Making Some TOUGH Decisions...

This week has been like a giant roller-coaster ride.  Wednesday - DAY 1 of Post-op, was a painful day.  Mam-ma's pain was never controlled, even with morphine.  Part of the problem was that the nurses got busy, and through a series of circumstances, she did not get any pain medication from 10:30 a.m. to 4:00 p.m., which caused her pain level to spiral out of control.  Knocking it back down was a daunting task.  She moaned and cried out in pain almost continually - even when she appeared to be dozing.

DAY 2, the pain was not much better, and as Mam-ma began to drink more liquids, I noticed she was not having any output.  I asked about this, and the nurses said, "We changed her at 9:00 a.m."  I asked again.  At 4:00 p.m., I went to the desk and said, "She HAS to be wet... can you please check?"  The nurses came and changed her... and declared her "Just a little damp."  I questioned... how could this be?  She had been drinking... Coke, sweet tea I brought from home, a Miralax "cocktail"... and she had been given TWO doses of Lasix!  No real answer.

When the shift changed at 7:00, I asked the nurses to please check again... surely my grandmother was wet now.  These nurses changed my grandmother, and again she was "barely damp."  However, this time, they noticed that her bladder was distended and tender.  She had told me her "belly" hurt.  The nurses did a scan of some sort that told them Mam-ma had at least 400 cc's of urine in her bladder.  They inserted a catheter, and almost immediately, Mam-ma's pain left, her whole body relaxed, and she has been like a new woman ever since!  Apparently the bladder muscles never woke up after surgery, so her body didn't know to relax and "go!"  I'm still not sure that is corrected completely.

I wish I could say the confusion is clearing.  Mam-ma looked brighter yesterday and has not moaned out in pain since Thursday night - except when they move her in bed or from the bed to a chair.  She still can't tell me my name sometimes - or hers - but she knew my husband yesterday afternoon.  He walked in, and I asked, "Who is this?"  She grinned and said, "GREG!"  Then she knew my cousin Amanda by name.  We thought maybe the anaesthesia was wearing off and she was clearing mentally.

Today, she is back in a fog.  I arrived at 9:00 a.m., and the aides said, "She drank her juice, but she wouldn't eat.  We got a couple of bites down her."  I looked at Mam-ma... she was not wearing her dentures.  I told them, "No wonder she didn't eat... she doesn't have her teeth."  "But she drank her juice!" they countered.  "Yes, but she can't chew without her teeth!"  So I put in her dentures.  The ward clerk retrieved Mam-ma's breakfast tray from the meal tray cart and re-heated her eggs, biscuit and coffee.  Mam-ma ate ALL of her scrambled eggs and half a biscuit with jelly... and she drank half a cup of coffee.  This is the most she has eaten all week. 

I told my husband a couple of days ago, "If I ever have to be hospitalized, PLEASE DON'T LEAVE ME THERE!"  If you or a loved one has to be hospitalized, be sure you have an advocate.  I have left my grandmother for a few hours... and these are good nurses... but I would not leave her there all day unattended - and I am there for both shifts, so all of the nurses know me.  My name and phone numbers are on the white board, along with the reminder that "Polly is DNR."  One nurse told me, "It is so much faster to pick up the phone by her bed and read your numbers off that board than to go search for her chart and look up your contact info."

Yesterday, given the lack of progress and my grandmother's inability to put her feet on the floor and stand, I asked one of the R.N.s (who calls my grandmother "Aunt Polly" and knows her well) what she thought about the possibility of putting Mam-ma in Hospice care.  Her eyes welled with tears, and she said, "I think that's a wonderful idea."  She said that she would call the Hospice coordinator and get the ball rolling.  I know many of the Hospice staff well.  My brother worked with them as an R.N., and then when he was dying in 1998, they cared for him.  They have cared for other family members since then, and the coordinator attends church with my mom.  They all know Mam-ma Polly well...and love her dearly.

