Friends I've Made Who Don't Know Me

 
Lately, some of the most interesting people I've been getting to know are residents at Autumn Leaves, the dementia care facility here in Arlington, Texas, where my Dad spent the last ten months of his life.

And let me tell you, not all dementia patients are alike!  Within each of its victims, dementia manifests itself as uniquely as each of these dear folks were in their pre-dementia life.  For proof of this, consider the individuals I've already blogged about, like Miss Mary, Mr. Laurel, and Shirley, one of the most legendary residents ever at Autumn Leaves.

Let me introduce you to a few more of them here.  And, by the way, to respect the humanity each of these people still possess, and since they can't give their consent to me talking about them, their names have been changed.


Bob

Talk about the bizarre challenges of dementia care, and I give you Bob:  A short, emaciated, wiry little White geezer who, from what I learned of his stubborn pre-dementia days from his proud son, would likely approve of the term "geezer!"

Of all the disturbing behavior Bob displayed at Autumn Leaves, one of his most memorable was when he gummed the shear curtains in one of the facility's activity rooms.

He didn't eat them - he quietly gummed them and left strips of thread hanging from curtain rods. Caregivers had already taken away his dentures because he bit people. So without any teeth, just with his raw gums, he shredded the curtains one afternoon - we watched him, perched on the top of a sofa - no blood or anything. We don't know how he did it, but the staff just left him alone, since he seemed content, and wasn't hurting himself, or anybody else. 

And David, the maintenance guy, simply ordered another set of curtains when Bob was done.

In his dementia, Bob hated curtains. Before we arrived with my Dad, he'd ripped down EVERY set of curtains in the facility's public rooms. He kept pulling down curtains along a hallway leading to the two dining rooms (it's a hall of windows), so staffers finally stopped re-hanging them; David removed the curtain rods and spackled everything up to look like there had never been any curtains to begin with.

Once, Bob ripped out a fire alarm box with his bare hands - and those are bolted into studs, not simply affixed on drywall. He ripped out electrical sockets, completely immune to the shocks he'd get. His arms and legs were a patchwork of open sores (covered by bandages that caregivers could barely keep him from pulling off) and bruises in various stages of healing.

One day, there was a caregiver tasked with following him around the facility, cleaning whatever surfaces he touched (and left blood).

He was CONSTANTLY in and out of the hospital, mostly from his many falls. One time, his son (a police officer) told me that although Bob allowed himself to be placed on an ambulance stretcher calmly enough, an EMT was otherwise invading Bob's personal space a bit too much. The son had been called by Autumn Leaves staff, so he was on-site before the ambulance left, and Bob's son told the EMTs not to handle his father more than they needed to, and certainly not to get into his personal space, particularly around his face.

But one of the EMTs didn't obey.  And Bob, laying flat on the stretcher, limp and barely alert, somehow summoned enough strength to reach up and pop the EMT full in his face, knocking him out cold.

Did I mention Bob had been an amateur boxer in his younger days?

Miss Polly

Even when she's down, Miss Polly rarely seems to have a bad day.

She's one of the higher-functioning dementia residents where my Dad used to be.  A soft-spoken Black single woman, Miss Polly has a large extended family and, according to one of her nephews, used to love the color yellow.  When she first arrived, less than a year ago, she was walking, but now she needs a wheelchair most of the time. Yet she's always dressed smartly, in coordinated outfits, with either a wig or a Pocahontas head covering.  (I had to Google that!  My paternal grandmother in Brooklyn used to wear them when she hadn't had her hair styled).

She's exceptionally friendly, even though she has no idea who anybody is. And it's relatively easy to have a brief, reciprocal conversation with her.

One day, she was sitting with some other residents at a table of crafts, and she was quietly mumbling something to the woman sitting next to her. Miss Polly saw me, and she broke off what she was saying, looking up at me like she was Miss Innocent.

"Oh, Miss Polly!" I teased. "What were you gossiping about?"

Her face blanched, and she quickly drawled, "I wasn't gossiping. I was just telling it like it is."

