When it appeared fairly certain that my grandmother would live to see her 100th birthday, I did a GOOGLE search for Willard Scott and found his website and the requisite forms to complete for submitting Mam-ma Polly's name for consideration as one of the centenarians featured on Willard's segment during NBC's "The TODAY Show." Sponsored by Smucker's, the celebrants' photos are superimposed on a Smucker's jelly jar label, and Scott tells a little something about the honoree. The information on the website stated that the forms had to be submitted at least six weeks prior to the actual birthday. Since Mam-ma's birthday was November 5th, I sent the forms in early September.
The information also stated that either we would receive a phone call to let us know that our centenarian would be featured... or the honoree would receive a card in the mail. Neither happened. Shortly before Christmas, I cleaned off my desk... and I threw away all paper work related to this endeavor. I decided I must have failed to complete the forms correctly or something.
December 22nd, our telephone rang, and Caller ID said the number was "PRIVATE". Since this is what shows when the Hospice nurses call, I feared the worst... but I answered. The caller was a gentleman from Willard Scott's office. He apologized for the delay, explaining that they were behind on airing the segments, but my grandmother was scheduled to be featured on Monday, December 24th, between 8:00 a.m. and 9:00 a.m. He asked about our time zone, and I told him we were on Central Time. He explained that the segment would air on the East Coast between 8:00 and 9:00 - and repeat for us the following hour. He said, "Set your DVR for 8:00 a.m. to 10:00 a.m." I set mine for 7:00 - 11:00!!
So I let EVERYONE know! I made sure all televisions at the facility would be turned on and set to the appropriate channel. My mom let the church administrators know, and they made a BIG SPLASH about it Sunday morning at Mam-ma's church. I think everyone in our community of about 7,000 people sat glued to their TVs Monday morning... along with family members and friends from coast to coast. And Willard Scott was not on. They did segments on all sorts of things, from ugly Christmas sweaters to revealing the sex of a baby expected by an Olympic volleyball champion... but no Willard Scott.
So we regrouped and set the DVRs for Christmas Day. This time, Scott was on... and a long segment aired, featuring several centenarians... but no Mam-ma Polly! Would she ever be featured? That afternoon, the phone rang again, and the same man apologized and said they were still very behind, and he thought that Mam-ma's segment would air on December 26th. I told him how disappointed we were, and he kept saying, "We have no control over what they do... the segments are pre-recorded, and we don't know when they will air." So we regrouped once again.
Wednesday morning, a friend posted on Facebook that she was spending the holidays in New York City, and she had just seen Mam-ma Polly on Willard Scott's segment! So I started letting people know that we WOULD see the feature. Sure enough, somewhere around 8:30 a .m., Central Time, Willard Scott's birthday feature aired... and there was Mam-ma on a Smucker's label! Soooooooooo... in case you missed it... here is my Mam-ma Polly... now forever known throughout America for her peanut brittle! I hope you enjoy it! (Watch all the way... she's almost the last one featured!)
Showing posts with label assisted living. Show all posts
Showing posts with label assisted living. Show all posts
December 27, 2012
May 25, 2012
When Your "A** Is in a Crack," Does it Help to Say You're Sorry?
Last weekend was rough. Mam-ma spent much of it curled in a fetal position, gripping her bed rail and groaning with pain. Friday and Saturday were the worst. She would begin moaning and begging for a pain pill an hour or more before one could be administered... and then it took another hour or more afterward for the pill to take effect. I asked if anything could be done, and the nurse did try to contact the doctor. But he was out of town for the weekend and did not answer his cell phone. I later learned that in these situations, I can call Hospice, and they can help. However, Sunday was almost totally different. The pain seemed to be far less substantial, and Mam-ma seemed clearer. Where she had been virtually unresponsive (except for the groaning) on Friday and Saturday, she was pleasant and clearly more comfortable on Sunday. Saturday, she flatly refused a bath when the Hospice aide visited. Sunday, she readily agreed to the same offer from the same aide. Every day is different.
Monday afternoon when I visited, the aides told me, "She threw a huge FIT this morning... told us that 'I can make my own decisions, and I want out of here.'" The aides interrupted an administrative staff meeting because the rant was so bad, and the facility administrator, the facility owner, and the nurse agreed to let the aides put Mam-ma in her wheelchair and roll her around - and they even took her outside on the porch for about 10 minutes. I was not thrilled by this. It wasn't that this really hurt anything, but Mam-ma is not thinking clearly, and just because she says she can make her own decisions doesn't mean she can. This weekday nurse was not on duty over the weekend. She and the weekday aides did not see how Mam-ma writhed in pain. They did not hear her groaning through the night and begging for more medication. They were not there when she was virtually unresponsive...and other family members and I were wondering if perhaps this was "the beginning of the end."
To make matters worse, the aides no sooner got Mam-ma back to her room from the wheelchair ride than she developed serious diarrhea... to the extent that she soiled her clothing, the recliner, the floor... everywhere. The aides cleaned Mam-ma and put her to bed, admonishing me to watch where I sat or stepped ... that "we'll be back to steam clean everything and disinfect." The Hospice nurse was there, and I noticed that Mam-ma's feet were still dirty, so the nurse put on gloves and got a packet of wipes and cleaned Mam-ma's feet and legs.
Monday afternoon when I visited, the aides told me, "She threw a huge FIT this morning... told us that 'I can make my own decisions, and I want out of here.'" The aides interrupted an administrative staff meeting because the rant was so bad, and the facility administrator, the facility owner, and the nurse agreed to let the aides put Mam-ma in her wheelchair and roll her around - and they even took her outside on the porch for about 10 minutes. I was not thrilled by this. It wasn't that this really hurt anything, but Mam-ma is not thinking clearly, and just because she says she can make her own decisions doesn't mean she can. This weekday nurse was not on duty over the weekend. She and the weekday aides did not see how Mam-ma writhed in pain. They did not hear her groaning through the night and begging for more medication. They were not there when she was virtually unresponsive...and other family members and I were wondering if perhaps this was "the beginning of the end."
To make matters worse, the aides no sooner got Mam-ma back to her room from the wheelchair ride than she developed serious diarrhea... to the extent that she soiled her clothing, the recliner, the floor... everywhere. The aides cleaned Mam-ma and put her to bed, admonishing me to watch where I sat or stepped ... that "we'll be back to steam clean everything and disinfect." The Hospice nurse was there, and I noticed that Mam-ma's feet were still dirty, so the nurse put on gloves and got a packet of wipes and cleaned Mam-ma's feet and legs.
The aides said a "bug" was going around the ALF, but they were also concerned that the wheelchair ride might have contributed to Mam-ma's diarrhea. I hinted strongly that I would prefer there be no more wheelchair rides! Before I left, I read a couple of Psalms to Mam-ma. It occurred to me that she never gets to hear scripture any more... and she has always spent a lot of time reading her Bible. However, while I read, she closed her eyes and I could not tell if she was even awake. After I finished, she didn't say a word.
I guess I made more of an impression on Mam-ma about the wheelchair ride than I realized, because Monday evening around 6:00, the phone rang... and Mam-ma's number popped up on my Caller ID. I answered, and her aide - also named Debbie - said, "Miss Polly wanted me to call you - she wants to talk to you." Okay... I thought... this should be interesting... and I was right!Mam-ma was actually fairly coherent, and she said, "I'm so sorry." I asked why she was sorry, and she said, "Well... I really got my ass in a crack." I asked, "Are you talking about the ride you took in the wheelchair?" "Yes," she replied. I told her not to apologize... it's over and done... but I outlined WHY we didn't want her riding in the wheelchair... and reminded her of how sick she had been over the weekend. "We just don't want you to start hurting like that again... and every time they move you for anything, you seem to have pain." "Well," she continued, "I'm sorry."
I went so far as to tell Mam-ma, "You know, we have signed papers saying that we are NOT going back to the hospital! So if you fall and hurt yourself, you will have to lie in bed in pain, and I won't be able to do anything but watch you hurt." She said she didn't know that. Now she does! Anyway, she ended the conversation by saying, "I needed to apologize. I'm sorry." I had to laugh... even in her "in-and-out" condition, she still can do the old "pull-a-stunt-and-be-sorry-later" routine!
Tuesday was uneventful, and I made plans to stay home on Wednesday and sew for Timothy and Zola. I was trying to get a package ready to mail to them, and I wanted to include some new clothes I was making. Late in the afternoon, I got a call from the nurse. She was filing a report that Mam-ma had tried to get up out of her recliner and nearly pulled it over on her. The nurse said, "This happened while I was at lunch, and the administrator and an aide got Polly up and left me a note about it." Mam-ma was not hurt. I asked if she was scared, and the nurse said, "She was more mad and frustrated." I thanked her for calling me.
By 6:30, a friend of my grandmothers was calling. "Jerome (another friend who is a resident) told me that Polly wanted to see me," she said, "so I went to her room, and she said, 'Call Debbie. I've never hurt as bad as I'm hurting now.'" I told Bessie that I knew about the fall in the afternoon - I had received a call. I debated whether to go to the ALF, but after finishing dinner and taking a shower, I threw on some clothes and drove down. It was about 7:30 when I arrived, and Mam-ma was asleep. I laid my car keys on her little bedside table, and she roused. I asked, "What are you doing?" and she said, "WELL! I'm trying to get these bowels to move!" She said the nurse had given her a dose of Miralax. She was complaining of pain and discomfort and said, "They won't do anything." However, a few minutes earlier she had been sound asleep!
