The Deli - Serving the Sandwich Generation

Another Empty Chair at the Table

2012-01-12T16:57:00.000-06:00

Last week when I took my grandmother to the doctor, she told me, "Ruth is sick." Ruth was my third-grade teacher. She and my grandmother became friends in the late 1950s/early 1960s. They were in B&PW Club together - both "business women" in an era when there weren't very many women who worked outside the home. Ruth had moved to the ALF several years ago, and when Mam-ma moved in, she was seated at a table in the dining area with Ruth and another friend, Ms. Evelyn. I spoke to Ruth and Evelyn on January 2nd when I walked Mam-ma to lunch. Both seemed well.

Ms. Evelyn, Mam-ma Polly, and my first grade
teacher, Ms. Ruth

By Thursday, January 5th, Mam-ma was telling me that Ruth was sick. She sat at the table that evening for dinner... but she did not eat. The next day, she was admitted to the hospital, where she died Monday morning from pneumonia. Ruth would have been 97 on June 16th. Mam-ma and Ms. Evelyn are heartsick. Evelyn and Ruth were "kitty-cornered" neighbors for decades before both moving to the ALF. Evelyn has told me over and over this week how long she and Ruth were friends - and how much she will miss her.

Monday, I went to the ALF to check on Mam-ma, and we talked at length about dying. She is so ready - and quite frankly, she is jealous that Ruth got the jump on her! She said, "I prayed this morning about this. I told the LORD I'm ready to go." Then she managed to get out... "Death... frightens... me." I asked, "Are you afraid to die?" No, she told me... and finally I managed to discern that she is afraid of lingering... becoming comatose or "like a vegetable." She also managed to express that she worries about those who are left. I assured her that we will be fine... we will manage... and without her to lean on, some might even have to step up to the plate and do better!

While we talked, I realized that the last few times I have visited, Mam-ma's attire has been a little strange. January 2nd, she had on summer white pants and a light-colored shirt. Many other visits, she has been wearing the same drab olive green pants and a multi-colored blouse. So I went through her closet and organized some "outfits". I asked her why she wore the same thing all the time, and she replied, blankly, "I don't know." My grandmother has beautiful clothes. Now that she has lost weight, she fits into all of them well. There is no reason for her to wear the same thing every day. Either the aides are not paying attention - or she chooses to wear the same outfit. I tend to think it is the latter.

So, just as I selected Timothy's daily attire, I grouped ensembles for Mam-ma - pants, shirts and a jacket. When I returned yesterday, I partitioned her closet, leaving notes on the summer things that said, "Summer Clothes - Do Not Wear Until After March 2012". The outfits for this winter, I labeled... "Please Help Polly Dress in These Outfits for Winter. Thank You!" So far, Polly has worn a new outfit each day this week. As one staff member put it, "There are people here who get paid to do laundry - there is no reason she can't wear a clean outfit every single day." It may not seem like much, but I think it makes a difference - not only in my grandmother's appearance, but also in her attitude. Change is good...even if it's merely your clothing!

I've been visiting more often and spending more time with my grandmother this last week or two. One day she is up and the next she is down. She is staying in her room more... and sleeping a lot. She is bored and depressed. My mother is traveling, and she said she hesitates to phone, because Mam-ma has so much trouble talking on the telephone - and even getting to it to answer. She said she would write a letter. However, I've been having to read Mam-ma's mail to her this week, so Mom is going to e-mail the letter to me, and I will read it to her. Once again, I see a similarity - we read to Timothy, and now we read to Mam-ma.

I told my grandmother that I have no idea when the LORD will call her home. I know it won't be until she has accomplished all she is responsible for here... and that may be something as seemingly small as smiling at an aide or working through the grief over Ruth's death with her friend, Evelyn. But I assured her that when the day comes, we will all be happy for her... confident she did all she was supposed to do in her lifetime - and that she is reunited with so many who loved her and have gone to heaven already.

This is a challenging time... a hurtful time, in a way I didn't really expect. Watching two ladies who are nearly 100 years old sit and stare through their tears is both a heartache... and a blessing. I've sat in Ruth's chair a couple of times this week when I visited. The empty chair is a constant reminder to these ladies of her absence. To realize that they are so ready to go to heaven makes the thought of losing them a little easier. It will be a sadness... but also a relief. They, like Ms. Ruth, will leave a rich legacy of lives well-lived.

In the meantime, the skills and tactics I use in nurturing a 2-year-old are coming in handy as I nurture my grandmother. Much of the frustration and stress associated with caring for Mam-ma in the last decade or more is being replaced with a new-found level of patience, compassion, and empathy. I look at some of the things she can no longer do, and I realize that, like a toddler learning to do things for the first time and often stumbling in the process, she cannot help herself much of the time. She has outbursts and expresses frustration and confusion, just like a toddler... and I have to respond the same for both ages.

And maybe that's why God has kept her around. I prayed for a number of years that my grandmother would not die with us at odds with each other... leaving me with bitterness. She can still push my buttons... but no longer in the same way as when she was "up and at 'em." Maybe God has kept her here and allowed this decline to soften the blow.

I apologize if my last few posts have been depressing. This is a bittersweet season in my life. And I suspect from comments I've been receiving that many of you are in the same boat... or you just got out! Right on cue, God blessed me last night with a phone conversation with Timothy that totally brighten my day and reminded me of the circle of life. Timmy told me of playing with his dinosaurs and reading books. Then he said, "Okay, honey, I'm gonna let you go and get some sleep!" With a "later, gator" and an "after while, crocodile" - and even an "I love you!" - he returned to play with his toys, and I hung up confident that he was happy and content... and always loved.

I don't know when I will get to see him again - and IF I will see my grandmother tomorrow. But I do know that God is working everything out perfectly. And for the moment, all is well.

Are You Smarter Than a 99-year-old?

2012-01-08T18:51:00.002-06:00

It didn't take my grandmother long to outsmart some of the efforts to keep her safe and prevent another fall. So it came as no surprise to me when the facility R.N. called on Friday and said, "Ms. Polly is a smart woman. She has figured out how to turn off her bed alarm, rendering it virtually ineffective as a safety device. Is it okay with you if I take it out of her room?" I laughed and told her yes, that was fine. Clearly, if she can disarm it before aides arrive, we all know she can be off and running (so to speak) and into a whole heap of trouble before help arrives. And bending down under the bed to turn off the alarm is enough to make her fall in the first place!

The nurse also noted that my grandmother is FAST, which also came as no surprise to me. On Thursday morning, I had spoken with Mam-ma and reminded her that I was picking her up later that day for a 1:45 p.m. appointment at the hospital outpatient clinic with her cardiologist. Telling me anything on the phone takes her forever now (and it's not much better in person), but she managed to convey that she was not happy with what she was wearing - that the aides select her outfits each day, and she didn't approve of this one for a trip to the doctor.

I told her, "Don't worry about it. I will come at 1:00 and help you dress - and I will fix your hair." She was scheduled to see the hairdresser when we returned from her doctor visit, but I knew her hair looked awful, and I had taken my curling iron once before and worked on it. I could at least make her presentable. So shortly before 1:00 p.m., I loaded my hot curlers and curling iron into the car and headed to the facility.

When I knocked on Mam-ma's door and tried the handle, it opened, and I stepped inside. "Knock! Knock!" I called. No answer. I started looking around. Mam-ma's call button was on the TV table. She was not in the room. I even looked over on the floor between her bed and the window. She wasn't there. I looked in the bathroom... not there, either. I realized that her walker was gone, too. GREAT! She's loose in the facility, without even a call button if she falls and needs help!

I stepped back out of the room and walked to the dining area, where several residents were still eating. No Mam-ma. I saw the maintenance man, James, and asked, "Have you seen Polly?" "Yes! She was just here eating." He stepped toward her table and realized she was not there, just as an aide said, "Polly's gone to the doctor." No... I had come to get Polly to take her to the doctor. The aide continued... "Mary Lou took her already." Mary Lou is the driver for the facility. The aide suggested I ask the nurse. I went to the nurse's office, and sure enough, a phone call to Mary Lou revealed that she was already at the hospital with Polly and another client.

We surmised that the cardiologist's office had phoned the facility instead of me to remind us about the appointment. When the facility got the call, they placed the appointment on the driver's calendar. I didn't realize I didn't get the call... and I didn't call the facility to tell them I was taking Mam-ma myself, because I didn't figure it mattered. Next time - if there is one - I will call. I utilize the driver for routine things like trips to have her dentures adjusted, a routine pacemaker check, and more. But when I feel I need to be with Mam-ma and hear what a doctor has to say, I will drive her myself.

So I hurried to the hospital, where I found Mam-ma, the driver, and the other resident sitting in the outpatient waiting area. Mam-ma looked up at me, grinned, and said, "Well! I didn't know you was a comin'." I just laughed. The driver began to apologize, and I assured her it was not her fault. However, she had fed both ladies their lunch early and brought them both to the hospital before 1:00, because the other resident had an appointment at that hour. This meant that Mam-ma was sitting a full 45 minutes before her appointment time. We didn't ultimately get in to see the doctor until about 2:15 p.m., which meant Mam-ma sat and waited over an hour. This might not seem like a big deal - and it's not for you and me. But for a 99-year-old who tires easily, this is an eternity. Think sitting and waiting with a 2-year-old for over an hour, and you sorta get the picture. Mam-ma got stiff, and her ankles began to swell a bit from sitting and dangling her legs.

In the exam room, I had Mam-ma prop up her feet. The exam was fairly routine... the doctor listened to her breathing and we discussed her hospital visits and the treatments. He looked at her ankles, and we discussed some of the medications she was given in the hospital and emergency room. Then he asked Mam-ma if she had any questions, and she raised a bony finger and pointed it at him and said, "Yes... they won't let me leave my room!" He looked at me, and I said, "Translation... she cannot leave her room without an aide accompanying her, because she is a fall risk." The doctor launched into a dissertation on how at age 99, a lot more goes into walking than merely walking... balance, memory, muscle tone, strength, and concentration, to name a few. He agreed that she needs someone with her.

"She wants to go outside and walk on the sidewalk," I added. "Oh, no, Ma'am!" he said. "You've already had a bad fall, and you are really very lucky. Your fall on Christmas Eve could have been so much worse... so much worse." She just looked at him. He asked if there was anything else, and she said, "No, but your answer disappoints me." He just laughed and said he would like to see us again in six months... or sooner if we need him.

By the time I got Mam-ma back to the facility, it was just after 3:00 p.m., and her hairdresser was waiting for her. She called me later that evening, and she was exhausted. I was not surprised. However, the nurse assured me Friday morning that she was alert, clear, and transferring well from one place to another, i.e. chairs, her walker, and more. The 30-minute checks by aides are still in place, but the alarm has been removed.

Then, Saturday night, I got a phone call about 7:30. I saw on Caller ID that it was my grandmother, but when I answered, there was no response. I called her name, and finally, she said in a weak voice, "Well, I was calling for Greg (my husband)." I offered to get him, but asked what she needed. It was a 10-minuted convoluted conversation about something about trying to call my cousin Ricky and not being able to get him... then she couldn't get anyone on the phone - all she gets are busy signals... and then it was crying, and "I'm crazy." She managed to tell me, "I called Ricky this afternoon... and he came over here." Then why did she need to talk to him again that night? "I don't know," she cried.

We went back and forth - she wasn't hurt, she wasn't sick, she didn't fall - and finally I got her to press her call button and get an aide in the room, telling her, "Call your aide and stay on the line. When she comes in, put her on the phone, and I will tell her what you need." The aide arrived, and she had a hard time understanding why Polly wanted her to talk to me, but finally she got on the line. I asked her to give Mam-ma her Ativan and put her to bed. She said she would, and she handed the phone back to Mam-ma, so that I could tell her goodnight. It took a few minutes of reassurance and "I love yous" to convince her that the aide would return and she would feel better in the morning.

I called later to check on her, and the aide said, "She has been upset and confused like this since I came to work Friday night at 6:00." But she assured me she had put her to bed and given the Ativan and would keep an eye on her. Based on previous experiences, I figured after a good night of sleep, Mam-ma would not even remember calling us. That was not the case... she told my sister and her husband all about it today when they visited her - as best she could. She told them that "I froze... I don't know what happened" and "Debbie talked to me and calmed me down."

I don't know what happened, either. I just know that while I was talking to my grandmother and trying to calm and soothe her, I thought to myself, "I could easily be having this same conversation with Timothy... and it would make about as much sense." The similarity was striking. Mam-ma now has so much trouble thinking of what she wants to say - and saying it - that she actually is harder to communicate with than our 2½-year-old nephew. As he learns so much each day and becomes more adept at manipulating objects, managing his own personal care - and talking - Mam-ma loses ground. And that's how life is... for all of us. I just happen to have a more poignant illustration right in front of me.

I don't know what happened. I don't know if Mam-ma had a little TIA, or if she just got so tired on Thursday that she was still mixed up on Saturday night...or if she is starting to "sundown" - becoming disoriented and confused late into the afternoon and early evening, which is common with patients who have dementia or Alzheimer's. This may happen repeatedly - or she might not ever become disoriented like that again. Time will tell. At times, I think the spunky little lady who can outsmart a bed alarm is still with us... and the next minute, I realize that time is slipping away - and taking her with it. My prayer is that, one way or another, she soon ceases to realize her limitations and be frustrated by them. This is something we desire for our babies... and now we wish it for our elders, as well. And the circle continues...

The Sights and Sounds of Christmas Shouldn't Include Blood and Sirens

2011-12-27T11:40:00.001-06:00

The Christmas Eve meal was pretty well prepared and in the oven. We were planning to eat at 3:30 p.m. My mother-in-law arrived early, and she visited with my husband as I finished up with last-minute kitchen preparations. I glanced at the clock – 2:10 p.m. My mother and her sister were to pick up my grandmother at her assisted living facility at 2:00, so they should be arriving any minute. I glanced up and saw Mom’s Jeep pull into our driveway, and I told my husband, “Mom is here with Mam-ma.” He and his mother started for the door to greet them, as I searched for something in the pantry. Then I heard my mother scream for my husband to come quickly. My grandmother had fallen. I rushed outside to see her lying lifeless on the driveway. We thought she had had a stroke. My husband rushed to call 911 as I hurried toward my Mam-ma. That’s when I saw the pool of blood forming under her head and trailing down our driveway.

In a panic, I ran inside and told Greg that Mam-ma was bleeding. He told me to get a rag and apply pressure to her wound. I ran inside and got a wet rag. Looking back, I don't know why I thought it had to be wet, but in my panic, I ran the rag under the faucet to dampen it! I knelt beside Mam-ma and pressed it tightly to her head. Her eyes were fixed, her mouth was open, and she was totally unresponsive. I thought she was dead.

I applied pressure, and asked, "Mam-ma, can you hear me?" A few seconds later, she said, "Yeah." We covered her with blankets. Thankfully the temperature had risen into the fifties and the day was sunny, so the concrete driveway was cold, but dry. As I applied pressure, the blood soaked through the rag and poured on to the concrete underneath. Greg brought me even more rags, as the pool of blood continued to grow on the concrete. We kept assuring everyone that head wounds bleed a lot and often look worse than they are. But since we didn't dare move Mam-ma to look, we had no clue exactly where she was wounded... or how bad it truly was.

The ambulance arrived after about 10 minutes, and my grandmother was placed on a back-board and fitted with a cervical collar. She was transported to the hospital emergency room, which is maybe two minutes from our house. A few hours later, CT-scans indicated no internal head or neck injuries. Once the bandages were removed and everything was cleaned, only a small puncture wound inside a larger hematoma sat behind her right ear. The only pain she complained of was from the back stabilization board. The ER staff said that this necessary precaution is "one of the worst things we do to people." She begged me, "Please, please... get me off this thing." But I was unable to do so until the results of the scans were read. I would guess she was strapped down about two hours.

When we could see that this was going to take a while, my husband came to the ER and sat with my grandmother, while I hurried home and finished heating our Christmas dinner and got it on the table for everyone. I ate with my family - Mom, her sister, my mother-in-law, my sister and her husband - knowing it might be my only chance to eat for the rest of the night. Then I returned to the ER and traded places with my husband. By this time, the doctor had given her a shot of something called Nubain for pain.

Greg said he asked Mam-ma, "Are you hurting?" and she said she was not. But when the doctor came in, he asked her if she was in pain, and she said "Yes." So he promptly ordered pain medication and gave her 5 mg of Nubain. He also wrote a prescription for pain medication for the next 2 days and said we needed to hurry to Wal-Mart to get the prescription filled, because the pharmacy would close early on Christmas Eve. It was now about 5:30 p.m.

This prescription should have been a "red flag," but in our shock and confusion, we didn't think to question it, so Greg headed to Wal-Mart to get the medication. Meanwhile, the doctor prepared to discharge my grandmother, declaring that he had “no medical reason” to keep her.

I could not believe it... and I tried to plead my case with him... Wasn’t it enough that she was 99 years old and had just had such a nasty fall? Didn’t her high blood pressure and her “loopiness” from the pain medication he had just administered qualify her to stay? Could he not consider that she was dismissed from a six-day hospital stay only 12 days earlier? He insisted his hands were tied.

The assisted living facility was contacted, and the nurse said they were understaffed and they could not perform “neuro” checks every 2 hours, as prescribed. I did not feel my grandmother was steady enough to stay in her apartment alone anyway.

The doctor suggested perhaps Mam-ma could stay with a family member. I just looked at him and said, "She fell trying to get into my house. Do you really think that's a good idea?" He agreed this was not a great option, but he said he was just trying to offer me some possible solutions. His final suggestion was, “I guess you could take her to apartment and stay with her there overnight.” I just walked away from the desk.

I was at my wits’ end. I didn’t know what to do. I called my husband and told him this while he waited at Wal-Mart. He was not a happy camper, but he told me the choice was ultimtately mine. I told him I guessed we would have to pray hard and take our chances in my grandmother’s apartment. Greg suggested I call my mom and relay all of this information to her and see what she thought. I looked up and saw a sign beside a door where I was standing. It said “Chapel.”

I stepped inside the chapel to call my mom, and as we talked, I started to fall apart. I looked at plaques that hung on the wall. They were scriptures, and the first thing I saw was Philippians 4:6-7..."Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus." Then I read Lamentations 3:22-23..."Because of the LORD’s great love we are not consumed, for his compassions never fail. They are new every morning; great is your faithfulness."...followed by Psalm 23, and finally... Jeremiah 29:11..."For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future." All scriptures are from the New International Version (NIV).

My mother insisted that she would stay with my grandmother at her apartment, and I reluctantly agreed. I knew that I was physically stronger and more able to manage Mam-ma, but neither of us had any business handling a 99-year-old injured woman who was spaced out on pain meds. Then I said a prayer before I left the chapel and asked God to handle this… to take my worries and fretting and give me peace about this situation.

When I stepped back into my grandmother’s exam room, I was visibly upset… and so was the charge nurse who had been treating my grandmother. I am not sure she hadn't been crying, too. Her face was red and she was sniffling. She had spent an hour cleaning Mam-ma's head wound, and I have to say, every single staff member - including the attending physician - was absolutely wonderful with Mam-ma. I expressed again my concerns and frustration… and the nurse agreed that I was right to be concerned. Then she asked which doctor my grandmother had seen when she was hospitalized earlier in the month.

I told the nurse name of my grandmother’s last hospitalist, and she said, “He’s on duty all weekend. I can ask the ER doctor to call him if you want and see if he will admit your grandmother - at least overnight.” She didn’t make any promises, but it was worth a shot. Of course I wanted her to ask! I thanked her for doing this, and she left to talk with the attending physician. A few minutes later, she returned to tell me that the attending had indeed agreed to call the hospitalist, who had agreed admit my grandmother for overnight observation.

I cannot tell you the overwhelming peace and relief that flooded me when the nurse offered to talk with the doctors. I cannot begin to express how I felt when she returned to tell me that the hospitalist had agreed. I was so grateful to God for working out what I could not… and for directing me into that chapel for a few minutes. There, as I read those scripture passages, God gave me what I needed… hope, peace, reassurance that He was in control… and love overflowing.

Orders were written, and Mam-ma was wheeled upstairs by the charge nurse. I continued to thank her for being there - for helping me - for caring. She said, "My hands were tied until you asked..." It was then that I realized... I had to ask to speak to the hospitalist. Since Mam-ma's primary care physician is the nursing home staff doctor (and practicies in another city and does not have admitting privileges at our local hospital), we had to find someone who had treated her and could vouch for the necessity of admitting her. Once I recognized her hospitalist's name on the white board, we had a chance!

Upstairs, the nurses on the floor - some of them childhood friends, and all of them good "new" friends from 2 weeks ago - jumped up and began to get Mam-ma settled. To a nurse, they were appalled that there had been any question about admitting my grandmother. One dear LPN said, "Were you supposed to pour her into your car after this shot of Nubain?" For the record, this is not a necessarily bad pain medication - the concern was my grandmothers size and age - and the dosage administered.

Every time they stood Mam-ma up or moved her in the least, she vomited. The nurses agreed to watch her and hold off on giving anti-nausea medication, in case the sickness was related to the head injury. Mam-ma was settled in bed by about 7:00, but she seemed restless. She kept saying, "Debbie, you go on home." I decided she might rest better if I left, so I returned to my family gathering for a while.

When everyone had eaten and visited, we declared our "Christmas" over and done, and all of the family members went home around 8:30 p.m.. I returned to the hospital to sit with Mam-ma for a while. The LPN asked me, "What are you going to do... are you staying?" I asked her if she felt it was necessary, and she said, "No... but I want your phone number written on the white board." I placed my contact information on the white board and reminded the nurses I was less than 2 minutes away any hour of the night or day. I also reminded them that my grandmother is a DNR - Do Not Rescusitate - patient. Be sure you remind the staff of this, if you have such directives as a DNR and/or Living Will. Apparently it does not always transfer on the records!

I sat with Mam-ma until about 10:00 p.m., kissed her goodnight, and returned home. Christmas morning, I was back about 9:30 a.m. - the nurses had said the doctor would make rounds by 10:00, they hoped. And he was pretty well right on time. Before he even examined her, he said, "We'll monitor her today, and maybe she can go back to her apartment tomorrow." I was thrilled by this news. But at the same time, I had to ask myself... how did we so quickly get from "We have no medical reason to keep her," to monitoring her for two nights in the hospital? The only answer I have is the grace of God and His divine countenance to put the right nurses - and this hospitalist - in the key places Christmas Eve.

Amazingly, Mam-ma is doing very well. She was dismissed to return to her apartment the day after Christmas, and we had her back in her own bed by about 1:00 p.m. The hospitalist told me that this will be mostly a "behavior modification" issue... helping my grandmother remember to ask for help when getting up for the bathroom, to go to meals, etc. In talking to my mom and her sister, we have determined that Mam-ma got out of Mom's car under her own steam and did not wait on Mom to come around and help her.

While Mom got the walker from the back of her Jeep, Mam-ma got out, closed her door, and was inching along the side of the vehicle. Mom's sister, who is probably 4'10" and about 85 lbs., saw Mam-ma wobble and tried to grab her coat. She says she quickly realized if she hung onto the coat, she would be pulled down atop my grandmother... so she let go. We are assuming that Mam-ma's blood pressure dips when she first stands, and she must wait and count to 5 before taking a step... giving her body time to catch up. We think this explains the other 2 falls, both of which occurred when she bent over or turned too quickly while standing.

