Maintaining the Rage

Things they don’t tell you about dementia, number 542: Rage.

Not Mum’s rage. That does come and go – but it always did. It’s hard to tell where Mum ends and dementia begins. I’ve been a target of Mum’s rage as long as I can remember. That’s not new. But it used to go on for months. Now she forgets within minutes. There are upsides.

No, the rage that’s a problem is mine. I want to kick, punch, and scream until my throat is raw. I want to throw things at the world. I want to tear something down. Blow something up. Beat myself senseless.

Do not, at this point, tell me that everything happens for a reason. There is no reason for this. Dementia has no logic, no reason, no plan. Dementia is a senseless, random trauma that crushes the breath out of me even as it eats away the life of my mother.

I want to scream into the face of the world that it’s not fair, but the world couldn’t care less. I go home, go to work, care for my children. I do the shopping, take my daughter to swimming and answer my email, when all I want to do is fling myself at the floor and kick and scream “THIS IS SO UNFAIR!” But life has no time for tantrums.

Break all the records, burn the cassettes

I’d be lying if I told you that I had no regrets

there were so many mistakes, and what a difference it makes

but still it shouldn’t surprise you at all

You know

I said it shouldn’t surprise you at all, You know

Don’t look now but you have changed

Your best friends wouldn’t tell you

Now it’s apparent, now it’s a fact

So marshall your forces for another attack

It was always within you, it will always continue

And it shouldn’t surprise you at all

You know

Billy Joel, Surprises

I am so angry. I hate this. I want it to stop. I want it to end. I want relief. I want to know what’s coming and how we will handle it. I want to pretend it’s not happening. I want someone to bloody well fix it, and now. I want to be held and told it’s ok. I want to push the world away. I want to make it stop. I want to run away. I want to stay home and hide. I want to drown my sorrows in chocolate and icecream. I never want to eat again.

I can’t do this anymore, and I can’t stop. It hurts. Don’t tell me how to help her – she won’t let me. Don’t tell me to remember the good times, there weren’t many. Don’t tell me you’re sorry. Just stand well back while I implode. She would hate this, but she left years ago. There’s no connection. No parent. There’s nothing left but rage and fear. But I can’t walk away. I shouted at her today. God knows she provoked me, but she crumpled like a child.

I need to be angry. It masks the fear, the guilt, and the sadness. All I can do is maintain the rage.

Down the Dementia Rabbit Hole

I don’t always write about my visits to Mum. There’s always something new, but often there’s no new emotion left to deal with it. Nothing left to say. Nothing new to feel.

Today was pretty normal at first, as far as dementia allows for any definition of normal.

Mum asked me where my parents live. “Only in my head, honey. Only in my head.”

Of course I didn’t say that, just answered lightly and steered the conversation to safer topics. But I’m used to that one now. Then she said I was her sister. That was new. She’s an only child. But she hasn’t reliably known me for months. I’m not greatly disturbed by who she thinks I am.

We went out to lunch. She was a little odd – differently odd, even for her – but nothing particularly radical. We walked back to her house, and I waited to see her inside before leaving. She fumbled with her keys and couldn’t get the gate unlocked. This is pretty normal for Mum these days, so I waited a bit in the hope she would sort it out, and then I got out my keys and tried the lock.

It was stuck.

I had the right key – I had opened the gate with it when I arrived – but it wouldn’t turn in the lock. The lock is a deadlock and the gate is one of those spiky ornamental ones. The house is really quite a fortress, so being unable to unlock the gate makes getting in a significant challenge.

Mum immediately started to panic. Her key chain is festooned with broken keys, and she was getting more and more stressed about trying to unlock the gate. I was worried she would break her key off in the lock and then we’d have no hope. To top it off it was getting late and I needed to get home to pick up my kids.

I tried to get Mum to stop wrestling with the lock while I figured out what to do. I couldn’t open the garage, as the batteries seemed to be flat on the keypad. There is no easy place to scale the fence. I tried my key in the lock again, to no avail – it was definitely the right key, but the lock just wouldn’t move. Meanwhile Mum was becoming increasingly agitated, saying it had never happened before and she never had any trouble with the locks, why was it happening now, what were we going to do, why was it happening now… her stress levels were sky rocketing and it was impossible to isolate myself from her panic. It was infectious.