I asked about the "fall," and she said, "Yes... I thought I could get up." I told her, "Mam-ma you have not put any weight on either foot since you had surgery almost a month ago. You are not able to walk!" She said, "Well... I forgot." And maybe she did. However, that raised a huge concern about her getting up out of her chair... or falling out of the wheelchair. And twice last weekend, the nurse and my sister (who is a weekend nighttime aide there) found Mam-ma in bed with both legs between the bed rails... trying to get out!
Two aides came into the room, and we all reminded Mam-ma that two days earlier she had been sick with diarrhea... and she had eaten very little since then. She probably did not need to worry about her bowels... and she did not need more Miralax. I told her I didn't know what else the staff could do for her... that she needed to try to sleep and rest. The aides assured her that they would return soon with night-time medication and another pain pill. I left... there was nothing more I could do, and my husband was waiting at home to watch a movie we had rented.
I set in on Thursday to pursue options for keeping Mam-ma safe... and to avoid another fall. When I arrived, she was sitting in her recliner... and the foot rest was closed. She could have easily leaned forward and fallen out. I don't think she had been that way very long, because as I began to question her and the aides, I determined that a Hospice aide had just been there to bathe her. This aide had not only left the foot rest down... she had also put Mam-ma's little pink house shoes on her feet - leaving the protective "boots" to help prevent pressure wounds in Mam-ma's bed underneath the bed sheet! The nurse came in and switched the house shoes for the boots... and I hid the house shoes in the closet!
I called the Hospice nurse who is our caseworker and complained to her... and ultimately, I asked that this aide not be assigned to Mam-ma any more. I hated to do that, but I have to consider Mam-ma's safety and well-being. The nurse wholeheartedly agreed, and she filed an incident report on my behalf. The more I have thought about it, the more I am certain this was the right thing to do - for Mam-ma and for other patients who might have similar experiences. This is not the time to always "play nice." Too much is at stake!
So after talking with the facility administrator, who in turn consulted the facility owner, I learned that physical restraints are 100% NOT allowed in the assisted living facility. When my maternal grandmother was in the nursing home, she wore a "vest" that tied her to the wheelchair. It kept her from falling out - or getting up - until she took her little sewing kit scissors and politely cut the straps! This type of device is not allowed for Mam-ma Polly. So I asked the administrator... "What do you suggest we do to keep Polly safe? I've run out of ideas."
The administrator said that she and the facility owner both felt that Mam-ma is going stir crazy in her room. "She needs to get out in her wheelchair... maybe sit on the porch outside." I don't feel comfortable allowing Mam-ma to go outside. I am afraid that she will be left unattended there, and who knows what might happen. So I conceded... "Okay... what if we agree to take her to the dining room to her table for LUNCH ONLY. I know she might be the last one fed... after her friends have eaten and left the table... but at least she can visit with them and have some time out of her room. Other than that and being up for a bath, she should spend the rest of the day in her bed. If she absolutely insists, perhaps you can get her up in the recliner for a few minutes... but hopefully the trip out for lunch will be sufficient." The administrator felt this was a good compromise.
I am assuming that this started today. I did not go... I stayed home and cleaned our house. The Hospice social worker advised me earlier this week that I should not feel as if I have to visit Mam-ma every single day. "That's why you have us and the facility looking after her," she reminded me. My mother did stop in this afternoon, and she said Mam-ma could not stay awake to visit with her... and Mam-ma did not know what she ate for lunch. My guess is that the trip out to the dining room for lunch wore her out, and as I hoped, she napped most of the afternoon. I am hoping that the daily bath and lunch trip will be enough to satisfy her - and tire her sufficiently - so that she naps in between and stays safely tucked into her bed. The bed adjusts to a sitting position... and she is turned every two hours... so this should be enough stimulation to prevent further pressure wounds - the continual justification for Polly being "up and about."
Every time that my grandmother does something like demand to get up and out... or to call me on the telephone... the aides say, "Oh, Polly's coming back!" I don't see it. She still sleeps a LOT. Most days she might make a couple of lucid comments... then the rest is one or two words - or gibberish. The Hospice social worker called her comments "social pleasantries" - answers like "I'm fine," and "Hello," and "Thank you" - simple answers to general questions. Anything more complicated most often gets a confused answer - if that. As Mam-ma takes less pain medication, and we get farther from the surgery date and the anaesthesia, she has more lucid thoughts... hence, the phone call and the "ass in a crack" comment that is so classically "Mam-ma Polly." But she was not putting many sentences together before she fell and broke her leg... so any hopes that she will do so now are not reasonable, in my opinion.
I am still hopeful that things will smooth out somewhat... that for a while, at least, I truly will not feel I have to pop in every single day. I want to learn from the experience with my maternal grandparents. I don't want this to make me completely neurotic and disrupt my relationships with my husband and other family members and friends. I want to keep this all in perspective and not micro-manage - OR compromise my own physical, mental, and emotional health. I don't think Mam-ma would truly want that, either.
Last night Greg and I went to dinner with one of Greg's best friends from high school, and his wife, who also went to school with us. We had a great time reminiscing and catching up... and it was great to think about other things and other people for a few hours. My grandmother's name came up, because someone stopped by the table and asked about her. Both of our friends rode the school bus when she was driving... and we marvelled that she is almost 100 years old. But we did not discuss her fall or her subsequent decline. We didn't need to... I didn't need to talk about it! And that felt great!
I have to admit... I was not really upset about the phone call Monday night. In fact, I was somewhat amused. For just a moment, I got a glimpse of the "Old Polly," and it actually felt pretty good. I knew it was a manipulative ploy... whether she realizes it now or not... but at the same time, her colorful language and the clarity of her voice was a welcome treat. I'm looking for blessings and positive notes in the most unusual and extraordinary places and events... and sometimes I'm finding them! Saying "I'm sorry" didn't fix a thing... but the phone call was still a little treat... and I'll take it!
I guess I made more of an impression on Mam-ma about the wheelchair ride than I realized, because Monday evening around 6:00, the phone rang... and Mam-ma's number popped up on my Caller ID. I answered, and her aide - also named Debbie - said, "Miss Polly wanted me to call you - she wants to talk to you." Okay... I thought... this should be interesting... and I was right!Mam-ma was actually fairly coherent, and she said, "I'm so sorry." I asked why she was sorry, and she said, "Well... I really got my ass in a crack." I asked, "Are you talking about the ride you took in the wheelchair?" "Yes," she replied. I told her not to apologize... it's over and done... but I outlined WHY we didn't want her riding in the wheelchair... and reminded her of how sick she had been over the weekend. "We just don't want you to start hurting like that again... and every time they move you for anything, you seem to have pain." "Well," she continued, "I'm sorry." I went so far as to tell Mam-ma, "You know, we have signed papers saying that we are NOT going back to the hospital! So if you fall and hurt yourself, you will have to lie in bed in pain, and I won't be able to do anything but watch you hurt." She said she didn't know that. Now she does! Anyway, she ended the conversation by saying, "I needed to apologize. I'm sorry." I had to laugh... even in her "in-and-out" condition, she still can do the old "pull-a-stunt-and-be-sorry-later" routine!
Tuesday was uneventful, and I made plans to stay home on Wednesday and sew for Timothy and Zola. I was trying to get a package ready to mail to them, and I wanted to include some new clothes I was making. Late in the afternoon, I got a call from the nurse. She was filing a report that Mam-ma had tried to get up out of her recliner and nearly pulled it over on her. The nurse said, "This happened while I was at lunch, and the administrator and an aide got Polly up and left me a note about it." Mam-ma was not hurt. I asked if she was scared, and the nurse said, "She was more mad and frustrated." I thanked her for calling me.
By 6:30, a friend of my grandmothers was calling. "Jerome (another friend who is a resident) told me that Polly wanted to see me," she said, "so I went to her room, and she said, 'Call Debbie. I've never hurt as bad as I'm hurting now.'" I told Bessie that I knew about the fall in the afternoon - I had received a call. I debated whether to go to the ALF, but after finishing dinner and taking a shower, I threw on some clothes and drove down. It was about 7:30 when I arrived, and Mam-ma was asleep. I laid my car keys on her little bedside table, and she roused. I asked, "What are you doing?" and she said, "WELL! I'm trying to get these bowels to move!" She said the nurse had given her a dose of Miralax. She was complaining of pain and discomfort and said, "They won't do anything." However, a few minutes earlier she had been sound asleep!
I asked about the "fall," and she said, "Yes... I thought I could get up." I told her, "Mam-ma you have not put any weight on either foot since you had surgery almost a month ago. You are not able to walk!" She said, "Well... I forgot." And maybe she did. However, that raised a huge concern about her getting up out of her chair... or falling out of the wheelchair. And twice last weekend, the nurse and my sister (who is a weekend nighttime aide there) found Mam-ma in bed with both legs between the bed rails... trying to get out!
Two aides came into the room, and we all reminded Mam-ma that two days earlier she had been sick with diarrhea... and she had eaten very little since then. She probably did not need to worry about her bowels... and she did not need more Miralax. I told her I didn't know what else the staff could do for her... that she needed to try to sleep and rest. The aides assured her that they would return soon with night-time medication and another pain pill. I left... there was nothing more I could do, and my husband was waiting at home to watch a movie we had rented.
