Some Days the Gap Seems Wider Than Others...

February 18... the phone rang around 2:30, and I recognized the number on Caller ID right away... the ALF.  The nurse told me that Mam-ma Polly had fallen and hit her head.  She had a nasty cut, and the nurse thought it needed stitches.  "Do you want me just to put her in my car and take her to the ER?" she asked.  I told her no... that I had signed papers saying that Mam-ma is not to go to the ER.  She said, "Then we need to call Hospice... and you can revoke those papers at any time."  I asked if I should come down to the facility, and she said, "It wouldn't hurt."

I was preparing for a workout, so I was not dressed.  I quickly pulled myself together and headed for the ALF.  I found Mam-ma with at least 3 facility staff members, sitting in her wheelchair beside her bed.  The workers animatedly began to tell me how she had "bled all over everything."  The bleeding had stopped, and she did indeed have a large cut above her right ear... just a little forward of the injury she received two Christmas Eve's ago on our driveway.  I saw blood on the carpeting and her oxygen compressor... but it did not seem excessive.

I told the staff that I realized it seemed like a lot of blood, but she bled so much more on our driveway - and she only had a small puncture wound from that.  The staff kept saying, "But she soaked an abdominal pad."  Yes... she soaked every rag in our house and the blood continued to run down the driveway.  This was not good... but I didn't see anything that I felt merited a trip to the ER.

We determined that an aide came in to ask Mam-ma if she wanted to attend a musical performance in the dining room.  Mam-ma was in bed at the time... napping.  She said she wanted to go to the performance, so the aide said, "I'll be right back to get you up and help you to the bathroom first."  Apparently, when the first note of music was played, Mam-ma helped herself up... and fell into her oxygen compressor.  The aide said when the first number stopped, she could hear Polly hollering... and she found her sitting in the floor with blood pouring.

The Hospice nurse came and cleaned the wound and Polly's hair - now read instead of it's beautiful snowy white.  The facility RN and two LPNs looked at her.  Neuro checks were ordered every 30 minutes for 24 hours.  Mam-ma basked in all of the attention.  The Hospice nurse lectured her sternly about not getting up without help.  Then she helped Mam-ma to the bathroom, and as they crossed the threshold, I heard the nurse yelling, "Wait!  Wait!"  Mam-ma had grabbed the rail beside the toilet and was already trying to help herself!  She will NOT listen - nor cooperate - and I am fully convinced that she knows perfectly well what she is doing.

I told everyone that when Mam-ma fell on our driveway, they did not suture the wound... they covered it with a gauze pad and wrapped her head like a turban.  It oozed and was ugly for quite a while, but it eventually healed.  A CT-scan was done, and she was given some pain medication she probably didn't really need - which made her woozy and very nauseous.  She spent two nights in the hospital... the first one vomiting every time they moved her.  For those reasons, I did NOT want to return to the ER.  Mam-ma seemed fine.  She was not complaining of anything.  The staff finally asked her enough times if she was in pain that she said "Yes," and they gave her one of her regular pain pills.  I told them, "If this controls things and she remains stable, this is the best option."  Some of them acted like I was Satan for not rushing to the ER, but I've quit caring about what anyone else things and now focus solely on what is best for Mam-ma Polly.  And this was best.

I stayed until Mam-ma was safely placed in the dining room for supper, and I left.  I told my husband later that I was totally exhausted... and I couldn't figure out why.  He said, "You spent two hours or more at Southridge!  That's exhausting."  And he is right.  It is... it was!

I knew fully well that my grandmother could have a more serious internal head injury - that she could even die in the night.  I was prepared for this.  After all, Mam-ma is 100+ years old and on Hospice... and she is living life on her terms.  I am done trying to add days/weeks/months/years to her life by artificial means... even medical ones.  I even wonder on some level if this stubbornness about getting up and around by herself is a self-conscious attempt on her part to speed things along.  We'll never know... Mam-ma couldn't tell me if I asked... and she might not even realize this herself.  I just know she is old and tired... and sick of living like this.