The nurses at the hospital admonished me that Mam-ma was going home as a "full one-person assist" when getting up for anything. She is weaker than ever now. In talking with the nurses at the ALF, we agreed that she truly doesn't remember to call for help... and she doesn't mind well, to boot! So the R.N. and I both talked to Mam-ma about calling for help. I asked Mam-ma, "What are you supposed to do when you need to get up?" "Call for help," she answered. I told her that was right and asked, "Where is your 'call button'?" She answered, "I don't know." I reminded her it was in the chest pocket of her pajamas.

The R.N. printed ten signs that remind Mam-ma to call for help before getting up. She taped them all over Mam-ma's apartment - the walls, every door and drawer, and above her bed. Even as she did this, Mam-ma started to get up out of bed unassisted. "This is good," I thought... "she will see first-hand how Mam-ma does." We reminded Mam-ma to call for help, and she said, "Well, y'all was both here." We agreed, but after the nurse helped Mam-ma to the bathroom, she turned her back for a few seconds, and Mam-ma was trying to stand on her own. She said, "I can see that this will not work."

I asked what else could be done besides 10 signs on the walls and doors, and she said, "I'm going to talk to the aides right now and order room checks every 30 minutes. If that isn't enough, I will put an alarm under her bed." Somehow, I have a feeling we will have that alarm before the week is over. The nurse said surely if an aide came in every 30 minutes and tried to second-guess what Mam-ma might need - bathroom break, something to drink, etc. - we could prevent her getting up unattended. We are all shocked that nothing was broken in this latest fall, and we are so worried that she will break something the next time.

Meanwhile, the ALF nurse shed some light on why the ER attending physician was so reluctant to admit my grandmother. Medicare has tightened the reins on admits and discharges and what they will cover. It is possible that this doctor felt that the hospital would not be reimbursed for Mam-ma's stay, because it occurred within 30 days of her last visit. The nurse told me, "I could have easily given you a dozen or more viable reasons to admit your grandmother," but apparently this doctor chose to go strictly "by the book." I want to give him the benefit of the doubt... but I'm struggling, given her age, high blood pressure (193/118) and her general condition.

The ALF nurse was also less than pleased that a woman weighing 113 lbs was given such a strong dose of pain medication - and a "take-home" prescription for Hydrocodone. She could not understand why someone with a history of falls would be prescribed narcotic pain medication and dismissed. I don't get it, either... and my grandmother will never see the Hydrocodone!

I feel that the staff at the ALF is doing everything possible to help me keep my grandmother safe. Physical therapy will begin later this week to strenghten her physically and cognitively. The goal is to get Mam-ma up on her feet again... with the help of a walker, of course. I asked the hospitalist if he could order a wheelchair for her, but he explained to me that this needs to be a last resort - and he does not want her in a wheelchair 24/7, because her skin tissue can deteriorate from sitting, and she would be at risk for infection. I am so glad this guy is so thorough. That had not occurred to me... and some doctors would have said, "Sure!" and written this order, just to placate me.

From what I have been reading, part of the new Medicare initiatives involves encouraging hospitals to do a better job of treating the patients while they are there... AND sending the proper care directives home with them to prevent a return stay and better rehabilitate the patient. I understand this completely, and for the most part, I've observed more detailed discharge directives for my grandmother. MY JOB is to follow through on these and make sure they are all communicated properly and nothing falls through the cracks!

As we left the hospital, I told one of the nurses, "I learned several new things this trip." She replied... "You will learn new things every time you come. It's not always things you would wish to know, but you will be better for it." What did I learn this time?

Do not be afraid to advocate for your patient. I told more than one nurse, "I know you are sick and tired of looking up at the desk and seeing me standing there to ask you something." More than once, I was told, "If you don't advocate for your grandmother, nobody will. Do not ever back down or hesitate. We understand completely."
Do not be afraid to question or challenge the medical staff. Now I know to ask to speak to the hospitalist if we are in the ER. Had my grandmother's doctor been one who had hospital admitting priviliges, I would have asked for him/her. But now I know to ASK! Question medications... What is this?... Why is it being given?

My grandmother will often say one thing one minute and another the next, as in "No, I don't hurt anywhere," followed by "I hurt all over." And because we are not sure which is true, I would rather she be given something for pain on the off chance she really was hurting. But you still should know exactly what is being administered, what procedures are being performed, what the ramifications are of these... and WHY they are being done.
This was not a new revelation, but I need to remind you that the medical staff does not know your loved one like you do. On Mam-ma's last visit, the doctors kept wanting to tinker with her blood pressure medications, because one day her BP would be extremely high, and the next it would be very low. I explained that she has done this for years now... several days of high blood pressure, followed by a day or two where it bottomed and she could barely move. Once they understood that this is "just Polly," they left the medications alone and let her body level out on its own.

I also made a point to "prove" to several nurses just how poorly Mam-ma follows instructions. While making sure she was safe and didn't fall and hurt herself, I let more than one nurse see how she gets ahead of you and will not wait for assistance. It didn't take long for them to get the necessary alarms and precautions in place.

Finally, I have been monitoring my grandmother's weight gain. When my mom and I visited a few days before Christmas, Mam-ma's ankles were swollen again - and I was alarmed. I questioned this and was told, "She's only gained seven pounds - but she is eating well." I pursued this and got the nurses to understand that "a pound a day" is too much weight gain... and it was not from eating well! Now the ankles are once again little and bony, and the hospitalist and I made sure that orders transferred that no more than a 3-lb. weight gain is acceptable. And I will be checking!

I was prepared to lose my grandmother on our driveway Christmas Eve. I felt God’s peace and calm there in a way I cannot begin to describe. But I am grateful that He chose to wait for another place and time for this inevitable event.

Meanwhile, I am reminded once again that God is in control… that I am His, and He blankets me with His love, grace and peace. I am also reminded of His perfect timing. Our little Timothy returned to live with his mother on December 3rd after being with us and my sister for nearly 4 months. Mam-ma entered the hospital on December 6th. I had little time to grieve the departure of Timmy. At the same time, I was so thankful that I was not trying to balance his care with that of my grandmother.

I had been pretty sad about celebrating Christmas without our babies. After all, the joy and excitement of children truly "makes" the holiday. But one of my first thoughts as I sat on the driveway holding Mam-ma's head and watching the pool of blood increase was... "I am so glad Timothy is not here watching this!" I have no doubt that my husband and other family members would have helped me care for the baby while I bounced back and forth to the hospital and ALF. But I thank God that he put Timmy back with his mom, where I am confident he is safe and happy... and I can concentrate on my grandmother. It's her "season" now. The other benefit is that I can truly rest and rejuvenate when I am not with her, instead of having to immediately focus on the care of a toddler.

I do not know what lies ahead. I felt quite certain another fall was imminent... I just didn't know it would happen like it did. Christmas Day as my mother sat beside my grandmother's hospital bed, Mam-ma told her, "I wish I had died." I know she is so ready... and I am trusting God and His timing. I am resting when I can, and talking to Timothy on the phone every few days. In a somewhat weary voice, his mother told us Christmas night, "Timothy was so excited about Christmas that he would not go to bed last night, so we opened gifts at 1:30 a.m. He finally conked out about 3:30 and slept until noon!" Imagine if I had come home to THAT! The best blessing of my Christmas Day came when that little guy said, "I opened presents, Aunt Debbie and Uncle Greg!" God gave Him a happy, "normal" family Christmas... and that in itself was my best Christmas gift.

I hope your holidays were less eventful. I pray that you find a good balance in the coming year, and that you trust God to meet your needs. Trust Him to work things out even when you cannot see a solution. Believe that He will give you the right questions to ask... and the perfect answers, as well. I know it's a little late, but Merry Christmas!

What do Six Days, Five Doctors and Fifteen Pounds Have in Common?

2011-12-12T23:06:00.000-06:00

The answer to this question can be answered in two words... Mam-ma Polly!

When Timothy went back to his mother in Texas, Greg asked me, "What will you do with your spare time?" It didn't take him long to get an answer! Tuesday, December 6th, the nurse at Southridge phoned me at 4:00 p.m. to tell me that Mam-ma's blood pressure was high. She said "I am going to give her the five o'clock blood pressure pill now and check her again in an hour, when it has time to work. If she still has a high reading, I told her she has to go to the ER." A little before 6:00 .m., the nurse phoned and said, "It's not as high, but it's still up there, and I think she should go to the ER. She doesn't have any chest pain, but this reading is too high." The top number had dropped from 167 to 142. I don't know what the bottom number was, but it had been 104, I think, at 4:00 p.m.

So I gathered my purse and jacket and headed to Southridge to get Mam-ma. The nurse would have called an ambulance if I'd asked, but I figured I could get her there faster, and she seemed well enough to get in and out of the car. It was "spitting snow," but we didn't have far to travel - less than 2 miles. I drove Mam-ma to the ER, and I helped her get inside. There were a few patients, but not many, and we were in an exam room by 6:30 p.m. Her blood pressure now was something like 198/112, which didn't surprise me... but it stayed that high the rest of the evening. The doctor assured me she was not having a stroke or a heart attack, but when asked, she did say she had shortness of breath.

The doctor ordered an EKG, a chest x-ray, blood work, and a urinalysis. Sometime around 11:00 p.m., he said the x-ray showed fluid around the heart and a little in the lungs. His diagnosis was mild CHF (congestive heart failure), and he said, "I'm going to give her IV Lasix and admit her. She will need a catheter so she doesn't have to get up... we don't want to risk a fall." I really liked the ER staff... especially this doctor, who we have seen before. He seemed to totally "get" Mam-ma - the fact that she is 99, and how delicate the balance is in her system. I was quite surprised at how swollen her legs were. She has had swollen ankles off and on for six months, but now her calves and even her knees were swollen. The calves were red and shiny and looked like bratwursts that would burst if you stuck them with a pin!

Mam-ma's wonderful nurse got the catheter in and collected 400 ccs of urine. Then she started the IV Lasix. By the time we took Mam-ma upstairs to a room, it was midnight - and there was another 1300 ccs of urine in the bag. The ER doctor said, "She is in incredibly good health for someone 99 years old, and we want to get her back to that and keep her there." It looked like we were on the way.

By the time I left the hospital, it was just after midnight, and over 2" of heavy, wet snow had fallen... and it was still coming down hard. Fortunately we live less than five minutes from the hospital, so I did not have trouble getting home - once I got all the snow scraped off my car windows!

I was back early the next morning to wait for the hospitalist. I had been told they were on duty from 8:00 a.m. to 4:30 p.m., and I didn't want to miss this doctor. He arrived somewhere around noon, due to icy roads, the nurses said. I did like Dr. Quintinar, and he said Mam-ma was doing well - progressing. About 3300 ccs of fluid had been collected. Dr. Quintinar told me that he would not be back this week... his associate would see us on Thursday.

We did see a new doctor on Thursday - I was there at 10:00 a.m. - Dr. Lewis arrived around noon and started making rounds, getting to Mam-ma's room around 1:30. He said he was ordering oxygen, and Mam-ma would have to wear it permanently to help with breathing. No oxygen was ordered, and the next day, I asked him, "What about the oxygen?" "Oh, yes... " he answered... "Oxygen... we will have to see if she qualifies for it." This meant a test to see how she walked up and down the hall with and without oxygen. The nurses said she did great... she did not need oxygen.

Each day, the doctor would say, "Maybe tomorrow you can go home." Mam-ma got daily physical therapy, which included walks in the hallways. On Saturday, we saw a very kind Dr. Ruiz, who was quite intrigued with Mam-ma. He gently stroked her face and hair and was very attentive and thorough. He said, "You can go home Sunday or Monday." Mam-ma told him, "You've disappointed me... I want to go home today!" He replied, "Home is a wonderful place to be... but for now, this is your home." He told me that the numbers were trending downward, but Mam-ma still had a little CHF. Also on Saturday, Mam-ma developed a little bit of a problem with getting to the bathroom in time. I think it was probably all of the green veggies she had been eating all week... it seemed nearly every meal included a hefty serving of broccoli or mixed vegetables with broccoli. Mam-ma told me, "I just LOVE broccoli!" which was news to me!

Sunday, we saw Dr. Konero. If you have lost count, that's five doctors, counting the ER doc. He ordered a stool sample to evaluate the bathroom issue before he would agree to dismiss Mam-ma. This morning, all the stars aligned, and we got discharge orders. Along the way, one doctor doubled one of Mam-ma's blood pressure medications. Another came along and cut the other BP medication in half. One discontinued her Lasix altogether after she lost almost 10,000 ccs of fluid and about 15 lbs... another reinstated it.

In the end, we went back to Southridge with tiny ankles and a slender face and tummy... and the exact same medications and dosages we arrived with last week! Dr. Konero said that Mam-ma seemed to be regulated on these dosages, and he ordered a daily weighing to monitor the fluids and a daily check of her blood pressure to determine whether or not she should get her Lasix pill. As I helped her dress, she said, "These pajamas are gonna be too tight." I told her, "I bet they aren't now!" As they buttoned with room to spare, I added... "That's what losing 15 pounds will do for you! I was reminded of all the times in the last months/years I have dressed Timothy as I helped Mam-ma into her pajamas and robe.

A nurse wheeled Mam-ma downstairs to the building entrance, where my wonderful husband had brought the car and parked it for us. He helped us get her in the car, and two aides met us at Southridge with a wheelchair and got Mam-ma into her room and settled into bed. She sank into her pillows and was almost instantly dozing. I asked if her bed felt good, and she said, "Heavens, yes!"

So hopefully we will have a few days of quiet, rest, and recovery. The RN at Southridge said she would order physical therapy for Mam-ma to help her regain her strength. I am so, so grateful that Mam-ma is at the ALF and could return to such care and attention. Had she been living at home alone, I am not sure what would have happened when she was discharged. I know she was in no shape today to return to a home to live alone.

This afternoon, I counted my blessings and marveled at God's timing. He allowed me time with Timothy before his return to Texas - time without having to dash back and forth to a hospital to check on Mam-ma Polly. When Timmy left, God gave me a couple of days to collect myself - and finish our Christmas decorating. Thankfully, while spending big chunks of each day at the hospital, I was not having to worry about Timothy - or leave him at home with Greg. And now, I will hopefully have time to get things ready for Christmas - and Mam-ma will have time to regain her strength so that she can celebrate with us. I even found time while sitting at the hospital to get all of our Christmas cards signed and addressed!

The one caveat I would offer about this week's experience was how CRUCIAL it is that you stay with a loved one who is in the hospital. It was not necessary for me to stay with Mam-ma 24/7... due in large part to the fact that this is a very small town, and I literally grew up with many of her nurses and therapists - some of whom refer to her as "Aunt Polly" - so I trusted them to look after her in my absence. But even with that, I did have to make several trips to the nurses' desk to ask for things she needed, and to check on lab reports, etc. And I spent a great deal of time sitting and waiting for a doctor to make rounds.

Had I not been there to get the reports, I would not have known that the changes in medications were being made... that one doctor said he was ordering oxygen and then apparently forgot. I am not sure the order to weigh Mam-ma daily at Southridge would have ever made it onto her discharge papers if I had not stepped to the nurses' desk Saturday night and asked about it.

At the end of the day, things fall through the cracks, even with the best medical staff in the world. I really, really liked the nursing staff. I actually liked every single hospitalist and felt comfortable with each of them. They were attentive and took plenty of time to listen to my concerns and answer my questions. And this was important, because Mam-ma can barely get her thoughts together these days, so she would not have remembered anything the doctors told her. And when they asked her questions most days, she would look at me in frustration and say, "Debbie, you tell him."

So please do not leave your loved ones unattended in the hospital for more than a short nap or perhaps at night when you are certain they are settled and ready to sleep. Too much happens... too many details can slip through the cracks. You would want someone to be there for you... do the same for your loved ones. "Hospital sitting" is the most tiring activity in the world. But it is also one of the most important when someone you know and love has to stay there.

When I left Mam-ma's apartment at Southridge today, I begged her to please call an aide for help before she got up for anything in the next few days. I told her, "The last thing in the world we want to have to do is go back to the hospital!" And I meant every word!

Saying "Good-Bye" Was Harder Than I Expected...

2011-12-05T22:35:00.001-06:00

This past week brought some of the most difficult experiences I've had in a long time. Our little Timothy has been spending time with us and his grandparents for the last 3½ months. I would say he has probably spent at least 1/3 of those days and nights with us... maybe closer to half. We have grown very attached, and Timmy truly bonded with us. My sister said he got up every morning he was at her house asking to come to ours... and every evening when she picked him up at daycare, he asked, "Go to Aunt Debbie's?" So I knew it would be hard to say "Good-bye" to him when he returned to Texas to live with his mother and baby sister... I just didn't know how hard.

The plan was for my sister and her husband to leave on Sunday, December 4, and drive Timothy to Texas. However, a scheduling conflict at work caused my sister's days off to be changed. My brother-in-law called me in a panic around noon on Thursday and said, "We have to leave tomorrow... do you want to go get Timmy and keep him tonight so you and Greg can have some time with him?" I told him that we did, and I stopped in the middle of decorating for Christmas, grabbed a quick shower, and headed to the daycare to pick up Timothy. Both the daycare owner and her aide cried when we left. They walked away so Timmy would not see them. He happily told them "Bye!" and "See you later!"

We thoroughly enjoyed every minute of the afternoon and evening with Timothy. We took a walk down the nature trail - taking turns pushing his stroller, and calling it a "big adventure." We played with toys and rode the tricycle. We read books, colored, and watched Timmy's favorite TV shows and videos on YouTube. And we tried not to count the minutes. My mother came for a visit, and she had a hard time saying "Good-bye." She had visited Mam-ma before coming over, and she told me that Mam-ma was not doing well... could not put sentences together... and that she had asked about Timmy and cried when Mom told her that he really was leaving.

Friday, we continued spending time with Timmy - doing everything he wanted to do and making the most of each hour. I knew my sister was planning to pick him up in the afternoon... we had made plans to attend a Christmas dinner with friends that evening. My sister phoned around 3:00 to see if Timmy was awake, but he was about halfway through what I thought would be a two-hour nap. I assured her I would call her when he awoke. Greg sat nearby and "listened" for him while I took a shower. I had just turned off my hair dryer when I heard him whimper.

Greg went to Timmy's crib and tried to console him. He was crying for his Aunt Debbie. Before I could soothe him, the phone rang... it was Mam-ma. I don't know how on earth she does it, but she always seems to sense when I am really busy with Timothy - or even when he is here. At any rate, she was upset... her glass bluebirds were "missing," and she just knew someone had stolen them. I assured her they would show up, and I tried to be patient as she complained and disagreed with me. She said, "I've cried more over them than anything... Timmy loved playing with them so." I told her Timmy was two - tomorrow he would love something else! Finally, I told Mam-ma that I would come on Saturday and look for the bluebirds, and we hung up.

I returned to Greg and Timmy, and we sat and held him together for several minutes. He was not good and awake, and he whimpered and sat snuggled against us. Greg decided to grab a quick shower, and I called my sister to let her know Timmy was awake. She said they were packing the car, but they would come soon and get him. By the time Greg finished with his shower and dressed, my sister and brother-in-law were here.

While Greg showered, I sat with Timmy and talked softly to him. I told him how much we loved him... that he was going to have a good time in Texas... and that he had to go home with his GaGa and get a good night's sleep so they could leave early the next morning to go and see his mommy and his sister Zola. I also reminded him that he could call me... every day... more than once. I reminded him that every time he saw the moon, he would know that Uncle Greg and I love him... and I told him, "Make your mommy read your 'God books' to you and Zola every night!" He would nod his head in agreement each time.

Timmy was still grumpy, and when he saw his grandparents, he started to cry again. He did not want to go. Greg and I sat with him and tried to assure him it would be a good thing. We all just sat for a while... until there was really nothing left to do but gather his belongings and say "Good-bye." My sister and I were already in tears, and Timmy began to cry loudly. He clung to me and didn't want to go. I carried him to the car, screaming and clinging to me. I put him in and strapped him into his car seat. Then Greg and I both kissed him one last time, and I shut the door. My sister said, "You know he will stop crying in a little bit." I did know that, but it still broke our hearts to stand on our driveway and wave good-bye and blow kisses, knowing it will be months or more before we see our little guy again. A part of me also cried because I knew he had missed his family... and he would be so thrilled to see them again.

I think God knew we needed a diversion, so he scheduled things in such a manner that we had this dinner party to attend. He definitely shielded me from the prolonged agony of Timmy's departure. I didn't have time to burst into tears and wail for hours, like I would have liked. I had to finish dressing and get my food together for the potluck dinner, then get in the car and drive to our friends' house. Greg and I both went into the "get-ready" mode and didn't say much to each other. I told my mother today that I know God shielded me all night, because I slept fairly well, and it wasn't until the next day when reality truly began to sink in and I had time to be sad and grieve a bit.

Even then, I didn't have much time for sadness, because I had promised to go to Mam-ma's and look for the bluebirds. I entered her room, and she was in a tizzy... they were still missing. I started looking... under the bed, I found one. She always keeps the birds atop the heat and air unit underneath her window, so I started systematically looking in that area. The first object I came to was a decorative hat box on the floor. I removed the lid... there were the other 3 bluebirds. Mam-ma became irate... "Now those were not there 30 minutes ago!" she exclaimed. She said that the maintenance man, James, had come into her room and assured her that he would find them. I told her, "Maybe he put them in here for safe keeping." She didn't believe me... but she insisted I bring the bluebirds home with me for safekeeping.

It was almost time for lunch, so I put the birds in my car and went back inside to walk Mam-ma to lunch. We sat for a while and visited with the other ladies at her table. I noticed a tall young man walk through the dining area with bags of lab equipment slung over his shoulders. I thought, "He's here to draw blood from someone." In the next minute, a nurse was coming toward us, "Ms. Polly... the man is here to draw your blood." She explained to me that the doctor had made monthly rounds on Friday, and he had ordered a Urinary Analysis and blood work... "because Ms. Polly is so confused. She is accusing people of stealing from her, and she can't put sentences together coherently."

I explained to the nurse that Mam-ma was upset because Timothy was leaving. The nurse did not realize that this was happening, and she understood and agreed that this probably was contributing to the confusion. She had seen Timmy and me there visiting Mam-ma the previous Sunday. I told her that I knew all about the bluebirds, and she said, "James went into Ms. Polly's room and found them this morning." I told her that I now have the bluebirds. I asked if she would notify me before the doctor changed any medications or did anything differently, and she said, "Oh, absolutely!"

I explained that we have seen a rapid decline in Mam-ma in recent weeks, and that she is praying to die. I told her, "We really don't expect to have her much longer." She seemed surprised, but she agreed that Mam-ma is definitely declining rapidly.

I added that Mam-ma could live another ten years, but I feel like she is beginning to lose her ability to function mentally, and the nurse agreed, adding that Mam-ma comes to the nurses' station several times a day and cannot remember why she is there. I stayed a little longer with Mam-ma and left her in the dining room eating her lunch.

When I got home, my sister called to say that they had made it to Texas, and I could hear Timmy squealing and laughing in the background. She said his reunion with my niece was amazing... that when he saw her, he began squealing "Mommy! Mommy!" Then my niece sent me pictures of our happy little boy, and I knew we would all be just fine.

