A childhood friend and I have been corresponding via text and e-mail for more than year now, and our conversations have involved several twists and turns. But they keep circling back to what he refers to as "the elders" - namely, a handful of senior citizen family members that he attends to as time and needs arise. Indeed, we are at "that age" where there is no shortage of "elderly folks" who need our attention.
Grandma E and her son (my husband, Greg)
My parents and grandparents are longer living...but my mother-in-law is still with us. We are blessed that she is able to live alone in her own home, even 8 months past her 90th birthday. She no longer drives, but unlike many children of seniors who have stopped driving, there are few requests for a ride anywhere. My husband (her youngest son) takes her wherever she wants to go...which generally consists of a semi-weekly trip to the hairdresser and the grocery store - and maybe to church on Sunday.
My great-nephew, Timothy, with my Mam-ma Polly and my mother-in-law, who the children call "Grandma E."
Even though I am not directly involved in the daily care of an "elder" at this point, many of my friends and loved ones are. I listen as they voice their concerns and frustrations. I hear their tales of parents who are stubborn and refuse to admit that they need in-home care - or to allow the caregivers to assist them with personal care, such as bathing. I understand completely when worries about falls, mixed medications, and failing memories are voiced. I totally GET IT!
Just like countless others, I've "been there, done that." And my mantra is, "You are not alone." I know that eldercare can be incredibly lonely...and if you are caught in the middle of a "sandwich" that includes children AND seniors - well, your world is likely something of a circus on any given day! This doesn't even allow for the fact that you may be juggling a job, a marriage, civic and church responsibilities, and more. You may be dealing with your own health concerns. It's enough to make anyone run screaming into the night!
This is partly why I started "The Deli" blog when my paternal grandmother was still living and in my guardianship. I wanted this to be a place where I could "vent" and share my frustrations. More importantly, I wanted this blog to be a venue where others could read about our experiences - and Mam-ma's antics - and see that "Hey! I'm not the only one in this boat! My parents/grandparents do a lot of the same things and have many of the same issues!" I wanted those who are juggling several "balls" at once to see that we CAN survive these years...and even remember them with a bit of fondness - not in what was happening, but rather, that we did a decent job of surviving!
I have toyed with the idea of turning this blog into a book...and I may still do so at some point. It would be great to be able to hand my friends and others a book that chronicles my journey and say, "Here...this might help you."
Meanwhile...a similar book does exist. My late mother wrote a book about HER experience with my maternal grandparents, who both spent their last days in a nursing home. Neither one of them wanted to be there, of course. NONE of us wanted this. But sadly, this is sometimes the only alternative. And Mother's book has helped countless people cope with this decision and the resulting experiences.
If you would like to order a copy of When Heads and Hearts Collide, I have plenty and would be glad to send you one. I am asking the minimal price of $10 postage paid...and you can order via PayPal by clicking this link or the one on the sidebar.
My grandmother is buried in a rural family cemetery. A week or so ago, my husband took a motorcycle ride and stopped by the cemetery to check on things. He observed that the once-beautiful floral sprays that were heaped atop Mam-ma's grave were now dried, brown and ugly. So tonight, we drove out and gathered everything in garbage bags and cleaned up the graves of my grandparents, my dad and my brother. I would say this is one of the last remaining tasks... but there seem to be "loose ends" to tie pretty much every week yet. My grandmother's funeral was seven weeks ago today... maybe that's to be expected.
My mother (known as "Granny")
and Timothy - Christmas Eve 2012
I never really thought that I would discontinue this blog when Mam-ma was gone... and now I am sure of it. As we pay the last bill and write the last thank-you to summarize her earthly life, our own mothers are both telling us that they "feel old." My mother just celebrated her 74th birthday, which I consider "young." However, she has several health issues, including COPD and diabetes... and she is beginning to develop some neuropathy in her hands and feet. My husband's mother will be 87 in June, and in recent months she suffered a mini-stroke... and that just about correlates with her comment that "...in the last six months, I've suddenly felt old."
My husband's mother (known to the children as
"Granda E")... with Nathan - Christmas Eve 2012
So I don't know what turns the next stage of our journey will take. But I have learned that we are a lot stronger than we think... and we'll be fine. I also hope that some of you will share your own stories with me, so that I can demonstrate by example that we truly are not alone. Two of our dearest friends have just placed his parents in an Assisted Living Facility, and now they are anticipating the arrival of their first grandchild in October. Now there's a "sandwich" in the making!
My niece and I had a yard sale this weekend, and a lady purchased a sleeper sofa from me, explaining that "we're downsizing." As her husband and teenaged son placed the sofa on their trailer, she asked if I happened to have a twin bed for sale. She said, "We've just moved my grandparents into our home. My grandfather is in a hospital bed, and we want to keep them together. There isn't room for more than a twin bed for my grandmother, so we are hoping to find one." If only I could have manufactured one on the spot, I would have given it to her! I felt an instant bond with this woman...I can't imagine what her "sandwich" must be like on any given day, but I know she faces big challenges!
So we will move and grow and change with the circumstances. I figure we will be the "filling" in a sandwich of sorts for several years (hopefully). We'll just have some variations in the "bread." I know that we can handle this, with God's help, and the support of each other. After all, we're all in this together at The Deli!
Yesterday, I attended a quarterly Family Council meeting at the ALF. Dr. Kimberly Curseen, Medical Director of the geriatric palliative care program at the UAMS Reynolds Institute on Aging was the speaker. I'll be honest... I almost didn't go. And as Dr. Curseen began to speak, I wondered why I was there. It wasn't her fault. But the discussion centered on Alzheimer's patients and their care... and dementia. However, as Dr. Curseen began to explain the stages of Alzheimer's and dementia... and the various kinds of dementia... she hit on several things that resonated with me and my situation with Mam-ma Polly... and she gave me several insights.
The first thing that hit home with me was Dr. Curseen's comment that "one of the last things to go" in dementia patients is the "social graces"... the ability to smile, say "Hi! How are you?"... or to shake a visitor's hand. She said this is why patiens will light up when someone enters the room and speaks to them... and this is 100% Mam-ma Polly. Later in the discussion, I said to the group, "If one more person tells me that Mam-ma 'still has that sweet smile,' I think I may scream." Mam-ma will die with that sweet smile. It's all she has left! The administrator chimed in and agreed... "Even when Polly feels really bad... like today... she is still smiling." Another family member attending the meeting asked, "Oh, is that the sweet little lady who is always peddling around in her wheelchair... the one with the white hair?" That's my Mam-ma Polly!
