Dad Speaks to the Birds and More!

As I've mentioned in previous posts, when communicating with Dad, you go with his flow wherever the conversation takes you. Yesterday evening, Shelley and I visited Dad and he was very talkative...we just had a very difficult time figuring out what he was talking about. Most of our conversation was in English and some in Spanish.

The following videos are of Dad speaking with the birds and in one of them you can hear him speaking Spanish to them. Dad asked us if we knew the names of the birds and we replied that we didn't, but he told me the names of the birds were in my phone. Going with the flow, Shelley told Dad that the names of the birds were Cheech and Chong to which Dad agreed.

In the first video you will see Dad approaching the birds and speak to them, In the second video you can hear him speaking in Spanish to them.

Other September Visits with Dad
On September 6 Dad spoke with his sister Noemi in San Antonio for a few minutes and he started to cry; maybe it was because he heard a familiar voice from his past.

On September 13, I visited Dad alone and he was asleep for most of the time so I just sat and watched him sleep. After about 10 minutes he open his eyes as if he knew he was being watched. He didn't know who I was but we just talked. His dinner came while I was there and I helped cut his food so he could eat it a bit more easily.

On September 14, Bruce visited Dad to say good-bye as Bruce and family have moved to Southern California, about 500 miles south of the nursing home. Bruce said Dad slept for most of his visit.

Photos of Dad in September

Dad's beautiful smile!

Shelley assisting Dad with his lunch

Dad is telling me a story...

...as he looks out his window

Tuesday evening with Dad

The Communication Challenge

Communication with an Alzheimer’s patient is challenging at best and nonexistent at worst. Communication with an Alzheimer’s nursing home is also challenging but should never be nonexistent.

Dad’s nursing home is constantly communicating with me about Dad’s condition and situation in the nursing home. A few weeks ago the nursing home advised me that Dad would be temporarily moved to a room next door so that his room could be renovated. A couple of days later the nursing home advised me that Dad had fallen and cut his forehead (2 centimeters) in his old room. Alzheimer’s patients do not do well with change; their life patterns must remain as constant as possible so as not to distress the patient and to keep the patient as safe as possible. Dad’s cut has healed and is doing fine.

Another method the nursing home uses to communicate with me and family members is to hold quarterly “care” meetings. At these meetings we (family members) are updated by the unit nurse, social services director, activities director, and other staff members about Dad’s condition. We are able to ask questions, make recommendations, brainstorm ideas, etc. in our joint efforts to maintain Dad’s quality of life at the highest level possible.

Our last care meeting was held on August 22^nd. Following are some of the updates we received:

• Dad had an x-ray done due to the fall the previous week. There were no fractures, only mild abrasions and contusions. He is under observation to make sure there is no evidence of a concussion.
• Dad still thinks he can get up on his own and walk around the facility whenever he wants. He never developed a pattern of using a walker so the idea never presents itself to use one. He must be assisted by a CNA or other person or be reminded to use a wheelchair or walker for support. (This is an on-going communication challenge.)
• He is weighted once a month and has shown a gain from 123 lbs. to 126 lbs. He eats well for someone his age and he takes protein supplements with each meal. If he looses a drastic amount of weight they will weight him more often, otherwise he is stable for now.
• Dad has been moved to room 3B from room 1A while renovations are taking place. We may just keep him in 3B if he seems to get used to being there however if he continues to go back to room 1A then we will put him back there once renovations are completed.

After the care meeting, Shelley and I went to visit with Dad but all he wanted to do was sleep. He said he was tired and just wanted to go back to sleep. So we said goodbye, gave him kisses and let him sleep.

Within 48 hours of the care meeting I receive a call from the Social Services Director to advise me that Dad had been moved again! This time he had been moved to room 27 on the other side of the facility. The reason given for the move was his roommate was being hostile with Dad so was moved for safety concerns.

I went to see Dad the next day and I could clearly see that Dad was not doing well at all with the latest move. His behavior and speech was erratic and seemed very agitated (see the video below; he even took my camera from me, something he has never done previously). I spoke with his nurse and she agreed Dad should not have been moved for a third time.

The next day, Sunday, I called the nursing home for an explanation for the third move and I demanded that he be placed back in his previous room for his safety’s sake and if his roommate was causing problems to then move the roommate and not Dad. After nearly an hour of conversations with three different persons, I was told someone would get back to me. I received a call back and was promised Dad would be moved back to his room that afternoon.

Even though the staff was able to accommodate my demand, I now had some concerns about the nursing home’s ability to handle Alzheimer’s patients and requested a meeting with the nursing home’s administrator on Monday morning.

On Monday morning, Shelley, Bruce and I met with the nursing home administrator and the nurse I had spoken with on Sunday. We expressed our concerns and a half hour later we were reassured that Dad’s best interests are first priority. The administrator even gave us his cell number so we could contact him on a 24/7 basis if needed, which is reassuring. At the end of the meeting we agreed to strive to communicate more effectively with one another despite the challenges.

Tuesday Evening with Dad

When we arrived at Dad’s nursing home for our regular Tuesday evening visit, the nurse advised us that Dad would probably be sleeping. An hour before we arrived, Dad had been given medication to help him regulate his sleep for nighttime versus being up all night and sleeping during the day.

However, upon entering his room, we found Dad eating. His dinner tray was still at his table and it looked like he had barely touched his food, looking closer we noticed he was eating a cookie. He had cookie crumbs all over his shirt, which you might be able to see in the first photo. You can see from his smile that he really enjoys the cookie.

When he finished the cookie I suggested he might like the spaghetti with meat sauce and he agreed to try some. I gave him a few bites and seemed to enjoy it. Shelley took over feeding him and he eventually ate all of his dinner.

