July 17, 2014

The Speech Therapist

During the extended wait for the hospital bed, my mother’s speech therapist, Alecia, called to report on my mother’s progress during her placement on my mother’s care team of visiting nurses from the Visiting Nurse Service.

Alecia was mostly suggesting activities and things we can do as part of a routine for my mother to help reduce her confusion and disorientation, especially upon waking in the mornings when she is most confused.

One suggestion she made is to make a poster that is visible from a distance instructing my mother about what to do when she wakes up. It will say something like: GOOD MORNING, MARY. PLEASE CALL ALICE AND TELL HER THAT YOU ARE AWAKE. It can also have a slot for the day and date to be written-perhaps a dry erase board will be helpful.

Another suggestion is to have a calendar by her bed. Every night, Alice can point to and say the day and date and review the activities of the day. She can also indicate what the day and date will be the next day and discuss the plans or visitors that will come.

The third suggestion is to make a special photo album of the faces of people she knows, one person per page. The album should be small, 4x6 prints, so that she can hold it easily and leaf through it. Alice, or someone, can quiz her to help her identify family and friends.

I will work on to make these things available to my mother as soon as possible.

I asked Alecia what her thinking is about my mother’s condition. Amazingly, she too, is not thinking dementia. (I MUST be crazy!) Her reasoning is that although my mother says Lulu is not her cat, for example, she recognizes Lulu and knows her name. I find this reasoning somewhat flawed. When I described some of the other dementia-like behaviors we have observed and experienced, such as loss of executive functioning long ago, she agreed that there may be some dementia going on, in that case.

Alecia has noticed a decline in my mother’s performance and cognitive abilities over the last two weeks. Still, her time is done. She told me that if my mother improves over the next few weeks, to ask my mother’s doctor to call her back. On the other hand, if my mother gets worse, we can call her back as well. Okay, but why not just continue? I don’t understand this system.

I did appreciate Alecia’s ideas for how to help. She stressed that the purpose of the calendar work and looking at the photo album is not to make my mother remember, but to establish a routine that supports her and can have a calming effect on her demeanor.

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