What's "Normal?"

How do you explain to an ER doc that you've brought your 91-year-old mother in because she's acting too normal? And when he asks her what month and year it is and she gets it right, and he looks at you like Maybe YOU need to give us a urine sample, how do you explain that it's not normal that she's acting so normal? It helped that she went on to explain that she saw snow flakes hitting the windshield on the way in (it wasn't snowing) and that she's been seeing curtains moving in front of her face for several days (there weren't any curtains).

This started about two days earlier when my mother did something she doesn't usually do--she got up in the morning, got dressed, and came downstairs for breakfast. That was the first sign that something was amiss, because she's usually asleep until Kathy, her caregiver, or I come upstairs in the mid-afternoon to wake her up. She has always been a night owl and an insomniac. Now that she's in her 90's, and lives in my house, I have come to expect this. Okay, let's be honest... I've come to appreciate this. I don't have to worry about her when she's asleep. I hear her door creak every few hours as she gets up to use the bathroom, and I call up, "HI MOM" and make sure she smiles and acknowledges me, so I know she's fine, but I can also shop, write, watch the news, meet friends, etc., with the happy knowledge that she has no idea I'm neglecting her. I'll wake her up when it's convenient, or Kathy will (which is more convenient), and she'll be shocked that it's so late in the day. She'll say what she says every afternoon: "I never sleep this late!" and I'll know everything is normal.

So having her appear in the kitchen at 9am, wide awake, dressed for the day, and perky, is weird for me. When it happened two days in a row, I had the selfish thought that my life might have to change. I don't entertain my mother when she's up, but I think I should. I should take her with me on my errands, out with my friends, to the grocery store, etc. I should sit at the kitchen table and chat her up like Kathy does. I should take her to stimulating places, like Kathy does. But I don't want to. I like my alone time. I like to race from store to store when I shop, sit for hours at my computer when I write, and listen to Dr. Laura on my iPhone when I cook I don't want to slow down and help little old ladies in and out of cars, walk slowly through automatic-opening doors while holding onto little old ladies' elbows so they don't fall. I LIKE TO MOVE FAST WHEN I MOVE AT ALL. People tell me I'm a saint for caring for my mother (and mother-in-law), but I know that if God can read my mind, I'm still going to hell.

On Friday morning, not only was my mother up early, but she was worried about her winter coats--where were they, had they been stolen when she moved, etc. She fretted about this at length, and then started asking about kitchen utensils she couldn't find. She remembered many of these in great detail, and expressed her disgust that various people had probably taken them when she wasn't looking. I couldn't tell her that I had let the auction guy sell 90% of her stuff several years ago. Not the nice coats, but most of the kitchen stuff. My siblings took some things, I took some things, but she hadn't thrown anything away since the mid-70's, and how many wooden spoons can a person use, even if they have nice metal handles?

Kathy spent most of Friday with my mother because the kids were out of school. Kathy's other job is substitute teaching, which is how I met her. I spend most of Friday with my kids, particularly Sami, 16, shopping, eating lunch, etc. Kathy called me at the end of the afternoon to tell me that my mother had been way more alert than usual, but fretted about little things that normally wouldn't even claim her attention. She was worried that the Thanksgiving groceries I sent them to buy were for tonight's dinner, and got cranky with Kathy when she wouldn't bring them home faster. She also kept talking about a plant in a bowl of marbles that had recently flowered. Kathy is a very sweet, gentle woman, and usually fabulous at redirecting my mother, but it wasn't working!

That evening, I was watching the news, and my mother was in Betty's room, watching a different news channel. She came out to find me and started talking about Newt Gingrich, and how he was going to change the tax code, and how immigrants and college students were going to be expected to pay off our 15 trillion dollar debt. She was animated and urgent and quite bothered by this. About half of it made sense, but the other half was a bit twisted. Then she said, "You know, before we went to Vietnam to get Mikey (my adopted son), I had a bladder infection that I caught from Betty. I don't think I should be sharing the same bathroom with her."

Alarm bells went off in my head. Ten years ago, when we traveled to Vietnam, she didn't live with Betty, but something had made her bring up this subject. "Do you think you have a bladder infection?" I asked.

"Oh, I have no idea," she answered. "I just think it's wrong to change the tax code and make immigrants pay for all this."

I keep those packaged urine specimen cups in my kitchen cabinet, which will tell you something about my life. I gave her one and asked her to get me a urine sample when she could. A few minutes later, she was heading for the bathroom, sans cup, and I chased her down and handed it to her. "Oh, I already did that," she assured me. "Yes, but I need one more sample," I said, and she took the cup.

I called Kim, Betty's caregiver, and described the contents--cloudy, with little white floaties. "That's a bladder infection," she said. I suppose I was hoping this could wait until morning, but Colette (nurse friend) and the after-hours nurse at the doctor's office said I should bring her in as soon as possible.

Dreading an argument, I told my mom, "Your doctor wants you to go to the Emergency Room to make sure you don't have a bladder infection."

"Now?"

"Yes."

"Will I need a coat?"

She was gathering up a book to read and looking for her purse before I could absorb the fact that she was cooperating so nicely. Fast forward to the ER, and the doctor coming in and checking her for signs of confusion, giving me the "Maybe you're the confused one?" look, the test showing she indeed had a bladder infection, and getting IV fluids and a prescription for meds.

Somehow the bladder infection had brought her back to me for a day, but I knew it wouldn't last. Thanks to the antibiotics, she would soon go back to her happy fog, and to being quiet, and not caring enough about what she was on television to get excited about how Newt Gingrich was going to screw up the tax code. It was like that Robin Williams movie, Awakenings, when Robert DeNiro comes out of his vegetative state for a time, only to revert back.

If you're a caregiver for a senior citizen with dementia, watch for unusual signs of normalcy. If you're a research scientist, please find a way to synthesize the protein created during a bladder infection and put it in pill form. It's better than Aricept.