Later, Dr. Curseen talked about how difficult it is to take Alzheimer's and dementia patients out of their routine. She mentioned that once-frequented restaurants may now be too crowded, noisy and confusing for the patient. She suggested that any visits to places outside of the facility be done at off times... with small groups... in quieter settings. This really resonated, too. Mam-ma did not do well at all the last few times we took her out to eat. And the ALF administrator added that they always see a lot of behavioral problems with residents around the holidays... when families insist on taking them out of the facility and away from familiar surroundings.
This was another revelation for me... and I thanked the administrator for speaking out. I told her that I truly grieved over the decision this Christmas NOT to take Mam-ma out and try to get her to our house on Christmas Eve. While I knew in my head that we could not physically get her inside - she didn't even make it off the driveway last year! - I still felt guilty. And then someone asked me, "How was it the last Christmas she was with you?" "Terrible!" I replied. "She slept most of the time or looked and acted miserable... and she was ready to go home before dark." "So there's your answer," this person told me... and she was right. And now I had reinforcement from the facility staff. Mom and her husband ate lunch with Mam-ma on Christmas Day... I was there for the facility dinner earlier... and a day or so before Christmas. And Mam-ma was fine... probably happier than the last Christmas she spent with us.
When the doctor finished her discussion, the family members began to talk and share. One lady, a retired nurse for the state hospital, told of her husband, who has Alzheimer's. She said she should have seen the signs earlier, but she didn't... and maybe she didn't want to. The doctor very lovingly reassured her that "We see the signs when we are ready. You did nothing wrong. When the time was right, you made the move." This sweet lady spoke so lovingly of her husband and how she visits him each day... and how hard it has been.
Another lady spoke of her mother, who is apparently the QUEEN of guilt trips. She told of visiting recently with her sister. Her mother lay in bed repeating, "Oh, LORD, help me! LORD, help me!" Finally, the daughter said, "Mother, what do you need? We're right here! Why don't you let us help you?" The mother replied, "Because I can trust HIM!" We all had a laugh, but the woman tearfully said, "It's been four years now... when do I stop feeling guilty? I can't even enjoy doing the things Mother used to do, because I feel so guilty that she can no longer do them."
I reminded this lady that we honor our loved ones when we do the things they can no longer do - or at least I believe we do. I told her that I can make my grandmother's sugar cookies and homemade rolls, and in sharing them with others, I feel like I carry on her legacy. Now, this woman's mother may not admit that to HER... but the administrators assured her that out of sight, this woman is adorable and pleasant - that she truly has mastered making her daughter feel guilty... and delights in doing so! And this may never change.
What can change is this woman's attitude. She can live in the world of her mother when she visits, and leave it at the door. I know it is hard, but you can do it if you work at it. We also all agreed that talking and sharing helps tremendously. I pointed out that I believe if anything positive can come from our experiences, it is that we share them with others who are going through a similar situation, so that they know they are not alone.
In the end, the doctor told us that statistics show that the stress level of caregivers with a loved one still at home versus that of a caregiver who has admitted their loved one to a facility is markedly similar... no real difference. I found that tremendously profound. I don't think I am nearly as stressed now that Mam-ma is at the ALF... but if I add up all of the trips and meetings and phone calls and struggles over laundry and diapers and wipes and medications and falls... the wondering if/when the phone will ring... the not feeling comfortable to leave town because this might be "the day" that we are needed... I see that the stress is still here. It's just packaged a little differently and distributed in spurts more than day-to-day (and sometimes hour-to-hour) like before.
So I came away from the meeting with a sense of community. We are all in this boat together... and we have stories to tell... people to encourage... and at least one for each of us who desperately needs us to reassure him/her that they are still loved, valuable, and honored. For the foreseeable future, this is my task. I pray for the patience to see it through.
Meanwhile, I need to throw in a happy thought. Timothy started HIPPY this week... the Home Instruction for Parents of Preschool Youngsters program. He LOVES it already, and he made quite an impression on the instructors at the elementary school when he went for his evaluation. All three of our little ones are growing like weeds (and keeping the other end of the spectrum in perspective!). Oh, LORD... give me strength!
My friend and her four siblings have been taking turns sitting with their 88-year-old mother, who recently returned home following rehab for a mild stroke. Dementia began to set in several years ago, but things were not so bad that the siblings didn't feel they could leave their mother unattended while the baby sister - who has lived with her mother for nearly 20 years - worked at a "day job" in this community. All bets were off when Sue* suffered the stroke. Now she has to be reminded - and often prodded - to dress, brush her teeth, and eat. Other times, she will do these things repeatedly. My friend told me one day recently, "Mom brushed her teeth three times this morning."
At her wits' end, my friend came to me recently and asked for help... what did she need to do to get the ball rolling for her mom to enter an assisted living facility. I told her I would be happy to help her "navigate the waters." I inquired a couple of days later at the Assisted Living Facility where my grandmother resides and discovered there was a room vacant right across the hall from Mam-ma. "But she better hurry," the administrator advised. I relayed this information to my friend that evening, and she sheepishly looked at me and said, "We're not ready." I nodded and told her I understood... I've been there... but she needed to be aware that the clock is ticking.
Two days later, my phone rang. My friend asked if I could meet her at the ALF and show her around... let her see Mam-ma's room and answer a few questions. I told her I would be glad to do that. We agreed on a time to meet, and I thought she said her sisters were coming with her. When she arrived, her husband and one sister were with her... along with her mother. She said, "I told Mom we were going on a little outing."
We toured the facility, I answered questions, and we visited with Mam-ma, who gladly showed them her apartment. I had visited with the administrator before the entourage arrived, and she told me to visit the vacant apartment across the hall. We did that, as well. I showed them menus for the week and the monthly calendar. We opened closets and drawers and everyone commented on how spacious the apartment seemed... perfect for their mom. Several people poked heads out of doorways and realized that they knew Sue and her family... and many came to greet us. Sue hugged my grandmother as she left and said, "I may be back real soon, and we can visit."
