Thursday, May 26, 2011

The Scoop on Poop!

My niece is having another baby in the next few days.  Timothy will be coming to stay with us for awhile until his mother and new baby sister get settled back at home.  Since my niece has begun potty training - and standing Timothy on a stool in front of our toilet produced trepidation and a few tears - I bought a "potty chair" and some "pull-up" diapers in preparation for his next visit.

I laughed as I considered that so much of life in the Sandwich Generation revolves around diapers of one size or another and poop.  We wonder about our babies... have they pooped today?  Did they have a "good" poop?  Are we feeding them the right things to produce "good" poop?  Did they eat too much fiber... or not enough?

When I talk with my grandmother, a frequent topic of conversation is her bowel function - and that of many of her friends.  It's tantamount in the senior's world.  My maternal grandmother was obsessed to the point of taking laxatives and yes, even enemas, until a doctor told my mother that she had so overstimulated her colon that it was now as thick and rigid as a garden hose.

My sister and I have laughed nervously and wondered aloud if we will know we are old when we talk about our bodily functions... all while we are discussing said functions of our babies.  I am continually reminded of the parallels in this universe... diapers and Depends, Enfamil and Ensure, walkers and strollers... and much more.

My grandmother keeps an array of "aids" in her medicine cabinet... Mylanta, Milk of Magnesia, Pepto Bismol and Immodium, to name a few... and she "doctors" herself according to her daily "functions."  Lest you recommend she eat more fruit and get more fiber, she has always eaten well and been very mindful of eating a balanced, healthy diet.  And I try to be diligent in giving Timothy fresh fruit, plenty of green and fibrous vegetables, and healthy grains for breakfast (although lately he prefers a scrambled egg).

I believe the key ingredient that both our children and our seniors may be missing is... wait for it... WATER!  When I was baby-sitting cousins some 40+ years ago, we always gave them water throughout the day, in between their bottles of milk or formula.  We kept a small bottle of water handy for hiccups, and just to hydrate the baby.  I'm not noticing a lot of baby bottles filled with water these days.

My grandmother does not care for water as a beverage.  She will drink iced tea (sweet, of course!), a Coke, or even a bottle of Ensure... and she will sometimes drink tap water with her meal (no ice!).  But to sit down and drink a glass of water is unheard of in her world.

I know, I know... you will suggest that we get plenty of water in the foods we eat and other beverages.  But all we have to do is look at the problems so many seniors - and babies - have with their daily "business," and it seems pretty clear to me that drinking more water certainly can't hurt!

So my tip for today is to find ways to get more water into the diet - yours, the kids', and most certainly your seniors'.  This inexpensive suggestion might be the simplest solution we get for awhile... and it if works, it will be more than worth it!

Wednesday, May 25, 2011

The Scouts Were Right - Be Prepared!

In the last few days, I've been thinking a lot about preparation.  My niece will give birth to her second child on May 31st, if not sooner.  This means that Timothy will come to stay with us for awhile until she recovers from her C-section delivery and gets on her feet.  I figure he will be with us for several days, at least.  I know that this means I will get virtually nothing done while he is with us.  So I have been in "preparation mode" - stocking the pantry and planning meals, cleaning the house, doing laundry, and catching up on some writing projects... along with working out and trying to rest!

Thankfully, my grandmother's virus was short-lived, although she is still sore from her fall in the closet.  Her bruises look pretty mean, but she is up and about... taking walks outdoors, exercising and attending all of the regular activities at her retirement center -  and even shopping at Wal-Mart... so I know she is okay.  She has had quite a bit of company lately, and that has brightened her days, as well.

Our little Timothy - dirty face and all!
Aside from thinking about our own preparations for the new arrival and Timothy's visit, I've had conversations with several friends in recent days who are in some stage of caring for an elderly loved one... and each time, the focus has centered on preparation.  In a couple of cases, virtually no preparation had been done for the "what ifs"... what if Mom/Dad falls ill and has to move to an assisted living or skilled-care facility?  What if we need money for their care?  What if they refuse to cooperate?

