Tag Archives: Dementia

10.1.17 Tinsley’s Struggle

Tinsley seemed to adjust his first week in his new home. I spent a couple of hours each evening to show my love and support for him. I showed him how I organized each drawer for his T-shirts, pajamas, and underwear. I showed him how I arranged his closet. Since Tinsley can’t carry on a conversation with much clarity, I mostly sat with him to be emotionally present. Sometimes I kept him company while we watched TV. When he needed a smile, I gave it to him. When he spoke, I nodded to affirm his attempt to make conversation. When he was ready for bed, he would lie down. I would put my chair right beside his bed and hold his hand for another thirty minutes. When he fell asleep, I headed home.

 

 

But his sweet personality changed beginning the second week of living there. 

“Why did you do this to me?!” he asked.

“I followed your doctor’s medical advice to keep you safe,” I replied. “You were in the doctor’s office with me when Dr. Booton said “It’s past time. Tinsley needs a higher level of care.”

Tinsley didn’t remember that appointment. He observed other residents with their walkers and wheelchairs. He became agitated.

“See that?!” he asked while pointing at a woman in a wheelchair. “This is just ridiculous!” I interpreted his comment to mean that because he didn’t need help with walking, he didn’t belong there.

Tinsley remained convinced that he shouldn’t be there. I began to doubt myself. Did I make the right decision for Tinsley? Did I hear God’s voice accurately? Was it the right time? When I observed the majority of residents compared to Tinsley, I have to agree with him. He looked like a misfit. Unlike the other residents, Tinsley dressed neatly and had no mobility issues. Maybe this decision was premature.

I decided to call a family meeting. They had interacted with Tinsley since Mother’s death and have seen his quick decline. They also went through this kind of decision with their own parents. They listened intently as I shared tears of pain and discouragement. After an hour of dialogue, they reassured me that Tinsley needed more care than I could ever give him at home. They shared multiple reasons to support their conviction that I have done all I am able to do for Tinsley.

But there was one person who felt it was the wrong decision, and he had no difficulty communicating that to me.

I showed up one Saturday to have supper with him. When he stepped into the dining room with me right behind him, he turned around and walked out of the dining area. I didn’t think much of it the first time. Then he would try again. He walked toward his table and saw me joining him, and he turned around and said, “No!” and walked out again.

“Tinsley, do you want me to leave?” I asked exasperated.

“YES!!!” he said angrily.

“I’m leaving now,” I said.

 

Each day that I showed up, it appeared that I was the trigger for his anger. When I arrived in the community room, he was calmly watching TV with other residents. But as soon as I hugged him and said hello, within five minutes he paced around the facility. He vented his frustrations.

“I need to get out of here,” he said. “Did you come in your car?” he asked.

“Yes,” I replied.

“I want to go home,” he said.

“This is your home,” I said.

“It is NOT!”

 

After a month went by, I decided to talk with the doctor. I expressed my concern that Tinsley seemed to have enough awareness to know what is going on.

“I need a second opinion. Did I make the right decision for Tinsley?” I asked. “For someone who has declined rapidly since my mother died, he sure seems to have clarity on what’s going on. He does NOT believe he needs to be here.”

“I have been doing this for sixteen years, and I promise you he is where he belongs,” Dr. Woodall said. “When I evaluated him, he became teary at times. He is still grieving the loss of Betty Ann. He is also deeply frustrated at his own loss of not being able to think clearly. He knows he’s confused, but can’t tag why. So there are many losses going on.”

The doctor and I agreed that I should not see Tinsley for at least a week to help him acclimate. I waited nine days because Tinsley’s sister would be in town to see him. We decided to see him together, which we hoped would be encouraging to Tinsley. Aunt Kathy brought a beautiful gift basket full of snacks Tinsley likes.

Aunt Kathy’s Snack Basket for Tinsley

Aunt Kathy and I spent two hours with him, and she experienced seeing his anger and negativity. When Tinsley said, “I don’t belong here,” she would try to reassure him that he is safe here. When Tinsley vented his frustrations, she coached him to think positively to help him make the best of his situation. Tinsley didn’t care to hear that as he looked the other way. He remained agitated and unsettled. Aunt Kathy decided to lean on a tradition that Papa Harvey had with her and Tinsley as children. While sitting on patio chairs, she grabbed our hands and invited Tinsley and I to recite the Lord’s Prayer with her. Tinsley knew it by heart and seemed to be calmer when we were done. When we left the facility, Aunt Kathy could see what I have been enduring the majority of the time I’ve been with him. As we drove back home, she said, “That is NOT Tinsley. It IS the disease speaking.”

