Today when Mom was coming in from the patio she stepped up into the house and then lost her footing and fell. I tried to help her get up but I couldn't get through to her what she needed to do. It must have been 3o minutes of trying this until finally I grabbed my 36 Hour Day book and looked up Falls. It said to try to remain calm, comfort the person and then try to get them to get themselves up. If they can't then call 9-1-1. I was panicky and Mom picked up on this. Finally I called A who was a huge help (thank you!) and she advised me to call 9-1-1. Within a few minutes two big police officers were there to help Mom up and everything was fine. Now I know to do this before either of us gets too distressed. I'm not ready to put Mom in assisted living and I know she's not ready to go there. I wonder if upping her Seroquel could have affected her balance? I will have to look at the side effects. I know dizziness is a side effect but she hasn't complained of that; only of tiredness. She was really squirrely during the time when she couldn't get up. She wanted me to get her to the piano so she could play but she couldn't quite comprehend that she needed to get up to do that. Then she wanted her shoes on, and her glasses. I've got to remember my patience. Poor Mom, to be stuck with me.

We went to the doctor today where Mom had her blood pressure checked (100/80) and her pulse check (56). After talking to us both, the doctor decided to up the Seroquel to a full tablet; 25 mg. Mom always has a fit about having to go the doctor and today was no different. I try to distract her and sometimes that helps.

Tonight the neighbor's puppy jumped on Mom's lap and licked her face. That is a sweet little puppy.

Our weather has cooled down and the humidity has dropped. What a relief. I don't really enjoy the hot stuff.

Mom has finally given up her lifetime membership in the clean plate club. It took dementia to do it. Our problem with diarrhea is temporarily gone; now the stool sticks to the front of the toilet bowl and doesn't go down when flushed. This morning I gave Mom her shower and washed her hair then we dried it. I was hoping this would be a task that the home aides could do but it was not to be. They didn't even help with trying to figure out where grab bars could go to help Mom in and out of the shower. I don't think I'll be calling them back. I've been thinking about this whole home aide situation and Mom's resistance to their care. How open would each of us be to some stranger giving us a shower? I think Mom is troubled by having them in the house especially since someone with dementia can't remember who people are or why they are in the house. I think she is worried about them stealing things (she said so when the house cleaner was here). Why does everyone think that is so weird? And aren't these aides supposedly trained in how to deal with someone with dementia?

Everyone is so worried about me getting help for Mom to help take the burden off of me, yet every time I try I'm thwarted. I'm really starting to get frustrated and angry with this. I now know what it's like to have a kid and I can see why I never had any of those. I need to stand up to Mom and make her do some of these things I guess. I'd really like to get her into the day program so I will concentrate on that now.

I think that is why I sleep late on my days off. It's my way of avoiding the reality of Mom's dementia and the exhaustion that accompanies it. At first I thought the Cymbalta was helping me to fee like getting up, but it's not. I still want to avoid getting up for as long as possible. I just want to delay the inevitable.

Mom wants to go outside again. She'll sit out there for a few minutes then want to come back in. Then she'll go outside again and want to come back in in a few minutes. It's exhausting for me because she wants me to go with her. I can't get anything done around the house because she wants me to be with her.

Mom has been emotional today and restless. I took a trip to Target and asked her if she wanted to come and she said no. When I got home she was all upset because she didn't know where I had been. She thought I was downstairs. She's up and down all the time. She wont accept help from the healthcare aide so I'm stuck with giving her a bath and making sure that she is clean. I'm exhausted so much of the time, I just don't have the energy to bathe her or struggle with her to keep her clean, fed, dressed, or to hear her questions over and over and over. It seems like everytime I try to get some help for myself it is thwarted. I'm really pretty angry with the home health care agency because they supposedly are trained to deal with patients with dementia yet the workers seem to not want to deal with normal dementia-type behavior. They want to medicate Mom. I'm sick of their syncophatic behavior. If I can calm Mom down then they should be able to also. I'm tired of all of this and I need a break! When A comes I'm going to try to get away by myself.

Judge Judy is on Larry King tonight talking about, among other things, Paris Hilton. Judy says, Paris deserves jail time, she broke the law not once but 3 times and each time she had a warning. I agree. She also says that the parents in the case are at fault as well for not instilling a purpose in their daughter. In fact, in my opinion, I think her parents are proud of her for her ill gotten fame and fortune. That is unfortunate. It used to be that the wealthy would frown on such behavior but now it is considered OK. That is too bad. Perhaps Ms. Hilton has finally learned a valuable lesson.

