Cognitive Decline or Just Obstinacy?

Regular exercise can keep dementia at bay – even if it’s in your genes: Being active three times a week stops the brain from shrinking. Experts recommend swimming, jogging, cycling and even mundane chores. – Daily Mail

When I was younger, my mother often rode her Willow Hardware red Schwinn bike to our ballgames, up to that wide-open space called the “fields”, those large blocks of sand and grass that were the summer salvation of every kid in Amherst.

When Mom had made her rounds through little and softball league games, and pleas for money for snacks, she cycled her bike home. But she rode that bike so few times, that often, my siblings and I absconded with her two wheels, instead of riding off on bikes that were becoming obsolete each season we grew.

Mom working hard at exercising.

Mom “working hard” at exercise.

My mother also enjoyed strolls on the beach. Not walks, but leisurely strolls that didn’t last long. Her only requirement was that she remained in the sun. As a matter of fact, the stretch that ran along the shores of Lakeview Park was the perfect length of beach for her. Anything longer, and the walk became work.

Even when she visited in Oregon, where my husband and I embarked on walks along the rugged coastline, her efforts were always cut short (the wind, my hair, this isn’t good for the baby).

My mother wasn’t lazy. After all, she had carted laundry up and down the basement steps at age 80. She traversed Italy with vigor and delight at age 78. But she just wasn’t the outdoors or exercising sort of gal, unless the sun was involved. Then, she could sit for hours or for her infamous twenty-minute naps, and wave to the truckers along State Route 2, which abutted our backyard.

In seventh grade, when I informed my mother I wanted to run track, she looked at me with a mixture of amusement and disdain. I had already broken a mold, learning how to downhill ski and keeping my parents up late until returning from our Brandywine ski area treks with no broken bones. But track? Track was new.

Oh, and I was planning to run hurdles, I told her.

The advice she gave back had nothing to do with training. Or endurance. Nothing inspirational whatsoever. What she said to me was, “Well, that’s going to make your thighs bigger.”

I gave her a seventh grade-version of me ne frego and ran the hurdles anyhow.

As I look back now, and attempt to engage a mother with dementia in exercise-related activities at her care home, I realize that Mom did not like to sweat yet sitting in the sun was somehow OK. Sweating was unladylike and Mom was of that era when encouraging, actually producing beads of sweat that would roll down your thighs just wasn’t supposed to happen.

Fast-forward to her years now, and the days of spending quality interactive time with my mother are few. The best care homes offer a multitude of activities, not only for the residents but also for family members to participate and interact with a loved one.

Thus, on many occasions, I arrive at Mom’s care home just in time for exercise hour. I have sat beside Mom while together we billowed a parachute up to the ceiling. We have whacked at balloons, playing volleyball. While seated, she will toss a few beanbags into a cornhole board, or roll a large plastic ball to bowl. But she would never stand up to move in Jane Fonda fashion in the same way she might be motivated to reach for a cookie.

I escort Mom to exercise hour because music playing in the background is stimulating or comforting or arousing. She can pattern herself after others’ activities. I want Mom to hear the sweet tone of Joanie, or the inspiring voice of Rosemary or the soft hush of Becky, encouraging the residents to stretch and roll. Sometimes the aid will play a DVD and instruct alongside the video instructor. Other times, exercise hour is live, in person.

Despite my mother’s aversion to sweat, I often break the cardinal rule of caregiving by caring only about what I think is best, not what Mom wants.

When exercise is on the schedule, for certain I will cajole Mom into walking the long corridor to activities. When we arrive and she is comfortably seated, Mom happily glances around at the other residents or comments about someone’s coat (Is that a, what is that, she asks, pointing to a cheetah-patterned jacket). In general, she will do everything BUT exercise.

But Mom can follow instructions. If I ask, Mom would you like some chips, and hold out the bag, she readily thrusts her hand into the bag or will instantly grab the bag and keep the chips for herself.

She knows to put her arm in the sweater if I am helping her, or to lift a leg or to move here or there, or to drink her Gatorade.

So, she should not be challenged in lifting an arm or a leg when directed.

Somehow, Mom knows this is exercise and simply refuses.

A chair exercise video was airing during my last visit. Mom could hear the audio because she repeated the words of the on-screen instructor. We (yes, I dutifully exercise when I am there, it might be my only exercise of the day and I do get my heart rate up) were doing arms lifts, like a chicken.

“Mom, lift your arms.”

“What?”

“Lift your arms, like this.”

“Look, one, two, three, four.”

She scrutinized the sweeping movements of those around her and crinkled up her nose.

“One, two, three, four,” I repeated. If I could get her to count, I could get her to move.

Nothing. No reply.

“Shoot like you are playing basketball,” the instructor called out next.

“A what? Oh you’re crazy,” Mom exclaimed to the video presence.

Finally, the instructor focused on legs. Mom had been having issues with swelling in her calves, due to less movement, less outdoors, etc. So, I decided to get her started.

I got down on my knees on the floor and gently began to swing her legs in time to the count.

“One, two, three, four. One, two, three, four.”

Ironically, the muscles in her short legs still had some shape.

The counting continued and I was deep in concentration. I didn’t want to yank Mom’s legs too high, for fear she would yell that I was hurting her. I didn’t want to let her feet rest low, in case she stopped.

Finally, I looked up at Mom.

She was swiveling her head around, as if an invisible force was moving her legs, as if there was no one else was in the room.

And I thought, I am doing all this exercise for her.

Greg, a rather youngish male resident seated nearby chuckled, but said nothing.

I plopped on my backside and laughed too.

I was exercising – for her. I was sweating – for her.

Damn it. She didn’t have to worry about her hair anymore and she still wouldn’t do it.

I don’t know why she was so disinclined to exercise, perhaps she had climbed too many stairs, or carried too much laundry, or stirred too much sauce.

I should give up on the effort, but a part of me still makes the attempt, as revenge for her years of (lovingly) mocking my tomboy manners.

And a part of me applauds Mom for fighting for what she wants, and not what her caregiver-daughter deems necessary.

 

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