My mom visited Mam-ma the following day and could barely locate the wound, which had measured 1.25" long by .25" wide and seemed deep.  She came to see me afterward and said, "You definitely made the right call."  And indeed, she has not missed a beat since.  Cousins from Oklahoma visited on Friday, and she enjoyed their company and the chicken legs they brought her from KFC.  On Sunday, she could not even visit with me because she was so focused on her ham and turnip greens lunch... and Thursday, she was sitting under the hair dryer getting her weekly "do."

Meanwhile, I've been like a switchboard operator... trying to keep everything rolling along.  Mam-ma's laundry has been in a shambles of late, so I've spent the last two visits sorting her closet and drawers, looking for HER items and returning more than I can count that did not belong to her.  I've also been coordinating appointments for my niece with the elementary school to enroll Timothy in HIPPY, a program for preschoolers that helps the parents learn how to become more involved in the child's educational growth.

I've also acquired several children's car seats, cleaned them and washed their covers, so that my mom, niece and I all have our own equipment for transporting the children. This will make it easier for Mom to help out with caring for the children... and we won't have to be constantly shuffling car seats.  I feel like something of a rocket scientist now after removing all of the strapping and reinserting it in no less than six car seats in the last couple of months!  Once you get the hang of it, everything is pretty straightforward... but those first two or three were doozies!

In the midst of all of that, Timmy, Zola, my niece and I have battled some sort of upper respiratory bug... and we've had overnight visits from both of the two older children, which were a ton of fun.  I've also worked on finding a suitable Pre-K for Timothy for this coming August, and we've put out what seemed like almost-daily little "fires" of some sort between the youngsters and Mam-ma Polly.

In the "down time," we've tried to maintain a "normal" live... exercise, eat, sleep, handle our own personal business, and spend time together as a couple.  We even found time to attend our high school's local regional basketball tournament.  My husband's great-niece will be on the Senior Girls' team there next year, so we try to support her activities, as well.  It's been a very busy three weeks!

Shortly after Valentine's Day, my sister, niece and I attended a women's ministry luncheon with Mom at her church... the church in which we were reared.  Timothy and Zola spent this time in the nursery with three very attentive sitters who were thoroughly entertained.  Timmy returned the next day for Sunday school and "Wee Church."  When it was over, he did not want to leave... in fact, he cried!

While my husband and I now attend another church in town, I was delighted to see so many ladies I've known since I was a toddler.  It was great to see a mix of ages... from young mothers my niece's age to the ladies who are my grandmother's friends, and every age in between.  In my own church, we have created a "Middle Contemporary Praise and Worship" service in a separate building.  This service is held at 9:30 a.m. and is geared toward young families.  There are some grandparents who attend... and a few folks like my husband and me... but by and large, the age demographic is 40 and younger.

There are a lot of older church members who attend services at 8:30 a.m. or 11:00 a.m. in the sanctuary that I never see any more.  And that saddens me.  One of my friend's moms, who is 88, said, "We never see children any more."  When all three services were held in our church sanctuary, we at least saw each other in passing as one service ended and another began.  I am not sure what the solution is to this dilemma, but I can say with certainty that there is definitely a generational gap in our church... and we are smack dab in the middle of the Sandwich Generation on this one!  If you have encountered this in your own church setting, I would be interested in hearing how you are addressing it.

I share this information to emphasize that I am feeling "sandwiched" on all sides... and in most every area of my life.  And there are plenty of challenges on any given day.  Whether we handle them well or not remains to be seen.  I don't have time to quit trying... and you probably don't either!

There are dozens of aspects to this I would not trade for the world.  We absolutely adore our great-niece and nephews.  We take incredible delight in watching them grow and hearing what they have to say.  Nothing beats a hug, snuggle or a blown kiss from our little ones.  We revel in watching our niece and her husband learn more each day about how to be good parents and to nurture and encourage these babies.  And we are blessed to see the children enjoy the privilege of a close interaction with their great-grandmother and her husband, whom they call "Granny and Pap-pa Lee."

