Thursday, December 27, 2012

Getting Your Face on a Smucker's Jar...

When it appeared fairly certain that my grandmother would live to see her 100th birthday, I did a GOOGLE search for Willard Scott and found his website and the requisite forms to complete for submitting Mam-ma Polly's name for consideration as one of the centenarians featured on Willard's segment during NBC's "The TODAY Show."  Sponsored by Smucker's, the celebrants' photos are superimposed on a Smucker's jelly jar label, and Scott tells a little something about the honoree. The information on the website stated that the forms had to be submitted at least six weeks prior to the actual birthday.  Since Mam-ma's birthday was November 5th, I sent the forms in early September.

The information also stated that either we would receive a phone call to let us know that our centenarian would be featured... or the honoree would receive a card in the mail.  Neither happened.  Shortly before Christmas, I cleaned off my desk... and I threw away all paper work related to this endeavor.  I decided I must have failed to complete the forms correctly or something. 

December 22nd, our telephone rang, and Caller ID said the number was "PRIVATE".  Since this is what shows when the Hospice nurses call, I feared the worst... but I answered.  The caller was a gentleman from Willard Scott's office.  He apologized for the delay, explaining that they were behind on airing the segments, but my grandmother was scheduled to be featured on Monday, December 24th, between 8:00 a.m. and 9:00 a.m.  He asked about our time zone, and I told him we were on Central Time.  He explained that the segment would air on the East Coast between 8:00 and 9:00 - and repeat for us the following hour.  He said, "Set your DVR for 8:00 a.m. to 10:00 a.m."  I set mine for 7:00 - 11:00!!

So I let EVERYONE know!  I made sure all televisions at the facility would be turned on and set to the appropriate channel.  My mom let the church administrators know, and they made a BIG SPLASH about it Sunday morning at Mam-ma's church.  I think everyone in our community of about 7,000 people sat glued to their TVs Monday morning... along with family members and friends from coast to coast.  And Willard Scott was not on.  They did segments on all sorts of things, from ugly Christmas sweaters to revealing the sex of a baby expected by an Olympic volleyball champion... but no Willard Scott.

So we regrouped and set the DVRs for Christmas Day.  This time, Scott was on... and a long segment aired, featuring several centenarians... but no Mam-ma Polly!  Would she ever be featured?  That afternoon, the phone rang again, and the same man apologized and said they were still very behind, and he thought that Mam-ma's segment would air on December 26th.  I told him how disappointed we were, and he kept saying, "We have no control over what they do... the segments are pre-recorded, and we don't know when they will air."  So we regrouped once again.

Wednesday morning, a friend posted on Facebook that she was spending the holidays in New York City, and she had just seen Mam-ma Polly on Willard Scott's segment!  So I started letting people know that we WOULD see the feature.  Sure enough, somewhere around 8:30 a .m., Central Time, Willard Scott's birthday feature aired... and there was Mam-ma on a Smucker's label!  Soooooooooo... in case you missed it... here is my Mam-ma Polly... now forever known throughout America for her peanut brittle!  I hope you enjoy it!  (Watch all the way... she's almost the last one featured!)

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Tuesday, December 11, 2012

They's a Lot Worse Things Than Dyin'...

All of my adult life, I've heard my Mam-ma Polly say this... "They's a lot worse things than dyin'..."  Now, it's her turn.  I had made plans to accomplish two things today... get the laundry done, and visit Mam-ma.  I started laundry, worked at my desk, then did a workout, showered and dressed.  Somewhere around 2:30 p.m., I headed for the Assisted Living Facility.  My mother had visited Mam-ma yesterday and thought she was pretty good... so well, in fact, that she planned to take Timothy and Zola to see her tomorrow.

Today was totally different.  The Hospice aide - and a dear friend of our family - was there bathing Mam-ma.  And the oxygen machine was running... hose strung across the room and into the bathroom.  Shelly (the aide) hollered to me, "She's really wheezing!" I told her she has been wheezing for a couple of weeks.  But Shelly said, "I could hear it when I got here." And I could hear it.  Shelly said, "I am wondering if I should have showered her... she's not doing good."  Mam-ma was shaking... and she had an ashy color.