I'm very thankful that my grandmother was at least somewhat cooperative.  My grandparents transferred ownership of their property to my parents in the 1970s, when the laws were different and there was concern that a sudden illness or disability could result in a move to a nursing home... and the loss of their homes to cover the costs.  The laws have changed now, and while I am not current on how they actually read, I do know that there are options... particularly if there is a spouse still living in the home... and the sale of the property may not have to be sold - at least not right away.

Meanwhile, I have advised my friends to start coaxing their loved ones to take some preliminary measures...
  • Encourage your loved one to designate a Durable Power of Attorney who can assist with major decisions - both medical and financial.  Believe me, virtually no one will talk to you about your loved one without proof of Power of Attorney - from medical staff to the utility companies.  Without this document, you will have a long, rough road to travel as you handle your loved one's medical/business affairs.
  • Add someone you trust to your loved one's checking account.  If you have a Durable Power of Attorney, this person is the logical choice.  Just this week, I cashed a refund check for my grandmother, and because she was not with me at the time, I had to add my signature to her endorsement on the backside of the check.  This was verified to see if I was, indeed, listed as a signee on her checking account.  You'll also need to be able to write checks on your loved one's account for everything from utility bills to the monthly payments to a skilled care facility.  This signature  authorization is vitally important!
  • Try to persuade your loved one to begin thinking about designating - and dispersing - valuable assets.  If your parent/grandparent has an heirloom pocketwatch they plan to leave to someone in the family, why not give it to them now and get it out of the drawer?!  Don't risk having these valuable family treasures come up missing - or squabbled over - if the senior has to move to a facility.  And certainly do not risk having these treasures "lifted" at the facility. 

    When my maternal grandparents moved to a nursing home, my mother substituted a very nice cubic zirconia drop necklace for my grandmother's real diamond necklace.  They looked exactly the same, and my grandmother could not tell the difference.  But the concern of having her "real" diamond lifted or misplaced was alleviated, and everyone was happy.  You may have similar valued jewelry that can be "traded out" for less-expensive look-alikes.
  • Understand that any assets your loved one has are subject to liquidation to pay for medical care, skilled care facility stays, and more.  While many seniors are stubborn or leery of suggestions to help manage their assets, there are things that must be done for their own protection.  The cost of consulting a lawyer to set up a Living Trust is well worth the investment.  This can help to protect many of your senior's assets, should a catastrophic event occur.  Long-term care insurance may also be appropriate.  It's expensive, but depending on the age and physical condition of your loved one, it may be worth the cost.
  • At best, sit down with your loved one and try to get a handle on what assets he/she has.  Make a list of these assets - important policy numbers, at least an estimate of their value, and where important paperwork associated with them is located. Is there property, such as a personal home, rentals, and/or vacant land?  Does the senior have life insurance?  What about a pre-paid funeral plan?  Is there a safety deposit box... and what sort of valuables are stored in it?  Does the senior have CDs, an IRA, and other investments?  Does he/she own a car, boat, recreational vehicle, tractor, or other motorized vehicles?
  • Make a list of "contacts" - people to notify in case of an emergency, the housekeeper, the person who cares for the yard, insurance agents, pastor, and more.  Once when my grandmother was ill, I completely forgot about a cousin who checks on her often.  Several days later, he phoned me - very upset - and wanted to know why he was not notified that my grandmother had been hospitalized.  It totally slipped my mind.  Now I have a list, and I carry it in my purse.  If/when something happens, I don't have to rely on my memory to make the appropriate calls.
I realize I am treading in delicate territory here.  Some of these questions may seem premature, at best - and downright intrusive.  But in order to do the best for your loved one... to provide the best care for him/her and to protect any assets... some plans must be made - TODAY!

Here are some links I found that might provide helpful information.  Please understand that this list does not represent my endorsement of these websites or their information.  I am merely providing you with some search results.

