[TIMELINE: January 2022]
The first week of January started out fairly quiet and calm—but then “Team Peggy” faced a few troubling events in quick succession.
The first of these was that my sister forgot what had happened to her beloved cat, Jezebel, who had died more than six months previously. Peggy asked one of her caregivers if she knew where Jezebel was, and was distressed all over again to learn the truth.
Peggy then informed me that she should be allowed to adopt five more cats. I assumed this was part of her processing Jezebel’s death (again), so I played along. I said, “Five! That’s a lot of kitties! Where will you put them all?” She calmly explained that they would all live with her in her room—her tiny, shared, dorm-sized room in memory care. It took all of my efforts to successfully change the subject, so I was glad that Peggy never brought it up again.
A few week later, Peggy experienced moments where she no longer recognized the face or voice of Liz, one of the supplemental caregivers I had hired to visit Peggy regularly in memory care. I was sad to hear this from Liz. I know that people with dementia typically can lose their memories of people in their lives between Stage 5 and Stage 6, but Peggy had been doing so well with her recognition up to this point! Peggy eventually recognized Liz again, but I was still worried. I was sure this episode was a harbinger that something worse was to come.
And then it did. Even knowing that Peggy could no longer reliably tell the difference between what had and hadn’t happened, when Angelique told me that Peggy said her roommate Patrica had actually hit her in their shared bedroom, I dropped everything to get to the bottom of it.
When I talked to Maricel, the memory care director, she told me she checked with all of her staff and Patricia’s private caregiver (who was there the whole time), and they all insisted that nothing happened. Not only that, there was no video evidence that anything happened, either. All of the bedrooms are equipped with motion-activated surveillance cameras that alert staff if somebody falls or is in danger. The director assured me that the cameras would have been triggered if there had been any sort of violent episode, even a quick one. They were not.
What had happened was a movie played on the TV in the living room earlier, and someone in the movie got punched. Did Peggy watch that, then transfer that experience and make it her own? Honestly, I had no idea. It bothered me that I could no longer automatically believe Peggy when she told me anything, especially something as significant as this.
When I was able to reach Peggy on the phone, the first thing she said to me was that Patricia hit her the day before. I asked her a bunch of questions and she didn’t stray from her original answers. So I considered for a second that maybe she really was telling me the truth.
Then I ran it all by Michael. He was really skeptical that Patricia could have hit Peggy. Patricia had fallen when he was there in December, and now she used a walker—plus her private caregiver was always around. But he sussed out the most plausible explanation.
He noted that Patricia was still spending time over on Peggy’s side of the room to look out the big window, and to get there she had to navigate through a really narrow passage. With her walker, it was a tight fit! Michael guessed Patricia accidentally tapped or brushed Peggy with her walker handle on her way to the window. He said Patricia is not always aware when someone else is in the room, including Peggy, so Peggy’s presence might not have registered.
This was the first time I’d even heard that Patricia had a walker; it was a new development since our last visit to memory care, and Peggy had never mentioned it to me. But the more I thought about it, the more sense Michael’s theory made. Peggy’s perception was way off. If Patricia hit her with the walker handle accidentally, Peggy may not have actually seen the walker at all and thought it was Patricia herself. And if she poked Peggy’s stomach area (which was about the same height as the walker handle), it would probably hurt.
So I asked Peggy if it was possible that Patricia accidentally hit her with the walker, and she agreed. Now this could have been Peggy just saying what she thought I wanted to hear, but if I had to make a bet, I think that’s what actually happened. Most likely Patricia barely tapped or brushed Peggy, but it felt like a push to her and she overreacted.
Alzheimer’s symptoms and behaviors are so slippery for caregivers. Every time I started to feel like I was on solid ground, it would slide out from under my feet. Whenever I felt confident in my understanding of where Peggy was in her illness, something new would pop up, like the walker incident. Then I’d have to shift into detective mode to figure out what had happened. I wished I could take everything Peggy told me at face value…but I knew now I couldn’t.