Learning to speak dementia: Stop the pop quizzes, just let people talk — about the black guy nobody likes or anything else

obama

I found out a couple of months ago that my parents’ annual physical exam now includes a 20-question pop quiz after a weigh-in and blood pressure check.

My 104-pound mom with high blood pressure tackled it first.

Doctor: What year were you born?

Mom: 1932

Doctor: Where are we?

Mom: Medina, I’ve lived here most of my life

Doctor: Who is the President of the United States?

Mom paused. She glared at dad, glanced at me and then rolled her eyes at the doctor and blurted: “I voted for him — you know, that black guy nobody likes.”

Her embarrassment exploded silently, flooding the tiny examination room with a muddle of fear and shame.

The doctor, who has taken care of my parents for decades, tried to paper over the moment with reassurances. But there was no consoling mom, who, against my father’s wishes, had hammered a gaggle of Barack Obama campaign signs into their front yard in 2008.

This doctor’s visit happened in December and I hadn’t thought about it much again until an Iowa-based gerontologist I follow — Elaine Eshbaugh — wrote about something similar in her witty, insightful, in-the-trenches blog “Welcome to Dementialand.”

In it, Eshbaugh described stopping to talk to a nursing home patient after the woman hollered to Eshbaugh that she had become a grandma.

When Eshbaugh asked the woman what her granddaughter’s name was, the woman — like my mother searching for an answer her brain couldn’t come up with — paused and flashed from happy to sad. She couldn’t remember.

Pop quizzes, it turns out, don’t only happen in doctors’ offices.

They happen daily and inadvertently when many of us talk to people with dementia.

When we ask grandpa if he recognizes us, or grandma what she had for breakfast, we’re quizzing them. And if they can’t answer — when they get that sad and shameful look — they know they’ve failed.

I’ve been too thick to realize how often I do this with my own family.

Mom, I ask, where did you put the newspaper? Dad, I prod, don’t you remember you had a stent when you were in the hospital two years ago?

Wouldn’t it be better for everyone if I found the newspaper without asking? Or recognize and embrace that I’m now, and forever more, dad’s medical memory?

Eshbaugh concedes, she, too, has unnecessarily caused angst in dementia patients — including the woman in the nursing home who became a grandmother.

“Instead of asking her to recall specific info about her granddaughter, I should have said, ‘Tell me more about your granddaughter’,” Eshbaugh said.

“She might have told me that she was 8 pounds when she was born, that she had blond hair, that she cries a lot,” Eshbaugh said.But she would be focusing on what she remembered rather than what she didn’t remember.”

That’s a good lesson for most of us.

My parents’ doctor, of course, doesn’t have that option. She is measuring memory function and a quiz is necessary.

After mom fumbled the president question in the office that day, the doc continued down a list of other queries, swapping out a World War I question for one she thought both mom and dad should know since they lived through it.

Doctor: When was D-Day?

Mom stumbled into an answer involving the 1800s and dad, trying to save her, reminded her that was the Civil War.

“Abraham Lincoln was a wonderful president,” mom said, telling the doctor she was confused now about dates because she doesn’t work any more and has no reason to keep track of time.

A few minutes later, as the doctor was typing into her laptop and the three of us were sitting quietly nearby, mom lit up.

She had found the needle buried in 82 years of memory haystack.

“Obama,” she said triumphantly, pounding her bony, little fist on the arm of her wheelchair. “His name is Obama.”

For anyone interested, here’s a link to Elaine Eshbaugh’s refreshing Welcome to Dementialand blog: https://welcometodementialand.wordpress.com

9 thoughts on “Learning to speak dementia: Stop the pop quizzes, just let people talk — about the black guy nobody likes or anything else

  1. Our “crisis” this last weekend was ‘ I can’t find my keys and my cell phone.” I told her not to worry about it, we would deal with it after breakfast. She then proceeded to tell everyone she saw that she couldn’t find her keys and cell phone. When we got back to her apartment, I called her cell, which was on a table by her recliner, in plain view. We searched for the keys to no avail, but we were talking by the door to the kitchen and her face brightened, like “Ooh, I just remembered.” She reached in the pocket of the pants she was wearing and pulled out the keys. Right now mom’s life seems to be a daily pop quiz of her own doing.

    Liked by 1 person

    • Hey Tim. Happy Birthday — and what an interesting way to spend it. I hope you guys had time to go thru all that stuff. i know it’s an undertaking. My basement could be a dig — for my parents’ stuff, Skip’s parents’ stuff, his sisters’ stuff. etc Re: pop quiz…As long as there is no deadline, I think many people can do OK, at least for awhile. My mom doesn’t know $5 from $5,000, but somehow pulled out Obama’s name. Brain is fascinating. I wish they’d make a wrist-phone not unlike fitbit..for old people…that way, they wouldn’t lose it. no fancy tricks to phone…just receive calls and maybe hold five numbers, including 911.

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  2. Hi Amanda – reading your post, it struck me how much of a schoolroom nightmare it must be to have questions fired at you and to struggle with the right answer. I’m trying to think of another time in our lives when we’re asked direct factual questions by a professional who, we know, has power over us. And not as part of an interview or a conversation, but as a test. For those who went to school long ago, when teachers were stricter, it must bring back uncomfortable memories of Maths classes or being quizzed on historical facts.

    A good friend of mine’s mother, at the beginning of her helter-skelter, spiral down into dementia, was terrified of the ‘test questions’. She knew that the ‘wrong’ answers would speed her closer to a care home. She used to write the answers to the usual questions on her hands, when she was lucid.

    I do understand the rationale behind the questioning, but you’d think we’d be able to develop a way of finding out about somebody’s memory through directed conversation rather than a quick version of the Spanish Inquisition. None of us would do our best under direct questions, and if you’re feeling fragile anyway, it must be upsetting.

    I do wish you well in your odyssey. It must feel like travelling through new, uncharted territory every day. You’re lucky to have your lovely husband at your side, travelling with you.

    All best wishes
    Elaine

    Liked by 1 person

    • How sad (but smart, too) — scribbling the answers. My dad — who has lesser dementia — writes notes to himself about everything. He also maintains a strict schedule, so that he does the same thing every day at the same time…from taking pills to when (against my wishes) he smokes a cigarette. Adult children who monitor their parents by phone — especially those who live at a distance — should be aware that their parents may try to hide their own failings by writing notes, etc. Thanks for your good wishes, Elaine.

      Liked by 1 person

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