Tranquil Times

Caregiver Fatigue Setting In...

2011-01-25T11:44:00.000-08:00

Now the the sciatica is long solved, and all that remains is the OCD/depression, we all have enough of visiting her every day.

Contributing to this is the realization, from her own children, that she is a most unreliable reporter. She lies less in front of me, because of all her relatives, I'm probably one of the most consistent in ignoring her tales of victimization, I just smile and try to say something positive.

This weekend, I went with my husband, but left for 15 minutes to pick up something at a nearby store. While I was gone, she did her favorite routine: she complained to my husband about his sister. She told this that (1) her daughter was mad at her because she thought that the $1000 wedding present she received was insufficient and (2) her daughter was mad at her, because she was nice to the second daughter over the phone when she called (the two daughters aren't talking to one another).

When my husband came home, he repeated the stories to me. I suggested that there is no way someone would get angry over a $1000 gift, and that there is no way that one sister would expect the mother to pick up their battles on the phone. He thought a little, and agreed. Who knows if the daughter was even upset with anything at all? Maybe the daughter told her to make more efforts, which is something she doesn't like to hear. A lot of the "fights" she reports are completely imaginary.

The Celexa doesn't seem to be working at all for her depression, though it may help with the OCD. She doesn't obsess about her pills like she used to. The problem is, the OCD used to keep her busy with constant, repetitive cleaning; now, she doesn't seem to know what to do with the time. Her entire life was consumed with pointless cleaning of tile grout with Q-tips and weekly washing of chandeliers. What now? With the OCD waning, I wonder how her hindsight about what she did with her life is changing.

She's been eating 400-500 calories at day at the most, though. We've tried to get her to eat more (over a lot of whining and resistance), it has been very time consuming and not particularly effective. At some point, she's going to become very frail. It's just a matter of time, there is very little we can do to stop it. If we took 3 hours every day, we could delay the inevitable by a week. It's not very motivating.

Taking A Short Rest From The MIL

2011-01-14T15:49:00.000-08:00

I decided to cut down on my accompanying my husband when he visits his mother.

Her constant lying about how "mean," "lazy," and "money-mad" people are is beginning to irritate me more than it should. She rags on her caregiver being late, taking phone calls, refusing to clean, etc. But it's not at all true; the caregiver is punctual, has a cleaning routine (she's more of a cleaning lady than caregiver at this point) where in a couple of hours she oversee her shower, "Swiffers" the whole floor, bleaches the sink, starts the laundry (laundry is done everyday, not matter how small), empties the dishwasher, cleans the counters, etc.

I'm fed up with hearing how badly her daughter mistreats her; her daughter a caring, doting sweetheart who spends a lot of time, effort, and vital energy attending to her medical needs and daily anxiety. I'm tired of her fighting me when I try to make excuses for her daughter's "behavior." She gets really tense and argumentative if you resist hating someone she would like you to hate.

She herself pretty much hates everyone she comes into contact with, so perhaps company and approval of her hate rants give her some sort of perverse pleasure.

These days I don't feel like she deserves my company, not that she desires it to begin with. She tolerated me when she was immobilized with the sciatica and I could do "things" for her, but she never so much as offered me a glass of water in 4 months, while she offered to treat everyone else with Chinese food. Or she'd offer some chocolate to another guest, but not me. I was never under any illusion that I was an exception to the universal scorn of others, but now that she's a little better, she's using the extra energy to make me feel it more.

Watch Out For Elderly Drivers!

2011-01-12T18:49:00.000-08:00

We couldn't believe it when she told us she drove herself, accompanied by her caretaker, to the doctor's office! She has severe muscle degeneration, and can barely walk, she could have killed somebody. She admitted that her legs were too weak, and that it had not been a good idea - but that she's trying to be normal again. Minus the driving, it's excellent news.

We later spoke to the caregiver would accompanied her in the car, she tried to talk her out of it over and over, and was quite frightened when she saw her slow reaction time and anxiety on the road.

Strange how she won't risk taking a shower alone for fear of burglars bursting in, but has fewer qualms about risking the lives of others on the road.

This is a little portrait I drew from memory. Two witnesses claim that it looks nothing like her...

Grocery Shopping

2011-01-12T06:36:00.000-08:00

To create some stable and predictable structure in her life, and care giving routine, I'm taking her grocery shopping every Tuesday at 2:00.

The first of these shopping trips, some time after she recovered from her sciatica, was very difficult. She called before to get out of it, when I arrived she complained of not having had lunch, when in the store she complained about nausea, palpitations, weakness, etc. She was unable to follow through her modest shopping list. Mostly, my son and I fetched the items for her, while she wandered very slowly and aimlessly. On one occasion, she bowed her head down and started to cry a little. After the shopping, she phoned all the relatives to complain that I had been mean to her.

