Come for Tea at Eight

Last night my husband and I sat down after dinner to watch some sitcoms we had recorded on DVR.  A little after 8:30, he woke me and said, "Do you need to go to bed?"  I had been dozing for the last couple of 30-minute episodes.  I was even more tired than I realized, and I had no trouble falling asleep for good... or sleeping through the night.  A little after 6:00, I had tucked Mam-ma into her new bed in her new home, and told her, "Welcome home!"  She said, "Y'all have done a wonderful thing today."  I knew she meant it.

Friday, I took Mam-ma to the beauty shop, and I returned to her house to sort and pack.  After she returned from the beauty shop, we sorted some more items - the medicine chest, some jewelry and cologne, and more.  At almost 5:30 p.m., she was exhausted, and so was I.  We declared it a good day, and I left, suggesting she get some rest. 

I decided on Saturday that I should go back and pack a few more things, feeling the more we had packed and ready to roll on Monday, the better.  When I arrived at Mam-ma's before 2:00 p.m., Ruby was entering the house, and she was all dressed up.  Another friend, Geneva, was picking them up to go to Southridge to visit friends.  "Go ahead," I told Mam-ma.  "I'm going to pack and sort things here, and you go have a good time." 

I did all I could to get things organized, labeled, packed and ready, and at 4:00, I vacuumed the carpets and walked across the street to visit a next-door neighbor who is also a dear friend.  About 4:30, I heard the familiar scraping of Mam-ma's walker being dragged across concrete.  I walked to my friend's front door, and there stood Mam-ma.  "You've locked me out!" she said.  I reminded her that she had her remote control garage door opener, and she said, "Yes, but you locked the interior door."  Indeed, I had done that out of habit.  So I unlocked the house and let her inside... and I realized right away that she was completely spent.

Apparently these little ladies had walked from one end to the other of two facilities at Southridge - the assisted living center AND the skilled care nursing facility.  Mam-ma was so tired she could not even put a sentence together.  I quickly showed her where I had put her underwear and asked a couple of questions, and then I seated her at her dining table and heated some food for her dinner.  She took her night-time medicine and said, "I think I'll go to bed."  I turned down her bed, laid out her pajamas, and sat with her while she ate.  The food helped, and she began to rally a bit and was able to speak in rational sentences.  I offered to help her put on her pj's, but she sat down on her couch and said, "I think I will rest here for awhile."

Sunday, I did not leave my house - and neither did Mam-ma.  We rested for THE BIG DAY.  But she phoned me at 9:15 a.m. - "WHERE is my underwear?"  She did not remember most of what I had told her Saturday evening.  I reminded her it was in the dresser drawer - ready to go to Southridge.  Oh, yes... now she knew.

Yesterday morning, my husband and I left home at 8:00 and headed for Mam-ma's, where we loaded her furniture into our vehicles and a utility trailer.  We then went to Southridge and unloaded the furniture, getting everything in place.  A local furniture company was to deliver a new mattress set after lunch... we had the bed frame in place and ready.  The mattress set arrived promptly after lunch.

After that, Greg went to deliver Meals on Wheels, and I returned to Mam-ma's to get her medicine dispersed into the daily compartments - see if any needed to be ordered - and to load her clothes and toiletries, etc., into my vehicle.  It will take a week or more for the pharmacy associated with the ALF to begin sending medicine for Mam-ma, so we needed to do this one last personal dispensation.  I went back to Mam-ma's new room and unloaded the clothes, toiletries, and other items.

I was scheduled for a mammogram... of all days, on this morning at 11:30.  So I drove up the hill to our hospital and checked in at the radiology lab.  Greg met me there and waited while I had the procedure.  The beauty of small towns is that we know so many people.  Fellow church members were my admissions clerk, and my radiology technician, and they whisked me in and out quickly and with little fanfare.  Greg and I grabbed a quick, delicious lunch at our hospital cafeteria (the best food in town!), and then we returned for another load of odds and ends at my grandmother's.

My sister met us at my grandmother's, and we loaded pictures, lamps, plants and other items into the cars and made another trip to Southridge.  This time, the maintenance man - James - met us and helped my husband connect and program the television.  He also hung ALL of the pictures for me - I would hold one up and point, and he would hang a nail and the picture - and he hung a little cabinet/shelf unit over the toilet in the bathroom.  James was wonderful... but then, so was all of the staff - many of whom dropped in throughout the day to say "Hello" and "Welcome!"  My sister and I made the bed and straightened the room.

By about 2:00 p.m., we were ready for Mam-ma.  Her room looked like she had lived there for years.  The bed was made... her pictures (many of which she painted herself) were hung on the walls... our family mantel clock was tick-tocking on the dresser, and her family Bible was on the coffee table.  Everything was in the drawers... pretty dishes held cosmetics on the counter in the bathroom, and her Mylanta and creams and ointMENTS were in the bathroom cabinets.  A decorative corner cabinet sat just inside the door - with seven shelves laden with family photos.  The room screamed "Mam-ma Polly!"

Greg and I drove to Mam-ma's house, and she was pretty well "locked and loaded."  She had turned out the lights, locked the doors, and she was ready to go.  She looked around... but not much... and Greg helped her to the car.  Earlier that morning, she had picked up a pocket-knife and handed it to Greg... her eyes filling with tears.  "This was Truman's," she said.  Truman was my grandfather.  "Would you like to have it?"  Greg sweetly told her, "I will hold onto it until Timmy is big enough to have it... and then I will give it to him - how's that?"  She replied, "That'd be okay."

I fully expected a tearful scene as we left for the last time.  There were a few tears and sniffles from the back seat... but really very few.  And the reaction when we presented her with the new apartment was priceless.  She was astounded... and thrilled.  You could see it on her face.  It was HERS.  Everything was familiar.  We had used all of her things, and she felt so comfortable.  She asked a few times, "Now, where is this or that?" and we showed her, but she settled into a chair and was grinning from ear to ear.  Greg showed her how to use the thermostat, and we got a list of the television channels so he could go over those with her and find "Wheel of Fortune" and the Fox16 nightly news.

Several staff members came and went, introducing themselves and welcoming Mam-ma to the facility.  I took the medicine box to the R.N. and went over the medication schedule with her... and I almost danced back to Mam-ma's room - glad to be relieved of that responsibility!  Around 4:00, Greg and I went home, and I started calling utility companies and cancelling services.  The first call I made was to the telephone company.  The very helpful rep I was assigned told me that no technician was required (although she was completely unable to remove the $45 connection charge - and she tried several times), and that phone service would be switched from Mam-ma's house to her apartment by 10:00 a.m. today... no later than 8:00 p.m. tonight.

I called the cable company and cancelled Mam-ma's cable TV service.  She has a rebate coming for pro-rated, and unused service.  By now it was almost time for dinner, which is served at 5:00 p.m., so I decided I should go back and help Mam-ma get to the dining hall and acclimate for her first meal there.  For the record, we live about ½ mile from Southridge.  My grandmother's house was on the other end of town, probably almost five miles from our home.  So this is not inconvenient at all for back-and-forth trips.

I located James and asked him to help me plug in Mam-ma's phone, so that when the switch was made today, everything would be in place.  James did this, and I recorded a new message on the answering machine.

I helped Mam-ma to the dining room, where she sat at a table with Charley and Kathleen... two very nice people.  Charley is a retired minister from Texas, and he didn't seem too interested in visiting a lot, but we did make acquaintance.  Mam-ma's friends were seated at other tables, and the administrator had told us that some of them have agreed to move to a new table today and sit with her.  So she will have a group of friends to share conversation with over her meals now... something she has not had in years.

I had ordered soup from the menu for Mam-ma - the "daily dinner special" was fish sticks, and as luck would have it - that was her last Meals on Wheels lunch entree!  So she had a big bowl of chicken noodle soup, a cornbread muffin, buttermilk, and banana split pie with whipped cream and fresh strawberries.  And she ate heartily.  As she scraped the last bite of whipped cream from her dessert, she laughed and said, "If they feed us like this every meal, I don't know what I will do!"  I told her we'll buy her a muu-muu - this is her time to live it up!  Truly, the food appears to be wonderful - the menu was extensive and sounded delicious. I gained five pounds just reading it!