I called my Grandmother on Sunday to assure her that Timmy is safe and well... and to remind her that I have the bluebirds. She said, "Well, we'll see... there are still about three birds missing." I told her that we only moved into Southridge with five birds, and I think one got broken several months ago. Last Sunday, there were four birds for Timmy to play with... and I brought home four birds. I told her, "Nobody is stealing from you... I have all of your bluebirds, and no one is taking anything else." She said, "Well, I'm not so sure."

So the changes have begun. It's been so quiet around our house, and it seemed strange to finish the Christmas decorating this weekend, knowing Timmy and Zola will not see it. But it gave me something to do to keep busy... and I was already more than 2/3 decorated, so it seemed silly not to finish. Mam-ma has not called again... and I did not call her today.

Mam-ma did call early last week to ask Greg why we didn't come to her birthday party. It took her forever to get out her questions... and Greg wasn't even sure she knew who she had called. We finally determined that Southridge had a collective party for all who celebrate birthdays in November. Greg assured her that we were not invited... that the party was for her and her friends there at Southridge. He reminded her that we did have a party for her... we took her to lunch at a local restaurant. But he was really bothered by how confused she was... and how difficult it was for her to speak on the phone.

Today, Mam-ma's long-time housekeeper, Mary, phoned me and asked if Mam-ma is sick. I told her no, and she said, "Well, I just talked to her, and she didn't sound well." So I explained what has happened and Mary said, "I've made sugar cookies using Ms. Polly's recipe, and I wanted to take her some tomorrow if you think it's okay. She is like family to me." I assured her it was fine... that I can't promise Mam-ma will eat them, but please go and take them. Mary said she would not stay long, but she would take cookies and some chocolate drop candy that Mam-ma enjoys.

People are so kind and loving to Mam-ma... including the staff at Southridge. I told Mary today that I think Mam-ma is losing her mind... and if that is the case, I hope she doesn't linger. It's not my call, and I know that... but I remember how hard it was to talk to my maternal grandmother and visit her after dementia set in. She always seemed to recognize me and my mother... but she had a baby doll she thought was a real baby, phantom "thieves" and ne'er-do-wells who visited her room, and she insisted my grandfather (who had been dead for several years) was living in the nursing home with another woman - she saw them dining together in the dining hall. I do not want my Mam-ma to suffer those indignities.

My husband asked me tonight what I plan to do with my spare time, now that we are not keeping Timmy several days/nights each week. I told him I have a stack of projects I've set aside. I am sure I will have no trouble finding something to do. I am also sure that there will be more to attend to for Mam-ma in the coming days/weeks, as well... and this time I will not have to juggle the care of a little one in order to get it all done.

The changes continue...and there will be more hard "good-byes" to come. But for now, I am resting... in more ways than one... and resting in God's promises that He will never give me more than I can handle - and that He will truly supply every need of mine and my family.

Change is Hard at Any Age

2011-11-27T19:19:00.001-06:00

It's been a busy month. I know I say that a lot, but this one has been especially busy. We've had Timothy every weekend while my sister worked, which usually meant picking him up either Friday night or Saturday morning, and keeping him until Sunday afternoon or Monday morning when he returned to daycare. Meanwhile, Mam-ma has done pretty well. She had about a week of celebrating for her birthday, including a visit from beloved cousins in Oklahoma who spent an entire Saturday playing "Chicken Foot" dominoes with her and taking her to her favorite restaurant - KFC, or "Kentucky Colonel" as she calls it.

My sister and her husband have decided that it is time for Timothy to return to live with his mother, baby sister Zola and Zola's daddy (who Timothy calls "Daddy," also). So this coming weekend, the plan is for my sister and her husband to drive Timothy to Texas, spend a few days visiting, and return home without him. After three months of spending so much time caring for this little guy, the thought of him leaving for an indefinite period of time is truly stressful. I am trying to stay positive. I know that Timothy needs to be with his family... but I am going to miss him madly!

And Mam-ma is convinced that Timothy will never see her again... which could be very possible. Today, we visited her apartment, and she said to Timothy, "I hope you don't forget me." I assured her we will never let that happen. When we left, she asked, "Will I get to see him again before he leaves?" I told her we will try to come and see her next weekend while he is with us, but I couldn't promise. There were lots of tears and hugs and kisses when we left, and I felt badly, but this is not something I can control.

Thursday, we had Thanksgiving lunch at my mother's. My sister filled Timothy's plate while I filled Mam-ma's. I carefully cut up her ham and made sure to get the things I felt she would want to eat. I think there was more thought required for her plate than Timothy's. However, after a few bites, he wanted down from the table, and he ended up sitting in my lap, beside Mam-ma, finishing his lunch. We brought him home late afternoon, so that he could wind down and get settled before bedtime. Friday, he returned to my mom's for most of the day, while my husband and I hosted a football watch party. We're all trying to make the most of these last couple of weeks before Timothy leaves.

I will admit that I am struggling with my feelings. Last week, I said as much to my husband, and he said, "You are blue because Timmy is leaving." I told him it's more than that. I feel like my life is on the verge of a major change. Having part-time care for Timothy these last 29 months has changed our world in ways we never expected and brought us both tremendous challenges and immeasurable joy. And when his family moved to Texas in August and we didn't see him for six weeks, I was pretty lost. At the same time, I have (gladly) put a lot of my own projects on hold since Timothy was born... never sure when the phone would ring and he would be coming to stay for a day or two - or a week or more! Now my niece says it will be at least the end of February before they return for a visit.

And then there is my grandmother... she continues to decline overall, and I feel like some morning the aides are going to find that she drifted away in the night - or she will contract some illness or infection and be gone in a matter of days. I know she has lost her drive and determination... and she is basically "waiting for the LORD" to take her home. So there is every possibility that the next few months will find me with two less people to care for, and honestly, I am going to have some adjusting to do!

Clearly, my situation pales in comparison to those of you who have full-time care of either a child or a senior - or both. But I am also certain that some of you know exactly what I'm talking about - you've "been there, done that!" So I ask that you remember my family in your prayers... that you ask God to make this reunion of Timothy and his family a good one - and that He equip the rest of us with whatever we need to handle his absence.

My niece needs prayers, too... she will be caring for her six-month-old daughter and 29-month-old son while living over seven hours from her parents and the support system she has relied upon for all of her 21 years. She is also dealing with the reality that she could lose her great-grandmother in the coming months and not be able to get home. In a recent phone conversation, she said to my sister, "If something happens to Mam-ma, someone will come get me, won't they?" My sister had to tell her that this was not likely, for a variety of reasons.

So this will be a challenging week. We will keep Timothy over the weekend until my sister and her husband get the car packed and are ready to head to Texas. I have given this situation to God, and I am trusting He will guide my steps over the next few weeks/months... and keep me sane.

A Good Look at Caregiving in the Sandwich Generation... Please Read!

2011-11-08T11:11:00.000-06:00

A friend of mine posted this link on Facebook today... it speaks volumes to the circumstances for those in the Sandwich Generation. The stresses, challenges, and emotions described in this post as they relate to fostering/adopting children are strikingly similar for caring for an elderly person. I highly recommend you read this post and share a link to it with everyone on your list.

MomLifeToday.com - How to Help an Adoptive Family

The Distance from 2 to 99 is Shorter Than You Think...

2011-11-05T22:27:00.001-05:00

Today was my grandmother's 99th birthday. My husband and I took her to eat catfish at a local restaurant she likes. We invited other family members to come along. Joining us were my sister, my cousin and his wife, and of course... Timothy, who was probably Mam-ma's favorite guest. Actually, it was probably a toss-up between him and my husband, and she sat between two of her favorite fellows. Having my cousin across the table made her day complete.

Mam-ma is tired. She looked well and ate fairly well, but when I phoned her this morning, she said she was going back to bed for a while. She said, "I think it's all downhill from here." Of course, in true "Mam-ma fashion," she told Timothy a couple of minutes later, "I feel purty good," when he asked her "You feelin' good?"

Timothy spent the night with us last night. He was so exhausted from a full week of early mornings and long days at daycare. Since my sister works the 6 a.m. to 2 p.m. shift at a local nursing home as a nurse's aide, he has to be dropped off at daycare at 5:30 a.m. He does take a 2-hour nap (sometimes longer) each day, and he goes to bed early, but it's still tiring for a 2-year-old. So he came to our house tired and cranky yesterday, and he spent the first hour or so alternating between playing with toys and standing at the window and crying, his lower lip protruding... saying, "I sad." Broke my heart.

I finally persuaded him to take a bath, and after soaking and playing with his toys for a while and watching "Jack's Big Music Show," he was rejuvenated and actually played and sang and was a very happy little boy until bedtime. Thankfully, he has begun going to bed without much fanfare... three stories, two songs, lights out, and he was asleep. Thank you, LORD! However, he did awaken this time at 2:00 a.m. and was unable to settle himself back to sleep. So we had to watch some more "Jack" and "Wonder Pets" and snuggle for awhile. I put him in bed with me, and he finally went back to sleep before 4:30 a.m. and slept until 8:30. But just before he succumbed to a second round of slumber, he leaned down from watching "Wonder Pets" and planted a big, spontaneous kiss on my face. How can you argue with that?!

Today, my husband and I juggled tending to Mam-ma and Timothy throughout the meal. My husband is such a blessing, and I couldn't manage without him. He took one vehicle and drove to the ALF to pick up Mam-ma. The car seat was in our larger SUV, and we decided Mam-ma might not be able to climb into it at this stage. So I drove Timothy to the restaurant. After lunch, Timmy went home with my sister, so I swapped cars with Greg and drove Mam-ma back to the ALF. The maneuvering of a walker into the back of the car is not the same as fastening a toddler into a car seat, but the amount of finagling and rigamarole required is about the same for both.

Once settled back in her room, Mam-ma sat on her bed and talked of resting. I figured she would have afternoon company. Morning visitors had happily disrupted her plans to "go back to bed," and as I suspected, she had several guests this afternoon. She complained that she is not able to make the walk to her friend's apartment in the evenings for tea and have any energy left to enjoy herself. She also complained that her pants were too tight and she was miserable. She changed pants, and I took her sharp sewing scissors and snipped some elastic loose from those she wore to lunch... giving her needed breathing room for next time!

I told Mam-ma she needed to rest in case company came, and I gave her a hug and a kiss... and she cried - just as Timothy had cried at the restaurant when I hugged and kissed him and told him he was going home with his grandmother. They cried for different reasons, but at the end of the day, "I sad" would pretty much cover both of them. And just like I was unable to console Timmy as he cried and couldn't get back to sleep, I have no answers for Mam-ma at this stage, either, except to tell her that the LORD clearly is not ready for her and she must still have things to do here!

Mam-ma may very well surprise me and live to see her 100th birthday, but I have my doubts. Life is just beginning for Timmy... but for my grandmother, it's winding down fairly quickly. He is tired from so much play and the daily absorption of tons of new knowledge.... she is weary from 99 years of learning and living. So many similarities exist between a 2-year-old and someone who is 99. The number of years that distance their ages may be vast, but the span of emotions and reactions to them is shorter than you think.

Mam-ma will probably tell others she had a wonderful time, but her limited attention span and hearing loss keep her from fully engaging in conversations and interactions with others now, and it didn't seem like she had all that much fun from my vantage point. Truly her favorite part of the day was feeding the mountainous plate of chocolate cake and fudge-topped ice cream the restaurant bestowed upon her to Timothy...one gooey spoon at a time. And that's good enough at this stage, I suppose. We were together... we celebrated and gave cards and gifts, hugs and kisses, and shared a meal. What else is there, really? I'm glad we had this day... and that we got to share it as a family. Time will tell if we get to do it again next year.

Where Has Another Month Gone?

2011-10-30T15:30:00.000-05:00

I knew it had been a long time since my last post, but almost a month... really? That should tell you something about how things have been going. It has at least seemed like an unusually busy month, and certainly there has been no time to get bored! But isn't that the life of all of us who are members of this Sandwich Generation?!

My sister finished her CNA classes and began a job at a local nursing home, working the 6:00 a.m. to 2:00 p.m. shift. Thankfully (and to my amazement!), the daycare that Timothy attends opens at 5:15 a.m. I asked his teacher, "Do you really have children come that early?" She nodded her head and said, "Oh, yes!" So Timothy arrives at 5:30 a.m., and my sister picks him up in the afternoons, sometime after her shift is over. So far, he is doing well... he certainly enjoys that late morning nap for 2 hours or more! But he is thriving at the daycare and really loving his teachers and his new friends.

When I last posted, my grandmother had just had her monthly visit from the facility physician. She had given him the same complaint she has given me for years, "I can't pee." If you have followed this blog for a while, you know that we even made a visit to her previous family physician for this once, and he tried to explain that she takes Lasix and does not need to go on the hour, every hour, all day long. But still, she continues to complain. So in an effort to appease her, the new doctor ordered an "in and out cath" to see how much urine she retains after going to the bathroom... and to show her that she is really emptying her bladder.

When I arrived for a visit, she said, "The doctor has been here, and he told that nurse they would do surgery." I questioned her... "Surgery? On what?" "Well, on my kidneys... I can't pee." That's when I found the doctor in the facility making rounds, and he assured me it was not surgery - just this "in and out" procedure.

The catheterization showed little urine in the bladder. But in the words of the LPN who administered the procedure, "It looked nasty." A culture was ordered, and we were told that there would probably be medication forthcoming... but not until Monday.

Meanwhile, Mam-ma began to complain of burning and being uncomfortable. The nurses kept telling me, "The doctor cannot prescribe any medication until the cultures are conclusive as to which bacteria is involved... and that will take 3 days." It took roughly four, since the pharmacy that serves the facility did not deliver any medication until late Monday night, and somehow there were no orders from the nurse (or any that were seen by an aide) for the medications to be administered. I now have a box of AZO tucked away in Mam-ma's bathroom that the LPNs or I can administer for the burning, if she has problems again.

In retrospect, this is what has been dragging my grandmother down for weeks. She had a UTI in late July/early August and was on antibiotics. When she became dizzy and disoriented in late August and we transported her to the ER, the attending physician's first idea was, "She has residual infection." But the labs came back clear. Now we realize that this test was probably a "dip stick" in a cup of urine... and without a culture, the underlying infection was not discovered.

At any rate, injections of a very strong antibiotic were ordered for 7 days, accompanied by 7 days of oral antibiotics and something for burning. And... over the weekend, the nurse telephoned and said, "We think Polly has pink eye. Her eye is red and swollen this morning. It's either that or allergies... or she slept on it wrong. We're ordering an antibiotic for that, too!" For seven days, Mam-ma took THREE antibiotics. Now she says she feels better from the UTI, but she is still trying to recover from taking so much medicine.

During all of this, we continued to keep Timothy a day or two here and there. One Saturday morning, I took him to his first birthday party... for a fellow daycare attendee who was turning three. This was a "prince and princess party" - about four little girls in princess attire, and two little boys. Timmy did not go in costume. The party was held at a local playground, and the parents had added a "bouncy castle" and a pinata, as well as a craft project, a cake that looked like something from the Food Channel programming, and party favors that went on for days. The bar is set high for future parties!

My 2 favorite boys... Timothy's
first football game!

Timmy had a ball, but he came home exhausted and really cranky and ready for a long nap. We've also taken him to a couple of local high school/junior high football games lately, and he has loved that... especially the band. It seems that we're learning to take him along wherever we go and continue with our plans as much as possible... knowing full well we may be leaving early. One night we didn't make it to halftime... Timmy fell asleep in my lap during the 2nd quarter!

With the routine of daycare and my sister's job in place, we were actually able to take a few days to help with a conference that was held in our community by the company we developed and sold six years ago. We still stay in touch with the new owners and try to keep up to speed on what is happening with our "baby," and this gave us a chance to renew some relationships and see firsthand how the business is doing today. But it was a hectic, tiring string of days/nights, and then it was back to our "routine" with our own family and household.

After several days of bouncing back and forth between caring for Timmy and seeing about Mam-ma and the conference, I had a chance this week to finally work on our house and get it cleaned and back in some semblance of order. I realized that it had been several weeks since I had actually done laundry for us, so that in itself took a full day or more. When you are washing towels and baby clothes and pajamas every day or so, it is easy to lose track - until you don't have any clean underwear!

We kept Timmy for a couple of days last weekend while my sister worked, and all day Saturday, he was fine. Saturday night we were watching videos on the computer when he suddenly erupted... vomiting everything he had eaten for three days, it seemed. Greg helped me get him stripped and to the bath tub, then watched him while I changed MY clothes and cleaned up the mess. Yes, if you are following this posts, this is twice this month that we have had these events. This little boy has had a rough few weeks!

After that, Timmy seemed subdued, but okay... until the next morning, when he was sick again. I watched him closely all day and monitored his food and drink, but by Monday morning, he was better and fever free, so I took him to daycare. He did pretty well all day, but that evening, my sister said he threw up all over HER... her first foray into this side of our precious charge! Bless his heart... he is so pitiful when he's sick... and it scares him - he does NOT understand what is happening. My sister had Tuesday off, so she kept Timmy at home and made sure he was feeling better.

I managed to get our house cleaned, laundry washed and ironed, and everything in place before the weekend. Greg had cousins visiting from out of state, and we were planning to spend time at with his family. I made a visit to the ALF to make sure Mam-ma was okay. I picked Timothy up on Friday afternoon at the daycare and brought him to spend the night with us. Greg's family came to our house for a visit and take-out pizza, which made it much easier with the baby. Yesterday we went for a brief visit at Greg's brothers... Timmy in tow... before my sister picked him up when she was finished working.

Today my mother has taken my grandmother for an afternoon drive to see the fall color, which will help her spirits tremendously. Tomorrow, Timmy will Trick-or-Treat at her apartment (I left candy there for her to give him), and next weekend, we will take her to lunch to celebrate her 99th birthday on Saturday. I am hoping that the days in between will be uneventful. The doctor will return for a monthly visit on Friday, and I anticipate that he will declare her to be greatly improved... if not completely well.

I feel like for the moment we are settled into something of a routine... helping with Timothy as needed while my sister works... checking on Mam-ma several times a week... and trying to have a life in between. My husband is so good to go and visit my grandmother, refill her bird feeder, and spend a few minutes with her - just the two of them. She loves that. I already know of at least two people who are planning to visit her from out of town on her birthday, and that will be huge, also. For now, we're trying to make the most of every day... savor the special moments with our little nephew AND my aging grandmother. So far, so good! Yeah, what am I saying?!

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On another note, I still have some checking to do, but it looks like I will not have to change Medicare Part D Prescription Drug Insurance providers for the first year since the program was implemented! Thank you, LORD!!! I think I have had five providers, so far...and that doesn't count the one that Medicare so nicely switched me to on their own the first year! (I got it switched back, since their plan covered virtually NONE of Mam-ma's drugs!) I am glad that at least once, it looks like I won't have to go through all of the shenanigans that are involved to transfer to yet another provider. I will make a call to the pharmacy to doublecheck this tomorrow, but it is looking pretty good at this point! Yippee! See how little it takes to make us Sandwich Generation "fillings" happy?!

AND... a cousin recently suggested to me that I needed to have a DNR order handy for my grandmother, so that no heroic measures will be taken to keep her alive, should something happen. These are her wishes, and I mistakenly assumed that the Living Will covered this. It does not! So... we now have a DNR (Do Not Resuscitate) order on file at the ALF, along with a copy of her Living Will. With both of these in place, no life-sustaining measures should be enacted, were she to have a stroke or heart attack, etc. If you do not have these documents for your aging loved ones, I encourage you to get them. You can download the forms online, or talk to your attorney and ask him/her to supply them.

I talked with Mam-ma about the DNR paper to be sure these were her wishes. She insisted they were, saying she did not want to be a vegetable. "And besides," she added... "the sooner I'm off your hands, the better!" I told her emphatically that she is NOT "on my hands," but I had assumed she was after a "one-way ticket." She said, "Well, I AM!" Gotta love my grandmother!

I hope things are well in your "Sandwich" this week!

Preparing for Anything...

2011-10-06T14:55:00.000-05:00

Today is a "rest day" for me... much needed after the past week. Timothy stayed with us the first part of last week, and then for a few hours in the afternoons on Wednesday, Thursday, and Friday, until his GaGa finished with her CNA classes. Friday, I visited with Mam-ma and did things at home that I had neglected. Saturday, I learned that my cousin's aunt... the one who just turned 90 and missed her birthday because she had to be hospitalized with a UTI... had passed away. I factored a visit with my cousins into my afternoon, along with a shopping trip for our own groceries... and shopping for my 85-year-old mother-in-law, who is having knee problems. My husband had asked her to please stay off her feet - and on her couch... and we offered to bring her some prepared meals and a few other groceries she needed.

By the time I finished all of my "rounds," I was too tired to cook dinner, so Pizza Hut was a welcome reprieve. Two carry-out pizzas and some R and R on the couch, and I was feeling much better. However, Sunday I "worshipped at St. Mattress," as my friend Mitch so aptly described it recently, and I caught up on some much-needed sleep and rest. I did a few loads of laundry, ran the vacuum, and did a workout. Then I picked up Timothy around 4:00 p.m. at his grandmother's (my sister's).

Timmy swimming at the Community
Center pool with his great Granny (my mom).

Timmy was wearing a "fever patch" on his forehead, and my sister said he had been feverish and had a runny nose all day. I brought him home, gave him Tylenol and some children's Zyrtec, and let him soak in a bubble bath. He seemed better after that, and we played until bedtime. He slept somewhat fitfully... but he did sleep. The next morning he was fever free, so I took him to daycare, so that my husband and I could attend the funeral of my cousin's aunt in the afternoon.

Following the funeral, we returned to my cousin's house to visit with the family members we rarely see. My little cousins, Owen and Olivia were there, and their mother said, "Oh, I wish you had brought Timmy." So I went and picked him up at daycare and brought him over to play. On the way to the house, I told Timmy we were going to play with Owen and Olivia. He was so excited, and he said, "I hug 'em!" Then he added, "I kiss 'em, too!"
Then Timmy said, "DebDeb... I so happy! Are Oooo happy?" I smiled and told him yes, I was very happy whenever he is happy. He said, "I happy, you happy, me happy! Yea!" So sweet! And he truly is a happy child... and he enjoyed playing with Owen and Olivia.

Meanwhile, my mother offered to check on Mam-ma for me... and Sunday afternoon, she took her on a long drive. We are having gorgeous fall weather, and Mom took Mam-ma "all over the countryside," as Mam-ma put it! She even took her to Sonic for an ice cream cone. Mam-ma loved every minute of it, and Mom has promised to do this again. She said, "I don't know why I didn't think of this earlier." Mom has been a big help with Mam-ma lately... visiting her when I am tied up with Timothy or other things and calling her more often.

Timmy did not sleep well Monday night... more fitful tossing and turning. Tuesday, he would not nap, and he ran fever off and on all day. The daycare did not have a vacancy for him, so we just played at home. Tuesday night, he was so tired that he went to bed at 8:00, but he was awake with nightmares or something at 8:30 and 10:30, and at 1:30 a.m., he awoke drenched in sweat, soaking wet diaper, and asking for milk. I changed him, stripped off his clothes (amidst a major, ear-piercing, hysterical fit), and settled him back in his bed. I thought, "He's settled for the night now!" NOT! At 4:00 a.m., he awoke, crawled into our bed, and said, "Milk! Jack!" I got more milk, changed him again, and turned on "Jack's Big Music Show."