I set in on Thursday to pursue options for keeping Mam-ma safe... and to avoid another fall. When I arrived, she was sitting in her recliner... and the foot rest was closed. She could have easily leaned forward and fallen out. I don't think she had been that way very long, because as I began to question her and the aides, I determined that a Hospice aide had just been there to bathe her. This aide had not only left the foot rest down... she had also put Mam-ma's little pink house shoes on her feet - leaving the protective "boots" to help prevent pressure wounds in Mam-ma's bed underneath the bed sheet! The nurse came in and switched the house shoes for the boots... and I hid the house shoes in the closet!
I called the Hospice nurse who is our caseworker and complained to her... and ultimately, I asked that this aide not be assigned to Mam-ma any more. I hated to do that, but I have to consider Mam-ma's safety and well-being. The nurse wholeheartedly agreed, and she filed an incident report on my behalf. The more I have thought about it, the more I am certain this was the right thing to do - for Mam-ma and for other patients who might have similar experiences. This is not the time to always "play nice." Too much is at stake!
So after talking with the facility administrator, who in turn consulted the facility owner, I learned that physical restraints are 100% NOT allowed in the assisted living facility. When my maternal grandmother was in the nursing home, she wore a "vest" that tied her to the wheelchair. It kept her from falling out - or getting up - until she took her little sewing kit scissors and politely cut the straps! This type of device is not allowed for Mam-ma Polly. So I asked the administrator... "What do you suggest we do to keep Polly safe? I've run out of ideas."
I am assuming that this started today. I did not go... I stayed home and cleaned our house. The Hospice social worker advised me earlier this week that I should not feel as if I have to visit Mam-ma every single day. "That's why you have us and the facility looking after her," she reminded me. My mother did stop in this afternoon, and she said Mam-ma could not stay awake to visit with her... and Mam-ma did not know what she ate for lunch. My guess is that the trip out to the dining room for lunch wore her out, and as I hoped, she napped most of the afternoon. I am hoping that the daily bath and lunch trip will be enough to satisfy her - and tire her sufficiently - so that she naps in between and stays safely tucked into her bed. The bed adjusts to a sitting position... and she is turned every two hours... so this should be enough stimulation to prevent further pressure wounds - the continual justification for Polly being "up and about."
Every time that my grandmother does something like demand to get up and out... or to call me on the telephone... the aides say, "Oh, Polly's coming back!" I don't see it. She still sleeps a LOT. Most days she might make a couple of lucid comments... then the rest is one or two words - or gibberish. The Hospice social worker called her comments "social pleasantries" - answers like "I'm fine," and "Hello," and "Thank you" - simple answers to general questions. Anything more complicated most often gets a confused answer - if that. As Mam-ma takes less pain medication, and we get farther from the surgery date and the anaesthesia, she has more lucid thoughts... hence, the phone call and the "ass in a crack" comment that is so classically "Mam-ma Polly." But she was not putting many sentences together before she fell and broke her leg... so any hopes that she will do so now are not reasonable, in my opinion.
I am still hopeful that things will smooth out somewhat... that for a while, at least, I truly will not feel I have to pop in every single day. I want to learn from the experience with my maternal grandparents. I don't want this to make me completely neurotic and disrupt my relationships with my husband and other family members and friends. I want to keep this all in perspective and not micro-manage - OR compromise my own physical, mental, and emotional health. I don't think Mam-ma would truly want that, either.
Last night Greg and I went to dinner with one of Greg's best friends from high school, and his wife, who also went to school with us. We had a great time reminiscing and catching up... and it was great to think about other things and other people for a few hours. My grandmother's name came up, because someone stopped by the table and asked about her. Both of our friends rode the school bus when she was driving... and we marvelled that she is almost 100 years old. But we did not discuss her fall or her subsequent decline. We didn't need to... I didn't need to talk about it! And that felt great!
I have to admit... I was not really upset about the phone call Monday night. In fact, I was somewhat amused. For just a moment, I got a glimpse of the "Old Polly," and it actually felt pretty good. I knew it was a manipulative ploy... whether she realizes it now or not... but at the same time, her colorful language and the clarity of her voice was a welcome treat. I'm looking for blessings and positive notes in the most unusual and extraordinary places and events... and sometimes I'm finding them! Saying "I'm sorry" didn't fix a thing... but the phone call was still a little treat... and I'll take it!
May 20, 2012
Do You Know...My Favorite Dinosaur is Cool? Do You Know Why This Matters?
Last night, we talked to Timothy and his mother for the first time in nearly two long months. They had spent the day at a nearby lake and botanical gardens/park, and Timothy had LOTS to tell us. He also had a lot to tell us about his birthday presents - and his dinosaurs... and the repetitive question was a dramatic, "Do you know... that my favorite dinousaur is cool? I will show it to you!" Of course, we could not see it on the telephone, but that didn't seem to matter. And this was all important because???? The 30-minute conversation with our beloved three-year-old was a welcome respite from the focus on my grandmother and her deteriorating condition.
Wednesday and Thursday were remarkably "good" days for Mam-ma Polly. She was clearer and put more sentences together than she has in months. She told me about visitors and asked about a mutual friend who is suffering with Bells Palsy. She said of this person, "I wish I was able to send her a note." She is still thinking about others - even now.
However, my mom visited on Friday, and nothing was the same. Mam-ma was virtually unresponsive. Mom had to keep waking her to talk with her... and even then, she wasn't sure things registered. And Mam-ma has a pressure wound on her right heel - the leg that is broken. It's about the size of a quarter, and the Hospice nurse put padded "booties" on her feet to keep them from touching the sheets. We are told by the nurses that this is the beginning of other problems... like more skin breakdown. And even worse, Mam-ma is in pain.
We got the doctor to increase her pain medication from 2 times per day as needed to four times per day, as needed. However, before the six hours is up she is begging and groaning in pain. When I visited yesterday morning, I found her in a fetal position, clenching the bed rail with both hands, frowning deeply and groaning. She was in a lot of pain. We have not been able to reach a doctor this weekend, which I am not sure I understand. But there are times when the Hydrocodone kicks in that Mam-ma is happy and laughing... it's just that last hour or so before the next pain pill - and then the hour afterward until it takes effect. When you add them all up, that is a lot of time to be in pain. Hopefully I can get to the bottom of it tomorrow and get either her dosage strength increased - or the frequency of administering the current amount. I do not want my grandmother to be in pain at this point.
I know every day is different... and the challenges and frustrations may only increase as we go along. For all who questioned at the beginning of this week whether Hospice was the right choice, I say, "Go visit her now." We made the right choice.
At the same time, I am trying to pace myself... and if you are in the same boat - or a similar dinghy - I suggest you do the same. Last Saturday, my best friend and I attended a party to celebrate the marriage of a mutual friend we have known since childhood. We laughed, danced, and reminisced... and for a few hours, I didn't think about hospitals, pain, Hospice, or anything sad. It felt great! Yesterday, I fired up my sewing machine and made pillows for our front and back porches. Sewing is my therapy... and I get lost in the beautiful fabrics and calculating yardage and creating something pretty... and I feel happy and peaceful.
In all of these challenges, we have to find balance. So talking to Timothy last night was the icing on the cake. Thinking about the carefree world of a three-year-old and his soon-to-be-one-year-old sister made us smile and laugh... something we haven't done often enough lately. Tonight, if everything holds together, my husband and I plan to veg out on the couch and watch movies... one drama... and one comedy.
This seemingly sudden 180-degree turn with my grandmother should come as no surprise. I know things can change quickly from here on out... but at the same time, it was a good reminder NOT to be surprised - or to take a "good" day/hour for granted. I'm still keeping my house in some semblance of order and trying to stay ahead of meals and laundry... and basically keeping my "house" in order (literally and figuratively). Nothing is certain... of that I am sure. But I am taking things one day at a time, and relishing in the fact that dinosaurs really are cool... and I know a little boy who can tell me why!
Wednesday and Thursday were remarkably "good" days for Mam-ma Polly. She was clearer and put more sentences together than she has in months. She told me about visitors and asked about a mutual friend who is suffering with Bells Palsy. She said of this person, "I wish I was able to send her a note." She is still thinking about others - even now.
However, my mom visited on Friday, and nothing was the same. Mam-ma was virtually unresponsive. Mom had to keep waking her to talk with her... and even then, she wasn't sure things registered. And Mam-ma has a pressure wound on her right heel - the leg that is broken. It's about the size of a quarter, and the Hospice nurse put padded "booties" on her feet to keep them from touching the sheets. We are told by the nurses that this is the beginning of other problems... like more skin breakdown. And even worse, Mam-ma is in pain.
We got the doctor to increase her pain medication from 2 times per day as needed to four times per day, as needed. However, before the six hours is up she is begging and groaning in pain. When I visited yesterday morning, I found her in a fetal position, clenching the bed rail with both hands, frowning deeply and groaning. She was in a lot of pain. We have not been able to reach a doctor this weekend, which I am not sure I understand. But there are times when the Hydrocodone kicks in that Mam-ma is happy and laughing... it's just that last hour or so before the next pain pill - and then the hour afterward until it takes effect. When you add them all up, that is a lot of time to be in pain. Hopefully I can get to the bottom of it tomorrow and get either her dosage strength increased - or the frequency of administering the current amount. I do not want my grandmother to be in pain at this point.
I know every day is different... and the challenges and frustrations may only increase as we go along. For all who questioned at the beginning of this week whether Hospice was the right choice, I say, "Go visit her now." We made the right choice.
