Bipolar Me

Executive Dysfunction Strikes

Last week in my post on lethargy, I alluded to a crisis that was requiring me to rouse myself and use nonexistent spoons to try to cope with it. Unfortunately, executive dysfunction got in the way.

What exactly is executive dysfunction? It’s “a disruption to the brain’s top-down management system that controls planning, working memory, emotional regulation, and task initiation.” In practice, that means you have trouble with “task paralysis,” when you’re unable to do what you know needs to be done; “time blindness,” or losing track of time; “working memory issues,” such as not being able to deal with multi-step instructions; “emotional dysregulation,” or quick frustration or feeling overwhelmed by changes; and “task switching impairment,” which is just what it sounds like.

Executive dysfunction is associated with ADHD, ASD, OCD, schizophrenia, depression, or, in my case, anxiety.

Here’s what happened. Dan’s mother is 99 years old (100 in February). Her other son lives with her and assists her with tasks of daily living. Unfortunately, Ben was stricken with a strangulated hernia and had to be taken to the hospital. Mom Reily panicked and called my husband. All this happened on a weekend.

I immediately tried to find a caregiver for Mom who could stay with Mom until Ben was able to take over again. Ordinarily, if you give me a phone and a computer, I can find or fix most anything. But this time, I could find only one caregiving agency that was available on short notice, and I got their information. I messaged the three grandkids, giving them the name and phone number of the hospital (I knew which one they use) and the info about the care company.

After that, I didn’t know what to do. My executive facilities began failing to function.

Fortunately, the grandkids and their spouses stepped in at that point and took over. Nick was the liaison to Ben and the hospital. Patricia got busy and was the point person. She got in touch with some of Mom’s neighbors, who were checking on her, found two care organizations that she thought would do, and set up visits with each of them. She chose one based on their introductory visits with Mom, and figured out the cost for two weeks’ care. (It was unclear when Ben might come home and how much he would be able to do when he got home. And now it looks like he will have to stay a day or two more due to suspected clots in his bladder.)

Patricia kept all of us informed via group chat on the progress of the plans. She figured out how much each of us would have to contribute toward Mom’s care, put the charges on her credit card, and set up Zelle and PayPal so we could send her the money to cover it.

She did all this despite working a full-time job at a veterinary clinic and despite the fact that all the grandkids, as well as Dan and I, live in different states than Mom and Ben.

Now that’s a woman with proper executive function.

My main function since then has been to keep my husband informed, at which I’ve not been entirely successful. He started talking to Mom about making a plan for the next time this happened (Ben’s gallbladder is dicey, too). Patricia and I had already discussed that and agreed that Ben should be in on making such a plan when he was better and at home. It was not yet time for such a discussion, but Dan jumped in anyway. Mom Reily was not receptive to the idea, which is why we agreed that we should involve Ben in the planning. Dan had put his foot in it, not being in on the chat. (He doesn’t know how to use that function on his phone and leaves such things to me.)

There was also confusion about whether Ben needed sweatpants to leave the hospital. I moved heaven and earth to find a Walmart near the hospital with same-day delivery. I got the address and phone number and the person to speak to.

But I was missing a piece of information. Ben was actually coming home the next day, and the hospital said the pants he had would fit over the bandages and equipment. Another of the grandkids made arrangements to have sweatpants delivered to his house the next day.

I may as well turn what executive function I still have to Dan’s cataract surgery and my wound care tomorrow.