The next morning, my friend called and dejectedly told me that her mother had thrown a fit in the car. She was NOT moving in with a bunch of people. I reminded my friend that we had toured that very same apartment one October, and the next day Mam-ma declared, "That's not for me. I'm not moving down there." Less than a month later, she was ready... and the apartment was gone. It would be several more LONG months before we were able to secure an apartment and officially make the move. Meanwhile, I see the toll this is taking on my friend and her siblings. Three of them are trading off days... sitting with their mother while the youngest sibling works. This woman is responsible for her mother each evening. I can only imagine how tired she must be after working all day... and how confined she must feel. Even if her mother eats dinner and goes to bed, this woman can't go out or do anything socially. She probably doesn't feel comfortable to do much entertaining in the home, either.
I told my friend that I fully understand her dilemma, but I suggested she continue with paper work and basic preparations, in case things change suddenly. AND... I reminded her that she is dealing with a problem we did not have... dementia. At some point, it may be necessary for the siblings to force this issue - for the sake of all concerned. Later in the day, while shopping, I ran into the other sibling who had come to the ALF with my friend. I told her that I had heard that her mother was not pleased. She said, "Oh, mother was SO upset. She is not used to being alone like that." I know I looked perplexed, and I said, "Your mother would NOT be alone at the ALF... there are people everywhere." She replied, "Well... yes... but she wouldn't participate in any activities. She would just sit in her room all day." I agreed that some residents do this... but she would always be given an opportunity to socialize and participate in activities. Then I told her that she and her siblings are going to wear out if they continue to provide all of the necessary care. She said, "We may have to get someone to help us a little, but if so, that's what we will do." I mentioned the sister who works and lives with her mom. "Oh, she's used to that," she replied. I suggested it was terribly confining, and she said, "That's all she knows... she's lived there almost 20 years!"
I realized in that instance where the real difficulties lie. The siblings are not all on the same page. Their mother may not be ready to agree to move to an Assisted Living Facility... but some of these children are most definitely not ready. And as long as there is dissension among the siblings, nothing will change. Their mother may have already surpassed her mental capability to make this decision... but these siblings are not emotionally ready to say, "This is best for Mom - and for us." Until this happens, they will continue spinning their wheels and making themselves crazy on a daily basis as they attempt to meet their mother's needs - and demands - in her own home.
I fully understand that this is a difficult decision. And thankfully, my grandmother was mentally capable of deciding on her own to make the move. But we don't all have that luxury. My maternal grandparents were somewhat "manipulated" into moving into a nursing home by convincing each one that they were going because the other one needed to be there. So my grandfather would say, "I'm only here because Mother needs to be here." My grandmother would tell others, "I'm just here until Daddy gets well and we can go home." My grandfather was virtually blind and deaf... my grandmother had Parkinson's disease. Neither one could care for themselves - much less each other - in their their own home.
I strongly suspect that this family will be like countless others ... they will rock along in their current situation until something else happens. Their mother will suffer another stroke and either lose her life or be so incapacitated that she has to go to a nursing home... or she will fall with the same results. Hopefully the outcome will not be such a toll on the caregivers that their own health suffers. And I am not saying that the ALF would be better. Sue might love it... or she might be perfectly miserable there and make everyone else miserable in the bargain.
All I can do is be encouraging and supportive... and share my own experiences in hopes they will help someone else. For the moment, my grandmother is doing amazingly well. She even managed TWO "I tell you whats" for me yesterday... more than she has spoken in months. However, she totally ignored me as she tried to wheel herself to the bathroom... so I know that another fall is always just one mis-step away. And I have accepted this.
I had to laugh as I checked out at Wal-Mart yesterday - I had diapers for Zola, our great-niece... and diapers for Mam-ma. We've been at this a while now. Timothy is three and has been out of diapers for about a year. Hopefully Zola will follow suit soon... but Nathan is only six months old, so we will have baby diapers in the mix for a while yet. And one of Mam-ma's friends is 103 and a half... and another is 106... so who can say how much longer we will be buying the bigger variety, as well!
Part of my consolation is that I am amassing a wealth of knowledge that just might help the next person... like my friend and her siblings. There has to be some redeeming purpose in all of this... and maybe that's it! If/when my friend and her siblings ARE indeed ready... I'll be here to help them.
When it appeared fairly certain that my grandmother would live to see her 100th birthday, I did a GOOGLE search for Willard Scott and found his website and the requisite forms to complete for submitting Mam-ma Polly's name for consideration as one of the centenarians featured on Willard's segment during NBC's "The TODAY Show." Sponsored by Smucker's, the celebrants' photos are superimposed on a Smucker's jelly jar label, and Scott tells a little something about the honoree. The information on the website stated that the forms had to be submitted at least six weeks prior to the actual birthday. Since Mam-ma's birthday was November 5th, I sent the forms in early September.
The information also stated that either we would receive a phone call to let us know that our centenarian would be featured... or the honoree would receive a card in the mail. Neither happened. Shortly before Christmas, I cleaned off my desk... and I threw away all paper work related to this endeavor. I decided I must have failed to complete the forms correctly or something.
December 22nd, our telephone rang, and Caller ID said the number was "PRIVATE". Since this is what shows when the Hospice nurses call, I feared the worst... but I answered. The caller was a gentleman from Willard Scott's office. He apologized for the delay, explaining that they were behind on airing the segments, but my grandmother was scheduled to be featured on Monday, December 24th, between 8:00 a.m. and 9:00 a.m. He asked about our time zone, and I told him we were on Central Time. He explained that the segment would air on the East Coast between 8:00 and 9:00 - and repeat for us the following hour. He said, "Set your DVR for 8:00 a.m. to 10:00 a.m." I set mine for 7:00 - 11:00!!
So I let EVERYONE know! I made sure all televisions at the facility would be turned on and set to the appropriate channel. My mom let the church administrators know, and they made a BIG SPLASH about it Sunday morning at Mam-ma's church. I think everyone in our community of about 7,000 people sat glued to their TVs Monday morning... along with family members and friends from coast to coast. And Willard Scott was not on. They did segments on all sorts of things, from ugly Christmas sweaters to revealing the sex of a baby expected by an Olympic volleyball champion... but no Willard Scott.
So we regrouped and set the DVRs for Christmas Day. This time, Scott was on... and a long segment aired, featuring several centenarians... but no Mam-ma Polly! Would she ever be featured? That afternoon, the phone rang again, and the same man apologized and said they were still very behind, and he thought that Mam-ma's segment would air on December 26th. I told him how disappointed we were, and he kept saying, "We have no control over what they do... the segments are pre-recorded, and we don't know when they will air." So we regrouped once again.