I called my husband to see if he had any suggestions, which at least calmed me a little, and I worked out that if I put my foot in the letterbox slot I could get myself up and over the gate (lucky I’ve been doing all that weights work recently is all I can say!). I had to sit on the spiky gate to get my other leg over which was no picnic, but I managed it.

I jumped down the other side to find that the lock was indeed jammed. But it was jammed outside the latch-hole. If we had tried the other handle, the gate would have opened.

This is the rabbit hole of dementia. I’ve felt for years that visits to Mum took my brain and ripped it into tiny pieces. I’ve long suspected that I didn’t ever manage to collect up all the bits, and that with every visit I, myself, become less complete. Less coherent. It’s impossible to be around that level of dysfunction without becoming somewhat dysfunctional yourself. But today I failed to open a gate that was, in fact, not locked.

I saw Mum safely inside. She became calm as soon as she was inside the house, fortunately. But her panic, her terror, her anxiety? I took them home with me. I pulled over on the side of the road halfway home and sobbed. Over a gate. Yet not over a gate at all. Over the mess that this damned disease has made of my mother, and is making of me.

I don’t want to play this game anymore.

 

Surrealism, dementia style

You know what they don’t tell you about dementia?

Well, actually, nearly everything. But chief among them is how incredibly surreal it can be. I was at a cafe with Mum today. And it was fine. I was showing her photos from our holiday. She seemed to recognise my daughter, who was hanging out with me today. And as we chatted she turned to me and said “You can do the maths. How long have we known each other?”

It doesn’t matter how often this kind of thing happens, it’s impossible to get used to it. I stared at her for a moment and she said “I mean, I know we’ve known each other for a long time. When did we meet? And where?”

All the dementia literature says not to burst the bubble. Just play along with their reality. So I said “Well, it was 44 years ago,” hoping she would let it go at that. She exclaimed over how long we had been friends and then said “So where did we meet?”

I wasn’t sure whether to burst out laughing or put my head on the table and howl, so I said “we met at the hospital,” thinking that perhaps she would twig. She looked puzzled and said “did I come to see you did I? That was nice of me.”

I agreed it was indeed nice of her, while my heart quietly shattered. But she hadn’t finished with me yet. “Well hang on, you were in hospital, how did we actually meet?” oh yes. Nice time to use logic, Mum.

“We were in hospital at the same time.”

“Wow. That’s amazing”

“Yes, yes, it certainly is. I am amazed.”

It’s hilarious, really. Except it punched out my heart. That’s surrealism for you, I guess.

Half an hour after I got home she called me to ask when she would see me, it’s been so long.

When you feel my heat
Look into my eyes
It’s where my demons hide
It’s where my demons hide
Don’t get too close
It’s dark inside
It’s where my demons hide
It’s where my demons hide

They say it’s what you make
I say it’s up to fate
It’s woven in my soul
I need to let you go

Your eyes, they shine so bright
I wanna save that light
I can’t escape this now
Unless you show me how

Demons, Imagine Dragons

It’s not like this is new. She has forgotten me before. But the human brain, pre-dementia, is surprisingly resilient. It bounces back to its base state whenever possible. And regardless of how fractured, how flawed my relationship with my Mum has been, the base state of my brain is heavily influenced by that most primal of relationships: parent to child.

And that relationship was like two ropes. One from her to me, one from me to her. God knows those ropes were sometimes more like barbed wire. Sometimes they were so tight it was painful, while at others they were so thin and loose as to be almost undetectable. Ultimately, though, they were always there. But now her rope to me is unraveling. In fact that’s probably a lie I’m telling myself even now. Face it, it has unraveled. Evaporated. Gone.

I don’t know why that hurts so much. Her remembering me was usually pretty traumatic. When Dad was still alive their “remembering” moments usually involved threats of legal action, or screaming down the phone. But I still feel shocked and sick every time.

She still knows she knows me. But she doesn’t know who I am. There is no doubt a day coming when even that last flash of recognition will be gone.

I spent the rest of the day doing what had to be done. I drove home. Did the shopping. And halfway back from the shops I suddenly sobbed hot, desperate tears. It will only get worse from here. And I’m not sure I can do this anymore.

 

The Heartbreak kid

Have you ever noticed how, when things get really bad, sometimes it’s not the blows that knock you down? Sometimes you get hit, and hit, and hit, and stay standing, right up until someone asks if you’re ok – and then BAM! You’re down for the count.