It has been a couple of weeks since her visit, and Tinsley has not improved emotionally. In fact, I believe he has worsened. One Sunday afternoon I came to visit him and found him in the community room watching TV. When I joined him, he stood up to walk away from me. He turned around so that our eyes locked.

“NO! Do you HEAR me?!!” he said loudly. I just got there! I never know exactly what he’s trying to say, so I’m forced to read between the lines and observe body language. It was clear that he didn’t want me there. So I said goodbye and left. It was a five minute visit.

He has become physically aggressive in the last week. When a resident asked me a question and I turned to respond, Tinsley grabbed my forearm and angrily said, “No!” His reaction isn’t rational, but it is heart-breaking to experience his hostility. The doctor is working on the right balance of medication to help Tinsley deal with his anxiety and his depression.

It has been a sad time for me. It feels like I have lost Tinsley. I have been grieving the emotional loss of Tinsley more than I have been able to grieve the loss of Mother. Though the doctor assures me that “it’s the disease, not Tinsley,” it’s still hard not to take it personally. It’s hard not to wonder if I am the reason he is so unhappy and angry. How do I know when it’s Tinsley speaking or when it’s the disease? It is so HARD to tell. Many family and friends are ready and willing to help him get out and play some golf, go to the club, have lunch with the guys, as he used to do. But right now, if any of us took him out, we’d never get him back in. He’s already taken a patio chair and set it against the fence and tried to scale it. I don’t know how long it will take for Tinsley to reach acceptance that he is where he needs to be. But at this rate, it appears that it will take another month or two.

I ask you to keep praying for Tinsley and his well-being. He has already lost fifteen pounds in three weeks. He said to me, “I’ve quit trying.” He needs the Lord’s peace and comfort. Please pray that the Lord will allow us to have a healthy relationship and that he would embrace it and appreciate it. The Lord knows how to heal Tinsley’s heart. I know many of you are prayer warriors. If you’ll continue to lift him up before the Lord, He can help Tinsley’s heart rest spiritually and emotionally in His perfect peace. I also need prayer for wisdom on how often to visit him. I want to see him every day and make sure he never feels abandoned. However, that isn’t prudent given Tinsley’s emotional condition.

8.31.17 “It’s Past Time”

I called Tinsley’s physician, Dr. Booton, mid-afternoon last Tuesday. For the last two weeks, Tinsley kept pacing around the house. On the days I worked from his house, I heard bedside drawers being opened, followed by the sounds of rummaging, and then drawers slammed back into place. I found him in his master bedroom.

“How can I help, Tinsley?” I asked.

“I can’t find my razor blades,” he replied irritably.

After twenty minutes of searching together, I found an empty bank bag stuffed with razors that he stored in the armoire that sits in his living room. On other days, we went through the same process looking for his wallet or for the remote controls to TVs. The pattern of hiding things started before Mother died, especially car keys. It took too much time to search every drawer in every room, so I bought Tiles that ring when you are within 100 feet of the object. So I inserted one in his wallet and attached another to his car key ring.

TILE on Key Ring

On good days, Tinsley would turn the kitchen faucet on to fill a watering bucket for his plants and then walk away. Or he would open the refrigerator in the garage and not shut it tightly.

The nurse had already asked Tinsley to pee in a cup for a quick urinalysis before Dr. Booton saw him. After he walked in and exchanged pleasantries, he began to evaluate him. He asked Tinsley if he had been going to the bathroom more to rule out a urinary tract infection. Tinsley couldn’t answer with yes or no. Instead, he spoke unintelligible mixtures of random words or phrases. I also told Dr. Booton that Tinsley complained about not seeing well. I reported that Tinsley’s ophthalmologist had already ruled out a detaching retina and cataracts. Dr. Booton ruled out the possibility that Tinsley was having mini-strokes. He then explained that Tinsley was probably suffering from a common phenomenon that happens to Alzheimer’s patients. They lose their peripheral vision.

Dr. Booton swiveled on his roller stool. “It is past time,” he said to me.

Tinsley is in the moderate stage of Alzheimer’s disease. Mother had the same condition. When Mother was alive, she and Tinsley found a way to maintain their independence. Tinsley drove at night because Mother’s vision had changed. She maintained a structured schedule on her Yahoo calendar, and all he had to do was show up. But ever since my Mother died, Tinsley was on his own and his anxiety kept growing.

