Friday, May 31, 2013

Friends Help Transport Mom to Berkeley Square





                        Even though “A Nightingale Sang in Berkeley Square” wasn’t one of my favorite songs, I liked Mom’s dream of going there on her 90th birthday, so after the memorial gathering—but before the one I had for my friends, who didn’t know her—Jonathan went online and got a good picture of Berkeley Square, and Kathy got cupcakes and a globe.  We put Berkeley Square on the piano and sang the words.

            I told some friends about this, and they thoughtfully remembered.  My office mate Bob Irwin told me he was singing it in the car on her birthday.  Leslie Simon, another friend, brought the Andrea Marcovicci recording of it to the gathering I had for friends who didn’t know Mom, and Tom Miyako made me a CD with several versions.





            A is for angel, and they’re not all at the Ritz.    






Thursday, May 30, 2013

Getting Mom to Berkeley Square on Her 90th Birthday--Two Weeks after Her Death


            For the past few days, that A Mom thought she had gotten when she was tested at the U.C. Davis Neurological Center has stood for Alzheimer’s—reviewed by the neurologist in terms of Mother (as I guess they adapt their form letters). 
            But now I’m looking for the A for Angel, which I’m pretty sure is in the lyrics for the song Mom used to play on the piano, “A Nightingale Sang in Berkeley Square.”  She’d say, “On my 90th birthday I’m going to London with some friends, and we’re going to sing that song right there on Berkeley Square.”  She continued to say this even when she was no longer traveling or even leaving the house.  She would forget that she didn’t,-- wouldn’t--go out, and she saw herself as she had been before Alzheimer’s—a woman traveling wherever she wanted to go..
            “We’re going to London and sing “A Nightingale Sang in Berkeley Square.”
            That was never one of my favorite songs.  I much preferred “I’ll Be Seeing You” among the World War II songs. 
            There were so many beautiful songs in that World War II Songbook that I think Kathy still keeps on the piano.
            I didn’t think this "A Nightingale Sang" was the best of them, and I wondered that Mom, who wanted to be egalitarian, liked it so much.  What was this about angels dining at the Ritz?



That certain night,
The night we met,
There was magic abroad in the air.
There were angels dining at the Ritz,
And a nightingale sang in Berkeley Square.


            She died two weeks before her 90th birthday, but we got her to Berkeley Square anyway, and more than once.  

(Friends are due to eat and watch a DVD of retirement parties of ESL faculty at John Adams--several years.  But we'll get back to Berkeley Square!)

Wednesday, May 29, 2013

Part 5, The End of the Letter A


(continuation of letter)

Some people choose to consult an attorney regarding financial matters pertaining to this disease.  Much of the care that Alzheimer’s disease requires is not covered by Medicare or regular health care insurance, so it is important to see that financial assets are structured so as to best serve you and your mother. {Thank goodness Mom had a retirement pension.  I’m pretty sure that paid for all of her care at Aegis as well as for what she needed before that.}

It is also important to make sure that you have the legal authority to act on your mother’s behalf.  The simplest way of doing this is to obtain durable powers of attorney for health care and finances, which you have in place.  {I got a copy of Mom’s Advance Health Care Directive in December 2005, when I was named as “successor Health Care Agent” after Cathy.  The document was filed with Kaiser Martinez.  At that time Kathy, Mom’s “California State registered Domestic partner, was designated as Health Care Agent with Power of Attorney for Health Care.} 

Because you have indicated your interest in being I the U.C. Davis Alzheimer’s Disease Research Program, a number of opportunities are available to you.  You may be asked, from time to time, about your willingness to have your mother participate in a research study.  This may include the testing of new drugs for the treatment of dementia, psychological studies, experimental brain scans, or other studies.  You are always free to accept or decline these offers.
We hope that our evaluation was helpful to you. We remain available to provide you with further information and advice as you may need it, so please do not hesitate to call.

Sincerely,

John Olichney, M.D.
Neurologist

Cc:  Kathy Loss {who should have gotten the original, not the cc}

This thorough, compassionate-sounding letter was so in contrast to the feed-back session following Mom’s interview with a really kind, gentle doctor, Dr. Ha.  Here’s what I wrote in my abbreviate journal:


Tuesday, March 01, 2011 Up around 12:30.  Got back to essays around 1:20.  (What was I doing till then?)  Stopped working on them around 3:00.  Slept with Battle Hymn of theTiger Mom, much of which I missed before. Had to deal with plagiarism in ESL 150.  Went home and made mushroom and spinach soup for Mom and Kathy, but it wasn’t as good as before.  Took them zuppa inglese and cucumber-watercrest sandwiches instead.  Left for PH at 11:30.  Got there at 12:15.  Suzy arrived around 12:40.  We three took Mom to the U.C. Davis Alzheimer’s clinic in Martinez.  Nice Dr. Ha.  Blunt-Talker other doctor.  Mom seemed so fragile—agitated and a little lost but a figure to be reckoned with!  Whole session (plus wait while doctors conferred) was 3 hours.  Got home and more or less collapsed.  In a longer account in a letter to Jonathan, I describe the Blunt-talking doctor.


