Saturday, March 21, 2009

All I Wanted Was Two Tennis Balls

I have to admit that my grandmother and I have ridden along at a "coast" for awhile, so I guess I was due for a "fender bender" last Thursday. I arrived early to work on dispensing her medications into the little daily pill boxes. I took my grandmother a bag filled with 10 "cuties" - mandarin oranges, or clementines, as some people call them. I said, "I brought you and Ruby (her friend) some oranges." She said, "Well, Earl already brought me two... I don't know what I will do with all of these oranges!" I suggested she split them with Ruby - that they were very small - and she told me again - at least four times in all, "Well, Earl already brought me two of those!"

I was cutting pills in half while my grandmother sat on the couch and read a magazine. Suddenly I felt her standing over me. "I need Ativan... I haven't had any in about three weeks." Knowing that she had quite a few pills in that bottle the previous week, I searched for it in her box. The bottle was there, and I poured out about 15 pills into my hand. "Mam-ma," I said... "here's your Ativan... do you think you will need more than this in the next week?" "Well, no," she said in disbelief. "I didn't know I had any... I thought I was out. This is fine... I"ll just take these to the bathroom - that's where I use them in the night." So she took her bottle to the bathroom and apparently put some of the pills in a bottle there.

I continued dispensing the medications, and when I reached for her Fuorosomide (Lasix), the bottle had about 15 pills. I knew I had just gotten all of her medications refilled the previous week or so, including the Fuorosomide. But I could not find it anywhere. I asked my grandmother about it - she did not know where it was. There was enough medicine to fill the compartments for the week, and I made a note to check with the pharmacy and see if perhaps we did not actually get that prescription refilled. The only other thing I could think of was that I left some empty bottles on the table for my grandmother to mark through the label and then throw away. Maybe she somehow got confused and threw away her new bottle of Lasix, too.

We went out to get in the car, and as I folded up my grandmother's walker, she said, "A man at church told me I need tennis balls on these legs. I want you to get me some." I questioned her, because just a month ago, we looked at her walker and determined the tips of the legs were not worn. I mentioned tennis balls at that point, and she adamantly informed me she did NOT want tennis balls for her walker! Now that a MAN at church had suggested them, she was all about the tennis balls!

So we got into the car, and she says, "I want you to go to that medical supply place and get me some tennis balls for this walker." I told her I could get tennis balls at Wal-Mart. I muttered to myself, "Let's see... I guess I really need just one," and she started screaming, "NO! NO! NO! You need TWO!" I told her okay, I would get two and cut them and put them on her walker's legs. She said, "They have them already cut at the medical supply place." I replied, "Okay, that's where I will go." She added, "I thought you would just take the walker there and have them put on." I answered, "Okay, that's what I'll do." She added, "They are hard to put on - or at least that's what the man said who put on the last ones (on another walker - she has three!) -- but he was a FREAK!" I asked, "Who was a freak?" She answered, "That man at the nursing home who worked in maintenance... I don't know his name."

We drove the rest of the way to the beauty shop in virtual silence. After I left my grandmother at the beauty shop, I drove to the medical supply store. I entered and told the saleswoman, "I need to get a couple of tennis balls for my grandmother's walker." The attendant shook her head no... "I don't approve of tennis balls on walkers." I suggested I get the walker out of the car and let the girl look at it. Immediately upon seeing it, she said, "Oh, she needs new tips... those are shot... I think I have some extras in the back." She returned with two new legs with brand new plastic tips. She put them on, and I asked her how much I owed her. "Oh, not a thing," she answered. She insisted, and I thanked her profusely.

Then it was on to the pharmacy, where I determined that we DID get Lasix on March 7 - two weeks earlier... I also ordered some more Ativan while I was there. I went to the store and bought my grandmother's groceries, then I went back to her house to put them away - AND to search for the missing Lasix. I did NOT find it. I did find a bottle of Ativan in the bathroom medicine cabinet... along with a nearly full bottle of some prescription I didn't recognize (probably a generic Darvoset). I will investigate that further another day. For now, I concluded that she threw away the Lasix inadvertently. I'll refill it in a couple of weeks and move forward.