Before dinner, one of Mam-ma's long-time friends and fellow Sunday School class members Ms. Viola, came over to welcome her again to Southridge. Ms. Viola is one classy little lady - and she has lived at Southridge for eight years now.  She will be a tremendous friend to Mam-ma.  She patted Charley's arm and said, "Charley, this is my good friend.  You be nice to her."  Charley shrugged and said, "Okay."  A few minutes later, another life-long friend, Ms. Evelyn, came to her table, and she shouted across to Charley, "She is my good friend... you be nice to her!"  Charley again said he would do that.

During dinner, the R.N. came around and dispensed medications.  Mam-ma will get her meds with each meal... and someone will watch her take them.  Yippee!!!  After dinner, Ms. Viola came over to the table and told Mam-ma, "Now, I know you are tired tonight, so we won't expect you to come out and do anything.  But tomorrow night at 8:00, some of us are gathering for a cup of tea, and we want you to come."  Mam-ma said she would.

I helped Mam-ma back to her room, and she said she was exhausted.  We turned down the bed, and she put on her pajamas.  I helped her find her denture cup, face cream, and other things in the bathroom. She fussed that she wished she had her "sleeping pill" - an anti-anxiety medication she takes "as needed."  I told her all she had to do was punch her little life alert button, and a nurse would bring it.  She wasn't happy that she can't keep that in her room, but it's a controlled substance and must be locked away safely.  I said, "Let's just test this..."  She pressed her button, and an aide unlocked her door pretty quickly and came to see what was needed.  Mam-ma told her, and soon, a nurse was back with the pill.  Mam-ma fussed about liking to take one "in the night," and the nurse assured her that all she had to do was buzz, and someone would bring her another any hour of the night or day. (And they will document this, so we know when she takes them - and how often - WHEW!)

I was getting ready to leave when my cousins arrived - just to stop by and make sure all was well.  They were amazed and impressed with the room and how nice things were.  And then, Mam-ma's phone rang.  At first I thought I had imagined this... but I answered, and a friend of Mam-ma's, who she knows from the dance hall, asked how she was doing!  Thank you, Lord... my grandmother was without phone service less than 3 hours!  I told Mam-ma - "This is a miracle!"  She agreed.  I also told her, "You now have EVERYTHING you need.  If you figure out something that we've missed, I can get it from your house any time."

My cousins left, and I tucked Mam-ma in and told her, "You're home, Polly."  That is when she said, "Y'all have done a wonderful thing today.  I bet Greg is tired!"  I told her I am sure he was, but he would survive it.  I have the most amazing husband, and he never complained about a single thing all day - was there to help me at every turn - and thought of things I completely forgot in my tizzy to get this all done!  As I opened the door to leave, I told Mam-ma I would return today, and she called out, "I love you!"  "I love you, too, Mam-ma," I replied.  I locked the door and shut it, knowing she would be asleep in no time... and not only would the staff watch over her, but clearly, Someone else was taking great care, as well.

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

This morning, I phoned Mam-ma around 9:15.  She said she slept well... was up a few times because "My air conditioner was blowing cold air."  Now, Greg adjusted the unit, and he showed her how to adjust it, but we'll have to review that again today.  She said she had a "wonderful" breakfast - scrambled eggs, bacon, coffee, juice and more.  And she was headed for exercise class at 9:30 a.m.  I told her to have a good time, and I would see her this afternoon.  Greg is going to surprise her with a bird feeder placed just outside her south-facing window (the room is very sunny!), and she will love that.

Mam-ma is doing just what I expected - jumping in with both feet and embracing this "new chapter" in her life.  I feel like I have just gotten my life back... and I get to keep my Mam-ma, too.  And that's a heckuva sweet deal.

Catching Up...

I know it has been a LONG time since my last post, and I do apologize. I could use the holidays as an "excuse," but honestly, I can't explain why I have not found time to share a few things with you. Perhaps I am like many people - I just need a break.  But life has marched forward, so here goes.

We celebrated Thanksgiving at my mother's home.  We had a good meal and enjoyed being together - I think.  Timothy was the star of the show, and he entertained us well.  I would have to say that much of the day, Mam-ma was very bored.  She didn't seem all that alert... and of course, she doesn't hear well... and she refused to bring her walker into the house.  So every time she stood, we held our breath as she reached for unfamiliar furniture and surroundings to "hold onto" as she toddled from one spot to the next.  My husband said he didn't know whether he was more nervous about Timothy getting into something he shouldn't, or Mam-ma falling!  I really think Mam-ma was the bigger liability!

Mom took Mam-ma to Wal-Mart to get more fabric for yet another baby quilt - this time for Timothy's new sibling, who will arrive late next spring.  Mam-ma has begun to tell a few people she is on the list to move to the assisted living facility. I have talked with the administrator, and she says a few things have changed, and there MAY be a vacancy ... but she has not returned my call to say we are on "Go!"  And if she does, I can't guarantee that Mam-ma will agree to move.

Last week was one for the books.  Mam-ma had told me the week before that her teeth were bothering her.  She mentioned it to Mom on Sunday over lunch, and Mom said, "Make an appointment to see the dentist, and I'll take you."  On Monday, Mam-ma said the same thing, and Mom told her again to make an appointment.  Mam-ma replied, "Well, they are a little better... if they start to bother me again, I'll call the dentist."  Less than an hour later, Mam-ma phoned Mom to tell her she had an appointment - for TUESDAY!  Mom was busy on Tuesday and didn't want to bother me with this, so she told Mam-ma to reschedule.  We had been keeping Timothy for a couple of days, and Mom knew I had a full week ahead with other appointments and obligations for Mam-ma and myself.

Mam-ma wanted to get a dental appointment on Wednesday, but Mom knew that we already had an appointment at our local hospital to get Mam-ma's pacemaker checked that afternoon.  So she told her the dental visit needed to happen on Thursday.  Now here's where it gets hairy.  Mam-ma had moved her beauty shop appointment to Thursday afternoon, so that we could do the rescheduled cardiologist appointment on Friday.  So... this meant that on Thursday, Mam-ma went to the dentist in the morning, then Mom whisked her to the beauty shop in the afternoon, where I picked her up afterward and took her home.

The pacemaker check went fine... we really were not gone very long at all.  The only real problem was that we have had very cold weather for early December, with lots of wind, and Mam-ma does NOT like wind!  But we persevered, and on the way to the hospital, Mam-ma told me that Ruby had fallen that morning in her front yard.  "Was she hurt?"  Yes, Mam-ma said her arm was hurt, but her doctor was not in his office on Wednesday afternoons, so she was going to tough it out until the next day.

The bottom line... Ruby's ankle gave way as she crossed her yard, and she fell and broke her wrist.  She has now seen her family doctor, an orthopedist, and has a cast on her arm.  She was trying to retrieve a box that had blown into the yard.  I would venture to say it was well below 32 degrees that morning.  By God's grace, a neighbor happened to be out and saw Ruby fall and helped her get back up and on her feet.

So Mam-ma told me that she had been taking her daily "walks" inside her garage.  I questioned her - wouldn't it be better (and warmer) to walk inside her house?  Well, there was more room.  And I surmised... "Oh... easier to maneuver your walker in the garage?"  "No...I don't use my walker in the garage."  This did NOT make me happy, and I tried to hold it together as I explained to Mam-ma that a fall in the garage could result in her lying on cold concrete for hours before anyone discovered her... and she could freeze to death!  "Well, that's right!" she replied.  But I have no doubt it went in one ear and out the other.

Thursday, Mom took Mam-ma to the dentist, where her dentures got yet another "liner."  The dentist explained to me that Mam-ma's jaw bones are disintegrating, due to age and the pressure of years of chewing, and there is really nothing for her dentures to fit around.  So he puts in a liner that makes them fit a little more snugly - for a few weeks/months.  If the dentures are loose, they rub very painful blisters on her gums.  We've probably had better than a half dozen new liners in the last couple of years.  The dentist is WONDERFUL with Mam-ma.  Since she is a former chairside dental assistant who has made a gazillion sets of dentures, they have a lot to talk about.

