Time with Leo

 

Time with Leo

(4/Sep/09)

Leo is now 70; his birthday was just a couple of days ago on the 1st of September. He was always a quiet man before his illness, gentle and did not like any kind of confrontation. He was also a very good artist; he was a sculptor in metal. He would do large works of art and for me when I would look at them, they would move, or perhaps dance, would be a better word, for they were made with many curves and no rough corners. He told me that in his early twenties he had a few shows in Philly and I think some of his creations are still hanging in some of the hotels here in Atlanta. Though they were executed so long ago that I can’t remember where they are today. I suppose he could have been famous, but he seemed to only like working when the fancy would come upon him, so as good as he was it seemed more of a hobby than anything else.

He started to show the first signs of Alzheimer’s in his mid to late 50’s, so he got it younger than most. It was little things, being in town and forgetting where he was, which at first was thought to be brought on by extreme fatigue. However things slowly got worse. Being very intelligent he could hide it from most, but those who knew him felt the change. I was with him, when in 1999 I drove him to the Neurologist for a check up. I was allowed to be there when he was questioned so the doctor could discern how far along his disease and progressed. It started off fine, he said hello, shook the doctor’s hand and seemed alert. In fact we carried on a conversation on the way in to his appointment and he seemed ok. However when the doctor started to question him things changed quickly. He did not know what country he was in, could not tell the doctor what state he was in, did not know my name, could not tell the doctor what a watch was, it went on and on. To say I was shocked was an understatement.

So for the last 10 years Leo has succumbed to the disease. Each case is unique; Leo tends to be just fading, though he is still there at times. He still gets humor, and there is a nice lady who comes to see him, her name is Salena, whom he always recognizes and perks up when she is near. She has been seeing him for years so she is now a long term memory. I am not sure that he knows her all the time, but her presence always seems to cheer him up.

Most of the time he just sits and stares and more likely than not needs help in feeding and in drinking. There are days when he seems to forget about eating all together yet he will eat when prompted, though it can take some time. Keeping him hydrated is also a problem at times. It takes two to put him to bed since he can panic when he is moved both from his chair to his bed and when he is turned while being cleaned. He is however still very gentle and for the most part easy to work with.

For the last two weeks he had been listing to the left in his chair and would fight when we would try to put in some pillows to get him to set up straight. This listing is not unusual, for in the past he would either go to the right or left and would allow us to set him straight, this time however he would fight a bit. Then one day he started to grimace in pain and groan loudly, which is not usual for him. Then one morning he had a fever and was in a lot of pain. I gave him something for fever and the pain and then called Rose the head nurse about this further development. When she came in she tried to find out where the pain was coming from, but because of Leo’s condition it was difficult to ascertain its position. She did feel something near the gall bladder but it was still not conclusive. The only thing to do, since we had to find out what was going on was to send him to the emergency room for some test. Something we try to avoid with someone with advanced dementia, the change is so dramatic that it can cause some trauma to the patient. However Rose and I as well as his primary physician felt it was necessary to do.

So we called an ambulance service that we use and got him in. Since his dementia is so far along it was not that bad for him. Though when he went in for the cat-scan he got a little agitated going down the hall, but that did not last long. Nothing really conclusive was found. Well a hernia, but we knew that. There was also a growth on the pancreas which the ER doctor downplayed and said that was nothing to worry about. So luckily we were able to bring him home.

He did not get better and Rose and to give him an IV to keep him from getting dehydrated. Comfort measures are always used in caring for those in our facility. His
physician mentioned that the spot on his pancreas could in fact be a gall stone, which is a cause for concern. Gall stones can be very painful and if they get into the bile duct can cause an eruption and a painful death. So we had another dilemma. So we had to put him in the hospital to see if the actual problem could be found, so that we could spare Leo from any unnecessary suffering and emotional anguish from his pain.

So Rose let me know that he would be going in yesterday afternoon. I followed the ambulance and stayed with Leo for awhile to ascertain if he would need someone to sit with him. The nurse came in and I helped a little in cleaning him and also held Leo’s hand’s while she placed a Catheter. Luckily it went in without causing Leo any distress.

Rose and Michael came by and Rose sat with him for a while. One reason why I went is that even though Leo does not know me, at times the sound of my voice seems to calm him down since he has heard it everyday for almost a decade, so I guess it gives him some kind of continuity. Rose is very good with the sick; loving and protective, which is a trait I guess all good nurses have, so she spent a while holding Leo’s hand and comforting him, which worked.

After they left I stayed on for a few more hours to make sure he would stay peaceful. When I left I notified the nurse that I was leaving but if anything happened to Leo, or they needed someone to come in and sit with him, to please call me and it will be arranged. As I was walking to my car my mind would review all the years I have known Leo, all the way back to 1968 when I first met him, a young man just getting out of the Air Force. I was 19 then and he was 28; where does the time go. I am often astounded at the dream like quality that life often takes on for me.