Wednesday morning, a friend posted on Facebook that she was spending the holidays in New York City, and she had just seen Mam-ma Polly on Willard Scott's segment! So I started letting people know that we WOULD see the feature. Sure enough, somewhere around 8:30 a .m., Central Time, Willard Scott's birthday feature aired... and there was Mam-ma on a Smucker's label! Soooooooooo... in case you missed it... here is my Mam-ma Polly... now forever known throughout America for her peanut brittle! I hope you enjoy it! (Watch all the way... she's almost the last one featured!)
A study released in June 2012 by the Bureau of Labor Statistics reports that... "In 2011, 16 percent of the U.S. civilian noninstitutional population age 15 and over were eldercare providers... This and other information about eldercare providers and the time they spent providing care were collected for the first time in the 2011 American Time Use Survey (ATUS). This release also includes the average amount of time per day in 2011 that individuals spent in various activities, such as working, household activities, childcare, and leisure and sports activities." Click here to read the full report... or go to http://blog.aarp.org/2012/06/28/sally-abrahms-caregiving-stat-collection/ for a great synopsis by AARP contributor Sally Abrahms.
I find these statistics provided by Ms. Abrahms to be particularly interesting...
56% of the 39.8 million eldercare providers were women.
23% of providers also had one or more kids at home under age 18.
One out of six people in the U.S., or 16% of the civilian noninstitutional population ages 15+, spent time helping elders, and
More than 60% of care for an older person came from someone age 45+; one-sixth by a person age 65+.
Pleaseread the full article and see where YOU fit into this picture. Eldercare is gaining recognition in this country... as it should! As Ms. Abrahms points out, this will hopefully lead to increased support and lessened burdens for those who find themselves involved in eldercare. I also am encouraged to see that many of the tasks we caregivers perform for the elderly are finally being recognized as "eldercare," such as providing housekeeping, meals and transportation, shopping, managing daily finances, and offering companionship. For many years, "caregiving" has been considered by many to include more personal care... help with bathing and matters of personal hygiene, medical care, and physical therapy and assistance.
We had lunch yesterday with some friends we had not seen in a long time, and one of them asked, "What do you do these days?" I laughed and told her, "We spend a lot of time taking care of others." If you consider the time we actually spend in the physical presence of our elderly loved ones, it doesn't seem like they keep us all that busy. But when I stop to consider the hours spent balancing checkbooks and paying bills, or shopping for personal items the ALF doesn't provide for my grandmother (like wet wipes and denture cleanser), it adds up. I think about the morning I spent sorting clothing to find suitable warm outfits for fall and winter... and the hours I spent mending broken zippers and buttons that had fallen off of garments. I look at the hours my husband spends mowing, trimming, weeding and fertilizing his mother's yard... or repairing broken appliances, replacing light bulbs, helping her decipher a bill or some financial decision... and even showing her pictures of her great-grandchildren on Facebook. All of a sudden, there is little question about where the time goes!
While time-consuming and vital to daily living, the more "routine" activities that many of us take for granted, such as meal prep, balancing the checkbook and paying bills, and driving Grandma to the doctor or beauty shop, were not considered to fall under the umbrella of services offered by a bona fide "caregiver." This is changing, thankfully. Someone commented to the AARP article, saying he hoped that the government would do more than merely recognize that eldercare is real and vital. This will take time. The first step IS recognition - and awareness... and that's what I am trying to do, in part, on this blog. By giving a voice to eldercare and the Sandwich Generation, we say, "Hey! We're here, and this is how we are coping." We can offer each other moral support and helpful suggestions, and we can be available for the next wave of caregivers who will surely join us.
As our population ages, this topic becomes even more important for all of us to consider. How are you impacted by eldercare... and how might you be affected in the future?
When I visited Mam-ma Polly yesterday, I found her cordless phone in the floor behind her night stand. Honestly, she has not spoken to anyone by phone in months, and it would be virtually impossible for her to do so now. I have left the phone in her room more for her peace of mind... an assurance that not everything has changed. But in reality, everything has changed, and the fact that her phone was on the floor behind her night stand told me that Mam-ma doesn't even notice. Removing the phone will actually give her more space on the night stand for things that do matter now, like her drink cup.
So this morning, I called AT&T and disconnected my grandmother's phone service. The number that has belonged to my grandparents all of my 55 years, and probably longer, no longer belongs to them. I have to admit, it was a bittersweet moment. A speech therapist is working on papers to qualify my grandmother for her assistance... to see if there is anything that can be done to help Mam-ma get out at least a few coherent sentences. It's worth a shot. We believe she knows what she wants to say, and LORD knows she certainly tries to talk... but the words just will not come. Her frustration is clearly evident... and often she simply cries. Through gritted teeth, she told the Hospice nurse yesterday, "I.am.so.tired." I don't know what will happen in the next few weeks/months. I've reserved a room at the ALF for a 100th birthday party for Mam-ma on November 4th (her birthday is actually the 5th, but that's a Monday). This morning, I sent the requisite application form and photo to Willard Scott, in hopes he will recognize Mam-ma on the TODAY show on her birthday. While these things have to be done well in advance, I know there is every chance that the birthday celebration will never happen... and that is fine with all of us, because I know that an even bigger and better celebration will be taking place... in Heaven.
For now, I will remove the phone and remind any who might still try to call my grandmother that she can no longer communicate with them in this fashion. I hope whoever gets this number next enjoys using it as much as she did... and has even half as long a run with it.
... the more they stay the same! This thought "came home to roost" with me recently. After 251 days, we finally got to see our little nephew Timothy again. His grandparents went to Texas to visit after Timmy's new baby brother, Nathan, arrived. They brought Timmy home to visit for a couple of weeks, before we return him to Texas. We were thrilled to see our little guy - and amazed at how he has grown and what all he can do now.
At the same time, I was struck by the similarities between him and my grandmother. The only difference is the scale. Timmy is now potty trained. He uses a little "Thomas the Train" adaptor seat that perches atop the regular toilet seat - much like the "potty chair" apparatus that sits over Mam-ma's toilet and provides her with a higher perch and arm rails. Timothy still has trouble understanding a few things - and often there is no reasoning with him... just as it is with Mam-ma.
You can tell Timothy to stop doing something, and in his little 3-year-old mind, it doesn't compute. You can tell Mam-ma to stop hollering or rattling her bed rails, and she just looks at you with a glazed look, then starts to holler and rattle. Timmy spits out foods he doesn't like... so does Mam-ma. Timmy frequently asks "Why?" Mam-ma does, too... as in, "I don't know WHY I can't walk."
