...almost as if Jeanne is Jeanne again.

Ah, I've looked back to Nov. 8, 2003. Jeanne is enrolled in the behavior modification program at Bethesda Hospital in St. Paul. And I'm about to make one of the hardest decisions of my life -- putting Jeanne into a nursing home. Here's my ponderings at the time:

I think about Jeanne every day. I love this woman. But in some sense, Jeanne is no longer Jeanne. Oh, I see glimpses of the real Jeanne. Things to cling to. The sweetness. If only for a little while. The neurologist tells me that there is a difference between dementia and insanity. But only in label, it seems to me. Jeanne is insane in that she no longer consciously controls her actions. The fact that she's on an anti-psychotic drug - a drug given to people with mental illness - is significant. Last night Jeanne seemed agitated. When she swears, I assume she's agitated. She keeps mumbling, 'Son of a bitch, son of bitch, son of a bitch.' And yet I doubt that she's consciously aware of it. Seems like a reflexive action. Maybe an outlet for deep-seated inner frustration. No other way to express her self. So she reaches to her depths and looks for a relief valve. Is this a way to express pain? Anguish? Dementia is a mental illness. Why deny it? Jeanne is not responsible for her actions. And when is 'institutionalization' best for Jeanne? What is the best and perfect way to treat someone with Jeanne's degree of dementia? Is the home-setting best for Jeanne? Or is it day care? Or is it a nursing home? What if I had a million dollars? How would it best be spent on Jeanne? How do we analyze or evaluate the situation and come up with the answer to what's best? The decision, ultimately, is in my hands, isn't it? It's the most god awful decision I'll ever have to make. I'd like a magic wand. Of course, I would cure Jeanne's dementia. I would make Jeanne Jeanne again. But in absence of a cure, I'd transform the relatives and friends. I'd create in them an overwhelming desire and ability to care enough for Jeanne to devote one day every five weeks to her personal care. To give me relief. One full day every 5 weeks. Devoted entirely to Jeanne. Directly. Oh, maybe I would have them periodically call Jeanne, too. Chat with her on the phone, if only for a few minutes. And I'd connect with someone in a dilemma similar to mine - caring for a spouse with dementia and with the desire to keep that spouse in the home-setting. And then we'd relieve each other. Give each other a break by caring for each other's spouses. It seems to me that caring for two dementia patients at one time is hardly any more difficult than caring for one. Especially if it's only for a few hours. That may be a stimulus for both the patients and the care-givers. Maybe this could be done through a support group of care-givers dedicated to keeping their spouses out of nursing homes. We could set up our own day care. Helping each other. Meanwhile, I wonder if Jeanne has been helped by her three-week stay in the behavioral modification unit at Bethesda Hospital. In some ways, she seems better. In other ways, worse. I think she has adjusted well to the setting. Seems happier overall. But she has lost much of her mobility. She shuffles her feet. I would not trust her walking unassisted. I wonder if that is due to her meds. Also, she seems to tire more easily. Becomes drowsy. Again, is that the meds? I begin to think that Jeanne would be happier in a nursing home - a good nursing home. She would have more opportunity to socialize there. At home, her contact is almost exclusively with me. We are mostly loners. I wonder if this does Jeanne more harm than good. Maybe this lifestyle was all right before dementia. Jeanne seems to be getting more stimulus at Bethesda than she got at home. Would that also be true in a nursing home? It could be the best of two worlds. I would be only 3 miles away from the nursing home in Forest Lake. And that would allow for frequent visits, even several times a day. And opportunities to take Jeanne out for a stroll or lunch and other activities. Jeanne is a social being. More so than I. Even with her dementia, Jeanne has retained some social skills. She is able to join in group activities. Like the music programs at Bethesda. She becomes animated. Sings. Claps her hands. Smiles. Her eyes sparkle. She looks alert. For a while, it seems as if my wish has come true...almost as if Jeanne is Jeanne again. --Jim Broede