When the geriatrician said my mother had entered the “late-stage” phase of Alzheimer’s last year, I was alarmed. Late stage already? I took it to mean that the end was near, and I began doing more research, feeling the need to understand better.
The three stages of Alzheimer’s – early-stage, middle-stage and late-stage – are suitably vague, and, as it turns out, the late-stage phase can evolve quickly or over a period of years and years. The stages describe what might happen as cognitive function deteriorates, and as communication between brain and body becomes increasingly erratic. They outline a path to complete dependence, including personality changes, heightened suspicions, mood swings, restlessness and an inability to communicate. I’ve heard it less scientifically described as “returning to infanthood.”
But I’ve noticed that my parents, especially my mother, have also been mirroring the “stages of grief” as identified by Swiss psychiatrist Elizabeth Kubler-Ross: Denial, Anger, Bargaining, Depression and Acceptance. Originally developed for patients facing an incurable disease, they can be applied to Alzheimer’s as well as cancer. Possibly we should acknowledge and address these emotional stages as well?
I say this because my mother was depressed, distressed and weepy for most of last year, both of my parents went through considerable denial when diagnosed, and anger is something that has bubbled up often (understandably) as their lives have changed drastically.
But now it feels as if Mom has has turned a corner and entered a stage of acceptance. (As I write this, I hear the echo of a friend who loves to say “Cut to scene two!” whenever someone makes an absolute statement that is highly unlikely, such as, “I’ll never eat/do/say that ever again!”…. so this might be a declaration that will come back to kick me in the butt, but anyway….) Hope springs a kernel.
Then again, my mother’s state might not be any stage of Alzheimer’s or grief, it might just be her new, ingenious coping device. A lively Scottish lass. Born of frustration and from the depths of someone who always wanted to be a stage actor, my mother has invented a delightful Scottish character who “emerges” when she is having difficulties speaking, and who has been emerging more frequently recently, with hilarious results.
Even if what she’s saying makes no sense, the accent is real (her father emigrated to Canada from Glasgow, Scotland) and the transformative effect is unbelievably positive. Standing in her GP’s office last month, she treated him to a full-on lecture from this imaginary Scottish gal, complete with finger wagging and wiggling hips. “You dunna noo what way you are goona be new!” she said, eyes wide and sparkling. “It’s a hoona dune for me and for you!” He stared at her in amazement, then turned to me for clues. Dunno! This is all her, and so adorable.
The caregivers have been treated to visits from the Scottish lass, and we all encourage “her” to come out and play. Last week we went to visit Mom’s best friend Sally – something she has been avoiding, painfully aware of her inability to have a normal conversation. Just before we left, Mom leaped into character, treating Sally to quite the performance, with Sally screaming “Stop! I’m going to pee my pants!”- she was laughing so hard. Seeing the two old gals giggle together made my heart swell.
Bottom line? Mom still has the power to make people laugh, and she’s using it to change the conversation. Instead of puzzled expressions, her Scottish damsel character is greeted with smiles and chuckles, which is a better outcome for everyone. Amazing, isn’t it?
Mom is calmer and more relaxed than she has been for a long while. It’s good to see, even if it can change in a nanosecond. We are going to our first “talk” therapy next week, and I’m eager to see how it goes. Just knowing that we have this appointment has perked Mom up – it means that we are listening to her needs and trying to meet them. I believe that if you have faith in someone and you’re not willing to give up, it can mean a lot to the individual who is struggling. So many of these lessons are universal.
Na tréig gu bràth, na géill gu bràth. And wah saw the tottie hookers!
“The best acting is instinctive. It’s not intellectual, it’s not mechanical, it’s instinctive.”
– Craig MacDonald