The second trip, a week later, was done with my husband and my son. My husband tried to push her much more than I did (she is HIS mother, so the interaction isn't as delicate as it is with me). She has a fixation on filet mignon and has a hoard of them in the freezer, she buys them at twice her rate of eating them. Also, she's losing a lot of weight from lack of eating. So my husband tried to guide her purchases away from filet mignon, and Lean Cuisine into higher calorie frozen dinners. She broke down crying many times, and everyone came home very upset, each for their own set of perfectly understandable reasons. After the shopping, she phoned all the relatives to complain that her son had been mean to her.

This third trip was a little different. She didn't call me before with excuses to get out of the shopping trip. She didn't complain that she hadn't eaten lunch and was hungry. When we arrived, the door was already unlocked (I ended up locking it, expecting to unlock it), and she was completely dressed with coat, boots and hat, sitting on a chair 3 feet in front of the door. When we opened the door, she jumped up nervously. God only knows how long she'd been sitting ther, waiting, focused on the lock mecanism. Being an OCD and general anxiety disorder sufferer, she worries immensely about the catastrophe of not being ready on time. At the store, her attitude was a little better. Every once in a while, she'd look at her basket, and lament, "it's not enough food for one week!" but I really wanted to motivate her to complete her task, and mind her shopping list during the week, so I told her that if she didn't have enough, not to worry, we could open some of her cans. I understand that the OCD/GAD are at play here, but I also don't want her to rely on us doing her shopping and taking over her food supply, or asking us to take us shopping any old day (it would exhaust us all to take her shopping whenever she becomes anxious about her fridge being "empty"). I kept a smile and upbeat attitude, and when she started to complain, she'd get a very short lecture about how well she was doing, I reminded her of the few, specific and realistic objectives of the trip, and walked away. That was really hard...

WHAT WE DID

Dropped her off at the door, and brought her a basket that doubles as a walker for her.
Brought her another cart when she complained that hers was rattling.
Checked her progress on the shopping list to keep her on task, and show that we were there.
Kept our distance so that she didn't feel we were breathing down her neck.
Brought a few items into her cart despite my resolve not to do so, because I felt she was making a huge effort and I didn't want to overdo it.
Transferred her purchases to the conveyor at the cash, and bagged the groceries.
Brought the groceries up to her apartment, an took them out of the bags.

WHAT WE DID NOT DO

Tell her what to buy. She was buying potatoes (she has tons, they're all going to rot, but a supply of potatoes might ward off her anxiety), and I reminded her that she had a lot of them, but after that, I decided I wasn't going to meddle in her purchasing decisions.
At some point, she said she was tired of pushing the cart, and asked that my son push it for her. But she uses it as a walker... so that wasn't a possibility. I encouraged her to keep pushing... that was a hard thing to do.
Put away the groceries in the fridge or pantry. I thought it was necessary, for her "food supply management" to see how much or how little she has of some items, or how much space she has (very little in fact, it's all packed with supplies)
Rush her. Although we wanted to crawl out of our skins with boredom, we let her take a hour and a half. Her speed of walking and decision making is very slow, and it's a huge store.

After the shopping, she phoned all the relatives to complain that I had been mean to her. But hey... some progress has been made, I'll grant her the reward of ragging on me.

Fear of Monsters?

2011-01-09T12:35:00.000-08:00

For the past few months, our elderly OCD/GAD/MDD patient (my mother-in-law) has been unable to take a shower on her own. The caregiver that she hired, and comes in the morning for a couple of hours, has been overseeing the showers.

When the caregiver went on holiday, I helped her take her shower, noticing that she in fact needs no help whatsoever. She blamed her insecurity on fear of falling (she has a shower chair), and fear of a 3 inch step to get into the shower. With a bit of coaxing, she finally admitted the real reason why she didn't want to take showers alone anymore.

She's afraid that a burglar will come. Or the fire alarm will go off. Monsters in the drain?

We thought it would be a good idea for her to re-learn to shower on her own. She did fire her psychologist, so I had to resort to a gauche imitation of what I had seen on the A&E show "Obsessed" - Cognitive Behavioral Therapy. I'm pretty sure I did it all wrong... but she got what she paid for. We made her take a shower with the door opened, while we sat in the living room.

No complaints were heard, but when she came out, she started to sob. "I never want to take a shower again."

We had planned to wait for her shower further and further each time, but maybe it's best if we stay in our living room in our next attempt.

OCD Holiday Feasts

2011-01-07T17:31:00.000-08:00

When she was healthy, and would visit other people's filthy homes, she'd bring bottled water and saltines in a double bag.