At the same time, I am trying to pace myself... and if you are in the same boat - or a similar dinghy - I suggest you do the same. Last Saturday, my best friend and I attended a party to celebrate the marriage of a mutual friend we have known since childhood. We laughed, danced, and reminisced... and for a few hours, I didn't think about hospitals, pain, Hospice, or anything sad. It felt great! Yesterday, I fired up my sewing machine and made pillows for our front and back porches. Sewing is my therapy... and I get lost in the beautiful fabrics and calculating yardage and creating something pretty... and I feel happy and peaceful.
In all of these challenges, we have to find balance. So talking to Timothy last night was the icing on the cake. Thinking about the carefree world of a three-year-old and his soon-to-be-one-year-old sister made us smile and laugh... something we haven't done often enough lately. Tonight, if everything holds together, my husband and I plan to veg out on the couch and watch movies... one drama... and one comedy.
May 15, 2012
Micro-management or Loving Care... How Do You Tell the Difference?
I am sorry it has been so long since my last post. To say that this has been a hectic and stressful week would be an understatement. The hospitalist agreed to keep my grandmother over the weekend so that she could be re-admitted to her apartment at the ALF on Monday and placed in Hospice Care. I met Monday morning with the Hospice director, the ALF administrator and R.N., and the Hospice R.N./Caseworker. We reviewed the care plan for Mam-ma and agreed that she would do only as much as she fel like doing... and that our goal was to keep her happy and comfortable for the rest of her life.
To say the weekend in the hospital was uneventful would be a lie. For starters, I arrived Saturday morning around 9:00, and the aides said, "She didn't eat much breakfast." I immediately knew why as soon as I saw Mam-ma ... she wasn't wearing her dentures! I told the girls... "She doesn't have in her teeth!" They sheepishly disappeared, and the ward clerk scrambled to find something in the nutrition room that we thought Mam-ma would eat. Then she realized the food cart was right beside the nurses' desk, and Mam-ma's virtually untouched tray was still there. She retrieved it and warmed the scrambled eggs and biscuit in the microwave. I fed Mam-ma, and she ate all of her eggs and half a biscuit with jelly - once we put in her teeth, of course!
I think one of the hardest things for me was that Mam-ma did not know me for several days. She seemed to recognize me, but when I would ask, "What's my name?" she would shake her head and say, blankly, "I don't know." Same thing for her own name. Friday evening, she knew Greg by name... and then my cousin Amanda. But it was late Sunday evening when I asked again, and she knew my name... and she was able to give her own name on Monday.
Saturday morning, the therapist came to do some exercises, but when she and the nurse lifted Mam-ma from the bed, Mam-ma virtually collapsed in dead weight, and they just sat her in a chair. The therapist, who is a friend whose grandmother is Mam-ma's contemporary, mouthed from behind Mam-ma... "You're doing the right thing" (meaning Hospice). That made me feel more confident in my decision.
Sunday was horrible. Mam-ma required several "brief" changes, and the nurses were always so kind. But sometimes it was an hour after we rang for help... and that is just too long - even if you are understaffed. So I had to make a few trips to the desk to remind someone I needed help!
By the time Sunday ended, my grandmother had suffered through several hours of severe gas pains that left her screaming in discomfort. She was unable to eat her dinner, and I discovered that while we were at lunch, Amanda and her dad had come, and Mam-ma had sent them home with some harsh words... she had a messy diaper and was embarrassed, and she told them in some pretty colorful language to go home. So they did. Another cousin came before dinner, and she helped me with Mam-ma for a while... managed to feed her some applesauce... and Mam-ma finally settled down and seemed to stop hurting around 7:30 p.m. I hugged her and promised, "I'll take you home tomorrow." She frowned and said, "Debbie, I'm worried about you. You're doing too much." I explained that I was only doing what she needed, and I would be okay. Later, as I kissed her goodbye, she cried and said, "Oh, Sugar... you've done so much... you are just so precious." I left in tears.
I came home and tearfully told all of this to my husband... who had been there with me for part of the afternoon drama... and he said, "You are overly tired. It will be okay." I was... and it is... but that was a rough day.
Monday, I arrived at the hospital, and the aide met me and said, "She hardly ate anything this morning." I took one look and said, "I can tell you why - she isn't wearing her teeth again!' This was another aide, and she said, "But it was pancakes and scrambled eggs!" I replied, "I don't care... she's not gonna eat without her teeth!" So the nurses ordered another tray and apologized profusely. This is "Nursing 101!" The charge nurse said, "If you were staying another night, I'd make a sign that said 'Be sure to check for her teeth before feeding!'" After meeting Monday morning at the ALF with Hospice and ALF staff, we got Mam-ma settled back in her apartment by late afternoon. No less than six aides, a nurse, and an administrator swarmed the hospital van to greet her when she arrived. That was such a great sight... I knew we were truly home. I spent more than an hour with the Hospice nurse and social worker, filling out paper work and getting things in order. It was another long day.
Looking back, this was a huge mistake. Mam-ma smiled and looked beautiful... and many came to the table to greet her. But she barely ate, and she didn't have a clue about where she was or what was happening. Back in her room, she immediately fell asleep in bed... clothes and all. A short time later, an aide got her up to curl her hair, since she didn't feel like going to the beauty shop for her regular appointment. This was all just too much for her.
During lunch, the activities director stopped by our table and told us that Mam-ma had come out to the dining room and played BINGO the day before. This was news to me, and I was quite shocked. I knew the nurse had told me she wheeled Mam-ma to the dining room a couple of times... but she had also told me that Mam-ma did not get up for any meals on Wednesday. I'm not sure exactly what she did. But the bottom line was that I realized that the staff had put Mam-ma right back into her old routine and was pushing her to get back to her "old self." I didn't know what to do, but I figured she was pretty close to "hitting the wall."
I was right. Friday morning, the Hospice nurse called me and said, "I've just seen Polly, and she is totally out of it. She cannot stay awake... she is lethargic... I don't know what happened!" I did! I explained how much that Polly had done last week, and the nurse told me that this had to stop. I agreed... but how? She told me that I needed to contact the administrator and discuss this with her... and I did... and we agreed that Mam-ma takes meals in her room, stays in her hospital gown, and only gets up for a little while each day and sits in her recliner - at least for now. She is still in a lot of pain, and only 14 days out from a major surgery at this point. Plus, she is less than 6 months from being 100 years old!!! Because Mam-ma looks so much younger - and generally acts it... and because the staff loves her so and wants her well... they were really working to rehab her back into shape!
So I'm getting some dirty looks and have had to go back and reiterate to a few that we are NOT pushing... that "less is more" in this case. But we seem to be getting there, and I do think this is the best thing for my grandmother. I am not willing her to die... nor giving up on her. I am managing her care. There have been times when I have called about something or gotten involved in a detail here or there, and my husband has suggested that perhaps I am micro-managing her care and causing myself undue stress. The Hospice nurse assures me that I am not... that I am simply loving my grandmother and making sure she is taken care of. It's hard to know how to balance this... and what can slide and what is important. I'm in some uncharted territory here (at least for me), and I am doing the best I can. When I visited today, a new shift of aides was on board, and Mam-ma had been to lunch and was dressed in pajamas again. So I had to "educate" them on the plan... apparently the word about her care plan did not get to them.
One aide seemed to question my comments... I told her and another aide that the doctors feel that even with therapy, Mam-ma most likely will not walk again, and this aide said, "Oh, I disagree! They don't know Ms. Polly!" Maybe not... but I do, and she is almost 100 and 14 days out from a major surgery. For now, at least, bed rest, meals in her room, and no wheelchair rides is the way to go. I did consent to letting Mam-ma wear her pajama tops instead of a hospital gown. She says the gowns "choke me." So she can wear the tops and a robe when sitting up in her chair... but wrestling on a pair of pajama pants is preposterous for someone in her condition!
I am so thankful for Hospice. I told someone that Hospice is as much for me at this point as it is for Mam-ma. I needed their support and guidance. I needed to know that someone who knew more than I will manage her care and help me with all of the decisions. And I needed someone I could call (besides a family member or friend) who was an expert... and who could be my sounding board.
At this point, we are day-to-day... or is it minute-to-minute?! Things change constantly with my grandmother, and I'm not anticipating anything at this point - good or bad. I'm trying to let things happen, and be prepared for whatever comes next.
Meanwhile, our little Timothy celebrated his 3rd birthday Sunday. We sent lots of wrapped gifts, and he had a big day with his family. We're hoping to hear from him firsthand soon about all of the festivities and get his reaction. I wish we could have been with him for this celebration... but at the same time, I'm so glad he is with his mother right now and not factored into this mix! God knew I couldn't handle both... and He was right!
To say the weekend in the hospital was uneventful would be a lie. For starters, I arrived Saturday morning around 9:00, and the aides said, "She didn't eat much breakfast." I immediately knew why as soon as I saw Mam-ma ... she wasn't wearing her dentures! I told the girls... "She doesn't have in her teeth!" They sheepishly disappeared, and the ward clerk scrambled to find something in the nutrition room that we thought Mam-ma would eat. Then she realized the food cart was right beside the nurses' desk, and Mam-ma's virtually untouched tray was still there. She retrieved it and warmed the scrambled eggs and biscuit in the microwave. I fed Mam-ma, and she ate all of her eggs and half a biscuit with jelly - once we put in her teeth, of course!
Saturday morning, the therapist came to do some exercises, but when she and the nurse lifted Mam-ma from the bed, Mam-ma virtually collapsed in dead weight, and they just sat her in a chair. The therapist, who is a friend whose grandmother is Mam-ma's contemporary, mouthed from behind Mam-ma... "You're doing the right thing" (meaning Hospice). That made me feel more confident in my decision.