The R.N. friend returned to Mam-ma's room soon to tell me that the coordinator was not in agreement - she wanted us to try therapy at the nursing home first.  I could not see the point in putting Mam-ma through the pain of therapy if every doctor and nurse are telling me she probably won't be able to walk again.  She can already sit in a chair - we don't need to go to the nursing home or get therapy for that!  So after I talked with the coordinator myself, she said if Mam-ma's facility physician would agree to Hospice, she would agree.  The facility physician agreed 100%. 

As it stands now, we will move back to my grandmother's apartment on Monday, where she will be placed on Hospice care.  A hospital bed, wheelchair, oxygen and bedside toilet chair have already been placed in her room.  I have paper work to complete on Monday, and the hospitalist heartily agreed to keep Mam-ma in the hospital until Monday.  Everyone tells me, "You are doing the right thing."  Based on this and how doors have continued to open at every turn, I believe this is the right decision.

This morning, the therapist came in and helped set Mam-ma in a chair (with the assistance from an aide), and she mouthed to me, "You are doing the right thing." Her own grandmother is in her late 90s, and I asked, "What if this were your grandmother?"  She answered without hesitation... "Oh, absolutely, I would do the same thing!" 

Mam-ma Polly - November 2009

A few have questioned me, or hung their heads at the mention of Hospice and said, "I'm so sorry."  But I just smile at them.  Today, my grandmother is exactly 6 months from her 100th birthday.  I have two goals for her for the rest of her days on this earth:  1) to be comfortable, and 2) to be happy.  The best shot she has of accomplishing this is to go back to her apartment at Southridge ALF and be among staff who love her and her many friends.  No more sorrow, no more pain.  My sister works the weekend nights at Southridge as a nurses' aide, so she will be there to keep an eye on Mam-ma, adding another layer of comfort for both of us.

Was this an easy decision?  Absolutely not!  I told the Hospice coordinator, "You know that my family is not eager to expedite things for Mam-ma."  She replied, "Of all the people in the world, I know that you are all the last people who would do this!" 

According to http://www.longtermcarelink.net/, "Hospice is a range of health and comfort care services that are delivered to patients who are nearing the end of life. In most cases, these patients have refused or otherwise are ineligible for receiving curative measures such as surgeries or advanced medical treatments. They are expected to live for 6 months or less after their admission to hospice care. The foremost consideration in hospice delivery is providing increased comfort care services."

As a friend who visited Mam-ma yesterday said, "People need to realize that Hospice care is not an immediate death sentence!"  We love my grandmother... this was a hard decision... but I believe it is the best for her. I don't know how long Mam-ma has left, but I want each day to count - and be a good one - as much as possible at this stage.

As I fed Mam-ma this morning, I thought once again of the many times in recent months that I have fed Timothy.  For someone who has never actually been a mother, I have certainly done my share of "mothering" in recent years - at both ends of the spectrum.  At the same time, one of the physical therapists who came in the other day was talking about how so many of their patients trip over small dogs or cats at home and fall.  I told her that my 86-year-old mother-in-law keeps dogs, and we worry about this happening to her.

The therapist said, "So in addition to your grandmother, you check on your mother-in-law?"  I told her yes, and until recently, we were helping to care for our 2-year-old great-nephew.  She replied, "WOW!  Your life is so RICH!  That's wonderful!"  I certainly don't hear that very often!  But she is right!  In so many ways, we are rich - and blessed - to have been given this opportunity... even with its challenges, rough patches, and tough decisions.  With God's grace, we're keeping all the balls in the air and making good choices...and I pray that this continues.

ESP and Old People

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What have I learned or been reminded of this week?

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

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

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

Apparently We Still Don't Understand!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Clearly, we still do not understand!

