It should have been a lovely day. Yes, there was a brisk chill in the air, but the sun was ’splitting the sky’, as my mother-in-law was fond of saying, as we drove off to see her for a spot of birthday afternoon tea. We had stopped off to buy an assortment of cupcakes and chocolates, and my husband had chosen a gorgeous bouquet of flowers. For the past few years, when looking after her at home stretched us to breaking point, my husband’s mother has has been living in grand old house tucked away in the English countryside. From the dangling wisteria, to the endless offerings of toasted tea cakes, it’s all very National Trust – only with locks on the doors and handrails and wheelchair ramps tastefully fitted into the mahogany panelling.
Our visit started out well enough. Mum was delighted to hear it was her birthday (when she asked how old she was, she quickly laughed and answered the question herself ‘Old, I suppose?”). She was even more delighted by the array of cakes and flowers her son was carrying. A member of staff suggested that we take it all down to the library while they organised a tray of teas and coffees. But as we were heading in this direction, Mum suddenly wondered if sitting in the conservatory overlooking the gardens might be nicer. Gordon quickly said he’d go and see if there were spaces, so we stood in the hall and waited. As luck would have it, this happened to be at the top of a small flight of stairs which has a narrow wheelchair ramp beside it.
Before Gordon could get back to us, another resident (I will call her Lucie) came out of the library, slowly making her way to where we were standing. I can’t say for sure how old Lucie is, other than very. She is also a tiny person, a situation which is not helped by the fact her spine is sadly now so curved that she stands not much taller than my waist.
Although Lucie gives no sign of ever recognising me, we have in fact spoken on many, many, many occasions. Invariably, these chats centred on the various conspiracies against which she labours daily. This time, as she approached, folded over double onto the two sticks she uses to stand, I heard her muttering ominously (to us? to herself?) ‘They stole my money, they stole my money, they stole my money…’
In the days before dementia flooded into every nook and cranny of our lives, I used to engage more openly with the other residents. However, Alzheimer’s is a long game, and I’ve had to pick up a few new moves in self-defence. Now, when I hear someone starting up with the paranoia chorus, I take a step back and make like a statue until they’re safely out of earshot. Usually, Mum does the same – albeit with a bit of eye-rolling and statue-elbowing. However, on this occasion, she caught me off guard by engaging Lucie directly.
‘Who stole your money?’
I can appreciate that, on screen anyway, this might not seem an inappropriate response to the situation. So this time, try putting on really snarly Glasgow accent. Go on… ‘WHO stole yer money?’
Momentarily thrown by this new street version of Gordon’s mum, I failed to react quickly enough. Lucie, on the other hand, rose to it. She seemed to forget that she’s made of matchsticks and, armed only with her doomed fearlessness, she raised her head to an almost normal angle and fired back, ‘Someone like YOU!’
Mum gasped. Eighty years of being reasonable fell away then, leaving behind a little girl who’d been wrongly accused of just about the worst crime in the playground. Her eyes filled, and for a second I thought my mother-in-law would burst into tears at the sheer injustice of it.
Instead, she flipped.
‘That’s it!’ She cried, leaping on to the wheelchair ramp. Unfortunately for Lucie, Mum is very sprightly. Not just for her age, but for yours and mine as well. ‘This time you’ve gone too far! This time I will wring your neck…and I will kill you!’ Then, to prove her point, she thrust her arms straight out in front of her, a bit like the way zombies always seem to in those old black and white films.
‘No Mum!’ I screamed, and thrust my own right arm out to grab her shoulder. Unfortunately, I was on the steps and the pair of them were on the other side of the wooden bannister, in a sort of cage-match-for-grannies arrangement. By the time I’d flung myself onto the ramp, Mum had her hands around Lucie’s throat, and was making her head bobble up and down on the end of her spindly neck. On the plus side, because we were on the upper part of the ramp, and Lucie was leaning onto her canes pointing uphill, physics was momentarily on her side. I kept shouting at mum to stop, but she was having none of it.
Since I so rarely engage in hand-to-hand combat, I didn’t realise how much weaker my left arm was than my right. It was a genuine struggle to tighten my grip enough to lever mum’s chin up in the air so she couldn’t see Lucie. Meanwhile, Lucie had by now remembered she’d come armed. She lifted one of her walking sticks up over her head and began using it to beat us back up the ramp. Thankfully, it was then that two staff members appeared and grabbed Lucie from behind. One of them tipped her over backwards against his chest, and dragged her away on her heels. With her prey sliding away from her, Mum stopped resisting me, and the force I was exerting on her suddenly spun us around and into the wall. I looked up to find Gordon was standing there, with his mouth hanging open, holding the bouquet and cakes. Mum then saw him too and broke into a broad smile. ‘Flowers?’ she cooed, brushing her blouse back down neatly over her trousers. ‘For me? Oh, Son, how lovely!’ And off we all went for tea and cakes; me still shaking and Gordon white as a sheet.