Don't wait until there is a crisis.  Don't wait until you are in the shoes of one of my friends... paying thousands each month for residence in a retirement facility, the money quickly running out... and a parent who won't cooperate.  Start taking measures now to protect your loved one and yourself.  Be a good Scout and be prepared!

Sunday, May 15, 2011

Sometimes Being the "Mom" Is Harder than Others

Our Timothy turned two yesterday.  It rained on his first birthday, and his birthday party in the local park was cancelled.  I vowed he would have a party this year, so my husband and I planned a simple dinner at our house for 5:30 p.m. - sandwiches, potato salad and baked beans - followed by cake and ice cream at 6:30.  We invited the immediate family for dinner... and additional family members and friends for the cake and ice cream portion of the party. 

 Timmy's grandpa wanted to make the cake.  He always made my niece's birthday cakes, and it was a big deal to him.  I had found a template on the NickJr. website for a "Jack" cake (from "Jack's Big Music Show - Timothy's ultimate favorite show!), and I printed it off for my brother-in-law.  He did an outstanding job on the cake.. and Timmy would point at it and say, "Jack!"

We kept Timothy all day on Wednesday while his mom and grandparents drove to a nearby city for his mother's OB/GYN check-up.  My niece is expecting another baby any day now, so she is making weekly visits to her doctor.  My husband had errands to run in town Wednesday morning, and he included a stop at Southridge on his route... to visit Mam-ma Polly and refill her bird feeder.  He found her upbeat and doing well.

Wednesday evening, Timothy fell asleep in my arms as we sat on the couch.  The phone rang, and my husband answered... it was Mam-ma... was he feeling alright?  He assured her that he was fine, and she reported that some 30 people at the retirement center were sick with a stomach bug.  So far, she was okay, but she was worried she had exposed Greg to the virus.  He told her to stay in and stay well, and she said she was trying.

I spent my spare time throughout the week getting things ready for the party and trying to keep on top of things, in case the baby came early and Timothy arrived to stay with us indefinitely.  Friday, I made final preparations for the party, while Greg worked outside, cleaning off the porches and driveways, etc.  He was supposed to go pick up Mam-ma for the party a little after 5:00 p.m.  I spoke to her in the morning and reminded her to tell the kitchen staff she would not be there for dinner - and to remember to sign out before she left.  She said she would ... and of course, she was thrilled that Greg was coming to get her.

Around 3:30 p.m., Mam-ma called and said she was not coming.  She said she had eaten a piece of cake for lunch that did not agree with her and she didn't feel well enough to come.  I told her if she was not feeling well, that was wise - we would miss her - but she had to take care of herself.

A little before 4:30 p.m., I called Mam-ma back and suggested she tell her nurse that she was not feeling well.  She said, "I already did."  I asked what the nurse had said, and she replied, "She told me not to take Immodium until I have diarrhea."  I asked if she felt like that was going to happen, and she said she did.  Then she said, "I have not felt well all day.  I'm cold, and I have a headache... and I actually feel sicker now than I did."  The next thing I heard  was her turning away from the phone and spitting into a trash can.  Then I heard her vomiting.  She returned to the phone and said, "I just got sick."  She vomited again.  I told her to punch the button and call for a nurse.  She began to cry.  I felt so badly for her.  I told her again, "Punch your button and call for a nurse."  She said she would, and I told her I was going to hang up so she could lie down.

I waited about 20 minutes - thinking I should give the nurse time to actually see about Mam-ma, even though her office is just a few feet from Mam-ma's door - and I called the nurse.  She told me Mam-ma was sick, and I told her, "Yes, I know - I was on the phone with her when she threw up."  The nurse said that there was an "epidemic" of this "bug" at the retirement center, and she had phoned Mam-ma's doctor to order some nausea medication and something for diarrhea, because "most everyone gets that after the nausea."  The nurse - Peggy - said she was waiting on the doctor to return her call, so we hung up, and I told her I would check in later.

