New Day - New "Sandwich"...What's in Yours?

As I write this post, I am sitting in the parking lot of an "eye clinic" in a nearby city.  Greg is inside with his mother, aka "Grandma E", who is having another "field test" for her glaucoma.  This is the third such test since October, when the doctor saw something she did not like.  She hoped it was a fluke, so Greg returned his mother in November for a second test, but the results were still not where the doctor hoped they would be.  Testing in December was delayed twice by icy weather... so here we are today.  Hopefully the results will be satisfactory and no additional treatment or testing will be necessary for awhile. (Added note...all seems well for now.)

 

I realize it has been a couple of months since my last post.  The "holiday months" were quite busy for all of us. Greg and I celebrated Thanksgiving quietly with Grandma E...she joined us for a lunch that I prepared.  My mother and her husband were away in Kentucky on a Workamping assignment, and the "kids" opted to have their own Thanksgiving dinner.  So I cooked a turkey dinner for three...and then we watched the original version of The Secret Life of Walter Mitty!

With just a few weeks before Christmas, I got busy the following day turning our house from a warm den of autumn coziness into a festive celebration of Christmas.  Thanks to Greg's help and "brute strength" in carrying all of the boxes down from the attic and assembling the big Christmas tree, I had everything decorated in a record two days!  Then it was on to baking and sewing...cookies, holiday breads, and pajamas, doll clothes and more.

In between, we endured a major ice storm that virtually shut down the town for about three days or more.  This put a halt to scheduled activities like the children's Christmas program at church, the Christmas parade, and many other events that had to be rescheduled.

I took the children to church two different afternoons to practice for their program.  As preschoolers, their role was to dress as angels and "ring bells". Assembling more than a dozen 2-to-5-year-olds...each holding two bells...is something akin to herding cats.  But the veteran conductor patiently persevered, and by the end of the second rehearsal, the children had pretty well figured out what to do and when to ring - and when not to ring!  And the adults had learned that it really didn't matter what happened... it was all going to be cute. When we would talk about the children's program, Timothy would say, "Everyone will be so PROUD of me!"  And we were!

At one of the rehearsals for the children's program, we gathered in the sanctuary. Since our children attend their Sunday school class while we attend worship in the sanctuary, they had never seen this room before.  Now it was fully decorated...massively tall tree filled with Chrismon decorations...poinsettias lining the choir loft railing...almost life-sized creche and angels in the foyer.

Timmy was in total awe. He kept pointing to the stained glass window over our choir loft that depicts a dove and the cross and saying, "Hey!  Look at that pigeon diving into the water!"  Even after I explained that it was a dove, he still called it a pigeon!  I explained to Timmy that this was where Uncle Greg and Grandma E and I come while he and Zola are in Sunday school.  He was impressed... but he still thinks there is a picture of a pigeon diving into the water over the choir loft!

The program was rescheduled, and the children stepped up to the plate and performed well.  Everyone enjoyed the production.

A few days later, the Christmas parade was held...having been rescheduled because of the ice storm.  I don't know who had more fun...the little ones or Grandma E.  The parade lasted about 45 minutes... and there was never a lull.  Our local courtsquare was fully lit and sparkled and glistened with brightly colored lighted trees, a nativity scene, a gingerbread house, and more. The two-storied courthouse glistened with lights outlining every window, wall and roof...and the children AND Grandma reacted as if they were walking through a fairyland.

Timothy had told us, "We won't see the real Santa. I don't think we will see the real Santa.  And we sure won't see Mrs. Santa."  A float came along with Santa - two of them - one on either side.  Clearly that was not the "real" Santa.  But THEN... a car came along with Santa... and MRS. Santa!  Timothy was so excited.

After the parade, we opted not to wait on the courthouse lawn to see Santa Claus and sit on his lap.  We headed up the sidewalk through an archway of lighted trees that Timothy had declared to be "magic" and we came face-to-face with Santa.  He walked up to Greg and Timothy and stuck out his hand and said, "Hello!  Merry Christmas!"  Timothy didn't miss a beat.  He said, "Merry Christmas, Santa!"

Then Santa came to Zola, Grandma E and me.  We had been told that Zola was scared to death of Santa, but he knelt and stuck out his hand and said, "Merry Christmas!" and she just grinned and giggled and said something we could not understand.

Timothy talked all the way home about seeing the REAL Santa and seeing MRS. Santa.  He loved the parade except for one thing... there was no Grinch.  He is hoping for a Grinch in the parade next year!

On Christmas Day, everyone gathered at our house for a big dinner and presents and stockings under the tree.  The children were so excited... Santa Claus had come to their house overnight, and now, they were getting to see not only their grandparents (my sister and her husband), but us, Grandma E, and my mother and her husband - just back from a nearly-four-month stay in Kentucky.  To say it was loud and crazy would be an understatement.  But it was also tremendous fun!