Mam-ma and the dentist she worked for made their own dentures, long before the advent of our dental labs of today.  The dentist would select the teeth from his tall cabinet of tray-like drawers... canines in one, molars in another, incisors in yet another... and he and Mam-ma would "set" the teeth in the soft "gum" form.  Then Mam-ma would take the teeth home and "cook" them in a big special pot on her stove (while supper simmered on the other burners), and this would "set" the teeth in the gums, and they would harden and become dentures.  I know there's more to it, but that's basically how it happens.

I spent many hours in this dental office as a child, and I was intrigued with the trays of teeth and thought nothing of that vat of dentures cooking on the stove at my grandparents' house.  So the dentist of today is fascinated by my grandmother - and her tales of earlier times - and he treats her like a queen.  I will be forever grateful to him for his kindness and love for her.

Since I had my own appointment Thursday mid-day, Mom took Mam-ma to the beauty shop at 2:00, and I picked her up there at 3:00, groceries in tow.  She'd made me a list the day before.  Of course, after her appointment on Wednesday, and TWO appointments on Thursday, she admitted she was really tired.  And it showed.  Her speech was getting loose and slurred... the thoughts didn't come very fast, and she was moving at the speed of a snail.  I dropped her at home and told her to REST!  She said she would.

Friday morning, my husband and I were there to get her at just after 10:00 a.m. to make a 30-mile drive to visit the cardiologist.  When I called Mam-ma the night before to make sure she took her medicine, she said, "I dread that trip."  She LOVES this cardiologist and always enjoys the trip to see him, so this was my first clue that she truly is realizing at least some of her limitations.  She continued, "I wish he came to our hospital, and I could see him there."  I told her one of his associates came to our hospital, and I was sure we could switch to him.  But I was afraid to do this, because I know how much she likes this other doctor.  However, she said, "I think it may be time to do this."  I asked if she wanted me to pursue it, and she said, "No... let's see how tomorrow goes."

The drives to the cardiologist are always interesting.  Mam-ma tells us all sorts of things about her childhood... and this trip was no exception.  The stories come S-L-O-W-L-Y, but she told of her dad working as a blacksmith... and a coffin maker.  She related how he would have her and her sister, Babe, hold the fabric and lace that lined the coffin while he tacked it into place.  She told of her school days and going to live with an older sister, Minnie, and her husband Ray, for about 6 months to attend school in another community.  I made notes, but I do plan to get to her house and get some of this documented better and in a more chronological order.

Once we were in the cardiologist's exam room, I asked Mam-ma, "What do you think... do you want to see about moving to another doctor?"  She replied with a sigh... "Well, I just believe we'd better."  So I asked the doctor, who was gracious and agreed that it was time for this change.  He gently reassured Mam-ma she was doing the right thing.  I told him she was on the list to go to assisted living, and he also agreed - and reassured her - about this decision.

We had lunch at Dixie Cafe before returning Mam-ma to her house, where three cousins from Oklahoma were just arriving to spend the weekend with her.  These "girls"... as Mam-ma calls them... are so good to Mam-ma, and they come to visit several times a year.  But Mam-ma always overdoes it when they are here, and she is exhausted when they leave... although she will not admit it!

The cousins stayed all weekend, going home Sunday sometime.  Monday, I checked on Mam-ma, and she seemed fine... of course, she said, "I'm really not tired at all."  Not thirty minutes later, she called me again and said, "You or Greg needs to come get my teeth.  They just broke in two when I tried to eat my dinner."  I called my husband, who was out delivering Meals on Wheels, and he went to Mam-ma's, got her teeth, and took them to the dentist.

Monday night, Mam-ma still didn't have her teeth.  We surmised the dentist had sent them out to a dental lab for repair, as Mam-ma said they snapped into two pieces.  I asked her if she had any canned cream soups she could fix for supper.  She said, "Yeah, I've got soup, but I have to thaw it."  I said, "No, I meant a can of cream soup - like cream of tomato, cream of chicken... don't you have something like that?"  She replied, "Yeah, but the soup in the freezer is vegetable."  Vegetable soup is one of her favorite meals.  I just quietly asked, "Well, Polly... how do you plan to chew vegetable soup with no teeth?"  She started to laugh... "I don't know," she giggled.  In the end, she had cream of chicken soup, crackers, and applesauce.

The dentist repaired the teeth himself, apparently, and late the next day, they were ready.  Mom took Mam-ma to get them, and an assistant put them in for Mam-ma and sent her on her way.  Mam-ma told Mom she had had a terrible headache all day from not having her teeth, and we surmise it was from not having much to eat (and probably the effect of little food and her medications on a somewhat empty stomach).

Tuesday night, Mam-ma was much better when we spoke, although her speech was very slurred and halting...probably from being tired.  But she said she had eaten, and her headache was gone.  She added... "I tell you what, I don't think I have EVER gone three days without my teeth!"  I said, "But Mam-ma, you weren't without your teeth for three days."  "Oh, yes, I was!"  "No... Greg picked them up yesterday at noon, and you got them back this afternoon - that's scarcely more than a day."  "Well... WHATEVER!"  I laughed and told her I was sure it seemed like three days, and she said, "It sure did!"

However, this made me realize that Mam-ma, who is prone to exaggeration, really convinced herself that she had been without her teeth for three days... and that tells me how confused she is becoming.  And there's more... she has taken almost a week to tell both my mother and me that her Home Health nurses have been talking to her about a new program called "Personal Care."

Mam-ma called me Monday night to tell me that a nurse had visited her and "evaluated" her for "Personal Care," a Medicaid program that provides additional in-home care for those who need it, particularly the elderly.  Supposedly, this aide will come three days a week and do laundry, housekeeping, and other things for Mam-ma.  She said, "I'll be the laziest thing in town - I won't have anything I have to do."  She also said, "You'll probably get a call... that nurse said she was going back to the office and get the ball rolling to get this for me."  She told my mother, "I didn't sign up for anything - I wanted to talk to Debbie first."  So I have not gotten a call and really don't know what is going on with this.

However, I asked Mam-ma... "Did you tell them you are on a waiting list for the assisted living facility?"  She said she did, and the nurse said, "That's okay... if you go, we'll stop it."  Not wanting to tell Mam-ma I've made an inquiry again at the assisted living facility and expect a call soon from the administrator, I asked, "You know, the assisted living facility could call us any day and say a room is available.  So, if they call and have a room ready for you, don't you want to at least go look at it?"  Mam-ma changed the subject somewhat and said, "Well, that aide said, 'Don't you want to stay at home as long as you can?' and I said 'Yes, I DO!'"  So I am having my doubts that Mam-ma will be agreeable to even looking at a room at the assisted living facility... much less agree to move there.

I've done a little Internet research, and while this program looks good, I am not sure it will provide the level of care my grandmother may need and/or desire.  For one thing, these aides cannot handle any medications... the assisted living facility provides nursing care and will monitor all of Mam-ma's meds. The aides can also not provide any transportation, and that's a biggie with Mam-ma - having someone to drive her places now that Ruby is not able to chauffeur her to the store and such.  And... while this is three days a week, Mam-ma needs PEOPLE around her EVERY day.  As we approach winter and she becomes more housebound by the weather, she will become even more restless and lonely.  At the assisted living facility, she would be surrounded by people all of the time.

Still... this is totally my grandmother's decision at this point.  She is mobile.  She went to her Sunday School brunch at a local restaurant this week.  She continues to "show her spunk" at every turn, and for the most part, we've managed to make the adjustments that are keeping her relatively safe in her own home.

I say "for the most part," because... last week, Mom called one afternoon to see if Mam-ma had taken her noon medications, and Ruby answered the phone.  Mom said, "I just called to see if Polly took her medicine."  Ruby responded that she probably did not, "because we're making peanut brittle."  Mom said, "I didn't know what to say to that, so I pretty much just hung up!"  When I went the next day to get Mam-ma for her appointment, there was absolutely NO trace of peanut brittle, save an empty corn syrup bottle tucked in a corner on her counter.  But I could smell the cooked sugar of candy making... I know that aroma all too well!  The candy was never mentioned.