Timmy has been having diaper leakage again, so I've been limiting his night-time liquids and double-diapering at bedtime. It has worked fairly well the last 2 weeks. Wednesday morning, we watched 2+ hours of Jack and "Wonder Pets," and we both drifted off to sleep again shortly before 7:00 and slept until 9:30. When Timmy woke up, he was feverish again and somewhat clingy.

By 10:30, I thought Timmy was ready for an early nap, and he actually said, "Couch!" We got on the couch and settled in together. But he asked for more milk, and when I got up to get some for him, he followed me to the kitchen. He whimpered and I picked him up and carried him back to the couch, where he promptly threw up... a LOT... all over himself, me, the couch, and rug. I scooped him up and started across the floor toward the kitchen, and he threw up again. This was the first time Timmy has thrown up since he was about 6 months old. It really scared him.

I quickly stripped both of us and carried him to a makeshift pallet in the living room floor. Thank goodness we have hardwoods, because we left a trail you would not believe. My husband came in and wrapped Timmy in a blanket while I ran around in my underwear and tried to sop up the mess and regroup. Timmy was burning hot with fever, so I gave him 7-up and Tylenol, and he laid limp on the pallet for about 45 minutes. Then as quickly as he got sick, he popped up and seemed much better!

The rest of the day we tried to remain quiet and keep the fever at bay; however, I could not get Timmy to nap. We ditched plans for a haircut and a visit to Mam-ma's... apparently this is a "bug" that is circulating in our town, and I can't risk exposing her and the others at the ALF. My sister picked Timmy up at 5:30 when she completed her last CNA class- she is official now (YEA!). She said Timmy was asleep before they arrived at home... and he slept until 8:30 a.m. today!

After the baby left, I stripped beds, did laundry, and regrouped... then headed for the couch! With a good night of sleep, I am better rested, but still tired. I realize that younger moms do this every single day... but for me, it's a lot... especially with the other factors and people for whom I feel responsible. I talked with Mam-ma today and explained why I have not been to see her this week. I feel like I am neglecting her, but I am confident she is safe and comfortable and well-cared for at the ALF... and she knows why I am not coming very often and seems okay with it.

My house is not nearly as clean as I would like, but I am learning to let things slide a bit in favor of being rested and doing what absolutely HAS to be done... and anticipating "the next big thing." I'm learning to roll with the punches... that comforting a frightened, sick little toddler beats dusted furniture and a haircut any day of the week... and that hearing "I so happy" from my little guy is possibly the BEST phrase in the whole world.

One other thought... Sandwich Generations are nothing new. At the funeral of my cousin's Aunt Louise, there was a lot of talk about the service this dear lady gave to her family. She never married... spent 90 years taking care of others. When her sister suddenly became a widow with three small children and another on the way, Louise took them all in, and they lived with her and Louise's parents... forever. Louise retired early to care for her ailing elderly mother, then she helped with the care of her sister, who developed Alzheimer's.

Along the way, Louise taught 3 and 4-year-olds in Sunday School for 25 years, helped with the rearing of her sister's four children - school functions, weddings, births of their children and helping to babysit, family gatherings, and much more. Louise's life was very much serving as the "filling" in a sandwich that included elderly parents and her sister on one side... and the younger generations on the other. And nobody could recall ever hearing her complain.

As we reminisced about Louise and noted how well she had loved and care for so many throughout her life, I realized that she is a tremendous inspiration. If I can make my "sandwich" half as rich as hers, I will have truly accomplished something in this world. I don't know how she kept such a positive attitude, but she has motivated me to work on the grumbling, too. Wish me luck!

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BTW... the formularies for Medicare Part D Prescription Drug Coverage have arrived... it's time to start picking our new plan for 2012! So sharpen your pencils and start calculating!

As God is My Witness...

2011-09-29T12:43:00.001-05:00

The last week has been busy, to say the least. Timothy has been staying with us quite a bit while my sister takes CNA classes. On top of that, my husband got some sort of cold bug - and Timmy has been a little congested with allergies - so I was not comfortable visiting Mam-ma for a few days. And the day I decided to visit her after I picked Timmy up at daycare, he threw a walleyed fit to go home and see his Uncle Greg, so we turned around in the parking lot at the ALF and headed for home. I didn't think a screaming unhappy toddler would cheer any of us.

I am astounded at the similarities in the world of two-year-olds and ninety-nine-year-olds. Last week, we took Timothy to see his first football game. Our junior high team played at home, and it was a cool, crisp fall evening, so we decided to see if Timmy would sit still for at least a few plays. Did he ever! He was so intrigued with all of the movement and action - especially the band sitting in the next section over - and he made it through an entire half of the game without leaving my lap.

We decided to leave on a happy note. Timmy was starting to yawn, and it was about 8:30 p.m. His day had been full... daycare, then the ballgame and all of that fresh air. He nearly dropped off to sleep on the ride home after the game. By the time we got him inside, he had "hit the wall," and a hysterical tantrum ensued. I removed his clothes and diapered and dressed him while he screamed hysterically at the top of his lungs, big tears rolling down his bright red cheeks. I just steeled myself and kept working until I had gotten everything changed. Soon, he was calm and sitting in my lap, "slubbing" his tears and composing himself... and by a little after 9:00 p.m., he was sound asleep.

The next evening, my phone rang around 8:30, and it was Mam-ma. She was upset and started telling me that someone had come into her room and taken her tweezers. The story was convoluted at best, but from what I could determine, she has had the activities director buy her several pair of tweezers at Wal-Mart... and they all disappeared. I told her I could not imagine that anyone would steal just tweezers - was anything else missing? No, just her tweezers.

Then she said "that girl" came in and dumped everything on the bed and showed her a pair of tweezers and said, "Now I don't want to hear anything else about us taking your tweezers." I couldn't discern who "that girl" was... but I decided that the container she dumped was Mam-ma's pencil container. She also said the girl who brought her laundry went through every drawer... and "I don't know what she was looking for."

I assured Mam-ma that this was not a problem... that we were not talking "the war debt" here (as my maternal grandmother used to say). She began to cry and say, "Well, I'm just so tore up." I asked her why... was she that upset over a pair of tweezers? No, she said, it was not the tweezers... but "I'm just so tore up." I asked if she was in bed... no. I told her to get her pj's on and get into bed... and to ask for a whole Ativan to help her sleep. I assured her that I would check on this the following week... that I had Timothy and could not come down there right away, but I would look into this. She hung up sobbing.

I let my mom know about this, assuming that Mam-ma would never mention it to her - even if she remembered - but just in case, I wanted Mom to know what was happening. I was not able to get down to the ALF for a few days, but Mom went to see Mam-ma on Monday, and she never mentioned the tweezers. But she did tell her that she had not slept well and hinted that there was a problem. Mom didn't bite, and Mam-ma didn't elaborate.

So Tuesday, I planned to visit Mam-ma, but that was the day that Timmy had his meltdown and I had to turn around in the parking lot. Wednesday morning, I dropped Timothy at the daycare and headed directly to the ALF. It was just after 8:00 a.m. and Mam-ma was having her breakfast in the dining room - fried eggs, bacon, toast and jelly - a delicious looking meal. She ate well. Afterward, we returned to her room and had a nice long visit. I tried to think of things to talk to her about, but the conversation waned.

At one point, Mam-ma mentioned MawMac - my birthday buddy and her friend, who passed last month. She said, "I think about her trying to sit at the dining table and eat..." and she shook her head sadly. I reminded her that MawMac is whole and perfect now... stately and able to do whatever she pleases. Mam-ma said, "Well, that's right!" Then I related a joke that I heard lately about an older couple killed in a car wreck. They get to heaven and everything is so nice and lavish - and FREE - no restrictions on diet, no workouts needed, free golfing for him, and more. The man tells his wife, "I'm so mad at you... if I had known it was like this, I wouldn't have eaten all that fiber. We could have been here years ago!" Mam-ma laughed.

Then she said, "Well, the other night I prayed to die." I asked, "You did?" "Yes," she replied, "I did." I asked if she was ready to die, and she said, "Yes, I am..." and she began to cry. I told her that we could not make that decision... that obviously God is not ready for her yet, but maybe He will be soon. She quickly changed back to an earlier topic of discussion, and I let it go.

I had been there nearly an hour, and I started to say my "Good-byes," and she said, "Wait. I need to talk to you about this episode." She was talking about the tweezers. I got up and looked in her pencil can... actually dumped it on the bed... and there were three pair there - two of which had her name written on them. I showed them to her, and she said, "Yes, they brought them all back." She also indicated there were more still missing. She kept saying that the activities director, maintenance man, and LPN would all tell me the same thing - that they said they would take care of this.

So I told her I would speak to the LPN. I walked out to the nurses' station and talked to the LPN, and she was clearly in the dark. She doesn't work on Fridays, but she said this was the first she had ever heard about any tweezers. So I clued her in on what had transpired and the hysterical phone call on Friday night, and she just shook her head. This truly appeared to be news to her - or she deserves the biggest Oscar in history.

I returned to Mam-ma's room and told her that the nurse did not know anything about this. Mam-ma said, "Oh yes she does!" and she got up to walk me back out to talk to her. Now this is where it got really weird. Her story now was that someone was accusing HER of taking the tweezers. She told the nurse, "Y'all are out to get me." The nurse sat down on Mam-ma's walker seat and looked her straight in the eye and said, "Look at me. Nobody is accusing you of anything. You have done nothing wrong. Nobody thinks you took anything." Mam-ma replied, "Well, I just want my name cleared. I don't want to be accused of anything. As God is my witness, I've never stolen anything in my life." And she began to cry.

The nurse tried again to tell her that she was making something out of nothing... that there was nothing to this. Mam-ma said, "Well, I'm not sleeping at night. I'm just so upset. I don't like walking down the halls and people looking at me and thinking I did this." She also shook her finger at the nurse and said, "Now you and the maintenance guy both came to my table and told me you would take care of this." The nurse didn't have a clue.

This went on for maybe ten minutes. We finally got Mam-ma to quit crying a bit, and the nurse kissed her and assured her that everything was okay, but they were going to go back to a whole tablet of Ativan at night so she could get some rest. We returned to Mam-ma's room. She was still crying. I hugged her and said, "You do believe us, don't you, that this is over?" "No!" she said, "I don't, because they know what's going on, and they are a makin' this up." I told her that I was totally convinced that this nurse was telling the truth, and that she loved Mam-ma and would not do anything to hurt her - or lie to her. Mam-ma was not convinced.

I had to leave, so I kissed Mam-m good-bye, told her I loved her, and left. I stopped by the nurses' office again and told her that Mam-ma was still upset and didn't believe us... and would she please keep an eye on her? She said she would. I repeated that Mam-ma said she and the maintenance guy had come to the dining hall and told Mam-ma that "we'll take care of this." The nurse said, "The only thing she has complained about was a couple of months ago, when she came to me with her Tylenol and Ibuprofen and said 'that girl' was coming and getting some, and she didn't feel she should give it to her. She asked me to keep the meds for her, and I said I would, and if 'that girl' needed some, she could come to me." I told her "that girl" was a resident friend of Mam-ma's, because she had told my mom about this and her concern with giving out the medicine.

The nurse just laughed... she said she had assumed it was a staff member... and that Mam-ma would not tell her a name. I told her, "That's because she didn't want to rat on her friend." The nurse laughed and said, "So this may be something that a resident has said and not a staff member." We both agreed... we don't know who Mam-ma thinks has accused her... or exactly WHAT has been accused by whom. It's totally convoluted. But the bottom line is, Mam-ma is upset and paranoid that people are talking about her.

I told the nurse, we've been through this before - but not to this extent. When Mam-ma first moved to the ALF, she called me one day and said her postage stamps were missing. They weren't, although she loudly insisted they were. I found them right where they belonged in her little secretary. Another day it was the room key. Even when she lived at home, she lost her life alert button (it was in a pants pocket), and she had deacons searching the church sanctuary for it. We even purchased a second one before she put those pants on one day and found her missing button!

But this is different. She has really worked this up in her mind... and she is in quite a state. I told my mom, I had a 2-year-old temper tantrum on Thursday night - and the next night, it was Mam-ma! And soothing either one was about the same! With Timmy's allergies, I've found myself wiping his little nose quite often lately... and yesterday, I was doing the same for Mam-ma. Do you see where I'm going with this? The age gap may be enormous, but the needs are much the same.

My husband stopped by later to check on Mam-ma, and he found her sitting sadly in her room. He was concerned by how she has declined... he said for the first time, she looked 99. She told him she was not leaving her room much - she can't see to read, and she just sits and looks out the window - and most days are "boring."

* * * * * * * * * * * * * * * * * * * *

I am not the only one with such challenges. My cousin's wife called Sunday evening to ask if I knew someone who could do home health care on the spur of the moment. Her 90-year-old aunt had been released from the hospital following an episode of a UTI that caused her to be incoherent and confused. She thought she was ambulatory (she is not!) and got up in the night to take herself to the bathroom... fell and hit her head (CT scan was clear and no broken bones)... and then her legs were numb and she was incoherent.

Apparently the elderly aunt was released too soon... she was incoherent when they got home, and after allowing her to sleep for a few hours to see if she improved, she became unresponsive and had to return to the hospital. She appears to be recovering quickly now after giving the family quite a scare. Meanwhile, my cousin's son and his wife delivered their first baby in the middle of Sunday night at a hospital 45 miles away. So someone had to be secured to stay with the aunt while the grandmother attended the birth of her new grandbaby! Yes, these sandwiches have many layers... more or less depending on the day!

As I told Mam-ma a few weeks ago, I will not be sad when she goes to heaven. She has indicated to both my mom and me in recent days that she is tired - and ready. I don't know what God has in store for her, no more than I know what He plans for each of us. This could very well be my last day on earth, for that matter! We don't know when babies will be born... I don't know how much longer Timothy will be staying with us... or whether any of us will make it through this day. But in the words of my grandmother, "As God is my witness..." we will make it through under His power and protection. At the end of the day, that's really all that matters.

Time Well Spent with Mam-ma Polly and Timothy

2011-09-14T13:11:00.003-05:00

We've had several visits with Mam-ma Polly lately. However, she hasn't always felt like walking the halls and pushing Timothy in her walker, which he loves. We sat in the dining hall for a long time Sunday, looking at the fish tank. Timmy loves it... and Mam-ma really needed to sit and rest. It worked for both of them.

I'm seeing a steady decline in Mam-ma's overall health and well-being. It's nothing definitive, but she is struggling to put her thoughts and words together, and that worries her. She told my mom that a dear friend and table-mate, Ruth, asked, "What have I done to you? You don't talk any more." Mam-ma told Ruth that she had not done anything, but she also added (in true Mam-ma Polly fashion!), "You need to wear your hearing aids!" Mam-ma doesn't understand that Ruth may have trouble using them in a noisy dining hall... and she may simply forget to put them in. Regardless, she doesn't wear them to meals, so she can't hear what Mam-ma says... and that makes Mam-ma very unhappy!

We are enjoying our time with Timothy... he learns something new every day. I have enrolled him in a local daycare for a few days a week as a "drop-in." He needs the structure and stimulation of being with other children; however, it's been harder for me than I thought. I am the "mother" I laughed at when I was teaching - the one who worries that Timmy will cry or feel abandoned when I leave him. And he did cry when I dropped him off Monday morning for a fun-filled day. I stood outside on the sidewalk and listened until the crying stopped - less than 30 seconds! All the way home, I told myself, "You are doing what is best for Timothy." I've told myself that many times about Mam-ma Polly, as well!

I remember the day we drove her to the ALF to move into her new apartment. I felt like I was leading a lamb to slaughter as we drove out of her driveway... but I can see (and I knew at that time) that this was the best place for her. And it's much that way with my 2-year-old nephew. I know this is best for him... and it gives me and his grandmother a break... but it is hard to leave a child who is crying and asking, "DebDeb... where are oooo?" - even if you know he is in loving, capable hands.

This sandwich has many layers, and all of them have a lot of "flavor" - some are even a little bittersweet!

It's All Part of the Sandwich!

2011-09-07T17:06:00.000-05:00

Give me a week, and everything can change! I visited my grandmother last Friday (if you are counting, that was five days ago), and she seemed so-so. Of course, I'm sure the death of her friend Geraldine - "MawMac", my Birthday Buddy - impacted her and made her sad. But overall, she seemed a little more frail and subdued in general. Her associate pastor and his wife had been there for lunch, hosting all of the ladies from Mam-ma's church who live at Southridge for a meal in the parlor. I asked her if she planned to nap in the afternoon, and she said she really didn't know what was planned. Then she added, "Gladys thinks she's having a birthday party, but it's not her birthday!"

In the meantime, she casually mentioned that the doctor had been there that morning - her first visit with him since we switched and made him the primary care physician. I asked, "And what did you think?" She replied, "Well... I don't know. He changed my medicine all up." I questioned her further, and she said he had discontinued her lasix and reduced her B-12 dosage. I looked down at her very swollen ankles and said, "I need to talk to the nurse about this." I found the nurse, who confirmed that yes, the doctor had discontinued lasix, potassium, and he had decreased her B-12 shots from one every 2 weeks to once a month. She told me the doctor and his nurse were still in the building... did I want to see them? Yes, of course! So she sent him to Mam-ma's room.

The doctor came in and explained that Mam-ma had told him she thought she had had a stroke during the week... and her speech was difficult and slow - as were her thoughts. She wagged her bony finger at me and said, "You know this... I've been a tellin' you that I can't get my words together to talk right." I agreed... but I reminded her that this had been going on for at least a couple of weeks - maybe longer. She insisted it was since our trip to the ER the week before. I told the doctor how she would not stay inside out of the heat, and the nurse piped up and said, "Oh, believe me, I know... I chased her halfway around the building this morning to get her back inside out of the heat." I explained to them that Mam-ma doesn't believe she is overheating, because she doesn't feel warm, and she doesn't perspire. They said they understood.

Still, the doctor said he wanted to temporarily make these changes, do some lab work to test blood counts and her thyroid, and see if the dizziness subsided. He said if she felt like she was having a stroke - or might have just had one - she was to tell a nurse, who would administer an aspirin and call an ambulance to transport her to the ER for a CT-scan. This would tell him whether to prescribe something stronger, like Plavix. I am still not sure that I understand all of this for a nearly 99-year-old woman, but he did mention preventing a fall... and if the medication will do this or prevent a stroke that leaves her in a vegetative state, I am all for that. It's just a gamble, in my book, to change anything at this point. But this doctor is supposed to be a specialist in geriatrics, so we will trust his judgment... after all, I have signed for him to handle Mam-ma's medical care!

I did mention that we discovered at the ER that somewhere in the last 5 years, Mam-ma has had a documentable stroke on the right side. The doctor confirmed this. We had never been told this before... and it is not a TIA... one of those mini-strokes Mam-ma has felt like she experienced a few times. This was a bonafide, measurable stroke... and one the ER doc said was common in older folks. So she is prone to more of them, given her history and her age. So we agreed to discontinue the meds and do the tests... and to monitor Mam-ma's blood pressure and overall condition for at least a week and see what happens. The doctor shook my hand and went on his way.

Soon, there was a knock at the door, and Gladys' daughter-in-law, Margaret, appeared. "Do you want to play Chicken Foot with Gladys and the other ladies this afternoon?" she asked Mam-ma. "It's Gladys' birthday, and your Sunday School teacher and friends are coming to play dominoes." "Of course she wants to play!" I interjected. Mam-ma sorta shrugged. I looked at her and asked, "You want to play dominoes, don't you?" "Well, I guess," she replied.

Margaret explained that dominoes began at 2:00 p.m., followed by sandwiches and birthday cake at 5:00. A former nursing home R.N., Margaret is a "take-charge" type, and she had already notified the kitchen that these ladies would be dining elsewhere that evening. She said she would be back to help Mam-ma to the parlor and left.

I had taken a new bird feeder to replace Mam-ma's old one, which broke, and she was very tickled to have fresh birdseed and the new feeder. She also sent home a couple of items of clothing for me to launder.

I helped Mam-ma change her sweater, comb her hair, and she put in lipstick and some rhinestone earrings that matched her blouse. I then walked her to the parlor for dominoes and the party. Margaret gathered the rest of the ladies, and I greeted those who had arrived from their individual homes in town as they came through the door, including Mam-ma's dear friend, Ruby. It looked like a lot of work had gone into planning these events, and I'm sure the ladies all had a great time that afternoon. I was thankful Mam-ma had so much to do to occupy her for the rest of the day and evening.

Later, Mam-ma phoned me to say she was "home," and that she had had a really good time, but she was too tired to return to tea. She said Gladys went back to her apartment at 6:00 p.m., because she goes to bed early but that... "Some of the rest of us stayed until 6:30!" The next day, Mam-ma phoned me again, with some excuse for calling that didn't make any sense. Basically, she just wanted to talk. And if I remember right, she did that again on Sunday, too. It was fine... I certainly didn't mind... but all of a sudden, she became more needy for several days.

Saturday afternoon, I picked up Timothy at my sister's. Our plan was to take him to church Sunday morning, and keep him Monday while my sister worked, then take him to daycare for the day on Tuesday. My sister would pick him up there after she finished working. That was the plan. When I picked up Timothy at my sister's, his nose looked a little runny. I questioned her, and she said, "It was running "green" when I picked him up at daycare on Thursday, but he's been fine since." Honestly, I didn't notice a runny nose again that evening, but he did seem to have a slight cough. I turned on the vaporizer, hoping to help with any possible congestion when he laid down for the night.

In the middle of the night, Timothy awoke - just before 3:00 a.m., pressed his little nose and said, "Nose!" He was stuffed up and coughing. We were awake 2 hours, watching Jack's Big Music Show, before he was able to settle in and get back to sleep at 5:00. He slept until nearly 8:30 - there would be no getting to church by 9:30!

Sunday afternoon, Timmy laid down for a nap, and after sleeping for an hour, I heard him crying. I went to check on him, and he was drenched... clothes, hair was literally dripping wet... bed linens were soaked. I put him in our bed under a fan and cooled him down... and he slept another 2 hours. When he awoke, his cough seemed to increase gradually. We played outside for just a bit late Sunday afternoon. A front had come through bringing cooler temperatures and a breeze, and Timmy enjoyed playing on the driveway with toy trucks - and running in the grass in our front yard. It's been so hot in Arkansas for weeks that we have not had many chances to play outside. When it only "cools" to a humid 85 at night, that's not much fun for outdoor play.

I figured Timmy would be up half the night after his 3-hour nap, but he went to bed around 10:00 p.m. with no fanfare. I ran the vaporizer again... just in case he had trouble with congestion in the night. He slept fitfully - was all over the bed - but he didn't wake up until almost 7:00 a.m. He sat up in bed, pointed at the TV, and said, "Jack!" I turned on the TV, and he said, "Milk!" I went to the kitchen to get him a cup of milk, and before I could return, I heard him coughing... and wheezing... then gasping for air. I got him up and started trying to prepare a steamy washcloth with eucalyptus oil... something I have done in the past for him. I put a few drops on a steamy hot washcloth and held it to his face for him to inhale. He would have none of that!

By this time, my husband had come to see about us. He had been in his office upstairs, and he said he heard the wheezing from there. He said, "That sounds like asthma!" I agreed, and we both felt Timmy needed instant medical attention. We threw on clothes and loaded Timothy into the car and headed for the hospital, which is only about 2 minutes away from our house. Once there, Timmy was quickly admitted. Then the fun began...

