Decision fatigue
June 10th, 2007
My mother is much quieter when I visit now. Today being Sunday, we took off for our usual lunch and drive. My sister comes along, as does Jasper the Sheltie (who really doesn’t like going for a ride, surprisingly–he runs and hides when I approach with his harness. This is pretty uncharacteristic for a dog and I’m hoping he grows out of it). Garden Manor has a Sunday afternoon barbeque, and today my mother seemed uncertain about whether she wanted to stay for that. Making even a simple decision is almost impossible for her at this point. A choice between coffee and hot chocolate, for example, is prolonged by her insistance that someone else pick for her. It’s a frustrating development at a time when I want to preserve what little choice she has in her life. At first I would not let her off the hook, but now I’ll just pick what I think she’d prefer. So today I suggested we forego the barbeque and go for a drive.
And this we did. She says next to nothing as we drive, which bothered me at first. I’d question her about her sleep, her meals, her activities, and she’d always answer me with vagueness–”I guess so,” or “I forget.” So I’ve backed off a bit. Every so often I’ll ask her if she’s comfortable or does she want to stop at a store, just to tune her in. I’m getting better at translating her silences–sometimes she’s just pleased to be out and othertimes, like today, she’s unsettled.
Lately she’s seemed like someone walking around with a pebble in her shoe. Always a little “off” but unable to pinpoint why. Constant, low-level discomfort. I don’t know how much this discomfort is turned up when my sister and I are around. I’ve asked the staff how she’s doing and they tell me she’s doing fine. And when I’ve arrived to find her sitting with her card-playing friends, she seems in good spirits and very engaged. She tells us that she does nothing all day, but I know otherwise. The staff photograph many of the social functions and then put the pictures on bulletins boards around the lobby. I originally thought that was a sweet little extra, but now I see that it is probably for the families who can’t get anything out of their loved one. I’ve spotted my mother in a few pictures–eating ice cream or listening to music–so I know that she joins in occasionally.
So I’m thinking that her taciturnity (is there such a word?) might be a little more complex than merely the verbal loss that accompanies Alzheimer’s. She’s been at Garden Manor for a little over five months now, and she seems to be making her own sense of it. On the other hand, I have my own sense of where she “is” and the two don’t often mesh, I think. I operate under the assumption that she remembers how she came to be here and my role in that change. I visit the woman who–I believe–thinks about her old life and wonders why I don’t show up more often. But she’s not that woman, and so I think my assumptions puzzle her.
I’m not saying that I need to map her reality, because I don’t think I can do that. But maybe I can back off and stop trying to fix what isn’t broken.
For example: one subject she invariably raises when I visit is her mother. “How’s Ma?” she asks me. “Where does she live?” “Did you have a fight with her?” “Does she know where I am?” I usually improvise in a very sloppy way, but I think that this is a theme I might have to consider more carefully. Or maybe it’s part of this stage of her adjustment to her new life.
On a personal note, I finally let go of my beautiful 14-year-old collie Lily yesterday. I was hanging on to her, despite her crippling arthritis and doggie dementia. But my poor girl developed a horrible pressure sore, and I knew I couldn’t put her through any more. She’d had a good, long life–and a healthy one, until recently–and her welfare was more important than my need to hang on to the past. I’m less distraught than I was when my boy Dustin died last August. His illness and death were unexpected, but I’ve been considering my Lily’s life for months now. She was a lively and inquisitive collie, so seeing her deteriorate was awful. I think my sadness now is alleviated by relief at being able to release her from her difficulties.
But, oh man, I’m starting to get severe “decision fatigue”…





June 10th, 2007 at 5:33 pm
I’m so glad you’ve posted again — I’ve wondered how you were doing.
We’ve lost two cats in the past two months (one who had been with us for 16 years, and one who was especially dear), and both times had to make that terrible decision. Over the years, again and again, we’ve had to accept that responsibility; it’s never gotten any easier.
Your “decision fatigue” is something I’m very familiar with. Perhaps it sounds silly, but this is one of few things in life that I think is worth running from from a while; in the same state, I give myself permission to simply avoid any decision-making that isn’t critical until I’m up to a more usual operational mode once again.
So I take the coffee if it’s handier than the tea, or whatever else is nearest, first, easiest. This works for parents, too, while all are in these states. Then, when the personal reserves are a little stronger, it’s possible to spend the extra energy involved in actually making (even trivial) decisions again.
It’s amazing how many decisions are just not important on a day-to-day basis, and what a relief it can be to simply put them aside for a while.
I’m so sorry for the loss of your Lily.
June 13th, 2007 at 11:38 am
I absolutely agree with Marty’s comment on decision fatigue: “It’s amazing how many decisions are not important on a day-to-day basis…” This plays out in both my and my mother’s life, but it took several years for me to “get” this, and I still struggle with it. I sometimes wonder if this is because the “normal” world is decision oriented: Everything becomes the crux of a decision, whether or not it needs to be. I guess it’s the tension between “doing” versus “being”.
I find your mother’s silences interesting. I’m wondering if it has nothing to do with you, or with any memories she might (but probably doesn’t) have about her move to her present home, but with an inability the demented often have to deal with differences in routine, which include less than daily (even when regular, as are your visits) differences in environment, as when you take her for rides. I’m not suggesting that you stop doing this…but that it will take her longer to incorporate this as “routine” because, even though they are regular, because their possibility doesn’t exist as a minute-to-minute constant in her usual routine. My guess is that, according to the pictures, her facility home is definitely routine for her, now. Her silences may indicate that she is still processing your visits…not her home, and is still processing those because they are unusual deviations of routine, not because they involve you. I’m wondering if the staff alerts her ahead of time to your visits. Perhaps, if they don’t, this might help. The alert, itself, would become part of her “routine” that “belongs” in her normal environment…thus, maybe, going a long way toward your visits and outings becoming “expected”.
Please accept my extreme sympathy on the loss of Lily. Just yesterday, as I passed our vet while running an errand, I suddenly and surprisingly burst into tears over losing The Big Girl…and that was two and a half years ago! I thought I was long over it!
I will, by the way, be responding to your much appreciated messages shortly, Deb. Being online has, lately, become less and less of my “routine”!