We took Timothy to see Mam-ma... I think it confused her, although she seemed happy to see him. All she could say was, "I tell you what!" and once she said, "He's so cute." Finally, Timmy raised his hands as if he were confused and said, "TELL ME what, Mam-ma!" She didn't get it. I suggested that Greg take Timmy to see the fish tank in the dining room, and he did. Thankfully he was with me... it would have been a real challenge to manage Timmy and Mam-ma by myself!
In the seventeen days that Timothy visited, I saw even more similarities, as Mam-ma expressed herself in 3-year-old fashion. More than once, when she was upset about something, she began to heave her shoulders and "cry" and sob... with nary a tear... a behavior I had seen from Timothy several times. I wanted to say, "Use your words," as I do with him... but it didn't seem appropriate. So instead, I would tell her, "That is not helping. You need to tell me what is wrong."
Honestly, I don't feel I have been nearly as patient with my grandmother in recent weeks as I should... and maybe that was due in part to the stress of caring for her AND my nephew. I think moreso, it's the culmination of weeks and months and years of continual stress and "wrinkles" and challenges. We are all just a tad weary - and none of us more than my grandmother.
I didn't take Timothy back to visit Mam-ma Polly while he was here. She never asked about him again, and he did not indicate he wanted to return. They saw each other, we snapped a photo or two, and we can say we've "been there, done that." If she wakes up someday and says she wishes she could see him, we can remind her that he did visit.
We have returned Timmy to his family in Texas. Saying "Good-bye" again was heartbreaking for all of us. I am hoping and praying that it won't be another 250+ days before we see them again. Meanwhile, I am regrouping, resting a sore knee that wasn't up to the rigors of a 32-lb. three-year-old who liked to be cuddled and carried. I am already focusing on the newest development with my grandmother... a speech therapist who has indicated interest in working on the expressive aphasia. If she is willing to do the paperwork to see if Mam-ma qualifies, I am willing to consider this.
So life continues... with all of its similarities - AND changes...and so do we!
Last weekend was rough. Mam-ma spent much of it curled in a fetal position, gripping her bed rail and groaning with pain. Friday and Saturday were the worst. She would begin moaning and begging for a pain pill an hour or more before one could be administered... and then it took another hour or more afterward for the pill to take effect. I asked if anything could be done, and the nurse did try to contact the doctor. But he was out of town for the weekend and did not answer his cell phone. I later learned that in these situations, I can call Hospice, and they can help. However, Sunday was almost totally different. The pain seemed to be far less substantial, and Mam-ma seemed clearer. Where she had been virtually unresponsive (except for the groaning) on Friday and Saturday, she was pleasant and clearly more comfortable on Sunday. Saturday, she flatly refused a bath when the Hospice aide visited. Sunday, she readily agreed to the same offer from the same aide. Every day is different.
Monday afternoon when I visited, the aides told me, "She threw a huge FIT this morning... told us that 'I can make my own decisions, and I want out of here.'" The aides interrupted an administrative staff meeting because the rant was so bad, and the facility administrator, the facility owner, and the nurse agreed to let the aides put Mam-ma in her wheelchair and roll her around - and they even took her outside on the porch for about 10 minutes. I was not thrilled by this. It wasn't that this really hurt anything, but Mam-ma is not thinking clearly, and just because she says she can make her own decisions doesn't mean she can. This weekday nurse was not on duty over the weekend. She and the weekday aides did not see how Mam-ma writhed in pain. They did not hear her groaning through the night and begging for more medication. They were not there when she was virtually unresponsive...and other family members and I were wondering if perhaps this was "the beginning of the end."
To make matters worse, the aides no sooner got Mam-ma back to her room from the wheelchair ride than she developed serious diarrhea... to the extent that she soiled her clothing, the recliner, the floor... everywhere. The aides cleaned Mam-ma and put her to bed, admonishing me to watch where I sat or stepped ... that "we'll be back to steam clean everything and disinfect." The Hospice nurse was there, and I noticed that Mam-ma's feet were still dirty, so the nurse put on gloves and got a packet of wipes and cleaned Mam-ma's feet and legs.
The aides said a "bug" was going around the ALF, but they were also concerned that the wheelchair ride might have contributed to Mam-ma's diarrhea. I hinted strongly that I would prefer there be no more wheelchair rides! Before I left, I read a couple of Psalms to Mam-ma. It occurred to me that she never gets to hear scripture any more... and she has always spent a lot of time reading her Bible. However, while I read, she closed her eyes and I could not tell if she was even awake. After I finished, she didn't say a word.
I guess I made more of an impression on Mam-ma about the wheelchair ride than I realized, because Monday evening around 6:00, the phone rang... and Mam-ma's number popped up on my Caller ID. I answered, and her aide - also named Debbie - said, "Miss Polly wanted me to call you - she wants to talk to you." Okay... I thought... this should be interesting... and I was right!Mam-ma was actually fairly coherent, and she said, "I'm so sorry." I asked why she was sorry, and she said, "Well... I really got my ass in a crack." I asked, "Are you talking about the ride you took in the wheelchair?" "Yes," she replied. I told her not to apologize... it's over and done... but I outlined WHY we didn't want her riding in the wheelchair... and reminded her of how sick she had been over the weekend. "We just don't want you to start hurting like that again... and every time they move you for anything, you seem to have pain." "Well," she continued, "I'm sorry."
I went so far as to tell Mam-ma, "You know, we have signed papers saying that we are NOT going back to the hospital! So if you fall and hurt yourself, you will have to lie in bed in pain, and I won't be able to do anything but watch you hurt." She said she didn't know that. Now she does! Anyway, she ended the conversation by saying, "I needed to apologize. I'm sorry." I had to laugh... even in her "in-and-out" condition, she still can do the old "pull-a-stunt-and-be-sorry-later" routine!
Tuesday was uneventful, and I made plans to stay home on Wednesday and sew for Timothy and Zola. I was trying to get a package ready to mail to them, and I wanted to include some new clothes I was making. Late in the afternoon, I got a call from the nurse. She was filing a report that Mam-ma had tried to get up out of her recliner and nearly pulled it over on her. The nurse said, "This happened while I was at lunch, and the administrator and an aide got Polly up and left me a note about it." Mam-ma was not hurt. I asked if she was scared, and the nurse said, "She was more mad and frustrated." I thanked her for calling me.