By 5:30, Timothy and his family were here, along with my mom and her husband, and Timothy's other great-grandmother.  We had dinner, and by 6:30, more friends had arrived.  Timothy opened his gifts, and then we served cake and ice cream.

I slipped away to call the retirement center a little after 7:00 p.m., and a CNA answered.  The nurse had left for the night, and she said she had not checked on my grandmother.  She did not know if medication had been ordered - she said nothing was mentioned at "shift change."  I was a little frustrated, but she told me that the orders were to check on my grandmother every two hours, and she assured me she would be checking in on her.  I returned to my guests.  Talk about feeling torn!  I was concerned that Mam-ma got sick quickly - and she has done this before - and I felt like every two hour to check on her was not often.  Yet it was more than she would have gotten at home... and I was so glad she had nurses and aides there to see after her and help her.  I also knew she had her "button" and could call for help at any time.

The last guest left around 8:00.  Timmy was delighted with his party and all of the attention.  When everyone had gone and we were somewhat settled, I tried to call Mam-ma to check on her. No answer.  I tried three times, thinking maybe she was in the bathroom or just could not reach the phone in time.  But still no answer.  By this time, it was nearly 9:00 p.m.  I called the aide again and asked her to check on Mam-ma.  She did... and when she returned to the phone, she said, "She was asleep and didn't hear the phone."  Mam-ma called me shortly thereafter and she said she was still very sick but had not thrown up again.  I asked if she had had anything to drink.  She said she had not.  I told her to ask the aides to fix her a Coke.  She said she would, but I had told her to do this earlier in the evening, and she said she forgot.

Luckily, the aide called me again, and I explained that Mam-ma dehydrates quickly.  She said, "Oh, we are keeping ice water in the rooms of all the residents who have this."  I told her Mam-ma won't drink ICE water on a day when she feels well... but she will drink an icy Coke.  The aide said she would fix one for her.  I explained how Mam-ma dehydrated in a matter of hours a few years ago and ended up in the hospital for a week and the nursing home for three months.  "It's very important that she keep drinking fluids," I added.  The aide was very nice and said she understood.

I hung up feeling like the situation was in control... and thankful that Timothy had not stayed overnight, in case things got worse and I was called to come to the retirement center - or the ER... neither of which happened.  (Thank you, LORD!)

This morning, I phoned Mam-ma, and she sounded terrible still.  But she had eaten oatmeal and "sipped at" a cup of coffee, of all things. She said those were the only things she could think of that sounded like they would be soothing to her stomach.  I spoke with her a few hours later, and she was still in bed, but no more vomiting.  She said the nurse was ordering a bowl of soup for her for lunch.

I talked to the nurse, and she said that meds were indeed ordered - and received.  She also was withholding Mam-ma's regular meds until she saw that she could keep down food.  As she put it, "No sense giving them to her and having them come right back up."  I told the nurse that I felt like I should come and check on Mam-ma - but I was hesitant.  She quickly said, "NO!  Do not come down here!  This stuff is mean, and you do not want to be exposed to it."  She added that several staff members had gotten it, along with most of the residents.  She assured me that they were taking good care of my grandmother... and I am trusting that they are. 

I told Mam-ma that I am thankful that she has a nice comfortable bed and room... that nurses are just a button press away... and that she has meals and medication delivered to her bedside.  All she has to get up for is to go to the bathroom.  Peggy, the nurse, said that this "bug" lasts about 4 days.  Mam-ma will be weak as water by then; however, the fact she kept down oatmeal this morning is a good sign.  Maybe after more than 2 months of eating well and regular medication, she is stronger and will fight this off more quickly than she would have at home.

I also told Mam-ma that I am glad she is able to talk to me on the phone, so I can at least gauge how she is doing in that manner.  And she did sound stronger when I talked to her around noon.  Hopefully she will mend quickly and none of the rest of us will succumb.  With a baby on the way and a toddler to care for, we don't have time to be out of commission for four days!

