Jun 22, 2011

Alzheimer’s, Confusion, Great Grams, and the Man with the Hat

I hope my sharing these moments helps others to be able to share what they have been going through and, perhaps, reduce their burden.

By Max Wallack
Alzheimer's Reading Room

Alzheimer’s, Confusion, Great Grams, and the Man with the Hat
In the comment box to one of my recent articles, someone said that she was aware that Alzheimer’s patients in facilities sometimes mistake other residents for their spouse.

I realize this is hard to deal with, sometimes more difficult than when someone can't remember the name of their caregiver.

Many caregivers with loved ones in care facilities are confronted with sx, confusion, and language problem, so I decided to write about our own experiences with my great grandmother, Gertrude.

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Great Grams showed some sexual confusion during her last years of life, even long before she entered any facility. One episode that was quite disturbing to our family was the time that Great Grams started crying for hours.

We asked Great Grams what was wrong?

Her reply was startling: “No one will want to marry me now that I have had sex with Nancy (her daughter and primary caregiver)”.

We spent at least an hour trying to convince Great Grams that she had not had sex with her daughter, but to no avail. Finally, grandma tried another tactic. Grandma figured that Great Grams really was not looking to get married anyway (at the age of 95ish), so grandma asked Great Grams if it really makes any difference and if Great Grams was looking to get married. Boy, we were surprised when Great Grams answered, “Well, I might want to get married if I meet the right man.”

That pretty much left us speechless, but after a while Great Grams calmed down and “forgot” the entire episode.

Another incident happened even earlier in Great Gram’s progression into Alzheimer’s World. During her very first hospitalization, before we even knew she had Alzheimer’s, Great Grams told the doctor that the “problems” she was having were because her granddaughter (my mom) had stolen her fiancé (my dad). She was very angry at my mom! Again, she “forgot” these things within a few hours.

A few months before Great Grams death, her son, my uncle came to visit. Great Grams was very hostile to him. At times, she didn’t know who he was, but she understood he was part of her past. She accused him of having led her astray, made promises to her, and then dropped her and married “that woman” (his wife).

Again, just hours later, she was happily having conversations with her son. However, her accusations seemed so real that her son raised the possibility that something similar to that may have happened in Great Gram’s distant past, something we will really never know.

On one occasion, Great Grams was acting really disgusted with Nancy, her daughter. Great Grams said that she thought it was wrong that Nancy was sleeping in the same bed with Eli (her husband). When grandma explained that they were married, Great Grams said, “I’m so glad to hear that.” Grandma tried to remind Great Grams about the wedding and how she had been there, but that was too much for Great Grams to grasp.

Once Great Grams was in the Alzheimer’s Unit (the last 10 weeks of her life), she encountered an older man who wore a hat exactly like the one that her husband had always worn. Clearly, Great Grams thought he was her husband. By then, Great Grams could not speak more than an occasional word. The unit supervisor asked my grandmother if it was okay with her to let them “hold hands”. Grandma said it was okay since it seemed to give Great Grams comfort. However, on one occasion, Grandma arrived and found Great Grams and her boyfriend in the TV room. Great Grams was restrained in her wheelchair, unable to speak. Meanwhile, the “boyfriend” was trying to pull her wheelchair closer and closer to him and saying “give me a kiss.” Great Grams looked quite frightened. Grandma just wheeled her to another room. This was a very difficult situation, and Grandma never mentioned anything to the unit supervisor. Do you think she should have? What would have been the right thing to do?

There was another incident I witnessed that had nothing to do with Great Grams. One of the residents of a dementia unit that Great Grams had been in temporarily, early on, had been a Harvard University professor. Her husband came to visit her every day, spending hours there. She seemed fairly cognizant of her surroundings while he was there. He always made sure she ate a good meal. I found it very sad to see that when he was not there, she spent her time wandering around, seemingly looking for him, and often spent time in another gentleman’s room that looked something like him.

I suspect that there are a large number of these types of confused behaviors going on in nursing facilities. I’m not sure how they should be handled.

I hope my sharing these moments helps others to be able to share what they have been going through and, perhaps, reduce their burden.

Max Wallack is a student at Boston University Academy. His great grandmother, Gertrude, suffered from Alzheimer's disease. Max is the founder of PUZZLES TO REMEMBER. PTR is a project that provides puzzles to nursing homes and veterans institutions that care for Alzheimer's and dementia patients.

Original content Bob DeMarco, the Alzheimer's Reading Room