volition

It's becoming harder and harder to pull Mom away from a task on which she fixates. For her, the kitchen seems to be the primary source for her compulsions: her need to grab anything cloth-like (including a plastic bag) to wipe the sink and countertop is strongest when she's in that part of the house. No other room seems to have such a pull on Mom, not even her beloved living room, where she spends so much time sitting and/or watching TV.

Mom is currently flipping through the doodling book I bought her; she doesn't seem too fascinated by the Rubik puzzles (Rubik's Cube and Rubik's Magic), perhaps because they require a level of logic that she can no longer summon. I suspect that Mom might be better off with something like a snake puzzle, or some other such toy that doesn't necessarily require one to solve it. I also suspect that, given Mom's love of "find the differences in the two pictures" exercises, that she might enjoy activities that are of a more pattern-finding nature, such as word finds or "Where's Waldo?"

One thing I did notice today was that Mom, if left to her own devices (but still supervised from a distance), would eventually desist in her compulsive cleaning activities. Dad's been using the term for some time, but this finally looks like the behavior associated with obsessive-compulsive disorder: the rituals in which OCD sufferers engage tend to be of a world-maintaining nature-- something that we religious studies students pick up on right away. Think about the guy who has to wash his hands a specific number of times, or the woman who cannot enter her house until she's turned her key in the lock a certain number of times and in a certain way. In both cases, these are people who, if their ritual is interrupted, will spend the next while believing that something is cosmically wrong. Once the ritual has been properly performed, however, the unease disappears: adharma, chaos, has been defeated and dharma, order, has been restored.

All this is new for Mom, but it seems to be the next logical step in her disease's progression. Before, it was possible to pry her away from a task without having to deal with her resistance. She would switch quite willingly from one task to another, requiring only our guidance. Now, however, if I try to cajole her or even to gently force her away from an activity, she becomes unhappy with me, saying, "Just a minute, Kevin! Kevin!" by way of resistance. Physically forcing Mom to do anything is not a job I relish, but I find myself doing it more often, especially when Mom's actions result in dirty fingers (she loves to clean the sink with her fingers) or possible injury (we had a close call with the sink's garbage disposal unit). Treating Mom as if she were a wayward child is no picnic; it's yet another reminder that the hale and whole Mom we knew is gone for good, and has been since at least April 16, if not before.

At the same time, seeing Mom regain some measure of her own will is heartening. It's too bad that her will articulates itself in this splintered, fractured way, but what can be done about that? The architecture of Mom's brain has been sundered; impulses that might have articulated themselves normally, in happier times, now have little choice but to manifest themselves in weird and occasionally self-destructive ways. As with the other changes we've experienced, Mom's OCD-like behavior now becomes something new that we have to incorporate into our ever-evolving caregiving paradigm. She's regained a measure of will, but brain damage has prevented the return of common sense and wisdom, both of which are informed by reason. Without reason, we have nothing: sense perceptions are useless without higher functions to find or impose order on them. Life without reason is as directionless as a finger painting by a one-year-old.


_