 

My point in sharing all of this with you is to make several observations:

• During the holidays, I found myself doing MANY of the things that my Mam-ma Polly did when I was younger...baking, sewing, filling the Christmas stockings for Santa, preparing the holiday meals, and more...and I thought of her...a LOT! 
• I also found myself juggling trips to take the children to rehearsals, attending Timothy's pre-K Christmas program, visiting Mam-ma's friends (and mine) at the Assisted Living Facility, and reaching out to people from multiple generations during the holidays.
• Most notably, I realized that Greg and I still are very much a part of the "Sandwich Generation" as his 87-year-old mother has assumed the senior role...and the three little ones still keep us hopping on the other end of the spectrum! These children could not love Grandma E more if she were their own flesh and blood.  The two oldest ones almost cry on Sunday if she doesn't go with us to church and out to lunch afterward.  And I'm noticing that she is always thinking about something to do for them...some little toy or trinket to give them.  It's a great relationship for everyone.

Grandma E's antics are not as entertaining - much less, challenging - as Mam-ma's grew.  Mainly, she is forgetful... and stubborn (like going to retrieve her paper in the ice after Greg expressly told her NOT to go outside)...and she would rather stay home and babysit a dog than do just about anything else in the world.  She is truly remarkable for a woman well on her way to age 88, and we hope she still has many good years of living alone in her own home and doing as she pleases ahead of her.

The best three words in the world from the kiddos are "I love you."  Timmy freely tells Greg, Grandma E and me that he loves us.  In fact, on the way home from lunch one Sunday, Timothy blurted out... "Grandma E... I love you!"  Melts the heart!  He also tells Grandma E nearly EVERY Sunday after lunch, "Thank you for paying for lunch, Grandma E!"

Our little ones are learning valuable lessons about life and relationships from the time they spend with my mother-in-law...and she gets just the right dose of being a great-grandmother in return!

In recent months, I've been asked more than once..."Now that Polly is gone, what do you do with all of your spare time?"  Clearly, that "gap" has filled in rather nicely.  Each "Sandwich" is different...but from the looks of things, we'll still be part of The Deli for several years yet!  I look around at others who are smack dab in the middle of their own "Sandwich", and I marvel at how some of them manage to "keep all the balls in the air".  For others, I offer three words of advice..."Hang in there."  We are not alone...this subset of the population grows by leaps and bounds every single day.  If you are not presently a member of the "Sandwich Generation", you very well could be next week or next year!

 

Knowledge is power, and for that reason, I am continuing this blog.  Please share your stories...your insights...what works for you - and what doesn't.  Ask questions, seek support...and know that there are people who can help.  Someone asked me last week, "What's next for you?  What are you looking forward to this year?"  I honestly do not have an answer... but I certainly know that life will be anything but dull.  What about you?

Getting Your Face on a Smucker's Jar...

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!)

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The More Things Change...

... the more they stay the same!  This thought "came home to roost" with me recently.  After 251 days, we finally got to see our little nephew Timothy again.  His grandparents went to Texas to visit after Timmy's new baby brother, Nathan, arrived.  They brought Timmy home to visit for a couple of weeks, before we return him to Texas.  We were thrilled to see our little guy - and amazed at how he has grown and what all he can do now.

At the same time, I was struck by the similarities between him and my grandmother.  The only difference is the scale.  Timmy is now potty trained.  He uses a little "Thomas the Train" adaptor seat that perches atop the regular toilet seat - much like the "potty chair" apparatus that sits over Mam-ma's toilet and provides her with a higher perch and arm rails.  Timothy still has trouble understanding a few things - and often there is no reasoning with him... just as it is with Mam-ma.

You can tell Timothy to stop doing something, and in his little 3-year-old mind, it doesn't compute.  You can tell Mam-ma to stop hollering or rattling her bed rails, and she just looks at you with a glazed look, then starts to holler and rattle.  Timmy spits out foods he doesn't like... so does Mam-ma.  Timmy frequently asks "Why?"  Mam-ma does, too... as in, "I don't know WHY I can't walk."

We took Timothy to see Mam-ma... I think it confused her, although she seemed happy to see him.  All she could say was, "I tell you what!" and once she said, "He's so cute."  Finally, Timmy raised his hands as if he were confused and said, "TELL ME what, Mam-ma!" She didn't get it.  I suggested that Greg take Timmy to see the fish tank in the dining room, and he did.  Thankfully he was with me... it would have been a real challenge to manage Timmy and Mam-ma by myself!

In the seventeen days that Timothy visited, I saw even more similarities, as Mam-ma expressed herself in 3-year-old fashion. More than once, when she was upset about something, she began to heave her shoulders and "cry" and sob... with nary a tear... a behavior I had seen from Timothy several times.  I wanted to say, "Use your words," as I do with him... but it didn't seem appropriate.  So instead, I would tell her, "That is not helping.  You need to tell me what is wrong." 

