Calm after.

Thankyou all for your congrats and virtual highfives :-)
I feel as if there is a big army of supportive lurkers behind me.

Okaasan seems fine.
last night at dinner she was calm and chatty and happy. She'd been out for lunch with Dear Son, she'd been out for a walk alone. At dinner she chatted on and on happily about how-my-cooking-school-was-near-the film star-Ishihara's -house-and-even-my-husband-came-to-look...telling us many, many times that old familiar story.
Seemingly no stress after the day service home visit and 74 question interview.
Amazing.
Maybe because it was at home? A young woman? Talk about exercising in winter?
She was calm.

I thanked Dear Son for his efforts by buying him two bottles of Belgian beer.
Wow. Great.
Now we are IN the care system. People who know things know about us and our situation. They will help. I hope.

We await the next stage.

VICTORY!!!!!!!!!!!!!!!!!!!!

Victory!!!! Victory!!!! Victory!!!!!!

Dear Son is a saint.

I am an awesome, all-powerful Oyomesan.!!!!!!!!!!

Care Section of Toyohira Ward Office in Sapporo is stupendous!!!!!

A young woman came this morning and spent an hour or more at the house, talking to Okaasan and Dear Son. She interviewed Okaasan with a 74 question survey.

"What season is it now?"

"Spring?"

"Does Sapporo have snow in winter?"

"No, Sapporo doesn't get much snow..."

...and other winners...  :-)))

The next stage, apparently is that she decides what level of care/service Okaasan needs and gets back in contact - after reading the doctor's report. And then, maybe in December we get a choice of suitable day service centers that would love to stimulate Okaasan's mind and body.

And Okaasan???

She seemed to go along with all of this. The fact that the roads are bad in winter and this will be her way of exercising.
To make sure of that I printed out 3 photographs of our street in winter, piled high with snow...and gave them to Dear Son to use as evidence.

Towards the end of the interview, Okaasan told Dear Son to leave the room and leave her alone with the city office woman! Either embarrassment, or could it be (hopefully) a taking control of the situation for herself? My health. My discussion? That would be good.

Or????? "I hate these people, please find me an air ticket back to Saitama, I must escape them....specially that British woman who interferes in everything.."

That would be good too.

So. The day has come. I really have wanted this day for SO long. Can't tell you how happy I am.
In fact, when I sat with my Dad's body in the funeral home in England 3 years ago, I told Dad "don't worry, we will get Yujiro's mother into day care or something, don't worry about me, it will be ok..." and then I cried a whole lot more. Sitting there with my Dad's body, clutching his favorite chocolate biscuits.
How's that for drama?
I know my Dad and step-mum worried a lot about me and this situation - the stress it was putting me under etc Yujiro's attitude to outside help.
Now, wherever they are - they can rest on this subject.

Maybe.
Of course, we haven't got Okaasan into the bus and into the doors of the day service center yet.
But we are another step nearer.

I didn't leave anything to chance though.
This morning I printed out my friend's translated letter. The one I gave to the doctor. Then I stuffed it in an envelope and rushed to the city office on my way to work at 9.15 am.
Bugger whether the city office care manager thinks I am an over-micro managing Oyomesan. Bugger that. THIS is important to me. I am a big part of the decisions and care of Okaasan, and I want my voice to be heard.
So I delivered it to the care managing desk - actually into the hands of the poor woman who was heading out to see her first client of the day.
She was a worriedly young-looking woman. Kind of social services/librarian type. Would Okaasan walk all over her. Would Okaasan be fooled by her youth into letting her guard down?
I wondered. And wondered. All the way to work.
Shit. Would she show Okaasan the letter, by mistake or on purpose?
In fact, I rushed back into her office to make sure: this letter is for you to read now, NOT for my Okaasan - despite the fact her name is on the envelope.
I was that nervous about it.

No worries. Maybe. She DID talk about the letter to Dear Son in the entrance hall of our house...surprising him a bit (but he is used to his micro-managing woman after all these years...). So, we hope Okaasan didn't hear that conversation!

Ahhhhhhhhhhhhhhhhh.

So Happy.

I did it.

C Day

Care Manager Cometh Day.

Wish us well. LOTS of positive thoughts two hours from now please - directed up to north Japan.

:-))

Showing she CAN?

These are bits of cut up giant raddish - drying for later-pickling. A very popular, autumn activity in Japan. All over the country at the moment people in villages, towns and cities (amazing that really) are hanging up giant raddishes and drying them. It's a sign winter is approaching.

And Okaasan did too.

Absolutely amazing. So, I took a photo.

Okaasan hasn't prepped/cooked ANY food for...what?...a year or more? And suddenly this?
I went into her room late afternoon to close a window and found the curtains neatly pinned together with clothes pegs, and a kitchen basket and a plate full of raddish bits, placed by the drafts to dry.
In the kitchen was the cut off top of the raddish, a supermarket box and a receipt showing Okaasan had gone out and bought it about 2 pm yesterday.
Come home. Done all of this. And then...gone out again, as per usual, about 4 pm.