Everything went fine for the first temperature check and when the nurse put the pulse-ox clip on his finger. But when that device was too large, she had to switch to a band-aid style device, and he was not having it on his finger. She tried the band on his toe, with mixed results. Then the nurse added the BP cuff... and when it tightened on Timmy's arm, he started to scream. It was downhill from there.

Timmy was in hysterics, and nothing we did could console him. Both Greg and I tried to reassure him, but he was having none of it. The ER doc was great... and very patient. But he could not hear anything in his stethoscope when he listened to Timmy's lungs except screaming and my hand patting his back to soothe him. He almost never got the device into Timothy's ears to have a look. The one thing that went well was looking into his throat. With all of the screaming, there was a clear shot well past his tonsils!

The doctor ordered a breathing treatment for the respiratory distress. A very nice therapist arrived with a mask that sported a cute little dragon face. She tried to show Timmy how the mask would make smoke. It took three of us to hold him down to put the mask on... no, near... his face. The treatment was supposed to last 5 minutes... we might have made it 2 minutes before calling it quits. But it was enough to greatly decrease the wheezing and gasping.

The doctor wanted to rule out pneumonia... and the only way to do this was with a chest x-ray. He said, "I do not want to draw labs unless I absolutely have to... so hopefully the x-ray will tell us what we need to know." The x-ray tech, a woman who attends our church, arrived. Timmy was still in hysterics. She said he would have to sit on the end of the table, but that I could hold the film between him and me and hold him. We tried to accomplish this, but Timmy would not let me put the film between us. The tech clearly got exasperated and irritated, and at one point, she quipped, "Where are the parents?" "They're in Texas," I shot back, equally irritated - with her! This was not the time to explain family dynamics and who we were and why we were there with this child!

The tech said, "I think you two are going to have to leave the room, and we'll call in nurses to hold him." Now, this sent me spinning. I asked if there was any other way... could we not just get some medicine and leave? The nurses said there was no way the doctor would prescribe anything without at least a chest x-ray. The nurse and respiratory therapist arrived and assured me they would hold him and not let anything happen to him. Reluctantly we walked out, and I told Greg, "I'm giving her 2 minutes!"

Almost instantly, Greg saw the light come on signaling that one x-ray had been accomplished. The screaming subsided... but only slightly. I was in tears, and now Greg had TWO babies to console! Poor man! The door opened, and the tech asked me to come back in and help hold up Timothy's arms for a profile shot. I tried... as he protested... and we got an x-ray of arms - I think mine, the respiratory tech's and the nurse's... perhaps the baby's! They decided to roll with the one good x-ray, which the doctor gave me the "thumbs up" on and declared all clear - no pneumonia.

So the doctor determined this was probably allergies or viral... but he ordered a workup at Timothy's pediatric office to rule out asthma. He wrote an optional prescription for a steroid syrup for the wheezing... and he recommended an OTC antihistamine to control the symptoms and the cough, plus children's acetaminophen for the fever. Greg and I loaded our exhausted, sweaty little boy into the car and drove home. We started him on children's Zyrtec, and he seemed to improve throughout the day... although he took another 3-hour nap.

Tuesday, Timothy was out of sorts from whatever ailed him, plus the medications. He was a typical 2-year-old for much of the day and had a fairly short fuse. I did not send him to daycare, because he was irritable and may have still had a slight fever. He slept three hours again in the afternoon. Today, his grandparents took him to the pediatrician, who says this is allergies, not asthma. He gave them an inhaler and said to keep using the OTC antihistamine.

To say I am somewhat drained is an understatement. I am trying to take these things all in stride, but it's been a crazy two weeks. I have made two trips to the ER, been to two funerals for dear friends, and tried to console a 99-year-old and a 2-year-old... all while trying to continue to have some semblance of a life! I know from previous experience that this is really small potatoes in the scheme of things... and no big deal compared to what others are dealing with! But I, like many others, have been thrust into circumstances I never expected... this "sandwich" life... and momentarily, it can throw me for a loop!

In an attempt to cope, I am reading the book Boundaries... When to Say Yes... How to Say No by Henry Cloud and John Townsend. I have also downloaded a couple onto my Kindle... one recommended by a dear friend and young mother of 2... Shepherding a Child's Heart by Ted Tripp... and another that looked good... Don't Make Me Count to Three by Ginger Plowman. I have learned a lot from the Boundaries book already and even found a matching workbook at a yard sale last weekend, so I plan to really study it in-depth (did I mention I have issues with boundaries?!). I will be sure to report and give a review of the other two when I finish. I also did a Google search about 2-year-old tantrums and found some great links...

Finally, I have to say that I'm looking for ways to cherish every moment with both my grandmother - and Timothy. Honestly, I don't know how long we will have Mam-ma with us... and Timothy's visit is supposed to be short-term. So I want to treasure this time with both of them.

When I took Mam-ma to the ER, I had grabbed my Kindle as I went out the door. I had downloaded a really great short story written by my friend, John Sykes, called Shirley Takes the Shot. It's about a hog killing in the South. I knew my grandmother would love it, so while we waited for labs to be processed, I read the story to her. She laughed and chuckled... and she recalled a hog killing or two from her past. It was a good time... one of those really neat, precious moments that we don't have often enough these days... and one that will be treasured for a long time.

When you can find a way to make lemons out of lemonade even while sitting in an ER exam room, things can't possibly be all that bad. I hope you are finding treasured moments of your own these days.

A Day Full of Changes

2011-08-29T22:32:00.000-05:00

Today was a day of changes. I took Timothy to a local in-home daycare facility to "test the waters" and see how he would do. He did better than I expected. I decided a few days ago that he needed the company and stimulation of children his own age. I told my mother, "Timothy is bored." She countered, "How could he possibly be bored at your house with all of the toys, books, and you and Greg to entertain him?!" I replied, "He's done it all by noon - twice!" I talked with moms of small children and others and decided that a few days a week at a local daycare would help him... and give his grandmother and me a breather, too.

So this morning, we visited, played, had lunch, and came home. I slipped into in another room a couple of times to see what he would do, and always, he came looking for DebDeb... "Where are oooo?" And he was not having any of the lying down on rest mats for nap time. So rather than cause a scene, we left. The teachers assured me that when I am not there, he will mimic the others and lie down without incident... something I experienced myself as a kindergarten teacher. And I hope so, because he is going back for the day later this week.

While we were there, my husband phoned to tell me that my dear friend, my "Birthday Buddy," Geraldine McCurry, whom I call MawMac, died last night. She was 93 on our birthday, July 4th... and she told me then that she was ready to go to heaven. Sadly, her almost-60-year-old daughter, Mary, died Saturday. Mary was born with cerebral palsy that crippled her body... and her family valiantly cared for her at home until she was well into her adult years and MawMac and a live-in caregiver both became too old to continue in-home care. This entire family treated Mary with love and respect in a time when most families put disabled children into group homes or facilities and treated them much differently. Mary had a bright mind - communicated clearly with her family members - and even played a mean hand of bridge! She was always amazing to me.

Everyone suspected that when one died, the other would not live long. We just didn't know it would be only a day apart. I saw MawMac yesterday, but she was sleeping and I didn't wake her. I last saw her awake on Tuesday, when I returned from the ER with Mam-ma. She was in the hallway, and aides were rolling her to the dining hall for dinner... her medications in one hand, a can of Coke with a straw in the other! I will forever remember the infamous "chicken livers" conversation of a month ago, when she informed me that "Someone needs to tell the kitchen you fry chicken in flour, not batter!"

This evening, I pondered the irony of this day - my angst at taking 2-year-old Timothy to daycare... would he feel I had abandoned him? Would he be frightened and confused? Would he have fun, as I hoped? On the other hand, I thought of my dear friend MawMac, who gave me such joy and wonderful advice... who never met a stranger, but could get to the heart of the matter and demonstrate Christian love and dedication like no other. She is no longer there to visit when I visit Mam-ma at the ALF. No more funny stories of life as we knew it in our small town when I was a child. No more great recollections of seeing my mother before I was born and suggesting she wait and have me on her birthday (and she did!)... no more shared cakes and Happy Birthday phone calls... and no more days of pain and suffering for her in her tiny body shrunken by osteoporosis some four plus inches.

A week ago, MawMac's two surviving daughters were struggling to juggle the care of their sister and their mother... wondering who would go first... wondering how the other would handle the passing of either daughter or mother. And now, in the course of a weekend, both women are gone. And just like that, their lives are changed forever. Last week, a minister in our area was preaching a funeral and fell dead in mid-sermon. He was fifty-five.

I called Mam-ma this afternoon to see how she was doing. She said, "Kindly sad." She then said someone had asked her how she was feeling about her friend's death, and she said, "Relieved." She knew MawMac was not well... and that she would be so grieved over her daughter's death. At the same time, it's hard on these older folks when their friends pass away... a harsh reminder of how brief the time is that they have left on earth.

Celebrating Geraldine's 90th - 3 years ago

On days when we wonder how we will manage... how we will get it all done, we would do well to remember how quickly time passes... how fast babies grow... how soon our elders are gone... and how fragile life really is. Today was one of those days for me... a day to cherish the time I have with Timothy as he experiences milestones and growth spurts... a day to check on my grandmother, make sure she was doing okay, and encourage her to spend time with her remaining dining table mates and encourage one another...and a day to reflect on the blessing of my dear friend Geraldine, whom I called MawMac.

I'm So Dizzy... My Head is Spinning...

2011-08-26T16:21:00.005-05:00

It almost never fails. Timothy comes for a visit, and Mam-ma Polly has a "spell!" So I should not have been surprised when my phone rang Sunday evening... "I tell you what," Mam-ma began... "I've got to go to the doctor. I'm can't take much more of this being dizzy." Mam-ma's dizziness had first been reported to me on Thursday, when the nurse arrived for work that morning to find Mam-ma sitting on the porch, overheated and wearing a thick sweater fastened tightly up to her chin. The nurse made her go inside. She also discovered that Mam-ma had not taken her night-time "sleep aid" because, as she told me later... "I don't want to get hooked on drugs."

I asked Mam-ma if she had spoken to her nurse, and she said she had. I told her I would speak with the nurse, also... at least by Monday morning. She then asked, "Have you got the baby?" "Yes," I answered... "but I will still talk with your nurse." We hung up, and I phoned the nurse at the ALF. It occurred to me that when I first moved Mam-ma to Southridge, I took all of her meds from home... and there was a scrip for Meclizine, which is prescribed for vertigo. When I spoke with Peggy, the weekend nurse, she said that all vital signs were good. I asked about the Meclezine, and she said, "You are right! She does have some... I will give her one."

So Monday morning, Timothy and I went to check on Mam-ma. She was dressed, but lying down on her bed, covered with an afghan. She said she was still dizzy. I spoke with the daytime nurse, Lola, and made sure that she was aware of the dizziness problem persisting... and she said she would keep Mam-ma on the Meclizine - and let her doctor know what was going on. I thought all was well.

So we had chalked up her dizziness to the heat and lack of sleep. All vital signs were good. I visited her on Friday, and she seemed fine. I returned on Saturday, and she was still well. When she called Sunday night, her first words were, "I bet you don't have time to talk to me." "Why would you think that?" I replied. She couldn't say. But she told me she needed to see a doctor for her dizziness. I reminded her that we no longer see a doctor - the doctor comes to see her now... every month. If there is a problem in between times, we need to report it to the nurse, who will talk with the doctor.

Tuesday afternoon, the phone rang... Lola. She said Mam-ma was still dizzy, and that she was not able to put her thoughts together well. She said, "It's worse than yesterday. I've spoken with her doctor, and he either wants her taken to our local ER... or transported to the hospital where he is in Jacksonville (some 50 miles away), so that he can do a total work-up on her. Now, while I am having this conversation, Timothy has picked up the extra phone in our bedroom and is talking to Lola... "Un-huh...oooohhh... yeah, yeah, yeah..." mimicking me and my responses to Lola! I got him off the phone and told Lola that I thought we would opt for the ER, but I would talk with my husband and get back with her shortly.

My husband said he would watch Timothy while I went to the ALF to check on things. When I arrived, Mam-ma was confused and dizzy, and we all agreed she needed to be transported to the ER. An ambulance came almost immediately, and off we went. I was not comfortable driving her there... and I knew that if we walked in, there was every possibility she would be made to sit up and wait in the waiting area for who knows how long. This way, she was wheeled immediately to a room.

Immediately an IV port was inserted, and Mam-ma was hooked to the machine to monitor her vitals. Her blood pressure was 114/69 - a very low reading for her. I was doubly glad we came and that I had her transported by ambulance. I handed my print-out to the nurses that contained all of Mam-ma's data - insurance/Social Security numbers, medications and dosages, prior surgeries and medical history, contact info for emergencies, allergies, and more. They were all extremely impressed!

The ALF doctor had suspected an inner ear problem, but Mam-ma's ears were clear. The ER doc suspected a lingering UTI, since she was treated for one a month or so ago, and he said sometimes they can be hard to obliterate - and cause all sorts of troubles, including dizziness. An EKG, chest X-ray, CT-scan, and lab work were ordered to rule out stroke, heart attack, renal failure, and a thyroid problem. All came back as "normal." The urinalysis was clear - no infection. Kidney function was slightly diminished, but the doctor said, "I'll take it for 98 years old. In fact, I'd take her labs any day of the week!"

The diagnosis was just unexplained dizziness... treatment was to continue Meclizine for a few days, stay off her feet and use a wheelchair to get around... and hope it subsided. Someone from the ALF came and got her and drove her back to the ALF. I followed, and we got her settled in bed.

James, the maintenance guy, had come to see Mam-ma as the ambulance personnel arrived, and he had promised her that "we'll get those cherries planted when you get back." I didn't know what that was all about. But later Tuesday night, my mother and her husband dropped in to check on Mam-ma, and she let it slip that she has been sent "to the house" several times lately for getting overheated. In fact, Tuesday morning, she had asked James to lower the hanging flower baskets on the front porch so she could remove dead leaves, and she got dizzy and fell. She told me this in the ER... but she had not told her nurse or the aides that she fell. Luckily, she was not hurt.

She told my mom that while cousins visited recently, they purchased fresh cherries at the store, and Mam-ma saved the pits and dried them to plant. She said James told her he would dig a hole and help her plant them... and that "we'll never see them," meaning she won't live enough to see a tree grow from those cherry seeds! Lola, the nurse, told me later that Mam-ma told James that she needed to dig the hole herself! I told Lola that I had experience with Mam-ma and hole digging - and I had wrestled a shovel from her once, and she cursed at me! Lola was stunned. I told her, "I'm just warning you... she can be a stinker!"

Anyway, I talked to James, and he assured me that he would take good care of Mam-ma and make sure she was "happy, but that she doesn't get hurt." Because he is a man, and Mam-ma adores him, he might have a shot at making that happen! While Mom and her husband visited Mam-ma, an aide came in with clean laundry and put it away in the drawers. Another aide came in to retrieve Mam-ma's dinner dishes... and Mam-ma had already been up and returned them to the kitchen! So much for staying off her feet and in a wheelchair!

The bottom line is, we are pretty certain that Mam-ma is overheating, despite her protests that she is not. She claims she is cold and doesn't sweat. The nurse has tried to explain to her that just because you don't feel hot and sweaty doesn't mean you are not overheating. She was also told in the ER that she needed to drink more fluids throughout the day... something she does not do.

When I got back home, Timothy had slept 2.5 hours, so his Uncle Greg had really had a fairly easy time of it, thank goodness. I had alerted my mom and my sister, and both were on standby, should I need them. But all worked out well in that regard.

I have cautioned Lola that my grandmother is stubborn and fiesty... and she doesn't listen. She will probably get overheated again... and that's just the way it is. My sister took Timothy to visit on Thursday, and she was already out of the wheelchair and using her walker again. My sister said the wheelchair was parked in the hallway outside Mam-ma's door... as if she were done with it! She pushed Timothy up the hallway in her walker... actually quite a distance. So I assume she is feeling better and the Mecclizine has worked.

The other concern I had at the ER was what might be done for - and to - my grandmother. I could see she was not "right," but based on my experience with her, I felt this still was not all that serious. And I questioned the doctor about all of the tests... were they really necessary? What would they do should a problem be found? After all, she is almost 99, a DNR (Do Not Recuscitate) patient, and she does not want any heroic measures taken to prolong her life. The doctor agreed... no surgeries, nothing invasive. But he said, "If it is a stroke or her thyroid, we might adjust her medications. If it is a UTI or a heart attack, we would give appropriate medications to treat the problem."

I felt better knowing that we were on the same wave-length, and my point is that you must speak up. You must advocate for your loved one and say, "Hey... no heroics here. No unnecessary poking and prodding and making him/her uncomfortable. We're not here to run a tab to Kingdom Come - even if Medicare and other insurances will cover it." After all, my grandmother and I had just had "the conversation" on Saturday about the last days of her life and how she does not want to be a burden - or put through the wringer.

So for now, the "crisis" of the moment is averted. Timothy comes again to stay with us for a few days on Sunday, so who knows what will happen. One thing is for certain... it will never be dull!

It's the In-between That's Worrisome...

2011-08-20T23:23:00.005-05:00

As I prepared dinner a few nights ago, I asked my husband, "Did you hear on the news that Robert Redford is 75 today?" He responded. About 20 minutes later, we sat down to dinner, and during the course of the meal, I turned to my husband and asked, "Did you hear on the news that Robert Redford is 75 today?" He looked at me like I had just grown a third eye. "I asked you that already, didn't I?" I said as I shrunk down in my chair, totally embarrassed. "Yes," he answered. "What was your answer?" I countered. It's the little things that make you wonder if you are really losing it ... or if you just temporarily tripped a breaker somewhere. I'm hoping for the latter!

So when I visited my grandmother today, every other sentence she began ended in, "I don't know," or "I forgot what I was going to say." This has not been a good week. Timothy's family has been here for a visit (and that is a good thing), and when my niece took the babies to see Mam-ma on Wednesday, she was lying in bed and said she was dizzy and did not feel well enough for company. I queried the nurse, who said all vital signs were good. However, when she arrived for work that morning, Mam-ma was sitting on the front porch wearing a thick sweater that was buttoned up all the way under her chin. We are still in the middle of an oppressive heat wave, with morning temps in the upper 80s and extremely high humidity, giving us some record heat indexes.

Lola, the nurse, asked my grandmother, "What are you trying to do - give yourself a heat stroke?" I think she made Mam-ma go inside. Then she discovered that Mam-ma was dizzy - and she said she had not slept the night before because she refused to take her Ativan (a prescription drug she takes in a very low dose for anxiety and as a night-time sleep aid). The nurse told me, "I know what is happening... I overheard enough of a conversation in the dining room to know that the little ladies at Polly's table have convinced her she shouldn't be taking something at night to help her sleep."

When I talked with my grandmother later, she said she had tried to cut out her Ativan, because... "I don't want to get hooked on drugs." She also claimed her sweater was a very light jacket over a very thin blouse. I seriously doubt it. I've seen her sweaters and blouses. At any rate, I told her to take the Ativan and quit worrying about it... she needs a good night's rest. Lola told her that overheating and not sleeping were enough to make anyone dizzy and feeling badly.

So today when I went to visit, Mam-ma was in the dining room listening to some live music. However, she quickly told me she was not well, and we went to her room to visit. She claims she is still dizzy. We visited about a funeral I had just attended for a man who was a deacon in her church and a lifelong friend. I told her neat things that had been posted on Facebook - recollections from former students who rode her school bus. And I told her about delivering Meals on Wheels to an old friend of hers who worked at a local Piggly Wiggly "back in the day" with Mam-ma's sister. Then we walked down the hall to visit my birthday buddy, MawMac, who is also a dear friend of my grandmother's. She's not doing so well these days, but she enjoyed our visit.

When we returned to Mam-ma's room, she told me she was not going to go to tea ... that she had not been in over a week, primarily because she is not able to remember what she wants to say, and it's embarrassing to her. MawMac had just told me how much she enjoys my grandmother's visits - and Mam-ma barely said a word while we were there. I pointed this out and said, "You don't have to say anything - those ladies want you there... even if you don't say a word. All you have to do is walk down to MawMac's room and hold her hand, and she is happy you came for a visit - and it's the same for your tea ladies." I also told her I bet the tea ladies were missing her... and she replied, "Well, I'm missing them." So she agreed to give it another try.

But when I mentioned leaving, she said, "I wish you would come more often," and she began to cry. This was about the fourth time she had broken down and cried today, but usually it's over fairly quickly as she remembers something sad and then recovers. This time was different. I asked what was wrong, and she said, "Well, I know you are busy," and I laughed and said, "Mam-ma - you are busy, too!" She said, "I know it, but things are changing." I took that to mean her inability to string thoughts together well these days, and a general decline in her overall well-being. I told her, "Mam-ma, I want you to live a long, long time. But I will tell you, the day you go to heaven, I'm not going to be sad, because you will be a whole lot happier than the rest of us!" She agreed... and said, "That's not it."

It took her awhile, but she finally said, "I'm not afraid of dying... it's the in-between that worries me." I told her I could understand, but we don't get to choose that. I asked if she was worried about suffering, and she shook her head, "No!" She was finally able to tell me that she doesn't want to be a burden. I assured her she would not be - that she is not a burden now, and she never will be. Whatever happens, we will deal with it.

I also explained that she can live out her days in her apartment. The facility has Hospice, and barring something that would cause her to have to be hospitalized, she can stay right where she is for the rest of her life. She said she didn't know that. I assured her that she was surrounded by people who love her and care about her... she has a resident doctor, nurses, and there can be Hospice nurses if/when they are needed. She will never be a burden.

Part of this is melodrama on my grandmother's part...her specialty! But part of it is a genuine realization - brought home by almost a half dozen funerals for friends and acquaintances in rather short order - that her life is winding down. Mam-ma will be 99 in November. She sees the rapid decline of our friend, MawMac, who is only 93... and she has seen friends get sick one week and die the next. She knows how quickly things can change. On top of this, it bothers her greatly that my niece has moved her family to Texas, more than 7 hours away. She even told my niece, "I will try to live until you come home for Christmas." (Yes, she is a drama queen!)

I assured Mam-ma that I would visit more often... and I will. Timothy is here for an extended visit, and we will go and see her. But I cannot stop the clock... or the aging process. I have no control over my grandmother's last days/weeks/months on this earth - nor how the end will come. I also know that I could die before she does. A business friend of mine died in a motorcycle accident just last week at age 55. None of us is promised another day!

So I think my take-away for this post is that a lot of times we don't really know what is bothering our seniors... and they can't seem to put it into words. But it just may be that they are wrestling with their own mortality. I told Mam-ma today that I don't want her to spend her time worrying about what is going to happen to her - or how and when she will die. I want her to be busy enjoying her life and being happy. The rest will take care of itself. I also hugged her tightly as she sobbed and told her that we have been through far too much already to fall apart now. And I used one of her favorite phrases (with a chuckle) and told her to "dry it up!" She laughed.

Tomorrow, my grandmother may not remember our conversation... and I have no doubt that we will have these teary encounters again... and I will once again reassure her that she will always be loved and cared for - and all of her needs will be met. Meanwhile, I am going to make an effort to visit more often and hope that encourages her... and I am going to try to be patient and listen - let her vent her frustrations and worries. I'm going to remind myself that knowing that the end of one's life is imminent is daunting... no matter how strong your faith is or how excited you are to get to Heaven and reunite with loved ones there.