Who Decides?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Throwing Out the Towels

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

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

The "Voice" of Reason

My mother-in-law is gradually improving.  She gave us a good scare while on the heavy medication.  Her thinking grew very fuzzy, and she was wobbly and unsteady on her feet.  Then she just felt "blah" and had no enthusiasm or energy.  The doctor attributed it all to the medicine - particularly the steroid dosepak - and assured us it would clear... and it has/is.  And he told her she could gradually and gently resume her former activities - two words she is not hearing, apparently.  She is presently dog-sitting - for three dogs!  Thankfully two of these dogs are from the same household and get along with the third.  She has not mentioned swimming yet, and as long as the dogs are visiting, she probably won't leave the house.  But the doctor did say she could swim again - just gently and not every day!

My husband Greg spent every night (and most of the days) with his mother for a solid week.  I "spelled" him for a few hours here and there to do things like mow our yard and tend to things on the home front, handle business affairs - and just get away and rest.  Each day, I went to my mother-in-law's house and fixed lunch and dinner and in-between snacks to be eaten with the scheduled medications.  I also did some housekeeping and laundry, and changed the beds. Greg vacuumed his mother's house.  When she began to feel better, my mother-in-law dismissed her son - told him he needed to go home and sleep in his own bed.  So we complied, although Greg returned daily for a little while longer.

One of the first mornings Greg was back at home, he got up early and went to a fast-food place and picked up a breakfast burrito for himself and his mom.  They shared breakfast, and she announced that she thought she would take a shower and dress for the day.  Greg came home, and about noon, he telephoned his mother - and got no answer.  Panicked, he drove to her house, where he discovered all was well with my mother-in-law, but there was a problem with the telephone.  In fact, nearly all of the people on her end of town were without phone service - including my grandmother.

My husband reported the outage, and the phone company recording said it might be two days before service was restored.  Meanwhile, my grandmother's neighbor, Merrellyn, e-mailed my mom and said that she had reported the outage for herself and my grandmother, and she was told the same thing ... but she was hoping they were mistaken and service would be back that Tuesday afternoon.  Sometime around 4:30, my phone rang, and it was my grandmother, calling on her housekeeper's cell phone.  She said, "Debbie, I don't have any phone."   I told her I knew that, and it had been reported.  She said, "Well, Mary came by and I told her, 'Let's call Debbie and tell her my phone is out.'"  I found that funny - like I am the all-powerful telephone repair wizard! 

I realized that this meant my grandmother's "life alert" didn't work, because it's tied to the phone service, but I hoped service would come back quickly.  I told Mam-ma that I knew the phone was out, but there was nothing else to do but wait, since it HAD been reported.

Concerned for both ladies, Greg and I got in the car around 5:30 p.m. and set out to check on each of them.  We ended up at my grandmother's house around 6:00 p.m., and her friend Ruby was visiting.  She lives one street over from my grandmother, and her phone service was out, too!  This didn't seem to faze my mother-in-law, but the other two little ladies were all in a tizzy without their phones!

As we drove home, we passed telephone service trucks in the neighborhood alongside an enormous hole in the ground, and one of the repairman was holding a huge fistful of cables.  Greg said, "That doesn't look good."  Later in the evening, other neighbors in the area reported on Facebook that someone digging a water line cut through 600 phone cables, and it would indeed take days to reconnect them.

But that was not the case for my mother-in-law and grandmother.  Both had service sometime the next morning.  For some reason, my grandmother's next-door neighbor, Merrellyn, was without service a few more days.  We still don't know what happened there.  But she did tell my mother that my grandmother walked over to her house immediately after the phone lines went down to report the outage. Merrellyn said her housekeeper heard my grandmother outside.  It was raining - but just a sprinkle at that time - and Mam-ma was all bundled up.  She was standing on Merrellyn's porch under the eave.  She wanted to tell her know that her phone was out, and Merrellyn said she would report it. Later Mam-ma told me that she had walked to Merrellyn's and told her that the phone wasn't working.

Of course, none of us was thrilled to hear that my grandmother had gotten out in any rain - sprinkle or downpour - and walked on wet, slick streets to a neighbor's to tell her the phone wasn't working!  But what happened the next day was even more bothersome, and Mam-ma has yet to tell me about it herself.

