Possibly the most difficult aspect of dementia is how it sneaks up on you in plain sight. We all know it is happening but in the earlier stages there is no clue as to how insidious it is. The doctors, although they recognize its onset, say nothing about how it progresses. I don't like that term when dealing with dementia. I can see nothing of progress here. 

Some years ago, around 2003 or 4, Mom fell down and broke her pelvis. There wasn't much we could do about it. I took time off from work and stayed in Tehachapi with her for about a month. The fracture healed itself. She was described as early onset dementia, nothing too noticeable but she wasn't as stable on her feet as she should be and of course there were those short term memory lapses. In 2006 she was going to have cataract surgery. She went in for a pre-op. They discovered she had excellent insurance so they put in a pacemaker. It was a private hospital in Bakersfield. I didn't find out about it until after it was done. 

She had lost enough critical reasoning power that she failed to ask for a second opinion. There had never been a hint of anything wrong with her heart, before or after this surgery. A favorite story of hers after this was about the doctor that spoke to her in private telling her that there had never been anything wrong with her heart. The point here is how easy it is to victimize people in this condition. 

After she recovered from this surgery, she could still drive herself around town, although she should not have been allowed to. She started getting lost. On a couple of occasions she had the sense to call a friend to guide her home. I soon had to take the car out of her reach. Fortunately she had friends that were willing to help out with shopping and occasionally take her out somewhere. She could still attend bunco games but I'm told a few people got impatient with her diminished ability to play. 

Well, in January of 2009, while waiting for some friends to come by and take her to a bunco game, her hip gave out and she went to the floor. It was fortunate that her friends did come by, looked in the window and saw her on the floor. If it wasn't the very next day, it was the day after, Kern County Medical Center in Bakersfield replaced her left hip. They did a great job but I'm not sure Mom ever fully recovered from the anesthesia. 

It took quite a while. She stayed in a nursing facility for about two months. They said she'd never walk again. The first couple of weeks she was entirely bed bound and thought the sprinkler heads in the ceiling were little men looking after her. At one point she thought it was me looking out for her. With the physical therapy there she regained limited mobility but enough so that I brought her home with me. And here is where she stayed for the rest of her days.  

As I mentioned, the nursing home figured she'd never regain the ability to walk. Again, fortunately a young physical therapist came to the house two or three days a week and soon she was able to use a walker. We soon needed to worry that she would go out the front door and get lost on the sidewalk. A couple of times we did have to go out and find her, too. 

By April she was enrolled in the adult day care facility OneGeneration. This provided an opportunity for her to get out of the house and socialize a little bit. I also took her to Balboa Lake fairly regularly and have her push her wheel chair as far around the lake as she could go. She loved seeing the birds and petting the dogs people were walking. She was never able to walk all the way around, about three quarters was the maximum, once. I'd push her the rest of the way. 

During the next three years I could see a gradual deterioration of both her physical and mental abilities. She would get fatigued more easily and confused more frequently. There was another problem, too. She never had her cataracts removed. I didn't want her to be completely blind so in November of 2011 she had a lens replacement in her left eye. This helped a bit but also introduced another source of confusion, colors she sensed were different between her two eyes. Her right eye still had a milky cataract. 

Well, by August she was no longer mobile enough to go to OneGeneration and soon she became bed bound. The really big challenge at this point became one of allowing her to retain some degree of dignity. How does one go about changing their mother's diapers and hand feeding them and still provide an illusion that things will get better. She never once expressed any fear of dying, only of falling. There were also heartbreaking moments of clarity when she expressed regrets for putting me through this. 

I enrolled hospice care for her, St Jacob in Northridge. They did a great job and provided the hospital bed with oscillating mattress, the oxygen machine, and all the diapers and pads we could need. Soon, however, she became unable to suck through a straw or even be able to be spoon feed. The nurse brought a very large syringe that I could fill up with Ensure. I used this twice before she was unable to swallow. 

At this point she started to become very dehydrated and very weak, unable to speak except for a very weak whisper. I'm told people in this condition can still hear so I told he I loved her and I like to think I heard her reply "I know...". On Monday the 15th we started 24 hour nurse attendence. Every three or four hours they would administer morphine drops under her tongue. At least she was no longer in any pain. 14 hours laters she was gone, 2 hours into the second shift. 1am Tuesday morning of October 16. 

I think the hardest part for me is not my mother's passing, it's thinking about just how difficult a time she had her last three years. Everything she'd worked for and attained, taken away. She had to leave all her friends of the last twenty years in Tehachapi and return to Reseda, where there was no one but me. Yet she remained stoic and almost never complained. 

I'm not done mourning so I will probably have more to say later but this is enough for now.