How many children can say they knew their great-great-grandmother?  While we have not taken them to visit Mam-ma often in recent weeks, Timothy and Zola HAVE visited... and I believe Timmy, at least, will remember her.  My mother's paternal grandparents died when I was in 5th and 6th grade or so... I still remember them and visits to their farm.  I know that Timmy, Zola and Nathan will remember visiting their Granny's home... and that is priceless.

So I keep on playing "Switchboard Operator" - arranging for Mom to keep one child while I keep another or so as my niece attends appointments or runs errands... scheduling visits to Mam-ma Polly and making sure that everybody gets where they are supposed to on time.  This is my purpose for this season of my life... and I pray God continues to give me the strength and energy to bridge the gap!

Waiting for "The Next Big Thing"

I don't have a whole lot to report this week, except to say that my grandmother seems to be in a "holding pattern."  She was doing fairly well when I visited her on Sunday - having lunch at her regular table with her friend, Evelyn.  She could not communicate, and she ate like a bird, but that is nothing new on either front these days.

Monday, my mom visited and found Mam-ma sitting in the dining hall, listening to gospel music by a couple from our community who come regularly to sing for the residents.  Mom said Mam-ma was doing well... singing the hymns along with the others, and apparently pain-free.  She was dressed in one of her new house dresses - a sleeveless number the aide had put on OVER her cardigan sweater!  Mom questioned the aides about how long Mam-ma had been up, and several rushed to her side right away to assure her that they were not letting my grandmother get overly tired... that she wanted to be up and out.

One aide in particular - one of my favorites - told Mom that Mam-ma had insisted on getting up and out one day the week before, and this aide had taken her to the garden to survey the peppers, squash and tomatoes growing there.  She said the planned to take her again that day, but Mom told her she thought Mam-ma had had enough activity.  She had been to breakfast, lunch, and now the singing.

I really don't know if Mam-ma went to the garden or not, but the next morning when I arrived, she had done a total 180-degree turn.  She was curled up in a fetal position in bed, moaning... and both she and her aides told me she had serious diarrhea and had required a shower just to get her cleaned up well.  The aides appeared in Mam-ma's room to tell me about Mam-ma's morning. One of them confessed that he did not know how the sleeveless dress worked - over or under the sweater. I told him under, and he apologized, despite my insistence it was okay. He began to tell me how he worked hard to smooth Mam-ma's frizzy bed-hair before taking her out of the room... and he asked if I would bring some mousse, so that he could do a better job.

I was touched by his care and concern... and later, the nurse told me that this particular aide goes to great lengths to make sure Mam-ma is presentable each day before taking her to meals.The Hospice social worker had requested a visit with me, so when she arrived, we moved outside on the porch to visit.  It was an unseasonably nice summer morning, so we sat in rocking chairs and talked about my grandmother and her care.

The social worker talked to me about moving Mam-ma to a skilled care nursing facility across the street from the ALF.  I quickly said "No!"  This has been the suggestion of several ... and I did back-pedal enough to allow the social worker to outline her reasons for this suggestion. At the forefront was, "I can tell from your conversation - and from what the nurses have told me - that you are frustrated... that you feel some of the ALF staff are not listening to you and your wishes.  You deserve to be heard."  I listened to all she had to say, and then I told her that I felt that a move at this point would be disruptive and upsetting to Mam-ma.

My mom and I had talked on Monday after her visit to the ALF.  Mom said... and I agree... "Your Mam-ma is driving them crazy.  She will not stay in bed or in her room, and they don't know what else to do except get her up and take her out for a while."  My sister confirmed that - at least on weekend nights when she is working - Mam-ma "sits" on her buzzer continually.  The "favorite" aide told Mom that whenever anyone passes Mam-ma's room, she hollers for them.  I have experienced this myself... if Mam-ma senses movement past her open door, she yells, "Hey!" until someone comes to see what she wants.  Often, she can't tell them when they arrive.  I know... it's frustrating for everyone!