Really amazing. She looks at cooking shows on TV endlessly, she writes down recipes, she stares at recipes in magazines, she cuts them out etc etc But she never actually DOES anything.
It is a real clearing of the dementia fog. This is something she has probably done every autumn of her adult life. And I bet she helped her mother do this as a child too. Something yesterday - maybe on TV - made her get up and go shopping and prep the raddish for autumn.
I am not exagerating, she really never, ever preps any food. Once in a blue moon heats rice and an egg in a pan (and burns it), heats and forgets things in the microwave occasionally, boils water in the kettle. That is it. Not Decide/Shop/Prepare something.

5.30 pm Okaasan comes home. I help her into the kitchen with a plastic pot of Oden (simmered veggies and fishpaste sold in convenience stores). Great. If she is eating this at 5.30 pm she won't need dinner at 7 pm. I go to the toilet and come back to the kitchen. Okaasan is looking at TWO pots of Oden on the table.
"Did you buy this? Who bought this?"
Well, obviously not me...

In her bag she had one pot, in her hand she had a second pot. She had gone to two different shops? The same shop? And bought the same thing. Buying Oden actually involves standing for a few minutes and talking to the shop staff, because it's displayed in hot tanks on the counter and the staff fish out the bits that the customer orders.
So, Okaasan had stood twice yesterday afternoon talking to two staff in one or two shops, ordering the same thing. And bring it it home.
She was pretty surprised to see two pots :-)

I was happy. Easy Saturday night for me. Yujiro was out at a party. Okaasan could eat her Oden. And I could have a quiet, relaxing dinner myself later by the TV. Easy. No dinner chat required at the kitchen table.

So, there. Another odd day in dementia.
Clearing of the dementia fog to prepare a seasonal food. And then complete fog-out a few hours later by shopping for the same thing twice.

Later Yujiro and I talked about it and he said:
"Sometimes recently I feel she is making a real effort to DO things, to show us somehow that she may be old, but she isn't incapable etc. She wants to wash dishes, the wants to prep food like this."

I agree....to a point. We never talk to Okaasan directly about her dementia. But I think on a basic level she does recognise her failing abilities and every-now-and-then she seems determined to DO stuff. It's great. It shows the woman she was is still there - wrapped in a fog of mindlessness a lot of the time - but breaking thru it sometimes.
The "sometimes" is "sometimes" though. The very fact of my amazement at finding the drying raddish shows what a rarity this kind of activity is for her. It's a parting of the fog for a moment. And then fog returns.

And tomorrow? 9.30 am. Cometh the day care manager.
She'll see the drying raddishes too. Hope that doesn't gain Okaasan too many ability points! Glad I've left the room uncleaned. :-)

Finishing with cute cat picture.
Sunday morning with the newspapers.
In the newspapers? Under the newspapers?

To clean. Or not to clean.

That is the question.

Should I go into Okaasan's room this weekend (as I always do) and clean a little - enough so that the rats aren't partying-on-down amid the rotting food, soiled underpants and layers of dirt...but not enough that Okaasan notices any difference?
Always a fine line to walk.

Monday morning a city office Care Manager person will come to check Okaasan and her living situation.
I'd like them to see her normal living space - the clutter, dirt, unfinished/forgotten activities. Because it is all clear evidence that she needs help in life.
But I don't want them to report me for Old Lady Abuse to Social Services!!!
"My GOD! What kind of Oyomesan is this, that lets this confused old lady sit and sleep amid piles of trash? What terrible people!!! etc etc".

So. A bit of a quandry this.
Hmmmm.

I'm not sure when Yujiro is going to TELL Okaasan that a Care Manager is coming at 9.30 am Monday. Knowing him, probably about 9.15 am.
The news is sure to stress her and panic her into room cleaning. That usually means scooping all the clothes off the sofa and dumping them on the floor in the other room.
I'm hoping/guessing the Care Manager will view both rooms.......

Hmm..what to do.

If the visitor sees the trashy room they will get a very good idea of Okaasan's abilities. Hell, they might even decide poor-full-time-working-Oyomesan is so pressured they'll send a care staff to HELP Okaasan clean once a week!!!! That would be awesome.
Or: they will think I am ignoring the plight of this old lady and report me to the police.....

Hmm.

Nice day today. I've just cleaned my living space and put bedding outside (we are both having nasty insect bites at the moment from being forced to share our bedding with two cats...)...hmm...nice day...this afternoon I am going to see the autumn colors at the university...and then to a movie about Tohoku.
Tomorrow? Forecast says rain. I may stay home and watch movies on TV, read newspapers.
Hmm....busy weekend.

Don't think there is any time in that for cleaning Okaasan's room.....

Think it's a "Not to clean" then.

Very. Bad. Oyomesan.

:-)

One-sided fighting.

This week Okaasan and I had a fight.
Apparently.
Cos she forgot to tell me. So I didn't know.
Just as well, really. That's the best kind of fight: one-sided.

All was fine.
Yesterday afternoon Yujiro got a call from Okaasan, while he was working.
"I want to out shopping, and I don't have any money."
"Ahh, I won't be home for about 2 hours. Can't you ask Oyomesan?"
"No, I don't want to borrow money from her. We are fighting!"
"Fighting? No, you're not fighting with Oyomesan. Ask her for money, when she comes home".