On Thursday, when I picked Mam-ma up at the beauty shop, we were leaving and her hairdresser stopped at her station and said, "Oh, what's this?  I wonder who left this candy?" It was a zip-loc bag filled with peanut brittle.  Mam-ma grinned like a proud school child and said, "I did!"  The hairdresser asked, "Who made it?"  Mam-ma grinned again, "Well, I did!" she said.  Behind her, I mouthed, "She's not supposed to make peanut brittle," and the hairdresser nodded in agreement, pulling me aside a few seconds later and saying, "She told me a couple of months ago that y'all won't let her make peanut brittle any more."  We both just sort of rolled our eyes!

I did not acknowledge any of this to Mam-ma.  We got into the car and started home, and she said, "Ruby said, 'Oh, I'm so glad we got that peanut brittle made before I broke my arm.'"  Again, I did not bite.  This irritated Mam-ma to no end, and she got short and curt with me afterward.  I changed the subject to something else, and I knew she was not happy - she wanted me to fuss at her and cause an argument.  I don't know how I held my tongue, but I did.  To her credit, she did not leave a bag of the candy for me to bring to my husband, or I might not have been so patient.

Clearly, as long as Mam-ma lives at home, she is going to test the waters... from making candy to walking in her garage without a walker to things I don't even want to imagine.  I pray each day that God keeps her safe... and that He gives me the strength to deal with whatever may happen next.  Meanwhile, I just chalk these incidents up as "fodder for the blog!"

On a side note, my mom has just written a new book about the history of the entertainment industry in Branson, Missouri.  Since so many people like to visit Branson, I thought there might be readers here who would find this information of interest.  My mom has now written five books... you can learn more about her work at her website... ArlineChandler.com.

Apparently We Still Don't Understand!

Last Monday, my grandmother called my mother and asked, "Do you want some turnip greens?"  Mom told her no, and asked, "Where did you get greens?"  Mam-ma replied that a church member had left them on her doorstep.  Mom told her to leave them there, and she (Mom) would get them later.  Mam-ma replied, "I've already got them in the sink, and I'm washing them. Mom sorta lost it and said, "I'll be right there."  She called me and told me about this and said, "I'm going right now to get those greens.  I may put them down the disposal."  I somehow knew she would not do this.

There are two versions of this story - Mom's and my grandmother's.  And amazingly, in most spots, the stories parallel!  Mam-ma's version is that "Your momma chewed my butt but good.  She talked awful to me."  Mom's version is that "I did talk pretty strongly to her, but she screamed at me... 'Just what am I supposed to do?'"  Mom told her she was supposed to cooperate.  To make a long story short, Mam-ma had started to wash and de-stem the greens, which she says she "loves to do."  Mom says nobody in their right mind likes to wash turnip greens, which is a long, tedious process in cold water.

This really is not good for my grandmother - she has to stand hunched over the sink, and she has problems with her neck and shoulders as it is.  This is not the best posture for her.  But she absolutely loves turnip greens.  They are like gold to her, and she assumes everyone else feels the same.  Never mind that her deacon has brought them to her recently - fully cooked and seasoned and ready to eat.  She was doing these for us, she said.  She told me on the phone, "I aimed for you to have some of those greens."  Mom said she even telephoned later and gave Mom's husband the message to "save some of those greens for Debbie." 

Mom finished washing the greens and sorting them - and some did indeed go in the disposal - and then she cooked them.  She said, "I will probably gag trying to eat them."  Now she feels badly that she let something as seemingly insignificant as a bag full of green leaves cause such an argument between her and her mother-in-law, but as she put it, "Your Mam-ma just knows how to push my buttons."  And I understand that... she pushes mine, too!  But Mom says that next time - and there probably will be a next time - she will just go get the greens and keep her mouth shut.

I think another thing that upset Mom is that this is the one man in her church who she knew took raw produce to my grandmother - and Mom had not found time to contact him and let him know we're not allowing Mam-ma to use her stove any more.  So she was mad at herself... and upset with Mam-ma... and it just was not pretty in the end.

It has now been about 10 days since the infamous car wreck, and and other than being upset that she can no longer ride with her friend Ruby, and her "life is over," Mam-ma has seemed to do fine.  In fact, by mid-week, she was not even mentioning her chest when we spoke.

All of this changed on Thursday.  Apparently Ruby mentioned that she was changing her closet and removing the summer clothing and putting in the winter clothing.  While she was at it, she was going to do some cleaning, and she would be taking some discarded things to the thrift store.  Mam-ma decided she had some closets that needed cleaning, too.  Ruby said that she told Mam-ma to place her things on the spare bed, and she (Ruby) would fold them and put them into plastic bags and take them to the thrift store for her when she went.

First of all, Ruby is recovering from broken ribs as the result of a fall last month, as well as her own jarring from the car wreck.  She really doesn't need to be hauling my grandmother's things to the thrift store for her. And secondly, Mam-ma doesn't need to try to clean her closets by herself.  Nonetheless, when Ruby went to get the clothing, it was already sacked and in my grandmother's garage.

I took Timothy to get a hair cut on Thursday morning, and while we were out, we went by Mam-ma's for a visit. She was so glad to see Timothy, but she said she had worked hard all morning cleaning closets, and that Ruby had taken "a ton" of things to the thrift store.  Ruby's story is that it was three very small shopping sacks of clothing.  Mam-ma asked me if I thought my mother-in-law would like to have some feather pillows.  I told her I did not think so... why was she getting rid of feather pillows?  "Well," she replied, "I don't need them, and I'm a gettin' rid of things." She also called my mom and asked her if she would like to have a lamp she was no longer using.

Thursday evening, Mam-ma called me about 8:30 and said, "I am going to take two Tylenol and go to bed.  My chest is killing me.  I hurt so bad."  And she sounded awful.  I asked her... was it her heart?  No, it was her chest... that breast bone above her breasts.  I told her it sounded like she over-did it with the cleaning. She agreed.  She indicated she had worked cleaning closets all afternoon.  I asked if she planned to take her anti-anxiety medication, too, and she said, "Not now... maybe later in the night."  I deduced that she must not be that bad, or she would have taken it, too.  She seldom hesitates to take one if she is feeling anxious. 

She also said to me, "You know, when Ruby fell, they didn't find her broken ribs on the x-rays at the hospital."  I knew where this was going.  The broken ribs were determined four days later in the clinic of Ruby's primary care physician.  I told Mam-ma, "If your ribs were broken, we would already have been to the doctor.  You were not even complaining until you over-did things today.  You've strained something."  She replied, "Well, you just don't know how bad I hurt!"

I told Mam-ma, "I have the baby tonight - I cannot come stay with you."  She said, "I know... I'll just have to tough it out.  I'll make it somehow."  I phoned my mom to alert her that Mam-ma was not having a good night and she might be calling.  But she didn't.  And the next morning, she indicated she was better, though not by much.

When I arrived to get Mam-ma for the beauty shop, she seemed a little slower and more confused than usual.  We looked at her grocery list, which was mostly household things like laundry detergent and Lysol for the housekeeper to use for cleaning.  She did need candy bars and milk.  She didn't have that much to say on the way to the beauty shop, but on the way home, she told me, "Ruby just can't understand WHY I hurt so in my chest. I told her, 'Ruby, you have no idea how bad I hurt.'"  I know that she told Ruby, "I hurt like HELL!" 

I did not comment.  I really didn't know what to say.  We got out of the car at Mam-ma's house, and she said, "If I'd a thought last night, I'd a taken that pill the doctor give me instead of them two Tylenol.  And I may just take it tonight."  She was referring to the one Flexeril (which is a muscle relaxer) that the doctor handed her in the ER to take when she got home the night of the wreck.  When we got home, she said, "Now I'm not taking that... I'll just take two Tylenol."  However, she made me leave it with her, and I knew it was only a matter of time before she took it.  I reviewed all of this medication's side effects with her on the discharge papers, and I told her, "Greg's mother had virtually every single one of these when she took the same drug for her back trouble a few weeks ago."  She said, "I know all about that!" Again, I just dropped it.