Honestly, I don't feel I have been nearly as patient with my grandmother in recent weeks as I should... and maybe that was due in part to the stress of caring for her AND my nephew.  I think moreso, it's the culmination of weeks and months and years of continual stress and "wrinkles" and challenges.  We are all just a tad weary - and none of us more than my grandmother.

I didn't take Timothy back to visit Mam-ma Polly while he was here.  She never asked about him again, and he did not indicate he wanted to return.  They saw each other, we snapped a photo or two, and we can say we've "been there, done that."  If she wakes up someday and says she wishes she could see him, we can remind her that he did visit.

We have returned Timmy to his family in Texas.  Saying "Good-bye" again was heartbreaking for all of us.  I am hoping and praying that it won't be another 250+ days before we see them again.  Meanwhile, I am regrouping, resting a sore knee that wasn't  up to the rigors of a 32-lb. three-year-old who liked to be cuddled and carried.  I am already focusing on the newest development with my grandmother... a speech therapist who has indicated interest in working on the expressive aphasia. If she is willing to do the paperwork to see if Mam-ma qualifies, I am willing to consider this.

So life continues... with all of its similarities - AND changes...and so do we!

I Can Still See "Them Eyes!"

He's here... our newest great-nephew, Nathan Daniel, arrived Friday morning.  All 6 pounds 13 ounces of his 18-inch body are perfect!  He will be a wonderful little brother for Timothy and Zola... and all three children will surely be a challenge for their young mother!  I can't wait to meet him and have some snuggle time - hopefully by the end of this month!

Friday afternoon, I visited Mam-ma Polly at the ALF.  I had not been to see her since the previous Sunday, although I knew that my mom had been there mid-week for a visit, and all reports were that she was doing remarkably well.  Mam-ma was sound asleep when I arrived, so I tip-toed around a while... and honestly, I considered not even waking her.  But I had brought her a picture of Nathan that I printed out all nice and big, and it HAD been a while since my last visit.  So I did a few things in her room until she woke up.  She was THRILLED with the picture and said, "Sit me up."  I did, and then she wanted to GET up and sit in her wheelchair.  The aides, Debbie and Kay, came and helped her, and they oohed and ahhed at the picture.  Dr. Smith was there making rounds, and Mam-ma said he had seen her that morning... and had very little to say.

Dr. Smith passed Mam-ma's apartment doorway and saw us, and he ventured in and told me everything was good, and he didn't change a thing.  He thinks "we are doing very well" and "hanging on..."  He commented about the picture, and I thought everything was great... until I got up to leave. 

I hugged Mam-ma and started to leave her apartment, and she grabbed my arm and began to frown. Then she heaved a big sigh and started to breathe heavily, and she said, "Well, I forgot to tell you..." and she couldn't get it out, and I waited and waited... and finally she said, "Well, them big eyes..."  I said, "Yeah?"  She said, "Oh... them eyes... they just haunt me."  I asked, "Whose eyes?"  She said, "That man!  I woke up and all I could see was them big eyes."  I asked, "You woke up and saw a man's eyes?"  "Yes!"  "When did this happen?"  "A few nights ago."  "Who was it?"  She tried and tried to think of the man's name, but she couldn't.  I asked was it someone she knew?  Yes.  Was it her deacon?  NO!  Was it someone who lived at Southridge?  Yes. 

By this time she was crying - and she even had a few tears in her eyes.  She said, "I was so scared."  I told her, "If that ever happens again, press your button.  Is that what you did the other night?"  She said, "No!"  I asked her what she did, and she said, "Well... I screamed!"  She said an aide came in and sat with her "a right smart while" (one of her favorite sayings).

I assured her that it was okay... and that I would ask around - that no one had mentioned it to me.  I told her "Good-bye," and went to find the aides.  They were unaware of this incident.  The nurse was also unaware.  The administrator had not heard about this and said none of her male residents roam or go into other people's rooms... that they are all "with it" more than that.  We both agreed it could be something Mam-ma cooked up because I was leaving - everything had been fine up to that point.

BUT... when I got back down the hallway, Mam-ma was out at nurse's office, and she was trying to tell Peggy, the nurse, this story.  Kay came along, and sweetly she said, "Oh, you know, lots of the little ladies see men in their rooms.  One lady has a man who comes all the way from Mississippi."  We again assured Mam-ma that no one was coming her room - that the aides and Peggy would keep their eyes open... it would be fine.  She was NOT convinced. 

I  once again said "Good-bye" and left.  I got out in the parking lot and remembered that Mom had told me the other day that the aides thought Mam-ma was confused... and the week-day nurse had ordered a urinalysis, just in case.  So I went back and told Peggy about the UA and the aides thinking Mam-ma was really confused, and maybe that was it... maybe this happened when she took her nap. 

