alone in the bathroom.

When we go back to the bedroom, he asks for something to help him calm down. Although I haven't heard from his doctor at this point, it's definitely time for medication.



This has been a particularly difficult day. Most days are not like this, thank heavens. I really appreciate the “normal” days. I try to fit in as many good times as I can on those days. Perhaps the recent good memories and the past good memories with his family and friends in Louisiana will help him over the confused times.

(It's midnight and Boo actually had a much better evening. That is seldom the case when he's confused. Generally when he is confused, it is far more pronounced in the evening. After his medication took effect, Boo calmly talked to me, ate his dinner and went to bed.)



1 comment:

  1. One of my husband's former parishioners suffered a stroke this year and what you're describing is a lot of what his wife talks about on Facebook.

    I can relate on keeping a consistent schedule as I have an autistic son. There is much wailing and gnashing of teeth when things get off schedule.

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