But I knew that at some point, she would not be able to resist the temptation to take this muscle relaxer.  So when we she said she might take it Friday night, I reminded her, "It will make you woozy."  She retorted, "Well, I'll just take it and go to bed."  And apparently she did.  My mother's husband was there to repair something the next morning, and he said she was weak and wobbly, and Mom said she probably had a hangover.  This morning she overslept and was unable to go to church.  But she did go to lunch with my mom and her husband, and she went to church with them this evening, so the fog is apparently clearing somewhat.

Friday, I refilled all of Mam-ma's medicine compartments, and the noontime medication for two consecutive days of the previous week was still in the boxes.  I showed it to her, and she said, "I know about that... that was for last week."  I said, "Yes, but you still didn't take it."  She said, "I know, and I said, 'Debbie is going to chew me out good over that."  I didn't say anything, but then I opened up the current week's compartments, and there was noontime medicine for Wednesday, Thursday, and Friday.  I said, "Mam-ma... look here.  You have not taken your medicine at noon today."  "No, I haven't," she said.  I added... "And you didn't take it yesterday or the day before."  "Yes, I did," she said.  "No, you didn't," I countered... "It's still here."  "Well, I don't know what to tell you.  I always take it!"  I assured her that it doesn't miraculously just reappear in those compartments.

She countered... "Well, those meals (Meals on Wheels) come before I'm ready to eat, and it just makes me forget."  I told her, "The arrival of your meal should be your reminder to take your medicine.  That doesn't make sense."  She answered, disgustedly, "Well, I guess I'll just have to go to sittin' out that medicine to remind myself."  I told her whatever worked was what she would have to do.  I also told her to go ahead and take her noontime medicine for that day.  She made a HUGE production out of it... moaning and coughing and saying, "Oh! Oh! Oh!  That hurts so bad. Oh, you don't know how bad that hurts."

Mam-ma also told me that the hairdresser "liked to killed me."  Apparently it was not comfortable to lie back for a shampoo, and she said, "I told her, 'Now I can't do this.  You're a killin' me.'"  That poor hairdresser.  Mam-ma said she told her, "I don't know what we are going to do with you," but she was somehow able to finagle the chair height and finish the shampoo.  The hairdresser never let on to me at all that anything had happened.  We are so blessed to have such loving, caring people who exhibit tremendous patience with my grandmother... like her hairdresser, her deacon, and her housekeeper, as well as many others.

Mam-ma is still complaining to my mom about her chest - and sometimes to me.  Last night I called to see if she had taken her medicine, and she said she had.  I asked, "Did you take it at noon?"  She replied, "Only after your momma called and reminded me."  I just don't know about this!  I told her I am having the entire family - even cousins - over for a chili supper on Thursday night, and she said, "Well, I hope I feel like coming.  We'll just have to see."  Do you really think she would miss it?  Mom says that she was the "belle of the ball" tonight at their church Fall Festival... and several men fussed over her and made her day!  Mom said she passed by as one man who was talking to Mam-ma pointed at her (Mom) and asked, "... and she is guilty?"  Mam-ma replied, "YES!"  Mom said she held up her hands and said, "Not me... I'm not guilty!" and walked away. 

Clearly, we still do not understand!

Who Decides?

By the time beauty shop/errand day rolled around, the week had already been quite busy.  On Monday night, Greg and I hosted a "family dinner" for everyone - Mam-ma, my mom and her husband, my sister and her husband, and my niece, her boyfriend, and baby Timothy.  Afterward, Timothy spent the night and most of the next day with us.

Tuesday evening, Greg and I had an appointment at our church to have pictures made for the new church directory.  I had scheduled an appointment for Greg's mother 10 minutes after our appointment, so she rode with us to the church.  But when we got there, her name was not on the list.  I told the volunteer, "I know I scheduled her for an appointment," and then Greg's mother said, "Yes, I made one, too."  "What?  You made an appointment?  Why didn't you tell us?"  Her reply... "Well, you said you made an appointment, so I just didn't think I needed to worry about mine."  I went to the church office and tried to find her name on a schedule sheet for another day, but I was not successful at first glance.  Meanwhile, she and Greg decided that we should all three be photographed together, which was fine ... and that's what we did.  I am still not sure why she felt it was unnecessary to tell us that she had made an appointment and duplicated our efforts.  In the end, the pictures turned out really well, and it will apparently all work out just fine.

Friday, I got to Mam-ma's house, and she was working on the new baby quilt.  Mom had taken her to Wal-Mart on Monday evening before coming to our house for dinner, so that Mam-ma could pick out new quilt batting and backing material to replace the fabric she ripped off the week before when my sister tried to help her.  Apparently this quilting set-up is still not perfect, but working much better than what my sister helped assemble.  Mam-ma had already quilted around several of the Winnie-the-Pooh characters.

I sat down at the kitchen table to dispense medicine, and atop the grocery list was an old, used tube of some sort of prescription cream.  I recognized the tube, and on the grocery list was "itch cream".  I told Mam-ma, "We've already tried this... the pharmacy said the prescription was so old that they could not refill it without asking the doctor, and when they called him, he said we would have to come in for a visit first."  Mam-ma glared at me.  I continued, "I am not taking you to the clinic for itch cream and risk you catching the flu or some other bug."  "But I need it!" she whined.  I reminded her that we had talked about this before, and I had gotten her hydrocortisone cream as a substitute. 

She glared at me and said, "Well, if you itched like I do, you'd understand how bad I need that!  It works so much better."  I told her, "I itch nearly every day because of my allergies - I do understand.  Use the hydrocortisone cream."  She said it "wears off."  I countered... "Re-apply!"

I suggested that the next time a Home Health nurse comes by, Mam-ma should ask her to call the doctor's office and see if she can get the cream refilled.  But I am not taking Mam-ma to the clinic for an itch cream.  I would not take myself for that reason, and it's not worth exposing either one of us to the potential germs and viruses that might be represented at the clinic.

I took the name of the cream with me to the pharmacy at Wal-Mart and asked what OTC substitute he would recommend - hydrocortisone.  So she has a new tube.

Meanwhile, I'm doling out the meds, and Mam-ma says that her friend Ruby is "going stir-crazy."  She added, "She's like me... she needs to get out and go somewhere and do something."  I laughed and said I guessed I was just different, but I can stay home for days on end and never get bored.  Mam-ma said, "Well, that's because you don't like flowers."  I do like flowers - but I don't care about gardening, and I told Mam-ma this.  She replied, "Well, I love to work in my flowers, and I feel better when I garden.  My muscles are not as sore, and I just do better."  I replied, "You know...  they said you could garden at Southridge."  She retorted sharply, and at a loud, high pitch, "I'm not a-goin' to Southridge!"  I laughed and said that was fine ... I was just saying that the lady told me they had two gardens and that Mam-ma could bring her shovel and other tools and "garden" there. 

Mam-ma came over to the table and stood over me and asked, "Do you want me to move to Southridge?"  I told her no... I wanted her to be happy - and to be safe. If she is happier in her own home, that's where I want her as long as she can live there safely.  She then asked, "Well, just who decides whether I go to Southridge or not?"  I told her she does.  "It's your decision."   She glared at me, and I just smiled at her.  "MINE?" she asked.  "Yes..." I answered, "whose did you think it was?"  "YOURS!" she retorted.  I explained that as long as she was mentally capable of making decisions, the choice was hers.  Should she become unable to think clearly, then yes, I would decide.  But for now, the choice was hers.  She replied, "Well, I'm not a-goin'!"  I told her that was fine.

Later that day, I saw my sister at Wal-Mart, and she said, "Oh, I had quite a conversation with Mam-ma last night.  She told me 'Y'all have taken away all of my privileges, and I've not been able to get it together since.  I can't cook any more, and you know I love to cook!'" (another thing she could do at the assisted living facility)  My sister tried to remind her that she could still cook - but only when someone was there with her to help.  She didn't acknowledge that.  Then she told her "A lot of that food they got for me (meaning Meals on Wheels) I can't eat."  My sister chided her about how she probably wouldn't starve. 