So I told the Hospice social worker that I would reserve the option to change my mind, but for now, I am just riding this pony!  I fully expect that there will be a "Next Big Thing"... Mam-ma will try to get out of bed - or stand and fall... she will develop another skin tear, pressure wound, or infection like the UTI... or her overall decline will catch up with her as she eats less and less and continues to have diarrhea almost daily.  When the "Next Big Thing" happens, we will deal with it.  I know the administrator at the skilled care facility, and if it should become apparent that Mam-ma needs to move, I will

I also told the Hospice social worker that *I* have to own the frustration... that a lot of it is on me.  I have to learn to let some of this go and move forward.  These staff members dearly love my grandmother.  They are doing what they feel is best for her, based on their daily relationship with her, my input, and my grandmother's requests and demands.  I have to trust God to take care of these situations... and to give me the strength and capacity to handle whatever happens next.  After all, something will happen eventually.  My grandmother will not live forever, and something has to facilitate her demise at some point.  And the entire family - and Mam-ma - are all okay with this!

So we agreed to let this go for the moment... to try to relax and take deep breaths... and wait for "The Next Big Thing."  I don't know if Mam-ma overdid it on Monday and the result was her diarrhea and inability to get out of bed the next day - or if it was just "one of those days."  But on Wednesday and every subsequent day this week, she was up, dressed, going to meals, and she appeared to be pain-free.  Maybe the antibiotics and the new time-released medicine are working.  Maybe she just had a string of good days.  Maybe she will actually rally for a few weeks/months - and even try to walk again.  I really cannot say, and it doesn't matter.  We are taking this one day at a time... until the "Next Big Thing."

As part of my attempt to chill out and not over-manage things, I stayed home a couple of days this week and did not visit the ALF.  I sewed... made darling dresses and shorts for some little friends... I worked out, wrote, and read.  My husband and I actually went out of town to attend the wedding of our dear friends' daughter.  And the sky did not fall!  I took the outfits I had made to show Mam-ma one day - and she smiled a GREAT BIG smile and gave me several "I tell you whats!"  A week earlier I had taken sewing, and she looked at it blankly and didn't respond.  So I count this as a good week...and I will take it!

As I have said before, I'm learning to find God's goodness, grace and mercy in the little ordinary things of the day... like time to work out, a few hours to sew or write... and time spent with my husband.  In truth, these are not little ordinary things at all, but rather, wonderful gifts we take for granted.  I know one thing is for certain... in all of this "Sandwich journey," I have received far bigger lessons than anyone... and I'm still learning!

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

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

MomLifeToday.com - How to Help an Adoptive Family

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I'm Not Playing BINGO ... There's Too Much to Do!

In the course of  seven days or so, we went from "I am so tired of looking at these four walls" to "There is simply too much to do here... I can't do it all!"  Every day, my grandmother calls with something... one day it was her lamp - "It's broke - it won't come on at all."  I asked about the little remote device my husband had fixed for her.  "No, that's not it.  I had that maintenance man come, and he put in a new light bulb - one of those energy efficient ones - and it still don't work.  He didn't know what was wrong."  I reminded her that she had a box of light bulbs in her closet... the ALF charges a few dollars per bulb if they replace one and I had told her NOT to ask for a light bulb.  "Well, I'll find him and give this one back." (She didn't - I brought it home and I'm sure it will appear on our monthly bill.) 

Greg and I met my sister and her husband at my grandmother's house one afternoon, so that they could pick up a bed and mattress set they are keeping.  The security alarm rep was able to meet me at that same time and retrieve his "life alert" equipment, so it was a good trip.  Afterward, we went by Southridge to see Mam-ma and check on the lamp.  Someone had turned it off at the lamp switch, so the remote didn't work.  That was all that was wrong.  Mam-ma didn't like the energy efficient bulb - she said it was not bright enough for her to see... so I handed Greg an incandescent bulb, and he swapped them.  Someday, she will be forced to use those others when we can no longer buy incandescents... but hopefully not for awhile.