Yesterday, during snack time, a caregiver wheeled her up to a tray displaying a variety of cookies.  The caregiver gave her one, and I commented, "Oh, it looks like white chocolate with Macadamia nuts!" Another caregiver glanced over and said, "No, I don't think those are nuts; we don't normally serve food with nuts to avoid any allergy problems."

But Miss Polly was too impatient. "Well, let's just see what it is," she interrupted, stuffing the cookie into her mouth. She chewed a couple of times, and confessed with her mouth full; "I'm a mess with sweets."


Sharon

Increasingly, Sharon is lost in her own fog that is dementia. Everything about her now seems to be quieter, dimmer, and a bit more disheveled than when she arrived at Autumn Leaves a couple of years ago. 

When I walked past a group of ladies at my father's dementia facility today, however, Sharon took full notice of me.

Although she is slowing down, Sharon remains the resident vamp of Autumn Leaves.  Tall, White, relatively slender, and relatively young (compared with most of the other residents), Sharon displays the classic dementia hallmark of an eroded social etiquette - particularly, um, when it comes to her feminine wiles.  If I told you some of the stuff she's done with a couple of the male residents in full view of many other people, let's just say that you would be incredulous.  Her son insists she was never that way in her pre-dementia life.  But today, her behavior is all part of the grim world of grown adults whose propriety filters have been destroyed by dementia.

And some of it simply ain't rated PG.

"WOW!" she exclaimed this morning, straightening her posture, and summoning from within herself a gusty enthusiasm that we haven't heard from her in a while. "Look at that MAN."

Have I ever mentioned that sometimes, dementia patients can be really good for your ego?  Of course, the other ladies sitting with Sharon - fellow residents of hers - merely looked at me with a mix of confusion and utter disinterest.

Which, frankly, is more the story of my life!


Flo

Flo is always a delight.

She's an even higher-functioning resident at Autumn Leaves than Miss Polly.  Slender, of average height, with dyed brown hair, some jewelry, and makeup applied appropriately, it took us a while before Mom and I realized Flo is a resident at Autumn Leaves, and not visiting a loved one like we do.

Many dementia victims develop a strange look in their eyes that seems to reflect their disconnection from reality, but Flo doesn't have that.  The only way I know Flo has dementia is that day after day, week after week, she can tolerate eating in dining rooms with other residents with dementia.  And let me tell you, watching a dementia patient eat is not for the faint of heart.

Well... I say Flo eats with the other residents... but there's a reason why she's so slender!

Last week, for example, it was lunchtime, and caregivers were helping residents into the dining rooms, but Flo just stood in the hallway, with her back literally towards the open French doors.  Actually, most of the residents have to be taken to eat - dementia somehow robs them of their ability to process hunger as their body's prompting for nourishment. So I encouraged Flo, "Hey, it's lunchtime! Time to get something to eat!"

Flo's face blanched. "I can't eat this food," she confided to me. "You know, I'm Italian, and the stuff they serve here just isn't any good."  And no, while I never ate any of the meals there, we'd been told that the cooks usually put some sugar into most of it, since sweetness is the last taste sensation to fade for dementia patients.  And the goal of mealtimes at a memory care facility is encouraging residents to eat for sustenance, not necessarily nutrition.

(I did once have a generous slice of fresh apple pie made from scratch by one of their cooks, and it was excellent... likely thanks to her liberal use of sugar!)

"Are you a good cook?" I asked Flo, fully aware that mine was a silly question to ask an Italian.

"Listen," Flo retorted, putting her well-groomed hand on my arm. "If I had cooked this, it would be FABULOUS!"

Today, Mom and I were visiting a resident at Autumn Leaves who is on hospice. We were chatting with the spouse of another resident in the main living room, and Flo strolled by. We welcomed her into our conversation, and then Madge trudged through, in her wheelchair, looking for trouble.

After angrily instructing us - pointed finger and all - that somebody had to get their act together (we don't know who, or what they'd done wrong), Madge started to wheel herself along again.

Looking at the departing Madge, Flo shook her head.

"With some people, I have to count to 30!" she muttered.

We all laughed, and I clarified, "you mean, to diffuse a situation, you normally count to ten before saying something, but with Madge it's thirty?"

"You got it, boy!" she affirmed heartily.

