No NO NO

After nine months in residential care, my wife’s behavior has stabilized again. She has also been using the rivastigmine transdermal patch for a few weeks. 

The behavior of over dressing that first occurred over two years ago has returned: double socks, double pants, and triple blouses. This now occurs after several weeks of dressing with little assistance.

Over two years ago I learned that “no” was conditional on the state of her “agitation” or the worries, as we then called this state. Just wait 3 – 5 minutes and repeat. Usually after 3-5 attempts the “no” became “yes”.

Now there are three forms of no. The first is a soft “no” with no change in behavior. She continues on with what she has in hand. The second is a clear “NO” emphasized with her traditional right hook that never touches anyone or anything. It often includes that raised eyebrow that silently controlled our kids.

The third “NO” includes a teeth-clinching grimace and a blow to the person involved. The stimulus is touching or attempting to remove something she is working with or is near but has not finished working with.

New employees over the past few weeks now ask “Miss M__, do you want to . . .” or “M__, can I take . . . “ and stand clear for the answer. Hitting has stopped.

For months I thought that short commands needed to be delivered in a rather clear and demanding voice. Asking a question for her to respond to seemed a waste of time. Now even the most soft-spoken residential assistant (RA) can get M__ into the shower or bed in a few minutes.

Last night I finally had an RA confirm the art of distracting and redirecting. There needs to be a break in attention. At that moment she can respond to instructions. The pause may only be a fraction of a second; putting something in its place and then (in an instant) stopping or turning to look for something new, for example.

6:54 pm. My wife said, “Lets just get ready for bed”, as we came back from the evening meal. She was smiling and happy. In a few minutes she was in her nightgown. This has never happened before. She is now lying down chewing two of the last pieces of Double Mint gum from our granddaughter’s wedding last week.

She wants to vote. I can still order absentee ballots by email.