I got in my car to go back to get my grandmother, and I turned the key, thinking about where I had to stop and what I still had to do. All of a sudden, I felt a presence next to my door, and I looked up into the face of my grandmother's neighbor, Earl (also a senior), on his motorized scooter. He had brought his daily newspaper to her. I did not see him slip up beside me, and I nearly jumped through the roof of my Jeep. Earl found this hilariously funny. Believe me, it was NOT funny to me. So now I must remember to watch out for Earl!

I picked up the Ativan at the pharmacy and then went back to the beauty shop to get my grandmother. When she was finished having her hair combed, she headed for the coat rack, and I said, "Here's your walker." She looked at it as if nothing had changed, and I quickly explained... "I went to the medical supply place like you wanted, and the lady there did not approve of tennis balls on the legs of a walker, so she put on two brand new legs with new tips, and she didn't charge us a thing!" My grandmother shook her head and said, "Well, all I wanted was two tennis balls!" The beautician turned the walker upside down and said, "But look, Polly, these are brand new legs with new tips... and it was FREE!" Mam-ma was still not satisfied. She just shook her head and muttered something about "Y'all just do whatever you want with me... you always do anyway." I told her "If you want me to go to Wal-Mart and spend $20 on a can of tennis balls and put a couple on your walker, I can do that!" She said, "No, that's okay... whatever!" That is her favorite line when she is not in agreement - "Whatever!"

So it was back to her house. I gave her the Ativan prescription and helped her inside. She said, "I sure thank you for the oranges. Earl already gave me two, so I don't know what I will do with all those oranges, but I appreciate it." Then she tried to pay me for helping her. She does this when she senses she has pushed my buttons! I assured her that I don't want money for caring for her. I wished her a good week and left.

I told my mom, I know my grandmother's days are numbered, and I don't want our last conversation to be an argument over tennis balls for her walker! So I am trying to just agree with her and go along when possible. Thursday, it wasn't possible to go to the store she requested and get the item she wanted. So I had to compromise and do what was best for her. So much of what we do for our elderly loved ones is a tight-rope act of trying to keep them safe and not rob them of their independence. I hope I am preserving my grandmother's independence - AND her dignity - as much as possible. My good friend Karen told me last week that she is learning that things we perceive as no big deal are HUGE to our elderly loved ones. Something as small as two tennis balls on a walker doesn't seem significant to us, but to my grandmother, that was tantamount last week. Karen and I are both working on being more compassionate and empathetic. The jury is still out. Meanwhile, I am looking for that "nice man at church" who suggested the tennis balls in the first place... he's going down!

Tuesday, March 17, 2009

Moving Your Elderly Parent Into Your House... Is It a Good Idea?

Nearly 20 years ago, my maternal grandfather had to be placed in a nursing home following a series of surgeries. My then 77-year-old grandmother announced that she could NOT stay in her home by herself. She had never lived alone... she was afraid, unwell, and lonely. Night-time was the worst. The cost to hire someone to spend the nights with her was astronomical... and my grandparents' Social Security income was pretty well exhausted to cover HIS nursing home care. While my grandmother's home was her castle, we all knew that secretly, she felt if she complained enough, my mother and dad would take her into their home. My mother told me one day, "If I bring Grandmother to live in my house, your daddy will leave." So friends "volunteered" (or did Grandmother twist their arms?) for awhile to take turns spending nights with her, and ultimately, she joined my grandfather in the nursing home... "just until he gets well."

My grandfather lasted about a year in the nursing home before his body wore out completely and he died of cardiac arrest. Seven years later, the Parkinson's Disease that had debilitated my grandmother for over a decade finally won, and she died peacefully one evening, surrounded by her family. Many of those last years, my grandmother was either semi-comatose or at best, delusional. There would have been no way for my mother to care for her at home... and it would, indeed, have spelled the end of my parents' marriage.

