Posted 12-9-19
I hope and pray that you had a nice weekend! 🙂 Mine was especially good and festive in getting in the Christmas spirit. I got to see my daughter who lives across the state (always a blessing) and I got to attend not one but two symphony concerts! That is the perfect storm of goodness for a weekend in my boat. As Dizzy Dean used to say, “who woulda thunk it” that symphonies came to mind as a nice article topic (if a somewhat long article title). Off we go!:
- Tones may vary…. In a good symphony, the lower pitch/tones should be louder than the higher ones because of the tendency to be smothered by them. For example, one exuberant piccolo can make it hard to appreciate the strong tuba unless he or she is whaling away at it, pardon the pun. In a nursing home melody, sounds can distract from communication more than most places. There is the mind-numbing beeping of the picolodic medical instruments, the clang of the mid-stage patient who yells loudly for no obvious reason, and the always a little too loud TV or CD player accommodating our friends’ poor hearing. This makes for a challenging communication environment and can add to the stress baseline, if only for caregivers. (Mom is pretty oblivious to most sounds there these days.)
- Flashing lights. In most symphonies I have attended, you can hear the orchestra tuning their instruments one last time before the lights are dimmed a couple times warning that the performance is about to begin and that they need to sit down. Even in less experienced crowds this seems to work. Perhaps with the exception of the arrival of a meal, there is no real rallying tone or sign that patients will herd to. Each patient has to be cleaned up, removed from his or her room and delivered to where they are to go. The more mobile, attention-span-challenged patients may be delivered there a few times.
- Awkward is OK. In a symphony, pieces of music often have multiple “movements” or sections, if you will. One complete song may have 4 or 5 or who knows how many song segments…all separated by a short recess with no sounds, often to give the listener time to ponder what they have heard (and to give musicians time to rest their chops). You can generally determine the experience of the crowd and the age of the orchestra members by how often someone awkwardly claps in between movements. Not so much in a professional orchestra, but in a children’s orchestra this is kind of OK. When caregiving in a team, remember that not everyone has the same level of experience. Whether a home crew or a paid staff at a nursing home, be flexible and try to be patient with mistakes. Limit anger to things that really matter in life (giving the wrong meds!, or food that your loved one is allergic to) and extend grace whenever possible. Mom gets food delivered, occasionally, with either someone else’s name or that is not pureed. We just lovingly get it fixed and move on. We don’t throw our shoe at the well-meaning
tubaemployee. - Confusion rules the day until it doesn’t. As I mentioned before, before the start of a performance, the musicians often sit in their seats and tune their instruments. Then, a performer, sometimes a string, sometimes a clarinet and sometimes someone else, plays a note that everyone matches up to…then another and perhaps another. Out of the chaos, order.
First:
Then:
This part of the symphony reminds me of the ups and downs of the daily life of patients with this disease. If left to their own devices, these loved ones tend toward chaos. With some loving tuning and guidance from a familiar sounding person, things run smoothly.
- Intermission. About half of the way through a performance, there is often an intermission. This break can serve a variety of functions, but, if done correctly, can actually build the suspense for the second half’s majesty. You may be able to use this time to use the bathroom, to get a snack or to just process what you have experienced. I really like intermissions. Similarly, when you are caring for a loved one with dementia, you NEED breaks. You need time to reflect, to have a snack, to use the bathroom in peace. You are a better caregiver when you have breaks. Your local area agency on aging or the Alzheimer’s Association office can work wonders in helping you get these breaks. You need them and your loved one needs them.
- Expect the unexpected. <“Nursing home visits/caregiving> is like a box of chocolates…. You never know what you are gonna get.” But, unlike a box of chocolates, there isn’t even a good map. At the Southwest Baptist University symphony last night, we were treated to a bunch of wonderful music concluding in a stirring rendition of Sleigh Ride . At the end of the song, a minute or so before the funny horse sound effect, artificial snow started falling from the ceiling on the crowd. They do it every year, but it is still fun and catches most off guard. In dementia, every day is a new day, especially in certain types of the disease. A year ago I might arrive to see mom sleeping, partially naked, walking back and forth with a pillowcase full of other people’s stuff or a combination of these. Be prepared for a variety and be flexible and remember that meditative breathing helps.
- Strange sounds happen. Even a good symphony occasionally squawks here or there if you know what to listen for. Pardon me from unveiling my somewhat hidden 12-year-old boy inside, but expect odd sounds out of your loved one here and there too. Body sounds and, later, onomatopoeia speech sounds are common…deal with it. 😉 You will get used to all of the above.
- A good conductor makes all the difference. In a symphony, it is amazing watching the conductor point and direct 36 things at once, and with passion. Here are few good/fun examples: Link Link Link. When you form a care team to help your loved one navigate the stormy waters of dementia, you need a leader. It takes every instrument to play the song, but someone needs to direct. Find an organized person, be sure they have a power of attorney or are at least on the HIPAA release forms, and request that everyone utilize his or her strengths in organizational care. The tendency is one hand not knowing what the other is doing, so choose wisely.
- Music soothes the soul. I have said it before here and I will say it again. Music is magic in soothing stress, in clearing a mind and in being used to initiate peace. The symphony makes my mouth hurt from smiling inside and out at the relaxing and joyful tones. I know not everyone likes that kind of music, but I encourage you to consider finding a music genre that soothes. Some like metal, some like jazz…I get it. Dementia patients often love music and are soothed by period music from their youth. Throw on some Patsy Cline or some “You Are My Sunshine“or perhaps an old hymn and see if he or she reacts…I bet they will!
- The pit. Orchestras are sometimes hidden inside of a lower section below the stage of a stage performance called the pit. It is lower than the rest and you can still hear them just fine. Similarly, dementia came from and belongs in the pit of hell. For now we hear its sounds, but some sweet day it will be gone and we can all enjoy the music at the same level and without a tear. The analogy isn’t perfect, but the sentiment is there…
Update: Mom had a great weekend. I have several Christmas cards that have came in for mom’s card shower. I plan to take the first batch Friday but will do a few batches depending on how many come in. 🙂
Here is the address if you would kindly send her (or drop by) a pretty card and note of encouragement:
SeniorAge
RE: Brenda’s Christmas Card Shower
1735 S Fort Ave
Springfield, Mo. 65807
My stepdad’s name is John if you want to encourage him as well. Remember, no gifts…especially money. I just wanted to brighten her Christmas season with a bunch of notes saying she was thought of. 🙂 While I would love to assume a cure was imminent, I expect that this will be her last Christmas without a miracle or a cure. She is happy and quite sweet these days after a very long year. Thank you for helping make for a smooth landing as she moves from life to eternity. 🙂
#EndALZ
