Tuesday, October 4, 2016

Mom's Major Meltdown

Journal entry dated September 2, 2012

Today is Brother C's birthday.  Mom insisted on having a party for him, so she invited the family over for a steak dinner.  I was tired the night before and didn't get a chance to bake Brother C's cake, so I had to do it after I got home from church.  Mom had barged in on me in my bedroom (we locked the bedroom door every night after that!), demanding that I take her to Grandma's church.  She had told Grandma she was going to church with her this morning and got upset that Grandma left without her.  She INSISTED she had to attend her Mass, but I told her it was okay if she didn't make it, especially with how late she'd be.  I offered her several solutions, but Mom was hysterical, so Husband G offered to take her while I got up to get ready for our church.  

I suggested to Mom before she left to not wear her high heels, but she insisted.  She had taken them off before she even got home.  I had left out the flats that I suggested she wear, but she ignored me.  By the time she got home, she was in full compliance of wearing the shoes I tried to give her before she left.  But why listen to me?  I don't know what I'm talking about!  She's acting like a spoiled teenager!

Mom was very dizzy, weak, and confused when we got to church.  I had to help her in and out of the car, up the stairs, get in and out of the pew, etc.  When we got home, she was taking too long to change her clothes so I went to check on her.  Company would be arriving later today and we hadn't even started dinner.  She had changed into her floppy aqua hat, aqua blouse, and white shorts, and was attempting to put on aqua eye shadow (she's been on an aqua and orange kick lately).  What a mess!  "Here, I can't do this right, will you finish it?" she asked, handing me her compact.  I fixed it as best as I could--it was way too dark.  I should've started over but we didn't have time--she'll just have to look like a lady of the evening.  She also had to wear lots of jewelry--how was she going to get dinner prepared with all those necklaces and bracelets getting in the way?

Grandma was stressing over getting the potatoes made.  Stressing and worrying are what Grandma does best (that must be where Mom gets it)!  Mom snapped at her more than once, causing Grandma to become even more upset.  I still had to get the cake in the oven and no one had remembered to take the steaks out before we left for church.  I was busy chopping vegetables for the tossed salad, being sure to set the tomatoes aside, as Brother C. was allergic to them.

It was chaos, to say the least!  Mom was running from one project to the next, without completing any of them.  On top of that, she was trying to paint her fingernails!  How on earth was she going to prepare dinner if she had wet fingernail polish on her hands???  She got up to start another task, so I hid the nail polish instead of arguing with her--I felt like *I* was the crazy one with how she was bouncing around the kitchen!  She would ask a question, we'd answer it, and within minutes, she'd forget and ask the same question, then want to argue about us already answering it!  I was losing my mind and on the verge of tears!  It was like I was running behind her with a small bucket, attempting to put out all these little fires in her wake.  

She sat back down at the table again, looking for the fingernail polish.  "You don't have time to paint your fingernails, Mom, there's too much to do to get ready."  

"Don't tell me what to do!  You are not my mother!" she barked.  I was slack-jawed at the tone of her voice.  Uncle S. stated, "She looks like she's slipped a few gears since the last time I saw her.  She's a lot worse."  I nodded in agreement.  

"Why isn't dinner ready?"  "Where's Brother C?"  "Why aren't the steaks thawed?" "Where's all the ice?"  Mom was running around like a chicken with her head cut off.  I thought I was going to lose it before everyone arrived (Uncle S was really early).  When Sister M. arrived, I brought her into our bedroom for a quick conversation about how Mom was acting--the chaos and utter craziness!  I apologized for not understanding how bad it was, yet I was glad to be there to relieve her of the sole burden of caring for Mom.  I broke down in tears and she hugged me.  I was sorry I didn't give her more credit, and felt better for being able to hash things out before facing the family.  She had confided in me some issues she was having with her husband J., telling me of his pain pill addiction and how he stole Dad's pain pills while Dad was dying.  I was shocked!  "Yeah, he's been in rehab twice.  I told him 'three strikes and he's out,' so he better straighten himself up!  So now you can see why I couldn't really deal with Mom on top of what I'm dealing with at home!"  I had no idea!