I got home about 4 pm and found Okaasan in the entrance hall with her coat and bags - she asked me for money, I gladly gave it to her (had forgotten to dole out a little in the morning) and off she went.

Yujiro told me later that I was in the middle of a fight with Okaasan, which we both found mysterious - because I wasn't to my knowledge fighting at all. However, looking back at Tuesday night dinner time Okaasan HAD seemed a bit stony faced and quiet while we prattled on about things.
Was that a fight? Over what? I took laundry from her room to do on Monday afternoon...as usual...was it that? I do that every week....

All very odd.
At 7.15 pm we all met in the kitchen for dinner. I felt nervous: would there be some terrible atmosphere and then accusations about "you go into my room and steal things" etc etc.

I walked into the kitchen. Okaasan looked up, all smiles and cheerful. Greetings. Response to chat. Giggles about the cat. Comments on the the food. All fine.
?????
The fighting had come....stayed a while...and gone.
Strange.

Care Manager Home Visit

Next Monday.
That's the next stage of the process.
At 9.30 am a city office care manager person will come and surprise the hell out of Okaasan by talking to her about how-nice-it-would-be-to-go-daycare....
It'll interupt the sleeping in front of the TV shopping, which is usually what is happening at 9.30 am.

Dear Son will be here. I will be at work.
Surprisingly the city office said only one family member had to be here.
Although I'd love to be here when the meeting happens - to see how it all plays out (and report back here in grim details!!) - I also think it's maybe best that I am NOT here.
That way Okaasan can keep this whole topic separate from ME in her mind, and maybe not blame me for the whole thing. She can blame Dear Son, but basically she loves him and trusts him - and after a few days of anger...will soon feel that way again.
If she suspects (as is true) that I am the instigator of all of this intrusive stuff. God help me!

So. I won't be here. Mother and Son and the Care Manager.
Oh, so wish I could bug the kitchen and hear how THAT meeting goes down.

I've already said to Dear Son, that if Okaasan refuses to go to day care even once a week - we should pay for a taxi to take her there and bring her back. Maybe she'd prefer that to getting in a bus with lots of wispy old people. Or pay for a taxi to take her to the local subway station so she can catch the subway downtown and exercise.
ANYTHING to make sure she goes out this winter and does vegetate by the TV.

But of course, I would be so so much happier if she would at least go and see a day care center.
There is a amazingly place near here - a big, pink building that looks like an annex of the Disney empire...and inside are hula dancing and stretching classes, and karaoke and hair salons - all SORTS of fun activities for an old lady. I see the pink and white vans for this place all over the neighborhood.
This is where I dream of Okaasan happily going once or twice a week.

But first....she has to agree to that idea.
The battle will begin next Monday.

And back again.

Okaasan is back.
Back to the kitchen table for family meals.
Back to talking to us.
Back to giggling over silly things and shuffling thru her routines.

Relief.
It is amazing how the voice and face changes. From Friday evening to now. So different.
Yesterday I bought gyoza, Chinese fried dumplings. They are one of Okaasan's fave foods - so much so that she doesn't need the ubiqutous bowl of white rice - cos she eats SO many dumplings. :-)

And so we sat at dinner, the three of us again. Talking about weather and cats, dumplings and noodles featured on a TV show.
All memory of Friday's events seemingly faded.
Until a care work arrives in our midst to talk about day center. Whenever that will happen.

The anger scale.

On a scale of 1 - 5.
HOW angry was Okaasan with us this weekend?
If 5 is sharpening the knife and digging a place under the floorboards...

Friday night after the clinic : 5. Grunts and a stony face.
Saturday morning: 4. Words, with fury behind them.
Saturday evening: 3. Words, with the minimal of politeness and eye contact.

She kept to her room all the time. Didn't want to eat with us in the kitchen. Shuffled into the toilet, but didn't say anything to us in the hallway. Went out for a walk and came home ok.

And so. She's pissed with us.
Yujiro is really worried about the change of mood. He said she seemed fine after the clinic and on the way home. But by the time he'd left her for an hour or two (went to put in the day care application directly at the city office GOOD man)...he came home to find the grunts and stony face.
I'm not worried. I've been the object of her anger before, so it's ok. Leave her alone for a few days in her own space, leave food out for her. She'll forget the details of Friday and come back into her normal routines and personality.
I hope.

I hope she'll get back some friendliness towards us by the time the next stage in this process happens: the home visit from a city office case worker. Of course, I'd like that to happen next week - but maybe it's better of there is a gap? Okaasan needs a few days of her routine and happy feelings. A stranger coming to check her and her living conditions and talk about day care wouldn't be the best thing right now.

It IS all for the best, but to get to the going-to-wonderful-daycare point I am sure there are more battles and stress ahead. Okaasan's dementia is probably going to get stronger for a while, under the stress and change, and then (I hope) settle again.

Meanwhile: I have a head cold. Last week too much stuff and stress. Not surprising really. I'm going to take myself to see a movie today. Forget about all of this.

And so............

Quiet here tonight.
We are watching baseball, hoping the local team will win this stage of the national championships.
Okaasan is sitting in her room downstairs watching TV.

