“It’s my beautiful girl,” Mom said when she saw me.
Wow, I thought, she knows who I am today!
My parents were sitting together in the courtyard of Mom’s care facility on an unusually warm November day enjoying the sunshine. I sat down to join them and amiably started chatting.
I couldn’t hold Mom’s attention for long. The warm weather was making her drowsy, and even though I felt like I had just arrived, Daddy and I decided to take her back inside where she could listen to music and doze if she wanted.
We barely made it back to her chair before she started complaining that she couldn’t walk another step. I saw her legs trembling, and I stepped in and took her arm. With Daddy on her other side, we walked her the last few feet to her chair.
It was about 10:30 am, and the occupational therapist was putting out games and drawing material for the residents. The staff constantly rearranges tables and seating assignments to match residents who have the same type of skills. Last week, they seem to have been less than successful in choosing Mom’s seat because we got a call from the duty nurse to let us know that Mom had hit another resident.
This is just like kindergarten, I thought as I listened to the report. The difference being that you can reason with little kids and appeal to their intellect. They can acknowledge the role of teacher and bow to his or her authority. With Alzheimer’s patients, there is no reasoning. Nor is there any ability to recognize an authority figure who may be acting on your behalf.
Adults, like kids, can also act out when they feel anger or aggression. My niece, who runs a small private nursery, told me about two two-year-olds, one who could already express himself and the other who could not. They began fighting precisely because the non-verbal kid had no other way to communicate. This kid will eventually learn to speak. For Alzheimer’s patients, aggression is a regression to those non-verbal communications skills. It may very well be unintentional to hurt someone, but their anger—and their inability to understand societal norms—compels them to act out.
Mom was apparently quite aggressive on this particular day. Daddy remembers visiting her and also observed her anger. She was convinced that the woman sitting next to her was insulting her mother. When Daddy was there, he distracted her.
This is where being the only English speaker in the care facility becomes a disadvantage. No one on the staff knew what Mom was angry about, and though they did try to calm her, they could only ascertain from her tone—and not the words themselves—how she was feeling. They were limited in being able to speak to her specific concerns.
It may not have made any difference that Mom couldn’t be understood. Mom had in fact constructed the whole conversation in her mind: the woman sitting next to her spoke Russian and if she had insulted Mom, Mom wouldn’t have understood it. I’m guessing that the other woman was probably perplexed by Mom’s incoherent ramblings. Anger, like most emotions, can flare up unexpectedly. Perhaps it is more intense for someone who is prone to unreal perceptions and misunderstood cues. The best way to break this anger is to distract and disarm it with humor or song. This can be hit or miss with Mom, but I can generally get her to smile and laugh with me.
What happened next is that Mom’s Russian table mate also became angry and told her to be quiet. Whether Mom understood or intuited the insult is unclear. What is clear is that Mom reached out and slapped her.
No one was hurt, but the staff had to report the incident and contact both families. I felt a spark of guilt that a parent feels for a child who acts outside the boundaries of common decency, as if I were somehow implicit in or responsible for Mom’s behavior. Mom is not a child per se but Alzheimer’s has robbed her of the ability to discern right from wrong.
So, my mom has a record. A black mark against her. I’m not sure it means anything, though I imagine that if this type of behavior repeats itself, it is a trigger for the staff to suggest alternative ways of keeping Mom calm, including medicines that might make her more docile. There is great difficulty in fine-tuning medications to achieve a balance of protecting not only the patient but those around her while also avoiding over-sedating them.
In the meantime, with the holiday of Thanksgiving this week, I am thankful that Mom is as alert as she is. I am thankful, too, that I can still find joy in my interactions with her, even when after identifying me as her “beautiful girl” (which is incongruous because I am a grey-haired 55-year-old), she asks me who I am.
We’re making a faux Thanksgiving dinner this weekend with some turkey, rice, and of course, our ubiquitous Israeli humus. I won’t even begin to describe my horror at the proliferation of “dessert hummus” in the States (there’s even one with pumpkin pie spices!), but I will go out on a limb here and suggest that humus can be made with other types of beans. Case in point: white bean humus. Try it, especially if it’s late Friday afternoon, the stores are closed, and you can’t find even one can of chick peas on your shelf, and you pull out the only can of beans you have. This recipe is adaptable to your taste in a thick or less thick bean paste and whether you love garlic or lemon juice to be a dominant flavor.
White Bean Humus
I didn't tell the kids I'd made their beloved humus with white beans until after they'd tasted it. I was surprised they didn't notice. Not only was there a subtle taste difference but this humus was so creamy and so pale. Thankfully, we all enjoyed it. Serve with toasted pita chips.
1 550 gr / 19 oz can of white beans in water
¼ cup water (from the beans)
2-3 Tbsp raw tehina
2-3 Tbsp lemon juice
2-3 cloves garlic
1 tsp sesame oil
1 tsp cumin
Salt and pepper to taste
1-2 tsp olive oil
Paprika or zatar (hyssop)
A sprinkling of pine nuts
Combine all ingredients in a blender and blend until creamy. If you want it a little creamier, add more water or lemon juice. Place humus in a shallow bowl and, using a spoon, create an indentation in the middle. Drizzle olive oil and shake a little paprika or zatar into the indentation. Add pine nuts for effect.