An Absent Mind(32)

Dr. Tremblay





Day 261—An Update


It’s been a while since I have given you an update on Mr. Reimer. Unfortunately, but predictably, the news isn’t very good. It’s been less than a year since Mrs. Reimer called me to inform me she was having her husband admitted to Manoir Laurier. Frankly, I thought she should have done it long before, for both their sakes, but the pattern seems to be for a caregiver-spouse to go through torment, agony, and especially guilt, until he or she can’t take it anymore. I believe that’s what happened to Mrs. Reimer in this case.

I’ve been to see Mr. Reimer several times in the last few months at Manoir Laurier. His case is fairly typical, the timing of each stage approximating the median. I would have to say he is in the late stage of the disease now. That doesn’t mean he will die in the next weeks or even months, but his cognitive and physiological abilities will continue to deteriorate at an even more rapid pace, until his entire system shuts down.

One thing we really don’t know empirically is how much, if anything, patients at this stage can comprehend. We do know that their ability to communicate coherently is practically nil. Sometimes a slight gesture, eye movement, or facial expression may be conveying any thoughts they may have. Occasionally, for a brief moment or moments, for some reason especially near the end, they may appear lucid and say a few words. Whether this is by rote or an actual mental decision, we don’t know at this point.

A wince may mean they’re in pain, and then we have to do tests to discover what, if any, other medical problem they may have that might be causing them discomfort.

There are two existing tools used to identify the severity of dementia, the Reisberg Scale, I’ve alluded to previously, and the Functional Assessment Staging. Both have shown communication abilities in individuals with late-stage Alzheimer’s disease to be minimal to nonexistent. There’s a fine line between the two. The former means there is at least some comprehension, even, if as stated, it is minimal. The question is, Can they really make any sense of it, and if, so how much? So far, there has been no conclusive research on this subject that I am aware of.

Yesterday, I told Mrs. Reimer that her husband would be better off on the third floor where there is more supervision. At first, she was adamant that he stay where he was, but I could see through her tears that she really wasn’t in a state of denial, but just was having trouble coping with the cruelness of it all. I assured her it was best for Mr. Reimer.

She looked up at me, patted my arm, and said, “I know, I know.”





Monique





Day 430—A Step Closer


Today is a day that I’ve thought about for a long time but prayed would never happen, even though Dr. Tremblay suggested it months ago. Saul is finally being moved from his room on the fourth floor down to the third. As I think I mentioned a while back, the third floor is reserved for those with … those who are the … what I’m trying to say is it’s the floor for the ones I used to call the zombies. You probably remember my referring to them that way when Saul first got here. Well, now he’s one of them, one of those who are incapable of almost any normal functions, physical or mental.

The move was scheduled for two o’clock. We had a family discussion and decided it would be less disruptive if we moved the furniture and his belongings while he was downstairs at the sing-along—not that he sings anymore. That way, hopefully, he wouldn’t really notice and become more confused than he already is.

The room is almost the same size, although the windows are on the left side instead of the right. Apart from that, and the walls being green, with his furniture and paintings, it should look almost the same. This is one time when I hope he won’t notice anything.

Now it’s five o’clock, and they haven’t moved a thing. The men who were supposed to do it were held up in traffic due to the snowstorm. I can’t blame them for that, but meanwhile we had already packed up the room on the fourth floor, and here we are in Saul’s new room on the third floor with bare walls and no furniture except a stool I took from the corridor and Saul’s wheelchair. It seems so lonely and cold.

So far, Saul doesn’t look like he notices anything different. At least I don’t think so. But he’s making some of the strange noises he sometimes makes when he gets agitated, so maybe he does.

But to be honest, I think the whole thing is affecting me more than him. To be alone, just the two of us, in this empty room, unable to communicate … Oh my God, I would give anything to turn back the clock.





Saul





Day 430—Where?


NOWhere noThiNg





Monique





Day 551—A Modern Day Torture Chamber


I went to a movie last night. It was a beautiful evening, so afterward I decided to walk over to Manoir Laurier. It was about nine o’clock when I exited the elevator and approached the open door to Saul’s room. I heard hysterical howling interspersed with a barrage of swearing. A nurse, with an unlit cigarette and a lighter tucked in her hand, walked by the room, not bothering to look in, and turned right toward a small balcony off the end of the corridor.

What I saw when I got inside Saul’s room is almost beyond description. There he was, flailing away, trying to escape the restraints wrapped around his body. There were ropes strung through the sidebars, pinning down his legs, hips, and chest, so only his head could move. His face was a flushed crimson as he struggled to get up. He was like a madman, his words barely intelligible, his shrill ranting piercing the air, his head bobbing up and down. What in God’s name were they doing to him? What did he ever do to anyone to deserve this kind of treatment?