I was initially frustrated last night over the responses I was given by the aides on duty.  But I think that part of this was due to the fact I was trying to juggle hosting duties at a party at the same time... and establishing the routine and relationship for the first time in one of these situations with the retirement center.  Once we had talked and I had explained my concerns, the aides were quite helpful and kind... and I do feel they were doing a decent job of meeting Mam-ma's needs.  It's a learning curve for all of us.

So hopefully this crisis will be short-lived, and we can all return to normal - whatever that is!  Meanwhile, I'm trying to rest for Timothy's return - which will be Wednesday, if not sooner... and could be a longer stay this time!  And when Mam-ma and the other residents are "bug-free," I'll return to check her out in person.  I'm sure she will be more than ready to see us by then!

Being the "Mom" to my grandmother and my great-nephew always brings rewards... and often has its challenges.  But sometimes, juggling the care of both of them and meeting their needs is harder than others... and this was one of those times.  I'm learning that I'm stronger than I thought... and that God has sent legions of angels to watch over all of us.  And for that, I am incredibly grateful and blessed!

Friday, May 6, 2011

Happy Mother's Day!

Thursday, May 5th, Southridge Retirement Center hosted a Mother's Day Luncheon.  Guests were invited.  I attended with Mam-ma Polly.  Because of the guests, the seating arrangements were something of a "fruit basket turnover," so we were seated at a different table than the one where Mam-ma usually dines.  Our table companions were a lady named Maxine, and a very nice gentleman from our community, Captain Claude Shaw.  Capt. Shaw is retired Navy, and he is a delightful man who has worked hard for several philanthropic organizations in our area.  After his retirement, he spent hours tending 105 rose bushes in his yard... and sharing the bounty with shut-ins and others throughout the community.  He was always buying bud vases at thrift stores and garage sales to use as vessels for his beautiful flower deliveries.

My Mam-ma Polly and me.
Before the lunch began, Mam-ma and I walked around and snapped some photos of her with a few of her closest friends.  One lady who was a guest of Mam-ma's friend, Mrs. Viola, snapped our photo, too!

Mam-ma's friend - Mrs. Viola - with her guest, Shirley.

Mam-ma Polly with her dear friend, Mrs. Viola.
My grandmother with her table-mates, Mrs. Evelyn
(a lifelong friend of our family), and Mrs. Ruth Garner
(my third-grade teacher, and a dear friend, as well).
The tables were set with tablecloths, nice appointments, vases of red roses and purple flowers picked from the beds that grace the facility grounds, place cards at each setting, and more.  Each mother received a carnation tied with a ribbon, and we all got candy kisses.  The meal included Waldorf salad, fried chicken, mixed squash, navy beans (which my grandmother calls "white soup beans" - and loves!), cornbread, and peanut butter pie.  The staff was busy serving coffee, tea, and water... and everything was quite lovely.

For the first time, my grandmother didn't have a SINGLE complaint!  The closest she came was telling me that she could not chew the apples in her salad.  Everything went well... she looked beautiful, the food was delicious, and the conversation was engaging.  Mam-ma had a great time visiting with Capt. Shaw... and long-time friends were seated at the adjacent table, so she visited with them, as well.

I realize that today could be altogether different.  Mam-ma is, after all, halfway to 99!  But I felt like we had significantly turned a corner yesterday.  I saw her engaged and active in her new surroundings.  I saw how the staff reacted to her as one of their more able-bodied - and clearheaded - residents.  They adore her... and she loves that!  Her needs are more than being met, and that is a huge comfort to me. 

Hopefully this trend will continue, and we can enjoy the next few years with each other.
I left her planning her next trip to Wal-Mart to buy gardening gloves, so that she can plant her prized pole bean seed as soon as the weather permits. 

I did feel badly for those mothers who had no guests to dine with them - and there were more than a few.  It seemed so sad to me that families can't find time to stop for a couple of hours and share an Easter or Mother's Day meal with their loved one.  I realize these special occasions have been held on a weekday, rather than on the actual holiday... perhaps because it's easier to have all staff members available to assist.  But still... could someone not come sit with these dear people on this day?  It astounds me.

