The little bits first:
My bike ride today was rather miserable. It was snowing heavily, which is bad enough by itself because the snow blows back in my face–very uncomfortable, and it makes me ride with one eye shut and the other opened no more than a squint. So that was bad enough, but even worse it was warm enough so that most of the snow was melting on contact and the road was covered with water. My front tire through up salty water (filled with all sorts of heavy metals and toxins from car exhaust) into my face and mouth. As if that weren’t enough my pants were quickly soaked, and then my underwear. Considering the fact that it was snowing I came back from the ride thoroughly soaked and my lower extremities beginning to freeze from the wet clothing.
Yesterday the whether was very nice. Grandma took advantage of the fact and had me take her out to the bank for some business and the car wash to clean her very new car. Since no one else was at home to watch over Grandpa we took him with us. His entire involvement consisted in sitting in the car and watching the outside world. I caught me by surprise when we pulled back into the garage after the trip and Grandpa said, “Well, very good. I really enjoyed that.”
Grandpa is usually disinclined to go out of the house, but in reflection I realized that his primary concern is over being required to do something outside of the house. If Grandpa feels secure that nothing is required of him and he can simply sit safe in the car and look at the world–that is all the enjoyment that is left to Grandpa. It isn’t unusual to find Grandpa sitting on the arm of the couch, staring out the window at the world beyond. In his own way I think he feels (at least in a subconscious way, if not consciously) the fact that his world has shrunk to the four walls of his house. While in one way it frightens him to think of going out and facing the difficulty of dealing with the wide world, another part of his wants to see the outside world, which still has echoing memories of his past, and better days. So today he went out and saw the living breathing, active world, and he saw the bright sunshine still shining down on the world.
And why wouldn’t he enjoy that?
But beyond that the slow downward spiral continues unabated. The bathroom problems continue to increase in frequency . . . Since Grandpa started throwing all the contents of bathroom garbage cans into the toilet, bag and all, I finally decided there could be no more garbage cans in bathrooms. (As I fished the garbage bag out of the toilet for one of the last times Grandpa asked, “Do you always have to do that?” to which I said, “Well, every time you through it in.”) The garbage cans were becoming too much of an issue as he was constantly trying to get them to “work” with the toilet when he was on his “I don’t know how the bathroom works” gigs. The upstairs bathroom garbage can was the first to go, but the downstairs bathroom can soon followed when I one day went down to check on him and found him tottering out of the bathroom with his pants down around his knees, intent on grabbing a throw rug and adding it to the garbage bag and contents already plugging up the toilet. Apparently he figured that if the first addition hadn’t made the toilet start preforming maybe another addition would help. So, no more garbage cans in bathrooms–Grandpa and everyone else must now walk out into the kitchen to dispose of anything but that is an easy sacrifice to make.
I’m thinking that Grandma’s collection of throw rugs should be the next banned item–it seems to have become Grandpa’s new fixation. A few days ago Grandpa told Grandma he needed to go to the “sewer” and then promptly dropped his pants and took aim at the rug in front of the refrigerator. When Grandma protested that he wasn’t supposed to do it there he turned to her and said, “Well then where am I supposed to do it?” Then a different day he did pee all over the through rug in front of the kitchen sink. And I’ve already had to permanently banish the throw rug in our bathroom because it was impossible to easily get the thing truly and easily clean when I was constantly cleaning up from his peeing accidents. It definitely seems that since garbage cans are no longer around to capture his attention the throw carpets are now the new item which has come to be associated with his bathroom needs (when he is confused . . . in his better states he still uses the proper facilities).
Today was a bit of a bad day . . . nothing really serious, but I intercepted him in the kitchen as he was in the process of undressing. When I asked him if he wanted to go to the bathroom (the usual meaning if he starts undressing anywhere) he said “No, not now . . . eventually I will.” I then asked him if he wanted to take a bath (second most likely possibility) and he said “No, I was going to do that earlier, but I’ve given up on that” (he had a shower a day or two ago so it wasn’t need anyhow). So I asked him what he wanted to do. At that point he looked at me rather blankly and then turned to the kitchen table and talked about getting things to work with things, and pointing at and picking up various objects. I pressed him on the reasons for getting undressed, and basically it came through he couldn’t remember where he was going with that, but he was trying to do something. So I let the whole pants issue go for the moment and asked him if he wanted something to eat (he was fiddling around with the leftovers I had got out for my late lunch–he had already ate earlier). He agreed, so I warmed up some food for him and he sat at the table in his diaper and ate a second lunch. Then he dragged a chair around the house for awhile, then sat down on the couch the watch TV with Grandma. I had to take Melinda to work, so I got his pants and put them back on him, and he offered no objection. However, Grandma told me later that after I left he took off his pants again and when Grandma questioned him he said he was wet. She got him a new diaper without checking the veracity of his comment. Probably it was true–Grandpa is generally cognizant of that, though I am beginning to suspect he occasionally isn’t–sometimes he thinks he is wet and he isn’t, and vice-versa. It might also explain the forgotten reason why he was getting undressed the first time.