While Dad was eating, I called my sister so she could talk with Dad for a few minutes. Dad seemed to recognize Joyce but he was more interested in eating.

After finishing eating and about 40 minutes since we had arrived for our visit, Dad could not seem to keep his eyes open. The medication was working. We said our good-byes and left him to sleep.

Following is a short video of Dad eating his dinner and some photos.  

Eating his cookie and enjoying it too!

Getting help with eating his dinner.

Almost done.

Done and going to sleep!

Sleeping by Day, Wandering by Night & Doing Fine

During my July visits with Dad, I have observed his continual memory decline but his overall physical health has improved. He is no longer in hospice care, he is eating more, and most importantly, he is drinking plenty of fluids.

It seems like every time I visited Dad in July he was in bed asleep, yet, according to the night time staff, Dad is awake at night and walks around.

During one of my visits when he was sleeping, I nudged him a little. He opened his eyes, smiled and said to me, “Hi dad.” Then he closed his eyes and went back to sleep. Instead of trying to wake him, I just sat at the edge of his bed and watched him sleep, probably the same way he used to watch us when we were young children. It is moments like these when it becomes so overwhelming in realizing just how much has changed as we’ve grown older. In many ways, it has not been fun but it has provided the opportunity to appreciate life more.

I took Dad for his follow up visit with his neurologist this past Friday (July 27^th). He answered a few of the memory test questions correctly, such as correctly stating the current month and season but he couldn’t answer any of the other questions posed. His doctor confirmed that he is in the late Alzheimer’s stage. However, as long as he continues to eat well and drink fluids, which will minimize any complications that could negatively affect his health, he should be just fine.

If I were to have taken a photo of Dad during my July visits,
most would look like this one!

Two Sons with Their Dad

Our visit with Dad

Yesterday, July 7, Bruce and I met at "the home" for a visit with Dad. Bruce had arrived about a half-hour before I did so they had a bit of one-on-one time. When I arrived Dad was engaged in a conversation with Bruce but I couldn't figure out what the conversation was about. Bruce indicated that he couldn't follow what Dad was talking about either.

That's the way our visit went with Dad; nothing made sense to us but we could tell that in his mind he knew what he was talking about. He kept referring to one of his nephews that looked like Bruce but couldn't remember who it was other than he may have been a sergeant.

Dad had difficulty searching for words to express his thoughts. For example, Dad kept slapping his forehead and I asked him why was he doing that. He said he wanted to keep the "thing" from getting out or protruding. He was referring to a mole-type growth on his forehead. I asked him what it was and he called it a "pecan."

Throughout our visit Dad kept referring to Bruce as Jay and at times he thought we were his uncles. He spoke of his sister, Noemi, and said that she spoke well and that his other sister, Patsy, was starting to talk and form words. I figure at that moment he was in the late 40s.

Also, for the first time since he's been in the nursing home, he did not recognize the photo of his parents. He said he was trying to figure out who they were.

This visit was difficult because we could see how Dad is sinking deeper into the depths of dementia, He may have some good days in the future but more and more Dad's times, places, events, and people are becoming more muddled.

Dad has lost more weight, he is now at 123 lbs. He is eating less again but is doing well taking in liquids. And the staff informs me that he does get out of bed to move around late at night.

Here is a video where you will see Dad slapping his forehead and calling the "thing:" a pecan. You will also hear him joking and making mimicking sounds.

Bruce & Dad having a good laugh

Dad Explains His Sister's Nickname: "La Chata"

Dad's sister, Noemi, sent a birthday card last week and I read it to him. His sister signed off using her nickname, "La Chata." I asked Dad who gave her that nickname and what does it mean. His reply are recorded in the following short video:

Here is a photo of Dad holding the card from "La Chata:"

According to Dad's nurse, he is doing as well as can be expected. Late evenings are his best times when he tries to get up and walk around (with assistance). He is eating most of his breakfast, but lately seems to not want to eat lunch. He has also been very cooperative when it is time for a shower (this is a huge change as he is usually very resistant!).

That's for this update. Maybe La Chata can confirm how she got the nickname?

Getting Past May

My last post was at the end of April 2012 and so much has happened since then. As most of you know, my mom passed away on May 3 and the rest of the month was spent making memorial arrangements, visiting dad, and making the trip to San Antonio and back. Getting past May has been more difficult than I anticipated but nothing is ever the same after the loss of a parent.

Now it is June and I want to update you all about my latest visit with Dad on Father's Day, June 17th. I drove down to San Rafael on a beautiful afternoon, which had significantly cooled down from the day before when the temperature hit the century mark. Shelley wasn't feeling well so I made the trip alone.

As I walked into Dad's room he greeted me with an instant smile of recognition, which was then confirmed when he addressed me as "mijo!" And he started to cry. I noted that Dad is looking well although he needed a shave. I started my conversation by telling him about the family I'd seen in Texas and about the trip. He asked where I'd spoken with everyone and I said, "In San Antonio," and he looked a bit confused. I reiterated that I'd just gotten back from San Antonio. Then I called Joyce so she could talk to him for a while. They had a nice conversation and Dad didn't cry as much this time.

I told him his birthday was coming up soon and he said, "Oh really?" I asked if he remembered his birth date and he couldn't remember. So I reminded him, June 19th. I said, "Guess how old you are going to be." He said he didn't have any idea. I told him, 84. He said, "I'm getting old!"

Lately Dad seems to be doing quite well health wise but it is very evident his memory is fading with each passing month and year. He can still joke around and laugh but he can also get angry if he doesn't like someone (like his roommate).

Here are a couple of photos I took of Dad during my visit:

Yes, Dad is smiling in both photos!