The dilemma we faced this Mother's Day was a gift for my grandmother.  What do you get for someone with limited space and needs?  Mam-ma has enough cologne to last her several years. She has plenty of body lotions and toiletries... and she doesn't need clothing!  She doesn't have room for books... and the library has plenty of choices. Our solution was to give Mam-ma "spending money" to buy some things she wants... like gardening gloves... on the weekly trips to Wal-Mart.

But here are some suggestions for items that might be suitable for your mom or grandma:

  • a big shady hat for wearing when he/she goes outside to sit in the sun or get fresh air
  • cosmetics - incidentals add up, so if you know that your grandma needs extra face powder or make-up foundation, this might be a good time to replenish her stock.  Or fix a little basket with shower soap (or regular soap), toothpaste, shampoo, and a long shower brush for scrubbing.  There are some great plastic containers that are perforated - intended to be kept in the shower, yet allow water to drain - and they would be perfect as your "basket".
  • note cards and stamps - if your senior is still able to send an occasional card - a book of postage stamps, and even some return address labels (even a sheet or two printed on your computer) would be helpful
  • a subscription to a pretty magazine... Birds and Blooms, and Country Woman have been favorites of my grandmother.  They have little copy and lots of pretty pictures... and when she is finished with them, she can share with other residents.  Reminisce is another good one.
  • a small photo album filled with family photos.  Make prints of some of your most recent photos of the family and start an album.  As you get more, you can fill in the remaining sleeves on subsequent visits.
  • a decorative chain or lanyard to hold eyeglasses or the resident's "call button".  My grandmother doesn't like to wear her button around her neck, but if she had a pretty chain for it instead of the lanyard with medical advertising, she might be more inclined to do so.  And how many times has your mom or grandmother misplaced her eye glasses?  Perhaps a decorative chain to secure them - or one of the little pins that you can loop them through when not wearing them - would be in order.
  • a large-print calendar, with important family dates (like birthdays and anniversaries) marked on them.  At the Easter luncheon, I was telling my grandmother about a funeral I had just attended for my cousin.  Mam-ma's friend, Ruby, said, "I'm so glad you tell Polly things and keep her informed.  If you don't tell us things, we lose touch."  Sharing important dates and keeping your senior informed can help to keep them aware of what is happening and feeling like they are "in the loop!"
  • sunglasses.  My grandmother recently purchased a pair of sunglasses at Wal-Mart that slide on over her prescription glasses.  They are called "Solar Shields" and come in a couple of different styles and colors - retail cost is around $19.  She can slip these on easily when she steps outdoors... the clip-on style is too difficult for her to manipulate any longer.
  • lipstick.  My grandmother still enjoys wearing a pretty shade of lipstick... and at around $8 or more a tube, this is not something she is inclined to purchase often for herself.  If your loved one is no longer interested in a lip color, consider a nice lip balm.
  • Books on tape.  If your loved one has vision difficulties and can no longer see well enough to read, consider giving her a device that will play books on tape.  There are some fairly simple models available that most seniors can manage.  Check out for options.
  • a bird feeder and bird seed.  We put a small shepherd's hook outside my grandmother's window and hung a simple tube feeder.  My husband sometimes uses this as an excuse to drop by - he carries a container of bird seed and replenishes the feeder.  We also got my grandmother a simple book on songbirds and their care, so that she can identify what birds visit her feeder.  More than once, she has called me to tell me that a "hairy woodpecker" or a "red finch" were feeding there.
You have to think outside the box to come up with a suitable and clever Mother's Day gift for someone who lives in a residential facility... but it can be done.  While they may have plenty of food and the basic necessities, this doesn't mean that a gift and a simple card are not still appreciated - even coveted.  Our loved ones went to a facility to get the care and attention to their personal needs that was required.  The enhancements to their quality of living come in great measure from continued contact with family and friends.  Holidays are an especially important time to be sure to remember these dear seniors... and to give them a gift that says, "Happy Mother's Day - we still love you!"