When we arrived, Mam-ma had just laid down for a nap.  Her local newspaper and other mail came while we were there, and she said she was going to lie down and rest and read her newspaper.  I cautioned her to keep her apartment door locked, even when she was inside, so that other residents could not enter unannounced.  All of the nurses/aides have a master key - and they knock first.  Other residents just walk right on in... and I reminded Mam-ma she could be dressing - or undressed - or even asleep.  She promised to keep the door locked.

We said goodbye and left the apartment, and I stopped at the nurses' station to leave some medicine for Mam-ma.  The nurse said something about the daily aspirin, and I said, "Oh... she has aspirin in her room."  The nurse said, "That can't be there... we're giving her an aspirin daily with her meds... if she takes extra, that can thin the blood too much."  I told her I would go get the bottle in Mam-ma's apartment and take it home with me, and she said that would be great. 

So I went back to Mam-ma's apartment and knocked on the door.  "Come in!" she shouted.  "The door is locked," I said, knowing we locked it as we left.  "No, it's not!" she answered.  I opened the door and there she stood - straight and tall - and I said, "Mam-ma, we just talked about keeping your door locked!"  "I know," she replied, "but that girl came by and said come play BINGO, so I'm a goin' to play BINGO!"  In the course of 5 minutes, she had gone from very tired and ready to lie down to up and at 'em and ready to play BINGO!

Later in the evening, Mam-ma phoned me - she needed return address labels... could I make her some?  I told her I would.  "How was BINGO?" I asked.  "Well, Honey," she retorted... "I can't see that card... the numbers are blurry.  I won't be goin' again."  She went on to say that one of the other residents - a lifelong friend - told her, "Just relax and enjoy being with us and forget about that card!"  But she continued, "I'm not a goin' back!"

Friday, my sister and my niece took Timothy to visit Mam-ma... she was in the dining hall - playing BINGO!

We're slowly settling in and adjusting, I think. Mam-ma's friend Ruby has been to visit... and she supposedly told Mam-ma her room was pretty, but she didn't think my grandmother needed a  small coffee table that is in her room.  That is where Mam-ma rests her feet when she sits in her little side chairs... and where she keeps her Bible, TV remote, and other things she needs readily accessible during the day.  Ruby also asked what happened to an enormous begonia that Mam-ma had on her sunporch.  I gave it to my friend whose thumb is as green as Mam-ma's.  Mam-ma said, "Well, I had asked the girls here if they would like to have it."  I assured Mam-ma those girls have plenty to do without repotting and tending to a begonia!

What have I learned or been reminded of this week?

• no matter how good things are, I will never know about it
• friends and relatives are going to say "helpful" things that really don't help
• I can't believe everything Mam-ma tells me
• Mam-ma is where she needs to be... and she is thriving already

As spring approaches and the weather improves, I'm hoping Mam-ma's attitude will soar.  I'm already feeling my attitude lighten along with my "load," and once the house is cleaned and everything is disposed of/dispersed, I know I will be able to focus on enjoying my grandmother more and spending time on other people and things I have neglected for the last few years.  The friend who tried to convince Mam-ma to stay for BINGO went to the ALF kicking and screaming.  Two weeks later, she wouldn't leave for all the tea in China.  I'm hoping that in another week, Mam-ma is firmly settled there, too... or well on her way.

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I would love to hear from those of you who are facing similar situations.  Are you sandwiched between the care of your elderly loved ones and younger family members?  Do you have questions and/or concerns we could try to address here?  What are your coping mechanisms... what are the triggers to your stress... how can we help?  Please contact me and let me know what you would like to see addressed in this space.  I want this to be a blog that helps us all to navigate the waters of the life of someone in the Sandwich Generation - and keep our sanity in the bargain!

This Belongs To...