If supper was served, she wouldn't touch the food, though sometimes she'd force herself to gag on a a few crumbs sticking to a fork.

All the while, she considered herself to be the perfect one, the gold-standard to which we should all aspire.

The Lies Are Hardly Helping

2011-01-02T16:08:00.000-08:00

Her children are only just beginning to realize that her regard for the truth has always been shaky. Depression has this effect of stripping a personality naked; attempts at deception are as transparent as they would be coming from a toddler.

The lies she tell follow a peculiar formula. She transforms a simple, normal human interaction into a case where she is abused and exploited, and riles all her relations into outrage. Being abused verbally and schemed against, by selfish, greedy or lazy people is a core theme.

Once, a helper that sees her for two hours in the morning felt that she was too shaky, weepy and upset to take a shower, and spent most of her time talking to her so that she should calm down. She called all her relatives to complain that the helper is getting increasingly lazy and bossy, and refused flat out to give her a shower. She said that the helper had been mean to her.

She fired a psychologist that was hired to help her when the psychologist suggested that she go out with her during her next session, as she has been largely housebound on account of the depression. The psychologist had previously written a report for her general practitioner to hasten the start of anti-depressant therapy. She told us, lips pinched, and with an offended tone, that the psychiatrist had said that the "psychologist had obviously spent more time trying to impress the medical staff than her patient." When confronted with the fact that her psychiatrist, who is a meticulously professional lady, couldn't have possibly sullied a colleague in such a manner, she backed down, and tried to soften the made up story to possibly make it more believable.

She also related a story about how my own son was extremely upset regarding a question that her daughter (his aunt) had asked him. It didn't at all sound like anything my son would say, I know him to be very even-tempered and difficult to upset. When verifying with him, she reported that she had tried to coax him into saying that he was upset, but he insisted he was not.

Once I witnessed a non-incident with her daughter, who is, quite understandably, eager for normal and healthy family relations. She had invited us all to her house for coffee and conversation. Very soon after arriving, her mother (our depressed subject), made it quite obvious that she was anxious to get back home. Her daughter was gracious and kind, and never rose to the bait. When we drove her home in the car, she tried to get us angry with her daughter for the poor way she had treated her! When I said that her daughter had done nothing wrong at all, and wished for more family gatherings, she exploded: "you should see how she mistreats me when she takes me for my infusions!"

As her dependence on other people's care has caused me to spent more time with her than ever before, I too have been the subject of some wicked false gossip. As per the advice of her psychiatrist, and the psychologist that she dismissed, I took her out for grocery shopping, and brought my adult son with me to help out and vacuum her floors. She called 90 before the time I was supposed to arrive to complain of every ailment under the sun, but I showed up and took her anyway. As a last-ditch effort to try to convince me that she should spend the time sitting on the same spot on the couch (with the blinds pulled down) she's been sitting on for the past 4 months, she said she didn't have lunch. I told her that she could eat when we returned. The shopping trip was a disaster; she complained of not knowing where the products were (she's been going to the same store for 5 years), that all the food made her nauseous, and she'd weep with her head down in the aisles. I sent my son to fetch the items on her shopping list, and I took her home. For my trouble, she phoned all my in-laws, and my own husband, to complain about how mean and abusive I had been with her. I had kept my smile and my composure the whole time. When my husband confronted her with that rather unfair bit of gossip, she turned to me, and denied ever saying it - and my husband told her: "Ma, you told ME that!"

The next week, my husband took her grocery shopping with our son, and according to the latter, it was even worse a disaster; so it was her her son who took a beating in her "I'm so abused" gossip-mongering.

Some time later, I was alone with her, and my husband was to meet up at her apartment in 45 minutes or so. Because we were late, and it was New Year's eve, I had cooked her supper in my kitchen. Earlier, she had eaten food partially cooked in my house, I'm not sure she knew this was the case. I also made something special that I thought she would really like. When I got there, she spoke to me with a loud, aggressive tone instead of her usual, depressed weak voice. I didn't think much of it, and kept to cheerful banter about topics I felt might engage her. When I put the food down, she shouted, "It told you I'm not hungry!" Now, she's wasting away from under eating and constant complaints of neausea, so while she did say she wasn't hungry, she has been complaining that food makes her want to throw up for months. I didn't know if she wanted to make me feel her anger because I took her shopping over her excuses, or because she was angry that I brought her food from my "filthy kitchen." I took the plate, saying "this is a problem that's easily solved" and I threw out the contents. Then I sat down, and after 10 seconds worth of words, we settled and had a nice conversation.

