It is the oddest feeling as I prepare to pull out my carry-on bag from the recesses of my closet. It both feels like yesterday and ten years ago since I’ve opened it. It’s been 17 months to be exact.
The last time I used it was when I was assisting my 89-year-old mother Ginny get settled in her new Independent-living apartment in a senior living facility. I live across the state from her and was staying a few days to unpack boxes and run errands with her.
And now, in some strange synchronicity, that is exactly where I’ll be returning. Over two weeks ago, my older sister had received a phone call that Ginny had tried to leave the building at 3:00 a.m. “Exit-seeking” seniors are immediately categorized as “high-risk” and are placed into a separate Memory Care unit inside the building. Memory Care is long-term nursing care with skilled staff trained to assist with cognitive issues like Alzheimer’s and Vascular dementia. It is a secured area with additional staff. Ginny was escorted to this unit by a guard in the middle of the night. The phone call was to reassure us that she was safe and being cared for but that there would be a substantial rent increase for the services provided in Memory Care.
Stepping back for a moment, our family was aware of isolated incidences of some form of dementia. Her doctor had never diagnosed a cognitive issue, so we attributed it to her advancing years. I wrote of one such incidence in “Unwelcome Visitor.” Otherwise, she pretty much retained her typical strong and independent nature and interacted with us and others normally.
She even continued to be herself through the long months of the COVID-19 lockdown. She enjoyed her 90th birthday during lockdown (as best she could) with a family visit through the window. She was relieved when restrictions were loosened and she got out to run errands (Covid be damned, she hugged her long-time hairdresser) and she resumed meals in the dining room.
But then the second lockdown happened. By late December, we noticed change. She seemed to turn inward; her thoughts focused on her parents. She talked about them in the present tense. She talked about “her girls” like we were living with her.
But all this was tempered with great hope. She was about to be vaccinated! It would not be long before we could see her in person, hug her, get her out into the sunshine. We told her that we were so close now! We talked to her constantly to keep her spirits up.
Then, on the day before her second shot, she fell simply standing by her door waiting for her breakfast to be delivered. She was taken to the hospital and released. No injuries. They reached out to my sister explaining that a nurse working for an in-house service agency had visited mom, and she had seen trouble signs that Ginny might need additional services “to help her get over this bump.” We immediately agreed. For us, it was a gift that she now had dedicated attention on her for two hours each day.
Initially, Ginny seemed resigned with this development but it only took a few days before the grumbling began. She didn’t appreciate people coming in “unannounced” and that she couldn’t stop them. It’s important to note that with my dad’s passing in 1978, Ginny has lived alone for 43 years and is fiercely independent. She has been a full-on warrior; meeting her needs and life’s challenges with great self-sufficiency for a very long time. She’s accustomed to being in charge of her life. Unfortunately, this new assistance was becoming a liability.
The next time I spoke with her, her voice seemed weaker. Dispirited. She couldn’t answer some of my questions, although that can sometimes be attributed to hearing issues. Still, there were moments when the old her broke through. When I asked if she was dressed yet (it was after 11:00 and I knew food would be arriving) she answered “What? Are you expecting a miracle?” and we both laughed. A moment later her voice diminished again and she just sighed saying she didn’t like people coming in and she practically whispered “there was nowhere to go and nothing to do.” The words and how she said them deeply pained me.
The repercussions of the Corona Virus have taken an enormous mental toll. It may not have created her cognitive issues, but it sure as hell has exacerbated them.
I found myself going online to see if there is any research about this phenomenon as it is so new.
Health Day News joined a recent discussion with Carla Perissinotto, M.D., geriatrician and associate chief for geriatrics clinical programs at the University of California in San Francisco as she addressed the current challenges facing seniors in assisted living or nursing homes during the COVID-19 pandemic.
“a lack of social interaction can be detrimental to a person’s cognitive health and even increase the risk for developing dementia over time by 50 percent, she explained… we are seeing these changes in real time. We haven’t actually had time to study this in detail,” Perissinotto said. “But, anecdotally, [I hear] from family members and friends and people living and working in assisted living and nursing homes that they are absolutely seeing changes in physical function and in cognitive sharpness, just by not being around other people and then by the subjective feeling of being alone.”
And so, taking matters into her own hands, mom had walked out the door. Or, tried to.
We need to be packing up her old apartment soon, but that is if they even let us in. Many Covid policies remain in place despite vaccinations. And because she is unable to afford that steep rent increase, we are looking at alternate facilities. One has a Memory Care wait list. Another one has been crossed off the list as it doesn’t meet certain criteria. We’re in a holding pattern with her current facility as they are not forthcoming about shared apartment options, our timeline to exit, and the bottom line of involved costs. There are many moving parts and we’re trying to gain a foothold.
We both spoke with her the day we heard the news. The phone system is such that a family member texts a cell phone and they bring it to the resident to use. The first call was less than a minute, but she seemed quite up which was an enormous relief.
The second time I spoke with her, it was a much longer call and she was alert and able to reference the Tiger Woods car crash. (I once mentioned in a blog post (click here) about finding small joys late in life and how much she loves to watch Tiger play. At the time, I could only speculate on why she was so drawn to him. She never played golf so I didn’t understand. The connection is literally dawning on me now. He’s a warrior too.)
Other parts of the call weren’t perfect though. She mentioned wanting to “go out the back door” and they wouldn’t let her. She did want one of us to come and get her which broke my heart all over again. I made the mistake of sharing some good family news that my husband had just been vaccinated and that prompted an irritated response that she hadn’t gotten her second shot (she had) and that needs to be addressed “now.” I need to learn the language of family members who love someone with advancing dementia. It is important to learn both what to say and what not to say.
Global death totals related to COVID-19 are shocking. But we’re learning first-hand how many other types of casualties linked to Covid lay just underneath. We’re devastated. We’re anxious. And we’re sad. Of all the challenges, we just didn’t think that our warrior mom would decline in this way.
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