We were talking in the doorway, and I heard Mam-ma's very clear and strong voice from down the hallway... "Debbie!"  I turned around, and she was right at her apartment doorway, and she raised her hand and pointed her finger and said, "Plank*!  His name is Plank!"  Peggy and Debbie said, "Oh... Mr. Plank!  We know him... he wouldn't go in her room."  Mam-ma insisted that he did. 
Then Debbie remembered that when she put Mam-ma down for her nap, she said, "Ms. Polly, you need to get some sleep," and Mam-ma said, "I don't know if I can... I keep seein' them eyes."  Debbie didn't know what she was talking about.  Peggy tried to explain to Mam-ma that dreams could be vivid... she had waked from a dream and thought it was real more than once.  Mam-ma was adamant - and agitated - that this was NOT a dream... Mr. Plank was in her room leaning over her bed - and now it was "night before last." 

So I assured her again that nobody was coming in her room - the aides and Peggy would be watching.  I finally went in her room and coaxed her back inside to drink a Coke.  I put a straw in a can  of Coke and handed it to her and said, "Drink this and look at the picture of the baby, and that will perk you up."  She took a big swig and said, "Well, now I have to go to the bathroom."  I made sure her call button was punched, and I told her "Good-bye" yet again... and left.

So I just don't know... Peggy was insistent that Mr. Plank would never do this... but how would Mam-ma know this man's name?  And yet, I know she was not confused earlier... and why would this happen just as I left?  It's all so convoluted...and disturbing.  I had to think about her so adamantly accusing one of her favorite aides a few weeks ago of bruising her arms. Is this a new "thing" with Mam-ma now... to imagine that people are doing things?  I am so sorry I woke her!

I called my sister and warned her... and I told her I wonder if I need to pursue this more... or if I should let it ride for now.  She said to let it ride... so that's what I will do.  I just felt she needed to know what had transpired before she went in for her night shift as an aide at the ALF.  Hopefully it's over with and Mam-ma will not mention it.  Time will tell.  I really thought Mam-ma was doing so well when I first arrived... but maybe not.  Suzanne did not even seem to know who Mr. Plank is.  It did throw me when I found out he really exists... but as my husband and Peggy both suggested, she probably had a nightmare... and he was in it!

My mother tried to console me by telling me that my maternal grandmother imagined things... she insisted that the nursing home staff where she resided were dressing rats and seating them in the dining room for meals. She was sure of it - she had seen them!  But what threw me the most was how quickly my grandmother spun from being really well and mentally clear to being totally upset and confused.  I seriously wonder if she was having a TIA... and we will never know for sure.  My mom encouraged me to put it out of my mind.  I am trying.

Hopefully it is all forgotten and Mam-ma will not mention it again.  Time will tell. I have seriously dreaded my last few visits.  It seems to always be something... ranging from mildly irritating to downright bizarre.  One thing is for sure... I can't say the visits are ever dull and uneventful... and that is not necessarily a good thing. I am hoping for a calm and peaceful week.  I will print out a couple more pictures of Nathan for Mam-ma to enjoy.  Maybe that will get her mind on something more pleasant - at least for a little while.

*Name has been changed.

All She Needs is a Tin Cup!

I've done some serious "textile therapy" in the last week, so I have only visited my grandmother a couple of times.  My mom has visited a few times, too - and my sister still works 3 weekend nights - so it's not like Mam-ma has not had visits from her family.  When my mom visits, she often reports that Mam-ma "had trouble holding her eyes open," so Mom ends up pulling up a chair and just sitting at her bedside for a while.  I find it interesting that I can go the very next day - or even the same day - and Mam-ma has no trouble staying awake.  I'm wondering if this "pretending to nap or be sleepy" is for Mom's benefit.  Mom thought that Mam-ma was mad at the world the last time she visited, and this was why she closed her eyes and literally shut everyone out!  We'll probably never know for sure.

I found things pretty well on Sunday when I visited.  I took more sewing to show Mam-ma, though she never even raised up in bed.  She looked it all over - twice - and declared, in a rather long sentence for her... "I said to myself, 'She's a havin' the time of her life with this sewing.'"  I heard this several times over the course of ten or 15 minutes.  My husband and I were attending the funeral visitation for a dear friend that evening, so I didn't stay long.  But I thought all was well... until I talked with my sister on Tuesday.

It seems that Mam-ma continues to holler, though she has not done so while I am there in about two weeks.  But at night and much of the daytime, if she is in her bed or recliner, she is hollering for any and every aide who passes her door.  And my sister said when she is on duty, she will hear "Suzaaaaaaaaaaannnnne!"  Worse still, when the aides to not respond as quickly as Mam-ma thinks they should... she has begun to rattle her bed rails!  I told Suzanne that maybe we should get her a tin cup, like you see the prisoners scrape across the bars of a jail cell in the movies.  She replied, "Don't you dare!"  I would never do this, and it's not funny... but I can just see my grandmother.

