The Sobering Truth

Yesterday I took Dad to Generations, a geriatric mental health practice. The doctor specializes in treating patients with Alzheimers and dementia. He will be the one overseeing Dad's meds as needed and keeping track of the progression of his mental deterioration. I took him because they wanted to do memory and cognitive testing and wanted a translator. After the initial interview with the doctor's PA, I was told to wait outside while the doctor spoke with Dad first. After that he would talk with me. Apparently this appointment was just for "mini-testing," so they could determine what other tests he might need.

When I was called back I met Dad's doctor, Dr. V, who told me that he didn't do any of the testing because Dad has progressed beyond a testable level. His short term memory is gone, and he has very little attention and focus, barely enough to answer basic questions. He was able to give his birth month, but not the year. He told Dr V. he was 84, which he will be in a couple of weeks. When the doctor asked him who he lives with at home, he couldn't answer, and it took a bit of back and forth before he was able to tell us his wife's name (in Taiwanese). He tried to say, "Jane," but it came out "James."

Dad was in a great mood though. Dr. V. said even when he couldn't understand the questions he just laughed, smiled, and nodded a lot, which is different for him. Maybe he liked the attention directed at him for once, since usually the doctors end up talking to me and Mom.

When I asked Dr. V. whether he had some sense of how long it would be before Dad would need actual nursing care, he shook his head and said it was impossible to say, everyone was different. Dad's storehouse of memories and knowledge are like Swiss cheese, and over time the holes will get bigger, so some things he will just know, and other things one thinks are obvious he will no longer remember.

Then Dr V. said something that really struck me. "I lose more caregivers each year than I do patients." He asked a lot of questions about Mom, about whether she had any support or resources, the nature of our household, what would happen to Dad if Mom got sick, like if she fell and broke her hip and was in the hospital for two months. He wanted to be sure we had an emergency plan in mind. He even said, "I'm really more worried about your mom than I am about your Dad. Two things determine when a person goes into nursing care: 1) They no longer listen to their caregivers, won't do what they say anymore, and/or 2) The caregiver reaches the point where they can no longer do what they are doing." Mom was at home with the kids, which turned out to be unfortunate because Dr. V. wanted to talk to her about how she was doing.

Later when I told Mike what Dr. V said, his response was,"Wow, that is really sobering. He loses more caregivers than patients? It makes sense, but it tells you how bad things can get." So we are re-committed to making sure Mom gets a chance to rest and regroup. Today I started inquiries into Adult Daycare, and also am trying to get Mom into a local support group, hopefully by this weekend.

None of this was a surprise to me. Living with Dad day in and day out, it's really easy to see how far he's gone. However, it makes his lucid periods that much more of a pleasant surprise. Today he was in a great mood, very responsive at his eye appt with the new doctor, as if he wasn't hearing impaired, and didn't resist going to the bathroom downstairs because we were running behind and didn't have time for him to get totally undressed like he does upstairs. I will hold on to these periods today, and not set any expectations for tomorrow, let alone next week.