Mam-ma's friend Ruby called to ask her for a recipe for chili.  Mam-ma said she would have to look up the recipe and call her back.  When I telephoned Mam-ma that evening about 5:30, she said, "I'm really worried about Ruby.  She's not answering her phone.  I told her I would call her with that recipe, but she's not answering.  I know what happened ... I bet you anything she went to the grocery store!"  And she said this rather disgustedly - obviously miffed that Ruby would go anywhere without her!  I said, "Maybe she went to get the things to make your chili," and Mam-ma replied, "No... that chili is for church!"  The First Baptist Church has a fall festival sometime in October that includes a chili cook-off.  I didn't know these 90-somethings were participating, but I guess they are!

Anyway, we talked about other things, and I told Mam-ma that Ruby would show up soon.  What I didn't know was that Mam-ma had already been to Merrellyn's house and asked Merrellyn's son, Sean, who was visiting, to drive her over to Ruby's.  Sean knows my grandmother, but he and his mom really didn't understand her request.  Merrellyn told my mom later, "We thought she was bored and just wanting to get out of the house."  They drove to more than one house, and Sean thought Mam-ma was a little confused.  But she directed him to Ruby's house, and I guess he stopped and Mam-ma got out.  From the reports of others, my grandmother barrelled into the house, calling, "Ruby!  Ruby!  Ruby!"  A man was lying on the couch watching TV - his wife was in the bathroom.  This was not Ruby's house!  Mam-ma was off by one house, I think.

The lady came out of her bathroom and told Mam-ma she was in the wrong house.  It turns out, Ruby was at work - caring for another 90-something friend a few streets over.  She had talked to Mam-ma on her lunch hour and told her "I'm going back to work at Gladys'." But I guess Mam-ma forgot or didn't hear or understand what Ruby said, and when she wasn't home, Mam-ma panicked.  She told my mom about it the next day and said, "Oh, I really flubbed up."  But she has not told me about it still... except to say one evening, "I really got upset over that little episode," as if I knew what she meant.  Of course, I do - from other sources.  I am assuming that after she barged into the wrong house, she had Sean drive her home.

On Friday when I picked up my grandmother for the beauty shop, she knew that we had kept our nephew overnight.  In fact, my sister took Timmy to visit Mam-ma on Wednesday.  Mam-ma asked me, "How is Timmy?"  I told her, "Timmy has a bad cough.  We were up for several hours in the night because he had trouble breathing."  She replied, "Well, I've got a terrible cough.  I've about coughed my head off."  That was the last she asked about her great-great-grandson, and she began to cough for me... and I have to say, it sounded fairly contrived.  But she had Tussin DM on her grocery list, and I bought her a bottle.

I ran Mam-ma's errands while she was getting her hair done and quickly deposited her at her house and put her groceries away.  I told her that I had left Timmy with my mom, because Greg was busy taking his mother for a follow-up visit at the doctor, and Timmy's dad was supposed to be coming to get him as soon as I got home.  So I needed to hurry back.  Mam-ma seemed fine with all of that.

By Friday night, I had a sore, scratchy throat.  By Saturday morning, I had a deep cough and felt lousy.  Sunday, my voice was GONE.   I felt better on Monday, but the voice is still not back.  So my mother has been doing double duty phoning morning and night to make sure my grandmother takes her medicine.  On Wednesday, Mam-ma phoned my mom and asked her if she would go to the pharmacy and pick up some medications that the doctor had ordered for her via the Home Health nurse.  The nurse happened by to give my grandmother a vitamin B-12 shot, and I don't know what all transpired, but my grandmother told Mom that the nurse called her doctor and "talked a long time." 

The bottom line was that the doctor prescribed "cough pearls" and an antibiotic dosepak that the pharmacist told Mom "might make her sick at her stomach."  Not good news.  Mom took the meds to my grandmother and insisted she eat some crackers and drink buttermilk before she took them.  Hopefully this will do the trick ... whether she needed it or not ... and prevent a visit to the clinic - or a truly serious illness.