Tuesday, May 3, 2011

Who Goes First? Reflections on the Seasons of Life

Palm Sunday began for us with a glorious worship service at our church, where young children from age 2 to early teens paraded up and down the aisles waving palm branches while our Praise Band sang a glorious anthem regaling Jesus' arrival.  It was heartwarming - and moving - to see these little ones in such numbers glorifying God.  I reflected on how blessed I am that God has seen me through the challenges of the past months, and now my grandmother is safe, healthy and happy in her new residence.

The rest of our day was equally good... a delicious lunch at a local restaurant with my husband and his mother... an afternoon nap... and a good, relaxing Sunday.  But all of that changed as my husband and I sat down for dinner.  The phone rang... an urgent message from a friend of mine... please call him immediately.  Since he and I are mutual friends of my cousin, Carla Lou, I feared something had happened... perhaps to Carla's dad, my cousin Carl, who is 87 and has recently undergone a major surgical procedure to repair a hernia.  Carl is also in the early stages of Alzheimer's.

I phoned my friend Scott, and he began to talk about Carla, a friend named Mark, a hospital, a brain bleed... and it was all running together for me.  Carla lives in Columbus, Ohio.  Was she in Arkansas?  I had heard she was coming... but then I heard she wasn't going to come, after all.  Was her friend injured?  Did Carla need a ride to her dad's?

Finally, Scott was able to make me understand that my cousin, Carla Lou, age 46... young, vibrant, beautiful Carla... had suffered a brain bleed and was in grave condition in a Little Rock hospital.  She was sitting on the patio with friends when she became incoherent and then collapsed.  She had been in our state for a few days, attending the 25th reunion of her college class.  She was planning to make the hour-long drive from Little Rock on Monday to visit her dad, and possibly other relatives and friends.  She never got here.

Carla Lou died in the early hours of Monday, April 18th.  Because her classmates were all talking about this on Facebook, Carla's brothers and I scrambled to get things in place to tell her dad - and my grandmother.  Carla's maternal grandmother, Bessie, was my Mam-ma Polly's older sister.  Just to complicate matters - and possibly confuse you - Carla's paternal grandmother (her dad's mother) - and my great-grandmother were sisters.  We are "double cousins."  I spent a lot of time late into Sunday night on the phone with Carla's friends and her two older brothers.  Early Monday, I dressed and headed for the ALF to deliver the news to my grandmother before someone from our little community called and told her over the phone.  My cousin was sitting on his dad's doorstep to deliver the news in person that Carla was dead.

I got to the ALF as Mam-ma finished her breakfast.  We sat and talked while she ate, and then I said, "Let's go to your apartment... I have something to tell you."  We walked back to her room, and I sat her down and delivered the news.  She cried, but she took it very well, all things considered.  I think there is an extra blessing  for older persons... a sort of insulation against the shock of such horrible news.  For my cousin, Carl, the shock of hearing that Carla was dead, along with the frailty brought on by his age and illness - not to mention his Alzheimer's - all served to temper the impact for him.  I am not sure how much of this he will ever be able to fully internalize... and that's a good thing.

We memorialized Carla Lou on Wednesday with a graveside service attended by dozens of friends and family members.  Carla's fiancĂ©, David, had flown in Sunday night on a chartered plane to be by her side before she passed.  David's two brothers had flown to Arkansas to be with him for the service - and another service held in the evening on the college campus of Carla's alma mater.  Carla's ashes were buried beside those of her mother and paternal grandparents.

When you say the numbers out loud, they don't make sense.  My cousin Carla celebrated her 46th birthday on February 27th.  She wasn't supposed to die before her dad... or my grandmother.  But of course, we don't get to choose the circumstances - or date - of our death.  And while my husband and I have made what we feel are thorough and detailed plans in the event of the death of either one of us, the death of my cousin Carla Lou had us once again reviewing our plans... crossing T's and dotting I's.