This morning I got a package from a dear friend in Queensland. I shared a pattern on Facebook ages ago for crocheted sandals made out of thongs, and she had made me some. It made me a little teary. I’m very lucky in my friends. I had a visit to Mum planned, so I resolved to hug the thought of those sandals to me, to remind me to smile.

I knew when I called Mum this morning that it was a bad day. She couldn’t hold a thought even for a moment. Meaning eluded her. She wasn’t sure who I was, or what was happening. Her conversation, usually fragmented, was in a lot more pieces than usual.

I think I’ve already lost you
I think you’re already gone
I think I’m finally scared now
You think I’m weak
I think you’re wrong

“If you’re gone” Matchbox Twenty

When we left her house Mum pointed at the possum box in the tree and asked me if I knew who had put it there. “It was my Dad,” she said proudly. “It was a long time ago but he must have been quite old when he did it.”

Her dad died twenty years before Mum and Dad moved into that house. I’m pretty sure he never installed a possum box in his life, and he certainly didn’t install that one. On the way to the cafe she pointed to a bench that she keeps telling me her Dad used to sit on, but this time she had an elaborate story about how he helped them move in and then sat on that bench. It’s as though she’s papering over the holes in her memory with stories that never happened.

We had lunch. I ordered something I thought she would like, because she couldn’t make sense of the menu. Chris and Bruce, the cafe owners, know what she has anyway. They treat her like royalty – which is nothing unusual, it’s the way they treat all their customers. She kept fretting about whether she had enough money to pay for lunch. I showed her some photos and she remembered some people but not others. She must have told me 15 times over a half hour period that she had a dog called Toby when she was little. I smiled, nodded, died a little inside, and kept it together.

Then, when I went to pay, Chris quietly told me that Mum has been coming in every Sunday for some weeks now, looking to buy a paper and some chocolate. Chris was so sweet about it, he said he just takes her next door, to the general store, and makes sure she’s ok, but he and Bruce wanted me to know. We talked for a bit about how Mum is deteriorating, but because she won’t see a doctor or let anyone into the house there’s nothing we can do. Bruce said “as long as she’s happy and not distressed.” But of course she is distressed quite a lot of the time. I think she only ventures out of the house when she’s in a positive frame of mind.

And then Bruce said “and as long as she’s not causing you girls distress” and it broke me. It absolutely broke me. I joked that that was a much longer conversation that would need something stronger than tea, but when I got back to the table I had tears rolling down my cheeks.

Where do I even start? How can I tell him about the hysterical phone calls demanding to know where Dad is? How can I tell him about the tears when she is looking for her parents? How can I tell him about the way my heart shatters when she doesn’t know me? Or about the times she gets angry over things I can’t understand? How can I explain how desperately we want to get her help? How helpless and alone we feel, unable to access any support services, because we can’t even get her assessed? (We really can’t. Believe me. We have exhausted every avenue. Don’t even go there.)

Things with Mum are so hard. Others only see a fraction of the story, but there are so many people who look out for her, and for us. There is so much kindness woven through our trauma. So many hands waiting to catch us each time we stumble. But here and now, today, I’m not sure I can keep doing this. How many pieces can get torn out of your heart before it stops beating?

I’ll be over here, clinging to my slippers.

Please don’t say you love me

Dear Mum,

We almost had such a good day today. You were unusually lucid – I think you might even have known me. We walked up to your local cafe for lunch. You won’t go there on your own, but we always go when I visit. The owners are so kind and welcoming, and endlessly patient when you repeat yourself, or when you can’t read the menu. They even prompt you, because they know what you like. They don’t need to be told that you have a long black, and that you like to have it after the meal. They bring me extra hollandaise with my eggs benedict.

Every time we visit that cafe I want to hug them, because they create such a safe and welcoming space. A little island of happiness amid the trauma of our relationship.

Today it was almost peaceful.

You asked about birthdays, always afraid of missing one, so I suggested you write a card for Jane and James, your daughter and grandson. You looked puzzled and stressed, but still it was a hammer blow to my gut when you said “do I know them? Do they know me? Will they know who the card is from?”

For the first time my tears came before leaving you, instead of after. I had to excuse myself and hide in the loo, leaning against the door and fighting to breathe, to suppress the tears and be able to come out again smiling.