It's been a long time since we went to the family physician for any type of visit, so I am not surprised that all of this transpired.  Mam-ma will sometimes tell me, "My doctor needs to see me ever once in awhile."  My mom has gone with her husband to visit his children and grandchildren in Tennessee, so my husband is going to go with me tomorrow for beauty shop day to serve as my "interpreter," since I still have no voice.

So things are adding up ... and not in a good way.  When you consider the mental confusion, at least two times recently that my grandmother has left a gas stove burner on with no flame, her refusal to stay out of her yard and do such things as rake pine needles, and then barging into someone's home ... it's not good.  While she dismissed me a few weeks ago when I mentioned the assisted living facility again, I think we may have to talk about it more seriously.  I simply feel like the time may have come when she can no longer safely live alone in her own home.

This is National Assisted Living Week.  I heard a staff member from an area assisted living facility say we caregivers should not feel guilty about choosing such a facility for our senior when the time comes.  We are offering them a chance to live as independently as possible while having all of their needs met by a trained, professional staff in a safe environment.  My social worker friend thinks my grandmother would be the "belle of the ball" in assisted living.  It may be time to find out.  I am hoping that my grandmother - and my mother-in-law - will listen to the voices of reason that surround them.  For the moment, my  "voice" of reason is silent.  I may learn that they prefer me this way!

I'll Go Graciously...

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

So Far .... So Good!

The daily phone calls to remind my grandmother to take her medicine are going well ... so far.  She seems to be enjoying the attention and is quite chatty ... and she is remembering to take her daily doses!

Last night, I tried to talk to Mam-ma about getting Meals on Wheels.  She argued with me that the meals are not the same as what is served to those who physically go to the Senior Citizens' Center for their lunch.  I assured her the meals were exactly the same ... and Greg confirmed this. He delivers on Mondays, and I've helped him a time or two, and I've seen how they serve the food - and it all comes out of the same pots! 

Anyway, I told Mam-ma I am concerned about her use of the stove and not realizing that the gas is on under a burner, but there is no flame.  She said, "I knew that gas was on.  Ruby had been here, and she told me that there was gas on at the stove, but I didn't get up and see about it."  I asked her why she didn't do that, and she said, "Well ... I forgot!"  I stressed to her that she must remember those things - and she must be very careful about the stove. She said she fries an egg each morning for her breakfast.  I guess now when Mom calls, she can ask, "Did you take your medicine?" AND "Did you turn off your stove?"!

Here's a link to a great story about a caregiving angel.  They do walk among us!
http://newoldage.blogs.nytimes.com/2010/08/10/the-caregiver-next-door/

So Much for Planning Ahead

I really didn't know what to expect Friday on my weekly trek with Mam-ma.  I ran some errands before getting to her house about 1:15 p.m. She had placed a towel in the floor on her carpet where the dining area meets the carpet, and I asked about it. First mistake. Well, it was because she had cleaned the carpet, and she wanted it to dry. So she had spilled something on the carpet? "NO! I just got stuff on it from the floor." "Oh, so you mopped the kitchen and splashed out?" "NO! I did this area and the one in the other kitchen doorway." Apparently my ESP was not working Friday. Finally, I surmised that she had decided the carpet leading into her kitchen and dining areas was dirty, and she had somehow spot cleaned it!  (When we returned from the beauty shop, I removed the towel - a huge tripping hazard that could have produced a fall.)

Then I sat down to dispense her medicine for another two weeks, and I looked at her grocery list, and on the bottom she had written "Lorazepam." I had just come from the pharmacy getting medicine for my husband and me - I got HER meds the previous Friday. I asked, "Are you completely out of this?" "Well, purty much!" she replied.  I counted - she had ten doses. I said, "You don't take one every day, do you?" Oh yes, she takes one every night - and sometimes in between. So she didn't think 10 would do her for another week.

