Friday, January 27, 2017

Sometimes the Solution Is Simple



From my years of visiting people with dementia at care facilities, I knew the general progression of the disease—short-term memory loss, confusion, changes in personality, long-term memory loss, inability to communicate, and the withdrawal into the person’s mind, or what’s left of it. I’m learning the many more symptoms and side effects of the disease, some of which are disruptive or even scary, such as sundowning (see http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/sundowning/FAQ-20058511 for a brief summary) and hallucinations. Other changes are not on that scale but can be quite annoying and sometimes dangerous.

I didn’t know that some experience heightening of the senses beyond what many people have as they age—sensitivity to cold, for example. With Dad, sensitivity to touch was one of the first. That new watch Mom finally found for him that met all the criteria? It lasted a few days, if that. He could feel it against the hairs on his wrist. That never bothered him in what I’m guessing is fifty-plus years of wearing metal watch bands, but to him, now it was awful. (So now he doesn’t wear it and again complains that he doesn’t have a watch anymore.)   

Irritating with how much time she and his brothers spent looking for a watch, but not that big a deal in the grand scheme.

Then came the seat belt. That was a big deal. Dad didn’t start wearing a seat belt until Texas law mandated it. He didn’t like being told he had to, but the seat belt never really bothered him, or he never let on that it did, regardless of where he sat in the car. We stopped him from driving about a year ago, and the troubles began.

He usually rides in the front passenger seat because he cannot connect the seat belt in the back by himself. It’s a bit harder to reach, and he can’t figure out how to move his hand to click the pieces together, which triggers anger. Whichever location, the seat belt was too tight, especially against his neck. I know that sometimes the seat belt does lock tight while putting it on, but that wasn’t happening.

Dad’s solution was to pull on the shoulder belt and hold it away from his body. Not great, but he’d go forward only a few inches if we stopped short or were in an accident. About three months ago, he switched to stretching the shoulder belt so he could put it in front of his knee. I don’t know whether he decided the few inches was still uncomfortable, or he was being creative so he didn’t have to hold the belt. Regardless, we now had a problem.

Explaining the danger and telling him he had to wear the seat belt normally was not an option. He doesn’t understand explanations unless they are part of his reality, and sometimes not even then. His reality is the seat belt hurts him. He has no concept of the possibility of an accident and slamming into the dashboard or the air bag as it moves toward him.

Our initial solution was having him ride in the back seat if more than two people were in the car. He wouldn’t understand riding there if the front seat was empty. At least hitting the back of the front seat is a bit better. He made a nasty comment about being back there every time, but he went. Alice suggested one of the pads for the shoulder belt that cushions it. I got one but don’t think Mom ever tried it.

Then in early January, Mom realized that she can adjust the top position of the shoulder belt where it goes into the side of her new Equinox. She moved hers down a bit and liked how it fit. The passenger side shoulder belt moves likewise. She dropped it an inch or so, and Dad left the seat belt where it’s supposed to be.   

When I took him out last week, I checked my car’s belt system. Sure enough, I can adjust mine too. I lowered mine a little bit to experiment, and then before he got settled, I reached behind him and put his about where I figured Mom had set theirs. I told him what I was doing and why, and when he connected the seat belt, I asked how it was. “Feels just right.” All three times he had it on that night, he left it alone.

Problem solved with a simple solution!

At least until he changes again …    

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