Sunday was horrible. Mam-ma required several "brief" changes, and the nurses were always so kind. But sometimes it was an hour after we rang for help... and that is just too long - even if you are understaffed. So I had to make a few trips to the desk to remind someone I needed help!
By the time Sunday ended, my grandmother had suffered through several hours of severe gas pains that left her screaming in discomfort. She was unable to eat her dinner, and I discovered that while we were at lunch, Amanda and her dad had come, and Mam-ma had sent them home with some harsh words... she had a messy diaper and was embarrassed, and she told them in some pretty colorful language to go home. So they did. Another cousin came before dinner, and she helped me with Mam-ma for a while... managed to feed her some applesauce... and Mam-ma finally settled down and seemed to stop hurting around 7:30 p.m. I hugged her and promised, "I'll take you home tomorrow." She frowned and said, "Debbie, I'm worried about you. You're doing too much." I explained that I was only doing what she needed, and I would be okay. Later, as I kissed her goodbye, she cried and said, "Oh, Sugar... you've done so much... you are just so precious." I left in tears.
I came home and tearfully told all of this to my husband... who had been there with me for part of the afternoon drama... and he said, "You are overly tired. It will be okay." I was... and it is... but that was a rough day.
Monday, I arrived at the hospital, and the aide met me and said, "She hardly ate anything this morning." I took one look and said, "I can tell you why - she isn't wearing her teeth again!' This was another aide, and she said, "But it was pancakes and scrambled eggs!" I replied, "I don't care... she's not gonna eat without her teeth!" So the nurses ordered another tray and apologized profusely. This is "Nursing 101!" The charge nurse said, "If you were staying another night, I'd make a sign that said 'Be sure to check for her teeth before feeding!'" After meeting Monday morning at the ALF with Hospice and ALF staff, we got Mam-ma settled back in her apartment by late afternoon. No less than six aides, a nurse, and an administrator swarmed the hospital van to greet her when she arrived. That was such a great sight... I knew we were truly home. I spent more than an hour with the Hospice nurse and social worker, filling out paper work and getting things in order. It was another long day.
Mam-ma seemed to do well on Tuesday... a Hospice aide came and bathed her. She has a hospital bed, a wheelchair, bedside toilet, and oxygen if needed. The four days per week that the ALF staff doesn't give her a bath are covered by Hospice aides who come and bathe. Mam-ma was concerned about me "doing too much," so I told her I would stay home on Wednesday and not visit. Honestly, my house was so dirty and messy, and I could not rest until I knew it was in some semblance of order. It never felt so good to clean a bathroom or dust and vacuum! I made potato salad and spaghetti sauce to freeze for quick meals and just basically caught up on things that had been neglected for nearly two weeks.
Thursday, we had a Mother's Day luncheon at the ALF. I had told the administrator that my sister and I would attend - and if Mam-ma could not attend, we would sit with some mother who had no one there to sit with her. When we arrived, Mam-ma had been bathed, and she had on pajamas - even the pants! Her favorite Hospice aide was there, so I didn't question the pajamas... although she had worn hospital gowns up to that point. We asked if she felt like going to the luncheon, thinking she would say no... but she said yes, and she wanted to wear her nicest suit! So the aides dressed her, and off we went.
During lunch, the activities director stopped by our table and told us that Mam-ma had come out to the dining room and played BINGO the day before. This was news to me, and I was quite shocked. I knew the nurse had told me she wheeled Mam-ma to the dining room a couple of times... but she had also told me that Mam-ma did not get up for any meals on Wednesday. I'm not sure exactly what she did. But the bottom line was that I realized that the staff had put Mam-ma right back into her old routine and was pushing her to get back to her "old self." I didn't know what to do, but I figured she was pretty close to "hitting the wall."
I was right. Friday morning, the Hospice nurse called me and said, "I've just seen Polly, and she is totally out of it. She cannot stay awake... she is lethargic... I don't know what happened!" I did! I explained how much that Polly had done last week, and the nurse told me that this had to stop. I agreed... but how? She told me that I needed to contact the administrator and discuss this with her... and I did... and we agreed that Mam-ma takes meals in her room, stays in her hospital gown, and only gets up for a little while each day and sits in her recliner - at least for now. She is still in a lot of pain, and only 14 days out from a major surgery at this point. Plus, she is less than 6 months from being 100 years old!!! Because Mam-ma looks so much younger - and generally acts it... and because the staff loves her so and wants her well... they were really working to rehab her back into shape!
So I'm getting some dirty looks and have had to go back and reiterate to a few that we are NOT pushing... that "less is more" in this case. But we seem to be getting there, and I do think this is the best thing for my grandmother. I am not willing her to die... nor giving up on her. I am managing her care. There have been times when I have called about something or gotten involved in a detail here or there, and my husband has suggested that perhaps I am micro-managing her care and causing myself undue stress. The Hospice nurse assures me that I am not... that I am simply loving my grandmother and making sure she is taken care of. It's hard to know how to balance this... and what can slide and what is important. I'm in some uncharted territory here (at least for me), and I am doing the best I can. When I visited today, a new shift of aides was on board, and Mam-ma had been to lunch and was dressed in pajamas again. So I had to "educate" them on the plan... apparently the word about her care plan did not get to them.
One aide seemed to question my comments... I told her and another aide that the doctors feel that even with therapy, Mam-ma most likely will not walk again, and this aide said, "Oh, I disagree! They don't know Ms. Polly!" Maybe not... but I do, and she is almost 100 and 14 days out from a major surgery. For now, at least, bed rest, meals in her room, and no wheelchair rides is the way to go. I did consent to letting Mam-ma wear her pajama tops instead of a hospital gown. She says the gowns "choke me." So she can wear the tops and a robe when sitting up in her chair... but wrestling on a pair of pajama pants is preposterous for someone in her condition!
I am so thankful for Hospice. I told someone that Hospice is as much for me at this point as it is for Mam-ma. I needed their support and guidance. I needed to know that someone who knew more than I will manage her care and help me with all of the decisions. And I needed someone I could call (besides a family member or friend) who was an expert... and who could be my sounding board.
At this point, we are day-to-day... or is it minute-to-minute?! Things change constantly with my grandmother, and I'm not anticipating anything at this point - good or bad. I'm trying to let things happen, and be prepared for whatever comes next.
April 02, 2012
I Think I'll Try the "Sink or Swim" Method
I know it's been a few weeks since my last post... and I have no other excuse except to say that I've been busy! My 88-year-old cousin who was dying was laid to rest on March 21st, so I spent much of that week with cousins and other family members. This was a bittersweet time... we will miss my cousin, but he is at peace and died as he lived - on his terms, and with dignity. I got to visit with cousins I have not seen in years... and some old connections were re-established, hopefully. At the same time, this was one more reminder for my grandmother that her day is coming... and that somebody else got to go before she did.
Some of the cousins did spend quite a bit of time visiting with my grandmother, and she thoroughly enjoyed listening to their stories. Since she can hardly get out a sentence these days, she likes for us to gather and visit in her presence. She can soak in what we are saying... and every once in a while, she gestures, smiles, or interjects a word or two. But mostly, she sits and smiles and enjoys our company.
Lately, my visits to see Mam-ma have centered around rearranging her closet and taking my latest sewing project to share with her. The latter seems to be the one thing that truly energizes her these days... the "common thread" (no pun intended) that we can share and enjoy. My grandmother was an amazing seamstress, and I still marvel at her tailoring skills and the ability to create tiny clothes for our Barbies - by hand! But she is impressed with the work I am doing, and she obviously takes great pride in my accomplishment.
Every excuse she thought of was readily addressed, but she still insisted she wanted to go home. Weary of the argument, my sister-in-law told her, "Fine... then make it work." She left her mother to her own devices. Her mother arranged for part-time in-home care. She has severe macular degeneration and cannot see, but she refused Meals on Wheels, insisting she will cook for herself. Doctors and therapists determined that she was better walking unassisted than trying to use a walker, because she could not see to maneuver it... and her arm, weakened from the fall and surgery, would not adequately support her weight.
My grandmother and I have come a long way on this journey, but we still have some "sink or swim" moments. She fell again recently... hit her neck on the edge of her night-stand. She admits she stood too quickly and lost her balance... and her walker was across the room. She explains that she uses the night stand and her bed as braces as she inches along the floor toward her walker, which she leaves parked across the room beside her television. Efforts to get her to pull her walker over beside her chair are futile.
Also fruitless was my attempt to get her to remember to count to five before taking a step. I reminded her that this was "the doctor's order." When she stood, I chided, "Count to five... count to five... Mam-ma, STOP and count to five!" Three or four steps later, she stopped and stared at me like I was from Mars. I realized I had just wasted my breath... and I've not reminded her again to "count to five." I know she will probably stand again, take off without letting her blood pressure regulate, and fall. And I am prepared to deal with any resulting injuries. She will either sink or swim... and I probably won't be there to rescue her if something goes wrong. Making peace with this has also been a journey... and a huge lesson in patience, surrender... and faith.
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What's happening with your "sandwich" these days? Do you have a story to share... insights or success stories? What's bugging you? Can we offer you some possible solutions or encouragement? Please leave your comments, or e-mail me directly using the link on the sidebar.
Some of the cousins did spend quite a bit of time visiting with my grandmother, and she thoroughly enjoyed listening to their stories. Since she can hardly get out a sentence these days, she likes for us to gather and visit in her presence. She can soak in what we are saying... and every once in a while, she gestures, smiles, or interjects a word or two. But mostly, she sits and smiles and enjoys our company.