I loved my grandmother dearly, but she was incredibly neurotic and manipulative... and a hypochondriac as well. Caring for her at home would have been a FULL-TIME job, to say the least. My mother's decision to place her parents in a nursing home was gut-wrenching. When I say this was a last resort for her, I mean she tried virtually EVERYTHING else beforehand. In the end, she did the only thing she felt she could do... and those seven years were hard on many of us. When still lucid, my grandmother was miserable, and her mantra was, "I'm going home!" She did, for a few weeks - and she showed all of us that she COULD live alone - even at night. But soon her health deteriorated to the point that she had to return to the nursing home in order to get adequate care. After that, the talk of going home gradually dissipated.

My paternal grandmother is 96+ and still lives alone in her own home. There are days that I think she would pack in an hour and move in with me, if I would invite her. But I know this would be a mistake for both of us. And thankfully, she is still mentally sharp enough to realize that her residing with my husband and me would be difficult, if not deadly, for our marriage. With Home Health, family and friends who visit daily, and my grandmother's own good health and mental capacity, she is still able to manage for herself... and everyone likes it that way.

So what DOES one do? Even when it seems that moving your elderly parent into your house is an option with all the right intentions, is it really? Here are some things to consider:

* How healthy is your loved one? Will he/she be able to manage personal hygiene and care? Can they bathe/shower unassisted? Do they use a walker or wheelchair? This is a critical question to ask because most of us are not trained to manage the lifting and balance of another person. Certified Nurses' Aides and other medical personnel are taught to do this properly without injuring themselves OR the loved one. They often wear special gear, such as a "kidney belt" to protect themselves when lifting, and nursing facilities often have special "lifts" that aide in transferring a person from bed to wheelchair, potty chair, or shower and back. When my friend's aunt was unable to get out of bed unassisted, she discovered that the only family member tall enough - and strong enough - to lift her aunt safely was her son-in-law. Since he worked and had a family of his own, he was not always available when the aunt needed to be moved from one place to another. Will you?

* If your loved one requires around-the-clock attention, will someone be there to provide it? I'm not necessarily talking about physical attention, such as help with bathing and the bathroom and just maneuvering around the house. I am also talking about meals, medication, and yes... entertainment. Does your loved one know how to manage the television remote, the thermostat, the cordless phone, and the coffee maker? If left unattended, will your loved one try to cook... and would this be safe?

* If your parent is unable to care for his/her personal belongings - are you willing and able to do this? Do you have time for extra laundry, linens, food prep, and other responsibilities?

* How accessible is your home for an elderly person? Are your bedrooms upstairs? Are your shower and bath tub equipped with grab bars and other safety features? Do you have hand rails and ramps for access into your home from outdoors? Is it possible for each of you to "escape" and have private time away from the other?

* If you elderly parent is still mentally alert and desires a social life, are you able to accommodate this? How will you feel about entertaining your loved one's guests in your home? Will you be able to transport your parent to his/her social activites that occur outside your residence?

* How strong is your network of support? Is your spouse on board with this decision? Do you have siblings and other relatives who can help when asked? How do they feel about this decision? What about friends and neighbors? Will you be able to manage your own family/job/life and provide a quality life for your elderly parent at the same time?

* What if something happens to YOU? Suppose you get sick, or worse yet - die. Who will care for your parent then?

I realize that many people feel as though they do not have any other options. Assisted living facilities are too costly for many. Nursing home care can cost upwards of $3000 or more per month for those with personal assets. In-home "private pay" care is expensive. This is a common topic on a Caregiving group I belong to at - "What do we do with Mom or Dad when they can no longer live alone?". Often, the only solution seems to be to take them into your home and do it all yourself. But you must carefully weigh this decision and look at all of the ramifications for each person involved. Investigate all options... and all avenues of assistance, from family and friends to Home Health agencies and more.

I am blessed that my grandmother is so healthy and able to live alone... and I know this! I've been on both sides of the coin, and I can assure you that this is a much easier road. It is a juggling act to make sure that enough support is in place for my grandmother so that she has all of the care she needs to be safe, healthy, and comfortable. But caring for her in my own home would take this "act" to a whole other level. I think we all want to live independently as long as we possibly can. The reality is that for many of us, the day will come when this is no longer an option. If you ultimately decide to move your elderly parent into your house, be certain that this is the best choice for everyone. Do your homework and weigh the pros and cons carefully. Moving your parent into your house is sort of like squirting toothpaste out of the tube... once it's done, it is virtually impossible to go back.