When Mam-ma complained today of not being able to get her thoughts together and remember what she wanted to say, I shared my "Robert Redford" story and told her it happens to all of us... even those in our 50s instead of our 90s... and she laughed. We still have lots of miles left in this journey, hopefully... and I want them to be happy, productive ones - for Mam-ma, and for us. I just hope I can remember what I told her the last time I visited!

But I Asked for Chicken Livers

2011-07-30T23:32:00.004-05:00

This morning I met several high school classmates at a local coffee shop to reconnect and visit. Then I went to see Mam-ma Polly at the assisted living facility (ALF). Mam-ma was already seated in the dining room for lunch, but she offered to return to her room with me for a few minutes so that I could unpack the things I had taken to her. Once there, she asked me, "How was your party?" I told her it was fine... not really a party... and I asked, "Who told you I was going to a party?" She snidely replied, "Well, you told me that you were too busy to come down here this week because you were cookin' for a bunch of people." I had told her that I might cook dinner for some friends who were busy moving to a new office space this week. But that did not materialize, and I answered... "I think what I actually said was that I was too busy this week to take you to Searcy yesterday to [your niece] Martha's retirement party... and I was. But I had coffee this morning with some of my classmates from high school." Mam-ma never asked if the coffee was nice, who was there...nothing... that was the end of it... and she sat in her chair and sulked.

I tried to think of other things to talk with her about, but not much came to mind, and we soon agreed to return to the dining room, where the other three ladies at Mam-ma's table were assembled and waiting for lunch to be served. One lady... my little friend "MawMac" said, "I'm having chicken livers. The choices were chicken livers or baked fish, and I chose chicken livers!" I nodded and told her that sounded nice. Then I noticed the "a la carte" menu on the table, and two of the choices were indeed chicken livers and baked fish, along with hamburger steak and a few other things. Soon the plates were arriving, and Ms. Ruth got hers first... a delicious big plate of boneless chicken breast, scalloped potatoes, mixed vegetables, and two rolls. She patted the aide's arm and said, "Sugar, if you have a plate with dark meat, I'd rather have dark meat than this chicken breast." The aide sweetly told her that all of the plates contained a chicken breast... there was no dark meat. Ms. Ruth shrugged and reluctantly said this was okay.

MawMac said, "Well, I'm having chicken livers." As the other three plates were presented, they were all the same - chicken breast. Ms. Evelyn began to protest loudly, "I ordered chicken livers!" MawMac chimed in... "I'm supposed to have chicken livers!" Mam-ma Polly added... "I ordered chicken livers, too!" The aide looked bewildered. She was new, and she seemed genuinely upset. Soon Mam-ma's regular aide appeared at the table. "This is what you ordered," she explained. The three ladies protested. Mam-ma said, "I told you I wanted chicken livers!" The aide said, "No... I specifically asked you this morning if you wanted our lunch special, which was Ranch Chicken, and you said 'That will be fine.'" Ms. Evelyn piped up and said, "Well, I ordered chicken livers last night!"

My grandmother nodded toward another table of ladies and muttered, "Well, I bet they got chicken livers." I told her I didn't think so, and she would not believe me... so I went over and checked... sure enough, every person in the dining room appeared to have the same meal... and it looked delicious. I tried my best to encourage the ladies to eat what was served... and told them how moist and tender the chicken appeared to be. While one lady loudly complained about not getting chicken livers, she was cutting up - and eating - her chicken breast! Another was saying, "I wonder when they are going to tell someone in the kitchen that you cook chicken in flour, not batter!" There was definitely "high drama" in the dining hall at the ALF today!

Clearly, none of the ladies understands that there is a "Daily Special" at lunch and dinner, and unless they specifically order from the "a la carte" menu - also called the "Sugarloaf Café," this is what they get! I tried to explain, but I got nowhere in short order, so I stopped. I suggested that tonight, they all ask for chicken livers tomorrow, and they could have them for lunch, and Mam-ma harrumphed and said, "Well... maybe!" And Mam-ma has told me more than once about the ladies complaining at the table... "that's not what I ordered," and that she "just eats whatever they bring me." Well, I'm here to report firsthand that all four of the ladies at this table were unhappy - and they were all quite vocal about it! I'm sure that Mam-ma would have been even more vocal, had I not been sitting there. I finally rose to leave, and Ms. Ruth said, "Do come back again soon... I'm sure we'll be mouthing about something!"

Honestly, if this is the biggest thing these ladies have to get upset over, we're talking pretty small potatoes. The food at this facility is delicious. I have eaten there more than once, and I could have gladly cleaned one of these plates today. This was not one of my better visits with my grandmother, but I reminded myself as I left that 1) she was in great health and moving around well physically, 2) she was reasonably clear mentally, and from all appearances, everything else was going well there, and 3) I must remember to "live in her world" when I am there and then leave it at the ALF.

The "three-ring chicken liver circus" I witnessed today could be viewed as sad and petty... but to me it was funny. It gave these four ladies something to rev their motors over, and in the end, nobody went hungry. The dessert cart contained big slices of white cake with chocolate icing... so if they didn't eat anything else, they had a tasty dessert. And from what I witnessed, all four of them were eating the chicken they said they did not order. Maybe it's time for us to give them the old "there are starving children in Africa" spiel they used to give us! Somehow, I don't believe it would work any better in reverse!

Since I don't have many graphics to accompany this post, I thought I'd include a fun photo of Timothy. The end of June, he moved to Texas with his mom and baby sister, and we are missing him madly! Hopefully he will return for an extended visit soon... meanwhile, we're talking on the phone and I'm looking at lots and lots of pictures!

Promises and Boundaries Are Closer Than We Think!

2011-07-25T14:26:00.001-05:00

My cousin and his wife are expecting their first baby in September, and I co-hosted a baby shower for them this weekend... held Sunday afternoon at another cousin's home. Since I was hosting, Mom and my sister volunteered to get my grandmother to the shower. My sister even visited Mam-ma at the retirement center on Friday and told her, "I will come over around 1:00 p.m. and help you dress." The shower was from 2:00 - 4:00 p.m. Mam-ma said she probably would not need help dressing, but 1:00 would be fine.

Saturday morning, my phone rang... Mam-ma. "I don't know how I'm going to get to that party." I reminded her that my sister was taking her. "Oh... well... I didn't know." "Remember? She told you yesterday that she was coming to help you dress. Why would you think she wouldn't come?" "Well, you know... people have other things to do!" Funny how she considered my sister's schedule... and this will be important later in this post!

I assured Mam-ma that Suzanne was indeed coming to get her... and should something arise, my mom had said she would step in and serve as the taxi. I thought I had her convinced all was well, and we hung up.

That afternoon, my niece phoned from Texas, where she and the babies are staying with her boyfriend's family while he works in that area. We visited, and she put Timothy on the line to speak with us. He asked about all of us... the kitties, Grandma "E" (my husband's mother), Great-granny (my mother), and then... the moon? "Yes," I assured him, "the moon is still here, and we will look at it when you come to visit." (We'll also read about it in his favorite "night-night" books!)

Saturday evening, my husband and I went out for awhile, and when we returned, there was a message on our machine from my grandmother, "Bring me some light bulbs tomorrow." Click! (End of message - she hung up!) Mam-ma is on a kick about needing light bulbs (although she has plenty), so I set aside some light bulbs to deliver to her at the baby shower.

When we got home from church on Sunday, my sister had called... Mam-ma had called her that morning to say she didn't think this would work. The bottom line was that she had decided she could not eat her lunch and be ready in time for the shower. Now, lunch is served at noon. My sister was not coming until 1:00 for a 2:00 shower. My grandmother was actually trying to back out of attending the shower. This former social butterfly who never missed anything has become the queen of saying she wants to go to something all the way up to time for the event, then backing out.

So when my sister and Mam-ma arrived at the shower, Mam-ma was muttering, "I shouldn't have come. I shouldn't have come." We assured her that all was well, and yes, she needed to be there. I think she had a good time, but she told me again, "I shouldn't have come." And as we helped her to the car, she began to cry and said, "I shouldn't have come." We assured her that we were all glad she was there, and everything had been fine. But we can see the pattern emerging... she has curtailed her Wal-Mart trips to almost zero. I used to drop her at home after beauty shop day, and she and her friend Ruby would beat me back to Wal-Mart! Now she is making a shopping list and sending it to Wal-Mart with the Activities Director. She said recently, "I guess I'm just too old to shop at Wal-Mart any more."

My sister had alerted me during the shower that a cousin was having a retirement party later this week in another city 30 miles away, and Mam-ma planned to ask me to take her. But after she was so adamant about this shower and how she shouldn't have gone, I hoped she might dismiss going to the next party. However, by 7:00 p.m., Mam-ma was phoning me... "We got a letter that Martha is having a retirement party. It's this Friday from 2:00 to 3:00." No "Will you take me?" or "I would like to go," just "This is when it is."

I told Mam-ma, "I cannot make this work." I have too much else going on next weekend. And this is partly the truth... although the people who "have other things going on" almost never includes me. Anyway, I told her that I did not think that Martha truly expected her to make the trip and come to her party. "Oh, yes, she does!" Mam-ma replied. "She told me so the last time she visited!" The party is in a courthouse on a downtown square. Parking is a problem, and the forecast is for triple digit heat.

I explained to Mam-ma that I didn't feel she was up to the 30-mile ride, followed by a big walk in the heat for a few minutes at a retirement party in a crowd of people. She said, "Well, if you can't take me, so be it." I knew she didn't understand, but honestly, by Friday, I figure she would back out anyway... and I truly don't believe she is able. The changes are subtle, but she is declining, slowly. I assured her that Martha would understand... although I don't think she was fully convinced.

My grandmother has become very comfortable and secure in her environment at the ALF... and that's not a bad thing. She knows the "lay of the land" there and has a pretty solid schedule and routine... and she has to make very few decisions. And this is a great comfort - to her, and to me. But there are times when she still wants to function in the "outside world" as she did before. She wants to be a part of social situations and family events... until she considers the logistics of getting ready, getting there, seating and more. I thought about the birthday party I took her to a few weeks ago, and how well she did. But this was an event she has attended for years. She knows exactly where we are going... where she will sit... who will be there, and what will happen. There is very little element of "newness" there... everything is familiar and comfortable, and I think that is the difference.

Try as we might to assure my grandmother that we can still make some of these things happen, I think she is often far less than convinced. Both my grandmother and Timothy often ask for "the moon". These days, delivering on the promise to a child is often far easier.

* * * * * * * * * * * * * * * * * * * *

In the spirit of offering helpful hints/suggestions, I would like to talk about "boundaries." I am presently reading Boundaries: When to Say YES, When to Say NO, To Take Control of Your Life, by Henry Cloud and John Townsend. In this book, the authors talk about how setting boundaries and saying "No" in certain situations is not cruel or selfish. In fact, sometimes refusing to participate in certain activities is in the best interest of each party... and I think my cousin's retirement party falls in this category. My husband suggested that I have given my grandmother an "excuse" - she can blame me and her "lack of a ride" for not attending. Yes, my mother would drive her if she asked... but I've told my mother that I don't feel Mam-ma is physically able to go, and she has agreed with me.

If I felt my grandmother was able to make this party, I would do so. This cousin is the last remaining niece... the daughter of one of my grandmother's older sisters. It would mean the world to her to have my grandmother there, I'm sure... but not at the expense of her health and well being.

I've also taken advantage lately of a service provided by the ALF for driving residents to doctor appointments on Tuesdays and Thursdays, at no additional charge. My grandmother had a pacemaker check on Tuesday morning at our local hospital. Thursday afternoon, she had an appointment for an adjustment on her dentures. The staff at the ALF was able to drive her to both of these. There was no need for me to go... no doctors were consulted at the hospital, and the dentist has made these adjustments numerous times - there is nothingdiscuss there. And even if there were, the dentist would be happy to phone me. So I scheduled the appointments on the days when delivery service was available and made sure I got them on the calendar at the ALF. And I was able to accomplish some of the things on my own "To-Do" list at home, knowing all was well with my grandmother.

A year ago, when Mam-ma still lived at home, I would have had to take her to the Tuesday a.m. appointment, the Thursday p.m. dentist visit, and to the beauty shop on Friday. That would have, in essence, eaten up the better part of three days in one week. And often we had weeks like that, followed by a party or church event on the weekend to which Mam-ma expected an escort. I am so thankful that I now have such reliable assistance available... and people my grandmother trusts. She appears to be just as confident going to these appointments with a staff member as with me. In that regard, we have both shifted the boundaries a bit... I'm depending more on the staff for assistance, and she is allowing me to do so!

My point is to examine your situation and ask yourself where you could possibly let go a little and allow others to help... and where you could lovingly step back and say, "I'm not doing this"... because it's the right thing for everyone.

A Birthday Party at 102?

2011-07-17T22:54:00.003-05:00

Another year has come and gone. Today we celebrated the 102nd birthday of my grandmother's friend since childhood... Lois Magness Taylor. Mrs. Taylor's daughter and son-in-law and other family members threw a celebratory buffet lunch party in her honor at their RV resort on the river, Wagon Circle RV Park. Mrs. Lois' birthday was actually July 15th. As they have done for a number of years now, the family invited my grandmother to attend as a special guest. Of course, she was eager to go... and I was glad to take her.

We got there a little early, so that Mam-ma could sit with Lois and visit. They had a grand time and seemed to have plenty to talk about for a little better than two hours. Later, Mam-ma remarked that she didn't get to visit with many people because she sat with Lois the whole time. I pointed out to her that every person in the room came by to speak to her and Lois, so in actuality, she probably got to visit with more people!

I had to laugh... Mam-ma is always concerned about the men in the group being taken care of... and today, Mrs. Lois was just like her. Before the meal was served, she called me over and gestured toward a group of men sitting alongside a table and said, "When are they going to turn those men loose on that food?" I told her the ladies were still preparing the meal and getting it to the buffet table, and that seemed to satisfy her. But I had to laugh that... at 102... she was still concerned that the "menfolk" were not going to be fed!

The men (and one woman) Ms. Lois wanted fed!

Ms. Lois and her daughter, Ann, with Mam-ma Polly

The party was lovely, and Mam-ma was treated like royalty. There was an abundance of food prepared by Mrs. Lois' daughter, Ann, other family members, and members of Ann's Sunday School Class, some of whom were there to share in the party - and help in the kitchen. There was fried chicken, smoked ribs, all manner of vegetables and side dishes, chips, dip, rolls, garlic bread, and more.

Mrs. Lois had a beautiful birthday cake, and someone led the singing of "Happy Birthday." There were other desserts, also, as well as Cave City watermelon - a "delicacy" in these parts! Nobody left hungry this day!

Mam-ma cried as she kissed Lois "good-bye" - and I know they both wonder if they will see each other again next year. Something tells me they just might!

* * * * * * * * * * * * * * * * * * * * *

I was quite pleased to hear Mam-ma tell more than one person today how wonderful her new living arrangements are at the ALF. She told several how she had so much to do there and enjoyed the people. AND... she said more than once that the food was wonderful! Mam-ma has been telling me that her clothing is too tight - that she has gained weight. I told her we would take a look at her pants and see if maybe it was time to buy some new ones. So I measured her - waist, tummy, inseam - and when we returned from the party, I took a look at the clothes in her closet.

Every time I would pull out a pair of pants and ask, "Are these too tight?" she would reply, "No, those are okay." We finally came up with one pair of pants that was too small and one blouse that she didn't care for... and I surmised that her real problem was that she had her closet in a mess and couldn't determine what she did have. I had her sit down in one of her comfy chairs while I took virtually everything out of her closet and sorted things. I arranged all of her pants together, by color... then all of her blouses together by color... and I separated all of her jackets, "house dresses" and more. When I was finished, I counted 14 pair of pants, and probably 2 dozen blouses. And that didn't count the clothing in her laundry hamper! I told her I didn't see any need to purchase new clothing!

This brings me to my hint for today. My grandmother has always been a neat and orderly person. Her drawers have always contained neatly folded items... from socks and underwear to pajamas and dish towels. She has always been quite meticulous about this. However, her closet was a royal disaster today. Once I got the empty hangers out and rearranged the clothing, she could see that she had quite a nice wardrobe... and plenty of space. However, I don't figure she will be able to keep her closet in this shape for long.

So I am making a mental note to reorganize her closet for her about once every month or two. It will help us both. I can assess items that have a stain she didn't notice or need mending... and it will reassure her that she has plenty of nice outfits for each day of the week. I don't want to intrude on her privacy... or make her think I feel she is incapable of managing her clothing. But I think I can do this in such a way that she won't get this impression... maybe under the guise of returning some of her nicer blouses she likes for me to launder - or rearranging to bring a different "season" of clothing to the forefront.

As our seniors age, they sometimes lose the ability to maintain order... yet order helps their day go a little bit smoother. This is just one small way we can help keep them in routine... and happy. And that makes the day go better for all of us!

Here's Your Slice of "Humble Pie"...

2011-07-12T14:21:00.008-05:00

The link to this story popped up on my Facebook wall today. Truly, this is a humbling story... and the statistics are staggering. Be sure you watch this video!

Click here:

CBS News - Caring for Mom & Dad

How Much Does It Cost?

2011-07-11T12:50:00.000-05:00

A few days ago when I visited my grandmother, I commented about something I did not intend to purchase, and she said, tearfully (and with just a touch of melodrama), "Besides... you're already out so much money on me." I assured her that everything was okay and that I was not "out a lot of money" on her. But in reality, there are "incidental expenses" that come with placement in an Assisted Living Facilities (ALFs) or Skilled Care Nursing Facilities (commonly known as "nursing homes") - above and beyond basic room and board. And this was the topic of a telephone interview with a writer for Smart Money Magazine today.

Regardless of whether the resident is "full private pay" or there is some level of assistance from Medicaid or another financial aid program, there will be expenses that are not covered in the basic room and board fee. For my grandmother, these include:

hair care - shampoo and set, haircuts, and permanents
manicures
toiletries - from skin cream to body lotion to makeup, toothpaste and OTC medications
clothing
subscriptions - newspapers and magazines. My grandmother's ALF does provide a subscription to the local newspaper, but it is shared, and my grandmother was not getting access to it often, so she asked for her own personal subscription, which she subsequently shares with other residents.
extra snacks - healthy snacks are provided at the ALF, along with beverages like coffee, tea, and fruit juice. However, my grandmother likes to keep candy in her room, as well as soft drinks, Ensure, and tea for her nightly "tea time" with fellow residents.
postage stamps and stationery
bird seed - my grandmother has a bird feeder outside her window that we keep filled. She enjoys many hours watching the birds feed at her window.
private telephone - my grandmother has basic telephone service in her room, and she enjoys being able to speak with family members and friends from the privacy of her room, whenever she wishes.
"spending money" - occasionally the residents who are able will shop at Wal-Mart or go out to eat. My grandmother needs a little cash on hand for these outings.

medication - while my grandmother has Medicare Part D prescription drug coverage, there is a copay of about $15 per month. If an additional medication is prescribed that the plan doesn't cover, this is another expense. When my grandmother got sick with the stomach flu a few months ago, the medication ordered by her physician caused her bill to more than double for that month. Her dentist sometimes prescribes a rinse for her gums... and this is an out-of-pocket expense, also.

The writer also wanted to explore the incidental expenses associated with the care of our little ones. While our situation is somewhat different than many, i.e. Timothy is not with us all the time, we still provide many things for his care when he does visit. I have spoken with other "grandparents" and aunts and uncles who echo my comments that their little ones arrive "with the clothes on their backs," and everything is provided for their stay... diapers, formula, clothing, toys, crib, high chair, car seat, and much more.

I told the writer that I have almost NEVER paid full retail for any purchase... I shop consignment/thrift stores, use coupons and end-of-season sales, and purchase nearly-new items at garage sales. But still, it adds up. Diapers alone can cost $25 a month or more, depending on how often Timothy visits.

The bottom line to our discussion was that making "Smart Money" decisions with regard to being in the Sandwich Generation takes planning and preparation... and a budget. Failing to plan means planning to fail. And quite frankly, most people are not thinking about the expenses associated with long-term care for a number of reasons:

this is an unpleasant subject
they are too busy getting through the daily grind
they don't think it will happen to them
the seniors don't want to talk about it

I am glad that people are beginning to recognize that this is an important issue that must be addressed. I have spoken with many friends in recent weeks who are suddenly thrust into making some major decisions for their elderly loved ones, and the expense - particularly that of "incidentals" - has been a daunting revelation. Now is the time to plan, so that wise decisions are made and you don't end up compromising your own livelihood in the process!

I don't have any clue if/when the article will run... stay tuned. Meanwhile, start taking a look at your own situation. Where is there potential for you to face a situation where you are suddenly faced with the care of babies or small children... or more likely, an elderly loved one. Are you taking the necessary steps to be adequately prepared? Isn't it time you did?

We've Lost Your Grandma...

2011-07-08T11:15:00.003-05:00

I visited my grandmother yesterday shortly before noon. She had worked on hanging baskets of geraniums that morning... removing dead stems. She asked the maintenance man, James, to lower the plants onto a bench, and she sat and removed the dead stems and flowers. Now, she was resting before lunch... her feet propped up on her bed as she sat in a chair. She seemed fine.

I left the ALF and went to my mom's to help her with a computer issue. Then I shopped for groceries, and I returned home around 2:30 p.m. My husband's niece was supposed to bring her two children for a visit around 3:00.

Our niece and her two children no sooner got in the door than the phone rang. It was the nurse at the ALF... "Is your grandmother with you?" "No... I was there around noon and saw her. Why? Is she missing?" "Well, yes... she wasn't in her room when they went to get her for her beauty shop appointment, and she isn't in the building... and she didn't sign out to go anywhere." I suggested maybe she was outside walking? "No," the nurse replied... "a lady sitting on the front porch said she saw Polly get in the car with another lady." The nurse suggested maybe my grandmother was with my sister? I told her that was highly unlikely, but I would check and make a couple of other calls.

I hung up and called my mom. I knew Mam-ma was not with her, but I thought she might have a cell phone number for one or more of Mam-ma's friends via the church directory. She didn't. I told Mom, "I hesitate to call these ladies. If Mam-ma is not with them, they will worry - and if she is, they won't be at home!" So I decided to wait. I did phone the nurse again and gave her the name of a man who lives across the street at the skilled-care nursing facility. His wife is in Mam-ma's Sunday School class, and Mam-ma frequently walks over and visits with him. The nurse said they had checked that building... but not a specific room. I assured her that Mam-ma had not run away (which she knew) and that she was probably at Wal-Mart, or at a friend's looking at a flower or plant in the garden, or something like that... and she would return soon.

Meanwhile, my sister called... she had gotten a call from the nurse, also. She wondered if I had found Mam-ma yet. I told her no, but I would let her know when she was located.
Our company left about 4:30, and I phoned the ALF. The nurse said she had gone to a secure wing of the facility, but she would page Mam-ma's floor and see if Mam-ma had returned. When she came back on the line, she said, "She has just come in. I'm headed down there now to give that little girl a talkin' too!" I laughed and told her to go for it!

I honestly don't know what happened. Mam-ma's story is that she told the ladies at the front desk she was leaving. But she admits she did not sign out on the little sign-out clipboard. She went with her Sunday School friends... they drove her across the street to play "Chicken Foot" dominoes with another Sunday School member who resides there. Mam-ma said, "James put my walker in the car... he knew where I was." In defense of the facility, James was mowing and working in the yard when I left at noon - I'm guessing the staff didn't think to ask him if he saw a little old lady get in a car and drive away!