Lately, my visits to see Mam-ma have centered around rearranging her closet and taking my latest sewing project to share with her. The latter seems to be the one thing that truly energizes her these days... the "common thread" (no pun intended) that we can share and enjoy. My grandmother was an amazing seamstress, and I still marvel at her tailoring skills and the ability to create tiny clothes for our Barbies - by hand! But she is impressed with the work I am doing, and she obviously takes great pride in my accomplishment.
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| Five pair of shorts, two onesies and matching pants, one dress, one appliqued tank, and a burp pad... all in coordinating prints of Groovy Guitars, Urban Zoologie, and more! |
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| Darling Diva outfit created from ladies cardigan sweater in animal print. Note the beading detail on the pants hem and the little jacket pocket! This was really fun to create! |
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| Orange dream created from ladies beaded knit top. |
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| Baby bolero jacket created from vintage embroidered dresser scarf with crochet lace trim. I love repurposing old linens! |
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| Our little friend Ada Jane models her fake fur zebra print bolero shrug jacket! Is she a darling diva or what?! |
Sewing has taken up much of my spare time in recent weeks. It keeps my mind off of how much we miss Timothy and gives me a positive focus. I've made dresses, shorts, burp pads, appliqued onesies, and even a fake fur jacket for the little friends, nieces, nephews and cousins in our family. I've even made matching clothes for an American Girl doll! The children all enjoy their one-of-a-kind clothes, and the moms are beyond thrilled. I know that the day will come soon enough when these little ones are teens who wouldn't be caught dead in one of my creations. But for now, they love their new duds... and I get such a kick out of creating them!
A couple of weeks ago, my husband's brother and sister-in-law visited for the day. Over lunch, my sister-in-law reported the latest news about her 95-year-old mother, who fell in November and broke her arm in two places. She required surgery, a lengthy hospital stay, and rehab at a local skilled care nursing facility. Each week since mid-November, my brother-in-law and his wife have traveled some 3+ hours to spend several days attending to the needs and business of this woman. Usually they would go on Thursday and return home on Sunday. Some weeks, my sister-in-law has stayed longer, as needed.
March 31st signaled the end of Medicare coverage for my sister-in-law's mother. She had the choice to continue her stay at the skilled care nursing facility and pay out-of-pocket. She could also move to an assisted living facility. Or she could go home and have continual care. Of course, she opted for Door #3. My sister-in-law had toured a local ALF and loved it. She hoped her mom would, also. She did not. She found all sorts of reasons to derail a move there... she had to take her own furniture (not a problem, she was assured). She would have to change therapists (also not a problem - she won't have therapists at home!) People would not come to visit her as often (the visits have already dropped to a trickle).
Every excuse she thought of was readily addressed, but she still insisted she wanted to go home. Weary of the argument, my sister-in-law told her, "Fine... then make it work." She left her mother to her own devices. Her mother arranged for part-time in-home care. She has severe macular degeneration and cannot see, but she refused Meals on Wheels, insisting she will cook for herself. Doctors and therapists determined that she was better walking unassisted than trying to use a walker, because she could not see to maneuver it... and her arm, weakened from the fall and surgery, would not adequately support her weight.
A few days before she was to leave the nursing home rehab, this woman fell in her room and sprained her ankle. My sister-in-law thought this might get the wheels back on the bus for going to an ALF. It did not. So this weekend, she and my brother-in-law moved her mother home... and then they returned to their home. In essence, my sister-in-law has said, "Sink or swim."
While I cringe at the thought of this, I get it. I remember the week before my grandmother moved into her apartment at the ALF and we argued over a folded envelope she had wedged behind a wireless doorbell apparatus plugged into the wall receptacle. She insisted it was not a fire hazard... I insisted it was. In frustration, I finally said, "Fine... if you burn yourself and this house down before you move next week, so be it!" Then when she was not looking, I removed the envelope. I don't know if my sister-in-law will get the opportunity for such an action or not... but I know she will take it if she has a chance.
We do this often with our children... we try to protect them as much as possible... tell them "don't touch that hot object" ... or "you won't like the taste of that!" But sometimes, they have to discover these things for themselves. The tricky part is allowing them to sometimes sink a little...without drowning! This is an extremely slippery slope with both age groups, and often we have to pray hard and trust God to protect our "little ones" of all ages.
My grandmother and I have come a long way on this journey, but we still have some "sink or swim" moments. She fell again recently... hit her neck on the edge of her night-stand. She admits she stood too quickly and lost her balance... and her walker was across the room. She explains that she uses the night stand and her bed as braces as she inches along the floor toward her walker, which she leaves parked across the room beside her television. Efforts to get her to pull her walker over beside her chair are futile.Also fruitless was my attempt to get her to remember to count to five before taking a step. I reminded her that this was "the doctor's order." When she stood, I chided, "Count to five... count to five... Mam-ma, STOP and count to five!" Three or four steps later, she stopped and stared at me like I was from Mars. I realized I had just wasted my breath... and I've not reminded her again to "count to five." I know she will probably stand again, take off without letting her blood pressure regulate, and fall. And I am prepared to deal with any resulting injuries. She will either sink or swim... and I probably won't be there to rescue her if something goes wrong. Making peace with this has also been a journey... and a huge lesson in patience, surrender... and faith.
I applaud the determination of the human spirit to become independent - as with children... and to keep that independence when we age. The challenge for those of us in the middle is to learn to handle the bumps, bruises, and disasters that ensue. For this, I pray for strength and courage for each of us.
What's happening with your "sandwich" these days? Do you have a story to share... insights or success stories? What's bugging you? Can we offer you some possible solutions or encouragement? Please leave your comments, or e-mail me directly using the link on the sidebar.
December 12, 2011
What do Six Days, Five Doctors and Fifteen Pounds Have in Common?
The answer to this question can be answered in two words... Mam-ma Polly!
When Timothy went back to his mother in Texas, Greg asked me, "What will you do with your spare time?" It didn't take him long to get an answer! Tuesday, December 6th, the nurse at Southridge phoned me at 4:00 p.m. to tell me that Mam-ma's blood pressure was high. She said "I am going to give her the five o'clock blood pressure pill now and check her again in an hour, when it has time to work. If she still has a high reading, I told her she has to go to the ER." A little before 6:00 .m., the nurse phoned and said, "It's not as high, but it's still up there, and I think she should go to the ER. She doesn't have any chest pain, but this reading is too high." The top number had dropped from 167 to 142. I don't know what the bottom number was, but it had been 104, I think, at 4:00 p.m.
So I gathered my purse and jacket and headed to Southridge to get Mam-ma. The nurse would have called an ambulance if I'd asked, but I figured I could get her there faster, and she seemed well enough to get in and out of the car. It was "spitting snow," but we didn't have far to travel - less than 2 miles. I drove Mam-ma to the ER, and I helped her get inside. There were a few patients, but not many, and we were in an exam room by 6:30 p.m. Her blood pressure now was something like 198/112, which didn't surprise me... but it stayed that high the rest of the evening. The doctor assured me she was not having a stroke or a heart attack, but when asked, she did say she had shortness of breath.
The doctor ordered an EKG, a chest x-ray, blood work, and a urinalysis. Sometime around 11:00 p.m., he said the x-ray showed fluid around the heart and a little in the lungs. His diagnosis was mild CHF (congestive heart failure), and he said, "I'm going to give her IV Lasix and admit her. She will need a catheter so she doesn't have to get up... we don't want to risk a fall." I really liked the ER staff... especially this doctor, who we have seen before. He seemed to totally "get" Mam-ma - the fact that she is 99, and how delicate the balance is in her system. I was quite surprised at how swollen her legs were. She has had swollen ankles off and on for six months, but now her calves and even her knees were swollen. The calves were red and shiny and looked like bratwursts that would burst if you stuck them with a pin!
Mam-ma's wonderful nurse got the catheter in and collected 400 ccs of urine. Then she started the IV Lasix. By the time we took Mam-ma upstairs to a room, it was midnight - and there was another 1300 ccs of urine in the bag. The ER doctor said, "She is in incredibly good health for someone 99 years old, and we want to get her back to that and keep her there." It looked like we were on the way.
By the time I left the hospital, it was just after midnight, and over 2" of heavy, wet snow had fallen... and it was still coming down hard. Fortunately we live less than five minutes from the hospital, so I did not have trouble getting home - once I got all the snow scraped off my car windows!
I was back early the next morning to wait for the hospitalist. I had been told they were on duty from 8:00 a.m. to 4:30 p.m., and I didn't want to miss this doctor. He arrived somewhere around noon, due to icy roads, the nurses said. I did like Dr. Quintinar, and he said Mam-ma was doing well - progressing. About 3300 ccs of fluid had been collected. Dr. Quintinar told me that he would not be back this week... his associate would see us on Thursday.
We did see a new doctor on Thursday - I was there at 10:00 a.m. - Dr. Lewis arrived around noon and started making rounds, getting to Mam-ma's room around 1:30. He said he was ordering oxygen, and Mam-ma would have to wear it permanently to help with breathing. No oxygen was ordered, and the next day, I asked him, "What about the oxygen?" "Oh, yes... " he answered... "Oxygen... we will have to see if she qualifies for it." This meant a test to see how she walked up and down the hall with and without oxygen. The nurses said she did great... she did not need oxygen.