Shelly got Mam-ma dressed in some sweats and insisted she get into bed.  Mam-ma started to protest... and even had Shelly put her in the wheelchair... but then she thought better of it and agreed she should be in bed.  Shelly stayed while I checked with the facility nurse.  When the Hospice nurse had visited around 1:30 p.m., Mam-ma's pulse ox was 80.  Normal for most of us is somewhere around 95 to 100.  They start to worry at 89-90.  So this was a low reading, hence the oxygen.

Mam-ma was clearly in distress.  She and I had a long talk, as she tried and tried to tell me something, but could get out no more than an "Oh, I want... or "Oh, I'm going..."  I asked her... "are you ready to go home?"  She raised up in bed, looked me squarely in the eye, and adamantly said, "YES!"  I told her it was okay to go... that we were all okay.  Then I began to tell her how my mom had said just this morning that some of her friends had announced to their children that they were no longer to prepare a big Christmas dinner... and that "honor" would have to transfer to the children.  At least one of those children said, "Fine!  We'll eat out!"

I reminded my grandmother of my cousin Carla, who died suddenly about a year and a half ago of a brain aneurysm at age 46.  Her parents went to a franchise restaurant one year for Thanksgiving, and she had a FIT!  I told Mom, I could see Carla's eyes rolling at the very thought that we would not have a home-cooked Christmas dinner.  Then our conversation turned to Christmas dinners... and who all would be sitting at our family's table in Heaven vs. the table here.  I told Mam-ma, "There will be a whole lot more of us there than here... and you should be with them."  She began to cry.  I soothed her and said, "Now, we're not going to cry about this... this is a glorious, wonderful thing, and you deserve to be with... (and I named everyone from her sisters and best friend to my grandfather, dad, brother, cousins and aunts and uncles who have shared our table's bounty - and our lives). 

Mam-ma settled fairly quickly... at least she stopped crying.  My sister and my niece arrived to check on her... and then my mom came.  As each person came, Mam-ma tried desperately to tell them things, clasping their hands, grabbing for their shirt sleeve, or cupping their face in her hand.  The only words I understood beyond the "I wants" and the "I'm going tos" was "Greg" - my husband's name.  Mam-ma has been very worried about my husband and me ever since we moved my niece and her three children home a couple of months ago.  I smiled and said, "Greg is fine.  We are both fine... and we're going to be okay.  You don't worry about us... we are both okay."

A few minutes later, the door opened, and my sweet husband came through.  He walked over and kissed Mam-ma, and she gripped his hand.  He was just what she needed.  The Hospice nurse told me to ask the facility nurse for an anti-anxiety pill for Mam-ma.  One hour later, she was still agitated... the pill had not worked.  The Hospice nurse had arrived to see for herself what was happening, and she ordered a pain pill for Mam-ma.  The facility nurse gave Mam-ma the pain pill, and about a half hour later, she was calm and resting better.

We decided to grab some dinner, and then I would return to the facility.  We were probably gone 45 minutes, and when I got back, aides were changing my grandmother and putting her bedclothes on her.  She was coughing more, and one aide took her vital signs.  The pulse ox was normal, thanks to the oxygen, but she now has a low-grade fever.  The Hospice nurse suspects she has some bronchial "something" going on.  BUT... as soon as Mam-ma was dressed for bed and settled, she drifted off to sleep immediately.  The aide on duty offered to come back after she finished her rounds and sit with Mam-ma until she was sound asleep, if necessary.  I sat with Mam-ma for about an hour, and my mom returned for a few minutes, as well.  Mam-ma never roused. Her brow has been furrowed in a frown all day... a sign that she is not comfortable... but she slept nonetheless.

So I asked the aide to be sure that Mam-ma continued to sleep.  Give her another anti-anxiety pill if she wakes, and don't encourage her to eat.  She refused supper... I'm hoping she will refuse breakfast. She had trouble swallowing water for her pain pill, and I do not want her to choke. I reminded the nurse and aides NOT to insist that she eat... to offer food, and let her decide.  The Hospice nurse, who is also a dear friend, keeps telling me, "You're doing great!  You're saying the right things.  You did well in talking to her.  Let her know it's okay to go."  So we are doing all these things.

This is not easy, by any means.  Mam-ma is right... "they's a lot worse things than dyin'..." and watching her like this is one of them.  While we were eating dinner, I told Greg, "I don't know why dying has to be so hard."  He reminded me that even though Mam-ma is ready to go... she is incredibly tough!  This could take a while.