Back to the dinner chaos, Mom snapped at Grandma again about the au gratin potatoes not being ready, yet had an I-don't-give-a-rip attitude about the rest of the dinner preparations.  She was getting mad about the steaks not being on the grill yet, and was still ranting about not being able to find her nail polish.  

After dinner, and after things settled a bit, I excused myself to walk the dogs.  As I returned to the house, Sister M's son N came outside and asked if I knew how to pick a lock--Mee Maw had locked herself in her bedroom and wouldn't answer the door!  What???  I rushed inside and unleashed the dogs, then headed down the hallway.

By the time I got to her room, Sister M had found the key and picked the lock.  She was standing next to Mom who was lying on her loveseat, chewing her out, saying something about "safety."  "Don't you ever do this again!  Next time we'll have to break down the door!"  Sister M. reprimanded.  

I knelt down next to Mom and immediately saw she was upset, on the verge of tears.  "Mom, what's wrong?"

Sister M. hissed, "She locked herself in here and wouldn't answer the door!"

I turned back to Mom and spoke soothingly while stroking her hand, and Sister M. took it as her cue to leave.  Apparently the stress of the day had gotten to her, and she "had to get away and get some rest."  Empathetic, I soothed her and calmed her down.

"She's always being mean to me," she spoke of Sister M, "and treats me like a baby!  I can't take it anymore!"  Tears welled in her eyes, and my throat tightened as I choked back my own tears.  My heart broke for Mom.  Yes, Sister M. could be a B, she knew it.  All of us siblings knew it!  She is definitely not one to have or show sympathy for anyone and chewed Mom out for "being so stupid"  (I had gotten a similar chewing out by Sister M. when I refused to put my baby up for adoption in 1991). I simply wanted to hear Mom out, find out what was bothering her, and try to make her feel better.

Mom poured her heart out to me--I felt privileged and honored that she could trust me enough to tell me everything that was bothering her, from how Sister M. took away her car keys after her accident to how her children decided--without her input--that she needed a full time, live-in caregiver (Sister M. said she kept Mom abreast of our discussions, although Mom was "down" at the time and couldn't really make any decisions on her own.  I don't know if she was given a chance to voice her opinion, and I'm embarrassed to say I didn't call her to find out for myself.).  I lovingly explained to her that we were all just scared for her--we just wanted to keep her safe and to protect her.  "Well, Sister M sure has a funny way of showing it!" she cried.  "Mom, your safety is our number one priority--Sister M means well, even if she can't show it in a loving manner.  I'm sorry."   

Mom cried and shared a lot over the next 15 minutes or so.  Sister M. really upsets her.  I prayed over Mom for several minutes, and prayed over Sister M., that she would learn patience, empathy, compassion, and kindness for our mother.  And for others as well.  

Mom began to feel better, then had to show me all the new "stuff" she bought when she and Grandma went shopping the other day.  Oh great--just what she needs--more clothes!  She already has an entire walk-in closet full of clothes she doesn't wear, plus the two closets in the guest bedrooms are full of her clothes, most don't fit and many still have tags on them!  Sister M. confided that on many occasions, she had found the receipts and returned all the clothes and Mom was none the wiser.  I guess that was a good way to "pick our battles" so that we wouldn't have to argue with Mom in the store.  It worked like a charm and I did it many times thereafter!

Eventually, Mom felt better and wanted to re-join the party.  A good 45 minutes had lapsed, and everyone had cleaned the kitchen and cut the cake.  The birthday boy had already left and others followed.  Mom was much calmer the rest of the evening.  She was so worn out that she fell asleep on the couch, and I was never so happy to hug my pillow when I laid down to go to sleep.  I was exhausted!

