How do you know?

I spent the afternoon with my inlaws today.

Pop had recent multiple surgeries which, while complex, he is recovering from beautifully and with no real complications. He got out of rehab after just one week and has been making steady progress ever since. He's up and moving around on his own with a walker and showing more stamina and alertness than he has in a long, long time.

I wish the same were true for Bubbe. She gave us quite a scare a couple of days ago. Pop's home nurse noticed that she was pale and clammy and that her blood pressure had gone up quite a bit. One of my sisters-in-law took her straight to the doctor, who determined that it was not a heart attack and did blood tests. Turns out she's got a bacterial infection (probably from hanging out at the hospital and then rehab) that has brought her low. I'm sure her immune system was running on empty due to all the stress of Pop's surgeries.

Yesterday, my husband went over and took them dinner and visited for a while. I took this afternoon off from work and went over to see what needed to be done. I went to the grocery store and the pharmacy for them. When the therapist-of-the-day showed up, I suggested that Bubbe go take a nap. While she slept and Pop got therapy-ed, I started cleaning the kitchen.

Now, Pop has been a bit concerned about Bubbe for a while, fearing the almighty Alzheimer's was moving into his wife's head. He took her to be tested and the tests came back that she did not have it (though I thought the only sure diagnosis happened at autopsy...). But she does seem to be slipping a little. Sometimes she would tell me the same story or ask me the same question several times during the course of a conversation, never seeming to realize that we'd already been there. Today it was all about macaroni and cheese - something she didn't usually eat, but wanted today for some reason. Mentioned it several times, so I got some when I went to the store.

On the way back to their house, I called my husband to check in, and he told me about a couple of instances of her leaving a burner on and putting a plastic plate down on it, or walking in and finding her eating a sandwich while the stove burner was red hot (meaning-she didn't cook the sandwich, so how long has that burner been on????). That sounded worrisome, but we didn't really want to lay that on Pop just yet.

Unfortunately, when I got back to the house, they were having a heated discussion over her medication and he was telling her that he was going to take care of her whether she liked it or not. She got up and walked out of the room, and I realized that things could get nasty if I didn't tell Pop now about our concerns. So I did. I explained that she was upset because I thought that maybe she realized a little of what was going on with her was not right and that she was scared. That when she fights him over things she wouldn't normally, that it wasn't her doing it but a mixed up brain chemistry. Perhaps it was a medication problem that will clear up, maybe some very small strokes, maybe the very beginnings of dementia. NONE of those things are Alzheimers, but could affect her memory and behavior just the same. He will have to be patient and keep an eye on things without being obnoxious about it. It will be difficult for him. He is not the most patient person in the world, but he loves her and I know he will do what needs to be done.

I did suggest that they get into the assisted living facility as soon as they could though. Between his physical problems and her eyesight and the other questionmarks, it might be best if help were just down the hall rather than several miles away. It would ease their minds in caring for each other, and ours because we just can't be there ALL the time.

How do you know when it's time to say or do something? That may be one of the hardest questions out there. And usually it's answered when to NOT say or do something causes more harm than good. I am only hoping I did the right thing in talking to him today about all of this.