Flo usually carries a book around Autumn Leaves with her, even though it's usually the same one, and it's doubtful she remembers the plotline.  I once asked her what the book was about, and she gave me an uncharacteristically blank face, her wit apparently unable to make something up on the spot (which is a common tactic of dementia patients).

Today, however, Flo was sporting a new book.  "Such a suspenseful page-turner, you can't put it down," gushed a blurb on the bookjacket.

"So," I asked Flo. "Is it such a page-turner that you can't put it down?"

She looked at the book, sitting closed on the table, next to her cup of coffee.

"Not yet," she chuckled!


Mr. Zack

Technically, I broke the rules.

Miss Polly had one last cookie remaining after snack time this morning, and she told me she didn't want it.

Mr. Zack, on the other hand, still seemed hungry. He was sitting next to her, his head down, his eyes closed, like they always are.  I'm not sure how tall Mr. Zack really is; his chin always rests on his chest, even when the staff has him shuffling along with his walker, with his eyes still closed, his broad Black face seemly set in an oddly contented smirk no matter what he's doing.

His left hand was resting in his lap, but his right hand was still drawing circles on the table.  It was like his big hand was some sort of automated machine that hadn't been shut off.  Both his hand, and the spot on the table, were wet and sticky from him occasionally stuffing some fingers into his mouth, his "cookie-transfer system" from table to mouth missing a vital component: a cookie!

Mr. Zack doesn't talk.  Ever.  He'd lost that ability before I'd met him at Autumn Leaves, when we brought my father.  I've seen him during visits with his family, just sitting; eyes closed, chin down, those huge hands of his piled atop his knees, yet he'd somehow be transmitting an understanding that he was in the company of loved ones.

Dementia is strange, indeed.

So I suggested to Miss Polly that perhaps Mr. Zack would like her unwanted cookie. After all, the spot on the table being circled by his right hand wasn't going to generate a new cookie for him all by itself!

And, to my surprise, Mr. Zack grunted loudly at my suggestion!  It was an obvious affirmation that my idea sounded pretty good to him!  I confirmed with Miss Polly that it was OK to give her cookie to him, and she drawled, "well, if he wants it."

It was on a napkin, so I scooted the napkin and its sweet cargo over to the messy spot on the table, right underneath where Mr. Zack's right hand was now hovering.  He reached down and tried to pick up the cookie, but his big fingers don't move very well - those enormous hands - and the cookie slipped onto his lap.

Instantly, his left hand felt for it, found it, and grasped firmly onto it.  Eyes closed the whole time.  He reached up and stuffed the whole thing into his mouth, fingers and all, reminding me of Cookie Monster, from Sesame Street!

Technically, I'm not supposed to give food to any of the residents at Autumn Leaves, but Mr. Zack certainly won't report my misdeed!


Ricardo

Ricardo is a slim and dapper Hispanic gentleman. Quiet and reserved, he sports a well-trimmed white mustache and wears his graying hair slicked back in an elegant man-about-town fashion.

It's tough guessing the age of dementia patients, since the disease can wreak strange havoc on its victims' personal appearance, but I'd estimate that Ricardo is in his late 70's.

He prizes order and neatness, even in his dementia.  So the staff usually have a basket of fake "laundry" ready for him to fold.  Towels and washcloths in bold, bright colors, so residents with poor eyesight can sort and stack them and get a sense of accomplishment and worth.  Ricardo takes his time to make sure all the edges of each towel line up, and the stacks are neatly ordered on the table.  Frankly, such precision is remarkable among dementia patients, so we usually take the time to compliment him on his work.

Today, he was lounging in his wheelchair near a large window, our cheerful Texas sunlight washing across him. And a young, attractive, female caregiver was massaging his hands with lotion.  During wintertimes, especially, the staff rub lotion into residents' hands to help moisturize them, as dry skin can help spread germs.  Some dementia patients can't stand having their hands being gripped by another person, which obviously is what happens during a lotion massage, but most love the sensations of being rubbed and feeling their skin soften.

Ricardo clearly is one of the latter!

I leaned into him, and slyly whispered, "So, you're letting her hold your hand now, are you?"

And Ricardo, as if suddenly transported back to his prepubescent life, burst into goofy giggles that he couldn't stop!