I've had a very concrete example the last couple weeks of why it is so important to have a psychiatrist involved with anyone who has dementia. I have seen over the years symptoms that could qualify as either depression or dementia, written off as the dementia progressing. I have a resident at the assisted living who falls in this category. But if you take the time to dig and because he has a psychiatrist that knows him well, we were able to correctly diagnosis and treat depression. His apathy, wanting to sleep much more including falling asleep at the table, and lack of interest in previous activities would seem to indicate the dementia was progressing. That is unless you knew that these symptoms began to appear just after he had a conversation with an estranged son.
You think sometimes that the same things hold true for everyone. The friends of this resident as well as myself thought, oh if only he could be in contact with his son again. That would make him so much happier. So pretty much out of the blue, this son contacts the resident. And for a time, he really was very happy. He talked about his son moving back to the area, living in his house and them becoming close. Then the weeks go by without another phone call and we see the symptoms begin. The resident is not as active or in the usually jolly mood. He seems to want to just sit in his room and sleep. Then another phone call and almost immediate improvement. I don't know what was actually said and what might have been wishful thinking. But the resident was under the impression the son would be in town in 4 days. So guess what happens when 4 days pass and no son. Again the symptoms begin and increase to where we have serious concerns about him falling because he seems so sleepy all the time. Absolutely no medication changes during that time, so it can't be blamed on medication. Someone who did not know him well would probably assume it was the dementia progressing. Thankfully he has the support of people who encouraged him to get the help of the psychiatrist. With medication changes, he seems to be improving slowly, but improving.
As happens so often, what happens at work for me strikes a chord with what is happening with my Mom. For the last couple months, she has been talking about her estranged brother. There were issues after the death of my grandmother. Greed and feelings of not being loved as much as the other were probably the root of the problem. The result was a restraining order against my uncle to not have contact with my mother. Now, I can tell, this relationship fissure is on her mind. She tells me she has dreams about her brother.
My Dad searched the internet for contact information and came up with incorrect information. I had a long shot to reach my cousin and had success. So, as usual, I rope my brothers into the situation. My analysis, having worked in hospice for a few years, is that mending broken relationships can be a very important part of spiritual healing in the last days and years of a person's life. One brother contributes that there should be no trust at all of the uncle based on past behavior. Probably a true statement. The other brother, who happens to be the middle child, has a middle view. He advocates conservative contact, setting ground rules to protect our mother as much as possible. Given what happened with the resident at work, I'm not so sure now what the "right" answer is. Fortunately, my solution is to chicken out and leave the decision up to my dad. Of course based on some other experiences at work, I realize the decision really isn't for me and my brothers at this point anyway, but that is for another note.
I think we would all wish for broken relationships to be ended and to feel positive resolution before we leave this earth and have no more opportunities to resolve things. But at the same time, we live on a broken earth filled with less than perfect people. Trying to resolve opens you up to possible hurt as well. Why is it I feel like the more experience I have, the less I think I know? Now I just hope my Dad doesn't ask me any advice on what he should do since I have so neatly dumped the decision in his lap.
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