When my husband (her son) returned, she turned to him, and hoping that he would give her the pleasure of ragging on me in her presence to prove his loyalty, told him "DO YOU KNOW what SHE DID TO ME?" failing to point out her own aggressive attitude. Since he's beginning to realize her accounts aren't reliable, he simply said that it didn't sound like a big deal at all.

She later called one of her daughters, saying that I treated her like those helpless seniors abused in homes. The daughter defended me, saying that after all I'd done for her in the past 4 months, I should be forgiven one bad day. The mother hung up on her, which she later denied - then admitted when my husband confronted her about it. She told the same story to her other daughter, but we don't know how she reacted.

When We Grow Old, We Become Caricatures Of Ourselves

2010-12-28T19:18:00.000-08:00

I've known my mother-in-law for 25 years, and I've never known her to have any hobby or interest in life other than cleaning obsessively. It's always been in the back of my mind that there was some measure of OCD involved in her behavior, but as an in-law, it never was my business to press the issue. It didn't seem to bother her or her family. She'd often complained that she'd rather die than go to a 'filthy' old age home; this was firmly thought to be the sort of thing to worry about when and if we got there.

And here we are. She's 80 now, the prospect of the old age home is looming close, and the OCD can no longer be ignored.

"PEOPLE ARE SCREWED UP"
I read somewhere that OCD sufferers are ambivalent in their relationships with others, and that certainly is true for my mother-in-law.

On the surface, she maintained an elaborate facade of exaggerated concern and worry about others, especially with regards to their health or safety. When my family went on vacation, my husband's first concern was to phone her to tell her we'd arrived safely so that she wouldn't worry. She would react to news of an ingrown hair like it was death in the family.

Paradoxically, when she spoke of others, it was always very ill indeed. With each of her own adult children, she complained of being mistreated, abused, and taken advantage of by the other two - resulting in the three of them being estranged.

She loved to extract confidences from people, befriending them, and squeezing personal information that she would scornfully repeat to others. Getting 'secrets' was a badge of honor for her. Those friendships, at first brimming with enthusiasm and promises, never lasted; for once revealed, the 'secrets' became cause for disparagement and eventually, hatred. She would gloat, with much emphasis, that they are "SCREWED UP." Recently, I've become aware that the confidences were often distorted, exaggerated, and sometimes downright fanciful.

In her world-view, everyone is greedy and money-mad - or SCREWED UP. No one was safe. Her gentle neighbors (several of them over the years), her deceased husband, her own children, grandchildren, her sister, all her relatives except her father (another likely OCD sufferer) - all greedy and/or SCREWED UP.

What people say about others, they say about you. I was no exception There were no exceptions.

"I'M PARTICULAR"
When was at the hospital for a few weeks, some months ago, the OCD became a sore point with the hospital staff. She'd call the nurse to have her bathroom floor re-cleaned, and she'd force them to clean yet again a third time, because she found their filthy mops to be woefully inadequate. She loathed sharing the room with another patient (especially sharing the bathroom), and barely touched the filthy hospital food. The staff called upon a psychiatrist consultation, and she righteously told him off: "I'm unhappy because I'm sick and the hospital is filthy. Make me healthy and I'll be happy." The doctor gave in too quickly, and left.

Just a couple of days ago, she was rating her acquaintances by degree of 'cleanliness' - I take this to mean that this is how a person's worth in measured, in her world. You have the "screwed ups," the "greedy," and the clean ones that are sane.

When she had children at home, she always had 'chars' and 'cleaning women' to help out, but from what I understand, none satisfied her - they were all mediocre. When relating these anecdotes, she would explain, proudly: "I'M PARTICULAR" but I've always wondered if, when you have OCD, it is your own act of cleaning that reduces anxiety, and that having it done by others do little to relieve this anxiety.

So what, so what, if she fretted about every crumb, and how much dust a tissue generates when you pull it out of the box. It's not hurting anybody, right?

DEPRESSION
About a year ago, she spent 2 or 3 weeks at the hospital for difficulty swallowing which, in hindsight, was probably a by-product of anxiety. Her constant, petulant complaints about "filth" tested the patience of both the nursing staff and cleaning staff. Since cleaning the same areas several times over failed to satisfy her OCD, a psychiatrist was called in. It would have been nice if she welcomed the help, since she would later fall into deep depression, but she lectured him away: "can't you see I'm sick? Make me healthy and I'll be happy."

My husband once asked her what were the happiest times of her life, to stimulate positive topics of conversation. She answered that it was having her children, though she wouldn't have children at all if she could reverse history; "it wasn't worth it."

He also asked her if she'd like to take up a hobby as a distraction. She was offered yarn and needles, for she did knit in her youth. When he emphasized how lucky she was to have all this free time to consecrate to pleasant pursuits, she started to sob.