Monday, March 16, 2009

Need a Caregiver? Hire a Workamper!

Today someone posted a query on in a Caregiving forum about finding a "private pay" caregiver. She was wondering how and where to look for such a person. This was my reply:

Here's another option... Workamper News ( This bi-monthly magazine lists job openings from coast to coast that are suited to RVers (people who live in a travel trailer or motorhome). You could advertise your need for Home Health care... there are probably plenty of Certified Nurses' Aides (CNA's) who live in your area who would be interested in applying. While most Workampers live in an RV, some are looking for housing... and if you are looking for live-in help, this might still be a good resource. The ads are listed by state and zip code, so if you are looking for someone in the Pasadena, California area, your ad appears in the California section in zip code order. If you are in San Antonio, Texas - the ad goes in the Texas section, etc. Right now people all over the country are seeking work - and thinking outside the box - so you might have several applicants to choose from. Thousands of people subscribe to this magazine and are looking for work.

Workamper News also offers the Workamper Hotline - ads that go out via e-mail each evening to Workamper News subscribers. You could place an ad there and have it appear instantly on the website and be sent out the same evening via e-mail. There is also an online resume service for those who wish to scan resumes for potential employees, but I'm thinking for this type of position, an ad in the magazine or on the Hotline would do the trick.

For the most part, Workampers are mature, dependable workers who are flexible, mobile, motivated, and possess a strong work ethic. As with hiring anyone, you should follow standard hiring practices - check references closely, and discuss thorougly the job description and requirements AND the compensation. IF you happen to live in a spot where there is room to park an RV (and this is not restricted by zoning laws), you could negotiate the parking space and utilities as part of the compensation package. There is a formula at to determine the monetary value of an RV parking space.

Just today, my husband went to deliver Meals on Wheels and met a woman who was working in the kitchen at the Senior Center who was a Workamper. She and her husband live in an RV - he works in the oil and gas industry - and she took this cooking job when he experienced a temporary layoff. Workampers come from all walks of life and are willing to do all kinds of work - and most are absolutely fantastic people!If you visit and wish to place an ad, look on the left under employers and click on "How to Begin." You will want the "Place Hotline Ad" or "Place Print Ad in Workamper News." The form will give you the rates and additional info.

If you do hire a Workamper, make a post and let us hear how it works for you!

If YOU hire a Workamper, please leave a comment HERE and let others know how it worked for YOU! Good luck and best wishes!

Tuesday, March 3, 2009

Elderly Driving: How Old is TOO Old?

When my grandfather passed a car and scraped the entire driver's side - and never even knew he touched anything - my mother wrestled with what to do about his driving. Grand-dad was adamant that he could still drive... even though at almost 80, he had lost most of his vision and hearing. Ultimately, the "solution" came in the form of an excuse. A beloved grandson who lived in Texas "needed" a car... and Grand-dad rather reluctantly gave his to him. That was after Mother had tried everything, including hiding his keys or taking them home with her. And for awhile, Mom compromised - Grand-dad could keep the car in the carport... but he was not to drive it! It got to where the easiest way to avoid a conflict was to try and second-guess my grandparents and drive them wherever they needed to go. But as fast as we could think ahead of them, they could outdo us, so that only worked to a point. So the ultimate decision to give away the car was a blessing.

There is no set answer to the question, "How old is too old to drive?" And there is also no set solution to the problem of those elderly drivers who refuse to give up their car or driving it. Believe it or not, some people DO give up their cars voluntarily. My great-aunt decided on her own that she was no longer a good driver, and she called her grandson one day and said, "I want you to sell my car. I'm not driving any more." Oh, that it were always that easy!

