FCC Week 5: Validation Principles and Prerequisites, Video 3 and online learning Please purchase the course before starting the lesson. Lesson tags: approaching, basic attitude, disoriented, maloriented, principles Leave a Reply Cancel replyYou must be logged in to post a comment. I visit my mother 3 days a week, for 5-6 hours in the Nursing home. It is very hard for her to eat alone, she likes her food hot, the menu at times is foreign to her, so I take items from home to complement her meal, she enjoys eating in the patio listening tango, classical music. I get there for lunch and leave after dinner. I live about 30 minutes from her. After being home for an hour or so, my mother calls me on the phone and tells me, ” it is 8:00 pm, no one has brought my dinner, I am very hungry, my stomach is empty, Come Immediately, If you do not, I will be dead when you come, might as well just go to the cemetery “. After learning that there is a reason behind the behavior, I am more calm when I get these type of calls. Because I am hopefully making a connection of her early childhood experience, she was born out of wedlock and was not wanted. I interpret that her hunger is not physical but emotional, she needs my reassurance by being available to her, I will not abandon her, by listening to her fear of having been forgotten by the kitchen and venting for some minutes, I tell her that I was with her at dinner and mention one or two things that I hope she will remember, in calm voice then slowly she says Oh! My memory is going!….. In the past, I tried to reason immediately and did not let her vent, I felt very guilty for not running to her, I was exhausted, and she would hang up the phone …. I would be in tears. The reading this week helped me better understand what may be going on with my mother-in-law’s repeated conversations that focus on her childhood. Her parents divorced when she was eight years old and she seems to be very focused on the pain of being an only child who was raised entirely by her mother during the depression. Her father was completely out of the picture. She moved frequently and she and her mother lived mostly with her relatives. She often asks me questions about how my non-Jewish family felt about my marrying into a Jewish family. I suspect that she experienced a lot of antisemitism growing up and felt the stigma related to divorce at that time. Like Stephanie, I have a fiercely independent mother. She often brags about being a “stubborn dutchman”. This week, amidst many situations in which it appears she had declined, and due to my upcoming departure after a month of FT caregiving, and worries that Marie would be unsafe, my brother and sister in law thought we should have her in “respite” at a memory care assisted living until another family moves back into her home at the end of August. Marie would have none of this, despite a nurse recommending same. I drove her to the facility just so we could “look at it” and she refused to get out of the car and became VERY angry with me. Later that evening (after I had explained she would stay in the her home with extra help), she kept asking me who I was, mostly mistaking me for one of her three other sisters with whom she always had power struggles – and didn’t like much. This has happened in the past, but the moments have been fleeting. I had such an “aha” moment because it seemed so clearly linked. (She has not once mentioned the trip to the LTC facility since it happened – has that memory faded despite its emotional strength – or is she afraid to mention it? Of that I do not know.) The interaction with her in the midst of her confusing me with her sister was easy because it ‘made sense’. A few times she asked, “well, who are you if you are not Leona?” and saying I was her daughter didn’t even register, so I started telling her I was someone who loved her. That seemed okay. A Difficult Situation: This past Monday, Mom left her apartment disturbingly (for us and for her) once in the early morning and again later in the mid-afternoon. In the morning she was not in her apartment when her long-time housekeeper arrived at 7:30am. She had gotten dressed, made her bed, and left with the door unlocked. There are a lot of ‘eyes’ all around the building where Mom lives and we were able to track her down in less than an hour. She was quietly sitting by herself in a chair by the pool. (The pool area is locked and there is a lifeguard on duty). I came by that afternoon and told Mom that I only had a very short time to spend with her that day. She said, ‘Well then come in, and let’s talk.’ We sat in the two chairs in her bedroom and talked. She wanted to know when she could go back to her apartment. (This is one of her very repetitive questions.) I individually pointed to a number of the furnishings in the bedroom and asked, “Whose bedspread is this?” “Mine,” she said. “Whose chair are you sitting on?” “Mine,” she said. “Whose chair am I sitting on?” “Whose nightstand, whose armoire, whose family portrait…” “Mine, mine, mine…” she said after each question. So I asked, “If all of these things are yours, whose apartment is this?” “Mine” she said. She agreed that it was her apartment… and then she said, “Well then, I’m ready to go back to my other apartment. I don’t want to stay here alone in this apartment, it’s too big and you and your sisters are going to have a lot of things to take care of when I’m gone.” I felt so so so sad, and unfortunately, I had to leave in order to make an appointment on time. She knew I had to leave, and she was okay with that. I asked her to please wait for Dupe (our afternoon caregiver) who would be there momentarily. Mom said, “I’ll wait for Dupe, but I’m going to leave when she comes and go back to my other apartment.” I breathed deeply and prayed to deal with my sadness as I drove to my appointment. The report from Dupe was that as soon as she arrived, Mom took her walker and her apartment key and stormed out of the apartment. Dupe of course followed, and they walked all around the building for close to two hours. They finally ended up in the lobby where Mom insisted that she was waiting for one of her daughters to come get her and bring her to her apartment. Joyce (our other sister) was already on her way to assist Dupe when I was finally free to return Dupe’s phone call. Mom did finally return to her apartment with Dupe before Joyce arrived… she was exhausted, had something to eat, and went to bed around 6:15pm. Principles that give me new ways to look at this behavior: The Validation principle that there is a reason for all of Mom’s behavior is profound. That there is a reason for her ‘wandering’ helps me to feel less bewildered by it, less afraid for her, and perhaps even less victimized by it. Since her seemingly bizarre behavior is not haphazard, random or arbitrary it gives me the sense that she still has some measure of agency and authority over her actions. In the midst of her malorientation, she is busily at work coming up with her own coping mechanisms to deal with the pain and difficulties of growing old. Describe the behavior & what could be the reason behind this behavior: In the instance when Mom left her apartment in the morning, she was likely looking for some stimulation outside of her apartment. She was probably wandering around for an hour or so before she ended up at the pool. I doubt that she was intentionally looking for it. But when she found it, she would have been content to be there. She learned to swim growing up in Michigan, loved it, taught it when she was in Junior High School, loved having a swimming pool in our backyard when she raised us, and thinks of herself as a swimmer today. (She was very happy to see Amalia and return to the apartment with her.) In the instance in the afternoon, she herself verbalized in our conversation that her apartment is big and that it is a lonely place for her. In other instances when she has wandered she has ‘run away’ in anger from her aides who she often feels invade her private space. My husband wants to go home in the evenings most nights now. He feels he is not in his own home. It is difficult to get him to understand that he is already home. He tries to go home. It helps to understand that he is acting on information from his past. When he does not understand what I am saying, that he is in his own home, it has made me anxious. I am not sure if I can reach him or not and that he might try to leave the house. I have been able to get him to understand sometimes with great effort and other times with little effort. I fear for his safety. I believe that he can sense the urgency in my voice which makes the situation for him worse. Now I can relax a little and know that he is both in this time frame and the past. This will allow me to be more patient and calm. Knowing that I will be able to reach him, will help me release the stress and participate more with him. It is comforting that on some level he has one foot left in what I call reality. My mother is fiercely independent and gets angry or denies offers of assistance. She interprets suggestions and offers of assistance as being treated like a baby or being bossed around. This behavior probably stems from her early childhood where she and her single-working mother moved around a lot. She describes various experiences of being the youngest and was often dominated by others. She also was left to entertain herself a lot. A current difficult situation with mom is that she will not leave the 2 fans in her house plugged in or turned on. It’s been quite hot in Denver over the past few weeks and her apartment is sweltering. I worry about her getting over-heated and dehydrated. I also worry about the well-being of her cats in such an environment. When I visit her, I plug in and turn on the fans and I explain that I’m turning them on because it is very hot in her apartment. She agrees with me and says it is hot, but the next time she goes into a room with the fan (sometimes less than 5 minutes after I’ve turned it on), she turns it off and unplugs it. My best guess at why she does this is a fear of having appliances catching on fire or causing some other problem. Or, perhaps, she is concerned about running up the utility bill and not being able to pay it. My mom regularly chastises me for ‘being too big for my britches’, being a snob, and generally for spending money which in her view is excessive. She has told us many times throughout the years that although she grew up in the depression, they always had enough to eat. However, we learned recently that during her childhood, my grandfather was in danger of losing his farm due to unpaid taxes and now believe that she has minimized the level of poverty in which she lived. We believe this has impacted her ability to celebrate success and instead focus on deprivation. I’m struggling with how to respond to this in a positive and loving way. How do I acknowledge and respect her experience without having to apologize every time I buy coffee at Starbucks? Identify a difficult situation with your relative Much of what my wife does seems to center around her personal safety. The most significant example. She will go around at the end of the day and check each exterior door, make sure it is locked and place something against it that will fall if it opens and create a sound. She then repeatedly asks me, “Are all the doors locked?” Another example, we live in a corner house and occasionally she will say, “I should have never purchase a corner house. Someone could throw something over the fence.” What you think could be the reason behind this behavior. I was a consultant before my retirement and frequently traveled. I consulted in Asia and in Russia and would be gone for weeks at a time. More typically I would be gone for one or two nights when consulting in California. I could not always call her and check in with her. I believe she managed my being gone but always worried about her safety. We have always had dogs and they are important to her. Now, as we go to sleep, I assure her all the doors are locked and then hold her and tell her I am always there for her, that our home is safe and that she has two “Jojimbo” (guard) dogs sleeping at the foot of our bed. I frequently find reasons to speak about the safety of our home. My mother is very independent, or thinks she is at least. She tries very hard to be independent, even for things she absolutely cannot do (like dressing herself). She told me once that she would rather die than ask for help. I found out recently that her parents were not around much to help and she and her siblings “raised themselves”. They did not dare disturb mother/father for help after work hours for fear of some retaliation. I previously just looked at my mother’s attitude as an innate stubbornness like a mule digging its heels into the ground, but if I consider it from a past consideration that asking for help led to punishment, I can see why she would never want to ask for help. But then, I have to figure out how to know when to offer help or intervene because my mother is still very combative and mean if anyone is trying to help her. This also means that I should be careful by responding in a negative way when she does ask for help because it only reinforces the negative memory of asking for help.