Sam Bauman: Respite work offers look at dementia clients' pain, survival

One thing one can be sure of when volunteering as a Respite provider for RSVP: the next dementia client is going to be different. Dementia is, of course, an umbrella term that includes Alzheimer's, Parkinson's and other diseases having to do with the brain. No two are truly alike, as one finds out quickly.

Tom was my first, suffering from Alzheimer's. (Note: names herein are changed for privacy.) He was quick to talk, often repeating questions within minutes. After several months of staying with him while his wife went out to play bridge, he and I became modest friends. He disappeared one week when his wife called and told me not to come. No details.

Then there was Ed, a former Chicago businessman, vigorous, quick to take up a billiard cue for a game of pool, suffering from an undiagnosed illness. He would talk endlessly about his past life. He, too, disappeared after several months.

Next came Theo, a quiet, intellectual man who enjoyed DVDs made by college professors on such topics as economics of the Roman Empire. He lasted only a few months as Alzheimer's overtook him.

Up next was Allen, a Parkinson's sufferer. He'd had a bad reaction to a drug given to him for dental work. He was a fine talker and had lived a vigorous life, hiking Mount Shasta and Mount McKinley, skiing all over Tahoe, hiking local trails such as Prison Hill or Dead Man's Creek. We meet weekly for several months until he began to suffer the "freeze" that Parkinson's victims experience. He would start to walk, then stop as his brain failed to connect with his legs. He was moved to a hospice.

Now I've got two clients who couldn't be more different.

Anton is mildly taken with Alzheimer's, but he enjoys life, works on the computer and hikes around the neighborhood alone, picking up trash. (We're not supposed to let clients out of our sight, but Tony's wife says he is known in the neighborhood and always finds his way back home.) Tony makes his own lunch, watches TV and clearly is able to enjoy his life.

My newest client, Bruce, is a different kind of case to me. He is bedridden, comatose, breathing oxygen 24/7. He has lost a leg due to amputation from diabetes damage, and he often feels phantom pain in the missing leg. He does not talk and lies in a hospital bed, covered head to toe in blankets and comforters. He receives morphine for the phantom pain.

I was sitting with him the first time last week and his spouse told me he could no longer drink with a straw, and that she was moistening his lips with a sponge on a stick. He was not communicating.

I had been alerted that the oxygen supplier would come, and he did, replacing the oil-barrel-sized oxygen system. Carol, a certified nurse assistant, also appeared. She was cheerful and all-business as she began her daily task of caring for Bruce - changing his sheets, clothing and bedding, emptying his urine bag and bathing him. She did it all quickly and efficiently, seeming undismayed by the unpleasantness involved.

She was a talker as well, telling how she had five patients like Bruce to whom she attended daily. Always upbeat, she talked as she worked.

"About 20 minutes after I've finished with Bruce, it's all out of my mind," she said. "I've erased it." She smiled as she turned Bruce in his messy bed, chatting with him as if they were conversing.

Carol is the kind of worker we Respite givers are not. She gets paid by the hospice for which she works, and whatever it is it isn't enough. RSVP people are not allowed to really help clients - no giving meds, no helping in the bathroom. Carol does that cheerfully while Respiters like me just sit and watch. We serve, but not to the extent those like Carol do.

"Fond detachment" could perhaps best define her philosophy. She dwarfs people such as me.

On the slopes

I'm heartened by seeing the number of seniors I do when I go skiing at Heavenly or Kirkwood or Mount Rose. Seems that the baby boomers have returned to skiing, complete with the contemporary shaped skis and loose ski pants. Well and good, but most of them apparently dropped out while skiing was undergoing a technique transformation with shaped skis - shorter, with deep side cuts - coming into play.

This required a change in technique, from the old rotary shoulder turn twisting the body outside the turn to the contemporary technique of turning inside the turn with the body weaving across the fall line. The new way is less demanding, smoother and more fun. But the seniors I see on the hill are still doing the old rotary turn. They need to take a brush up lesson with a teaching pro to truly get the best out of the new shaped skis and the hill.

• Sam Bauman writes about senior affairs, among other things, for the Nevada Appeal.