My paternal grandmother drove until she was in her early 90's. Mam-ma's life centered around her car. It spelled FREEDOM for her, and she was extremely reluctant to give it up, even after backing out into another car and a few other fender benders. She drove a two-tone Chevy impala (I think it was a 1968 - Army green with a white top) - it was a TANK! So she was not hurt, but she really did a number on the other person's car. In 2003, Mam-ma fell and had to go to the nursing home for about 3 months of rehab. The following year, she fell again and had to return for more rehab. This time, she was so weak and sick that we questioned whether she could even return home, at 91 years of age. Mam-ma did go home, but she realized she was not able to drive any more, and she asked my sister and brother-in-law to sell her car. They did - for $500, and she was thrilled. However, in recent years as her health has improved somewhat, she has commented, "If I just had my car, I could take myself lots of places!" We are thankful the car is gone!

My friend's father drove an old Chevy suburban, and he caused many accidents all over town. Since we live in a rather small community, and everyone knows everyone, most people knew to look out for this man, but there were still some fender-benders and such. So my friend went to the chief of police and asked him if he could talk to her dad about his driving. He told her that her father had passed his driver's test (how that happened, we aren't sure) and there was nothing he could do. Another friend told me that the police chief came to him, friend to friend, and said, "It's time to have the talk with your mother about no longer driving." The man asked the chief to do it for him and was told with a smile, "I'm sorry, but you are on your own with this." So my friend had "the talk" and told his mother she could no longer drive.This has got to be one of the hardest issues we face with our "seniors." The car does spell "freedom" for them... and independence.

My 96-year-old grandmother has a best friend who just turned 90, and she is still driving. She told me recently that she drove several of the little ladies to a friend's house to play dominoes, and she said, "There were five people in my car, and I was the only one without a walker." I asked what she did with the four walkers, and she said, "I just folded them up and put them in my trunk!" When the day comes that HER son has "the talk" with her, I wonder what those other little ladies will do - if they are still alive. This dear soul represents their last vestige of independence from their children and grandchildren - and a ride to many places they want to go.

I take my grandmother to get her hair done each Thursday, and while she is there I buy her groceries and run any other errands she needs. However, she "supplements" these trips with rides to the store with her friend (the 90-year-old). In fact, one Thursday I dropped her off at home and got her settled, and then I went to Wal-Mart to buy my OWN groceries. I looked up and my grandmother was coming toward me, pushing a buggy. She had hitched a ride with her friend, and she was buying "a few things." I am certain I have no idea how many "outings" these ladies make - or where they go - and I pray they do not have an accident and hurt themselves or anyone else.

It seems that quite often, an "incident" spurs the submission of the car keys... as in the case of my Mam-maw and her stint in the nursing home. I know a lady who was driving herself and a friend to the PX at an Air Force base about 65 miles from our home town, and one day she got lost. She didn't have a clue where she was, or how to get home. That was the last time she drove. Sometimes licenses are revoked after accidents. And yes, SOME seniors do just decide to no longer drive.

I've thought about this a lot... what would I do if I was widowed and could not drive myself safely? I have no children, so who would I call? Thankfully I could probably afford to hire someone to drive me... as does my 96-year-old friend, Olive. And I feel certain younger relatives and friends from church would pitch in... but it would be on their timetable and at their convenience, not mine. So I do see how frustrating this is for our seniors... and I try to be as accommodating as I can to my grandmother - and still keep a semblance of a schedule for myself and my household.

I am a firm believer that when we talk about a problem, we should talk about a solution. While there is no cut-and-dried answer to this dilemma, there are some things that could possibly help a bit:

  1. Make arrangements in your calendar to schedule your senior's errands and act as their chauffeur. I do this for my grandmother on Thursdays. Thankfully I can make this weekday work for both of us. When I was still a business owner, it wasn't as easy - and often I had to take a long lunch hour to get this done without eating up my entire Saturday. Some Thursdays, I can accomplish all of the errands and the trip to the beauty shop in a couple of hours. Other times, the day is filled with doctor visits and other stops, but I try to consolidate as much as I can on this one day.

  2. As my Mam-maw ages, she tires more easily, so I have learned to do what I can for her by myself, such as grocery shopping, and trips to the pharmacy and bank. Obviously she has to go along to her doctor visits, but whenever her presence is not required, I gently suggest she let me handle the errand for her while she rests and conserves her energy. This also speeds things up for me, as just getting in and out of the car takes twice as long when she is involved.

