What does 'with it' mean?

2parents/brain change · February 2024

Dear Alz friends,

This is totally a way for me to process the phrase 'with it'. My FIL is in memory care, 10 months now. 95. Has had falls and brain bleeds leading to his placement in MC.

My FIL family has always revered him as invincible. He was and in many ways, without mom, (4 years) still the patriarch.

What I find so hard to ignore is the under current of..........he's not like the other people in the MC. Even the private paid aide who is with him 3 hours, daily, reports.......he's not like the other people in this unit.

When I visit Dad, he seems very typical dementia. The Aide insists, 'he needs more stimulation'.....

I think she is quite attached as she first helped with mom, at the house. Then with Dad. The the family hired her to visit him in MC.

I think I know the answer, to just ignore it. I wanted to write about it as for me, staying in reality will help me engage with him appropriately. I wish there was a social worker at this center, but to my knowledge there is no such person.

At any rate, I have my friends here to 'talk to'

Thanks for reading,

Two parents/brain change

2parents/brain change · February 2024

Sorry.......the favorite description is 'He is really with it'! One of the aides said the same thing about a woman down the hall who keeps crying out......Let me know when dinner is ready.......oh 'she is really with it', she just wants attentionl..

Quilting brings calm · February 2024

With it usually means his brain is engaged. Also a way of implying that his cognitive impairment is less than people say it is.

I would ignore it as you can tell his usual cognitive state for yourself.

2parents/brain change · February 2024

https://alzconnected.org/discussion/comment/197773#Comment_197773

/thank you.

M1 · February 2024

I think the aides use "with it" to describe anyone with some social skills still intact, such as ability to recognize cues, boundaries, and routine social speech such ad "hello" and "how are you." My partner maintains these so far. She watches the staff and other residents like a hawk. So interesting to me that even well into stage 6 she can distinguish who has dementia and who doesn't.

harshedbuzz · February 2024

There are a lot of pieces to this.

Any MCF that allows a PWD to age-in-place will have an ebb and flow of an average baseline in a unit based on who is living there at the moment. A person with FTD dementia may have stunningly poor executive function while their memory is fairly intact initially. A unit that has a lot of "long timers" on it may skew more to the impaired side of things-- most facilities will try to balance the workload for staff by mixing "easier" moderate stage residents with those further along.

It could be the aide hasn't had a PWD who presents like your dad. My dad maintained conversational speech and ambulation right up until he died. He couldn't swallow safely and his body no longer really digested food, but professionals who weren't hands on got a sense he wasn't as far along as I thought he was.

Related to the above, it can be really hard to know where a person is in terms of disease progression by looking. There was a woman on dad's unit who was stylishly dressed and tended to other residents with pats and hugs. I thought she worked there. Nope, she was nonverbal and handfed but had an aide 7 days a week to come get her ready for the day with hair, makeup, manicures.

It could be the aide is angling for more hours. Perhaps your dad is a relatively easy client and she'd rather spend more time with him than take on someone new.

Maybe the aide thinks she's being "supportive". I have a son with high functioning ASD who was a handful in the early grades. I can't tell you how many times well-meaning friends, scout leaders and even teachers minimized his very real challenges as a way to say something nice about him.

@M1 My dad was the same. He was always telling me who was "looney tunes". When I suggested maybe he could sit at the table where the lady I referenced above sat he said "she may look regular, but she's the craziest one here." While I wouldn't phrase it thusly, he wasn't wrong.

HB

2parents/brain change · February 2024

Wow!

Thank you sOOOO much. FIL is in a glamours looking place but my sense is there is not a skilled person anywhere. Yesterday I spoke briefly to an activities director who works with the Assisted Living Folks and she pretty much confirmed my hunch........Not a staff member older than their 30s.

My married into family tends to over state Dad's abilities. Meanwhile what they have settled for, is a place that does not recognize the individuality of their residents.

Currently there is NO director of the unit. They fired the one they had and now have no one.

There is an 'activities room' that is largely empty any time I am visiting.

So in short, what abilities Dad has left are not strengthened or nurtured.

I have found going to see him once a week is healing for me, and I think for him. I don't go with other family members as they 'expect' things of him. I really understand how 'minimalizing' my FIL dementia, then turns around to kick you. Because you miss his very real abilities!

I will keep trying to take it one day at a time. It's so sad to me. The grace is, he really tunes into me and talks to me when I am there.

Thanks so much for taking time to share with me!

2parents/brain change · February 2024

https://alzconnected.org/discussion/comment/197847#Comment_197847

Thanks, By visiting him when family isn't around I get a more clear picture of him. I am a retired Speech and language therapist, having worked with communication impaired children and kids for many years. It amazes me how staff are simply not trained to recognize different ways people have of communicating. My Dad communicates clearly, if only people will really listen.

What does 'with it' mean?

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