Tomorrow, the Hospice nurse will consult her doctor and see if anything further can be ordered at this point to keep Mam-ma comfortable.  I'm hopeful.  Tuesday, December 18, will mark 80 years since my grandmother and grandfather married. My Pap-pa has been gone since August of 1984.   I would love nothing more than for the two of them to celebrate this anniversary together... in heaven.  I know I don't get to tell God how to run things... but I do believe He hears requests.  I'm just hoping He honors this one.

Sunday, December 9, 2012

Making a List... and Checking it Twice...

This week, I had to sign a paper at the Assisted Living Facility saying we do not want any more antibiotics to be given to my grandmother.  When I went to the administrator's office to sign the paper, I noticed that there was also an option (with a check box) for not taking the resident to the hospital Emergency Room for treatment.  That box was unchecked. I  asked, "Don't we need to check that box, too?"  The administrator asked, "You mean you don't want her taken to the ER?"  "No!" I replied adamantly.  "Hospice has assured me they will keep her comfortable in her apartment, and she does not want to go back to the hospital... for anything! 

The administrator nodded and said, "Then yes... you need to check the box."  Now honestly, I assumed this was already understood... and covered by the fact that my grandmother is under the care of Hospice. I was wrong!  So while I would have been able to refuse an ambulance (if I were called in time), one very might have been called if necessary.  For instance, the day my grandmother had the "coughing spell," the administrator said she almost strangled.  Had she lost consciousness, I am sure they would have called 911.  When she broke her hip last spring, the EMTs had already loaded her into the ambulance by the time my husband and I arrived... and we live five minutes from the ALF!

I am sharing this information to tell you that you cannot assume ANYTHING!  Ask questions... be sure you know what is documented... and that all agencies involved are coordinating efforts.

In a different vein, I've had some "fun" with other agencies recently that I'd like to share.  I had it on my list to call the insurance provider for my grandmother's Medicare Part D and verify that all of her medications are covered by this company.  Believe it or not, after having to change companies some seven times in six years (including one year when Medicare just arbitrarily changed us to a company that we did not select - and one that did not cover Mam-ma's medications), we have been with HealthSpring for 2 years now... and we will be with them again for the coming year.  The website showed that all medications were covered again.  But I like to hear it from the company to be sure.

So I called HealthSpring to verify this, and the rep told me that "I'm sorry, but I cannot discuss this with you, because I do not see your authorization."  I explained that I was my grandmother's Power of Attorney... I've been calling this company for three years now and talking about her case, and a copy of the Power of Attorney is on file with them.  She insisted it was not... I insisted it was, because I've always gotten this information.  The lady told me several times that she could not discuss anything with me.  I tried to explain that says that all of my grandmother's medications are still covered by their company.  I was merely trying to verify this with HealthSpring.  Finally, the rep said, "Did you say she has been our customer for two years?"  I told her yes, this was correct.  She continued... "Then all of her coverage will roll over to this next year."  "All of her medications will still be covered?"  "Yes, they will roll over."  I thanked her and said, "That's all I needed to know."

Now for the record, this is not necessarily always true.  Just because a company covered your meds last year doesn't mean they will this coming year.  This is why we moved from company to company so many times.  Some of the medications my grandmother took along the way were quite expensive, and companies loved to drop them from the formulary as quickly as possible.  So when I would get the formularies for the coming year, those expensive drugs would no longer be covered.  I still don't know what happened to the record of my Power of Attorney... but at this point, I have what I need, and I'm not going to pursue it any further.

Last week, I tried to pay my grandmother's pharmacy bill online, and I put in the wrong password on the account and got locked out. Usually, I call an 800# for the main bank (in another city), give them the info, and they unlock the account. This day, I got a girl with attitude who told me that she could see I was listed on the checking account, but the online account was in my grandmother's name (DUH) and only SHE could talk to her. I said, "Look, she's 100, she's on Hospice, she cannot talk, and she is dying. I'm trying to pay her bills." The girl got pretty curt, and I asked to speak to someone else and she said there was no one else to speak to. So I had to set up a whole new login/password account in MY name... and I lost all of my auto bill pays. The girl kept saying, "Let me try to explain this to you in a way that you can understand."  Really?  By the time I hung up, I was in tears, and the girl said, "Have I explained this in a way that it makes sense?" I told her no... but not much of anything makes sense right now!