For clarification purposes, my sister is the "golden one" who can get by with saying things to my grandmother that I cannot.  On a few occasions she has filled in for me when I was sick and taken Mam-ma to the beauty shop and run the errands.  Mam-ma usually cooks my sister lunch beforehand - and buys her groceries at the store afterward.  I neither want nor need the lunch and/or groceries, but I think you get the picture of how this all goes.

So my sister said that she tried to explain to Mam-ma that we are only trying to keep her safe and out of the nursing home by asking her not to use her stove any longer - and she pointed out that she can still use her microwave and toaster.  Mam-ma flatly told her she had no intention of going to the nursing home!  This all gave me huge insight into why she had so quickly flown off the handle to me about going to the assisted living facility... it was continuing the thread of the previous evening's conversation!

After we had church pictures made on Tuesday, we went by my grandmother's to check on her.  Catching her off guard, she was more alert and able than when she knows we are coming!  She was smiling and happy to see us - and of course, a lot of that was because Greg was with me.  She told us how good the Meals on Wheels lunches were, and that she had really not had anything bad yet. (She told my mom that her lunch on Monday - chicken strips - was "horrible - the worst one yet!")  She is telling us the lunches are good - but she is telling everyone else how bad they are - sort of a reverse of the way she normally complains to me and tells everyone else how things are fine.

Mom and I tallied this week alone, and Mam-ma had a big dinner at our house on Monday, pork chops and gravy for dinner at a cousin's on Wednesday, and Mom took her butter beans and cornbread another night for dinner.  Then Saturday night, Mom made vegetable soup and took her some.  Mam-ma had already re-heated the rest of her Meals on Wheels lunch, but she told me, "I'll toss that in the dirt - I ate the soup instead.  It was delicious!"  So she is eating well - and in no danger of starving!

An elderly cousin telephoned me one night last week, and we talked about the situation with my grandmother.  He lives in a condo on the campus of the assisted living/nursing home facilities.  Before his wife died, they shared an apartment in the assisted living facility for a while, so he is quite familiar with the facilities and what is available.  He told me, "Anyone in town with any sense would wonder why on earth your grandmother is not already at the assisted living facility."  He was not being unkind, or implying I am using poor judgment - he knows my grandmother about as well as anybody.  He was merely pointing out that I should not feel badly if she has to move there. 

I asked him, "Does this mean you are on my team if I need reinforcements to encourage her?"  He assured me is is indeed in my corner.  I took this as one more sign that I am not off base in making preparations. 

Honestly, we are feeling like it may be sooner than later that this move occurs.  My cousin said, "Two weeks of living there, and I bet you wouldn't be able to get your grandmother to move back home."  He thinks she would really enjoy the company of others and the activities there. My mom doesn't buy it for one second.  I am just not sure.  I want to think my cousin is right, of course.  And I know that Mam-ma will never admit to me that she likes it, even if she is having the time of her life.  But I have to believe that my philosophy is right for now - as long as she is relatively safe and able to live in her home, she should live there.  The minute that changes, she should move.  The question of "who decides" will be determined by these factors.  Ultimately, the decision maker will probably be me... and I'm okay with that.

Meanwhile, my mother-in-law has returned to her family physician for a follow-up visit.  Her sacroiliitis is better, but her dizziness is not.  The doctor changed her blood pressure medication, added a diuretic, and scheduled her to see a cardiologist and a physical therapist.  There is apparently new therapy that may help with vertigo, so the doctor wants to try it and see if this helps with the dizziness.  Three mornings this week of therapy, then another doctor's visit at week's end.  Greg maintains that the doctors will find something to treat, even if there is nothing really wrong.  He is monitoring this closely, because our past experiences have made us wary of all of these tests, diagnoses, and treatments.

Friday, I was running errands with my grandmother while Greg was taking his mother to doctors and therapists.  And so the cycle begins anew.  Friends came from out of town to visit us this weekend, and they asked, "So what have you been up to?"  Grandmas and babies... with "life" sandwiched in between.   The complexity of the layers changes daily, but the components stay pretty constant... at least for now.

Things Can Change in a Heartbeat

I've been reminded this past week just how quickly things can change, particularly when it comes to senior citizens.  One week ago Friday, my mom ran errands for my grandmother and took her to the beauty shop, so that my husband and I could go to an estate auction out of town.  We took my husband's mother along.  My husband was so attentive and hauled our purchases to the car for us, got us cold bottles of water from our cooler and even brought his mother a lawn chair to sit in and rest.

The auction was a BIG one, and it lasted until well after lunch time.  We had our Yukon packed to the rafters with purchases.  My mother-in-law was particularly excited about a box of beautiful china dishes she got that were made in Germany.  She also got  an old foot locker to refurbish.  We enjoyed a late Subway lunch with her afterward before we headed home to unload our purchases.

By Sunday, Greg's mother was complaining of back pain.  She and her friends bought hand weights to use when swimming at our new Community Center pool, and she had used them for the first time on Thursday ... and she said she and her friends exercised pretty vigorously.  Then we stood a lot of the day for the auction on Friday.  On Saturday, she worked in her garage, standing on a concrete floor to sort the things in her boxes.  Somewhere in there, she got her electric lawn mower from underneath the house and mowed some high patches of grass in her yard.  And during all of this activity, she twisted her back badly ... to the point that she was sore on Sunday and in a lot of pain by Monday.  She started taking Aleve ... and lots of it ... but the pain was still fierce.

Her pain progressed each day to the point that by Wednesday morning, she was vomiting and dizzy.  The doctor was called, and he said, "Go to the ER."  My mother-in-law had never been to the ER ... will hardly take an aspirin.  She decided to wait a while and see if she felt better - and I truly think she did for most of the day.  But by the evening, she was worse, so my husband stayed with her for the second night in a row.

By the next morning, the pain was again so bad that my mother-in-law was dizzy and vomiting any time she tried to sit up.  So my husband called an ambulance and transported her to the ER.  The diagnosis was sacroiliitis, which the ER doc described as "excruciatingly painful."  He prescribed bed rest and several medications:  pain pills, muscle relaxers, steroids, and an anti-inflammatory drug.  She is not to stand or sit for long periods of time, nor bend over or lift more than 10 lbs.  The doctor said that once you have this, it's much easier to get it again and/or re-injure yourself.  So my mother-in-law, who is incredibly vibrant and active and belies her 84 years, will have to make some serious lifestyle changes in order to avoid further injury and pain, once this episode is over.

Meanwhile, my grandmother's dear friend and fellow church member - a man she depended on for everything from changing light bulbs to supplying her with fresh produce from his garden (not to mention wonderful friendship) - passed away Friday from cancer.  He had taken his wife and Mam-ma to a local Visitor Center to hear a musical performance last Saturday night ... sat with fellow church members at an after-service fellowship reception on Sunday night.  By Tuesday, he was in a Little Rock hospital, where he died Friday morning.

These two events have given me pause.  How did things change so quickly from one Friday to the next?!  How did a woman who was buying German china and old trunks end up flat on her back and incapacitated a few days later?  How did a man's cancer progress so quickly that he ate with friends one Sunday evening and was dead and buried before the next weeks' morning worship?

The point for those of us who are caregivers is that everything is fluid.  What is going smoothly this minute can be totally screwed the next.  Two winters ago, my grandmother attended a birthday party for a friend one Saturday afternoon, talked with my sister that evening around 7:30, and by 9:30 she was violently ill.  She ended up in the ER with five infections and was not only hospitalized for about 5 days ... she was then sent to the nursing home for more than a month of rehab!

So just because today is a good day doesn't mean everything is rosy or you can get complacent.  You have to stay on top of your game ... and ready for anything.  Just like your small child's fever can spike in a half hour - an elderly person's whole world can change in a matter of minutes.  In order to "keep all the tops spinning," you must be prepared and "bring your A-game."