Each day, the doctor would say, "Maybe tomorrow you can go home." Mam-ma got daily physical therapy, which included walks in the hallways. On Saturday, we saw a very kind Dr. Ruiz, who was quite intrigued with Mam-ma. He gently stroked her face and hair and was very attentive and thorough. He said, "You can go home Sunday or Monday." Mam-ma told him, "You've disappointed me... I want to go home today!" He replied, "Home is a wonderful place to be... but for now, this is your home." He told me that the numbers were trending downward, but Mam-ma still had a little CHF. Also on Saturday, Mam-ma developed a little bit of a problem with getting to the bathroom in time. I think it was probably all of the green veggies she had been eating all week... it seemed nearly every meal included a hefty serving of broccoli or mixed vegetables with broccoli. Mam-ma told me, "I just LOVE broccoli!" which was news to me!
Sunday, we saw Dr. Konero. If you have lost count, that's five doctors, counting the ER doc. He ordered a stool sample to evaluate the bathroom issue before he would agree to dismiss Mam-ma. This morning, all the stars aligned, and we got discharge orders. Along the way, one doctor doubled one of Mam-ma's blood pressure medications. Another came along and cut the other BP medication in half. One discontinued her Lasix altogether after she lost almost 10,000 ccs of fluid and about 15 lbs... another reinstated it.
In the end, we went back to Southridge with tiny ankles and a slender face and tummy... and the exact same medications and dosages we arrived with last week! Dr. Konero said that Mam-ma seemed to be regulated on these dosages, and he ordered a daily weighing to monitor the fluids and a daily check of her blood pressure to determine whether or not she should get her Lasix pill. As I helped her dress, she said, "These pajamas are gonna be too tight." I told her, "I bet they aren't now!" As they buttoned with room to spare, I added... "That's what losing 15 pounds will do for you! I was reminded of all the times in the last months/years I have dressed Timothy as I helped Mam-ma into her pajamas and robe.
A nurse wheeled Mam-ma downstairs to the building entrance, where my wonderful husband had brought the car and parked it for us. He helped us get her in the car, and two aides met us at Southridge with a wheelchair and got Mam-ma into her room and settled into bed. She sank into her pillows and was almost instantly dozing. I asked if her bed felt good, and she said, "Heavens, yes!"
So hopefully we will have a few days of quiet, rest, and recovery. The RN at Southridge said she would order physical therapy for Mam-ma to help her regain her strength. I am so, so grateful that Mam-ma is at the ALF and could return to such care and attention. Had she been living at home alone, I am not sure what would have happened when she was discharged. I know she was in no shape today to return to a home to live alone.
This afternoon, I counted my blessings and marveled at God's timing. He allowed me time with Timothy before his return to Texas - time without having to dash back and forth to a hospital to check on Mam-ma Polly. When Timmy left, God gave me a couple of days to collect myself - and finish our Christmas decorating. Thankfully, while spending big chunks of each day at the hospital, I was not having to worry about Timothy - or leave him at home with Greg. And now, I will hopefully have time to get things ready for Christmas - and Mam-ma will have time to regain her strength so that she can celebrate with us. I even found time while sitting at the hospital to get all of our Christmas cards signed and addressed!
The one caveat I would offer about this week's experience was how CRUCIAL it is that you stay with a loved one who is in the hospital. It was not necessary for me to stay with Mam-ma 24/7... due in large part to the fact that this is a very small town, and I literally grew up with many of her nurses and therapists - some of whom refer to her as "Aunt Polly" - so I trusted them to look after her in my absence. But even with that, I did have to make several trips to the nurses' desk to ask for things she needed, and to check on lab reports, etc. And I spent a great deal of time sitting and waiting for a doctor to make rounds.
Had I not been there to get the reports, I would not have known that the changes in medications were being made... that one doctor said he was ordering oxygen and then apparently forgot. I am not sure the order to weigh Mam-ma daily at Southridge would have ever made it onto her discharge papers if I had not stepped to the nurses' desk Saturday night and asked about it.
At the end of the day, things fall through the cracks, even with the best medical staff in the world. I really, really liked the nursing staff. I actually liked every single hospitalist and felt comfortable with each of them. They were attentive and took plenty of time to listen to my concerns and answer my questions. And this was important, because Mam-ma can barely get her thoughts together these days, so she would not have remembered anything the doctors told her. And when they asked her questions most days, she would look at me in frustration and say, "Debbie, you tell him."
So please do not leave your loved ones unattended in the hospital for more than a short nap or perhaps at night when you are certain they are settled and ready to sleep. Too much happens... too many details can slip through the cracks. You would want someone to be there for you... do the same for your loved ones. "Hospital sitting" is the most tiring activity in the world. But it is also one of the most important when someone you know and love has to stay there.
When I left Mam-ma's apartment at Southridge today, I begged her to please call an aide for help before she got up for anything in the next few days. I told her, "The last thing in the world we want to have to do is go back to the hospital!" And I meant every word!
When Timothy went back to his mother in Texas, Greg asked me, "What will you do with your spare time?" It didn't take him long to get an answer! Tuesday, December 6th, the nurse at Southridge phoned me at 4:00 p.m. to tell me that Mam-ma's blood pressure was high. She said "I am going to give her the five o'clock blood pressure pill now and check her again in an hour, when it has time to work. If she still has a high reading, I told her she has to go to the ER." A little before 6:00 .m., the nurse phoned and said, "It's not as high, but it's still up there, and I think she should go to the ER. She doesn't have any chest pain, but this reading is too high." The top number had dropped from 167 to 142. I don't know what the bottom number was, but it had been 104, I think, at 4:00 p.m.
So I gathered my purse and jacket and headed to Southridge to get Mam-ma. The nurse would have called an ambulance if I'd asked, but I figured I could get her there faster, and she seemed well enough to get in and out of the car. It was "spitting snow," but we didn't have far to travel - less than 2 miles. I drove Mam-ma to the ER, and I helped her get inside. There were a few patients, but not many, and we were in an exam room by 6:30 p.m. Her blood pressure now was something like 198/112, which didn't surprise me... but it stayed that high the rest of the evening. The doctor assured me she was not having a stroke or a heart attack, but when asked, she did say she had shortness of breath.
The doctor ordered an EKG, a chest x-ray, blood work, and a urinalysis. Sometime around 11:00 p.m., he said the x-ray showed fluid around the heart and a little in the lungs. His diagnosis was mild CHF (congestive heart failure), and he said, "I'm going to give her IV Lasix and admit her. She will need a catheter so she doesn't have to get up... we don't want to risk a fall." I really liked the ER staff... especially this doctor, who we have seen before. He seemed to totally "get" Mam-ma - the fact that she is 99, and how delicate the balance is in her system. I was quite surprised at how swollen her legs were. She has had swollen ankles off and on for six months, but now her calves and even her knees were swollen. The calves were red and shiny and looked like bratwursts that would burst if you stuck them with a pin!
Mam-ma's wonderful nurse got the catheter in and collected 400 ccs of urine. Then she started the IV Lasix. By the time we took Mam-ma upstairs to a room, it was midnight - and there was another 1300 ccs of urine in the bag. The ER doctor said, "She is in incredibly good health for someone 99 years old, and we want to get her back to that and keep her there." It looked like we were on the way.
By the time I left the hospital, it was just after midnight, and over 2" of heavy, wet snow had fallen... and it was still coming down hard. Fortunately we live less than five minutes from the hospital, so I did not have trouble getting home - once I got all the snow scraped off my car windows!
I was back early the next morning to wait for the hospitalist. I had been told they were on duty from 8:00 a.m. to 4:30 p.m., and I didn't want to miss this doctor. He arrived somewhere around noon, due to icy roads, the nurses said. I did like Dr. Quintinar, and he said Mam-ma was doing well - progressing. About 3300 ccs of fluid had been collected. Dr. Quintinar told me that he would not be back this week... his associate would see us on Thursday.
We did see a new doctor on Thursday - I was there at 10:00 a.m. - Dr. Lewis arrived around noon and started making rounds, getting to Mam-ma's room around 1:30. He said he was ordering oxygen, and Mam-ma would have to wear it permanently to help with breathing. No oxygen was ordered, and the next day, I asked him, "What about the oxygen?" "Oh, yes... " he answered... "Oxygen... we will have to see if she qualifies for it." This meant a test to see how she walked up and down the hall with and without oxygen. The nurses said she did great... she did not need oxygen.
Each day, the doctor would say, "Maybe tomorrow you can go home." Mam-ma got daily physical therapy, which included walks in the hallways. On Saturday, we saw a very kind Dr. Ruiz, who was quite intrigued with Mam-ma. He gently stroked her face and hair and was very attentive and thorough. He said, "You can go home Sunday or Monday." Mam-ma told him, "You've disappointed me... I want to go home today!" He replied, "Home is a wonderful place to be... but for now, this is your home." He told me that the numbers were trending downward, but Mam-ma still had a little CHF. Also on Saturday, Mam-ma developed a little bit of a problem with getting to the bathroom in time. I think it was probably all of the green veggies she had been eating all week... it seemed nearly every meal included a hefty serving of broccoli or mixed vegetables with broccoli. Mam-ma told me, "I just LOVE broccoli!" which was news to me!
Sunday, we saw Dr. Konero. If you have lost count, that's five doctors, counting the ER doc. He ordered a stool sample to evaluate the bathroom issue before he would agree to dismiss Mam-ma. This morning, all the stars aligned, and we got discharge orders. Along the way, one doctor doubled one of Mam-ma's blood pressure medications. Another came along and cut the other BP medication in half. One discontinued her Lasix altogether after she lost almost 10,000 ccs of fluid and about 15 lbs... another reinstated it.