The last month has been revealing. I knew Tinsley was in a bad place when he started wandering away from the house. He used to step outside to pick up the morning paper, the mail, or to check out his yard. But that changed in the last month. Two weeks ago he wandered all the way to Mesa drive, which is a dangerous road. Our neighbor picked him up and took him home. Then a couple of weeks later, he announced to our renter upstairs at 9:30 pm one evening that he was “going somewhere.” He had his cap on and intended to walk out the door. She gently guided him to his chair in front of the TV, gave him a glass of water, and sat with him to calm him down. Then it happened again last week. He not only left the house, but he headed to his friend’s house that sits at the top of Mesa, which is a huge incline.

Looking Up Mesa Drive

It was a hot morning, and our renter followed him in her car. She kept trying to coax him to get in, but he refused. He wanted to be with his friend, Sonny. Sonny wasn’t expecting him, but he lovingly took him in and spent half a day with him.

It has always been my goal to honor Tinsley’s estate plan, which is to keep him home for as long as possible. But my biggest struggle was providing daily supervision. Since Mother died, I’ve taken care of him and made sure he had lunch and dinner. I kept him company as often as possible, including working from his house when I didn’t have client appointments. Instead of going home after work, I watched television with him so he wasn’t alone. At night, I made sure he was tucked in bed before I locked the house and headed home. During the day, I watched him enjoy three chickens that often came to our house from across the street.

Tinsley with a Hen

It didn’t take long to figure out that I couldn’t maintain this kind of schedule. Tinsley needed a consistent caregiver. While praying for guidance, a new opportunity arose. A retired lady from my church needed a place to live within 30 days, so I offered a room upstairs to rent at Tinsley’s house. She was even willing to provide meals for him periodically. She moved in on July 1st. Tinsley adjusted to her living in the house with him, and he appreciated her help on many occasions. However, none of these solutions kept him safe at all times. I could install a deadbolt lock on the front door, but Dr. Booton didn’t like that idea. He said that would increase Tinsley’s anxiety and agitation.

The feeling of failure followed. Why can’t I make it work for him to continue to stay at home, even though he lives in a state of confusion? Can’t I live with him and bring in care throughout the day so I can go to work without worrying about his safety? If Tinsley had received consistent care from one person from Helper Bees, this idea would have merit. Unfortunately, I experienced what many others experience with home health workers. They come and go often. And someone with Alzheimer’s needs a familiar face. Sadness settled in. This is a man who has unconditionally loved me from the moment he married Mother. He was always there for me and never judged me. To say “I love him so much” doesn’t get close to how deeply I respect and adore him. I want to return his love 100 times over, but moving him to a care facility doesn’t express that. It feels so wrong and unfair for someone at age 79. How do I even begin to live with myself? How could I do this to him?

I found Arden Courts, a memory care community, which gave me peace. He’s right down the street from Balcones Country Club, and the community is smaller and more intimate. They have four wings with fifteen rooms in each. Each wing has its own kitchen, community room, and a lovely outside walk area. They have a couple of activity rooms in the main area of the building. He is only twelve minutes from my house and fifteen minutes from my office. I can see him easily every day. After signing paperwork, I drove to his house. I found him in the bathroom trying to shave his face without shaving cream.

I knew it was past time.

 

Blessings,

Lee Ann

12.7.11 You Do What?

     A year ago my father purchased a foreign currency that is about to be revalued, meaning we had to find a free checking account at a bank that can exchange the currency—and quickly. I suggested a local bank I knew with free checking and a $1 minimum deposit, but when my father looked into transportation, it turned out the service he normally uses doesn’t reach that area. We moved to Plan B. 

     I confirmed that Wells Fargo would exchange the currency, and I called Dad to let him know that we were in business.  I asked him to wait until it was time to exchange the currency, however, and then I’d meet him at the bank and assist him in opening the account and completing the exchange. 

     “What if you’re in Kansas when this happens?” he asked.  “Shouldn’t I have my account open and ready?” 

     “That’s a good point, Dad,” I said. “But let’s wait for this week to play out before we worry about that.” I was fairly certain the currency would be exchanged before I left. 

