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.)
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.
ReplyDeleteI 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.