Author Nicholas Andrefsky never envisioned that he would one day be a caregiver. Nothing in his life prepared him for that daunting task, but he was in need of money and his dearest friend on the planet asked for his help. Caring for Mary documents the ups and downs of his time as a caregiver to the strong-willed Mary as she struggled with dementia. Mary was no pushover, but Nick took a unique approach to understanding her needs. They bonded, and she came to view him as a trusted ally instead of an enemy. He recalls several different scenarios that occurred as he cared for Mary, complete with straightforward, occasionally humorous, and always honest in the assessment of how to handle each situation. His message is that you must understand that the person for whom you are caring will not change, that the best way to work with them is with humor and understanding, allowing them to maintain their dignity. Being a caregiver is not easy, but it can be rewarding when handled in the right way. Dementia is not reversible, and it grows progressively worse as time wears on. Even so, there are glimmers of recognition and humor, both of which come shining through in these winning stories.

Caring for Mary

One Caregiver's Humorous Dialogues with a Demented Old Italian WomanBy Nicholas Andrefsky

iUniverse, Inc.

Copyright © 2012 Nicholas Andrefsky
All right reserved.
ISBN: 978-1-4620-9759-3

Chapter One

Getting Started

Meds may well be the hardest part of the journey because they are critical in my case. Timing is everything, and the daily routine cannot be ignored.

Mary suffers from colitis, diverticulitis, high blood pressure, and anxiety. She is also sensitive to nearly everything she eats. Learning to keep the meds down was a trick in itself.

I eventually figured out that all forms of fiber upset her stomach. This would cause her to vomit her meds or have diarrhea. It was a protein and starch diet for her. Since her favorite snack was anything with sugar, I had to hunt down something sweet that wouldn't pack the pounds on her. Flavored mini rice cakes were the way to go. They are low in everything, and she thinks of them as a treat.

Mary also suffers from an insidious cough. This cough is so wet it sounds like pneumonia. The few times we made the trek to the hospital, I had to assure the doctors that her left lung always manifested like pneumonia and to ignore it. This was not easy to do as a layman. I finally got her primary physician to make a note in her chart that she had a bad left lung.

I discovered that she was allergic to dairy products. When she stopped eating them, the cough slowly abated. We had to wait till she was unable to care for herself to get her to stop ice cream—a dietary staple. Speaking of staples, because she could not have roughage, she had stool softeners. More joy there.

Nicholas: Ah, honey, you're awake.

Mary: I don't know what I'm doing.

Nicholas: I could tell by the two skirts, two blouses, and one nightgown you put on over your other nightgown. Did you change your undies?

Mary: I think so.

Nicholas: Then where are your dirty ones?

Mary: I don't know.

Nicholas (after some in-depth search): Could this be them under your pillow?

Mary liked to dress herself because at one time she was the nattiest of her legal secretary sect. She prided herself on looking pretty. We ended up simplifying things: four lovely cold-weather dresses for when she was going somewhere nice, four lightweight mid-calf-length summer skirts with many mix-and-match lightweight tops. Even a colorblind goober like me was easily positioned to keep her as fetching as an eighty-seven-year-old could be. She was cold all the time, but that is its own chapter.

Lesson Learned: Know your charge's meds, the food they like, and routine, routine, routine.

The Poop Chronicles

The primary problem with Mary dressing herself isn't the multiple outfits as much as it is the hide-and-seek with dirty underwear. We switched over to adult diapers but called them undies to save a little face—but a little more on this later. It is hard to do when someone is doing the following:

Nicholas (through closed bathroom door): How we doing, honey?

Mary: Not so good, dear.

Nicholas (coming in through a poorly locked door): Let's see what's going on, shall we?

Mary: Oh, honey, I'm so embarrassed. I'm nearly naked.

Nicholas: You're embarrassed about being nearly naked, not about getting poop all over the floor, your feet, slippers, and hands?

Mary: You be nice to me.

Nicholas: I am being nice. I could toss you in the tub headfirst but instead will allow you to disrobe like a lady and step in so we can clean you up.

Mary: Thank you, honey.

Ah, stool softeners. Where do you think we'd be today without them? Probably cleaning up little brown marbles instead of entire bathrooms. It wasn't that simple, though—we had some tweaking to do to stop the following from ever happening again.

Mary (emerging from her room): Honey, I have a problem.

Nicholas: I can see that. Your jammies are covered with poop from waist to foot. What happened—couldn't make it to the toilet?

Mary: I don't know, dear. I just don't feel good.

Nicholas: Let's get you on the toilet. (We strip off the jammies—but not quite in time to make a clean landing. Diarrhea squirts everywhere.)

Mary: What's going on?

Nicholas: You've got the squirts, honey.

Mary: I don't think I like it.

Nicholas: That makes two of us, darling.

She pooped for a while, got in the shower, squirted a little more, and finally stopped. Before we continue—a note about the jammies. Mary had a penchant for removing her undies when going to bed, peeing or pooping the bed, and not knowing why she was filthy in the morning. Beth came up with the button-up footed jammies with the feet cut out. Mary had a problem with the buttons so the undies stayed intact all night, making less of a mess for moi.

Back to the softeners. The one extreme was explosive diarrhea. Here's the other:

Mary: Honey, there's something wrong.

Nicholas: Yes, dear. There is blood everywhere.

Mary: Why do you think that is?

Nicholas: My guess is you tried to poop and had a blowout. Have you tried pooping?

Mary (embarrassed): Yes.

Nicholas: And?

Mary: I did a little, but the blood came out.

Nicholas: Are you done pooping?

Mary: I think so.

Nicholas: Okay, let's get in the tub.

Mary: I don't want to take a shower.

Nicholas: You're not going to take a shower. You're going to depoopify yourself.

Mary: Okay, dear.

Yes, occasionally you have to use harsh language like "de-poopify" to drive your point home. I wish this were the end of the Poop Chronicles, but there is another issue that needs to be addressed.

Nicholas (through the badly locked door): Honey, are you putting your hand in the toilet?

Mary: Don't listen by the door.

Nicholas: I wasn't listening. I was passing by and heard splashing. Are you putting your hand in the toilet?

Mary: No.

Nicholas (toilet crashing again): Then why is your hand wet? Why is there poop all over your hand and under your nails?

Mary: You be nice to me.

Nicholas: How exactly am I not being nice to you?

Mary: You shouldn't be asking me such questions.

Nicholas: And you shouldn't be lying to me. Are you done?

Mary: Not quite.

Nicholas: Then, honey, use the baby wipes next to the toilet.

Mary: Okay.

Nicholas (just outside the door): Now how we doing, honey?

Mary: Better, I guess. (splash)

Nicholas (enter SWAT guy): Honey, why are you still using your hand?

Mary: I'm not.

Nicholas: But, honey, you are. Look at your hand.

Mary: You can't tell me what to do.

Nicholas: Okay, clean up when you're done.

You know, folks, there's only so much you can do—unless you want to do it yourself. I have placed those darned wipes in her hand, on her lap, and made her swear—but it's still all about the hand. Eventually I just cleaned up after she cleaned up and had to accept that.

I don't know where the disconnect happened, but—somewhere along the line—this tiny, pretentious Italian woman convinced herself that wiping her butt with dirty toilet water was okay.

Lesson Learned: Like with everything else in life, choose your battles.

Bathing

Beth had a theory that...