So THEN I realized that I had a $700+ payment going out the next day to the ALF. I got worried that if I set up billpay again, as this girl had said I should do... it might pay twice and make an overdraft. So I called back. Guess what?! I got a DIFFERENT girl, who was much nicer...but by then I had set up a login and password for myself on the account. She said, "I can't tell you anything, but if you ask the right questions, I can answer them." So we did determine that YES... that payment was still scheduled to be made, and had I put it in again, we'd be in the hole and have to pay an overdraft of about $30! So much for Customer Service!!  

I get that banks have privacy laws, but the first girl said, "You gave me your name when I answered the phone, and it doesn't match the name on the account, so I know you are not Polly." In other words, if I had lied to start with, she would have unlocked the account. CRAZY!  I gave her the last 4 digits of MY Social Security number, my grandmother's, and other vital information... and she could SEE me listed as a co-signer on the account... and still, she would not help me.

In her defense, this girl was just doing her job.  And I am glad that our banking info is secure.  But it was more her attitude and her unwillingness to work with me in any way.  I told my husband that I guess that LITTLE thing was what triggered my BIG meltdown. I'm okay now... just one more lesson learned. My mother suggested that I should have hung up, called back and pretended to be Polly.  It probably would have worked!  I'm just sayin'!

These are the types of things that make life for those of us in a "Sandwich" so challenging. As if we didn't have enough to do already, we have to deal with Customer Service reps who seem to go out of their way to make life difficult.  I know that this is often a ploy just to distract and deter the elderly.  Somehow, I think that bank CS knew she had not exactly made my day...but never once did she say she was sorry or act the least bit sympathetic. If this had been my mother-in-law or another older senior, the conversation probably would have ended much more quickly. 

You would think that after all of these years, I would be better at "playing the game."  And I had to laugh as I thought of the many times that a CS rep would not talk to me and asked to talk to Polly.  I would call her on my cell phone and hold it up to the land line receiver, and this little woman would say something like "Sugar, you just ask Debbie whatever you need, and she'll tell you."  Somehow, that was acceptable and believable.  Kinda makes you wonder, doesn't it?!

Monday, December 3, 2012

I'll Make Do...

My sister and I shared a Thanksgiving lunch with Mam-ma Polly the Tuesday before Thanksgiving. A few days after Thanksgiving, Mam-ma told my mom, "I don't know WHEN I've seen Suzanne (my sister)."  Mom tried to remind her that Suzanne and I ate lunch with her the previous Tuesday.  She argued that Suzanne was not there.  I snapped pictures of my grandmother and my sister... here is one.

A few days later, Mam-ma fussed that I didn't come often or stay long enough... and that "I'm seeing quite a bit of Suzanne."  I reminded her that yes, Suzanne works as an aide at the ALF on weekends, so she is there Friday, Saturday and Sunday nights.  That did not seem to register.

Last Tuesday, I went to visit Mam-ma.  She was in the hallway near the front door.  She said, "I'm lookin'... I'm lookin'..."  I asked who she was looking for, and she replied, "For YOU!"  I asked how she knew I was coming.  She couldn't tell me.

We returned to Mam-ma's room, and nothing was right.  She needed gloves from home.  I opened a dresser drawer and produced half a dozen pair.  I left some gloves and ear muffs on her table... was she wanting to go outside?  She shook her head, "No!"  I commented that it was realy too chilly anyway, but whenever she needed her gloves, they were there.

Mam-ma cried quite a bit, and told me, "I'm so lonesome."  She then told me, "I've tried to explain that I'm working on it... not being lonesome."  I told her being lonely is not something we overcome easily or at the snap of a finger... that I was sorry she is lonely, and I don't know what to do about it.  She replied, "You don't come often enough."  I tried to explain that I have a lot of responsibilities now... new ones with my niece and her husband and three children... my 86-year-old mother-in-law who had a mini-stroke this fall... my husband and my own household to run.  She cried and said, "I don't begrudge you these things.  I'm just lonesome."  It was a really, really bad visit.  Mam-ma spent most of the time I was with her telling me how I don't come often enough or stay long enough.  She was simply miserable.

The next evening, my mother took Timothy to see Mam-ma.  She had been asking for him and his siblings, who have been sick and unable to visit.  Mom said Mam-ma was overwhelmed... and overjoyed to see Timmy.  They didn't stay long, but Mam-ma was beaming.  Mom said, "It meant so much to her."