Part 4 of the Letter A


{I went to campus yesterday so I could score the Scantrons for an easy T-F test my speaking-listening students took last Friday, but the campus was closed.  So I went back home and kept typing up reports they wrote about their group work and evaluations of their final presentation, wanting to convince them that they are appreciated and valued even if their skills aren’t quite where they need to be.  But they’ll progress.  Now we’re back to my mother, whose Alzheimer’s would have progressed had she lived that long.}

Part 4 of the Letter A

As I explained at the appointment, I feel that medication might be helpful in managing some of the troublesome symptoms you are dealing with.  I will communicate this to Dr. Johnson, who should be the one for you to follow-up with regarding this medication.

{Dr. Johnson was the ghost figure during the time we were trying to help Mom.  He was the MD who prescribed what the psychologists thought necessary or desirable or possible.  As for the medication, sometimes I wonder whether the medicine Mom took aggravated the situation instead of helping—but that was the anti-depressant, anti-anxiety medicine.  We know that Mom had so much anxiety about things like the perfidy of her bowels that she didn’t want to leave the house or sometimes the bathroom.  I had wanted her to be like Alice from next door to my house, so blissed out even while repeating, repeating, repeating.  But here I assume that Dr. Johnson is talking about some other kind of drug.  The answer to Alzheimer’s:  Hugs and drugs.  But on with the letter.}

In addition, we discussed Cholinesterase inhibitors and meantime, medications approved by the FDA for treatment of Alzheimer’s disease.  They have only been tested in persons with Alzheimer’s disease of mild to moderate severity and who are in otherwise good health.  {That would be Mom.}  Since there is no way to predict whether or not one of these medications will help our mother, the only way to determine what effects it will have is to try one of the drugs.  We will indicate your interest in the medications to Dr. Johnson. Through discussion with him you can weigh possible benefits, risks and costs in order to decide whether or not to try one of them.  Included in your blue folder is some additional information about the drugs.

{Did I ever have a blue folder?  Did Kathy, Mom’s primary care-giver, get one?}

As I indicated earlier, it is important that you care for yourself while caring for your mother.  At the appointment we discussed attendance at a support group.  Knowing you are not alone and benefiting from the practical experience of other caregivers is important.  {Kathy did go to a support group.}


Monday, May 27, 2013

Part 3 of the Letter A




            This morning I drove to the Y around 5:00 AM and found it deserted, which got me to thinking about Mom’s dad who worked for the YMCA in Paris during and after World War I and would have taken Memorial Day seriously instead of regarding it as sales day at Macy’s (which can be seen from the Stonestown  Y parking lot).
            But now I will continue with the letter following the test Mom thought she had aced.

I recommend that she abstain from alcoholic beverages.  Although we do not think that alcohol is the cause of her problems, alcohol depresses the nervous system, can disturb sleep, and most importantly, causes short term memory and judgment problems.

{Mother was not drinking more than an occasional glass of wine at this time.}

Fortunately, your mother is not driving and should not drive. Since she is not driving, we do not need to report to the Department of Motor Vehicles.

{Ah, Mom, who learned to drive at the age of twenty in Los Angeles traffic and later drove us all over the nation after packing up after Daddy took a job in another state.  From California to Idaho to Iowa to South Carolina to Kansas and back to California.  She was such a good driver except for that time she drove into the NYC tunnel the wrong direction.  (That was really an aberration.  When she got tired, she’d pull over on the side of the road and nap.)  She was much more competent than I have ever been.  In fact, I’m writing this before Javier and I take off on a road trip with another couple to go to Santa Fe.  Instead of driving, I’m paying for all the gas, but Mom would have driven her fair share.  Even in her last years when I visited her on Fridays and for weeks during the summer, she drove competently but wisely sold her car to their gardener’s son, who was so happy to have it.}

One of the most difficult aspects of caring for a person with Alzheimer’s disease is knowing how to respond to the confusion, mistakes, and changes in behavior that dementia produces.  We discussed specific aspects of how to respond to her behavior at the appointment.  Managing the behavior of a dementia patient often requires much practice and so the more you can learn about it, the better.  The blue folder than I gave you contains a booklet on behavior management, a one page sheet of tips families have found helpful, and a list of recommended readings.  You may wish to attend some of the workshops on behavior management that are held from time to time in this area.  The Alzheimer’s Association or the Family Caregiver Alliance are good sources of information regarding upcoming public events.)


I don't think this is the kind of community-provided bench the SF Chronicle was talking about today in its article https://www.sfchronic...