I saw the most interesting transition in mother's behavior over about 1 1/2 hours on her birthday last week. I arrived at the end of one dosage cycle for pain meds, and stayed through about 45 minutes into the next cycle. So, I got to see her "with pain" and without it. Or so I assume. It seemed more like with will and determination, and without them, but I am assured by the nursing staff that pain is there, but Alzheimer's causes the sufferer to be unable to identify it as such. Rather, it causes generalized agitation, anxiety and fear. Whatever was the cause, her behavior was like day and night. When I arrived she was in a bad mood. She ignored the things I brought to share with her for her birthday, refused even a single bite of cake, and spent all her time and effort trying to get out of the geri chair. She made a sweet plea to me to get me to take her away, but when I told her I couldn't take her, she turned hostile.
She would struggle to get out of the chair, pushing and pulling on the tray that keeps her in, trying to slide out, etc. After a few minutes she would give up, exasperated, and collapse back against the chair back. Then in a minute, she was at it again. This went on nonstop. At first I talked to her about her situation, the reasons for it, and how sorry I was that she was unable to do the things she used to be able to do, but eventually, I stopped. Suggesting that she would have to accept that she couldn't walk or talk well enough to be out of the chair and effective in communicating her needs seemed pointless, because she clearly wanted none of that. Her behavior indicated that she did not know or believe either of those abilities was impaired. And yet, they are.
Then she got her pain meds.
Over the next 30 minutes the physical struggling and efforts to talk slowed down and then stopped. She became a relaxed, calm, serene, and seemingly happy person. She accepted my offer for some birthday cake and responded with a beautiful smile at hearing happy birthday wishes.
I can take away many things from this experience. Pain meds reduce the desire to escape from your situation, whatever it is. Alzheimer's makes it harder to remember that you can't do things. But in an odd twist on logic (which I can handle now that I realize there are ways of seeing for which logic is not well suited), I also take away that failure to accept what is true is painful.