How to talk to someone with Alzheimers The Tonic www.thetonic.co.uk

Last conversations with my mother

No matter your age, it comes as a seismic shock when your mother loses her mind. Christabel Smith navigates the choppy verbal seas of her mother’s Alzheimer’s…

Ten years ago, when I was 42, my 80-year-old mother – a gracious, selfless, clean-living lady, the same age as our Queen and one of her most exemplary subjects – rang me, off her head.

She was in hospital, due to have a hip replacement the following day. ‘They’ve given me morphine,’ she boomed down the line. ‘It’s absolutely marvellous!’

Then she lowered her voice conspiratorially. ‘All the nurses are spies, so I can’t talk.’

With that, she hung up. ‘I wouldn’t mind some of whatever she’s having,’ I thought, reeling.

Soon after coming round from surgery, my mum called again. ‘Bonjour,’ she breezed. ‘Parlez-vous français?’

‘Er, non,’ I managed. ‘Pardon.’

This made her laugh uproariously.

Later that day, I bumped into a doctor friend. My brow must still have been zigzagged with bemused concern, because she immediately asked me what was up.

When I explained about the bizarre conversations, she told me the combination of pain, shock, drugs, anaesthetic and infection often triggers dementia-like symptoms in elderly people. ‘It’s unlikely to be permanent,’ she reassured me.

Sure enough, back home and thankful her artificial hip had put paid to the agony she’d been suffering, my mother was herself again. She remembered nothing about the resurrected language skills or the double-agents on the ward.

Over the next years, a bad fall and an emergency hernia operation brought a return to her erratic mental state. That passed with time, but as with any storm, the landscape was never quite the same again.

At 85, she finally conceded the time was right to move into a care home. She soon settled in to her pretty garden room, surrounded by her most precious possessions, and thoroughly enjoyed meeting new people, the social programme on offer – yoga, music, even cocktail night on a Tuesday.

‘You could give classes in conversational French,’ I suggested.

 

‘You need to go for the younger men,’ I advised gently. ‘Octogenarians, preferably.’

 

My siblings and I, scattered all over the UK, visited whenever we could, but in the meantime, on the phone, it was wonderful to hear her renewed zest for life.

‘I have three boyfriends,’ she announced one day. ‘One’s 102, one’s 101 and the other’s 99.’

Heartache followed as in time, each old boy dropped off his perch. ‘You need to go for the younger men,’ I advised gently. ‘Octogenarians, preferably.’

It’s hard to know exactly when her brain began to cloud over for good. Perhaps when letters began to arrive without envelopes, just a scrawled address on a stuck-on label, or one birthday, when I received a collection of get-well, sympathy, new home and driving-test congratulations cards.

At 88, her diagnosis of Alzheimer’s was distressing, but it brought some clarity too. Back then, her major preoccupation was the swarm of ‘black bugs’ she insisted had invaded her room.

This is a common disturbance, but knowing that doesn’t much help when you’re with a parent who’s suddenly gone bonkers and cuts into every conversation with agitated cries of: ‘Look! There! You MUST be able to see.’

One visitor became pro-active, arrived armed with anti-insect spray, even a jam jar to help catch the critters, but that only seemed to agitate her more.

Mollification, saying ‘there, there, they’re not there,’ was futile too, because in her new world, they were as real as we were.

 

As she constantly scanned the walls and windows from her chair, tracing the bugs with her finger, I’d sit with her and quietly do the same

 

We had to learn not to argue, that applying logic was just helpless loved ones’ desperate attempt to – in the words of Dylan Thomas – ‘rage against the dying of the light’.

Some battles simply cannot be won.

As she constantly scanned the walls and windows from her chair, tracing the bugs with her finger, I’d sit with her and quietly do the same. Two amateur entomologists, charting the progress of unknown, invisible creatures. It wouldn’t have made the most compelling episode of Planet Earth, but the effect was calming for us both.

However broken the body and brain, the unique style of a person remains. That essence can still communicate with another essence, given the chance.

I felt sadness and nostalgia, of course, for the lost sharpness and engagement of our interchanges of old. But going with the flow, allowing myself just to be with someone in the only way left, felt peaceful and loving.

Six weeks ago, it was clear that my mother, 91, was reaching the end of her life. Her heart was slowing to a halt and it was as if her mind and memory had been chopped up with scissors.

Yet she continued to display the indomitable spirit that carried her through World War Two and the births of five large babies with not even an aspirin to take the edge off.

When I raced from Kent to Sussex to see her, she was convinced I wasn’t Christabel, her daughter, but Christabel’s friend.

Summoning up nearly a century’s worth of good manners and, as ever, channelling the Queen, she asked: ‘Have you come far?’

She wanted to know how I knew Christabel. I ventured that I actually was Christabel, but she wasn’t having any of it.

‘Where did you two meet?’ she went on, curiously.

I gave in. ‘Ramsgate,’ I answered. My home.

That elicited a wise nod. ‘Do you work together?’

‘Yes, Mummy, we do.’

My self-employed status suddenly felt less lonely! My company had doubled in size. I giggled, she grinned.

‘I bet that’s fun,’ she said.

The following day, I visited again.

‘Hello darling,’ my mother said. ‘A very nice friend of yours visited me yesterday. We roared with laughter.’

They are words I cherish now I’ve lost her. Even old age can’t take away a lifetime of communication and a brilliant sense of fun.

PROFESSIONALS’ ADVICE FOR THOSE VISITING PEOPLE WITH ALZHEIMER’S

Make eye contact. It’s vital they see you, so try to be at the same level as their head. Don’t stand or hover over them.

Speak slowly. Half your normal speed, ideally, and take a breath between sentences so they can catch up.

Avoid the R word (remember). They may feel angry, insulted or embarrassed.

Don’t talk down or correct them. They’re not children.

Validate their feelings. Phrases like ‘I can see you’re angry/sad/upset’ may help them to feel less isolated.

Take props. Photos or music may bring up happy memories.

Let them repeat themselves. Let them tell the old stories on a loop. If they’re asking the same question over and over again, try to keep patient and answer as if for the first time, because for them, it feels like that.

Keep visiting. Even if they don’t appear to know who you are, your contact may be vital to them.

If they get agitated, change the activity or subject. Start afresh, there’s nothing to lose.

Use their name frequently.

Ask first before touching them. Check before taking their hand in case they think you’re grabbing.

 

For more help – Alzheimer’s Society

Christabel Smith

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  • Dear Christabel, I feel so sad for you. My husband started with Alzheimers two years ago aged 66. I feel I started losing him then. He is getting worse now. People say he seems fine. I know he’s not. He loses more words everyday. After seeing the film Iris, about Iris Murdochs Dementia, it helps me to know what he’s going through and what to expect. We have been married 48 years and it feels now like being with a different person. I want my husband back but I know that will never happen. We live in his world now. I want to correct him but know I can’t. So we live in world he thinks is right. Best wishes .Sheila xx

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