By 6:30, a friend of my grandmothers was calling. "Jerome (another friend who is a resident) told me that Polly wanted to see me," she said, "so I went to her room, and she said, 'Call Debbie. I've never hurt as bad as I'm hurting now.'" I told Bessie that I knew about the fall in the afternoon - I had received a call. I debated whether to go to the ALF, but after finishing dinner and taking a shower, I threw on some clothes and drove down. It was about 7:30 when I arrived, and Mam-ma was asleep. I laid my car keys on her little bedside table, and she roused. I asked, "What are you doing?" and she said, "WELL! I'm trying to get these bowels to move!" She said the nurse had given her a dose of Miralax. She was complaining of pain and discomfort and said, "They won't do anything." However, a few minutes earlier she had been sound asleep!
I asked about the "fall," and she said, "Yes... I thought I could get up." I told her, "Mam-ma you have not put any weight on either foot since you had surgery almost a month ago. You are not able to walk!" She said, "Well... I forgot." And maybe she did. However, that raised a huge concern about her getting up out of her chair... or falling out of the wheelchair. And twice last weekend, the nurse and my sister (who is a weekend nighttime aide there) found Mam-ma in bed with both legs between the bed rails... trying to get out!
Two aides came into the room, and we all reminded Mam-ma that two days earlier she had been sick with diarrhea... and she had eaten very little since then. She probably did not need to worry about her bowels... and she did not need more Miralax. I told her I didn't know what else the staff could do for her... that she needed to try to sleep and rest. The aides assured her that they would return soon with night-time medication and another pain pill. I left... there was nothing more I could do, and my husband was waiting at home to watch a movie we had rented.
I set in on Thursday to pursue options for keeping Mam-ma safe... and to avoid another fall. When I arrived, she was sitting in her recliner... and the foot rest was closed. She could have easily leaned forward and fallen out. I don't think she had been that way very long, because as I began to question her and the aides, I determined that a Hospice aide had just been there to bathe her. This aide had not only left the foot rest down... she had also put Mam-ma's little pink house shoes on her feet - leaving the protective "boots" to help prevent pressure wounds in Mam-ma's bed underneath the bed sheet! The nurse came in and switched the house shoes for the boots... and I hid the house shoes in the closet!
I called the Hospice nurse who is our caseworker and complained to her... and ultimately, I asked that this aide not be assigned to Mam-ma any more. I hated to do that, but I have to consider Mam-ma's safety and well-being. The nurse wholeheartedly agreed, and she filed an incident report on my behalf. The more I have thought about it, the more I am certain this was the right thing to do - for Mam-ma and for other patients who might have similar experiences. This is not the time to always "play nice." Too much is at stake!
So after talking with the facility administrator, who in turn consulted the facility owner, I learned that physical restraints are 100% NOT allowed in the assisted living facility. When my maternal grandmother was in the nursing home, she wore a "vest" that tied her to the wheelchair. It kept her from falling out - or getting up - until she took her little sewing kit scissors and politely cut the straps! This type of device is not allowed for Mam-ma Polly. So I asked the administrator... "What do you suggest we do to keep Polly safe? I've run out of ideas."
The administrator said that she and the facility owner both felt that Mam-ma is going stir crazy in her room. "She needs to get out in her wheelchair... maybe sit on the porch outside." I don't feel comfortable allowing Mam-ma to go outside. I am afraid that she will be left unattended there, and who knows what might happen. So I conceded... "Okay... what if we agree to take her to the dining room to her table for LUNCH ONLY. I know she might be the last one fed... after her friends have eaten and left the table... but at least she can visit with them and have some time out of her room. Other than that and being up for a bath, she should spend the rest of the day in her bed. If she absolutely insists, perhaps you can get her up in the recliner for a few minutes... but hopefully the trip out for lunch will be sufficient." The administrator felt this was a good compromise.
I am assuming that this started today. I did not go... I stayed home and cleaned our house. The Hospice social worker advised me earlier this week that I should not feel as if I have to visit Mam-ma every single day. "That's why you have us and the facility looking after her," she reminded me. My mother did stop in this afternoon, and she said Mam-ma could not stay awake to visit with her... and Mam-ma did not know what she ate for lunch. My guess is that the trip out to the dining room for lunch wore her out, and as I hoped, she napped most of the afternoon. I am hoping that the daily bath and lunch trip will be enough to satisfy her - and tire her sufficiently - so that she naps in between and stays safely tucked into her bed. The bed adjusts to a sitting position... and she is turned every two hours... so this should be enough stimulation to prevent further pressure wounds - the continual justification for Polly being "up and about."
Every time that my grandmother does something like demand to get up and out... or to call me on the telephone... the aides say, "Oh, Polly's coming back!" I don't see it. She still sleeps a LOT. Most days she might make a couple of lucid comments... then the rest is one or two words - or gibberish. The Hospice social worker called her comments "social pleasantries" - answers like "I'm fine," and "Hello," and "Thank you" - simple answers to general questions. Anything more complicated most often gets a confused answer - if that. As Mam-ma takes less pain medication, and we get farther from the surgery date and the anaesthesia, she has more lucid thoughts... hence, the phone call and the "ass in a crack" comment that is so classically "Mam-ma Polly." But she was not putting many sentences together before she fell and broke her leg... so any hopes that she will do so now are not reasonable, in my opinion.
I am still hopeful that things will smooth out somewhat... that for a while, at least, I truly will not feel I have to pop in every single day. I want to learn from the experience with my maternal grandparents. I don't want this to make me completely neurotic and disrupt my relationships with my husband and other family members and friends. I want to keep this all in perspective and not micro-manage - OR compromise my own physical, mental, and emotional health. I don't think Mam-ma would truly want that, either.
Last night Greg and I went to dinner with one of Greg's best friends from high school, and his wife, who also went to school with us. We had a great time reminiscing and catching up... and it was great to think about other things and other people for a few hours. My grandmother's name came up, because someone stopped by the table and asked about her. Both of our friends rode the school bus when she was driving... and we marvelled that she is almost 100 years old. But we did not discuss her fall or her subsequent decline. We didn't need to... Ididn't need to talk about it! And that felt great!