At any rate, Mam-ma didn't seem that upset about it, thankfully... so if they got onto her for it, she took it well. And I am so thankful to know that the staff is that attentive - and that concerned. Mam-ma said that someone told her they would try to reschedule her for a hair appointment today. She said, "It doesn't matter if I get my hair done or not!" Now, there was a time when that was not the case... but I guess a good game of "Chicken Foot" trumps even nice hair!

This little situation resulted in numerous phone calls - back and forth to the ALF... to my sister and my mom to let them know that all was well... and to Mam-ma to check on her and make sure she was okay. My mom even called Wal-Mart and had my grandmother paged... and she called Mam-ma's friend, Ruby, to see if Mam-ma was there. Thankfully Ruby didn't answer - she was with Mam-ma playing dominoes!" I had told Mom that I didn't want to call Ruby, in case she was at home alone and didn't know where my grandmother was. I knew that would upset her. But Mom called her anyway... and of course, Wal-Mart...where they paged Polly. Of course, she didn't answer the page... she wasn't there!

I later told my mom... "It is uncanny that the minute I get busy with someone else, there is a 'crisis' with Mam-ma. I'm thinking of her stomach bug the afternoon of Timothy's birthday party... and now just as our little niece and nephew arrive from Missouri for a visit, she goes missing! How is that?!" Just another reminder that I'm still smack in the Sandwich Generation... and there don't appear to be any changes on the horizon!

* * * * * * * * * * * * * * * * * * *

On another note, a dear friend from my church suggested I read a good book on "boundaries." I selected Boundaries... When to Say Yes, How to Say No to Take Control of Your Life by Henry Cloud and John Townsend, from Zondervan Press. I'm almost halfway through the book, and I can already see that it will help me tremendously with a number of relationships. I am recognizing some of the comments made to me last summer by a gerontologist, i.e. "What makes you think you are responsible for the care of all of these people?" I am also learning why I have a hard time saying "No" - and how to change that!

I downloaded this book to my Kindle, but this title is available in several formats from Amazon.com, and I highly recommend it. I think this book would be a great resource for any member of the Sandwich Generation and those who are struggling with the issues of caring for aging loved ones. I'm sure I will be reading it again and making many notes for reference. If you think you have no issues with boundaries, you might still find this book helpful. This could be just the resource that helps you maintain smooth sailing... and preserve your sanity for the long haul!

Should Mom Get a "Medical Alert" Button?

2011-06-29T11:05:00.000-05:00

"Should I get a 'medical alert' device for my mom?" This was the question my sister-in-law posed over dinner last night. I emphatically answered "YES!" and my other sister-in-law echoed my sentiments. My grandmother had a "button," as she called it, for years while she lived at home alone. Now that she is in an Assisted Living Facility, she still has a "button." The difference is that this alert is tied into the system for the ALF, while the one she had at home notified a security alarm company, who then took steps to determine if emergency assistance was needed.

But back to the question... my sister-in-law's mother is in her eighties. She has a daughter who lives with her, but there are times when she is alone... and as we all know, things can happen in a heartbeat! The woman's family physician recommended that she get a cordless telephone and program it with emergency numbers that could be accessed with the press of one button.

However, as we pointed out to my sister-in-law, this is only a good option if her mother will always carry her phone with her... and we never could get my grandmother to do this. We tried to get her to carry her cordless phone to the bathroom with her - or anywhere else she traveled in the house or yard. Her response was always, "Well, I forgot." I can't tell you how many times I couldn't reach her on the phone for long enough to start to worry, and she would say, "Well, I was out on the sunporch quilting," or "I was in the bathroom and didn't hear the phone." "Did you take your phone with you?" "Well... no... I forgot."

So the "medical alert" button becomes a more viable solution. My grandmother's device cost her a little over $21 per month... and it was worth every penny. Oh, you will hear stories from those who fell and could not reach their button... or those who accidentally pressed the button in the middle of the night and heard a voice coming from the "base" box that asked, "Mrs. So-and-So... are you alright?" But by and large, these devices offer a level of security and safety with little downside. And my other sister-in-law got a model for her mom that is like a wristwatch... she wears it all the time on her arm.

Waterproof styles are available... at least waterproof enough to be worn in the tub or shower. This was especially helpful for my friend, Olive, who became so weak one day that she was unable to get out of the bath tub. She was able to press her button and call for help... and ambulance personnel were summoned to assist her.

How does one find a reputable company for obtaining this service? Start by asking around for recommendations from others in your community who already utilize such a device. You can also contact your local security alarm companies and ask if they provide such a service. There are national franchises that provide such devices - and these can be located via a Google search. My sister-in-law used a service offered through the hospital in her mother's community.

The point is... there are plenty of viable options... and all are reasonably priced and well worth the peace of mind they provide. If you have an older loved one who lives alone - or who is alone for large chunks of time - you owe it to them, and to those who care about them, to investigate this service. The senior may balk, at first, but do it anyway... and do it now. This is one of those times where "an ounce of prevention" truly is "worth a pound of cure."

Flying By the Seat of My Pants - an Interview About the Sandwich Generation

2011-06-20T13:18:00.000-05:00

This morning I was interviewed by Heather Mundell, a life coach who hosts Mom In the Balance, a website for mothers who find themselves part of the Sandwich Generation. The interview was delightful... Heather made me feel very comfortable, and I found myself feeling like I was simply having a conversation with a fellow member of this group. I will post a link to the interview when I receive it. Meanwhile, be sure to check out Heather's website. She may just offer a service you are needing. I am flattered to think that Heather considers me something of an "expert" in any way/shape/form on the Sandwich Generation... most days I pretty much fly by the seat of my pants!

Friday, we kept Timothy for a few hours while his mom took care of some personal business. He was as fun as ever, and we enjoyed him immensely. He was with us about four hours... which was a good length of time for an impromptu visit! We are always glad to keep him; however, I think at this stage in his life, a stay of more than a couple of days and nights is a little much for him. He really missed his family during the week he spent with us when his sister, Zola, was born... and I think it was confusing for him. We are fairly sure he thought he was returning for another lengthy stay on Friday, and he cried and didn't want to leave. I am sure he got over it quickly, but when a baby is clinging to your neck and crying to stay, it's hard to put them in the car!

My niece and my sister took the children to see Mam-ma last week... her first introduction to Zola, her second great-great-grandchild. She really enjoyed getting to see them, and as I visited with her yesterday, she told me about how she held the tiny baby and marveled at her small size and delicate features.

When I arrived at the ALF yesterday, Mam-ma said rather gruffly, "Well! I thought y'all had forgotten me!" I asked why she thought that, and she said, "Well, I hadn't heard from anybody!" I told her that I had tried to call her several times over the last few days, and I never could catch her in her apartment. I added with a laugh... "You're apparently too busy to talk to us on the phone!" Then I reminded her that my sister and niece had visited and brought the children... and I knew that she had spoken by phone with my mother. It was just one in a handful of minor complaints she voiced.

I think the main problem this week is the heat. We are having brutal heat in Arkansas... hotter than normal for June - actual temps as high as 100-105. When you add humidity, you have a recipe for some serious heat troubles. Mam-ma was complaining that she could not sit out on the porch. There was a breeze, she said, but the air was so humid and thick that she could not get her breath. And I know this keeps her from walking outside around the facility like she enjoys. So when my grandmother cannot get outside for awhile each day, things are not right in her world.

I asked Mam-ma if she would be having tea time last night... she supposed they would. "But it's not been very good the last couple of nights." I asked why, and she said, "Well, one night Molly (a younger woman from her church) brought milk shakes for everyone." "Oh, that sounds nice," I said. She replied with a harrumph... "Well, I couldn't drink it all." I commiserated that perhaps a milk shake after dinner was a little much, but I also pointed out that she didn't have to drink all of it - and I am sure Molly didn't care. "So, if Molly brought enough for everyone... what was the problem?" "Well, I just couldn't drink it all!" she said. I surmised that there were probably some ladies who could drink all of it, and she confirmed that yes, there were.

One of my grandmother's chief "complaints" about the ALF is that "there is too much food, and I can't eat it all." I do not consider this a problem. There is no way that the facility can personally tailor every plate to the appetite (at that moment) of each resident.

Heather asked me what I have learned from my years as a member of the Sandwich Generation... what advice would I offer? Here's what I told her:

Remember that your loved ones are still real people, no matter how crazy or irrational they may become... or how ridiculous their comments may seem. They still deserve dignity... and toward that end, we must allow them to vent and express themselves and filter the comments and behaviors accordingly.
Remind yourself, "It's not about me. It's not my fault. I am not responsible for this." Do not own your loved one's frustrations. Understand them, commiserate as much as possible, and do what must be done to cope, but do not take that upon yourself. Remind yourself that your loved one is frustrated, scared - and perhaps not thinking clearly - and this is the only way they know to express this... then leave as much as you can at the door.
Do not forget to take care of yourself and your own family. If you have a spouse, be sure to make time for him/her that does not include conversation and activity with the children and/or elderly loved one. It is truly about balance, as Heather's website suggests... and do not get so caught up in your loved one's life and concerns that you neglect your children... or vice versa. Above all, take some time for yourself... recognizing that unless you do, you will be of no use to anyone else. Do not beat yourself up for time spent on a workout... the afternoon you take to scrapbook or shop for a new dress... or the 30 minutes you spend soaking in the tub!

Don't feel guilty for screening calls and returning them later... or telling your loved one, "I cannot do that today." Remember... you are only one person, and while the world will not fall apart if you are not there to do everything, it won't function as well without you. So make sure you do all you can to be as well as you can - mentally, physically, emotionally, and spiritually!
Although I didn't mention this directly in the interview, don't hesitate to get help and support, if you need it. Read blogs like this one - and websites like Heather's. Spend a few $$ and get books that will help you - or hire Heather to help you balance your life! The one component that has been in large measure missing for me in this journey has been support from others with "hands-on" experience. I have friends to whom I can vent, and an incredibly supporting and loving husband... but there have been times when I really wished I had some sort of "Hotline" to call to say, "HELP! What do I do now?"

This was in large part why I started this blog, and I do hope that you feel you can contact me and ask this very question. I may not have the answer you need, but I will do all I can to help you find it. And so will people like Heather!

The Sandwich Generation is definitely a lesson in balance. Some days are better than others, but if we all stick together, we can stay as close to the center as possible!

I'd Like to Buy a Vowel

2011-06-12T22:34:00.000-05:00

I visited with my grandmother after church today. She had called last night, but a thunderstorm was in progress with very serious lightning, and I suggested we talk another time. When I arrived at the ALF today, Mam-ma's room was unlocked, but she was nowhere to be found. An aide suggested she was out walking the halls. I started searching for her, but I couldn't locate her.

I visited a dear friend of mine who moved to the ALF last week. My little "birthday buddy" who shares my birthday has declined tremendously in recent weeks, and I found her in bed, under oxygen, looking frail and quite unwell. However, when I squeezed her hand and spoke to her, she immediately began talking to me, and she seemed quite lucid. She told me she had been very sick, but today she had eaten four bites of oatmeal and drunk a cup of milk. She said, "Oh, the milk tasted so good." She also told me she had fallen again, and she felt so badly that she didn't think she would dress today. This little spitfire who has been my hero for over 50 years is now in tremendous decline, and it saddened me greatly to see her this way. As I left, she said, "Happy Birthday." Our birthday is not until July 4th, and I told her, "Happy Birthday to you... we've still got a few weeks, but we're gonna make it." Secretly, I wonder if she truly will see 93.

I let myself out and started looking for Mam-ma again. A resident told me she was sitting on the front porch. And that's where I found her... sitting in a rocking chair, looking at the redwing blackbirds and enjoying the relatively cool morning under a cloudy sky. As I sat down in a rocker beside her, she said, "Well, I didn't know you was here... I've been a lookin' for you all day." It was nearly noon, and I asked, "How did you know I was coming?" She replied, "Well, you told me last night that you might come today." I had to wonder... would she have sat there all day waiting for me?

We had a good visit, and my grandmother talked about my "birthday buddy"... who is also her friend... and an elderly cousin who is ill... and Mam-ma cried. She said, "Sometimes I wonder why I am still here... and I wish I wasn't." I told her about a book I read this week... 90 Minutes in Heaven. The author tells of crying out to God and asking why he had to leave and return to earth to suffer terribly through nearly 2 years of excruciating recovery. Heaven was so glorious...so amazing it defies description... yet he didn't get to stay. He learned that God had a purpose for him... on earth... to minister to specific people in a way that no one else could. He was directed to several people who were enduring the same recovery that he had endured... and they could only relate to the empathy of someone who had "been there done that."

I explained to Mam-ma that she has a purpose... at Southridge. I didn't even acknowledge that she is important to us... that she serves a purpose in our lives. She might not even believe me! But I pointed out several at the ALF to whom she is ministering... friends, aides, nurses, staff. I told her, "Maybe your purpose is to help James (the maintenance man) to become a better gardener!" That made her laugh. I also told her that heaven will be just as glorious - if not more so - when it truly is her time to go... but for now, she has work to do here!

I stayed until Mam-ma went to lunch, and then I filled her bird feeder and came home. Mam-ma called a little before 6:00 p.m., and I didn't get to the phone in time, so the machine picked up as I answered. She said, "I can't get my TV to work... it says cable." I told her to hang up and I would call her right back. "Okay," she said. I hung up, but she didn't, and I waited a few seconds, and finally she DID hang up, and I called RIGHT back... and ... wait for it... I got her machine!

Lately, there have been a few times when I have told Mam-ma, "Let me call you right back," and she has said okay... and when I phone her immediately, she doesn't answer after six rings... and I get her answering machine! I had to try three more times before the machine finished its cycle, and the phone would ring. I heard her pick up and start dialing. "Mam-ma! Mam-ma! POLLY!!!" "What?" she asked innocently. "Where did you go? I told you I would call right back." "Well, I don't know... I don't know what I did."

So she said her TV was messed up - "It's on cable, and I can't change it." I told her she is supposed to be on cable. No, she wasn't... it wasn't right. She didn't know what she had punched. I tried to talk her through punching the "TV" button on her remote - she could barely see the markings to read them to me. Then she started reading SS1, HDTV, Dolby... "No, that's not it," I told her. She said something about only getting an orange screen. Finally, I said, "I'll just come down there... I'll be right there." "Okay," she said.

I collected the manuals for Mam-ma's TV and headed to Southridge. When I got there, her TV was on, and it appeared everything was fine. I picked up the remote and started flipping through the channels, and everything was fine. "No, it's not!" she insisted... "It says 'Cable'." "Yes, you are on cable," I told her. I explained that this little display shows "cable" when she punches the "TV" button on her remote, but it will go away after a few seconds.

I flipped all the way to what appeared to be RFDTV. "How many channels are you supposed to get?" "40," she said. "Okay, I'm on channel 40." She showed me her channel guide, and I showed her the Weather Channel, "60 Minutes" on CBS, "Dateline NBC" on NBC, and RFDTV on Channel 40. She said, "Well, all of my programs is not there." I looked at the clock... 6:25. "Are you looking for 'Wheel of Fortune'?" I asked. "Yes." "Mam-ma, this is Sunday... 'Wheel of Fortune' isn't on tonight." "Yes it is!" "No, it's not... that show is on every night of the week except Sunday. You should be getting 'America's Funniest Home Videos' and 'Extreme Home Makeover,' but there is a ballgame tonight on ABC, so that's what you will get there."

I FINALLY convinced her that "Wheel of Fortune" was not on tonight, and there was nothing wrong with her remote, and I showed her the button to press to be sure she was on TV. She showed me the SS1 and HDTV settings she was referring to on the phone - they were on a sticker on the front of her TV! They were for Surround Sound, Dolby Sound, HDTV, etc. - and just indicated her TV was programmed for these features. I explained that these were part of a sticker and were not actual buttons - pressing them did NOTHING.

Finally, she was convinced all was well, and she said, "Well, Sugar, I'm real sorry." I told her it was fine... I did not mind running down to check. I told her what might be on tonight that would be of interest to her, and she said, "Well, I'm a fixin' to go to tea!" I said, "Okay... well, your 9:00 news will be on for you when you return."

So next time, I will know a few more questions to ask before I make the trip. And I have no doubt I will have to return again at some point to "fix" the remote. As for the phone, I don't have a clue. Mam-ma's apartment is less than 300 square feet... she has a cordless phone. How she gets that far away from it in 15 seconds is beyond me! Mam-ma had asked for pretzels and raisinets for "tea time" - and I'm sure by the time she got there tonight, all was forgotten about the television and the remote - and the phone... until the next time Pat and Vanna are not on at the appointed hour. Once again, I'll be called upon to "solve the puzzle" and get things back in order. And so it goes...

The Sandwich Adds a Layer

2011-06-07T16:48:00.000-05:00

Our "sandwich" added a new layer last week. One week ago today, Zola Claudette - Timothy's baby sister - was born. She weighed in at 5 lbs, 15 oz. - 19 inches long. She is the tiniest thing I have ever seen!

Zola was born on a Tuesday afternoon. My husband and I picked up Timothy the night before, and he stayed with us for a week. His PawPaw picked him up yesterday morning. I was sad, but also very tired and ready for sleep and a chance to regroup. I have no doubt he will return soon, as his family will need a break.

I am so thankful for my husband. I truly do not know how single mothers do it. I got pretty good this last week at sneaking in a shower and other tasks, but there were times when it was great to know that someone else was "in charge" while I stole away to the water closet for a few minutes uninterrupted! I learned quickly that some "play time" in the bath tub in the morning could buy me enough time to dress and "put on my face," wipe down the bathroom, and maybe answer an e-mail or two on my laptop. Night-time baths included time to play while I did my Bible study and answered more e-mail.

One morning, while my husband and Timmy ate breakfast, I slipped away and showered. When I returned to the table, my husband said, "I'll watch him while you shower." He was astounded that I already had managed to accomplish this.

Timmy is not always a good napper or night-time sleeper. He sometimes has night terrors, and we count ourselves lucky that he has begun to sleep through the night - although that is relative, since "through the night" means about 6 or seven hours. So if he goes to bed at 9:30 p.m., he is awake by 5:30 or 6:00 a.m. at best. Yesterday morning, he was awake at 4:15 a.m. We watched "Jack's Big Music Show" in bed for an hour, then we went outside to play with his tricycle and blowing bubbles. However, he was not in a good mood... and not wanting to wake the neighbors - or my husband still sleeping in side - I decided we should "get outta Dodge." So we loaded into the car and went to Wal-Mart to shop for groceries.

I was barely dressed... Timmy was in his pj's and sandals... and I didn't care. I slapped on a little powder from the compact in my purse, added some lipstick... ran the comb through my hair, and we headed to the store. Timmy slept on the drive there and back and was a perfect angel while we were in the store. I unloaded the car at home while he continued to doze in his car seat. We were back inside by 7:30, with the groceries unpacked and breakfast underway.

Thankfully, my grandmother is doing so well at her new apartment in the Assisted Living Facility (ALF), so I was not having to worry about her well-being and safety this past week. Timmy and I visited her twice, and both times, she was doing incredibly well. She pushed Timmy around the facility on her walker (which has a bench seat), and we printed pictures of her new great-great-granddaughter for her to share with her friends. One nurse said she had shown them to everyone. I am hoping that she will get to meet Zola in person soon.

As luck would have it, I had scheduled an appointment at the hairdresser for the day after Zola arrived. Since those appointments are like gold and hard to secure, I asked my mom to watch Timmy while I got my hair cut and colored. She gladly obliged. That morning, my husband and I drove Timmy to the hospital in a city 30 miles away, so that he could meet his baby sister. Then we returned in time for me to take Timmy to my mom's before my appointment. Luckily she only lives a block from the hairdresser's salon.

The next day, Mam-ma had a six-month checkup scheduled with her cardiologist. The visit was to happen at our local hospital, which is about 5 minutes from our house. Again, there was no way to change the appointment. But this time, my mom was not available to help. My husband rearranged his schedule to watch Timmy, and the appointment didn't take that long - and we were able to mark that off our list!

My grandmother was "dressed to the nines" and looked like a million bucks when I picked her up for her 10:00 a.m. appointment. This was her first visit with a new cardiologist - an associate of her previous doctor who actually sees patients at our local hospital's outpatient clinic, which saved us the 30-mile trip (one way) to see the original doctor. None of this new guy's staff could believe that Mam-ma was 98. She looked so good... was spry and able-bodied, and she hopped up on the scales to be weighed - she'd lost a pound and a half.

Why is it that doctors feel they simply must find a problem? My grandmother is doing fantastically well. Her left ankle was slightly swollen. The doc noticed it and made mention - which opened up Pandora's box with Mam-ma. I tried to discount the swelling - it wasn't as bad as she has many other days, and I surmised she had probably eaten something salty. The doctor launched into a campaign for Mam-ma to go on a low sodium diet and be more active. Goodness, if she were any more active, we'd have to take extra vitamins to keep up with her!

Mam-ma told the doctor her food was "terrible" - no seasoning. For the record, my grandmother salts her food before she ever tastes it. Anyway, the doctor finally asked, "Do you see your family physician regularly?" "No," Mam-ma replied. I explained that we do not see him unless she needs to... and she is remarkably well. BUT... the staff at the ALF is in contact with him, and he was consulted when she got the stomach flu recently. I also pointed out that, while most residents were in bed at least 4 days to a week with the bug, Mam-ma was back eating in the dining room within 2 days... a testament to how well she is doing these days.

The doctor asked if Mam-ma's kidney function had been checked recently. "No," she told him. "Yes," I countered.. "you had a complete physical in January to prepare to enter the ALF." Oh... she forgot. The doctor said, "Well, Mrs. Chandler, since you are doing so well and seeing your doctor here regularly, let's just see you again in six months and not change anything now." He hinted at upping her Lasix for the ankle swelling, and I told him that this is how we get into trouble - when doctors start tinkering with her meds. That's how she ended up depleting her potassium, falling, and staying 3 months in the nursing home a few years ago.

The doctor asked, "Do they check your blood pressure regularly at the ALF?" "No," Mam-ma told him. "Yes," I countered... "they do... at least once a week." The doctor said, "Okay, so since they are keeping close tabs on you there, let's just see you in a year." Mam-ma slumped her shoulders, looked forlorn, and said, "Well, don't put me off like that." He laughed and said, "Okay... come back in six months. I just don't want you to spend all of your time going to doctors." She looked at him and wagged her finger and said, "I don't go to doctors unless I have to!" I just didn't comment.

While we were waiting, we visited with friends of my grandmother... the parents of a schoolmate of mine. Both are in their eighties and are declining in health. On the way back to the ALF, I told my grandmother that my friend is really struggling with the care of her parents. Her father is very ill, and her mother is lashing out and not always cooperating. Mam-ma never missed a beat... she said, "Well, Leon is just like me. All his life, he's just done whatever people told him to do and not complained. He's just gone right along with it." I had nothing... given Mam-ma's history, what do you say to that?!

I told my husband that I am so grateful that Mam-ma is settled and safe. If this had happened even six months ago, I don't know what might have transpired. I know that Mam-ma is less self-absorbed now... and less demanding. She is busy, involved and active... and thinking of others. And she has been a great sounding board for me in recent weeks as I've experienced some personal frustrations.

Meanwhile, my"birthday buddy" - a dear lady who shares my birthday and will be 93 in a few weeks - has moved to the ALF. Physically, she is not doing as well as my grandmother, but Mam-ma is doing all she can to encourage her and to comfort her daughters, who are struggling with her decision to make this move.

