Learning to "Play Along" in the Role of Dementia-Challenged Caregiving
By [http://ezinearticles.com/?expert=Joel_Kriofske]Joel Kriofske
The old man's most evident trait, perhaps that which best defined him, was his talent for comedy and storytelling. He had an exceptional, even extravagant at times, sense of humor and comic timing. Like an ambush, swift and unexpected, his humor could often cause a spontaneous eruption of laughter. At other times, his words could sting painfully like darts or biting insects, leaving scars or open wounds.
In the early 1990's the old man was diagnosed with two forms of cancer, a condition further complicated by rampant dementia. A younger son, his wife and sister, assumed the father's health and emotional care. The hospice episode lasted a lengthy 19 months, prompting re-certification not once but twice.
He -- the dying and cancer-afflicted old gentleman -- was called Joe by family and friends. He was a university educated lawyer who spent most of his career as a Special Agent of the Federal Bureau of Investigation, achieving a degree of fame and many service awards and commendations over the course of his 25-plus-year career in the Bureau. Whether he was proud of it or not he never said, but a certificate of commendation from J. Edgar Hoover hung on a wall of his basement bar, and remained there until Joe and his wife traded their large, two-story family home for a more manageable condominium, living spaces confined to a single floor.
As an FBI agent, Joe served in Washington, DC and Chicago, before eventually being assigned to the Milwaukee office. There, during the final years of his FBI career, due in large measure to his entertaining personality and his ability to hold an audience, he became chief teacher and trainer of police and sheriff's departments throughout Wisconsin and the Midwest, through which his students gained investigative dexterity in the FBI method.
As Joe reached his mid-80s, disease and dementia became his defining characteristics. In his decline, dementia stole his short-term memory, and behavioral episodes -- some of them highly amusing if challenging and exasperating -- began to paint the final landscape of the inexorable father-son journey to the end of the old man's life.
As one of the principal caregivers, the son became identified by his father's wild imagination -- variously cast as a fellow FBI agent, a long-dead brother, an accomplice to an implausible gun battle -- all born of the father's knotted ramblings. He would call his son at three or four in the morning in his role as intrepid FBI agent. The dialogue would go something like this:
Father -- "What's your assignment today? Robbery? Murder? Surveillance? Commie infiltrators? Who's your partner? What squad are you assigned to?"
Son -- "Yeah.. surveillance at the Country Grounds. Possible commie infiltration. Don't worry, we'll be vigilant. Agent Bodkin's my partner. Squad MI-25... "
If the son hung up on the old man, or told him he was delusional or dreaming or he should go back to bed, Joe would simply call back five minutes later, again and again, and so the son learned to "play along," to accept the assigned role.
Playing along wasn't always easy. On one occasion, when taking his father to regular doctor visits to see his oncologist and his vascular surgeon, Joe introduced his mid-50s-year-old son to a reception nurse as Joe's brother, Roman. Roman would have been 93 at the time... and dead!
Another episode centered on "twin cities." Father and son were driving through downtown Milwaukee, the son delivering a kind of "travelogue" as the pair motored along Wisconsin Avenue. The old man suddenly erupted into excited speech, proclaiming that this city was identical to the one he had recently visited. The son quickly realized that his father thought he was still in the authentic "Twin City" of Minneapolis, and that Milwaukee looked eerily identical, right down to the old Federal Building in which his former FBI offices were housed.
"Call the newspapers," shouted the old man. "They'll never believe it... two perfectly identical cities... " The son pulled over, exited the vehicle and found an empty telephone booth, pretending to make a call.
"There. I've notified the press," the son announced upon climbing back into the car with his father.
"Good," said the old man. "Now let's get to the tavern."
The old man had a particular fondness for alcoholic beverages, beer and brandy his preferred combination, a "shot and a beer," the tonic that revived so many of the working class when quitting time blissfully arrived. Father and son outings invariably ended at a tavern, a "saloon" as the old gentleman preferred, a place of joyful, mind-numbing elixirs for the old gentleman. While the father was still a consumer of strong drink, the son had come to terms with his own alcoholism and was, at the time, some five or six years into recovery. There was, however, a considerable challenge to the tavern visits. The old man, convinced beer and brandy still cost a buck or so for the duo, he, now permanently lost in a cocoon of a 1940s or 50s time zone, reacted quite badly to what he considered over-charging.
As a preventative measure, the son would hold a private conversation with the tavern owner or bartender, explaining the old man's idiosyncrasies, and asking that his father's stash have just a quarter or fifty or 75 cents maximum extracted, with the balance taken from the son's pile of coins and currency. This little "pageant of deception" worked well, except when it didn't. On those occasions the old gentleman would explode into a bombastic barrage of rancor and insults, such as, "Crooks, thieves, gangsters," and worse.
Nothing could prevent the inevitable final scene, as the father lay dying of cancer of the liver, his son at his side, holding his hand, speaking softly about their past history of contention and mutual dislike. "Where did we go wrong? For that matter, where and when did we go right?" asked the son of his mute, mostly unconscious father. The old man's breathing was labored, coming finally in short gasps, finally a prolonged but quiet exhale.
Now much further down the road of adulthood, the son chooses to remember his father's extraordinary gift. The old gentleman was remarkably funny; he told wonderful stories. He was a far better grandfather than father, and his grandkids hold him in their hearts with only loving thoughts and memories. The son chooses to share his father's stories with family and friends, and intends to do so until he himself is just a memory.
Published authors and professional editors have reviewed this author's work; none has rated the author's book, from which this article is derived, at fewer than the top or five-star rating. Because the article deals with hospice care as one of its essential topics, the review given the author by a career geriatrics social worker and health care provider is significant. It reads, in part, as follows: "The author 'nails it' in terms of how to deal with a parent struggling with dementia. Instead of 'fighting it,' the author and his wife develop an excellent methodology and coping strategies. They learn to 'play along,' adopting a policy of sensitive and caring role-play in order to enter the parent's reality, vs. constantly browbeating the parent over what's real and what isn't... " The story can be an enjoyable tale for anyone, and certainly a caregiver's tool, with particular immediacy for those facing or soon to face health and emotional care for an aging parent or other relative challenged by dementia or Alzheimer's disease. URL: [http://www.outskirtspress.com/andgoodnight]http://www.outskirtspress.com/andgoodnight. (also) [http://www.outskirtspress.com]http://www.outskirtspress.com. (Search under book title: "And Good Night to All the Beautiful Young Women")
Article Source: [http://EzineArticles.com/?Learning-to-Play-Along-in-the-Role-of-Dementia-Challenged-Caregiving&id=9288184] Learning to "Play Along" in the Role of Dementia-Challenged Caregiving