The rest of my visit was a whirlwind of anxiety. You wanted to go to the bank, but you didn’t know why. You wanted to get money out, but you weren’t sure how much. You thought perhaps you had forgotten that you were meeting someone at lunch. When I took you home and took my leave, you wrapped your arms around me, told me you loved me, and that you were so lucky to have me.

But I don’t feel lucky.

Just please don’t say you love me
‘Cause I might not say it back
Doesn’t mean my heart stops skipping when you look at me like that
There’s no need to worry when you see just where we’re at
Just please don’t say you love me
‘Cause I might not say it back

Please don’t say you love me  – Gabrielle Aplin

I am lucky, I know I am. Because along with your memory, the dementia has taken away a lot of your fear, and most of your anger. Now that you don’t always know who I am, you no longer reject me for every perceived offence.

You don’t threaten me with legal action much anymore. Before the dementia took hold you used to do that if you thought I had committed any of a whole range of crimes, from talking to my uncle – or sometimes even my sister – to asking about Dad’s health.

I’m not even sure if I love you, to be honest. I feel desperately sorry for you, but in truth life is easier this way. You’re calmer now. Maybe life is easier for you, too, without all that rage.

You used to be so afraid. Afraid I wouldn’t do what I was told – you said you wanted us to be independent, but disagreeing with you was a hanging offence. Afraid I loved others more than I loved you – now there was a self-fulfilling prophesy if ever there was one. Afraid people would let you down, or reject you – so afraid that you invariably rejected them – us – first. Your fear made you lash out, and even though your viciousness was objectively ludicrous, it reduced me to rubble every time.

You used to try to bind me to you with guilt. “If you loved me, you’d…”

“If you really cared, you’d…”

“We were up all night because you were so cruel to us… if your father has an accident and dies on the way to work, it will be all your fault.” I can’t remember exactly what caused that one – it was either someone offering me some furniture, or someone inviting me over on Christmas day. Both triggered massive meltdowns, which of course were entirely my fault.

The meltdowns are different and less frequent now, and they never last because you forget so quickly. I visit more often than I can really handle, but not as often as I feel I should. I wonder if it really matters because 5 minutes after I’ve gone you don’t know I’ve been. Still I feel guilty, because guilt is our currency of choice. All my life you have ruled me with the iron fist of guilt.

I mourn deeply, but I’m not sure that I mourn you. I mourn the mother I dreamed of, who loved me unconditionally and would never disown me. I mourn the mother who knew me inside out and loved me outside in. I mourn the mother I could talk to about my fears, who would support me instead of judging me, and who was proud of me even when I struggled. The mother I wished I deserved.

I don’t mourn having to choose my words with care. I don’t mourn fearing that you might find out I’ve been spending time with someone else. I don’t mourn the long silences that meant an explosion was brewing. I don’t mourn the fear.

But each time I drive away from your house I feel sick. I can’t breathe. Perhaps forgetting who we are is one final rejection that comes and goes almost daily, along with your memory. Maybe this is a new way to lose and re-lose the Mum I never really had. Maybe  everything is still my fault.

I just wish you would stop saying you love me. Because I might not say it back.

 

Holding Patterns

Today my sister was shocked when my Mum asked her if she had any brothers and sisters. Mum wondered whose birthday she could see on her calendar (it was her grandson). Last week she asked me if it was my parents who had a house at the beach. I wonder if she sometimes wonders why I haven’t introduced her to my Mum? I wish I could.

Dementia, for us, consists of thousands of these moments, interwoven with snatches of lucidity. Some things seem to stick better than others – she often seems to know I have kids, but has no idea how many, or what they are studying at University (they are 9 and 12 years old), or even their gender. But it’s clear she no longer identifies as my Mum – except when she does.

And it’s obvious she doesn’t know my husband’s name, although we’ve been married for over 20 years. Except when she does.

And she has certainly reached the point where she can’t read a menu. Except when she can.

There’s definitely no way she could find her way to the local shops and back anymore, except on the days when she does just that.

This, I think, is one of the deepest and most unexpected traumas of dementia, for those trying to wrap their lives around caring for the patient: The astonishing lack of certainty. It’s a disease with no fixed pattern. No identifiable time frame. Nothing you can rely on from one day to the next.