  3. If you are completely unable to schedule time to chauffeur your senior, investigate the senior services in your community. Our senior center operates a bus that does door-to-door pickups for trips to shop at Wal-Mart, doctor visits, and lunch at the center. My grandmother's church operates a bus that would pick her up for services and deliver her afterward. (So far, I have not had any luck getting my Mam-maw to use this bus. Her complaint is that she has to accommodate the church bus schedule. My take is - what else does she have to do? So what if she is the first one on and the last one off? Her choice is often to stay home and watch church on television, and that is okay, too. But she does have a choice!)

  4. Consider trading with a friend or relative... one week you take his/her senior and yours - and the next it is his/her turn. At the very least, if someone else is driving your senior quite a few places, offer to buy a tank or two of gas for them!

  5. Don't be timid about asking for help. If you have other family members who can pitch in and act as the "taxi" once in awhile, call on them. It truly does "take a village," and that's just how it is when caring for the elderly.
Nothing about caring for the elderly is simple, or one-size-fits-all. We all have to tailor our care and services to the needs of our loved one or friend. But at the same time, we owe it to ourselves and those in the direct path of a senior driver to try and head off danger at the pass. I often find that creating a space in my calendar for my grandmother's activities can avoid a "head-on collision" of sorts - and all of the time and energy that would come with it. And as is often the case with seniors, the driving challenge just is what it is... and the coping strategies may have to be stronghanded, or at the very least, creative.

Learning Never Ends

If my dad had outlived my mother, I am sure we would have faced many interesting challenges. It wasn't that he didn't know how to take care of himself - or a household... but he never had to do it, so he didn't! He left his shoes and socks in the floor... the daily newspaper in the bathroom. He was rather color blind, so we had to lay out his socks for him, so that he didn't wear green or navy ones with a black suit. I could probably count on one hand the number of times I saw him make a bed or run the vacuum. So I could relate completely with Beka Miles' post of her dad's attempts to cope now that his beloved JoAnn is gone. I give him an "A" for effort!

The underwear saga continues: When Dad and I talked late this afternoon, he was sorting his “undershorts” and weeding out the ones that had lost their elasticity. It seems that the whole John Miles’ undershorts saga began in the early days of mom’s hospitalization when Dad came to Mom who was stretched out there in her hospital bed and he asked her what he should do because his underwear kept sagging down. Mom explained that he needed to get rid of the sagging ones and go to the store and buy some new underwear. So, having finally found some new underwear that fit, Dad was going through his drawer this afternoon and getting rid of the old ones. He asked me,

“Now what do I do with the old undershorts?”
“Just pitch them, Dad.
“NO, I can’t throw them away. Maybe I could give them to Goodwill.”
“Goodwill doesn’t want used underwear with busted elastic. Why don’t you put them in the rag-bag that hangs in the laundry area. Underwear is good for dusting.”
“Darling! I can’t walk around the house dusting with my drawers! That wouldn’t be right!”
“OK, Dad, just put them in a bag, and I’ll take care of it when I get there”, (which really means, “If you can’t pitch them, I’ll pitch them.”
“Beka, how many pairs of undershorts should I have?”
“There is no set number, Dad. How many pairs do you want?”
“Maybe I’ll count my underwear including the ones I’m getting rid of. That way I’ll know how many pairs of undershorts JoAnn kept in my drawer.”

Mom always told my siblings and me, “If something happens and I go first, your Dad is going to need help from yall.” We didn’t give that much thought because she was so much healthier than Dad; it seemed near impossible that she would die first. And somehow, even when I did think about it, I imagined that she meant moral support, a listening ear, and help organizing his bills. It never occurred to me that we would be having ongoing discussions about what to do when his underwear sagged. He has many questions about the household that I would never have anticipated. I think I’m going to give him a housekeeping book that explains all of the basics. I told him I was going to bring him a book like that and he said, “It would be too complicated for me.”

Sometimes I think maybe he’s just pulling my leg and he actually knows a lot more than he lets on. But then I realize that there is a lot he simply does not know about homemaking. But he is happy to learn, and he laughs and laughs about his house-keeping problems. His attitude is remarkably good under the circumstances.