We had dinner seperatly. We ate first in the kitchen and she stayed in her room. Then after we finished and came upstairs, she went and got food and took it into her room.

The doctor said:
Okaasan scored 15 out of 30 points in the dementia test. Not early stage dementia anymore, pretty advancing dementia. More than we thought.
Even before meeting the doc, when the nurse asked Okaasan: "How often do you have a bath?" she cheerfully said: "Oh, every day!", and when Yujiro corrected her she said:"you don't know because you are out, I have a bath". Of course that could, techincally be true...but it isn't for sure. She always does laundry in the bathroom and leaves the water in the bath, and wet towels around.
That only happens when we TELL her to have a bath, once or twice a week.

The doctor says a recommendation for day care shouldn't be a problem. Dear Son should go back to city office and make the application, she will recommend it.

Phew. All of it.
But for now, we are quiet.
He is feeling down - "I thought I was doing my best for her, I didn't realise how bad she was", and I just feel tired with it all.
Okaasan, who amazingly DID agree to go along to the doctor on her son's direct "in winter, you don't exercise enough, you should go to daycare, but first you must go to a doctor" - I am sure she is feeling tired, stressed and not happy.
So, we'll leave her to have a quiet weekend and hope it all fades in a day or two...and she will come back into her routines.

So. There, we did it. 15 out of 30. It ain't very good. We probably already make allowances for her, because we live with her. She does a good job of covering her confusions about life. But big gaps are developing in her mind.

Back to the baseball. This week was neverending on so many counts.
My weekend starts here.

He got her there....

Report from the classroom window.

At 1.59 pm I saw him striding towards the clinic, with Okaasan scuttling behind him.
I jumped up and down, punching the air in joy.
My 2 pm student arrived.

The car was still here in the parking area at 3.25 pm when I went to the gym.
It's gone now at 4.15 pm.

So.........

Tonight the three of us will gather happily round the kitchen table and chat about our day? So Okaasan, how was your trip to the mental health clinic????

I guess not.

Maybe...hopefully....Okaasan will be tired and stressed and not want to have any dinner. She'll sleep away the evening on the carpet, under the blanket by the TV and we won't have to have dinner with her.
And he can tell me why he hates me for forcing him to do this.
And then we'll drink some wine and beer.
And Nippon Ham Fighters from Hokkaido will win tonight's game.

Let's see....

D-Day

Doctor Day
Dementia Day
Desperate Day

All of the above.

So, I came to work just now and left him at home, faffing around until lunchtime when he will suddenly say to his mother:
"Okaasan, y'know, recently your memory has been not so great, after lunch we are going to talk to a doctor. Be ready at 1.30 pm. Would you like more tofu?"

How would you react?
I think I'd get angry with him, defend myself strongly and then stuff the tofu down his throat and go back to watching the weather channel on TV.
That's what I'd do.
That's what I fear is going to happen.

But I can't do any more. I've brought her and him to this day: the day you actually bring Dementia out into public and ask for help.

He wasn't talking much to me about this today. I showed him the new-patient entry form on the clinic website, he downloaded and printed it out. Then put it in a file and didn't do anything about it yet. I have to stand back and let him take the action from here. He isn't going to do the white lie way. He's going for the truth because he says she will  rise to the challenge of proving that she is ok. Proving it by taking an interview test.

I wish I was a fly on the clinic wall today.

My final input was to deliver my letter to the doctor last night. The clinic is just round the corner from my classroom, so on my way home I jumped out of the car and ran across to put it in the mail box - my appeal for help with daycare and my assessment of Okaasan's abilities.
Couldn't find the mail box!!!
WTF???
This business doesn't have a mail box??? Just a glass sliding door? Don't they get letters? I hunted all round the building front, and in the apartment entrance area round the corner. Couldn't find one anyway.
Finally, I managed to slip the envelope under the glass doors into the clinic hallway. Ggyahhhh!!
This is going to be like some movie where the all-important letter slips under the doormat and nobody ever reads it.

Okaasan? All oblivious to what's going to happen to her today. Or, not happen.
We haven't said anything about it at all. If we did, she would fuss and fuss and stress and stress.
But of course, in that sick-pet-getting-perky-at-the-vets-kind-of-a-way she was on GREAT form yesterday.
Came out into the kitchen at breakfast time and greeted me cheerfully, took every single pair of dirty underpants into the bath to wash (but then forgot them all and left them in damp piles around the bathroom), and at dinner was very chatty with us about her husband and his golf playing...how she used to go along with him and sit in the golf clubs studying English and chatting to the caddys (but did repeat the stories several times).
All so normal.

I swear she pops downtown to an Internet cafe and checks this blog, and does this to wind me up.

Dear Son doesn't think she is so bad - he tells me each and every single time she does the washing up - I tell HIM each and every single time she leaves food rotting in her living room.
We trade stories to justify our point of view.
Such is family life around a touchy, health topic.

Haaaah. Let's all just cross our fingers and hope today goes as hoped.