I asked the Home care agency to put our account on hold until the medication has a chance to work for Mom. Tonight she said that she enjoyed having the home care worker here. Maybe the med is starting to work?

It is a beautiful evening tonight. We went outside and Sateen, the cute little black puppy across the alley, was out and she and J ran over to play. Mom loves that puppy. She is pretty darn cute.

Mom has been emotional tonight. She finally went to bed at 9:30 then yelled at Olivia when she came and stood in the window. She yelled something about not being a baby and not needing someone in her room with her. Yikes! This is the third night of the Seroquel, I can't say that I've seen much difference. I'm beginning to get a little freaked out with this situation. It's been non-stop for 2 years almost and I need a break. We did get out today even though it is very hot here. We have what appear to be monarch butterflies in our Linden tree near the garage. Every time a car would drive they would all flutter out of the tree, it was pretty amazing to see. I bought a hibiscus plant today and re-potted it into a bigger pot as the woman at the garden center suggested. I hope it does well. My tree rose died and I wrote to the company for a warranty replacement or my money back. It's too bad because it was really beautiful last summer.

Mom is having a great birthday. She's gotten lots of cards and presents. When she opened A's present she said 'I love it!' and then we watched 3 episodes from the DVD. ME called as did A. I somehow slept so late today is scandalous. And I've been sleepy all day since getting up. It's hot here. Talked to Mom's broker and he said it has been in the 50s and 60s in Duluth. Sounds like a typical June there. I got my bottle of Opium perfume today. That's what I wore all through college. It smells so good. And just a little goes a long way. Day 2 of Seroquel. Mom seemed OK though she was emotional because of all the cards, calls and present for her b-day.

It is still hot here, in the 90s. Tonight when I got home Mom was mad because 'she was trapped in the house all day while I get to go out'. So, I dragged my butt back into the car, took Olivia to the vet to have her manicure, brought her home and went back to the lake with Mom. Mom actually got out of the car and did a little walking. That's a good thing. Tomorrow is my b-day lunch with my manager. Not sure what to expect from that. I'm still not comfortable around him; still stinging from his behavior when I was depressed.

The last few days have gone fairly smoothly other than the Metamucil incident. I gave Mom some berry flavored Metamucil in her water and it worked like a laxative for her. Poor Mom. The doctor said to add some fiber to her diet, and she mentioned Metamucil, so I bought some and put it in Mom's water. Mom drank all of her water that day (20 ounces) but then she had diarrhea the next day. No more of that for her! Today it was so hot! 90 degrees. Mom seems to like the new home health aide, she says she is very nice. The nurse is going to stop by tomorrow so that is good.

It's easy to get caught up in my own life's drama but today I realized that others are experiencing drama in their lives. I was able to get to know K in my vanpool a little bit better today. I learned that she is divorced and that she has 3 kids. In a matter of months she separated from her husband and kicked him out, put her house up for sale and then was diagnosed with breast cancer. She is a strong lady who works 2 jobs; one full time and one part time. She had to sue her husband to get him to pay child support. How can a human being refuse to support their own offspring? I will never understand that.

Last weekend I bought myself a pink iPod shuffle. It's little and cute and I like to take it to work to listen to music. I also like to take it on walks sometimes but I also like to just listen to the quiet when I walk. Olivia is scratching at my new rug and pulling out threads. I'm going to have to take her to get her claws trimmed again. Today I went to Target and then I came home and Mom and I went for a drive, picked up a sandwich to split and went and parked by the lake. It started to rain a little but it never did rain hard enough to matter. Talked to ME today. She had called on my b-day to wish me a happy one but I had to hang up and go help Mom in the bathroom. She called back today to find out if Mom wears Depends. She said she does; I told her Mom does too. Isn't that sad? It breaks my heart to see Mom so frustrated with her hip and her memory. And her incontinence. Old age is definitely not for sissies.

We have a VHS video that Uncle N copied for us of old home movies of Mom and ME. It is priceless to watch. I copied it onto DVD today. Aunt ME asked for a copy, but I think she already has one. It has scenes of all the Deckerts and Bartholomaeis at Grospapa's cottage on Lake H. It's very cool.