And one more thing... while we were at the ER, I was once again reminded of the importance of taking an advocate along.  My mother-in-law was given Valium to ease her discomfort and make her more relaxed.  So when the radiology technician came to prep her for a CT-scan, there was no way she could answer the 2-page questionnaire concerning her medical history and health concerns.  Thankfully I was able to do this for her.  AND... since I had gone with her to her last doctor visit, I knew that there had been some question about her renal function ... and a discrepancy in her blood work.  I mentioned this to the tech, and she said, "Ohhh!  We're not going any further with the CT-scan until I see the results of the blood work."  Since the CT-scan required an injection of dye, it was important that the radiology tech be alerted about even a possibility of some problem with the kidneys.

Furthermore, when the diagnosis was made, the doctor began talking about medication and going home, and my husband and I questioned him about his mother's pain.  She had arrived by ambulance, unable to move without being dizzy and/or throwing up.  Six hours later, the doctor wanted to send her home by car and start oral medications that we were to go and collect at our local pharmacy.  My husband asked, "Why can't she have something for pain in the hospital and let it have time to work before we leave?"  My question was, "Why can't an 84-year-old woman who lives alone and is about to be given heavy medication for excruciating pain be admitted to the hospital for a few days?" 

The answer to my husband's question came down to a matter of liability ... if she was medicated and left - and then fell in her garage getting into the house and broke her hip, the hospital didn't want to be held responsible.  Apparently they thought it was better for her to get into a car, ride across town, get out of the car, walk into her house up several steps, and then get to her bedroom and into bed and then take pain medication when we could get it from the pharmacy.  We didn't get this answer all at once in this concise manner ... but rather through a period of hems and haws and hints that led to our ultimate deduction that liability was the concern.

The answer to my question was, "There are certain criteria that have to be met for hospital admission, or Medicare and other insurance won't pay.  If we admit her, we can't guarantee she will meet all the criteria and be totally covered."  This seemed absurd to me... I have no doubt that between the ER doc and the personal physician, some finagling could have been done to assure that my mother-in-law met the criteria ... if she didn't already! And while I appreciated their concern about her money, this was not the issue at the moment!  Again, I felt there was an attempt to cover the hospital and any liability.  And people think we don't need health care reform!

So ultimately, we left the decision up to my mother-in-law, and she opted to get some pain medication in the ER, give it time to kick in, and then go home.  My husband signed a paper saying we relieved the hospital of any liability for the pain pill.  Don't get me wrong ... I do not like hospitals.  I was not necessarily advocating my mother-in-law stay ... but at the same time, her medications would have been monitored, she would have been given food and snacks that fit her dietary restrictions, and trained professionals would have hopefully monitored activities such as getting out of bed to go to the bathroom, showers, and more.  To be so hesitant to admit her seemed ridiculous to me ... but paled in comparison to failing to treat her pain and sending her home in the same shape as she arrived.  And had we not been with her ... or one of her elderly friends or a neighbor had brought her instead of us ... this is exactly what would have happened.

To top it all off, her discharge instructions included being told to that her family physician wanted her to be "in his office in the morning at 8:30." 

My husband decided he would wait until the next morning and see if his mother could even get out of bed before considering whether to make this trip.  The next morning, he telephoned the doctor's office to see if he could determine why the doctor wanted to see his mother, and the nurse said, "That's crazy!  She spent six hours in the ER yesterday - why would we want to see her today?"  Needless to say, the trip to the family physician's office was cancelled.

I cannot say this loudly enough, DO NOT LET YOUR LOVED ONES GO TO THE DOCTOR'S OFFICE OR THE HOSPITAL UNATTENDED.  Virtually everyone needs an advocate to go with them for medical exams and consultations, and you absolutely cannot leave someone alone in the hospital for any length of time.  Don't let the medical staff intimidate you.  Ask questions, and stand your ground.  Don't leave until all of your questions and concerns have been satisfactorily addressed.  If anything sounds strange or doesn't add up, ask about it. 

Be sure you make the medical staff aware of any and all medical conditions or anything else you feel is important and would affect the patient's care and treatment. Do not be intimidated or bullied by health care professionals.  Be polite, but firm.  In my mother-in-law's case, the doctor had given his diagnosis, stated his opinion and plan for treatment, and left the exam room.  We had to ask the nurse to find him and ask him to return, so that we could question him further.  And this is perfectly within our rights... and yours. So often, the patient is in no condition to challenge anything or give information.  Advocates are vital to the health and safety of medical patients ... and the same can be said for those who are in nursing homes and assisted living facilities.

Think of it this way... if we were talking about an infant or a small child, we wouldn't even consider letting him/her go to a doctor or into an emergency room for treatment without an adult in attendance.  We shouldn't allow this to happen to a person of any age, but particularly older adults.  As the advocate, be vigilant and thorough.  Pay attention, ask questions, and stand up for your rights.  Your loved one's well-being - or very life - may depend on how well you represent them.

I'll Go Graciously...

It's been two weeks since my mom and I started calling my grandmother each morning and evening to remind her to take her medicine, and she hasn't missed a single dose.  She seems to be enjoying the daily phone calls from each of us, so she has not complained about the reminder - so far.  However, she has complained that she lacks energy - and she did cut back to walking every other morning in the brutal summer heat we have been experiencing.  Even though she walks around her block at 6:00 a.m., the humidity level has been high enough to pester her breathing.  So pacing herself and taking a break every other day is a good idea.

During a conversation with my mom, she noted that she feels Mam-ma's transition to an assisted living facility - of not a nursing home - is inevitable.  I've fought tooth and nail to keep her in her own home as long as possible, but after the incident a few weeks ago where the gas was on under a stove burner with no flame, and the numerous missed doses of medication, I realize that this run at home may be ending.  So I called a local assisted living facility and inquired about accommodations, pricing, and possible financial assistance.

I am still vague on some of the details, but apparently there are two options - a one-room "suite" that has living area and bedroom together with a separate bath for $2600 per month, or a two-room "apartment" that has a living/dining area with "kitchenette" (refrigerator, sink, and room for microwave and coffee pot), plus a separate bedroom and bath ... for $3000 per month.  There are four tiers for Medicaid assistance ... the higher the tier, the more Medicaid will pay.  This is based on an evaluation by authorized nurses and personnel who decide how much help the client needs and assign him/her a tier level accordingly.  So it's possible that Mam-ma could afford this facility, even though her monthly Social Security income is about one-fourth of the "suite" rate.  I thanked the person who gave me the info, made some notes, and set them aside.

That same evening when I talked to Mam-ma, she said she and her friend, Ruby, had been to this facility to visit two of their friends who live there.  Both of them have suites, and Mam-ma said, "Oh, they are NICE ... and real spacious."  I asked, "Do you ever feel like you might to live there?"  She replied, "Well, I just might."  I know that one of her friends who lives there has encouraged a move ... and the friend's daughter-in-law has talked to Mam-ma several times about moving there. 

Mam-ma said that there was an area where she could do her sewing - that in fact, her friend was working on a painting there the day she and Ruby visited.  She said, "Well, it would just be nice to have people to visit with and be around."  But she also added that she didn't think she could afford the facility fees.  I told her I'd done some checking, and I thought maybe she could.  But I assured her it was her decision, and one that didn't have to be made now.  Should she decide she was interested, I'd do more investigating and get the ball rolling for her to be evaluated.

On one hand, I can see how this would be great for my grandmother.  She loves people and having lots of folks around.  Her meals would be prepared, she would have her meds dispensed, and she would be far safer, hopefully, than she is in her own home.  There would be a level, safe place to walk outside around the facilities and plenty of activities to occupy her time ... with her own room to which she could retreat for privacy.  On the other hand, she would not have flowers or a garden to water and tend - at least not as many - or her own cooking to enjoy. 

She could not take all of her "stuff" with her, and while she doesn't have all that much ... she would want to take much of it along.  My mom thinks she would expect to keep her home, much like she did 22 years ago when she "traded" houses with my husband and me.  Her thinking at that time was that she would get "a little apartment" in town and still use her farm house like a giant closet for all of her things.  That didn't happen.  I think she understands that she lives in a home my mother provides, and that the move to assisted living is complete and not a temporary thing.