So this has been a week of blessings and new experiences... and lessons learned. I've learned that I can still multi-task... and I am glad I've been working out for the last few months! Timothy is a tall 34.5" two-year-old who weighs 29 lbs. - and my back would be screaming if I had not done strengthening exercises in the last few months.

I've learned that I can survive a trip to the store with a kid in his pj's and myself in some semblance of disarray - and that it's okay if the house is a wreck and the dishes don't get done but once a day. I've learned that it's okay for a 2-year-old and his great-great-grandmother to share a Three Musketeers and get melted chocolate all over both of them... and old people need to see babies more often. Timmy is always a hit at the ALF... and Mam-ma loves to show off how handsome he is!

I've also learned how precious a good night's rest can be. I've slept and napped and rested most of the last 24 hours since Timmy went home... because I know that Mam-ma will be calling - and Timothy will be back... and I need to be fresh and ready for both!

The Scoop on Poop!

2011-05-26T18:31:00.000-05:00

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!

The Scouts Were Right - Be Prepared!

2011-05-25T13:01:00.000-05:00

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!

Sometimes Being the "Mom" Is Harder than Others

2011-05-15T00:03:00.000-05:00

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!

Happy Mother's Day!

2011-05-06T12:12:00.000-05:00

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 http://www.amazon.com/ 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!"

Who Goes First? Reflections on the Seasons of Life

2011-05-03T12:42:00.000-05:00

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 fiancé, 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?

Where's the Beans?

2011-04-16T14:24:00.000-05:00

Einstein said the definition of insanity was repeating the same thing again and again... and expecting different results. Maybe that explains why we have told my grandmother more than once that everything is gone from her house - sold/shared/donated - and the house itself is under contract to be sold... yet she continues to ask where certain things are. This is the same person who said as we packed the things to take to the Assisted Living Facility... "Just stick a match to the rest of it!"

So one afternoon last week, Mam-ma left a message on our answering machine... "It's Mam-ma... I was a wonderin' what y'all did with the stuff in the drawer of that cabinet out on the back porch." Click. That was it. I called her back, but she was out of her apartment, so I left my own message. "I am not sure what you are wanting from the drawer, but everything is gone. There is nothing left in your house, and it should be sold in the next couple of weeks."

That evening, Mam-ma called again. "Well," she said, "I was a lookin' for them bean seeds that were out in that drawer. What did y'all do with 'em?" I told her I had no clue... they did not come home with me. Now, I vaguely remembered my mom's husband, Lee, coming into the kitchen with an envelope or jar of beans and asking me about them... and I'm pretty sure I told him that there was no telling how old they were - and to toss them! Mam-ma continued. "Well, who got the things in the freezer?" "We divvied them up amongst us," I told her.

"Well, there was another jar of bean seed in the freezer. I've called my friends Leon and Wanda - they give me that seed, but they don't have any more. Their daughter Lesa drove to Clinton last week and got some for them... but I'm not a goin' to Clinton." Her voice trailed off pitifully. I told her I was not going to Clinton, either. Clinton is a 45 minute drive across the lake from our community. I told Mam-ma I was sorry, but the bean seed was gone... like everything else. "Remember," I told her, "you picked out everything you wanted to take and keep, and we dispersed the rest. I didn't know you would want bean seed."

It turns out that the maintenance man at the ALF is helping Mam-ma and some of the residents make a garden... and Mam-ma apparently at least thinks she is "large and in charge." She told "that girl" (I think she means the administrator), that they needed to plant pole beans, and this person said if she had some seed, James (the maintenance man) would plant them. So Mam-ma was on a mission to find some bean seeds. And apparently the ones she got from Leon were akin to gold.

When I related this story to my mom, she said, "I know what she is talking about. Leon brought her an envelope of bean seed one Sunday, and he handed them to her at Sunday-school, and she quickly locked them inside her purse like they were gold coins!" Of course, we found several jars and envelopes of seeds - some marked, some not - and we had no clue what some of them were - or how old they were - or even if they would grow anything. So I am sure many packets were tossed in the garbage - not out of malice, but because we had no idea what else to do with them.

So the following day, my mother e-mailed me and said she had related this story to her husband, Lee, over lunch. Lee stopped eating and said, "I have some seeds... if I can remember where I put them. I'm not sure whether they came from Polly's or my brother's." Lee's brother died a month ago in California, and he and my mom spent the previous month parked in his driveway in their RV... helping with the care of Lee's brother and the subsequent cleaning of his house when he passed.

Mom said she went to walk her dog, and when she returned, Lee had found the seed and was on his way to Southridge to give them to Mam-ma Polly. Mom said, "I saw the envelopes on the kitchen table - and they were labeled in what was clearly Mam-ma's handwriting. And I recognized one envelope as the one that Leon had given her at church that Sunday - it said "rattlesnake beans." I remembered then... Lee had come into the kitchen and asked me about "rattlesnake beans!" I told him I'd never heard of them... no telling how old they were or where Mam-ma got them... and to just toss them. He told Mom... "I don't always listen well!"

So now Lee is the "Golden Boy" who saved the bean seed. However, he will also be the one Mam-ma asks, "Whatever happened to such-and-such?" Surely if he saved the bean seed, he must have saved other things!

As a footnote to this saga... yesterday, I went to an estate auction. As I was leaving, I saw Leon and Wanda approaching... and as I neared my car, I saw their daughter, Lesa. I said, "Oh, I have a funny story to tell you!" I began relating about the bean seed, and she said, "Yes, I know... I've got to dig through the freezer this afternoon and see if I can find another packet of seed for Polly." I stopped her... "Oh...no, no, no! You don't need to do that... Lee had saved the seed, and he's already delivered it!" Lesa was thrilled. And I was so happy at the Divine Intervention that caused us to meet, because I rarely see my childhood friend. It had to be a "God thing!"

So we laughed about our parents/grandparents and caring for them, wiped our brows with relief that all is well with the prized bean seeds, and went our separate ways. I told Lesa, I pity the people at Southridge who are planting that garden, because they will never "garden" to suit my grandmother. If you've read this blog for any length of time, you know how she is about plants, flowers, and gardening. James handles Mam-ma pretty well... he's already somewhat "gotten her number". But when it comes to gardening, things are on a whole other level. I hope he doesn't "rurn" it... but more than that, I hope Mam-ma doesn't cuss at him! It may be a long, hot summer!

Chocolate, Heaters, and Two-year-olds

2011-04-13T12:02:00.000-05:00

Everything is going well with my grandmother. She made a trip to Wal-Mart with the Southridge activities director and bought herself some sunglasses and a hat for her walks outside around the facility. The staff told me she had spent time yesterday morning in the garden... although she didn't mention it to me at all! I'm learning to function more in her "world" when I am there and leave it at that... so far, so good!

Yesterday, I visited Mam-ma, filled her bird feeder, and took back some clothing I had laundered and ironed for her. When I arrived, she was not in her room, but residents nearby told me she was in the "library" area near the front entrance. As I made my way there, I heard the unmistakable talk and laugh of Timothy. My sister had brought him over for a visit. I found the three of them there... my sister and Mam-ma sitting in chairs, with Timothy perched atop Mam-ma's walker (it has a little seat). He was looking at a little book made out of fabric with Mam-ma. We visited for a minute or two, and then Mam-ma insisted we return to her room.

I had noticed when I was outside filling the bird feeder that Mam-ma's heater was running. The temperature had risen to the upper 70s, and it felt quite nice outside. Inside Mam-ma's room was another matter altogether. It was very hot, of course... and she didn't seem to notice, sitting comfortably in her chair wearing a blouse and a jacket made of sweatshirt material!

Timothy noticed a bowl of peppermints on the coffee table. Mam-ma told him he couldn't have one, but she would find something for him. She got a fun-sized Three Musketeers bar out of her drawer and unwrapped it for him. He started eating... the chocolate started melting. As he navigated the small room fingering Mam-ma's knick-knacks, she admonished, "Don't let him get that candy on the quilt!" Yeah, right! I maneuvered him away from the bed, and I opened drawers until I found a roll of paper towels - quickly darting to the bathroom to moisten one. I returned in time to wipe Timmy's hand and the two drawers he had just smeared with chocolate!

Back to the bathroom with Towel #2... and when I returned, Timmy had switched hands, and now the OTHER hand was covered in chocolate. My sister finally retrieved the rest of the candy bar and helped Timmy finish it, so we could clean up and be done with that. I learned later that Timmy gets candy every time he visits. I said to my sister, "Well, DUH... he knows to ask for those peppermints so he will get chocolate!" She said she supposed so. I'm quite sure of it... he's smart enough to figure out that one!

Chocolate and heat and all things considered, it was a good visit. We sang and "performed" for Mam-ma... and she laughed and clapped at Timmy's antics. He grew restless, and Mam-ma told me to "Put him on that walker and push him up and down the halls." I did, while she and my sister visited. And I told my husband later... the residents LOVED it. They were gathering in the hallways in anticipation of dinner in the dining hall, and each time we passed them, they oohed and ahhed over Timothy - "Bring him here! He's so precious! Come here and let me have a look at him!"

We forget that older people seldom see a baby or a small child... and they miss them! And Timmy was fine with all of the attention. He gave a man named Charley a "high five" - he smiled and jibbered for a couple of ladies I know, and he waved at everyone.

These visits are good for all concerned - they thrill my grandmother... AND her fellow residents. They give us a buffer - something to focus on other than my grandmother's complaints. And they teach Timmy to love and respect the elderly. In all, I would say that while the visits had elements of a rodeo, it was still time well spent.

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Creating Balance in Your Sandwich... How to Avoid Doing the Wrong Things

2011-04-04T14:05:00.000-05:00

The sale is over... and the final clean-up has begun. I have to box up what did not sell and get it ready for the local thrift store... and then meet a driver who will come to collect the items. That should finish my portion of the business with regard to Mam-ma's house and belongings. Lest anyone think that this frees me of any responsibilities, there are still monthly bills to be paid... so that involves a checking account... and almost daily phone calls from my grandmother with something she needs... forgot... doesn't like... or has just remembered.

There are still "wrinkles" to smooth - like a mix-up with the pharmacy used by the ALF and over billing... and a few other little things... but nothing major. This morning our power went out during a thunderstorm and was off for two hours. I was so thankful that my grandmother was in a place where someone could attend to her and handle such matters... and I wasn't worried about her... or the contents of her freezer melting, and other problems.

Last week, I attended my first "Family Council" meeting at the ALF one afternoon. The meeting ended up lasting two hours... but it was time well spent. The speaker was an R.N. who is affiliated with Hospice, and the focus of her presentation was on Hospice care for Alzheimer's patients. However, the information was appropriate for anyone caring for an elderly person... particularly those with dementia or the onset of dementia.

I learned several things about Alzheimer's patients that I did not know... how they often become obsessed with sorting, and many of them spend hours every day sorting their clothing, packing, and making little piles of their belongings. The nurse and the ALF administrator said the biggest hurdle with some of these obsessive behaviors is getting the caregivers and family members of these residents to "let it go" and be okay with the disarray in the room and the annoying behaviors. Another common thing is dressing in multiples... wearing more than one shirt and/or pair of pants. It doesn't hurt the patients, but it makes some caregivers and family members nuts! And learning to let this be okay is vital to the mental health of all parties!

I also learned that, even with my grandmother, when we are at the ALF, we must operate in their world. If my grandmother is focused on something she views as a problem... like what happened to all of her stuff... it's my job to gently change the subject and redirect the focus. The administrator said that one day she entered the room of an Alzheimer's patient who was packing, and the patient said, "I'm going home today." She replied, "Great! Come have dinner with us first - before you leave." By the time the resident ate, he/she had forgotten about the move. If I can learn to avoid conflict and argument with my grandmother and gently redirect the conversations when they become argumentative or controversial... then leave it at the door... we will both be happier!

I relayed some of what I learned to my mother, and she said, "Yes, I did it all wrong with my mother." And while I'm not sure that is totally true, she did argue with my grandmother a lot. When Grandmother saw my grandfather (who had been dead for years) in the dining hall "with another woman," and Grandmother insisted she had read about their liaisons in the local newspaper, she shouted, "I will not have this!" And my mother insisted that she was NOT seeing Grand-dad... and that this was totally ridiculous. They argued about this for months. My grandmother had Parkinson's disease... which produces a dementia similar to Alzheimer's. She thought her baby doll was real... and she called my niece Samantha to almost her dying day. My niece's name is Jasmine. There were dozens of these little quirks... and admittedly my grandmother was always quirky... but they escalated as she declined... and we did not handle them well much of the time.

Had we learned to redirect the conversations more and steer Grandmother to more pleasant and less confrontational topics, we might have had happier visits quite often. There's more to this story, but every little "tool" helps to create a happier environment, so I was glad to gain a few strategies from my meeting... and I hope they will help others.

Toward this end, here are a few other suggestions that were presented in a hand-out we were given from the National Caregiving Foundation. I have selected a few that I feel apply to any elderly person - not just those with Alzheimer's.

Your care-recipient will be upset about what the future holds. He needs to be reassured that the family will see that he is cared for. He needs to continue to feel that he is a valued family member.
Be very vigilant about keeping him as involved as possible in the family's activities and decision-making; this will help him to cope with his own anxiety.
Don't talk about his memory loss in front of him and certainly not as though he is not there; such behavior on your part, can be very upsetting and demeaning for him.
Don't allow him to become withdrawn because he can't remember short term events and conversation very well.
Don't be demanding about normal daily activities. An example is letting him dress himself even though it takes time. Be patient; not critical. You can assist him by setting his clothes out in the order of putting on.
He will almost certainly still be able to manage simple chores which do not tax his memory, so involve him; it will help him to maintain his dignity.
If he tends to get lost when he goes on errands put his name and address in his wallet to make him feel more secure.
In the event that he forgets the names of people he knows well, prompt him discreetly, to help him save face.
Don't confront him with complex, challenging decisions or questions; if you do, you will almost certainly add to his confusion.

The website for the National Caregiving Foundation offers lots of good information and support. I encourage you to check them out for yourself by visiting the website. And remember... it's all about balance. Last week, in the middle of all of the chaos of the sale and getting things in order, I took an afternoon off to hike six miles with my husband and share a picnic lunch on a sunny spring day. A few days later, I set aside everything to spend the entire day playing with our little Timothy... hiding Easter eggs, reading books, working puzzles, singing and dancing, and appreciating the wonders and excitement of a 2-year-old's world.

Thinking about that time made the hectic days that followed so much more manageable. I hope you are finding ways to create balance in your "sandwich!"

ESP and Old People

2011-03-28T22:51:00.000-05:00

It has been four weeks today since my grandmother moved to Southridge. We've just about got everything priced for the big "moving sale" this weekend, and it looks like my mother may have a buyer for the house. Things are progressing well, and the proverbial "elephant" is disappearing... one bite at a time.

Last week, my sister spent her two days off helping me sort and price things for the sale. My mother and her husband came and helped during those days, also. It's a huge task to sort, clean and tag everything, and we have a few more hours of work to do before the doors open, but I think we are about ready. I know my sister and I were sore and tired after spending a couple of LONG days on our feet, digging through drawers, and scrubbing really dirty items from the garage and storm cellar.

In the middle of the first day, shortly after my mother arrived to help, her cell phone rang. It was my Mam-ma. "I've fallen out of the bed," she told Mom. Mom asked her if she was hurt, and had she called for her nurse? When she hung up, she said that my grandmother's first word was "Debbie?" "No, you've reached Arline - you called my cell phone." Mom asked, "Do you think I should drive to Southridge and see about this?" I told her no... I wanted to wait and see if Southridge would contact me. "Let's give this system time to work," I told her.

Very soon, my cell phone was ringing. The R.N. on duty at Southridge assured me that Mam-ma was fine... nothing broken. She said that Mam-ma slid out of her bed as she tried to get into it for an afternoon nap, and she hit her hip and her forehead on the night stand. The nurse said "I have no idea how she managed that!" She said Mam-ma would have bruises and be sore, but otherwise she was fine... and mad about her bed being too high. She said that Mam-ma told her, "I've already called that guy who sold me the bed and told him it's too high!" I thanked the nurse and hung up.

My second call was from Mam-ma. "I've fallen out of my bed." Yes, I know... the nurse called me...and she said you would be okay." "Well, this bed is too high, and I've called Max (the furniture salesman) and told him, and he's a gettin' me a shorter one." I could not believe what I was hearing. "You've called Max about the bed?" "Yes... a few weeks ago... and I just talked to him, and he said he's ordered me a new one, but it hasn't come in yet." I said, "Mam-ma, you should not have called Max... you need to let ME handle these things." She starts to blubber and cry... "Well, I didn't know what else to do... I told you the bed was too high." "No... you told everyone BUT me. You have not mentioned the bed to me since the day you moved in."

She continued to cry... "I wish I had never moved down here." I looked around at her house... piles of items to sort... more piles priced to sell... "I just wish I could die," she told me. I stopped her quickly... "I will NOT listen to that!" I told her firmly. "You've had a scare, and you need to pull yourself together and calm down. Get into your bed and rest." "Well... if I can get in there." "You've gotten in for three weeks now... I think you can get in a few more days... and if you can't get in without help, sit quietly in your chair." I hung up... my blood pressure rising. We discussed the possibility that Mam-ma sensed that we were working on the sale of her things... my maternal grandmother had a massive stroke the day before HER estate sale that resulted in my mom holding a bedside vigil over her in a Little Rock hospital. Do old people really have ESP about these things?

To make a long story shorter, I talked with my friend, Max, at the local furniture store. Yes, Polly had been calling for three weeks, telling him that her new mattress set was too tall... and he had ordered her a thinner box spring. I was so embarrassed. I apologized and told Max that this was the first that I was informed that there was a problem with the mattress set. He assured me it was no big deal... although he and his son later admitted that the discarded box spring will have to be discounted and cannot be resold as "new." However, they would not hear of me paying them for taking a new mattress to Southridge, changing it out and remaking the bed... even when I learned that Max's son had to wait while Mam-ma took her bath!

I tried to stress to Mam-ma that she must let ME handle such things in the future and not be calling all over town. My sister and I stopped by to see her later that evening on our way home, and she was bruised and talking up how sore she was... but the nurse told us that she managed to get herself up, walk around the room, and call Max at the furniture store BEFORE she rang her alert buzzer for a nurse to come to her aid! The nurse said, "I knew right away nothing was broken."

So my mother's husband spent the past weekend in a Little Rock hospital after experiencing a urinary blockage. After spending 2 nights in the hospital, he was released on Monday and helped us sort, price and move things on Tuesday and Wednesday. He saw his urologist on Wednesday and thought things were fine... but Wednesday night, he had another flare-up and returned to our local ER for medical assistance. Now my grandmother says, "Well, I've had trouble with my kidneys for over a week now, and I can't pee good."

If you have followed this blog, you know that a summer or so ago, we visited the doctor because Mam-ma "couldn't pee." He assured her that her Lasix was doing the trick, and by early afternoon, she had gone all she needed to go for most of the rest of the day. Nothing has changed. Tonight on the phone she told me, "Well, one time that nurse came and I told her I couldn't pee good, and she talked to the doctor, and he told her to give me another pill." (I have no idea what nurse - or when this occurred, but it was nothing recent.) She continued, "I don't think this nurse is giving me all of my medicine right." I assured her that when we visited her doctor in January for an evaluation for the move, he reviewed all of her medications, and HE was the one who sent the medication orders to Southridge and told them what to give - and when to give it! And yes, she still gets two Lasix pills a day... that has not changed!

I am quite sure that Mam-ma is having these problems because Mom's husband is having trouble. There is virtually no ailment known to man that my grandmother has not experienced. All you have to do is say, "I have such-and-such," and she says, "Oh, I know all about that... back in so-and-so year, I had the worst case of that and I've never been so sick in all my life!" So I am thinking that when Mom's husband improves, Mam-ma will, also... or the new ailment of the day will arise.

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Saturday, I talked to Mam-ma shortly before she headed to the dining room for dinner at 5:00 p.m. About 5:30, I began my daily workout routine. The phone rang. I figured either my husband would get it or the answering machine would pick up... and since Mam-ma had already called, I didn't think it would be her. A little while later, the phone rang again. I was still working out and didn't answer. Both calls showed on Caller ID to be my grandmother. I tried to return her call, but the line was busy - and then she was gone to tea. So it was after 8:30 when I finally reached her.

"Did you call again earlier?" I asked innocently. "Yes," she said... and she began to cry and blubber. "I wanted to apologize to you." "For what?" I asked. "For calling about that mattress. I don't want you to be mad at me, but I didn't know what else to do. That mattress was too tall." I assured her I was not mad... it was over and done... the new mattress was in place, and she needed to move on... I had! She continued to sniffle. I reminded her to let me handle these things from now on, but to forget about the mattress and just enjoy it.

The next day I learned that when I did not answer my phone, Mam-ma called my sister and cried to her... she could not reach me, and she wanted to apologize. My sister talked very frankly to her (my sister can say things to Mam-ma that I could never get by with saying!) and told her to stop her crying and move on... that nobody was upset, and it was over and done! The crying spells are becoming more frequent and irrational... and we can see that my grandmother is declining mentally and emotionally.

On a funny note... before my grandmother moved to Southridge, I noticed one day that she had two fairly new hand-held mixers in her kitchen. I used my maternal grandmother's hand-held Sunbeam until the motor literally began to smoke and the cord shorted out... and then I bought a cheap mixer at Wal-Mart. Mam-ma's looked much nicer, and she told me, "Take whichever one you want." I selected a six-speed GE model.

Saturday, I made banana bread, and I used the "new" mixer. It worked great, but halfway through the mixing process, I smelled something burning - and it seemed to come from the motor. I also noticed something rattling in the mixer. So once the bread was in the oven, I got my screwdriver and dismantled the mixer. First I had to soak and scrape crystallized sugar from the exterior near the small slit-like vent openings. Once I got the mixer apart, several "rocks" of crystallized sugar fell out, and I chiseled a chunk of crystallized sugar the size of a large marble from the interior. AND... no lie... there were TWO peanut halves that fell out of the mixer! I have no clue how in the world those peanuts got inside that mixer with only those teeny vent slits... but I had to laugh. Only my grandmother's mixer would contain peanuts and sugar! I cleaned the mixer and reassembled it, and it runs like new... minus the peanut/sugar rattlers!

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I know I said that I would start to utilize this space to offer helpful suggestions and tips for coping with the challenges of being a part of the Sandwich Generation, and I do want to honor this promise. So my suggestion for today is to investigate long-term care insurance. This can be quite costly... but if the day comes that you or your loved one needs it, you will be so happy to know you made provisions. Assisted living facilities, nursing homes, and even in-home care can be so costly. There are dozens of options for long-term care coverage, but there are plans that even will cover in-home assistance... everything from medical aid to housekeeping, cooking, transportation, and general care.

Start by talking to your insurance agent and find out if his/her company offers options. Then query a couple of other agents about their options and compare them side-by-side. You can also do a Google search for long-term care insurance and compare plans, read reviews by consumers, and basically do your homework before plunking down hard-earned cash for the coverage you desire.

I've know far too many people who get to a time when extra help is needed, and they either find themselves totally unprepared and unable to afford the services, or they can't liquidate their assets fast enough to pay for the help that is needed. Don't get caught in this quandary! Start investigating long-term care insurance now... hopefully well before you will ever need it!