Found this article:

Forming an Alzheimer's Care Dream Team

Big Changes Needed to Make the Dream Team a Reality

By Miranda Hitti
WebMD Medical News

Reviewed by Louise Chang, MD

May 9, 2006 -- If everyone with Alzheimer's disease had a "case manager" for their Alzheimer's care, it might help Alzheimer's patients and their caregivers, a new study shows.

The study, published in The Journal of the American Medical Association, included 153 older adults with Alzheimer's disease and their caregivers.

All of the patients and caregivers live in Indianapolis. That's where researcher Christopher Callahan, MD, works at Indiana University's Center for Aging Research.

Callahan and colleagues make the case for "collaborative care," a team of specialists led by a nurse to help patients and their families navigate Alzheimer's care. But even without such a team, there are steps caregivers can take to take care of themselves while tending to Alzheimer's patients.

Alzheimer's Study

Alzheimer's disease is the most common form of dementia among older adults. But it's not a normal part of the aging process.

The Alzheimer's Association estimates that 4.5 million Americans have Alzheimer's disease, with that number set to grow as the U.S. population ages.

The Alzheimer's patients in Callahan's study were almost 78 years old, on average. Most were financially disadvantaged and had other health problems. About half were black.

Patients had "moderate" dementia at the study's start, the researchers write, based on scores from a mental skills test.

Collaborative Care

Doctors randomly assigned 84 patients to get a year of collaborative care. Advanced practice nurses were at the heart of collaborative care.

The nurses coordinated weekly meetings by a team of geriatricians, geriatric psychiatrists, and psychologists. The nurses also tracked the details of the patients' cases, including depression, medication use, and patient-caregiver attendance at group therapy sessions.

The other 69 patients got standard Alzheimer's treatment, plus information on Alzheimer's, communication skills, caregiver coping skills, and legal and financial advice. They also received patient exercise guidelines and a caregiver guide.

The researchers compared the two groups after a year (when the collaborative care program ended) and again six months later.

Study's Results

The collaborative care group had some different results from the other participants:

• Fewer behavioral and psychological dementia symptoms at 12 and 18 months.
• More likely to take antidepressants and Alzheimer's drugs called cholinesterase inhibitors.
• Less distress and depression in caregivers as the study progressed.

However, collaborative care wasn't shown to improve or worsen mental skills (cognition), activities of daily living, or rates of nursing-home placement, write Callahan and colleagues.

The study shows that "care for patients with Alzheimer's disease can be improved in the primary care setting, but not without substantial changes in the system of care." In other words, the dream team for collaborative care isn't in place.

Future studies should test whether collaborative care is cost-effective, the researchers note.

Tips for Caregivers

The Cleveland Clinic (which wasn't involved in Callahan's study) offers these tips for people who are serving as caregivers for Alzheimer's patients:

• Take time for yourself. Make sure you have time to relax. If necessary, enlist the help of other family members or even hire someone to help out.
• Learn as much as you can about your loved one's disease so you will know how you can help. You'll also understand what changes to expect in your loved one's behavior or symptoms.
• Help your loved one participate in as many activities in the home and outside the home as possible. Maintain the intricate balance between helping your loved one accomplish a task and actually doing the task for him or her. Allow the patient the time needed to complete daily activities on his or her own, such as dressing.
• Consult your loved one about his or her family affairs. Although it's not easy to discuss these topics, you should be informed of your loved one's wishes regarding a living will, durable power of attorney, and do-not-resuscitate (DNR) order.
• Set realistic goals for yourself and your loved one. Do not attempt to do everything. By setting attainable goals, you are setting everyone up for success, rather than disappointment.
• Do not put your life on hold. Continue to meet with friends, participate in hobbies or groups, and maintain a schedule as normally as possible. You will feel more energized and are less likely to feel resentful in the long run.
• Have someone you can talk to. You are there for your loved one -- to listen and to offer support -- but you also need a support person. Talk openly and honestly with a friend or family member. If this is not possible, join a support group. Understanding that you are not alone and that someone else is in a similar situation helps you to feel nurtured.

SOURCES: Callahan, C. The Journal of the American Medical Association, May 10, 2006; vol 295: pp 2148-2157. News release, Indiana University. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Alzheimer's Disease: Your Role as Caregiver." News release, JAMA/Archives.