So on one hand, we feel like maybe she cannot help the fact that she hollers.  But when you know enough to call the aides by name and rattle your bed rails... it's hard to believe you are clueless.

I am assured that there are others who do this sort of thing... and worse.  But they are not my grandmother.  And they don't have a loved one working there.  It's a dilemma... but my sister insists that she wants Mam-ma kept in this facility - that she is managing just fine.  So we remind Ma-mma often that she must not holler... that it doesn't make the aides come any faster or more frequently to check on her.  And I'm waiting for the day the administrator calls to tell me her bedrails have been removed.

My grandmother has come so far in the last two months... farther than I ever dreamed she would when we left the hospital in early May.  Still, she is declining, in many ways.  I am prepared for the possibility that she might continue to improve enough that she no longer qualifies for Hospice care at this time.  But I feel like the far more likely scenario will be that she falls...develops an infection of some sort... or overheats sitting outside on the porch.  Every day is different.  Meanwhile, we all agree that we should keep objects that can be clanged against the bedrails at a hefty distance.  If Mam-ma figures out how to make noise with one of those, we're sunk!

What Do Old People Talk About?

Someone was talking to me recently about visiting a nursing home resident, and she said, "I don't want to go... I don't have anything to say."  The resident was much like my grandmother... expressive aphasia, meaning she can say very little beyond the "social niceties" of "Hello," "How are you?" "I'm fine," etc.  Lately Mam-ma has gotten out some pretty long sentences and some big words... but on any given day, she opens her mouth to say something, and all she can muster is "I don't know."  OR... the words are not appropriate, as in telling my husband her sweet tea was "precious!"  I think she probably meant "delicious."

So I told this person, "Don't talk TO the resident... talk with someone in front of him.  Carry on a conversation about your previous shared experiences... kids and grandkids... mutual acquaintances, the weather, or whatever comes to mind... and let him listen.  When we do this with my grandmother, she lights up and becomes engaged.  I visit with the other ladies at her dining table, and she listens... and she enjoys that.  She feels as if she is participating without saying anything.

I've not spoken with my friend yet to see if she has visited her nursing home resident, but if she followed my advice, I am quite sure that the visit was positive for both of them.

As for my Mam-ma Polly, she is best described as "up and down."  Friday, I found her in the parlor, having donuts and coffee with several residents.  Ladies from my grandmother's church had come to visit and host a get-together.  Apparently they do this about once a month, which is great!  The ladies from the Sunday school class that hosted mingled with the residents and visited with each one, and I could see that Mam-ma enjoyed this immensely. 

Sunday morning, I went to see Mam-ma, and she wanted to go outside and sit on the porch.  It was already 93 degrees in the shade, so I suggested we go to the dining room. “Would you like to hear me play some hymns?” I asked. “YES!” she said enthusiastically. I positioned her beside the piano in the dining room and began to play some of her favorites. Soon, several residents had joined us, and one lady sang virtually every hymn I played. She sang strongly and knew all the words. I tried to play each hymn through at least twice to give her time to really recognize it and sing along.

As I played the hymns, I considered how some of them remind me of Holy Communion, as they are often played during this service. “Nearer My God to Thee,” “Blessed Be the Tie That Binds,” and “Faith of Our Fathers” come to mind as some of the “Communion hymns” I recall. So I asked my grandmother, “Would you be interested in taking Communion again?” The answer was “Yes!” and I talked with her and a table-mate, who belongs to my church, about receiving Holy Communion.

When I rose to leave, a man at a nearby table motioned for me to come to him. He asked, “If you are going to have Communion, are you going to serve it once a week, like the Bible says?” Another man at his table looked at him, perplexed, and said, “Where does it say that in the Bible?” The first man said he didn’t know the exact verse, but the Bible says that they gathered once a week at the church to “break bread.” “What else could that mean?” he asked. Man #2 and I almost simultaneously replied, “… to share a meal!” Man #1 retorted to us, "Well, you're full of CRAP!"  Needless to say, he was not happy! I wished them a good day and left as the two men continued to argue.  I felt like I might have started a religious World War III!

The Hospice nurse had done a urinalysis on Mam-ma last Friday, and the report was that everything was clear.  By Sunday, her urine looked "milky" - like watered Milk of Magnesia.  So the nurse did another urinalysis, which showed a UTI.  I don't know of the first round of antibiotics did not totally wipe out the infection, or if another one promptly arrived.  Either way, Mam-ma is on another round of antibiotics.  However, she told the nurse she didn't like taking so many pills.  So the nurse talked with Mam-ma's doctor, and he removed virtually everything not absolutely necessary... multi-vitamin, Claritin, fish oil, and more.  I think he cut the number of pills she takes daily by almost half! 

The nurse also discovered that many of Mam-ma's symptoms... confusion, frequent urge to urinate, and more... were side effects of her new pain medication.  Thanks to her research on the Internet and her initiative to pursue this with Mam-ma's doctor, we are now back on a lower, regulated dose of Hydrocodone for pain... and Mam-ma does seem mentally clearer at times.  We have actually had some decent conversations this week - interspersed with some bizarre ones, of course!  Nothing is simple - or consistent - at this age and stage!