Yesterday, I climbed another mountain of stress and survived. Did a speech in Japanese to the Inner Wheel Club, (the women of Rotary members). 3 weeks in preparation and 30 mins plus questions/answers in delivery.
SO relieved when it was over.
Doing things formally in Japanese is a big challenge for me, despite living here for 20 years. The topic was UK Volunteering...and I concentrated on sponsored events, charity shops and casual, local community volunteering. I think it went ok.
All a blur really. Made a mistake of not taking off my watch and putting it on the table in front of me - so first of all I didn't know how long it was all taking - until I somehow wrangled the watch off (while juggling with the microphone) and got it onto the table.
So elated afterwards. Huge weight off my mind. Came back to the classroom and ate a chocolate pudding to celebrate. Felt giddy-happy for the rest of the day.

Hope I feel giddy-happy later today.

There's a story in Japan at the moment of a woman who murdered many family members over many years and put the bodies under the house. Japanese media are wallowing in it.
Blog readers who know where I live (Heather, Izumi, Kumiko etc): if I don't post anything here for 24 hours after now, pleeeeese come and dig in the garden! 
There's no knowing how Okaasan is going to react to being told she needs to see a doctor about a mental health issue.

D-Day.

Oyomesan Dementia Scale

No - not me! Yet.
Although, with all the stuff that I am trying to fit into this week my time is probably not far off.
There will have to be major sitting and doing nothing this weekend.

Tonight I found time to try and condense Okaasan's ability level into an easy-read A4 page.
A kind Japanese friend has agreed to do a quick translation job on it, in time for THE doctor meeting on Friday.
So, here it is. Trying to be truthful here. As a general appraisal of Okaasan's abilities. She isn't a gibbering wreck, but she isn't an old lady operating on all cylinders. Some of my students are in their late 70s and early 80s and I notice the difference in their public conversation ability and direction of their lives.

Here is where I think Okaasan is in the autumn of 2012...after almost ...oh shit... FOUR years of living with us! FOUR!! How time flies...

Oyomesan Dementia Scale

Thank you for agreeing to see my mother-in-law.

My main worry is winter: her dementia becomes worse. She goes out to walk only 2 or 3 times a week. She cannot judge weather or road conditions. She is home alone 9 am to 6 pm, watching TV or sleeping. My husband is away from home for work 1 week-10 days. I work full-time. 3 nights a week I work until 7 or 8 pm.

Her mental and physical condition becomes bad, and she is doubly incontinent. She hides soiled underwear and uneaten food in her room.

She needs once or twice a week day care mental and physical stimulation.

 

Her abilities.  Scale 1 – 5  (5 is good)

 

Going out alone and returning.                                   4

           ( a few occasions of return with police or neighbors)

Feeding herself.                                                             4

Dressing herself.                                                            4

Body washing                                                                 3

(but bathtime and hair salon must be arranged for her)

Clothes washing                                                            2-3

Room cleaning                                                               2

Cooking                                                                           2

Shopping                                                                        3

(same purchases day after day, same shops)

Money management                                                    2

Conversation initiation                                                2

Conversation response                                                 3-4

Single incontinence (urine)                                          2

Double incontinence (feces)  Winter                         3

Understanding of TV/newspaper etc                          3-4?

(but recently watching weather channel 1 hour etc)

Awareness of “what did you do today?”                                 2

Machine use at home                                                    3

Sleeping at night                                                           2-3

Hallucinations (winter: stranger at front door)        3

Awareness of season/month/date                               3

Awareness of time/having eaten lunch etc                3

 

Yes. It was Me.

Seething in Sapporo....that letter in The Japan Times on Sunday.
Yours truely.

Dementia sufferers need familiarity.

And then....?

After the joy.
Comes the worry.
WILL the doc see what we see? WILL she give Okaasan a low/high? enough score on the Hasegawa scale that the city office will approve day care.
Hell. WILL Okaasan go at all next Friday?
All of these questions go round and round my head.

I think on the last point it'll be ok. I think Dear Son will take my advice and tell Okaasan that "every 80 plus year-old in the city has to have a doc interview check", just to get her to go with him and walk into the clinic.
He is always overly honest. But he is also overly lazy and wants to take the easy way in life. Telling the little, white lie to get her to go is the easy way in this situation. I think he understands that. (I tell him enough...nagging power is in the DNA of every woman :-))

But the rest? I worry. Of course the doc is a professional and used to interviewing people who are good at consciously/subconsciously masking their selves. Okaasan can chat along politely with someone for a while...and then....and then....in an interview with questions about dates and times and Prime Minister names - I hope the truth will emerge.

Should I go too? Should I write the doc a note to explain Okaasan's home abilities? Will Dear Son tell it like it is? Will he be sitting in the same room WITH his mother, and thus sugar-coat it all a bit? Will she deny what he is saying and the whole interview get stressy?

You can see I've already played out the visit a million times in my mind.

I will be 400 meters away in my classroom actually working at that time. I don't think I should go with them - because I think Okaasan would feel embarrassed to have me there and it would just add to the stress.
But should I do a letter? I can write it and ask a student/friend to translate.
Outlining what Okaasan Can and Can't Do.

????

Don't know. Would the doc think it strange? Too much. Not trusting of her professional ability to suss out dementia level? I don't want to antogonise the woman.