I learned several important lessons that day:  Mom's bipolar disorder requires lots of structure and patience.  I can't lose my cool when dealing with her, because her emotions only ratchet up several notches as she resists any and all instruction or advice.  A soft voice goes a long way in calming her down, and she can't handle too much chaos at a time.  If she needs to escape a high-sensory environment, she should be allowed to and not be shamed for it, nor have to explain herself.  A simple, "I need some alone time" should suffice in the future.  Most importantly, based on our personalities, I believe I am the best fit as a caregiver among all the siblings.  I feel I have the most patience, sympathy, and compassion to handle Mom's ups and downs.

Sometimes being a Quiet Caregiver has its advantages.

Getting to Re-Know Mom

Six weeks after learning of an accident my mother was in with her late husband's truck, my Husband G and I arrived in Maryland to be her full time caregivers.  Initially, I was only aware of her Bipolar Disorder, but after living with her for several months, I began to suspect she had dementia as well, although her general practitioner at the time insisted she didn't have it.  My Sister M had mentioned that Mom was showing signs of confusion and memory lapses, but didn't seek an official diagnosis for her.

I had moved to Colorado in 1996, to end an unhealthy relationship with my children's father, so I didn't get to visit Mom on a regular basis.  I was also considered the "black sheep" of the family, moving out at the tender age of 18 because my parents "didn't understand me."  It was because of this early tension as a teenager and young adult that my mother and I didn't share a close bond.  In fact, part of the reason I moved to Colorado was to get out from under my mother's thumb and my Sister M's control and constant criticism. She didn't like that I made my own decisions, choices that didn't concern her in the least, so it was better that I lived 2/3 of the country away from all of them so that I could live my own life.  Because of my disagreements with Mom, there would be months at a time when we didn't speak.  I can count on one hand the number of times my parents visited me during the 16+ years I lived in Colorado.  So when I moved back in with her, it was like getting to know her all over again.

Mom's Bipolar Disorder (BPD) had been diagnosed several years prior.  I had gotten the story through Mom, who was in denial about her mental health.  I imagine her boss at work suspected something was wrong, as Mom accused them of "being against her" and trying to "force her into retirement."  Maybe they suspected something and tried to talk to Mom about it, but she didn't want to admit that anything was amiss.  The way it all came about, Mom had been at work and broken her ankle.  Being in a cast for 6 weeks, she was forced to stay at home, on crutches.  The day she went back to work, she broke her OTHER ankle, and was off work for ANOTHER 6 weeks!  During that time, at home for 12 straight weeks with nothing to do, she started going through some old paperwork.  She discovered that Dad's insurance coverage dwindled after his retirement, along with his pension, so she started worrying incessantly about their finances.  She thinks this is when her downward spiral began.  She became so obsessed with their finances that she fell into a deep, dark depression, unable to pull herself out of it.  Regardless of if the depression was a result of the retirement or vice versa, Mom could not shake herself of the darkness that enveloped her entire world.

Eventually, she started to feel better.  Much better.  So good, in fact, that she would go on shopping sprees and spend hundreds, even thousands, in one day!  Mom and Dad rarely, if ever, argued about anything during their almost 45 years of marriage before he died of cancer in 2007, but I guarantee Dad hit the ceiling when the Discover bill arrived in the mail!  He took precautions and, unbeknownst to Mom (or she forgot), opened a separate checking account where he deposited his paychecks from his part time job at American University and all his early inheritance money from his parents.  He had to "protect himself" is how the story went (Mom said he was "selfish and didn't want to share his money."  She, on the other hand, used her money from the sale of Grandma's house--an early inheritance--to get their new driveway paved).  More on that in a later post ....  Anyway, she would go through these phases of depression and mania, nearly driving Dad (and my local siblings) up the wall!  One day, my Sister M came across an article in a magazine about bipolar disorder and showed it to Mom, "This is what you have."  Mom later shared the article with her doctor, and the diagnosis became official.  She was started on numerous prescriptions to treat it, but he wasn't a psychiatrist and didn't know what he was doing, so Mom suffered as a result.