Grandpa’s weakness (related to his back pain) has been increasing, as well as his times when he is unable to walk (because of Alzheimer’s’s related issues. This, combined with his bathroom troubles, have formed the crux of some problems that have been troubling my mind.
To start with the bathroom problem, as I have already related before, this issues is exacerbated by the fact that Grandpa is still tries to get to the bathroom and not piss himself. Of course if you have a good diaper on pissing yourself (in the abstract) is better than a lot of other options, but this type of thought doesn’t cross his mind. I’ve woken up in the middle of the night to find Grandpa standing in the middle of the bedroom with his diaper down around his ankles, struggling to get out so he can go down the hall to the bathroom. Now anyone with familiarity with this type of setup knows that at that moment he could no longer hold it in, so as he is trying to get out the urine is going sprinkle, sprinkle over everything (much to Grandpa’s distress). One’s initial reaction is to go, “Aaahhh! No, no! Put it back on, put it back on!” but the best solution is to lung for the bedroom garbage can and position it to catch as much as you can.
Basically whenever Grandpa is seized by the sudden and desperate need to go to the bathroom he blind instinct is to first drop his pants and then find the proper receptacle for his business. So another mid-night jaunt finds me following Grandpa down the hall as he heads for the bathroom as fast as he can, sprinkling the hall carpet as he goes. He’s holding it in as pest he can and finally makes it to the bathroom door, turns the corner and lets loose at the bathroom in general. After emptying half to three-quarters of his bladder across the floor he realizes his mistake.
Cleaning up the linoleum bathroom floor is no problem. But, excepting the kitchen, the rest of the house is wall-to-wall carpeting, and while I have been mopping up various small amounts of piss out of the carpet I’m foreseeing a lot of cleaning efforts in the future, and perhaps some unavoidable bad odor.
I have noticed that not only is Grandpa forgetting how to use the bathroom, but I think he is beginning to have difficulty interpreting the signs that he needs to go. For quite a while he has struggled with the sudden need to use the bathroom and this has been related to his prostate problems. But now he has begun to exhibit symptoms of preparing to do something and then forgetting what it is he was intending to do . . . he will either try to take off his pants or put a garment on and then say, “What am I supposed to be doing?” When you suggest he needs to go use the bathroom he will say no, not now . . . then a few minutes later he will suddenly say, “I’ve got to go, bad!” and he won’t be able to make it. At this point it seems as if he only recognizes the desperate urge to use the bathroom.
This evening Grandpa wanted to use the bathroom while I was occupying it. I told him I would be right out, and he said not to hurry. A minute later I was off and out . . . and Grandpa had already taken his leak in the kitchen garbage can (which reminds me, I still need to change it). So it seems Grandpa’s bathroom need awareness is rapidly shrinking to “just before” awareness.
The real problem here is keeping the carpets clean. The rest of the bathroom issues cleanup I can easily handle. So what is the solution?
But wait. The next problem is Grandpa’s weakness. I have already previously expressed my concern about me not keeping careful watch over Grandpa every time he goes out on a bathroom trip at night for fear he will fall down the stairs or get into some other trouble. Well, as his strength has lessened and his back problems come in full force, this has become an increasing concern. I see the glimmerings of the possibility that one night Grandpa might go to the bathroom and not have the strength to get back. When he is really bad he basically staggers and falls toward his destination, careening off corners and grabbing at various objects until, breathing hard, he makes it back to bed. When his back is killing him this is physically draining. I’m becoming more tuned for signs that Grandpa might not make it back. A recent night I came back out of a dozing light sleep to hear the familiar Thump-thump of Grandpa’s shoulder working it’s way along the wall as he slid along toward the door, and the clawing rasp of his hand fumbling for the doorknob. The noises sounded all very blind and confused . . . it didn’t sound like a good trip.
I scrambled out of bed and opened the door. I found Grandpa sagging against the hall wall in the dark. “Boy am I glad to see you,” he said. “I didn’t think I was going to make it.”
“Need help?” I said.
Taking his hand in one of mine, I put my other hand in his armpit and bodily hoisted him up. Helping support some of his weight, I guided him back into the bedroom and bed.
Grandpa’s weakness, failing ability to walk, and back pain means its unlikely he is going to wander off. But it does present other problems. Twice he has had a crises in the garage (which is part of the basement). Once was not strictly related it his walking problems, but I will mention it anyhow. He had decided to change the kitchen garbage. It was after dark, he didn’t need to change the garbage, but since a bit of gentle persuasion wasn’t going to dissuade him, I wasn’t going to argue over the matter and let him carry the bag of garbage off downstairs. I made a mental note to check on him if he didn’t come back in a reasonable amount of time, then went back to what I was doing.
