With my Dad’s dementia condition, the “waking centre” is like a centre of reality, where he’s able to recognize everything as it is right now, and which he is able to use as a ‘ground zero’ for proceeding with the activities and the tasks that fill his day.

Watching for and managing the flashpoints

In terms of those activities and tasks he is fine and well, provided all things proceed smoothly and unabated. If there is an interruption in the sequenced structure as he is going through it, then there is like a fork, a junction, a crossroads or roundabout in his path – and consequently this a source of questioning and potential confusion. He then tends to either make a choice or continue on a loop around the roundabout depending on the complexity or the question.

If he is to make a simple choice – say, to put something away in what he thinks is ‘the right place’ – then things proceed and he is out of the loop.

If he feels that he can’t make a choice because it is complex, or confusing, or if that loop on the roundabout provides no answers for him, then he has some emotional responses to the confusion that vary between humour, anxiety, frustration, anger. These are the ‘flashpoints’ that I do my best to ‘manage’ for him in order to bring him back to the “waking centre”. There is a degree of dependency on my being with him, or noticing his confusion quickly, in order to help this happen more readily. Occasionally this will not be the case, and these will be times when (depending on the complexity of the questions that arise for him) matters can go a bit haywire.

One of his sisters and nieces came to visit us yesterday which, while being wonderful for him to see them, actually got him into one of those loops of confusion. The confusion was that the seeing of them and hearing their voices prompted him to think about them – and then talk about them. Only thing was – he talked about them to their faces which was initially quite a challenge for them! They saw the funny side which was great, and eventually he was able to put 2-and-2 together!

Another flashpoint happened this morning (probably brought on by the extra levels of cognition he had to bring to bear the day before). He had woken from (presumably) quite a deep sleep and was looking for my mother, who has been dead five months, because her bed was empty and he wondered why she had already got up and not ‘given him a nudge’. Detaching myself from the various levels of emotion this whole episode carried, I was able to engage with him and guide him back towards his “waking centre”. Once he’d arrive there, I knew the rest of his day would proceed in the usual way.

Vitamin B12

A deficiency in vitamin B12 tends to exacerbate memory-related dementia. Over the last couple of weeks his GP Surgery has been ‘catching up’ with his B12 levels to such a point that he will then only need a shot every 3 months. The difference in the quality of his cognitive recall and short term memory has been noticeable during this catch-up period and this has been really helpful in broadening his reality base.

Phases of the Moon

Rather like children become more hyperactive when the weather is windy, it seems that dementia sufferers are susceptible to changes in the phases of the moon. A time of particularly hyper levels of behaviour is around full moon, and so when my Dad’s comments and actions are a bit off-kilter then I check to see what ‘time of the lunar month’ it is. Many years ago I remember studying, quite extensively, my bio-rhythms and related it to particular highs and lows, greater or lesser moments of clarity etc. There were lunar aspects of these as well, so I can easily recognize how the balance of my Dad’s own perceptions and moods are affected in this way.

The “Appointment Card’

Going out somewhere has always been a considerable ‘flashpoint’ moment for my Dad, because it cuts across his daily routine and is something that he feels he is being forced to do against his will. Once he is out of the house and that moment has passed, he is fine – and enjoys the experience. In the midst of the flashpoint, however, his anger can bubble and boil over into tantrums and florid swearing. However – he has always been a great believer in discipline, respect for professional people, and the requisite order of things (rather than chaos!) One of the features this brings is the Appointment Card – which I have latched on to as being the means of getting him out to (say) the Health Centre without any undue fuss. Provided I show him IN WRITING that he is required to be at a certain place at a certain time, and that this requisition of his time has authority that is not to be questioned, then he goes willingly. The next trick is to get him out to a restaurant for Sunday lunch by making up a printed ‘Invitation’ – requesting his presence!

Time alone will tell – but it will surely work better than whatever ways we are attempting at present.