I called the pharmacy and ordered a refill... her last. She had not had this refilled since April, so that tells you how often she takes a half tablet - clearly not every night! But she is never going to grasp the concept of planning ahead... it's all I can do to get her to buy milk when she still has part of a half gallon! And I bought her EIGHT bags of Cotton Pickin' Cornbread Friday, because they hardly ever have it any more at Wal-Mart and don't carry it at the other grocery store in town. A friend of mine was checking out behind me and said, "Your grandmother must eat a LOT of cornbread." I told her, "You have NO idea!"

As I hung up the phone from calling the pharmacy to order the Lorazepam, Mam-ma pressed on her lower abdomen and said, "I think I'm getting a .... oh, a ..... oh... um... well... a kidney stone. Sometimes it really hurts there... it comes and goes." Well, if it comes and goes, that's probably not a kidney stone. I just ignored her. As my sister pointed out later ... she tells me this on a FRIDAY afternoon?!

As I filled her meds, there were SEVERAL compartments that were still full... like all for a Friday and Saturday, and some for a Thursday night. I questioned her... did she not take her medicine today? Yes, she did... that was for Friday. "Today is Friday." "Well, I don't know." But she assured me she had taken her meds that day... and even at noon. So I have no clue why there was three days worth of medicine there, but I told her, "You know, when you miss your medicine, that might be why you feel bad and can't explain it." She didn't respond. All of those compartments should have been empty except for the one for Friday night's medicine.

We stopped and got her Ativan (Lorazepam), and on the way to the beauty shop, she asked, "Are y'all gonna join that place and swim?" I told her we have not joined our city's new community center, and we haven't decided whether we will. She said, "Well Ruby went out there, and she says it's real nice. She's gonna do some things out there. She told me 'Polly, you ort to have Debbie take you out there and get you a membership, and you could go with me.'"

I suggested she let Ruby try a few times and see if she liked it and was going to continue going before we got a membership, but I added, "...but we can get you one.  They aren't that expensive." She retorted immediately, "Why it won't cost me a thing!" I asked her how she figured that, and she said, "Well, if you have Blue Cross, it doesn't cost you anything." Now my mother-in-law told us that if you have Blue Cross/Blue Shield medical insurance, you can participate in the "Silver Sneakers" classes at no cost... or so she heard. But I said to Mam-ma... "But you don't have Blue Cross." "I most certainly DO!" she retorted! "Mam-ma," I told her... "you have Medicare and Medicaid. Your prescription drug coverage this year is Blue Cross. That is NOT medical insurance." "Well I know it IS!" she shot back. I told her *I* would look into it for her. I do not want her calling out there and playing the "poor little widder woman" card.  Hopefully she has not done so already!

I plan to check into the memberships at our community center ... there is a lovely walking track, and that would be a safe, comfortable place for Mam-ma and Ruby to walk year-round.  I think it will cost her $10 a month, and she can well afford that.  I plan to investigate the memberships this week and will probably get her one that starts August 1st.  So hopefully I can take a 3-month membership (the minimum) to Mam-ma next Friday that will be effective the following Monday.

I have not heard another word about the "kidney stone," and it was not mentioned when we returned from the beauty shop.  I'm assuming she has moved on to some other ailment or distraction by now.  If she gets upset, she has plenty of Lorazepam now!

Meanwhile, I recently heard about a woman who was diagnosed several years ago with vascular dementia, which has symptoms that sometimes mimic Alzheimer's.  Her daughter noticed that there was something wrong with the back bumper of this woman's car.  When she asked her about it, the woman said, "Oh, the paint is just peeling."  Wanting to be sure, the daughter asked her husband to take a look, and he said, "She's hit something."  So when confronted, the mother said, "Well, I didn't want to tell you, but I was trying to parallel park, and I backed into a car behind me."  The daughter said, "And you found the driver and exchanged information?"  The mother replied, "Well NO!  I got out of there!"  Her daughter tried to explain that this was illegal and could be considered a "hit and run," but the woman didn't care ... she was not sticking around to risk a citation! 

It was a funny story that really wasn't funny ... but at least I was thankful Mam-ma no longer drives.  Hey ... I will take a "silver lining" anywhere I can find it these days!