Anyway, nothing else was said about the assisted living facility.  Mam-ma's cousins from Oklahoma came for a weekend visit, and she was on Cloud Nine, planning and preparing for their arrival ... cooking a meatloaf and other dishes, even though the women assured her they would go out to eat... and getting her hair done.  She had scheduled a much needed perm for last Friday, but when she learned the cousins were coming that afternoon, she called me and wanted to cancel.  I told her that she needed to get it done, and she said, "Well, I really don't feel like it."  I asked, "So you don't feel like the girls coming to visit?"  "Oh, yes!  I feel plenty well enough for them to come." 

Sounding very much like my mother when I was a teenager, I said, "Well, if you are well enough for the girls to come, I think you're well enough for a perm.  It will even make you feel better... you need it!"  It was shades of a parent telling a child, "If you are well enough to play outside, you are well enough to go to school!"  So she relented, although she wanted to go early.  I told her that we didn't know if her hairdresser could take her early, and Mam-ma said, "I don't know why not ... she's always just sitting around when we get there."  That is not true, and I pointed out that the hairdresser takes her lunch break shortly before Mam-ma's 2:00 p.m. appointment.  And I felt quite sure she had arranged for a babysitter to watch her 4-year-old grandson while she stayed late to do this hair perm. 
So I told Mam-ma I would not take her early unless she called the hairdresser and confirmed that it was okay.  She did ... we went at 1:30 p.m.  The hairdresser had forgotten she scheduled an extra blow-dry client at 1:30, and she squeezed in someone else while Mam-ma's perm processed, and we still didn't get done until 4:00 p.m. (which would have been the original time to finish).  This was fine with me, but I could tell Mam-ma was anxious to hurry home.  The cousins didn't arrive until 5:00 p.m., so we had plenty of time to spare.

The weekend apparently went great.  The ladies played Chicken Foot dominoes both nights.  They ate Mam-ma's meatloaf Friday night.  Saturday night when I called, the cousins were frying okra and cooking fresh peas and other veggies from the farmer's market (purchased early that morning), and another Chicken Foot game was planned for afterward.  Ruby came over and joined them, and they had a ball.  The ladies took Mam-ma to church on Sunday and then to lunch somewhere (maybe leftovers at home?), before leaving about 2:00 p.m.  When I talked to her Sunday night, she said, "I'm not tired at all." But she had not been up to returning for Sunday evening church services, and I'm betting she slept like a rock!

During our conversation, Mam-ma said that Ruby had said to her, "Polly, someone told me you are thinking about moving to the assisted living facility."  I don't know who could have told Ruby that, but Mam-ma thinks it was the daughter-in-law of her friend.  I asked, "Did you tell Gail we had looked into this?"  She said no, but she must have said something.  Anyway, Ruby told her, "You won't like it there without me."  Mam-ma said she told Ruby she had no plans to go.  And then she said... "I don't know if I would like that... those rooms are really tiny."  I questioned her ... a few days earlier she had declared them "very nice" and "spacious."  She said, "Well... they're not!"  She said she would want an "apartment" if she moved there, and I told her that might be possible, although the apartments were $400 per month more than the "suites."  That surprised her.   She said, "I'd need a place to have company."  I'm sure she is thinking the cousins could stay there with her, but I honestly don't believe this would be allowed - nor would they want to.  I'm sure they would gladly come to visit and get a motel room somewhere, but I know this is what is bothering Mam-ma.

I asked if Ruby ever considered moving there, also, and she said not really... but maybe.  I think they would be very happy there together.  But I also reassured Mam-ma that we do not have to talk about this - or even think about it - today... but we do have options.  She said, "Well, I told Ruby, when the time comes - if it does - I'll go graciously."  I laughed and told her I want that in writing!

We will see what happens.  It would be wonderful if both ladies would decide to make this move while they are still relatively healthy and able - and can enjoy the other residents and the amenities.  God will handle this, thankfully ... and I'll do the legwork if and when it is required.

On another front, my mother-in-law went to her family physician last month for a bout with vertigo.  She's had a few episodes of this ailment over the last 12 years.  This time, it had been long enough that the doctor wanted to see her again.  Since she almost never goes to the doctor, he drew blood and did a full lab work-up on her at the same time.  He also discovered her blood pressure is now high enough that she needs medication.  Since she is 84, we feel blessed that she has not required such medication sooner ... and the doctor gave her a sack full of samples.

Last week, someone called from the doctor's office and said that my mother-in-law needed to come back for a follow-up visit.  There was a problem with the lab report.  I went with her, and the kidney function numbers were all seriously out of whack ... to the point that they indicated renal failure.  She had no symptoms, other than high blood pressure.  The doctor promptly said he was scheduling her to see a nephrologist, told her to avoid salt and any anti-inflammatory drugs (including the Aleve she takes when her arthritis flares), and he drew more blood.  That was on a Tuesday. 

On Friday, I called the clinic to inquire about the lab results and schedule a follow-up appointment, and the nurse said, "We've not gotten the lab work back, but we've called the hospital to request it."  Meanwhile, she had scheduled a visit with a nephrologist for sometime in September.  I noted the appointment date and time and did a Google search for this physician, whose clinic is in another city 65 miles away.  No one called back about the lab work all day. 

At 5:30 p.m., the nurse called and said, "We've been looking at these lab results all afternoon, and we can't figure it out, but everything is normal.  All of her kidney functions are normal.  We don't know if there was a mistake the first time, or a mixup at the lab, or what, but everything appears to be normal.  And she didn't have any other signs of renal failure when we saw her on Tuesday."  She said the nephrology appointment had been cancelled, and they would see my mother-in-law for a follow-up visit at the local physician's clinic in mid-September.

So we are grateful that these results are good... and hoping they are correct!  Since my mother-in-law's bout with vertigo, she has seen an ENT to have her ears cleaned, she is scheduled to see a surgeon for a colonoscopy, and she was scheduled to see a nephrologist.  She said a friend told her, "Those doctors will find something wrong with you and make you sick!"  We are determined this will not happen. 

We are not being cavalier with her health, but we've decided not to fuss when she salts her food at the table.  She is swimming every other day at our new Community Center pool, and if she wants to take an Aleve when her "bad knee" aches at night, we are thinking she should do just that.  This woman is the picture of health - you would look at her and think she was in her early seventies at best ... not 84.  Prior to taking medication for high blood pressure, she took an occasional Aleve, a somewhat daily B-vitamin, and two drops daily of an eye medication for glaucoma.  Contrast that with my grandmother who takes SEVEN medications daily in varying dosages, as well as a frequent anti-anxiety pill, Tylenol, and probably a few OTC things I don't know about!  In my husband's words, "I'm not going to let the doctors make Mom sick."

I've seen both sides of this equation.  My maternal grandmother had a pill for everything, and her favorite pastime was seeing the doctor for some ailment - real or imagined.  She ended up with Parkinson's disease, and I feel that it was at least partly due to the way she mixed and matched her medications.  Once when my mom was helping straighten up my grandparents' house, she found one of Grandmother's pills in the closet - atop a pair of shoes!  My Mam-ma will tell me of her family physician, "He needs to see me ... he's my doctor!" 

My dad had a "routine" arteriogram at age 61 that resulted in instant "cholesterol showering," which we found is more common with this procedure than most realize.  Within a month, he was in complete renal failure, and he spent the next 22 months or so on daily dialysis before suffering a heart attack and stroke that claimed his life at age 63.  This helps to explain why I recently went almost a month with a respiratory ailment that had probably turned into bronchitis at best ... or even pneumonia ... before I broke down and took an antibiotic, which helped me get well in a few days.  I have a healthy respect for physicians ... but also a healthy fear of creating problems where none exist.

So for now, we are in a holding pattern ... holding steady with my grandmother in her own home and taking measures to keep her safe there ... holding steady that my mother-in-law is healthy as a horse for her age and doesn't need a barrage of tests and specialists to tell her differently.  We know that things can change drastically in a heartbeat with older adults, and we are prepared for inevitable challenges down the road.  But for now, were taking it one day time.  I have total confidence that there will be many changes ahead, but I know of at least one who probably will not "go graciously" as promised.