In the end, we went back to Southridge with tiny ankles and a slender face and tummy... and the exact same medications and dosages we arrived with last week! Dr. Konero said that Mam-ma seemed to be regulated on these dosages, and he ordered a daily weighing to monitor the fluids and a daily check of her blood pressure to determine whether or not she should get her Lasix pill. As I helped her dress, she said, "These pajamas are gonna be too tight." I told her, "I bet they aren't now!" As they buttoned with room to spare, I added... "That's what losing 15 pounds will do for you! I was reminded of all the times in the last months/years I have dressed Timothy as I helped Mam-ma into her pajamas and robe.
A nurse wheeled Mam-ma downstairs to the building entrance, where my wonderful husband had brought the car and parked it for us. He helped us get her in the car, and two aides met us at Southridge with a wheelchair and got Mam-ma into her room and settled into bed. She sank into her pillows and was almost instantly dozing. I asked if her bed felt good, and she said, "Heavens, yes!"
So hopefully we will have a few days of quiet, rest, and recovery. The RN at Southridge said she would order physical therapy for Mam-ma to help her regain her strength. I am so, so grateful that Mam-ma is at the ALF and could return to such care and attention. Had she been living at home alone, I am not sure what would have happened when she was discharged. I know she was in no shape today to return to a home to live alone.
This afternoon, I counted my blessings and marveled at God's timing. He allowed me time with Timothy before his return to Texas - time without having to dash back and forth to a hospital to check on Mam-ma Polly. When Timmy left, God gave me a couple of days to collect myself - and finish our Christmas decorating. Thankfully, while spending big chunks of each day at the hospital, I was not having to worry about Timothy - or leave him at home with Greg. And now, I will hopefully have time to get things ready for Christmas - and Mam-ma will have time to regain her strength so that she can celebrate with us. I even found time while sitting at the hospital to get all of our Christmas cards signed and addressed!
The one caveat I would offer about this week's experience was how CRUCIAL it is that you stay with a loved one who is in the hospital. It was not necessary for me to stay with Mam-ma 24/7... due in large part to the fact that this is a very small town, and I literally grew up with many of her nurses and therapists - some of whom refer to her as "Aunt Polly" - so I trusted them to look after her in my absence. But even with that, I did have to make several trips to the nurses' desk to ask for things she needed, and to check on lab reports, etc. And I spent a great deal of time sitting and waiting for a doctor to make rounds.
Had I not been there to get the reports, I would not have known that the changes in medications were being made... that one doctor said he was ordering oxygen and then apparently forgot. I am not sure the order to weigh Mam-ma daily at Southridge would have ever made it onto her discharge papers if I had not stepped to the nurses' desk Saturday night and asked about it.
At the end of the day, things fall through the cracks, even with the best medical staff in the world. I really, really liked the nursing staff. I actually liked every single hospitalist and felt comfortable with each of them. They were attentive and took plenty of time to listen to my concerns and answer my questions. And this was important, because Mam-ma can barely get her thoughts together these days, so she would not have remembered anything the doctors told her. And when they asked her questions most days, she would look at me in frustration and say, "Debbie, you tell him."
So please do not leave your loved ones unattended in the hospital for more than a short nap or perhaps at night when you are certain they are settled and ready to sleep. Too much happens... too many details can slip through the cracks. You would want someone to be there for you... do the same for your loved ones. "Hospital sitting" is the most tiring activity in the world. But it is also one of the most important when someone you know and love has to stay there.
When I left Mam-ma's apartment at Southridge today, I begged her to please call an aide for help before she got up for anything in the next few days. I told her, "The last thing in the world we want to have to do is go back to the hospital!" And I meant every word!
September 14, 2011
Time Well Spent with Mam-ma Polly and Timothy
We've had several visits with Mam-ma Polly lately. However, she hasn't always felt like walking the halls and pushing Timothy in her walker, which he loves. We sat in the dining hall for a long time Sunday, looking at the fish tank. Timmy loves it... and Mam-ma really needed to sit and rest. It worked for both of them.
I'm seeing a steady decline in Mam-ma's overall health and well-being. It's nothing definitive, but she is struggling to put her thoughts and words together, and that worries her. She told my mom that a dear friend and table-mate, Ruth, asked, "What have I done to you? You don't talk any more." Mam-ma told Ruth that she had not done anything, but she also added (in true Mam-ma Polly fashion!), "You need to wear your hearing aids!" Mam-ma doesn't understand that Ruth may have trouble using them in a noisy dining hall... and she may simply forget to put them in. Regardless, she doesn't wear them to meals, so she can't hear what Mam-ma says... and that makes Mam-ma very unhappy!
I remember the day we drove her to the ALF to move into her new apartment. I felt like I was leading a lamb to slaughter as we drove out of her driveway... but I can see (and I knew at that time) that this was the best place for her. And it's much that way with my 2-year-old nephew. I know this is best for him... and it gives me and his grandmother a break... but it is hard to leave a child who is crying and asking, "DebDeb... where are oooo?" - even if you know he is in loving, capable hands.
This sandwich has many layers, and all of them have a lot of "flavor" - some are even a little bittersweet!
August 20, 2011
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!
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.
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!
July 30, 2011
But I Asked for Chicken Livers
This morning I met several high school classmates at a local coffee shop to reconnect and visit. Then I went to see Mam-ma Polly at the assisted living facility (ALF). Mam-ma was already seated in the dining room for lunch, but she offered to return to her room with me for a few minutes so that I could unpack the things I had taken to her. Once there, she asked me, "How was your party?" I told her it was fine... not really a party... and I asked, "Who told you I was going to a party?" She snidely replied, "Well, you told me that you were too busy to come down here this week because you were cookin' for a bunch of people." I had told her that I might cook dinner for some friends who were busy moving to a new office space this week. But that did not materialize, and I answered... "I think what I actually said was that I was too busy this week to take you to Searcy yesterday to [your niece] Martha's retirement party... and I was. But I had coffee this morning with some of my classmates from high school." Mam-ma never asked if the coffee was nice, who was there...nothing... that was the end of it... and she sat in her chair and sulked.
MawMac said, "Well, I'm having chicken livers." As the other three plates were presented, they were all the same - chicken breast. Ms. Evelyn began to protest loudly, "I ordered chicken livers!" MawMac chimed in... "I'm supposed to have chicken livers!" Mam-ma Polly added... "I ordered chicken livers, too!" The aide looked bewildered. She was new, and she seemed genuinely upset. Soon Mam-ma's regular aide appeared at the table. "This is what you ordered," she explained. The three ladies protested. Mam-ma said, "I told you I wanted chicken livers!" The aide said, "No... I specifically asked you this morning if you wanted our lunch special, which was Ranch Chicken, and you said 'That will be fine.'" Ms. Evelyn piped up and said, "Well, I ordered chicken livers last night!" My grandmother nodded toward another table of ladies and muttered, "Well, I bet they got chicken livers." I told her I didn't think so, and she would not believe me... so I went over and checked... sure enough, every person in the dining room appeared to have the same meal... and it looked delicious. I tried my best to encourage the ladies to eat what was served... and told them how moist and tender the chicken appeared to be. While one lady loudly complained about not getting chicken livers, she was cutting up - and eating - her chicken breast! Another was saying, "I wonder when they are going to tell someone in the kitchen that you cook chicken in flour, not batter!" There was definitely "high drama" in the dining hall at the ALF today!
Clearly, none of the ladies understands that there is a "Daily Special" at lunch and dinner, and unless they specifically order from the "a la carte" menu - also called the "Sugarloaf Café," this is what they get! I tried to explain, but I got nowhere in short order, so I stopped. I suggested that tonight, they all ask for chicken livers tomorrow, and they could have them for lunch, and Mam-ma harrumphed and said, "Well... maybe!" And Mam-ma has told me more than once about the ladies complaining at the table... "that's not what I ordered," and that she "just eats whatever they bring me." Well, I'm here to report firsthand that all four of the ladies at this table were unhappy - and they were all quite vocal about it! I'm sure that Mam-ma would have been even more vocal, had I not been sitting there. I finally rose to leave, and Ms. Ruth said, "Do come back again soon... I'm sure we'll be mouthing about something!"
Honestly, if this is the biggest thing these ladies have to get upset over, we're talking pretty small potatoes. The food at this facility is delicious. I have eaten there more than once, and I could have gladly cleaned one of these plates today. This was not one of my better visits with my grandmother, but I reminded myself as I left that 1) she was in great health and moving around well physically, 2) she was reasonably clear mentally, and from all appearances, everything else was going well there, and 3) I must remember to "live in her world" when I am there and then leave it at the ALF.
The "three-ring chicken liver circus" I witnessed today could be viewed as sad and petty... but to me it was funny. It gave these four ladies something to rev their motors over, and in the end, nobody went hungry. The dessert cart contained big slices of white cake with chocolate icing... so if they didn't eat anything else, they had a tasty dessert. And from what I witnessed, all four of them were eating the chicken they said they did not order. Maybe it's time for us to give them the old "there are starving children in Africa" spiel they used to give us! Somehow, I don't believe it would work any better in reverse!
Since I don't have many graphics to accompany this post, I thought I'd include a fun photo of Timothy. The end of June, he moved to Texas with his mom and baby sister, and we are missing him madly! Hopefully he will return for an extended visit soon... meanwhile, we're talking on the phone and I'm looking at lots and lots of pictures!
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