Playing Peek-A-Boo With Mom

The Science : Children

For those of us who have played peek-a-boo with babies or young children, their reactions can vary from encouraging giggles to perhaps cues of discomfort because we are no longer visible for a brief moment. Important cognitive and emotional development happens when playing peek-a-boo. Babies are slowly grasping the concept of object permanence. Object permanence is when babies learn that something (or someone) still exists although it is not in plain sight. Babies typically start to show signs of object permanence between 4 to 7 months.

Object permanence is crucial when it comes to forming a secure attachment with your child. Think of the following scenario: A mother leaves her child with a new caregiver. Her child cries and crawls toward the exit door, wanting to only be comforted by the mother. Crying, although uncomfortable to watch, is one sign that the child understands that their mother still exists and wants to be with them. They know that mom is on the other side of that door. When the mother returns, the child is able to calm down again. This signifies that the child is forming a secure attachment with their mother. They see their mother as a ‘secure base’ for comfort and contact. This example shows that the child can recall that their mother is a real entity that has not ceased to exist, but has only ’disappeared’ behind that door for a moment. It’s almost like a drawn out game of peek-a-boo. Facial expression and exposure are so important. Experiments have been done to prove the harmful effects of loss of ‘object permanence’. Imagine the psychological and emotional damage done to school and pre-school children during the ‘lock-down masking’ years. Imagine the harm done to isolated seniors with cognitive, hearing and speech difficulties. Daily sporadic games of peek-a-boo provide babies with opportunities to slowly build up to the concept of object permanence. It re-affirms that both parties of the engagement are part of the world, that they are connected.

Some Words From ‘The Alzheimer’s Association’ website : More Science

Dementia is not a single disease; it’s an overall term – like heart disease – that covers a wide range of specific medical conditions, including Alzheimer’s disease. Disorders grouped under the general term ‘dementia’ are caused by abnormal brain changes. These changes trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behavior, feelings and relationships.

Alzheimer’s disease accounts for 60-80% of cases. Vascular dementia, which occurs because of microscopic bleeding and blood vessel blockage in the brain, is the second most common cause of dementia. Those who experience the brain changes of multiple types of dementia simultaneously have mixed dementia. There are many other conditions that can cause symptoms of dementia, including some that are reversible – such as thyroid problems, vitamin deficiencies, diet, elder abuse, social isolation and medical interventions.

Dementia is often incorrectly referred to as ‘senility’ or ‘senile dementia’, which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging.

The Humanity : Mom

I remember playing Peek-A-Boo with my daughters. They had to be in the mood for it. All of their other basic needs had to be met first, very much like playing with a pet cat or dog. They ran the show. The game had to be on their terms. It can start with a gentle belly or chest poke and then move on to the hands to the covering of face and reveal as part of the play.

“Wo ist Kirsten und Sonja?”

“Peek-A-Boo!”

“Oh, da ist Kirsten und Sonja!”

The giggles were priceless, mutually healing and therapeutic, much like laughter in later years through good times and those not so good. Their brains were growing, making new synapse connections and memories -firing in so many different directions. It was slapstick or pratfall play and humour like something you’d get from watching The Flintstones, The Marx Brothers, or Charlie Chaplin.

With mom, the early signs were mostly verbal. Without any context, she would at times exclaim, “Oh dear, dear, dear”, or “Oh my brains.”, when she forgot something. She would occasionally forget certain details of her daily life or be unable to recall events of the past. Sometimes this was a blessing considering some of the horrors, trauma or disappointments she experienced as a child during the war or after she had emigrated to Canada as a young adult. After becoming twice independent from deficient men she did not deserve, and up until that first fall, she looked after herself quite well. She kept a clean and organized home and conducted her own affairs. She was selective on who she spent time with but mostly wanted to be left alone – to be social on her terms. She never really had a taste for Jeagermeister or brandy until enabled or encouraged to do so by certain family and ‘friend’. They invited themselves over to visit ‘because they cared about mom’s well-being’. They catered (bootlegged) the events, took her for occasional lunches and let her pay. Even after she was diagnosed with early onset dementia and after a few more bad falls and recoveries while in rehab or full care, they made sure that she always had a little something in one of her cupboards. When she had her last fall at Summerwood she had a schnapps glass in her hand and had cut herself quite badly. So much for continuing care by her advocates. By that time mom surely had a dependence requiring certain family and ‘friend’ to continue their kindness if they deigned to visit at all. As her independence declined so too did her living spaces. Her possessions, valuable or not, began to disappear. Her world got smaller. Dementia is brain cell decline and death, the disconnecting and misfiring of deteriorating synapses. Alcohol speeds the process. Somewhere in there, after the initial diagnosis of ‘onset dementia’, the family and ‘friend’ took mom to a lawyer, who apparently deemed her competent enough to change her will and personal directives in ways that were not entirely in her best interests. Things slipped even further from then. Greed and self importance of ‘friend’ and ‘family’ replaced concern, compassion and care.