This week I have this bloody Rotary club ladies' lunch speech to do - Thursday - so my time and stress is also focused on that. Doing a thing about Okaasan too...is that a good use of my time?

Agh.

Yesterday we went out for a nice relaxing trip to a local hot spring, nice family trip for the three of us. Just a short shuttle bus rode away from our local station. Actually, we went there last year too - just a few hours of hot water soaking and lunch.

Agh. Hard work. Hard. Hard. Hard.
For me.
While Dear Son was soaking away his worries in the men's baths, I was in the women's baths with Okaasan who was fiddling around with all the new things and decisions-to-be-made.
The locker keys; the towels; the toilets; the washing places and the water/shower functions; the body soap/shampoo choices; the baths; the steps; the locker rooms; the clothes; the hairdryers; the wet towels.....aghhhhhhhhh.
The worst point was when she came and got into a jacuzzi style bath place next to me. And then couldn't get out...

The bath had this kind of swimming pool ladder.

Okaasan was trying to out her first foot BETWEEN the ladder and the wall, over the top! I was trying to show her where to put her feet....but she was all confused about this new fangled thing.

Then, I got her sitting on the side of the bath and swinging her legs around so that she was sitting next to the ladder outside the water - and showing her how to pull herself up by the ladder rails. She couldn't. Recently no power in her legs...and she has got fatter.

She kept refusing help. I left her to it and went and sat in a nearby bath. Other women tried to help. She refused. Other women commiserated with me in big whispers...and after 5 mins. I went back to her and put my hands under her armpits and helped pull her upright....great for my gammy knee of course!

This physical situation isn't really connected to dementia, many elderly people have problems getting up from a low position - but it reminded me that Okaasan is needing help in life situations.

 

We finally got out of the bath and met Dear Son in the restaurant for lunch. Only 45 mins late. I was knackered. Don't think we'll be doing a family trip to a hot spring again, anytime too soon.

 

Last year we went to this place and Okaasan was much better at doing things herself. All the little decisions in a Japanese public bath. Small stuff like how to operate the hair dryers or push the shower button. Looking for information about where and what and how. This time she really needed guidance. It all took much longer.

 

Just another sign, that slowly but surely Okaasan's abilities are slipping.

 

Anyway. Sunday morning. Time to focus on my Rotary Club speech thingy. Bugger.

A doctor date :-)

Dear Blog readers - let us stand and join hands in celebration.

Dear Son has booked an appointment at a doctor's office next week for Okaasan to go along and have the assessment.

Finally.

I feel so lightheaded and happy today - nothing can pull me down. Walking with a spring in my step (despite reoccurring gammy knee) and a silly grin on my face.

Happy.

Yup. We are finally moving towards getting outside help on this situation. This time next week Dear Son will somehow persuade Okaasan to follow him trustingly into a clinic and into a nice, friendly doctor's office where she will do the Hasegawa dementia assessment test interview, and score mild to intermediate - and get recommend as suitable for day care etc etc etc.

ETC!!!!!

This is what I hope. It's very late to get Okaasan all set up for day care this winter as the roads here will be bad 2 months from now, and she may give us many stresses along the way as she fights the change - but I want us to be trying this, and trying it with outside help - a day service staff or city office case worker.

Finally we went with one of the doctors recommended by my student's husband. As I was getting ready for work yesterday I was telling Dear Son to call the clinic - NO! DON'T talk to Okaasan first. No! Clinic first, then a white lie to her on the morning of the visit. No reason to get her all stressy before that.
In movies people have important conversations sitting at a table, in my life I seem to have them dashing around trying to get out of the house for work - hunting for students' homework books, car keys and knee support band..."yes, call that clinic today...no, don't talk to her first....we must do this soon..today.....".

And he did.
All summer I put off activating him on this topic, he put off responding, we've both delayed too long. Finally action.

The clinic looks really nice. And I looked at the web site, the doctor is a woman...the clinic is a small, clean, calm looking place. Unfortunately it is called XX Mental Clinic, which isn't a great name..."mental" gives most people a bad impression and certainly for a Japanese woman of Okaasan's generation.
But maybe Dear Son can distract her at the entrance with chat about a pretty flower display or something....so she misses the word "mental" on the sign board.

The nurse told him that they can do the interview, but don't have the equipment to do CT brain scans. I hope that's unnecessary - Okaasan would never submit to actual machines and drugs and things. A chatty interview just about.
She does have dementia and the interview alone should show that clearly.

I would so, so love to be a fly on the wall of the interview. But I guess it'll just be mother and son...or mother alone with the doc. I wonder if I can burrow down under the building and press a glass against the floorboards?

Oh, great. I so hope this is gonna happen. Yipppppppeeeeeeeee!!!

*...and other doctors..

* I went and did the barium drinking test for a stomach cancer check-up. Not at all as bad as I was expecting. I think the Japanese delicacy of fermented squid guts is far worse. Results in 2 weeks.

* I went and did two lots of physio at the orthopedic hospital for my knee. It's tough love, but obviously good. I need to build up much more strength in my left leg so that the pressure on the knee is reduced. It is scary how seemingly simple exercises are hard when you have to do them 10 or 20 times. I felt exhausted.