We are in a "holding pattern" on the big move to the Assisted Living Facility (ALF), known as Southridge. I have done all I can do on my end... the rest is up to DHS. The life insurance check arrived in the mail yesterday - one more piece of the puzzle is set. My grandmother is getting antsy... she is ready to move, and the longer she sits and stews, the more anxious she becomes.

Today, I am going to my Mam-ma's house to start labeling her clothing and the things she plans to take. In true "Mam-ma style," she started without me. She told me last night she had been labeling her underwear. I questioned... did she use a "Sharpie" marker? No... she didn't know what she used. Now, I know she owns a Sharpie... we use it to write the name of her "nerve pill" on the cap of the medicine bottle so she can distinguish it from the others. I told her, "I hope you used something waterproof, or all of your hard work will come out in the wash." She said, "I hope so, too!" Finally, I was able to determine that she did indeed use the "Sharpie" marker she keeps for her medicine. I asked her not to label anything else... I said, "I'll be happy to do that for you."

I also told her that I will clear a closet today, so that she can start hanging clothing there that she knows she wants to take with her. It will give her something to do. Nearly every day, she is telling my mom on the phone that this is "too much for Debbie." Mom has assured her that it is not... that a lot of the "after" work will be done when she returns in March. And as far as Mam-ma needs to know, that's the truth.

The other interesting dynamic has been the input from others. Almost daily, Mam-ma's Home Health aides are telling her this or that about "how it will be at Southridge." Much of their information has been innacurate. One aide told her that Home Health could still come and care for her in the ALF. If you are a "private pay" resident, you could probably pay Home Health to sent out aides. But Mam-ma is not a "private pay" resident, and her care is included - and provided by Southridge. Another aide told Mam-ma that she did not need to take linens... bath towels, etc. - that these would be provided. So Mam-ma was not happy that I spent her money on new towels. I assured her that our "Resident's Manual" clearly states that bed linens, towels, toiletries, etc., are the responsibility of the resident and not provided by Southridge.

Mam-ma's friends are asking her continually, "Polly, when are you moving?" Polly doesn't know, and this is getting on her last nerve, understandably. I know people mean well... and these people all love my grandmother dearly... but they don't realize that she is already a bundle of nerves, and more care needs to be given to what is said to her about the move at this point.

Hopefully a Medicaid nurse will come soon to evaluate Mam-ma. Hopefully she will deem Mam-ma a suitable candidate for Medicaid coverage for this move. Hopefully the DHS case worker will complete her paper work quickly once the nurse's report is filed. And hopefully, Moving Day will come very, very soon!

Meanwhile, we'll keep labeling...

Throwing Out the Towels

I was reading back over a few recent posts and saw something about towels my grandmother had placed on the floor as "throw rugs" in the areas leading from her kitchen/dining room to the carpeted living area.  We've argued back and forth about how she is not allowed to have loose rugs on her floor because they are a hazard that could potentially cause a fall.

Friday, the "red towel" was once again across the threshold from her kitchen to the hallway.  I quietly picked it up, folded it, and placed it on her clothes dryer.  The next time I find a towel or throw rug on the floor, it's going in my purse!

I Baked a Cake

Today, my husband went by to visit my grandmother after he delivered Meals on Wheels.  They talked about her getting them and how it was unsafe for her to cook.  She told him, "I baked a cake this morning, but that girl was here."  We assume she meant her home health aide.  Anyway, my husband shared their conversation over lunch ... how they discussed her not having any more vegetable gardens, and no peanut brittle making ... and no cooking unless someone was there.  He forgot to mention the cake to me.

So when my mother e-mailed and said Mam-ma had made a cake, I told him, and he said, "Oh, yeah... she mentioned that and said 'that girl' was here."  I called my mom to tell her it was okay - the aide was there.  Mom said, "NO!  She told me that the girl had left!"  She also told my husband that all she had left to do was ice the cake. I'm thinking buttercream frosting - Mom says she makes a "boiled" icing on the stove.  Yikes!