A short time later I heard loud shouts of distress from the basement. “Help! Heeelllp! Heelllp!”
I ran downstairs and opened the door to find Grandpa in the darkened garage. I figured out what had happened quick enough. The light switched to the garage is in the finished part of the basement and the door between the finished part and the garage is a fire door which automatically swings shut. Grandpa walked out into the garage without remembering to turn on the basement light and the door promptly swung shut behind him, plunging him into darkness. By the position of the garbage back it seems he at first thought this was no big deal and intended to continue to the trash can. Halfway there he thought better of it and turned back. He probably intended to open the door and turn on the light . . . instead he grabbed the handle to a filing cabinet drawer opened it, and stuck his hand inside the drawer. At this point I think he realized he was completely and utterly lost in the dark.
He was clearly shook up when I arrived, but tried rather thinly to make light of it. “It sure took you a long time to get here,” he said. “I thought I was going to be stuck down here forever. I thought I was a goner.” And when I got him back upstairs to Grandma he said, “I thought I’d never see you again.” He didn’t precisely really think any of those things, but behind the joke was the faint echo of the real terror he felt when he couldn’t find the door to get back out.
The second time he got stuck down in the garage was on a day when he was in a fit of agitation going inside and outside, upstairs and downstairs trying to do “things” which he weren’t quite sure what they were and generally getting himself utterly exhausted. I had an idea where this was going to end up so after a few minutes of his downstairs in the garage and not returning after one of his trips I went down to check on him. His ability to loco-mote had expired at the front of the car. I found him bracing himself against the car, looking like someone who couldn’t figure out how he was going to make it to the door. Exhaustion and confusion had combined to lock up his brain and he couldn’t move himself forward.
I took his hand and tried to encourage him forward and get his brain back in gear. At first he staggered and shuffled in place but with my coaxing his feet finally unlocked and we made it to the door. After that his brain relaxed and he made it back upstairs, but for a moment I had considered the fact that I might have to carry him upstairs.
So there is this growing problem of Grandpa getting around.
And what is the solution to these problems. Is there a solution? There is no perfect solution, but a couple of weeks ago I did think up a good solution that would reduce a lot of issues . . . if only people agreed with my solution. First, I would install a gate on the top of the stairs leading down to the basement that Grandpa couldn’t open. That way Grandpa would never be going down a flight of stairs without my assistance. Second, I would bring the commode out of storage and put it in our bedroom, and further I would so arrange it that after I was in the bedroom for the night Grandpa would not be able to open the bedroom door and get out without my help (there being several ways I could accomplish this). Third, take a roll of old linoleum out of the barn and put it over the carpeted floor in our bedroom. The end result would be that during the night Grandpa would only use the commode in our bedroom where he wouldn’t have to travel more than a few steps and I could constantly keep an eye on him. And, with the gate installed at the top of the stairs Grandpa during the day couldn’t do dangerous things on the stairs. Some of the greatest dangers eliminated.
The problem with my solutions is that Grandma and Grandpa have their own and differing objections. Grandma isn’t thrilled with a gate installed because that will lower resale value (though I haven’t yet approached her and argued my case) and Grandpa, I know, would be highly offended by the restrictions on his movement.
I know all these things must be done eventually, sooner better than later. But I’m taking it slow. First I get the linoleum rolled out in the bedroom. Then I discuss the possibility of Grandpa always going to the bathroom in the bedroom at night and night leaving the room. That is going to be very very hard, and I might not get the staying in the bedroom past Grandpa’s muster. He doesn’t much care where he takes a piss so long as everyone else is happy, but being able to get up and leave the bedroom when he wishes is a point of personal dignity. Very understandable, and I wouldn’t worry quite so much if I knew there was a gate on the stairs . . . and that is the last sticking point. I think Grandma will be rather appalled at a gate installed at the head of her stairs, but I’m hoping if I present it properly she will find herself unable to object. It needs to be done, badly, before Grandpa takes a serious tumble. Earlier this week Grandpa decided to carry a kitchen chair down to the basement. My quick assistance helped him get downstairs with the chair without any injury, but there are too many opportunities.
They are definitely unhappy solutions, all of them. They are very practical, but they bring the ugly realities of where we are going out where everyone can see them. And it will be especially hard on Grandpa because he isn’t so stupid as to not realize he is being penned in. My only hope is that I can talk to him and make him agree that for his own safety this steps are necessary. And I am dreading that conversation, so I am putting everything off . . .
Well, I stayed up way later than I should have writing all that, so I’ll sign off now. Somehow I seem to always make sure I’m the most tired when grocery day comes around . . .