So today when I visited, Mam-ma told me she was "fussy!"  And boy, was she ever!  When she saw me talking to the Hospice nurse, she summoned her and said, "I don't want you a tellin' Debbie about me."  The nurse told her, "I was just telling her you are good today... but I also tell her when you are bad!"  Mam-ma didn't say anything else to her!

I'm thankful that we have a Hospice team we know - and who know and love my grandmother so.  They treat her as if she were their own grandmother... and that also means they take no guff!  I'm also grateful for such a loving staff at the ALF.  They, too, treat Mam-ma like a queen.  She is spoiled rotten on a daily basis. 

I hear about trips to the garden to pick fresh vegetables - as evidenced by the tomatoes in her room.  I see how one of her favorite aides, Josh, fusses over her hair each day before taking her to meals.  I've heard her speak of him and the maintenance man, James, as if they were gods!  I actually think they may walk on water! 

I'm also thankful for the occasional moment of clarity that Mam-ma has... the times she lovingly fingers something I've sewn and says, "I tell you what!  I'm so envious!"  Today she asked, "Are you not sewing today?"  I told her no... but I plan to soon, and I will bring new things the next time I come.  She grinned widely.

Mam-ma Polly and Timmy,
sometime in the fall of 2011.

I'm grateful that our little Timothy is with his mom, stepdad, and sister... but golly, we miss him!  I can't believe it's been seven months since we've seen him... and I'm struck by how my world has changed from diapers and wipes, car seats and toys to adult diapers, wipes, rubber gloves and wheelchairs with "lap buddies" to prevent falling overboard.  Things can change in a hurry... and I've learned to roll with the punches.  Maybe next time one of the residents tells me I'm "full of crap," I won't be so totally stunned!

Waiting for "The Next Big Thing"

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

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

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

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

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

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

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

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

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

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

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

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

Just How Sick Are You If You're "Sick as HELL"?

This has been yet another interesting week.  Over the weekend, I found Mam-ma Polly dressed once again in pajama pants and her little pink house shoes.  Someone apparently dug them out of my hidey hole in the closet!  Beyond frustrated, I gathered up every single pair of pants and pajama pants and brought them home... along with the pink house shoes.  As I mulled this over, it dawned on me that the facility policy manual states that pajamas and robes are allowed in the dining room for breakfast... but the residents are expected to dress for lunch and dinner.  I fully understand that.

I thought about Mam-ma and her trips to the dining room in her pajamas, covered by a blanket, and I realized that this was not only uncomfortable... it was demeaning.  So Monday morning, I went to Fred's and Wal-Mart and purchased five new house dresses for her.  Since I had removed the pants and pajama bottoms, I labeled her new dresses and grouped them in the closet with matching sweaters and jackets.  I then told the nurse and every aide I saw that I wanted Mam-ma dressed in THESE outfits.  A couple of the aides got pretty excited over the bright colors... and the ease of dressing Mam-ma in something with snaps and zippers.  I showed them where Mam-ma keeps her camisoles in the drawer of her dresser and suggested they put one of those on underneath - for modesty.

Monday was Memorial Day, and James, the maintenance man, grilled burgers and hot dogs for the residents and guests.  So I ate a FEAST with Mam-ma and her friends at her old table.  Over the weekend, I had discovered that the aides were placing Mam-ma at another table in the dining room, so that one aide could help both her and another resident eat at the same time.  This was not great for Mam-ma's socialization, but I realized that she might eat more... and I couldn't count how many people came to the table to speak to her and give her a hug.  So I didn't fuss.  But Monday, we sat with her friends.  And honestly, I realized then that it didn't matter, because Mam-ma only ate because I pretty well fed her... and she did not interact with her friends and me in the least.

Tuesday was not a good day.  Mam-ma became very confused and complained of burning when she urinated... the nurse told me, "I'm pretty sure she has a UTI."  The Hospice nurse came and a urinalysis was done... with positive results.  Mam-ma saw people in the room who were not there, and she was just generally sick all day.  Wednesday, she seemed a little less confused, but I still spent quite a while with her... straightening her room, handling some laundry issues, and consulting with nurses and aides about her care.  She had not gone to the dining room on Tuesday, since she was so sick.  But Wednesday, she told me, "Debbie, I want to go to lunch in the dining room."  So I asked the aides to dress her and take her for lunch, and they did.

My mom visited in the afternoon, and she said she sat by Mam-ma's bed for about 45 minutes and read a book... and Mam-ma slept.  She said occasionally, Mam-ma would wake up a little and say, "I wish I could stay awake."  Once, she raised up and clearly and distinctly spoke a man's name.  Mom said, "Yes, he's the man who wrote 'Singing the Blues,'" to which Mam-ma said, "I don't know."  Now, this man is someone who has been dead since 2004... and my grandmother really did not know him!  Why she spoke his name so clearly is a mystery to us.  Did she see him in the room?  Did someone mention him to her in passing conversation?  We seriously doubt the latter... but we will never know!

