Tuesday, October 28, 2008

You Can Only Control So Much...

It has been awhile since my last post. I got some sort of "bug" the first week of October, and it kicked my butt for the next 10 days, and I've been pedaling fast since then to recover. The challenge for caregivers is to stay healthy - when we are down, who dispenses the care? Thankfully, I have a wonderful husband who is willing and able to pinch hit for me when needed. I prevailed upon him to make the pharmacy run and deliver some blank checks to my grandmother's house on "errand/beauty shop day," and by the grace of God, my niece had a day off and was able to do the actual errand run. My husband could have done it, but I knew my grandmother's medicine needed to be dispensed into her daily dosepacks, and he'd never done that before - my niece is a CNA and was familiar with my grandmother's meds, so she was the logical candidate.

There was no way I wanted to expose my grandmother to my illness - I sounded like a man when I talked, so she KNEW I was sick! And thankfully I was only potentially contagious for a few days, so I missed just one week of errands. But it is a dilemma. What does one do when unable to handle the normal caregiving duties? I think it behooves all of us to come up with a "Plan B." For me, I often have family members I can ask to help. However, I am re-evaluating that plan and considering other possibilities. In my situation, the kicker was the medicine, and I realize now I could have asked for my grandmother's Home Health service to send a nurse to do it (I don't know if an aide would be legally allowed to handle the medication). There were neighbors and friends I could have asked to do the other errands, had no family members been available.

Last week my grandmother told me that she thought she was "coming down with a cold." She said she had a headache and a runny nose. I feared she was indeed getting my "bug." I spoke with her around noon one day, and she felt certain she was getting sick, and she said she would rest that afternoon. The same afternoon, around 5:00, my phone rang. It was my grandmother wanting to know what I was doing. I told her I was scrubbing my shower. She said, "Well, I have the biggest mess of greens you ever saw, and I wondered if you wanted to come get some." I told her that I did not, and I asked where she got greens. She said, "Well, I mentioned to someone at church yesterday that I would love to have some greens, and they went and picked a mess today and brought them to my friend Ruby." She added that her friend had washed them three times and gotten them all good and clean and then brought them over to my grandmother, who had stemmed them and gotten them ready to cook. I asked, "I thought you were sick - do you feel like fooling with greens?" She replied "No, but what else can I do?" I told her she could let them go. She said, "Why, I can't do that!" I suggested... "Who would know?" She retorted, "Well, I would!" I told her if she was too sick to fiddle with them, that was what she should do. She did NOT like that comment!

So I told her to leave a bag of greens in the refrigerator for me, and I would get them later in the week. She agreed. Two days later, I phoned her to see how she felt, and she was much better, and the greens were cooked and in the freezer. I asked if she left a bag in the refrigerator for me, and she said she did. She mentioned how she had seasoned her greens with salt pork, and I said, "I will probably cook mine with bacon." She said, "Well why would you want to do that?" I told her that I was allergic to something in salt pork and could not eat it. She said, "Well, I've already COOKED your greens!" I was not all that surprised, but no less aggravated. I told her that I had wanted them left uncooked because I couldn't eat salt pork. She said, "Well, I didn't put in enough to hurt her." I tried to explain that ANY amount was too much for my allergies, but I could tell that just made her mad. So I told her not to worry - that my husband would eat them. She said, "I just cooked ALL of the greens. I'll freeze these and get you some more." I told her NOT to do that - that I really didn't want/need greens right now, and she certainly didn't need any more! So, when I went for errand day, my cooked greens were still in the refrigerator, and she spooned them up to send home for my husband. I didn't say a word. Sometimes you just have to let it go.*lol*

The grocery list was much bigger than usual. Company was coming - three cousins from Oklahoma. Now the last time they came, they covered two counties in three days, and Mam-ma was exhausted when they left and subsequently got very sick. It took her weeks - actually a couple of MONTHS - to recover. But she had already baked a pan of brownies, and she informed me they were staying at her house, and there was no arguing. If she gets sick, so be it. I couldn't tell her that she couldn't host the company! But I did ask her to promise she would not overdo it and let them wear her out. She assured me if she got tired, she would ask them to take her home. And apparently she did.

My point for this week is that we can only control so much. We are going to get sick from time to time and be "out of the game," and we better have a "Plan B" and a list of "subs" we can call to assist us. And our elders are going to do pretty much what they want most of the time, so we have to learn to accept the things we cannot control. I won't hesitate to speak up if I feel my grandmother is doing something that will cause her trouble later or is too strenuous for her. I am responsible for her safety and general well-being - to a point. But she is always saying that this person or another "is 21," and so is she - in fact she is 96! So I have to let her do what she can as much as possible - and within reason. And just because she cooks the greens doesn't mean I have to eat them!