Friday, my husband and I collected Timmy and his 18-month-old sister, Zola, and brought them to our house for the afternoon.  We played with toys, looked at the Christmas decorations, and watched Frosty the Snowman and other videos.  Late in the afternoon when the temperatures warmed, we took them to a local park to play.  We had not been there long when my phone rang.  It was the nurse from the ALF reporting that Polly was having difficulty breathing.  She and the facility owner (who is an RN) had both listened to her chest and heard a rumble.  Hospice had been contacted, and the nurse said she thought the doctor would be consulted about an antibiotic.  Mam-ma was also retaining fluid... level 3 to 4, the nurse said.  She told me, "We'll see if the doctor wants to send her to the hospital for that."

I questioned the antibiotics for someone on Hospice and told the nurse we had agreed NOT to send Mam-ma back to the hospital.  She assured me that I did not need to come to the ALF...that she had given Mam-ma an Ativan to calm her, and everything was fine.  A few minutes later, the Hospice nurse called to tell me that the doctor had ordered a seven-day round of antibiotics, cough syrup, and a steroid shot.  Again, I questioned this, and the nurse said even if the problem was congestive heart failure (CHF) and not something bronchial, the medicine might help with her cough - and in that regard, keep her comfortable.  She also told me it would be fully understandable if I refused further medication.

So I visited on Saturday.  The nurse and I talked, and we both agreed that Mam-ma is - as she put it - "ready to go Home."  Mam-ma was coughing terribly, and wheezing audibly.  She complained that her pants were too tight, so I helped her change them.  These were also too tight.  I surmised she was retaining fluid in her mid-section.  An aide came in with a basket of freshly cleaned laundry, and I grabbed a stretchy sweatsuit.  The aide changed Mam-ma into the suit, and as I put her shoes back on her, I said, "I think I may need to buy you some more sweats."  She shook her head, "No!" and started to cry.

I questioned... what was wrong?  She cried more.  I finally asked, "Do you not think you will be here to wear the sweats?"  She stopped crying and took my hands and said, "I'll make do."  I took that as her way of saying she was done, and I nodded in agreement. I stayed a while longer and got Mam-ma settled for lunch, with the understanding that she would nap in the afternoon.  She had worn herself out changing clothes and coughing... and in fact, she coughed so hard at the dining table I thought she might trigger a heart attack.  The nurse had insisted that this is CHF... and if she does have something bronchial, she indeed does have CHF as well.

I struggled with this all weekend.  Mam-ma is like a doll that falls over, and we prop her back up with medication for a while.  She doesn't want to be here any longer.  We are not honoring her wishes.  So this morning, I spoke with our Hospice nurse/caseworker, and then I called the ALF administrator and told her that this will be my grandmother's last round of antibiotics.  She has indicated that she does not want further treatment, and I am representing her wishes... serving as her advocate and speaking for her, because she can no longer speak for herself.  I will sign a "compliance" paper that says that this is what we desire on my grandmother's behalf.

Late this morning, my mother visited again and found Mam-ma doing well.  Mom said her conversation was fairly pleasant, although Mam-ma cried about a few things.  She coughed some, but Mom did not think it was all that bad.  However, my sister attended an inservice this afternoon, and the administrator told her that I had requested that no more antibiotics be administered, and she advised... "She won't last much longer."  She went on to say that Mam-ma had a serious coughing spell this morning in the lobby, and a staff member had to dash to get a drink of water for her to get it stopped.

My sister also told me that Mam-ma has suffered from diarrhea since sometime Saturday.  We agreed that we are not ready to say "Good-bye" to Mam-ma... yet we know she is ready to go to heaven.  It's been a really rough week.  I have struggled with these decisions, knowing fully that my grandmother is tired of living.  I know that we could go to her apartment and ask her point blank, "Do you want to keep taking medicine?" and she might say "Yes"... then turn right around and say "No."  Her answers are no longer dependable... but her demeanor is.  And I am ready for her to be at peace.

My mom said that when she and Timothy visited a few nights ago, Mam-ma kept looking at him and saying, "I tell you what..."  Finally, Timothy said, "Tell me, Mam-ma!"  When Mam-ma Polly gets to heaven, she will be able to tell everyone what again... and that will be the best medicine ever for her.  Meanwhile, we'll handle whatever lies ahead... and do our best to "make do."