She could go on like this for years. Or she could die tomorrow. Of course, that’s true of all of us. Life is far less certain than we would like to believe. We hedge ourselves about with calendars, plans, and timetables in an attempt to pin some predictability onto our lives, even though it could all evaporate in a puff of smoke at any moment. But the human brain is very good at inhabiting its self-created patterns and not looking outside itself to the terrifying possibilities of tomorrow.

“How we envy you, envy you! Lucky humans, who can close your minds to the endless deeps of space! You have this thing you call… boredom? That is the rarest talent in the universe! We heard a song — it went ‘Twinkle twinkle little star….’ What power! What wondrous power! You can take a billion trillion tons of flaming matter, a furnace of unimaginable strength, and turn it into a little song for children! You build little worlds, little stories, little shells around your minds, and that keeps infinity at bay and allows you to wake up in the morning without screaming!”  

Terry Pratchett, A Hat Full of Sky.

Dementia forces those shells open, and breaks them into pieces. Dementia is the reason you wake up screaming. Dementia keeps dragging you back to ceaseless, merciless awareness that today, tomorrow, or next week could be a catastrophic crisis. A shocking new fall downwards. A crisis whose shape you can only guess at. A crisis that you can see coming but can’t possibly prepare for.

How do we look away from that crisis and go on with the day? How do we stop flinching every time the phone rings, and dreading what we will see when we open her door? How do we grieve for the loss of our mother while keeping her alive as best we can?

There are no answers here. Only questions we can’t bear to ask.

 

Dementia sufferers

When you hear the term “dementia sufferer” I bet you think of people whose memory is going. Who may not be able to care for themselves any more. Who don’t even know their loved ones. And there is no doubt they suffer, but it feels to me as though my Mum has almost gone past suffering. True, she has moments of fear, of panic, and of loneliness, but for the most part who she was has bean eaten away, and emotions are so fleeting now that she never suffers for long. She calls in search of her parents, but five minute later has forgotten both the call and her parents. It is both the blessing and the curse of memory loss that nothing lasts for her anymore. The distress those calls leave behind, though, lasts a lifetime for us.

Today I ran the “Memory Walk” 3.5km run in support of Alzheimers Australia. There was a “roving reporter” interviewing participants about their reasons for being there, and on being asked to contribute I felt unexpectedly teary. I tell myself I am calm and contained, and that there is little I can do to help Mum apart from visiting, and taking care of day to day tasks like managing her finances and paying her bills. I tell myself I am ok with that, that I have come to terms with the reality of dementia, and that I’m not too stressed about it. It’s just part of life now.

But the truth is it’s a constant background strain – except when it is smack bang in the foreground. It’s a leaden chain wrapped around my feet. A deep and sickening terror in my belly. The one thing I know for sure about Mum’s dementia is that it’s bad, and it’s going to get worse.  Some days I’m pretty sure she doesn’t know who I am, although she hides it well. Some days she is angry. Some days she’s distraught because she can’t turn her TV on. Some days she thinks people are spying on her.

She won’t see a doctor. She refuses to let anyone in who she doesn’t know, so we can’t organize home assistance or get her any kind of medical care. We are literally waiting for her to fall ill or break a bone, so that we can get her some kind of help. There doesn’t seem to be anything else we can do.

We can’t just “put her into care” as people regularly insist we should. She’d walk straight out again. Last time we tried to take her to the GP she got out of the car in the middle of a major road, screaming that she was fine and that we had no right to force her to see a doctor against her will.

So we wait, and hold it together as best we can.  And while the dementia eats away at her brain, it eats away at our lives and our hearts. We field the frantic, angry, or distressed phone calls. We visit fearfully, wondering what we will find behind the door. And we wonder what the next stage down this long, torturous and painful road will look like. Will she have a fall? Will she get violent? Will she forget her way home, or lock herself in her house? Will she lose her purse again, as she hides it from the people spying on her? Will she leave the house naked? (She’s already forgetting pants a lot of the time.) Will she go searching for her parents?

Or will it be worse than all of that, in some way we can’t even begin to imagine? Her fate, and ours, closes in on us. There’s no pre-empting it, and no evading it. Perhaps the best I can do now is look that fate in the eye, instead of trying to pretend it’s not there. “Dementia sufferers” is a rather broader term than I thought. We all suffer, and none of us want to admit it.