Tuesday, October 7, 2008

Keep a Close Eye on Things

Last week was not a good one for my grandmother. After a trip to the doctor on Monday for more sample steroid inhalers for her cough and the admonition to continue her nasal spray for the fluid on her eustachian tube, she started a routine of roller-coaster blood pressure. One day it would be 150/80, and the next day it would be 90/70-something. By Thursday when we went to the hairdresser's, she was very week and wobbly, and her BP was about 115/70-something. For probably the last three months, my grandmother's weekly grocery list has changed dramatically. One week, I might buy a cabbage and salt pork - the next, household items and a loaf of bread and some butter. I know she has food in her freezer, so I have not questioned too much - other than, "don't you need milk or eggs?" Almost every week, I buy a package of Chips Ahoy chewy chocolate chip cookies - and at least every two weeks a 6-pack of 20-ounce Cokes and a bag of Hershey's kisses. She tells me that she is trying to keep her energy level up, and those things taste good to her - a woman who almost NEVER ate a store-bought sweet and maybe drank a Coke a month. Now she has a glass of Coke every morning instead of a cup of coffee.

At nearly 96 years of age, I figure whatever my grandmother chooses to eat is HER choice! She has always cooked meals that no other single person I know would cook for just one - chicken, vegetables, mashed potatoes, cornbread - so I wasn't worried. However, lately she has not felt like cooking as much - and we won't even talk about what ensued when Meals on Wheels was mentioned. She does NOT like their menu - and she feels she can't afford it, although I have assured her she can... and even if she only drinks the milk each day, it's worth that. I used to buy her a half-gallon of whole milk AND buttermilk each week - now her milk ruins before she can drink it all.

So, it came as little surprise to me last Saturday morning when her blood sugar was 309! The Home Health nurse reported to my grandmother's doctor (as she is required to do for such a high reading), and he promptly ordered a prescription over the telephone for pills to lower the blood sugar. I felt quite certain that wasn't really necessary, so I told the nurse I was not going to pick up the prescription - that I figured the number was due to Mam-ma's poor diet. Once I explained to the nurse how Mam-ma was eating, she understood fully. I asked Mam-ma to lay off the sweets Saturday and eat a decent diet, and Sunday the blood sugar was 121. Monday it was 110!

Monday morning, the doctor's nurse called at 8:15 and said, "Don't pick up that prescription just yet." I told her I had no intention of picking it up - that Mam-ma doesn't need it, and I told her why - and she talked to the doctor, and now they are going to check Mam-ma's blood sugar 2 times a day for a week and see how it is. She will not be happy, and I don't blame her, but thankfully it is just a finger prick and not full-blown bloodwork.

Bottom line: You have to know the whole story - you have to have the whole picture. It frustrates me to no end that a doctor prescribes a pill over the phone - on the weekend, no less - without having someone's records in front of them, much less all of the facts. With the enormous case load doctors have these days, there is no way they can possibly recall everything about an individual patient from memory and prescribe properly from their living room chair or kitchen table. I would never want to deny my grandmother treatment or in any way interfere with her health and well-being, but at this point, I feel like she and I know more about how she is doing than anyone else. So my suggestion to anyone who is caring for a senior - or someone of ANY age, for that matter - is to consider the WHOLE picture... make sure what you are being told makes sense in the scheme of EVERYTHING.

Be a good detective, ask LOTS of questions, and take a step back and look at all factors before accepting a diagnosis and/or prescription. My grandmother did NOT need a pill to lower her blood sugar - she needed a good plate of meat and potatoes (which she ate!) and an egg or two. The day before her high reading she had capped off the night with a bowl of potato soup and a slice of lemon cheesecake! Thankfully, when the nurse mentioned a pill to her, she had the mental faculties to tell her, "I want you to talk to Debbie first." Your loved one may not be able to do that, so you will have to be ready to step in yourself and handle these situations. Be your loved one's advocate - stand up for yourself - and especially for THEM!


On another note... for several weeks ago my grandmother has been hinting she might need to go to the hospital. The word "hospital" has been dropped several times, in the context of how well "those girls" (meaning the nurses) cared for her. Last weekend, I reminded her that a trip to the hospital would most likely result in a follow-up visit to the nursing home - if only for rehab. This had NOT occurred to her, and she did NOT like it! She agreed that we do not want this to happen and must do all we can to avoid it. Having to return to the nursing home is one of my grandmother's biggest fears. I told her we do NOT want to go to the hospital - and we certainly do not want to go to the ER. She agreed and said, "I know it is an inconvenience, but if I have to go to the ER, I would rather go to Searcy (30 miles away)." I swallowed hard and said, "I'm sorry, but you do not have a doctor in Searcy except for your cardiologist, and if it isn't related to your heart, he can't and won't treat you. So that is just not an option." I followed up by adding that we have no intentions of going to ANY emergency room, so we were not even going to discuss this. She agreed.

I've quit saying that I've heard it all. There are more wacky comments and ideas to follow... I just know it!