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

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

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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.

Lost the memory of...lost.

If you have short term memory holes - how do you remember when you've lost something?
The losing.
The thing.
The problem.
Vicious cycles. Or is it circles? Vicious anyway.

Last night at dinner I was chatting about the Autumn Food Festa in the city park - it's been running for 3 weeks and I've now been twice and stuffed myself on oysters, beef, cake and wine. I love Sapporo.
Okaasan said she hadn't gone. Typical really. But recently she seems to have been locked into the routine of local walks: Seiyu supermarket and the Macdonald's next door. Maybe a diversion to the convenience store.
So, we kind of knew that she hasn't been downtown recently...kinda...

"To go downtown I need the subway, don't I? I don't have a card for the subway, do I?"
????????????????
Yes! You do! You have an old people's special card, in that little black wallet in your handbag. You always use it to go downtown!

Cue: family hunt  for the subway card...hunting thru the FIVE little shopping bags Okaasan has scattered within reach; the stuff on the table; the coat pockets; the newspaper pile etc etc etc
Today I went to buy a temporary card and ask at the local station. Nothing. Gave the card to Okaasan - which stopped her hunting desperately round and round her room with piles of stuff mounting up on all sides.
On my way to work I dropped into Macdonald's. Described the little black wallet. The staff hunted under the counter...and then I caught sight of a familiar large brown shopping bag.
Yup - with 3 week old magazines inside, three little wallet things, receipts, tissues, towels...and the subway card.
Phew.
Took it home and tried to stress to Okaasan that something important belongs IN the handbag, not amid the flotsam of her shopping bag. Tried.

But it really made me think. That was probably lost 3 weeks ago. Okaasan maybe went to the subway station many times since then, looked for her card and not finding it...walked on locally. And then forgot. So, she never looked for it. She never mentioned it. Went to the station the next day, looked for the card...and on and on.
We are at work most days and when we meet Okaasan in the evening she doesn't have the ability to tell us anything much about her day....so we don't ask. Just chat about the weather and general things. No specifics. And she doesn't remember, so we don't know....and...and...

Yesterday I met a friend (and ate a huge oyster and deer curry in the Food Festa), and we chatted about dementia assessments.
Her late father had one. An interview in hospital...he scored 11.....and the doctor said: "It's not because of Alzheimer's, it's because of alcohol abuse..." - she and I chatted about memory and ability etc.
Anyway, the weather is still good - so Dear Son is working and not going to the ward office to get more information. I have to bide my time.....bide...bide...

* I slipped into Okaasan's room last night and left the new black trousers on a hanger among her clothes. I don't think she will think it is strange when she finds them....black trousers are black trousers really...she always did have 2 pairs exactly the same. We bought one pair, very expensively, this spring and then within 2 months she'd fallen over and badly scuffed the knee material. After that she didn't wear them.This latest pair are quite a bit cheaper, but still ok. Hopefully she'll just find them and use them,

Scoring dementia.

I've been hunting around the Internet wondering WHAT kind of assessment the city office might use with Okaasan....dreaming, dreaming of the day they come and do it.

There is something called the Hasegawa Dementia Scale, which has been used in Japan for years and revised. It seems to be 11 questions - some factual like "What's the date today?" and some ability tests "Can you count backwards/remember 5 items".

In quiet moments between lessons I've been looking at the questions and wondering how Okaasan would score. A total of 30 points, with anything under 15 being a stage of dementia and a score of 15-20 being an early sign of it.

This assuming she would agree to talk to a person doing this kind of test...
I can imagine her getting annoyed and leaving the room and shouting at all of us.

I HOPE they do it with some gentle, common-sense.

1. Dates - Okaasan is pretty bad at that.
2. Where are you? 2.5 points.
3. Age? 2 points.
4. How long since? Maybe bad.
5. Birthplace. No problem.2 points.
6. Dates of public events? Maybe ok. 3.5 points.
7. Days/Minutes. hmmmm
8. Prime Minister? Maybe ok, does ANYONE in Japan remember who it is right now? 3 points.
9. Subtractions. Maybe ok. Okaasan was a book keeper long ago. 6 points.
10. Repeat backwards...um...maybe no.
11. Remember items...maybe no.

Well, that's a score of 18....maybe.
The thing is, Okaasan is pretty good on short conversations - I am really hoping that the fact of both Yujiro and I working full time, and him being away in winter - so she is alone with a foreigner speaking strange Japanese - I hope THOSE facts will get us into day care.
And this is bad....I was thinking of getting her to a hair salon soon....but I thought it could wait until after the assessment, because she looks so much worse with her long, straggly hair unbrushed and all a bit crazy.......
That's bad of me. But I stated that at the start of this Blog. I am no angel. Devious is my middle name.

Today I went shopping for Okaasan: bought some new underpants and a pair of black trousers to replace the damaged ones. And got the dry cleaning for her. Clothes duties.

And the Aloe yogurt frenzy continues. We have 4 packs of it in the fridge at the moment. Okaasan buys it every time she goes out....

Cross fingers that the assessment happens, that she scores badly enough to get into day care....and that it happens with a nice city office person persuading Okaasan that "wouldn't it be nice...?"