I have to admit... I was not really upset about the phone call Monday night. In fact, I was somewhat amused. For just a moment, I got a glimpse of the "Old Polly," and it actually felt pretty good. I knew it was a manipulative ploy... whether she realizes it now or not... but at the same time, her colorful language and the clarity of her voice was a welcome treat. I'm looking for blessings and positive notes in the most unusual and extraordinary places and events... and sometimes I'm finding them! Saying "I'm sorry" didn't fix a thing... but the phone call was still a little treat... and I'll take it!
Last night, we talked to Timothy and his mother for the first time in nearly two long months. They had spent the day at a nearby lake and botanical gardens/park, and Timothy had LOTS to tell us. He also had a lot to tell us about his birthday presents - and his dinosaurs... and the repetitive question was a dramatic, "Do you know... that my favorite dinousaur is cool? I will show it to you!" Of course, we could not see it on the telephone, but that didn't seem to matter. And this was all important because???? The 30-minute conversation with our beloved three-year-old was a welcome respite from the focus on my grandmother and her deteriorating condition.
Wednesday and Thursday were remarkably "good" days for Mam-ma Polly. She was clearer and put more sentences together than she has in months. She told me about visitors and asked about a mutual friend who is suffering with Bells Palsy. She said of this person, "I wish I was able to send her a note." She is still thinking about others - even now.
However, my mom visited on Friday, and nothing was the same. Mam-ma was virtually unresponsive. Mom had to keep waking her to talk with her... and even then, she wasn't sure things registered. And Mam-ma has a pressure wound on her right heel - the leg that is broken. It's about the size of a quarter, and the Hospice nurse put padded "booties" on her feet to keep them from touching the sheets. We are told by the nurses that this is the beginning of other problems... like more skin breakdown. And even worse, Mam-ma is in pain.
We got the doctor to increase her pain medication from 2 times per day as needed to four times per day, as needed. However, before the six hours is up she is begging and groaning in pain. When I visited yesterday morning, I found her in a fetal position, clenching the bed rail with both hands, frowning deeply and groaning. She was in a lot of pain. We have not been able to reach a doctor this weekend, which I am not sure I understand. But there are times when the Hydrocodone kicks in that Mam-ma is happy and laughing... it's just that last hour or so before the next pain pill - and then the hour afterward until it takes effect. When you add them all up, that is a lot of time to be in pain. Hopefully I can get to the bottom of it tomorrow and get either her dosage strength increased - or the frequency of administering the current amount. I do not want my grandmother to be in pain at this point.
I know every day is different... and the challenges and frustrations may only increase as we go along. For all who questioned at the beginning of this week whether Hospice was the right choice, I say, "Go visit her now." We made the right choice.
At the same time, I am trying to pace myself... and if you are in the same boat - or a similar dinghy - I suggest you do the same. Last Saturday, my best friend and I attended a party to celebrate the marriage of a mutual friend we have known since childhood. We laughed, danced, and reminisced... and for a few hours, I didn't think about hospitals, pain, Hospice, or anything sad. It felt great! Yesterday, I fired up my sewing machine and made pillows for our front and back porches. Sewing is my therapy... and I get lost in the beautiful fabrics and calculating yardage and creating something pretty... and I feel happy and peaceful.
In all of these challenges, we have to find balance. So talking to Timothy last night was the icing on the cake. Thinking about the carefree world of a three-year-old and his soon-to-be-one-year-old sister made us smile and laugh... something we haven't done often enough lately. Tonight, if everything holds together, my husband and I plan to veg out on the couch and watch movies... one drama... and one comedy.
This seemingly sudden 180-degree turn with my grandmother should come as no surprise. I know things can change quickly from here on out... but at the same time, it was a good reminder NOT to be surprised - or to take a "good" day/hour for granted. I'm still keeping my house in some semblance of order and trying to stay ahead of meals and laundry... and basically keeping my "house" in order (literally and figuratively). Nothing is certain... of that I am sure. But I am taking things one day at a time, and relishing in the fact that dinosaurs really are cool... and I know a little boy who can tell me why!
I am sorry it has been so long since my last post. To say that this has been a hectic and stressful week would be an understatement. The hospitalist agreed to keep my grandmother over the weekend so that she could be re-admitted to her apartment at the ALF on Monday and placed in Hospice Care. I met Monday morning with the Hospice director, the ALF administrator and R.N., and the Hospice R.N./Caseworker. We reviewed the care plan for Mam-ma and agreed that she would do only as much as she fel like doing... and that our goal was to keep her happy and comfortable for the rest of her life.
To say the weekend in the hospital was uneventful would be a lie. For starters, I arrived Saturday morning around 9:00, and the aides said, "She didn't eat much breakfast." I immediately knew why as soon as I saw Mam-ma ... she wasn't wearing her dentures! I told the girls... "She doesn't have in her teeth!" They sheepishly disappeared, and the ward clerk scrambled to find something in the nutrition room that we thought Mam-ma would eat. Then she realized the food cart was right beside the nurses' desk, and Mam-ma's virtually untouched tray was still there. She retrieved it and warmed the scrambled eggs and biscuit in the microwave. I fed Mam-ma, and she ate all of her eggs and half a biscuit with jelly - once we put in her teeth, of course!
I think one of the hardest things for me was that Mam-ma did not know me for several days. She seemed to recognize me, but when I would ask, "What's my name?" she would shake her head and say, blankly, "I don't know." Same thing for her own name. Friday evening, she knew Greg by name... and then my cousin Amanda. But it was late Sunday evening when I asked again, and she knew my name... and she was able to give her own name on Monday.
Saturday morning, the therapist came to do some exercises, but when she and the nurse lifted Mam-ma from the bed, Mam-ma virtually collapsed in dead weight, and they just sat her in a chair. The therapist, who is a friend whose grandmother is Mam-ma's contemporary, mouthed from behind Mam-ma... "You're doing the right thing" (meaning Hospice). That made me feel more confident in my decision.
Sunday was horrible. Mam-ma required several "brief" changes, and the nurses were always so kind. But sometimes it was an hour after we rang for help... and that is just too long - even if you are understaffed. So I had to make a few trips to the desk to remind someone I needed help!
