Cussing is Cathartic

How quickly my mother's condition is deteriorating now!  She is extremely reactive to anything we do, flying into angry fits and threatening us.  Some of it is actually laughable but most is just sad, patience-testing, and anger-provoking.  I knew about various mood changing drugs that would help but was opposed to using them.  I worried about side-effects and hated to administer something artificial; but after putting up with her little outbursts for several weeks,--each one being a bit more violent, I finally contacted her doctor and received a prescription for anti-anxiety, anti-agitation drugs.  "A few drops will calm her down," I was told.  So off I went to the pharmacy to pick up a tiny bottle that cost $55 (our portion of the payment AFTER insurance had paid over half of the total!)  I couldn't wait to administer the dosage and see if she would become a calmer version of herself.  

The first day, there was no change but the second day it seemed like Mom was more of a Zombie than usual. At least there were no emotional outbursts though.  Then day three hit. I walked into her room to help her get up and get dressed.  Her Depends were off (she removes them at night) and there was a large puddle on the floor of her bedroom. As I walked in narrowly missing stepping in the puddle, I saw that Mom's nightgown was on backwards indicating that she had removed it at least once during the night.  Well, at least it was back on her and she hadn't been running through the house naked!  I removed her clothes from the locked closet with Mom standing next to me practically panting with anticipation and pointing her finger at the shoes on the floor.  
"I need the...the...those!" she reminded me. (Mom couldn't remember what the shoes were called but she most certainly remembered that they were in the closet.)  As she sat down she was more focused on the shoes than on getting dressed, freeing herself to grab at them every few seconds.  (I should note that dressing Mom is like dressing an octopus. Her hands grab at everything and she is unfocused on the job at hand.  If left alone, she would wear nothing but her shoes and be perfectly fine with that!)

When I finally managed to get Mom downstairs I was already in a lather since her room was hot and I was working fast and furiously to get her dressed quickly.  I took several minutes sitting under the ceiling fan rotating on the 'high' setting to recover and cool off.  Then I began my day.  Mom sat at the counter eating her breakfast and blowing her nose in her napkin.  As usual, the napkin was then placed on the counter where she took her mug and ran over the top of it 'ironing' it flat.  

"Please don't do that, Mom."  I told her like I had never told her that before,when in fact Skip and I tell her that at least five times per meal.  "The napkin is dirty. You blew your nose in it.  Throw it in the trash."  

Mom argued that the napkin was clean.  As always, I showed her the wet spots and told her again to throw it in the trash.  I would have done it for her but was handling food and didn't want to personally touch the napkin.  Mom sat stubbornly refusing to throw the napkin away and eventually, I reached over and tossed the napkin in the trash.  Problem solved!  Mom shot me a look of defiance grabbed another napkin and blew her nose.  Then she place that napkin on the counter flattening it with her hands.  I turned my back on her and walked away counting silently to 10. When I turned back, Mom was headed for the screened porch and  I was able to retrieve her breakfast dishes, dirty napkin, and coffee mug that was covered in sticky jelly. (It is always a risk handling Mom's dishes!)

All morning Mom walked in and out every couple of minutes.  She was agitated and yet, stupidly, I thought that I could handle it.  By noon, when I fixed her lunch I was so tired of being patient and understanding I could barely wait to feed her and get her back outside.  Again, I dealt with the napkin-turned-tissue that Mom refused to throw away and instead turning it into some sort of origami project.  

"Stop handling that!  It's dirty."

Mom scowled at me and continued to run her fingers across the mucous-soaked napkin.

"Ugh!" I gagged.  I opened the cabinet to show her the trash can.  "Put your napkin in here."

Mom lifted her plate and started to throw it away.

"No!  No!  Not your plate.  Your napkin!  Throw your napkin in the trash."

"I don't have to and you can't make me!"

"Oh yes I can!" I had reached my breaking point.  "Now do it!"  (Mom sat stubbornly, refusing to cooperate.  She mumbled something that was unintelligible.)  I shook the trash can at her and coaxed her a little impatiently.  

