Alzheimer's disease · Caregiver · Doctors

The good doctor / August 23, 2006

Today my sister and I had an appointment to talk with my mother’s primary care doctor. I left our meeting with a good feeling, not because of any hopeful news about my mother, but because I feel fortunate in having my mother under this doctor’s care.

We were referred to him shortly after the AD diagnosis by a friend of my sister’s, who had taken her own elderly mother to see him. He is an older man himself–close to seventy, I’d guess. He has his own practice, which is staffed by his lovely German wife and a very conscientious receptionist, who always makes sure to talk directly to my mother (as the doctor and his wife do) when she visits. It’s a small office, but literally a stone’s throw from my house and a very short drive from my mother’s. He loves American history and sailing, as his waiting room reading material attests. There is often a bit of a wait because he’s very generous with his patients.

We wanted to tell him what our perceptions were and what we were doing about them–the assisted living plans, the Aid & Attendance application. He gave us some feedback on places we’d visited and talked about the differences between assisted living, dementia care units, and nursing homes. He listened to our stories of Mom’s recent behavior and talked a bit about the progress of Alzheimer’s.

When I expressed my worries about removing her from her home, he said, “You know, that house has sheltered her for almost 60 years. It will continue to shelter her in a way if it can help you get what you feel is the best care for her.”

I liked that idea–that the little house that she and my father bought on the G.I. Bill after the war would return in some way the care they had lavished on it when they were younger and able. Without my father’s skills, it’s fallen into some disrepair, and maybe it deserves the new blood. But it was a shelter for all of us, and I appreciated the doctor’s way of looking at it. His words will help me to make the tough transition of moving her and selling it.

We talked some about my mother’s mood–would being with others during the day give her some emotional respite from the disease, while she was still aware of her situation? He said he didn’t know how my mother would react, but he’d seen individuals who’d seemed comforted merely by sitting silently amidst others. He then told us a story of a nun with Alzheimer’s who could sing her hymns long after she lost her ability to communicate on her own. “The spiritual ‘ability’ is often one of the last to go,” he said, and I recalled my mother reciting the “Pater Noster” each night along with the Mass:

Pater noster, qui es in caelis,
sanctificetur nomen tuum.
Adveniat regnum tuum.
Fiat voluntas tua, sicut in caelo et in terra.
Panem nostrum quotidianum da nobis hodie,
et dimitte nobis debita nostra,
sicut et nos dimittimus debitoribus nostris.
Et ne nos inducas in tentationem:
sed libera nos a malo. Amen.

As we finished our visit he shook our hands and said, “Your mother is a lovely woman. Even though I didn’t know her before her illness, I can tell what she is like by talking to you.”

Well, I almost cried at that point, but I quickly reminded myself that I’d used up my yearly quota of tears over the past week. But this courtly and careful doctor gave me an emotional boost–not by any false promises or patronizing information, but by his attention, by just the right mix of the personal and the professional, and quite possibly by the wisdom of his years.

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