So much for being scared by burning the dried peaches in the crock pot - much less listening to anything we told her about not cooking unattended!  Thankfully, Mam-ma's deacon visited her last night and took her a supper of black-eyed peas and turnip greens - and he took home his peanuts and corn syrup, along with the recipe for making peanut brittle.  He spoke by phone with my mom today, and when she told him about the cake, he said, "You are kidding!"  He was planning to return her recipe book later today and have another talk with her about not cooking any more! 

Meanwhile, I've spoken with cousins who sometimes take her out to dinner and bring her peanuts and sugar to make peanut brittle.  At first my cousin thought I was asking him NOT to take her anywhere, but I explained that no... out to eat, or giving her a ride to Ruby's house was fine.  But taking her to the grocery store or helping her "make a garden" was out of the question.  I hope he understood.

I know it's hard for people who don't know the whole situation to grasp this.  For one thing, my grandmother seems so able bodied and "talks a great game."  And she has no problem telling people, "I'm just a poor old widder woman who can't drive any more."  She also has told me directly that she tells others that "... my kids don't care anything about me.  They've got better things to do than see after me."

So another day brings more "fun."  I have my doubts that this is going to work for long, but the Meals on Wheels may begin as early as tomorrow.  I'm planning a family dinner for next week - and I plan to use some food from her "deep freeze."  I'm also going to call the assisted living facility administrator and tell her that - for now - we do not want the room she has available."  Something tells me this may be a very temporary fix.

Thoughts on Caregiving

You never know who will be placed in your path.  Such was the case when I took my grandmother to a birthday party for her friend, who was celebrating 101 years!  A nephew, Mich Magness, had come from Oklahoma for the party, and in general conversation, he said he was a gerontologist for the Oklahoma Department of Mental Health.  We began to discuss caregiving and the elderly, and he made some comments and observations about caregiving that I felt were worth sharing here.

• Most caregivers are women.  Men will tell you they are caregivers, but when pressed and asked specific questions about what services they render, they consider financial duties, such as bill paying, writing checks and balancing the checkbook, and yes - hiring skilled caregivers to qualify them for the title of "caregiver."
• Many women do not consider themselves a "caregiver" unless they have performed an intimate act, such as bathing the elderly person, feeding them, or helping them to the toilet.  If you are consistently driving someone to appointments and handling errands, going with them to doctor visits, helping with medications, making sure that they have adequate services and arranging for specialized care, and more, then you are very much a "caregiver."
• Many nurses and teachers fall into roles as caregivers because others consider them "caring people" and readily assume they are the logical choice to provide caregiving.
• Mich said that the "sandwich" portion of a "Sandwich Generation" looks more like a club sandwich than a conventional one-layered affair, because generally, the person in the middle is more likely to be a grandmother who is caring for her own parents while rearing a grandchild or grandchildren.
• Sadly, many caregivers are so stressed out that they become ill, have weakened immune systems, and/or die before the person for whom they are caring.  He said it is not uncommon for caregivers to suffer a heart attack, develop cancer, or become ill in some fashion.  He said, "While the caregiver is having a heart attack from the stress of caregiving, the Alzheimer's patient is sitting in the corner, totally oblivous and happy as a clam."  He didn't mean to be flip... he was just offering an observation based on his experience and the statistics.

Mich noted that each state has an Area Agency on Aging... the "Triple A" of senior citizens - not to be confused with the AAA that refers to auto assistance!  The Area Agency on Aging offers not only care for senior adults...but also respite care for the caregivers.  He noted that each state does its own thing with regard to how these services are offered, administered and regulated.  Today, I did some checking and learned that in some instances (if not all of them), these respite services are "private pay."  Frankly, that's why many people are caring for their seniors in the first place... they cannot afford to do otherwise.  So I don't know that this AAA's "respite care" program is a viable option for many.  But it's good to know it exists for those who can afford it and are interested in the assistance.