It was clear from the moment we sat down that the entire episode had already faded into the mists of time for Mum. The fact that she had no idea any of ever even happened is both an enormous relief – she would be mortified if she knew how volatile her behaviour can be – and an enormous worry. If she can’t remember something as dramatic as this for the time it takes us to walk through the main lounge area and into the conservatory, what else might be going on when we aren’t there to witness it?
I excused myself from the table almost as soon as we’d taken our seats, with Gordon nodding at me that he understood my purpose. First, I wanted to make sure Lucie was all right. Secondly, I wanted to apologise to the staff for the upheaval – and to try and find out if any written account was being made of what had just happened. Finally, I wanted to ask for a doctor to be called. It was clear to me that Mum most probably had a UTI (urinary tract infection) and so a sample would need to be collected and tested before the doctor could prescribe a course of antibiotics.
When I found them, the two men who had helped break up the brawl were on a cigarette break, regaling a handful of other colleagues with the tale. They saw me and one of them (I’ll call him Kris) laughed when he saw me, and asked if I had recovered yet. Kris has known Mum since the day we first moved her there, and has always been very kind to her. I said how shocked I’d been, and everyone immediately agreed that this was not at all Mum’s style. Kris assured me that I shouldn’t worry too much about it, because if it happened again he was confident that Mum could take Lucie and, in any case, the whole thing will definitely have been Lucie’s fault since she is a know instigator, and Mum never causes any problems. At least, hardly ever. I explained my concern wasn’t so much, what if Mum ends up picking on someone she can’t then successfully take down, so much as what will the police say if she ends up snapping a fellow resident’s neck and their relatives file some sort of official complaint? Or indeed, what if I’d ended up snapping Mum’s neck while trying to stop her from trying to kill Lucie? A murmur of agreement went through the small gathering. Kris handed the cigarettes around again. Although I’d never had a whole one before in my life, that day I smoked three at once.
A few days later, I was telling a friend the whole saga and, when I got to the bit about my theory it was all down to some kind of infection, she said, ‘A urine test? That’s a bit random.’
Except it wasn’t. The test had come back as a strong positive, and the reason I knew this was because we have a slew of family members who have hit their 80s in the past decade, and whenever one of them goes loose cannon on us, it is invariably because of a urine infection. My friend then told me I should be writing a blog about ‘this sort of thing’, and so here it is. My first post about all the seemingly random tips and tricks I have learned about dealing with Alzheimer’s and dementia over the past few years. I say seemingly, because the reality is that none of it is random but rather all entirely predictable. Assuming you know what you’re looking for.
WHAT I LEARNED…
Obviously, everyone’s situation is different, and what works for one family won’t necessarily be of use to another. But there were a couple of things from Mum’s 87th birthday which I suspect could translate across to other situations.
1 Out of sight is out of mind.
As soon as Mum began trying to kill Lucie, my first thought was obviously to get them apart. As part of this strategy, I tried to lift Mum’s chin into the air so that she was looking at something else. Any form of distraction can give you the edge and, depending on how severe the person’s dementia, even seconds are enough for you to completely change their impression of what is happening, so that you can regain control.
2 Grandparents behaving badly? Make them pee in a bottle.
Dramatic changes in character and behaviour are your cues to check their temperature and get a urine sample. One of the many problems with dementia is that people lose their ability to tell you when they aren’t feeling well. When she first came to live with us, Mum could sometimes tell us she wasn’t feeling right, but she wouldn’t be able to tell us what it was. One of the issues was that she suffered from recurring UTIs and so, on advice from the GP, we stocked up on sample bottles, Uristix, and invested in a digital thermometer. This way, on days when I was home alone with Mum, I didn’t have to drag her down to the surgery with me. I could ring through the results of the urine test, and the doctor could have a course of antibiotics waiting for one of us to collect from the pharmacy.
3 Push fluids.
The older we get, the more important it is that we keep hydrated. However, older people often refuse to drink sensible levels of water and/or juice in a day. Partly, this is down to the fact that as we get older, we don’t experience thirst in the same way, and so don’t think to drink. But equally, even when elderly people do think about drinking during the day, they then seem to have this logic-fail thing whereby they actively decide against it, because then they will just need to pee and may end up getting caught short. So if you are looking after someone with dementia, it is really important to push fluids regularly throughout the day. With my own parents, who are more stubborn than yours, I swear to you, one of the things we tried is to start the day by labelling two 1.5 litre bottles of water with their names on them, and then leaving these in plain sight. The idea being that they have empty these bottles before bedtime, in addition to everything else they were drinking during the day. But for this to work, the participants either have to want to co-operate, or else you have to be willing to argue the toss all day long. In our case, the battle goes on…
What’s your experience of living with dementia? Have you got any top tips on how I could have/should have responded to Mum’s outburst? If so, I’d love to hear them.