My husband has always maintained that the odds are in favor of him dying first.  My mother has maintained for several years that her health conditions will result in her passing well before her husband.  I have maintained to both of them that we simply cannot be certain of this.  I think now they might be starting to believe me.  I know this has sparked discussions among several people about planning for "the day" when they are no longer alive.  It's tempting to bury your head in the sand and pretend that day will never come - or to say, "My kids and family members can figure it out when I'm gone."  But that is simply wrong thinking - and selfish, at best.

I am so thankful that I got my grandmother settled.  Should something happen to me today, I know that her care could now be far more easily managed by someone else... and her needs would all be met.  I am thankful that we have settled her estate, streamlined her paperwork and finances, and settled her in a place where she is happy, healthy, and safe.

But others have not made the same arrangements... and some are finding out firsthand what the results of a lack of planning can be.  A friend of mine was called to her winter home in Michigan recently to attend to her father, who was not well and refused to see a doctor.  My friend's parents divorced years ago, and she had developed a closer relationship with her mom... but when she was in Michigan during the summer, she had lunch with her dad about once a week.

My friend found things worse than expected, and her dad was declining rapidly.  In the course of about three weeks, things continually became more critical, and ultimately, my friend's dad was hospitalized and placed on Hospice.  Her brother flew in from Arizona to assist her with decisions, and together they selected a skilled nursing facility for her dad.  Two days later, he died peacefully.  The rollercoaster of emotions and challenges have certainly tested my friend.  Thankfully she has had the support of her brother... a true blessing.  Often all of the care and decisions fall to one family member, regardless of how many are capable of helping.

Every situation is different.  Often the seniors are either not capable of making rational decisions... or they are uncooperative.  They worry about people meddling in their business - and stealing their money.  They think they are invincible and "it will never happen to me."  Or they simply choose not to think about these things at all and "let the chips fall where they may."  But for those who face the challenge of making decisions and hard choices, this can be a daunting, scary time.  When you are suddenly faced with making decisions on the fly about long-term care, medical procedures, Hospice, funeral plans, and more, the challenges can be overwhelming.

So my advice to each of us today is... GET YOUR "HOUSE" IN ORDER!  Make plans... spend the money to get good advice and make a will or get a living trust.  Get a Living Will, investigate Power of Attorney, and consider pre-arranging funerals... or set aside money to cover the cost when needed.  The elderly aunt of a friend told her, "I don't need a will... the lawyer said when I die he will handle everything!"  Of course he will!  He stands to make big bucks off of probate and all of the work needed to settle an estate without a will.  A Living Trust generally costs less than $2000, and it is worth every penny!

Pre-arranged funerals lock in the price.  If you select a "package" for $5000 today and live another 50 years, the cost to your family will still be $5000.  There may be a few incidental add-ons, such as flowers, but the basic cost of the funeral will not rise... and your loved ones will not be faced with making decisions about your wishes at what is already a difficult hour.

If you have children in your care, the need for you to make thorough plans is doubled.  You not only need to help your senior plan for his/her future... you need to plan for your own - and that of your children.  Now is the time for action... not when someone falls over dead on a patio. This is one of the most selfless acts of love you can demonstrate.  What are your plans?

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On Thursday, April 21st, my grandmother's ALF hosted an Easter luncheon.  Guests were invited, and Mam-ma's friend, Ruby, and I attended.  There were decorations, a lovely ham dinner, party favors, and more.  Everything was delicious and served by staff and volunteers.  Here are a couple of pictures.  I am in one photo with Ruby (left) and my Mam-ma (right).  In the other photo, Ruby and Mam-ma are on either side of Mrs. Ruth Garner... my third grade teacher, who also resides at Southridge.  And the last photo is of Ruby and Mam-ma - two best friends.  Don't the ladies look great?