Christmas Eve - an early gift

I've had this in my head most of the day...

Twas the morning of Christmas and all through the house
Not a creature was stirring, not even a mouse.

I awoke to find my dad had a fall
His head was all bloody, a hole in the wall...

It was about 4:30 am and I was having a coughing attack. I got up to take some cough medicine, and found my dad sitting on the floor of his room, right by the open door. I turned on the hall light, and he just looked at me. "Dad, you OK?" "I'm fine" was his response. I hurried to awaken Tom because I wanted some help. I wiped my dad's head, and found the blood had already dried. I flashed back to a "kaboom!" I had heard about midnight. I thought he had rolled over and hit the wall. I was sure of it when I heard him mumbling, which he does in his sleep. But seeing the blood had already dried, I am pretty sure he had been sitting there for hours. During the transition from the floor to a chair, I realized that my dad did not know that he could have called me for some help. I also saw that he had no idea how to get himself up. I ended up sitting on the floor next to him and showing him what to do with his legs so he could get up into tall kneel. He did imitate what I did with my legs, but Tom and I had to help him up to kneeling, and then help him to position his foot so he could push up to stand - again with some help. He had obviously been getting up to use the bathroom, so there was that mess to clean up, but it seemed insignificant to the fall. And it was a good one. There is a hole in the wall, about a 6 inch circle and about an inch and a half deep, where his head hit. (He told me not to worry about it, that he would fix it later.) He has some good scratches in that area of his head, and a deeper gouge just above his eye at the end of his eyebrow. I told Tom that God had given us an early Christmas gift - no broken bones. It could have been a lot worse than it was.

So...today I looked up the symptoms of a concussion -
http://www.mayoclinic.com/health/concussion/DS00320/DSECTION=symptoms
Ask my dad if he had any of the symptoms? Nope. The most common symptoms, confusion and amnesia. Can't use that as an indicator. No vomiting, no slurred speech. Headache, dizziness, ear ringing? Can't trust his answers. So we'll be looking for the nonverbal cues, as discussed in the article. He seems OK, but today was the first day that he needed help getting off the toilet. I could attribute that to soreness from the fall. It was also the first day that he put on 3, count 'em 3 shirts. Not one then another, but 3 on top of each other. He always tucks his shirt in, and with that extra bulk, he had quite a hard time fastening his pants.

Lessons learned:
* There is now a night light in his bedroom. I had thought it best to keep his room dark so that he would sleep, and not get his days/nights messed up. But safety is winning out.
* My dad does not know to call when he needs help.
* I was able to go into the bathroom and help him get down and up.
* Tom was able to go into the bathroom and help him get up, even though he was protesting.
* We are going to get some type of bars to help him in the bathroom.
* I need to role play with the caregivers in case my dad falls when they are here.
* Keep all doors SHUT except for his and the bathroom, day and night. The master bedroom door was open and he went in there to use the bathroom. That toilet is lower, and he was in there forever, ("I'm fine"), and he could not get up without help.

My dad slept til 12:30 pm today. I think it was because he was up most of the night sitting on the floor, not because of the head hit. I am hoping that is what it was. He ate well today, and enjoyed our Christmas Eve dinner, watched football, and was his usual quiet, pleasant self.

So I'll keep my eye on him tomorrow. Poor guy. I think he's gonna have a black eye.

A sincere Merry Christmas to all!

pick, pick, pick

This is kind of gross, but my dad picks. He picks any anomaly on his skin. Anything that is above the skin's surface is target. It doesn't matter if I put lotion on him every day. I don't think it has anything to do with dry skin. It's "old man skin" I tell him. So he picks, and he bleeds. His legs, arms, head, and chest all have sores. I clean them and bandage them, and sometime during the night, or just later, he takes off the bandages. Then...picks. It's a mindless activity for him. His fingers will be full of blood, the front of his shirt soaked, and he will have no idea what happened to him. There is one sore on his leg that has been there, I would guess, 5 years. Maybe longer. It almost heals, and then, you guessed it. He picks. It's the weirdest thing. My job. . . .I know I can't stop it, it is what it is, right Jean? I have a large container filled with cotton balls, Aloe Vera, Neosporin, gauze, band aids of every size, and tape. It's my daily friend to keep things clean and covered. It's all I can do. That's what I pick to do about this symptom of A.D.