The first couple of weeks after arriving in Maryland, I spent observing Mom and taking notes in a "health journal."  The day after Husband G and I arrived, the three of us drove to Vermont to celebrate some dear friends' 50th wedding anniversary.  Mom did okay the first day, but the second day, she "went down," our mom-speak to say she entered the depression phase of her BPD (if she was in her manic phase, we said she was "up").  She stayed in her room at the bed & breakfast with the curtains drawn, refusing to join us for a cookout on the lake or for meals in the common dining room.  I checked on her often, helpless not knowing what to do or how to help her.  She assured me this was "normal" for her.

Her general practitioner at the time, Dr. L., had her on a regimen of Klonopin, Olanzapine, and Prozac, among other psychotropic drugs, which I was to change the doses depending on where she was in her manic and depressive phases.  It was difficult to keep up with the changes in her meds, but I did my best.  I referred to a sheet of paper that Sister M had written up for me (I'll have to find it and update later).  I felt like I'd never get the hang of all these medications (13 total), so for Mom to be able to keep up with them was expecting way too much, especially in her mental condition! No wonder she crashed Dad's truck!

Mom was considered a "rapid cycler" in her BPD:  she would go up (mania) and down (depression) every 4-6 weeks, give or take a week or two.  I charted her cycles on a calendar using yellow and blue colored pencils, and eventually I could predict when she would go up and down within a day or two using this chart and observing her behavior.  During her down phases, she would stay in her bedroom, keep the blinds drawn, and either sleep or watch television.  Her appetite waned and she would barely eat anything during the first week.  After about the second week, she would start to eat again, but not much.  She had put on about 30 lbs. since her diagnosis and it bothered her a lot, especially because she maintained a svelte 130-lb. figure and jogged seven days a week before her ankle injuries.  She refused phone calls and visitors during her down phase, and regardless of how many messages one left, she would not return their calls.  She wanted nothing to do with any socializing and refused to even go to church.

During her manic phases, she was a completely different person!  She became a scatterbrained chatterbox, bouncing from one unfinished project to the next!  Brother M nicknamed her "Chatty Cathy" during these phases, as she would call everyone in her address book and talk for hours on the phone!  She delivered Meals on Wheels with Grandma (this was before Husband G and I arrived), volunteered at the church and at Sister M's school, and helped her neighbors.  She would tell strangers at the bank and grocery store that she had BPD, and as a result of having no social filter, she asked them personal questions or shared inappropriate details about herself.  It was embarrassing!

Within the first month of arriving, Mom was having trouble keeping steady on her feet.  She had to hold onto a shopping cart whenever we were in the store.  Bruises and scratches would appear on her arms and legs, but she had no idea where they came from.  She would get belligerent if I suggested she needed to hold onto me if she was dizzy, thinking she was "fine" and could "do it herself."  Her stubbornness knew no bounds!

On August 31, 2012, I entered the following in her health journal:

The subject of driving came up.  Mom said, "Oh yeah, I need you to give me the car keys because I'm driving to church on Sunday."  

I was a bit confused.  Didn't she remember she was just in a car accident and wasn't allowed to drive anymore?  The reason Husband G and I were there was for me to be her chauffeur.  "Mom, I can't give you the keys, remember your truck accident?"

"I don't care!  That was a long time ago!  I'm gonna drive!"

I looked at my husband--I think we were both in shock at her level of belligerence!  She was getting upset.

"Mom, I'm sorry, but I can't give you the keys.  That's why I'm here."

"I CAN drive!  Why won't you give me the keys?"

"Because Sister M told me to take them away.  She said I can't let you drive under any circumstances and all of us siblings agree."  

"I CAN drive, and I'm gonna PROVE it!"

"Okay, Mom, but only after Dr. L. gives you a Clean Bill of Health in writing, and you pass a driving test at the DMV."

"Okay, you watch!  I'm gonna drive again!"

Grandma was no help in this situation.  All of the siblings agreed that for Mom's safety, she was NOT to drive again, but Grandma kept putting a bug in Mom's ear, "Don't let them take away your driving freedom!"  We really need to get Grandma on board with the safety plan before she sabotages all our hard work!

Mom's dizziness and mobility have become an issue too.  She sat on the floor with the dogs and couldn't get up by herself.  I tried to lift her by myself but couldn't (she weighs around 165 lbs.).  I started to panic, but calmed down and directed her onto all fours, then told her to crawl over to the couch where she could pull herself up and I could help her.  It took several minutes, but we got her up!