Thursday, I did not go to visit Mam-ma, and around 6:30, the phone rang... caller ID showed it was her number.  I answered, and the aide said, "Polly wants to talk to you."  She put Mam-ma on the line, and I asked, "Hi, Mam-ma... what's wrong?"  She said, "Well... I'm sicker than HELL!"  I told her I was sorry, and she said, "I thought I'd drive over, but..." and she trailed off.  Then she started to cry and moan, "Oh... oh... Debbie... well, Sugar, I ..."  Then she said, "Call me sometime."  I told her, "I'll be to see you tomorrow, okay?"  More moaning and crying, and then she mentioned a cousin and a photo.  "Did Carolyn come to see you again?"  "Yes."  "Did she bring a picture and leave it for me?"  "Yes." 

I told Mam-ma SHE might like to have the picture, and Mam-ma said, "No... I want you to get it... I don't want anything to happen to it."  That was her only lucid comment.  Next, she said again, "Call me sometime."  I assured her that I would see her the next day - and that her aides would come soon and give her night-time medicine to help her sleep.  We hung up, and I told Greg, "Mam-ma is sundowning*."

Today, I arrived at the facility a little before 11:00 a.m., and as I entered the building, I heard throat clearing that sounded all too familiar... it was Mam-ma.  I looked around... where on earth could she be?  There she sat, in her wheelchair in the hallway, along with a long line of residents.  It was "rounding" day for the facility doctor... and Mam-ma was in line.  I have no idea how long she had been sitting there, but she was slumped in her wheelchair... her feet dragging the ground.  I went and got a folding chair from her room for myself - and the foot rests for her wheelchair.  I stopped to speak to the duty nurse, who told me that Mam-ma was really sick this morning with diarrhea.
 
I tried to show Mam-ma some sewing I had brought to share with her... she was not interested.  She was tired and weak.  The facility owner (who is also a nurse and was attending the doctor during his rounds today), came out between patients and assessed the group.  I waved to her, and she said, "Polly is next."  Sure enough, we were next in line to see the doctor.  I thought the doctor did a thorough job of examining Mam-ma.  He was gentle and kind and extremely attentive... and also assertive.  He spent a long time on his hands and knees looking at Mam-ma's pressure wound on her heel... even measured it.  The nurse asked if it should be debreded... he emphatically said no... that it should be left alone, and if it needed any treatment in the future, he would handle it personally.

The doctor also explained to me that we can expect more skin breakdown as things progress, along with the possibility of more UTIs and even pneumonia.  Even though an antibiotic was begun earlier in the week for the UTI, he prescribed 10 days of a different antibiotic, based on her lab cultures.  He also changed her to a time-release pain medication that should stay in her system all the time and prevent these hours of pain in between pills that she has experienced.

The attending nurse asked the doctor about getting Polly up and out more... did he want her more mobile?  He said that getting out of bed for a short time would help with pain, skin breakdown, and even possibly the sundowning.  The nurse said, "So we want to get her up 3 times a day - for meals?"  I mentioned that we are getting Mam-ma up for lunch now, and the doctor said, "Lunch is a good start... and then if she builds up to it, she could add breakfast or dinner."  The doctor and nurse finally agreed to write orders to get her up "as tolerated."

I questioned the nurse... "This means meals only... right?  You won't have her out playing BINGO and going to activities, will you?"  She looked at me and said, "Listen, Polly pretty well rules the roost around here, and when she says she wants to do something, she's gonna do it! "  I reminded her that lately, Polly says one thing one minute... and the next minute she is asleep!  Her "yes" is "no" and vice versa.  She replied, "Yes, well, they're all that way."  I reiterated that I did not want Mam-ma to be up and out so much that she is in pain.  The nurse assured me that "We're not going to leave her sitting somewhere slumped over asleep and go off and leave her unattended."   And I don't think they would... intentionally.  But I know how busy the aides are... and things happen... and I'm just looking out for my grandmother.

The doctor kept reiterating that our goal here is to keep Mam-ma comfortable. The nurse also asked about physical therapy.  More to the point, she asked him, "When can Polly start bearing weight on her feet?"  I reminded them that she has not put ANY weight on either foot since she fell... and the doctors in the hospital told me she would most likely never walk again.  The doctor concurred... but he said that some gentle physical therapy could help with stiffness and pain and overall well being.  The nurse said, "I've already talked to PT... she's at the top of my list!"  I later learned that there is a good chance that Medicare will not cover physical therapy, since my grandmother is on Hospice... and the doctor did not mention it in his orders.