After a half hour of visiting with this man, he said, "I've just met you, but as an objective observer, it seems to me that you are one of those people who feels responsible for others.  You said you have no children.  I imagine that others feel that this means you are 'free' to help, as in... 'Oh, she has no children, so she has time to help with this.'  I would further suspect that you not only feel compelled to help those in your own family, but you probably take on the needs of others outside your immediate circle."  I told him that my former pastor had told me many years ago that "No!" is a complete sentence, and I cling to that. 

However, in thinking over our conversation, I can see that I need to make some serious adjustments.  For one thing, I need to pace myself more and learn to use that word "No!" - even with myself.  Instead of trying to conquer the world, I need to conserve my energy for my husband and my own household, as well as the care of my grandmother and our nephew, Timothy.  I also realized that I have underestimated my caregiving role. With time and effort, I've pared down the days I actually am in physical contact with my grandmother to one per week.  We do her errands on Fridays - beauty shop, grocery shopping, pharmacy.  Occasionally, there will be a doctor visit on another day - or a party, such as Sunday's.  Often she calls me during the week to discuss something - or I phone her for the same. 

But because I have condensed our errands to one day per week, I had begun to see my "caregiving role" as diminished.  I would think to myself, "I really don't do that much for her."  But in retrospect, I am not considering the weekly attention to her checkbook and bill paying.  I am not thinking about the hours spent choosing a new provider for her Medicare Part D prescription drug coverage.  I have discounted the time I spend filing her health care insurance papers and her statements and bills...and the time I spend on the telephone reminding her for the sixth time that yes, she can afford to have her air conditioner serviced, and explaining to her where my mother and her husband have gone and why they don't answer their phone.

I have not accounted for the time I spend planning my route to encompass all of the errands and making sure I am finished in time to pick her up at the beauty shop when her appointment ends.  I have not factored in the hours I spend arranging for Mam-ma to have a birthday party or figuring out how she is going to get Christmas gift cards for everyone or making arrangements to ensure that I have all of her medical information in my wallet - and those of my mom and my sister.  I didn't include the time I spend updating an emergency phone list, so that I don't forget to call a long lost cousin the next time Mam-ma has to make a trip to the ER.

My point is that "caregiving" - much like parenting - comes with a set of subconscious nuances and stressors and "to-do" lists... and they have a collective effect on the caregiver/parent.  It really explains a lot!  When I'm driving down the street and drive right past a place I had planned to stop and Mam-ma says to me, "I thought you were going to stop there," I wonder... "What is wrong with me?!"  Now I know!  Well, okay... I partly know!  But I think we "caregivers" are too hard on ourselves, sometimes... and frankly, I'm going to try to change a few things.

I'm going to be a little easier on myself, and not expect to accomplish as much in a single day.  I'm going to realize that I'm doing the best I can to keep all the balls in the air, and some days, a frozen pizza for dinner is just fine.  I learned last week that Timothy will survive if I don't vacuum the floor right before he arrives... and sitting on the couch reading Ten Little Ladybugs for the umpteenth time is far more important than making a daily post on this blog!  And napping is highly under-rated!

So to all of you caregivers, I say, "Give yourself a break... and a pat on the back.  You're doing more than you realize... and it's probably taking a toll.  Take a deep breath, spend a half hour enjoying a good cup of coffee or a glass of wine, and simply 'let it be.'  Be kind to yourself and don't apologize for time and activities spent just on you!"  After all... if you wear down and become the "caregiving statistic" who becomes incapacitated, what happens to your charges then?  I consider yesterday my "wake-up call" -- is this yours?

What Time Are We Going?

Before 8:45 this morning, our phone rang... it was Mam-ma...
"Debbie, what time are we going?"
"Noon."
"Noon?"
"Yes... twelve o'clock.  Is that not okay?"
"No... that's okay.. I couldn't remember what time we said."
"We talked about a lot of times... but we left it on noon... "
"Okay... that's fine."
"I'll be there to get you at noon."
"Okay."  CLICK - she hung up!

It was already 82 degrees before 10:00 a.m. - another scorcher is predicted.  It may be a longggggg day!