Minutes later, I was in my bedroom when I heard Mom yelling for me!  I dashed into her bathroom and found her on the shower floor!  She had fallen and couldn't get up!  She was wet and slippery and it was difficult to get a good hold on her.  I suggested I call Husband G in from cutting the grass to help, but she refused.  I turned off the shower, laid a towel under her so she could get a better grip on the tile floor, I told her to grip the handicap rail, then I put my arms under her armpits and locked my fists across her chest.  Between her pulling on the bar and me pulling her up, she was finally able to stand.  Her legs were really shaky so I toweled her off, rubbed body lotion on her, and helped her get dressed.  She then left with Grandma to go shopping.

I was so overwhelmed by how out-of-sorts Mom was!  Who knows how long she's been like this?  I can't imagine she had many falls before now, otherwise, how would she have gotten up?  Grandma is too weak to be able to help, and Nephew B is hardly around.  She's very confused, forgetful, and scatterbrained.  She'll start a project, move onto another one, and leave the first project uncompleted.  When she's up, she's always talking, talking, talking! I don't know how much of this talking I can handle!  I have to escape to my room sometimes.  Luckily, Husband G is a talker, so they talk a lot in the mornings.  

With the whole argument over driving and Mom's resistance to help, as well as being in denial about her condition, I told Husband G that I needed to talk to someone.  He suggested Sister M.  "No, I need someone understanding and compassionate."  I called Sister N instead.  She's just what the doctor ordered!  Sister N was very understanding, compassionate, sympathetic, and concerned for me and Mom.  I put her on speaker phone so Husband G and I could talk to her.  Sister N helped me understand that G and I are the "bosses," we need to make decisions in the best interest of Mom and her safety, such as not letting her have the car keys, and that "whatever we say, goes." As I was talking with Sister N, I realized I should NOT have allowed Mom to go with Grandma!  Especially with how dizzy she's been, Grandma is incapable of keeping both of them balanced.

When Grandma and Mom got home later, Grandma told me that Mom had gotten really dizzy and had a hard time keeping her balance!  I felt so guilty letting them go off shopping together!  This is definitely a learning experience!  Later that evening, Mom and I were in the kitchen --I was sitting at the table and she was at the counter next to the refrigerator.  I heard, "Oh! Oh! Oh!" and her feet shuffling.  In that split second, I jumped up and turned, but she had crashed headlong into the refrigerator, hitting her forehead on the corner!  I grabbed her and pinned her against the counter until she could gain her balance.  I had her sit in the chair and I put ice on her forehead--that was FOUR falls within 24 hours!!!     

Also, when Mom is in her manic phases, she doesn't get nearly enough sleep!  She'll stay up all night watching TV in her room, lie down for about 2-3 hours, then get up early and have coffee with Husband G.  That may be contributing to her dizziness.  And she eats a lot when she's up.  

This first month has been filled with new learning experiences.  I am usually very quiet and keep to myself.  I've always stuffed my feelings inside and rarely speak my mind.  I've even hesitated being a proper advocate for my children in the past due to my resistance to making waves, ruffling feathers, or hurting others' feelings, even at the expense of my own.  But I have realized that if I'm to be Mom's caregiver, I have to put her safety number one, and I can't let her go off shopping with Grandma anymore unless I accompany them.  I have to SPEAK UP, set boundaries, and stick to them!  I have to be firm with Mom and not let her call the shots, no matter how loudly she protests!  I have to remind myself of what Sister N said, "I am the boss, not Mom!"  I don't know if I can get used to this role reversal.  This has been a very intense time for me, but I hope to get the hang of it soon.  At least I have Sister M and my brothers to help me, and possibly Nephew B and his girlfriend S, who are still living downstairs.  I sure hope they get their house built soon, because I don't know how long Husband G and I can live in a small guest bedroom, crowded with boxes and furniture, where I have no place to escape when my senses get overloaded.