How Many Fingers Am I Holding Up?

September 30, 2008 at 3:35 am (Uncategorized)

Sorry about the absence of a post yesterday, people. I was with Nana, and Julie from the Aged Care Assessment Team over at Nana’s place in Maroubra. It made for a long and exhausting day, although lovely Llewie was in the mood to celebrate his own clean bill of health, and so he managed to scrape me out of my puddle of over-tiredness and refashion me into something approaching human before taking me out to dinner. Not bad, is he? We went to the GPO wine and cheese room in Martin Place and sat underground in the sandstone ‘tunnel,’ enjoying a rather romantic, ideal meal featuring several of our favourite things (no prizes for guessing what, given the name of the joint). It was a really gorgeous evening.

Back to Nana, it was interesting listening to the types of mental exercises and tests Julie from ACAT kept dishing out to Nana. I was in the kitchen making tea and pretending not to listen, but of course I was fascinated and watching everything they did like a hawk. I was torn between cheering for Nana when she nailed one task, despairing when her memory abandoned her at the next, behaving like a real heel just when she needed it most, and then being relieved, guiltily, that a professional was finally involved and seeing for herself that Nana isn’t really in such great shape, despite still being able to point to her right elbow with her left hand.

The real shocker was the husbands. Nana’s had four. Yesterday, she could only recall two. Number one, my granddad, came through clear as a bell, not surprisingly given he was such an unforgettable character, and poor old Reg, a real English gentleman with skin as fine as rice paper, scraped in at number four. I prompted Nana about number two – “What about Bruce?” – and she looked mildly surprised and then said, “Oh yes. I forgot about him.” Number three has unfortunately been lost to history – I couldn’t and can’t for the life of me remember the missing husband’s name, and Nana was no help whatsoever, but I do know I’ve always been under the firm, unwavering impression that there were four. How shocking it was to see the blankness behind Nana’s eyes when she was asked to name these men she once loved enough to marry. It was heartbreaking; when Julie asked her if she’d divorced Granddad, Nana didn’t hesitate: “Oh no,” she said firmly, and then she looked at me for confirmation I could not provide. Awful. 

Julie also asked Nana to name as many animals as she could think of in under a minute. I was almost faint with hunger, so the first animal that went through my mind (with apologies to Jenny) was “cow,” followed shortly by “beef patty.” Next up was “pig” and “bacon.” After that I couldn’t concentrate anymore. I just wanted something to eat. I was tired and hungry and suddenly all these tasks seemed like the most difficult series of questions I’d ever heard. I found myself thinking, shit, I’m glad Julie’s not asking me. I don’t think I’d be doing too well either right about now. I’m totally off the air. Meanwhile, Nana started off confidently. “Oh well,” she said, like this was going to be a cinch, “Dog. Cat.” Pause. She looked around the room and we waited, breathless. “Koala.” Dead silence for a while, and then a nervous laugh from Nana. “Isn’t this silly?” she said. “I know hundreds of animals and I can’t think of any.” She strained in her seat, staring around the room at everything on the walls and all the trinkets along the sideboard. “Horse,” she said at last.

That was it. The minute passed and Nana had named four animals. Have you recently sat out a minute in total silence? It’s a surprisingly long time when you’re one of three women sitting in a small room watching your last surviving grandparent cast about for words that have packed up and shipped out of her mind. It was really heartrending, and yes, a little terrifying too. She went off to get her glasses and returned, proud of herself, with her gold fob watch. “What was it you went to get?” Julie asked. Nana looked down into her hand, clearly puzzled by the question, then held out the fob piece to her interlocutor and said simply “Watch.” Just then she seemed as a child to me, one who has just learned a new word, and is trying it out on a smiling audience of admirers, secretly hoping to be rewarded.

 

Postscript: thanks to our family friend Janet, the missing husband’s name has been recovered: Taz. I reminded Nana of Bruce and Taz, husbands two and three today – Thursday 9 October – and she said “Oh, I haven’t thought about either of them in years.” Clearly!

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2 Comments

  1. Pete said,

    Di – What a mix of feelings. Like you I’m glad that your nana is getting attention but sorry that she does seem to be quite fragile. We learned some of those tests in my training so I was quite excited to see them (the naming animals in a minute for example). She probably did a mini-mental on your nana and tests for the different areas of the brain. The animal category test also tests executive functioning since it’s the ability to initiate. When I’m anxious I might also freeze up like that and not be able to name many either. So not a definite sign of dementia but the memory lapses not a good sign. Sounds like she’s in good hands but must be a worry for you.

  2. doctordi said,

    Oh , she’s fragile all right, Pete. I think the real bastardry of dementia – and clearly there’s some kind of neural degeneration happening here, although precisely what kind we won’t know until after we get her tested October 9 – is that she never, ever knows she’s forgetting things. Naturally this makes her defensive when questioned, and prone to glossing, both of which make it hard to keep track of what’s really happening. As I said to her on Monday, she’ll have the certainty of the righteous that she’s done something (eaten, showered, put on a load of washing, taken her medication, on and on it goes), but the recollection may well belong to another time. And the mounting evidence is that in many cases it does. Yes, it does sound like a mini-mental – some of it was testing the brain’s ability to send clear calls to action to other parts of the body. From an observational standpoint it was interesting, from a personal standpoint it was a nightmare in slow motion.

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