The visit concluded, and an aide came to whisk Mam-ma to lunch in the dining room.  I had gotten her a hankie from her room, because she had a runny nose.  When I got to the dining room, I noticed the hankie was covered in something... and it looked gross.

I gave Mam-ma some paper napkins and retrieved the hankie and put it in her dirty laundry pile.  Thank goodness her apartment is only a few steps from the dining room - and nurse's station!

When I got back to Mam-ma, her lunch had arrived... spaghetti, broccoli, and garlic bread.  She was eating the bread while her aide fed another resident.  I noticed something on her dress, and as I looked closer, I realized that Mam-ma had spit up all down the front of her clothing.  I told the duty nurse who was standing nearby, and she immediately flew into gear helping pass out lunch plates so that the aide could help me get Mam-ma to her apartment and get her cleaned up and into fresh clothing.  Two aides actually came to do this, and soon we were back in the dining room, and one of the aides was feeding Mam-ma chicken noodle soup.

I gathered Mam-ma's best blanket/throw to toss into my washing machine, and headed home.  While the blanket was in the clothes dryer, ran errands and bought groceries... and more wipes for Mam-ma.  Then I returned to the facility with the clean blanket and wipes.  Mam-ma was sleeping comfortably in her bed.  She roused enough to say, "I feel a little better."  Some very dear lifelong friends popped in to say "Hello," and Mam-ma tried to talk to them, but every sentence was truncated midway as she drifted back to sleep.

I clasped her hand and wrist as I prepared to leave and told her that my sister would be there soon for her weekend night shift... and that I would see her later. I was struck by how thin and frail Mam-ma has become.  I wonder just how much weight she has lost in the last month.  I spoke with the Hospice nurse later, and she was pleased with the doctor's report.  My mom had visited while I was running errands, and she was pleased with how she found Mam-ma.  In fact, a close friend of Mom's who Mam-ma has not seen in probably a decade was with her, and Mam-ma called the friend by name and even asked her about her own sons.  Mom was amazed at that... and the friend was thrilled.

I told the Hospice nurse this afternoon that sometimes I feel like I've been through a battle by the time I get home from the facility.  For the most part, everyone seems to be on board with keeping Mam-ma comfortable and allowing for moderate activity each day.  But some are still hoping for the "old Polly" to emerge... and I just do not see this happening.  And as I pointed out to the doctor and owner/nurse today... "that's not what she wants at this stage."  I also stressed that I am not wanting to tie my grandmother to her bed... nor am I trying to expedite her passing.  But I know her... I know that she wants every minute she is alive to have quality and be comfortable... and so far, we can't say this is always happening.

Let me hasten to add that I am truly pleased with the ALF where Mam-ma resides.  I couldn't ask for a staff to love her more... and cater to her every whim.  This is not about the ALF.  Just yesterday, Mom lunched with two of her oldest friends who both expressed that "Polly should get to do whatever she wants to do."  The first week Mam-ma was back at the facility after her surgery, the other friend said to Mom, "If Polly wants to go to BINGO and other things, I think she should get to... she should do whatever makes her happy."  The trouble is... Polly doesn't always know what she wants or what makes her happy.  She is not thinking clearly... and her answers are often irrational.  It is up to me as her caregiver to discern what is appropriate... and like any good mother, that sometimes means saying "No!"

Mam-ma is tired.  Tuesday, in the stupor of her UTI, she reached out and took my hand and said, "Oh, Debbie... what would you think about me going home?"  I wasn't sure what she meant by "home," so I said, "Well... Mam-ma... you are home... you've lived in this apartment for over a year now."  She shook her head.  I asked where she thought she was, and she said, "I don't know."  I learned that earlier in the day, she had told the administrator she was afraid.  The administrator had found her clenching the bed rail and looking very frightened.  When she asked, "What are you afraid of, Polly?" Mam-ma replied, "I just don't want to go back to the way things was."  Again, the administrator didn't know if she meant the hospital.  I have had more than one person who knows my grandmother say they feel she was trying to tell me once again she is ready to go HOME to Heaven... and I suspect they may be right.

I know this is a long, and probably dull and uninteresting post for some of you.  But for those of you who find yourselves in a similar situation, it may sound all too familiar.  What is the take-away from this?  For me, it was the visit I had with a dear friend this afternoon.  She and her husband cared for his mother in her last years until she died at the age of 101.  She was by then under the care of Hospice, and her grand-daughter was living with her fulltime.  But my friend said, "Remember... this is not forever - for either of you.  It will end... and you both will get relief."  I know this, but I needed to hear it.  "This, too, shall pass"... literally.

Meanwhile, I will keep doing the only thing I know to do... being a "bulldog advocate" for my grandmother and make sure that her wishes are respected.  In her case, she really isn't too old to rule the roost... and I'm doing my best to see that she gets to do exactly that!


*(Sundowning is also known as late-day confusion, often associated with dementia and/or Alzheimer's.)

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. 

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!