Fade

Mother started talking crazy about a week ago. The folks at the assisted living facility said she was getting lost inside the building. She had forgotten how to use dining utensils. She was talking about her husband, dead and gone these many years as if he were still alive.

Not good. Not good at all.

My brother the nurse took her to her local treating physician on Monday. He ordered lab work and a CT scan. He was asked if her meds could causing this. After all, the psychiatrist had increased the dose of her anti-depressant just the week before all of this amusement started. He told my brother that while he had an open mind, he suspected that the Parkinson's Disease had finally caused her to lapse into dementia. A call to the neurologist offered the same opinion. Her psychiatrist was on vacation and unavailable for comment until Friday.

Mother has a pretty complicated medical situation. She is pushing 84. As if the Parkinson's was not sufficiently burdensome, she also suffers from anxiety and depression. She takes at least 8 or 9 pills a day. This is the main reason she is in assisted living as she was having trouble keeping track of all the damn pills she consumes on a daily basis. Somehow I wonder how the staff at her facility keeps up with it.

Mother's precarious mental status resulted in her needing a level of care beyond what assisted living is designed to do. So, Tuesday I got her eligible for home hospice care. I arranged for a home health care aide to "backfill" around hospice. I started signing her up for nursing homes in the local area. I actually had to catch up on my work Wednesday and Thursday. And Friday I called the Reynolds Center on Aging.

For a little jerkwater town, we in Little Rock are lucky to have two first class medical facilities in Arkansas Children's Hospital and the University of Arkansas for Medical Sciences (UAMS). The Reynolds Center is on the south side of the UAMS campus. We take mother there twice a year for check-ups, mainly to keep a handle on the dementia. I called them on that Friday morning. A nurse promptly returned my call. I described what was going on and I informed that the tests run earlier in the week were all normal. She told me to bring her in that afternoon and she would be seen.

The Reynolds Center is a beautiful place. It has a light and airy feel to it. The walls are adorned by photographs and paintings-mostly depictions of rural scenes-created by Arkansas artists. God knows I am no decorator, but it seems to me that the spaces in the building are designed to impart feelings of peace and hope. As we waited for the doctor to enter the room, I thought back to our first visit there two or three years ago. As a matter of coincidence, a local lawyer friend here in town was there with her father on that day. They do not allow family members to go back on the initial evaluation. So we passed the time talking on our cell phones and poking at out PDAs. Meanwhile the respective members of "The Greatest Generation" that brought us into this life were back there in the clinic counting backwards from 100 and trying to remember the name of the President.

Eventually the doctor arrived in a swirl of white as they tend to do when they know someone has been waiting. She was an Asian woman, tiny and serious.

She took a history and examined the medical record from Mom's home.

" So, the blood work was normal?" she asked me.

" Yes, and CT was normal?"

" Yes."

" I see here some mention of her receiving injections from a son who is a nurse. Are you a nurse?"

"No. I'm a lawyer."

"Oh."

She turned to type on the computer keyboard.

" So she is lucid on the 11th when she sees the psychiatrist, he increases the Cymbalta and by the weekend she is talking crazy? Am I getting the picture?"

"Yeah. Pretty much."

She swivels and faces me. And then this serious, pretty little woman in a lab coat crossed her eyes and shrugged her shoulders as if to say " Durrrrrrrrr."

Which caused me to laugh out loud in spite of my anxiety.

She turned to Mother. "I'm going to call a friend one that knows all about these medicines. I will be right back."

She returned with a box of medicine and written orders for the folks at Mother's facility. "You are off the Cymbalta. Here is a 2 week supply of something else that I want you to take beginning Tuesday when the Cymbalta is out of your system."

She took Mother's hand again. " You are going to feel better soon. I want to see you in two weeks. And if you are not better by then we will try something else until we get this figured out."

No mention of Parkinson's related dementia or any other organic brain syndrome. No mention of anything but hope for a better day and continued assistance.

I got an e-mail from her brother last night. He said he had a good talk w/Mother. I talked to her sister the other day. Ditto. Charlsie said that she told Mother that she was lucky to have 4 good boys for sons. Mother said that she wrote our names down and put them in her purse so she wouldn't forget who we were.

I didn't have the heart to tell Aunt Charlsie that Mother has lost her purse!

Even though things are looking up, I am still going to explore nursing homes here in the area. We dodged a bullet this time. But that day will come when Mother's needs will exceed the additional help we can provide to keep her in assisted living. It's just a fact.

The Greatest Generation, the one that survived both the Depression and Hitler, is slipping away before our very eyes. I thank God for their sacrifice and for His lending me breath, as the old hymn so eloquently puts it.

And I thank God for the kind and thoughtful people at the Reynolds Center for providing care and comfort to The Greatest Generation as it inevitably recedes into history and eternity.