Quantifying Change
Part II: The Bluff
This morning a manic Hubby woke me up at 7:30 AM very concerned (and rightly so) about a strange swelling on the front of his leg. His diatribe went from the leg, to the very strange phenomenon he is encountering each morning when he wakes up discovering his blankets are inexplicably scrunched up in a pile at the end of his bed. His focus then returned to fixating on the bump on his leg. Actually, I too found cause for concern- not about the blanket, but about the leg. An emergency doctor appointment was arranged and off we went this afternoon to meet our family doctor of 25 years.
Having assessed the lump as less than life-threatening, Dr. N. kindly used the opportunity to administer the standardized Memory Test of which I have spoken. The same questions posed to Hubby, as in the years gone by, but different answers this time. Actually, very few of his answers were relevant, and that was the problem. The patient is always asked if they know what city they are in, what month it is, the date, the day of the week, what building they are in. Hubby knew the country he was in, but cleverly waffled his way out of answering the others questions. This is a classic reaction when a dementia patient cannot access an answer required. Hubby tried to deflect the doctor’s attention with comments that were relevant to the himself, but not related to the question posed. When asked about the name of the city “that we are in”, Hubby responded “Well, we came here about six weeks ago so we have been here for a while.” The major effort at bluffing his way out of the situation was humorous, but only for a second. We live “here”. We did not return from anywhere six weeks ago. We have not traveled for two years. The reality hit me. He was doing very poorly on the same test on which he had responded quite well -each time in the past.
This is of course, exactly why the same test is administered world-wide and it actually tells the physician a great deal. This evening, I have a bit more appreciation for those doing the “measuring” of mental changes, time after time.
There is no debate whether patients need to be assessed. Benefits, treatments and suggestions can only be offered if there is some standard by which to measure the severity of an individual case in point. Still, at some point the family needs to decide how much energy they have to expend on the dozens of appointments which various specialists will tell us are all essential. Not all of these assessments will be helpful at the end of the day. It is unlikely that most medical professionals realize just how all-consuming and exhausting appointments with so many specialists can actually be …for both the patient and the family. Patients with dementia issues are usually elderly, but even the younger ones find every excursion a tiring challenge.
Years ago, my parents of blessed memory, lived in Florida and their lives seemed to revolve around their doctor appointments. I am sure that at the time I thought it was excessive. Now Hubby and I find ourselves in the same pattern. I am studiously looking for unnecessary appointments to cancel!
We caregivers need not be martyrs. Everyone has their limits, and a good “kvetch”, Dear Diary, does wonders for the spirit!