But.

But.

But.

Okaasan is going to get assessed for day care or something. Everything else - even the fact that I have to do a 30 minute speech on volunteerism in the Uk to a Rotary ladies lunch IN JAPANESE next week - even that, is doable.

Happpppppy.

You can all let go of eachother's hands now and relax.

Telling it like it is.

The Japan Times Editorial looked at "The Future of senile dementia" yesterday - with stats and government ponderings on what to do about it all.

Central government is telling local governments to set up 300 "senile dementia treatment centers staffed by experts" - mainly so that people currently in hospitals can be released "back into the community"...and save somebody somewhere some money.


Ho, ho, ho....yeah right. I expect that will happen.

This is all scheduled to happen between 2013 and 2017. Maybe after rebuilding tsunami struck communities along the north-east coastline. Because that is going so well already....

Sapporo city could make a great start on all of this by shifting initial assessment interviews from over-worked doctors in over-crowded hospitals, to kitchens all over the land. You don't need a hospital to assess dementia. A kitchen table and about an hour of chat should do it.

But will they listen to me? Nah....

Had myself a nice weekend. Hanging around at home, lunch with a friend, out to see flowers with another friend, sunshine, TV, reading...and OH MY GOD - prepping stuff for the speech I have to do October 18th to Rotary Club ladies....UK Volunteerism...in Japanese. I have so many pictures to illustrate this talk I am hoping they'll just look at those and not listen to me trying to fill 45 mins in atrocious Japanese.

haven't heard anything from the psychiatrist friend, but it's a 3 day holiday..so hoping next week a phone call or mail will come.

Okaasan is fine at the moment. In fact, as Yujiro keeps pointing out to me, she is really pretty good and even washing dishes and folding up newspapers in her room.
You know, it's like taking sick pets to the vets. As soon as you wrangle them into the carrier and GET them there, then they sit up on the consulting table and look perky - while back home they looked half dead.
Okaasan is trotting thru her days fine - while her dear family plot all sorts of shocks and indignities. Inklings of guilt whisper at me.
But I'm shouting them down.

*#*#?#$

Hear me wilting from there?
####****&%$#$.

The city office says we have to get Okaasan to a hospital and a doctor for the assessment.

+)('&%##$%%&'I(NMJFTYXYRHMN<##%'(P))(''??**`"

Can't type the word I want to type here without Blogger deleting this account for public obscenity reasons.

Okaasan who hates hospitals and doctors, because she knows better than anyone in the whole wide world. Well, Health Guru Nishi-sensei knew a little better. But he's dead. Probably because he refused day care help and his demented mind stopped working. So we can't ask him to help.

I'm so, so so disappointed. Really thought that today it was all finally going to grind into action. Instead, came home from the city office after just 10 minutes, changed my clothes for work and will probably eat a huge amount of chocolate today to comfort myself.

A last ditch effort for help - the husband of one of my students is a psychiatrist. He offered back in the summer that someone from his hospital would do the assessment of Okaasan for us. At home? At the kitchen table over a cup of tea? I hope so. How I hope so.
I've sent my student e mails and stuff and we'll hold our breath. See what her husband thinks. Was it just a kind offer from someone who doesn't know the details of how the system works in Sapporo city? His specialty isn't old people, he was offering to introduce a colleague. Would a home visit assessment from a qualified person be ok? Frustratingly, my friend who is a public health worker near Tokyo says in HER city home assessments are available.
Not in Toyohira ward, Sapporo. Bugger.

The alternative is that this weekend we take Okaasan to a nice local hot spring and have warm friendly, family time...and then Yujiro will spring the topic on her.
He (predictably) wants to go the Total Honesty route: recently you've been having bad memory problems haven't you? Why don't we go along and chat to a nice doctor person and see if you qualify for a nice, friendly day  care place this winter, you could go along in a free bus and exercise and meet people and have fun! Couldn't you! That would be nice , wouldn't it!

And she will agree to this. And off she and Dear Son will go next week to a local hospital, and the doctor will say she is Level 2 on the dementia scale, or whatever, and he will recommend the city office make a Care Plan - and we will all skip happily into the sunset.

Or: she will say "I don't need anybody's help, cos I know best", or she will say "Yes" and then get to the doors of a hospital and see the words "Mental" or "Senior" on a sign and refuse to enter the building.

Not fair. Not fair at all. I get it : home assessments are expensive and my taxes would have to increase to support this. Most old people love going to hospitals and talking about themselves to a doctor.

Not ours.

FUCK IT. Hope Blogger doesn't delete me, cos otherwise I will go on a rampage with a large machine gun and take out my frustrations on the 3rd floor of the city office.

Squeak!

The mouse returned....

9.30 pm last night...we were just getting ready for bed. Popo was hanging around.

And then he was hanging around with - oh YUK! The still twitching mouse...tossing it around the carpet as cats do.

Where did he stuff it during the day? Under the fridge? It's the only place I hadn't looked. But there it was. Still alive. Just. Poor, poor thing.
Awful. 
We did the cat and mouse dance of trying to catch the cat without losing an arm, and then picking up the mouse without getting a rabid bite....giggling like maniacs.