     Dad considered my suggestion maybe five minutes.  That same day Dad went into overdrive and decided he needed to pursue this ASAP, so he got on his computer and found Wells Fargo himself. He’s had a non-profit account for his ministry there for years.  Instead of lining up transportation to open a checking account, he noticed on the website that he could open an account online, so he proceeded to do so without consulting me. That afternoon I got a phone call stating that he put $150 on his Chase credit card for an opening deposit and $25 for a Savings account. 

     It sounded tame and simple enough at first. But his follow-up email led me to believe we had bigger issues.  He was going to have to set up a draft of $25/month to “keep the account afloat to avoid $10/month fees,” which sent up red flags.  After spending two weeks last spring unhooking over twenty bank drafts tied to his credit cards and his bank account, this was the LAST thing I was going to embrace. “Why isn’t his checking account free?” I thought.  And why was the minimum deposit $150 of all things?”  The account at the other bank only required $1 and was free. 

     My response to his email was firm. “If we don’t have a free checking account,” I wrote, “then it is not serving the purpose for which it was intended. “ I re-emphasized that this Wells Fargo account was only a shell account, and once the currency is exchanged, the dollars will be wired to his brokerage account at Ameriprise, and the Wells Fargo account will be closed.  In the meantime, I would be stopping any drafts of $25/month.  Dad responded to my email with confusion.  “If Wells Fargo can receive and exchange my currency,” he wrote, “who needs Ameriprise?”  (Have I mentioned that Dad set up his brokerage account with me as his advisor to manage the dollars that will come in from the exchange?)  I picked up the phone to avoid multiple emails and reminded him that I was a professional financial advisor.  “You do what?” he asked.  I was floored.  It was in this moment I fully grasped the seriousness of Dad’s dementia.  Could it be that my father had no recollection of what I do for a living?  

     With Dad’s mental faculties impaired, I realized I needed to scan his email for any transactions I may not have been aware of.  I discovered two emails of the same date entitled, “Welcome to Wells Fargo.”  One email was sent at 2:53 p.m. and the second was sent at 4:06 p.m.  I’m thinking Dad opened two checking accounts online because he forgot about the first. Both emails showed $150 as the opening deposit.  By this time I was commercial, industrial-strength frustrated.  I called Dad to ask if he was aware of opening two accounts, and he said no.  His intent was to open one checking for $150 and one savings for $25.  I told him the emails were indicating two accounts at $150 each.  He then asked if I could fix this, and I told him I would try.  At this point I was struggling with why I had to clean up yet another mess.  If he would quit attempting financial transactions and let me do them for him, we wouldn’t have these problems.  I have very little downtime for myself.  I feel emotionally drained when I have to use the scarce resource of time to deal with a situation that was preventable. 

     Seeing that time is precious, I decided I didn’t have time to throw myself a pity party.  I pressed on and looked up his Chase account online.  Sure enough, there were two pending payments of $150 waiting to be sent to Wells Fargo.  What started as a proactive step on my father’s part had turned into a financial fiasco.  Dad’s debt is still growing, albeit slowly, and the last thing we need is $300 charged on a credit card plus the interest that will accrue.  

     Since I had Dad’s permission to “fix this,” I took a copy of my Power of Attorney (POA) and a copy of the account number and went to the nearest Wells Fargo bank.  I was nervous because some organizations don’t accept a POA until it’s reviewed by their legal department, which can take a couple of weeks.  However, this sweet banker was fine with the documentation I provided and was willing to talk to me about this fiasco. I explained the whole situation, and her solution was quick and decisive. 

     “Since we don’t see the opening deposits yet,” she said, “we can just close the accounts right now, and the Chase payments will be rejected.  It will be as if these accounts were never opened.”  I agreed with her recommendation.

     “Let’s close them,” I said.  She also offered a solution. 

     “Your Dad doesn’t need to go online to open a checking account.  Since his ministry account is here, we have his drivers license, signature card, SSN, etc, on file, so it only takes a phone call to open an account.”  I asked if I could do that for him when the time came, and she said yes because she has my POA on file.  I profusely thanked her and marveled at God’s wonderful grace.  

     God just delivered Dad from a mess he unintentionally created.  That’s the kind of God we serve.  His grace abounds in the messes we make.  I have created plenty of messes in my life, and I am thankful that God unconditionally loves me and delivers me.  He did it today for my Dad, and He will do it again if He needs to.  God is good all of the time.  His grace always abounds–even when Dad forgets what I do for a living. 

Blessings,

Lee Ann