She looked away and said, "Stop it!" 

"These are my rules," I told her.  "You have to follow them."

Mom screamed loudly saying that she didn't have to follow my rules.  Now we were in a full-out battle of wills.  I was not going to back down even though I knew that I was dealing with a temper tantrum from a two-year-old. Instead of being the adult though, I countered with my own display of temper and need to control.  "You do this now!" I bellowed in my authoritarian voice that implied the words, "YOU WILL OBEY!!!"  At this point, Skip, who had been working in his office, came running to see what was going on and to keep the two warring factions from killing each other.  When he approached, instead of becoming 'Peacemaker' he entered into the fray.  He told my mother to listen to us and do what she was asked. When she refused, he took her napkin, threw it in the trash and told her to get down from her stool and go sit down in the family room.  When she refused, he guided her taking her by the hands and placing her hands on the walker, then pointing the walker in the direction of the family room.  I could see Mom's face.  She was furious.  By the time she sat down next to me I decided to take the high road and talk to her with a rational and calm voice.  "I can see that you are angry.  Why?"

"Because," she sputtered, "Those people over there think that they are such big shots and they're nobody!  I'm going to get my husband to take care of them. They'll be sorry!" She threatened this in a voice filled with malice.  

(It was definitely time for a dose of the medicine.)  I reached over and administered the dropper-full smiling sardonically.  Within minutes my mother was calm and cooperative.  So much so, that when it was bedtime I didn't think that any more medicine was needed.  Oh how wrong I was!  All night, Mom remained agitated and walking around her room, refusing to go to sleep.  I was too sleepy to responsibly administer any medication and endured the noise and commotion coming over the monitor.  By 1:30 Mom had opened the door a couple of times and Skip got up to put her back in bed.  Mom refused to lie down so Skip assisted her guiding her backwards with his hand on her arm.

"Don't touch me!" she shouted.  "Don't you dare touch me!"

"I'm just trying to help you lie down," Skip told her patiently.

"Get your hands off of me, you Son-of-a-Bitch!" She fumed.  (Mom never, ever said that.  I never heard her use that expression nor did she ever use bad words.  She was always the picture of decorum and propriety.  In all my life I had never heard those words coming out of my mother's mouth. But here she was at 2 AM cussing at my husband.)  There was a long pause and then I heard the door open and close.  Skip returned to bed trying to control his breathing.  I could tell he was upset.  

"What happened?" I asked.

"She called me a Son-of-a-Bitch!" he repeated with disbelief.

I laughed out loud.  What next? I wondered.  Would she drop an 'F' bomb?   For someone with Alzheimer's when there is little control over one's life, one's words, one's actions and even one's thoughts, maybe cussing is cathartic.  Maybe that was the one way my mother could express herself when all other words escaped her, when cognition was limited, and when more than anything, she wanted to be at peace. It was as if we kept poking her with a hot poker until she reacted.  She didn't understand, didn't know why, didn't care.  She wanted to be left alone.  Sadly, I fell asleep understanding this and yet feeling helpless to do anything about it.  I am Mom's caregiver, but felt overwhelmed and more than a little over my head, incompetent, and exhausted. Recognizing this, I was immediately grateful for the answer that came in a small amber bottle with a dropper dispenser.  
Just before drifting off to sleep two things struck me: first I thought of Charlton Heston screaming, in Planet of the Apes; "It's a madhouse, A M-A-D-H-O-U-S-E!" Immediately my mind switched to One Flew Over the Cuckoo's Nest when the patients were given their daily dose of medication to keep them compliant, drugged, and docile.  Was I turning into Nurse Ratched? A small nagging guilt grew inside of me and yet...and yet...I knew that there was no way I could or would be that calm, composed caregiver that could tolerate the cussing and violence.  Yes, it's a madhouse and I have the means to make things better.  I fell asleep with the knowledge that I was doing the very best I could do.