The truly hard part is watching mom progressively fade further from cognition and self awareness. She is unable to walk and is only occasionally able to feed herself. The ‘understaffed’ staff keep her on a schedule of ‘wake’, ‘eat’ and ‘sleep’ with occasional scheduled fun if they can get away with it. Diane J. is a caring friend and neighbor to mom there. To be sure there are some caring and compassionate staff at the facility where she’s at but there are limitations. Mom goes where she is pushed. She seems to understand what is being said to her but cannot form the words to respond appropriately. She does not protest. She is accepting and gentle. I can see it in her eyes. She cries sometimes. She wants me to take her with me when I leave from a visit. Sometimes I cry, knowing that there is not much more I can do to make her living conditions better.

I miss those weekly phone calls and conversations of the past, especially when the girls were young – the “Hi and bye Omas”. I miss the weekly visits and sleepovers when I went to Edmonton every week to help dad transition through his loss of independence, dementia and death. Mom was a great comfort and support all the while recognizing that she could very well end up in a similar situation. At some point, Dad had awareness of his declining mental state, even before the diagnosis. He called it ‘Oldtimers Disease’. He wanted to just be thrown over the fence into the weeds when he died.

There have been bright periods though. In May of this year, mom’s sister Elli, my aunt, came to visit, accompanied by cousin Kenneth, her son, and his wife Nancy as well as cousin Barb and her Bernie. This visit was so important in that it might very well be the last time the sisters met in person. It offered up the opening of windows and doors of mom’s mind and spirit so that the sisters might truly connect and reminisce a bit. The positive effects of the mutual time and stimulation spent, carried for weeks after the visit. In spite of a self promoting, cringeworthy, unwarranted and unwanted intrusion by ‘family’ and ‘friend’, that could surely be more meaningfully present at other times, during and after ‘the Elli visit’, mom was more responsive and chatty and willing to communicate even if the words didn’t come out right. I confess to briefly, selfishly and secretly watching Mom and Elli chattering over photo albums. Sue me.

Weeks after the visit mom was still interested and stimulated by peek-a-boo and facial and pratfall play. A raised eyebrow or two, a pulled face, a wink or peering over ones eyeglasses actually raised a “Du bist einer Scheisser” response. She smiles. A hand held and some Heinje or Heino folk ballads played can also evoke a range of expression. It’s why good and caring people should show up more often. A window or door could open at any time. It’s important and human.

Just this week it was announced that The Edmonton General Continuing Care Facility where mom resides is currently under an ‘outbreak notice’ requiring the usual restrictive and ‘preventative’ measures that limit contact and communication. Visual and verbal cues and responses will also be restricted by gowning, masking and shielding – Mom’s spiritual lifeline shredded, restricted or cut. While the health and safety of all vulnerable residents is important it remains a shame that that rare and intermittent light that shines from mom might be restricted. She has no choice. Her sweet disposition dictates that she must go along with the measures without fully understanding. We can only hope that staff and those members of family and ‘friend’ have had some awakening to the damage and harm that was done to the vulnerable during the last ‘lockdowns’ and stand up for mom on helpful measures and stand down on those that aren’t.

We’ll have to see this through. For mom. To express our own humanity and care and concern over self interest. We owe her this much and so much more. It’s more than establishing that object permanence that will continue to fade.

Hello Mom!

Mama!

Peek-a-Boo!

We see you!

We are here for you!

Everyone should be there for you.