By the time Sunday ended, my grandmother had suffered through several hours of severe gas pains that left her screaming in discomfort. She was unable to eat her dinner, and I discovered that while we were at lunch, Amanda and her dad had come, and Mam-ma had sent them home with some harsh words... she had a messy diaper and was embarrassed, and she told them in some pretty colorful language to go home. So they did. Another cousin came before dinner, and she helped me with Mam-ma for a while... managed to feed her some applesauce... and Mam-ma finally settled down and seemed to stop hurting around 7:30 p.m. I hugged her and promised, "I'll take you home tomorrow." She frowned and said, "Debbie, I'm worried about you. You're doing too much." I explained that I was only doing what she needed, and I would be okay. Later, as I kissed her goodbye, she cried and said, "Oh, Sugar... you've done so much... you are just so precious." I left in tears.
I came home and tearfully told all of this to my husband... who had been there with me for part of the afternoon drama... and he said, "You are overly tired. It will be okay." I was... and it is... but that was a rough day.
Monday, I arrived at the hospital, and the aide met me and said, "She hardly ate anything this morning." I took one look and said, "I can tell you why - she isn't wearing her teeth again!' This was another aide, and she said, "But it was pancakes and scrambled eggs!" I replied, "I don't care... she's not gonna eat without her teeth!" So the nurses ordered another tray and apologized profusely. This is "Nursing 101!" The charge nurse said, "If you were staying another night, I'd make a sign that said 'Be sure to check for her teeth before feeding!'" After meeting Monday morning at the ALF with Hospice and ALF staff, we got Mam-ma settled back in her apartment by late afternoon. No less than six aides, a nurse, and an administrator swarmed the hospital van to greet her when she arrived. That was such a great sight... I knew we were truly home. I spent more than an hour with the Hospice nurse and social worker, filling out paper work and getting things in order. It was another long day.
Mam-ma seemed to do well on Tuesday... a Hospice aide came and bathed her. She has a hospital bed, a wheelchair, bedside toilet, and oxygen if needed. The four days per week that the ALF staff doesn't give her a bath are covered by Hospice aides who come and bathe. Mam-ma was concerned about me "doing too much," so I told her I would stay home on Wednesday and not visit. Honestly, my house was so dirty and messy, and I could not rest until I knew it was in some semblance of order. It never felt so good to clean a bathroom or dust and vacuum! I made potato salad and spaghetti sauce to freeze for quick meals and just basically caught up on things that had been neglected for nearly two weeks.
Thursday, we had a Mother's Day luncheon at the ALF. I had told the administrator that my sister and I would attend - and if Mam-ma could not attend, we would sit with some mother who had no one there to sit with her. When we arrived, Mam-ma had been bathed, and she had on pajamas - even the pants! Her favorite Hospice aide was there, so I didn't question the pajamas... although she had worn hospital gowns up to that point. We asked if she felt like going to the luncheon, thinking she would say no... but she said yes, and she wanted to wear her nicest suit! So the aides dressed her, and off we went.
Looking back, this was a huge mistake. Mam-ma smiled and looked beautiful... and many came to the table to greet her. But she barely ate, and she didn't have a clue about where she was or what was happening. Back in her room, she immediately fell asleep in bed... clothes and all. A short time later, an aide got her up to curl her hair, since she didn't feel like going to the beauty shop for her regular appointment. This was all just too much for her.
During lunch, the activities director stopped by our table and told us that Mam-ma had come out to the dining room and played BINGO the day before. This was news to me, and I was quite shocked. I knew the nurse had told me she wheeled Mam-ma to the dining room a couple of times... but she had also told me that Mam-ma did not get up for any meals on Wednesday. I'm not sure exactly what she did. But the bottom line was that I realized that the staff had put Mam-ma right back into her old routine and was pushing her to get back to her "old self." I didn't know what to do, but I figured she was pretty close to "hitting the wall."
I was right. Friday morning, the Hospice nurse called me and said, "I've just seen Polly, and she is totally out of it. She cannot stay awake... she is lethargic... I don't know what happened!" I did! I explained how much that Polly had done last week, and the nurse told me that this had to stop. I agreed... but how? She told me that I needed to contact the administrator and discuss this with her... and I did... and we agreed that Mam-ma takes meals in her room, stays in her hospital gown, and only gets up for a little while each day and sits in her recliner - at least for now. She is still in a lot of pain, and only 14 days out from a major surgery at this point. Plus, she is less than 6 months from being 100 years old!!! Because Mam-ma looks so much younger - and generally acts it... and because the staff loves her so and wants her well... they were really working to rehab her back into shape!
So I'm getting some dirty looks and have had to go back and reiterate to a few that we are NOT pushing... that "less is more" in this case. But we seem to be getting there, and I do think this is the best thing for my grandmother. I am not willing her to die... nor giving up on her. I am managing her care. There have been times when I have called about something or gotten involved in a detail here or there, and my husband has suggested that perhaps I am micro-managing her care and causing myself undue stress. The Hospice nurse assures me that I am not... that I am simply loving my grandmother and making sure she is taken care of. It's hard to know how to balance this... and what can slide and what is important. I'm in some uncharted territory here (at least for me), and I am doing the best I can. When I visited today, a new shift of aides was on board, and Mam-ma had been to lunch and was dressed in pajamas again. So I had to "educate" them on the plan... apparently the word about her care plan did not get to them.
One aide seemed to question my comments... I told her and another aide that the doctors feel that even with therapy, Mam-ma most likely will not walk again, and this aide said, "Oh, I disagree! They don't know Ms. Polly!" Maybe not... but I do, and she is almost 100 and 14 days out from a major surgery. For now, at least, bed rest, meals in her room, and no wheelchair rides is the way to go. I did consent to letting Mam-ma wear her pajama tops instead of a hospital gown. She says the gowns "choke me." So she can wear the tops and a robe when sitting up in her chair... but wrestling on a pair of pajama pants is preposterous for someone in her condition!
I am so thankful for Hospice. I told someone that Hospice is as much for me at this point as it is for Mam-ma. I needed their support and guidance. I needed to know that someone who knew more than I will manage her care and help me with all of the decisions. And I needed someone I could call (besides a family member or friend) who was an expert... and who could be my sounding board.
At this point, we are day-to-day... or is it minute-to-minute?! Things change constantly with my grandmother, and I'm not anticipating anything at this point - good or bad. I'm trying to let things happen, and be prepared for whatever comes next.
Meanwhile, our little Timothy celebrated his 3rd birthday Sunday. We sent lots of wrapped gifts, and he had a big day with his family. We're hoping to hear from him firsthand soon about all of the festivities and get his reaction. I wish we could have been with him for this celebration... but at the same time, I'm so glad he is with his mother right now and not factored into this mix! God knew I couldn't handle both... and He was right!
