Friday, 18 September 2015

How's your life? Interview....

A tale of two lives at the kitchen table this morning: Okaasan's view of her life...and then our view of her life.
And the city office interviewer trying to make sense of it frantically on her clip board.

After the recent mental health interview, this was the final Public Care Status interview, which determines what public assistance we can get in the next 2 years.

Okaasan's Daily Okaasan:

I go walking almost every day. I go to Odori (downtown) by subway almost every day. I meet my friend. Go shopping.
Yes - I have a bath, brush my teeth, brush my hair. Of COURSE!
Food? Um - what time? Um. Cooking? Um. Microwave? Um.
How many people live here? Um?
What season is it now? there a calendar? Um...autumn? The day? Um.
How old am I? Um...around 80?
What time do I go to bed? Wake up? Um....
Do I sleep on a futon or a bed? Um.....
Yes - I cut my nails! Of COURSE!
Doctors? Hospitals? Health supplements? NO!!!
Can I stand on one leg? Can I get up and down from the carpet? YES!

Okaasan's Daily Dear Son and Moi:

Walking every day, if the weather is good.
Downtown...once a month in the past year or so.
Sometimes confusions about money/tickets/possessions.
Doesn't get lost.
Doesn't bring back other people's possessions.

Has a bath/cuts nails if we direct her to do it. Can do them herself.

Food - can feed herself (messily). We do all the shopping and cooking. Lunch box deliveries and food left out for her to eat.
Microwave ok. Cooker - rarely uses and burns pans when she does.

Money control - we do it for her.

Goes to sleep and gets up herself. Sometimes we get her up in the morning. Lots of daytime sleeping.

Endless repeat conversations. Random - unconnected topics common.
Mixing up of childhood and adult stories and places.

Thinking long ago life and people is happening now? No...not really.

Can't follow complex explanations - we leave written messages about plans.

Awareness of seasons/weather - patchy. Clothes choices sometimes not suitable.
Night time wandering? Eating? No - not that we know!

There was the Remember 3 Things test: Apple/Car/Train.
I scored 2 and a half. WAS the third one train? Okaasan was a complete blank. She couldn't name any of the things. Even with a hint.

The city office staff was obviously impressed by Okaasan's physical ability: balancing on one leg, getting up and down from chairs and the carpet, turning over, stretching out her arms etc. All very good for 85 years old.
She IS good.
Many of the questions made me realize that so many elderly people have a whole range of physical limitations/weaknesses. Okaasan really doesn't.

But: the mental ability is also clearly not so great. The silences, or hesitant answers to questions about self and routine showed that.

I think it is sad: Okaasan is/was a physically healthy person. She used to walk and do hula dance. Socialize with people. Look after herself. Eat sparingly and well. Travel. Study. Learn. In her late 60s and 70s she was doing all the things you are supposed to do.

But still. In her late 70s this thing called dementia crept up. By 77 she wasn't cooking for herself, she wasn't managing money very well, she wasn't cleaning. And then her son took the decision to look after her.
Physical activity is Dementia 101. But doing it doesn't protect you. By the age of 77 and 78 Okaasan was on the slippery slope.

The interviewer's question about believing past events are in the present was interesting. She went on and on explaining what she meant by this: and Dear Son and I couldn't think of anything that demonstrates that with Okaasan.
She doesn't mistake delivery men for her father, or think the Sapporo supermarket is a Kawagoe shop. Nothing like that.Yet....
Although....the recent "there are four people living here" answer to the Census taker maybe shows confusion about her current living and the past as a wife and mother in Saitama.

All in all a good interview. It was an honest laying out of Okaasan's mental/physical status at the end of 2015.

The interviewer was a totally nice, middle aged woman. Professional and friendly. But - I DO wonder why they do the interview with the family members right in front of the client. We sat there dissing what Okaasan had just said. No - she can't do that. Nor that. Not that. No - she is wrong. It's hardly a warm, positive feeling to hear your family disagree with you in front of a stranger. There was NO suggestion that we should talk privately in our part of the interview.
Bad I think. But then if we did - would Okaasan be suspicious about us talking to someone without her hearing?

After the woman left and the three of us were in the kitchen I chatted brightly about: what a nice woman! Yes, she was surprised at how flexible your legs are!

Okaasan for her part tried to explain away the not going downtown: I don't go recently? Really? I don't have any money? I don't have a card? The weather is bad?

And then I came to work. Dear Son started cooking curry. 
And Okaasan retreated with a cup of tea back to the TV and safety.

We wait now for the Day Care manager to arrange this winter's care. Once a week trip by taxi to the supermarket would be good.


Now: Tell me - what were those 3 things I asked you to remember earlier?

Can you tell me?


  1. Oh no, I could only remember apple and train. Oh dear. And I am half her age!

  2. Ooh, you almost got me with that question. I remembered though, probably because I was thinking about what the question would have been in Japanese... anyway, hopefully I still have a while before the memory starts going!
    Thinking back on your posts over the years, there's definitely a clear decline. In the beginning, weren't you going to have her live next door? And the plan to get her to join hula classes, the toilet problems, that time when she needed money for a magazine or couldn't figure out how to get home.. Perhaps the thinking past events are happening now stage isn't too far away, or more than likely, it's already starting to creep into her life? It seems like you two are managing to give her a fairly high quality of life at the moment though, tough as it may be sometimes (and those winter months alone with her are coming up soon...) I just wanted to say that I admire how you're continuing to manage the situation. I will be interested to see how the Tokyo trip works out.. hope nothing too drastic happens, although I'm sure there will be some stressful moments for everyone. Thank god some other members of the family finally stepped up to help out!! (if only for a day or two!) Polly

    1. Hey there - thankyou for reading such a long time :-)
      Yes, there IS decline - I think also now we are more relaxed with it - so we are not surprised and noticing so much. We just provide home comforts: shopping/cleaning/food/bath/hair cuts/toe nail trimmings/magazines - and she drifts from day to day, month to month. Year to year. She doesn't have to expend nervous energy on things like hula dance clubs, or daily life activities - just sit and watch TV/sleep/eat/go for a walk/listen to family chat. It must be good for her.
      I also think that we only know what she SAYS as expressions of her thinking - she may mix up a lot of past and present in her thinking....but if she doesn't say anything, we don't know it.