Thank goodness Okaasan only brings back aloe yogurts.

On a happier note...
I asked foreign residents of Sapporo for advice about gammy knee doctors - I used the popular mailing list Hokkaido Insider, run by a friend Ken Hartmann.
Bloody 'ell.
Opened my email this morning and had over 25 (and counting) responses from all sorts of people who have had gammy knees and other body parts, recommending their doctors and clinics.
Simply amazing. SO many people have had bad knees - I guess the foreign community here is aging and Hokkaido is a very outdoorsy place, so we are all skiing and mountain climbing. And damaging our bodies.
I am now trying to decide which doctor/hospital is best for me to access.
But I am sad that I shall have to cut back or cut out my gym exercising. Yesterday my knee hurt after just an ordinary day. Not a good sign at all.

* And...just to ensure that there is never a worry-free week - I also went along this morning and made an appointment to have my first ever stomach cancer check-up next week. This is on the Japanese health insurance system. 
I think it's the don't eat anything 12 hours before, have an injection and then drink barium and climb on a tilting table routine.

Since that ovary scare and operation I have joined the Japanese health insurance system and am now FAR more conscious of health problems and checks. I pay a lot of money for this insurance (including 2 years? back payments), so I am determined to get everything checked out.

Barium. Oh yum. I wonder if it is low cholesterol?

The final countdown...yeah!

Ok. NOW going-to-the-city-office-to-ask-for-assessment is on the schedule for this Friday.
So it might actually happen.
Come typhoon or earthquake, bubonic plague or meteorite ...he and I will finally ask for help.
He was still doing nothing, and I am despairing of a rainy day forcing him off-work so he'll go to the city office. Last night I told him to TAKE time off work and let's do this thing - get the wheels turning. He agreed and said today, then rescheduled for Friday.
Friday it is then.

I seem to be seeing wispy/vacant old people everywhere at the moment - and comparing them to Okaasan, who trots off happily alone most afternoons for a walk and shop, and comes home to sort of particpate in dinner conversations. Am I over reacting? Is it too early for day care? I guess this is guilt setting in. This will happen (assuming it WILL happen) because of me: I can't cope with Okaasan in the winter. Seeing Okaasan now - when the weather is good and she goes out most days - gives me uncertainty.

She is still pretty able in all things, and our care for her is doable. Frustrating often and funny often, but doable.
I really have to remind myself of the change in winter. When he is away for weeks working and I come home late afternoon to find she hasn't ventured out again. And her mood goes down and down, and the shitty toilet accidents come back, and the hamster wheel conversations.
I need to remind myself of those times.
She needs mental stimulation and physical exercise. She really does. And I need carer support. I really do.

Okaasan DID finally use the found subway card and go downtown again. Sunday afternoon, I was going to the supermarket which is next to the station, just after she'd left the house (okay, so I was kinda following her :-)))
and she trotted into the subway station and thru the ticket gate and off she went.
Later, at dinner, I mentioned downtown: "Did you go downtown today?"
"Downtown? No, I don't think so. I forget. I went to Macdonald's...."
But I'm glad she went and returned ok. There's been a 3 weeks gap since she was there and I wondered if she would be ok about going and returning, whether she would remember it all - but she seemed ok.

In other news: our cats are turning this house into the Horror House of Death. Birds...mice..insects...oh god, it's horrible. I love cats, I really do...but...oh....horrible.
Yesterday Chichi brought a piegon home. A whole pigeon. Yujiro followed the trail of blood upstairs to the corpse at the top. At 5 am Popo got us all awake by growling over his dieing sparrow...and then in the minutes before I went to work 5 hours later - he reappeared with a still squeaking mouse.
I really had to go to work, so I closed all the interior doors and left the chase-to-the-death happening in our utility room.
Came back 4 hours later...and there is NO trace of the mouse! None! No tail, no guts. Nothing. I've looked everwhere. Found two toy mice and a lot of dust. I fear the remains will turn up in my ski boots bag in December, or in the cleaning equipment box when I clean on a Blue Moon.

And my knee. It's back. Bugger.
Three years ago, two years ago - this blog was full of my left knee and its cartilage. I thought it was almost ok now. I ski (slowly), I walk in parks, I can even trot across roads when the lights are about to change. I go to the gym 3 times a week and don't wear knee support so much. Still take a Glucosamine tablet daily.
Two weeks ago I went away for a wonderful weekend trip with my friend and her cute 9 kg plus baby.....obviously I carried him too much. My knee/thigh started aching and aching. I've tried taking it easy....but the is no escaping the fact: it hurts and I am starting to curtail activity again.
Bugger. Oh bugger. Bugger.
I hate this. I am only 51 years old. Will I never get this thing better? It doesn't bode well for me as an old lady...
I'm looking around for a recommended orthopedic doc. An MRI maybe? More of those awful injections??
I hate getting old.

Physical aging problems, like gammy knees, are one thing. Getting dementia is another.
This week a friend who is a big fan of the TEDX lectures sent me a link to this video: a woman describing the steps she is taking to prepare for life if she gets dementia. Have a look, it's very moving and thought-provoking.

Alanna Shaikh talks about Alzheimer's Disease Preparations.