Why does the world or at least the media, care so much about Paris Hilton? She's nothing but a spoiled, rich brat who never left behind her high school persona. She can't even do things for herself, she relies on others to tell her if it is OK to drive when she signed something that says she wouldn't drive. There are more important things in this world then the drama of this rich little tramp who parties her life away. She deserves to spend time in jail, maybe she'll learn something about the real world.

We took Mom's car in to the dealer because it was shaking when it would idle and the service engine soon light was on. Five hundred dollars and five hours later we finally left that place behind. It was a bad fuel injector according to the service advisor. It's time to sell that car I think.

Ang is having a drama. Webster has given her bookoo bucks to go there but she has her heart set on Kent because it's close to her high school boyfriend. Bad reason to pick a college.

D-Day! It started out scary, Mom was confused this morning. She asked me what I was doing here and thought that someone else was in the house. But my friends at work remembered me, bless them. And my sis. She sent me a great present, a tote for scrapbooking goodies; one I had seen and admired before. Alas, Mom did not remember. Mom always remembered birthdays with cards, cakes and presents so this is very uncharacteristic. I miss that. Birthdays were special in our house. I miss my confidante. I miss being able to tell her anything. She does seem to like the nurse's aide and that is good. She said the aide offers to help her with a shower but she doesn't think she needs one (she does). Maybe next time she will let Sophie help her. She's been dozing all night long. I think she was pretty restless last night as I heard her up and about several times.

I am trying to figure out if all I need is a network hub in order to use my work laptop.

It's the day before D-Day! I received my first (and probably only) b-day card. From my high school friend Julie. We are both marveling that we are in our 44th year. YIKES! Seems like yesterday when we were in Chinese Government and Politics laughing about Kressy. My fibro flare continues. I was in excruciating pain today but I am better now. We are watching Raymond as usual. Thank God it's a funny program. I bought the smaller 3 x 5 rug to place in front of the door. Can't wait for it to get here. Mom is getting used to Sophie the new aide I think. I'm hoping she will be able to get Mom to take a shower soon. Meanwhile, the summer is flying by and it isn't even officially summer. Mom and I watched family home videos tonight including one her parents shot when she was a child. She seemed to recognize herself, her homes and her grandparent's summer cottage on Lake Huron. But when we watched the video of M when he was a baby she got confused and thought it was her and she didn't know my Dad. Those videos are priceless. It's amazing to think that we have live video of Mom and Aunt ME as children. Tonight it is cool, great sleeping weather. Wish I could open my window.

I woke up feeling very disoriented. First of all, I thought it was Monday so I thought that I had overslept and missed my vanpool to work. It took a few minutes for me to realize that it's Sunday. I must have slept very deeply or the Flexeril is still in my system making me groggy. Mom was disoriented as well, she burst into tears when she realized that she was not alone today. I have been giving her Metamucil in hopes that it will help with the bowel incontinence. I'm not sure that the higher dose of citalopram is helping; she seems to be more agitated. But it's only been a week. I just don't want her to suffer. She is still reading The Reagan Diaries and asking me if he is dead every so often. It's cloudy and cool today. We are supposed to have thunderstorms off and on today. A is off to Denver today until Thurs. M is not liking his summer job, it's very hard and he is in pain, but he's making tons of money. An is bored this summer...On Friday I stopped in to Pier One and found a set of nesting tables with tile on the top to replace the one on the patio that is all broken up.

Tried to get to bed early last night but it was not to be. Mom was a mess. Then she had an accident and got it EVERYWHERE. She was sobbing hysterically and saying how she was 'bad'. This was at 2:00 AM. She was in her bedroom and I heard her say 'someone help me'. When it got upstairs there was stool everywhere including on the new shirt I had just bought for her. I through all the clothes in the washer and then washed both her and the bathroom down. After I was done cleaning I walked into the den and Olivia was snuggling on Mom's lap purring and that seemed to calm Mom down. Sometimes that little cat can be a lifesaver. I slept until 10:00 AM this morning from exhaustion I think. Then I took Mom for her INR and stopped at Target to pick up stuff including a new iPod shuffle that I will use for walking. Now Mom is sleeping and I am watching 'Pandemic' on the Hallmark Channel.