He's still got it!

Have you ever played Scrabble for 2 hours? Not 2 hours of game after game, but a 2 hour game? I just finished playing that with my dad. And he beat me too, 258 to 172! How can someone that puts words like isawfi and wezsa on the board win????? It was the first time we've played it since he's been here. I was surprised that he wanted to play it when I made the suggestion, and even more surprised that he could play it. The more words that got on the board, the harder it was for him to play. That's when isawfi and wezsa appeared. It was one of those lessons learned tonight. I learned that my dad could do it, yea, Dad! I also learned that I have a lot of patience! Maybe it made me have that patience, and wow, was I patient! Yea, me!

sitting on the fence

Decisions, decisions. What to do about Aricept. My dad has been off Aricept for about 6 weeks now. Was it helping? Seems like maybe it was. He is quieter, seems more confused, has been less of a game player (both not wanting to and has poorer skills), and other things. Is it the progression of the disease? I do know that people with A.D. can stay at the same level for years, but I have also found, from my support group, that people can change rapidly. Was Aricept helping him to function?

Per WebMD, "Donepezil (Aricept) is used to treat mild to moderate confusion (dementia) related to Alzheimer's disease. It does not cure Alzheimer's disease, but it may improve memory, awareness, and the ability to function. This medication is an enzyme blocker that works by restoring the balance of natural substances (neurotransmitters) in the brain."

The most common side effects include:
Nausea -- occurring in up to 11 percent of people
Diarrhea -- up to 10 percent
Headache -- up to 10 percent
Insomnia -- up to 9 percent
Generalized pain -- up to 9 percent
Dizziness -- up to 8 percent.

Was he having these side effects? I have no idea. I don't think so.
Like I said, decisions, decisions. And I do not know why headache and insomnia are highlighted above in the list of side effects.

Not getting feedback from my dad about his health, or much else, is really hard. He can't tell me he doesn't feel well, or if something is bothering him, or if something out of the ordinary is happening to his body. His one leg has been swelling, and he never complains, but I see it daily when I clean and bandage his leg sores (that some mystery person is picking). One thing about this disease is that the caregiver has be be very aware, ever vigilant, and have good observational skills. Being the detail person that I am, I do notice little things that others would probably miss. But being in this situation with my dad, I choose to ignore a lot, just saying that this is the way it is. Deciding what is important...there's the challenge.

Now what do I do about this Aricept?

Still grateful

With the holidays approaching, or any upcoming event, I need to be careful about what I say to my dad. I still put up decorations, and will comment to him about them. He has even helped me with a few things. But saying things like Christmas will be here soon, or I have to do my shopping, or talking about an upcoming event...those are no-no's. I need to remember to keep to the present. Tom is really good about this, but I sometimes have trouble with it. When I do, my dad says things like, "Christmas? I have to get home". The look on his face is confusion, and I hate that. Sooooo, my topics need to be closely monitored, by me! I need to avoid the "open mouth, insert foot!"

I've noticed a few things about my dad lately. In the mornings, I say to him,"good morning! Did you sleep well?" His typical responses are things like "I slept like a dog", or "I slept like a coon (raccoon)". This morning, he said, "I slept like a boon". Other word finding things I have seen are - he has gotten lost when saying the prayer before meals, that he was unable to recite the Lord's Prayer when the Eucharistic ministers came the other day. (He also said, "no thank you, not today", when communion was offered.) He's had some problems with the car seat belt, and some clothing fasteners. :( But, on a positive note, he still dresses himself without any help (except for me putting the dirty clothes in the basket so he won't put them on again), eats independently, and he showers himself, with prep work by me. :) And, of course, he is still very cooperative with his haircut, shaving, and teeth care.

According to this site, http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp there are 7 stages of Alzheimer's. My dad has all of the symptoms up to and including stage 5, and some in stage 6.

I'm kinda lost for words after reviewing those stages.
But I continue to be grateful he is here with us, and am blessed that my family has been so supportive. Thanks again Tom, Dawn, and Smith!!!