Who Needs a Tub When You Have a Pool?!

Grandma E has always loved a good soak in the bath tub.  However, as she has aged - and her knees have begun to give her trouble - she has found getting out of the tub to be nearly impossible.  This was discussed a couple of years ago when my husband and his older brother supervised the remodel of Grandma's master bathroom and offered the option of a walk-in tub.  She opted for a shower with a seat and detachable sprayer...and she said, "I just won't take baths any more."

But a few months ago, a neighbor alerted me that Grandma had told her how difficult it was to get out of the tub in her guest bath...explaining that she had to turn over onto her hands and knees and crawl out, one leg at a time!  The neighbor had suggested she investigate walk-in tubs...and she wanted me to know this!

Even though the tubs were discussed at one point - and dismissed - my husband did his due diligence and investigated them thoroughly once again.  He presented the details to Grandma E and explained that, while they look like a great solution, there are drawbacks.

You must get into the tub, close the door, sit down, and wait while it fills with water.  This can take ten minutes or more.  The process is the same for the tub to drain after the bath.  You cannot open the door until all of the water is out of the tub.  While many models do include a heater in the seat, it still can get fairly chilly as you sit there...especially if you are wet and waiting for the water to drain.

The tubs must be thoroughly cleaned...or they can mildew.  For an older person, this can be a daunting chore, and not all seniors have housekeepers to do this for them.  Additionally, the price and quality varies greatly.  The "better" models can sell for upwards of $25,000...yes, twenty-five THOUSAND dollars!  One reviewer said that he went to the trouble and expense of installing them in his senior living condos...only to remove them later because they were not being used - or people were using them as storage hampers!

But the kicker for Grandma E was when she said, "I just want to sit and soak in warm water up over my shoulders."  Even in the best walk-in tub, this is not going to happen!  So I suggested that perhaps she should come with me to our city's Aquatic Center and sit in the therapy pool.  Heated to a balmy 94 degrees Fahrenheit, this pool has a built-in bench along one wall where one can sit and enjoy the jets (or not). Depths range from just over 3 feet to 5 feet, so there are plenty of spots along the wall where a person can soak in warm water up around their ears!

Grandma participated in senior water aerobics classes a few years ago at this pool, but she was reluctant to return now. I had tried to get her to go with me several times, and she would always say, "I look horrible in a bathing suit now."  I told her I should hope to look so good in a bathing suit when I am 90!  We talked some more about the pool, and I mentioned several selling points...I would pick her up and take her home...and she could soak while I did my aerobics workout.  There is even a motorized "lift" if she felt she was unable to use the steps to walk into the pool and get back out. I would handle everything with regard to a membership. Finally, she agreed to give it a try.

It took one trip for Grandma to be hooked!  We now go at least three days a week.  The "lift" has never been used...and Grandma never just sits and soaks. She walks around, bounces to the music that is piped in, and visits with others who happen to be soaking/swimming in the therapy pool. We stay about an hour. She has a new swimsuit and swim cap...and with insurance discounts, her "membership" fee was a whopping $25 for the year...with unlimited use!

Aside from the benefit of getting to soak in the warm water, Grandma's knee is much better.  She had been receiving a cortisone shot in her knee every three months.  In February, she was hurting so badly that she counted nearly every minute of the last week before her shot date. She started going to the pool right after that injection, and when her scheduled appointment rolled around in mid-May, she canceled it!  She says she is sleeping better and feeling better all over...and she will be 91 in three weeks!

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I made a point to set up overnight stays for Timothy, Zola and Nathan on consecutive Fridays, so that they could swim on Saturday mornings with Grandma E and me.  While the child and I play in the Olympic-sized swimming pool, Grandma watches us from her bench in the therapy pool.  This makes for a great interchange on the ride to and from the pool, and it gives Grandma something to do while she sits and soaks for an hour.  We plan to do more of these trips this summer.

As always, there are some interesting parallels between the children and Grandma.  I watch both carefully as we get in and out of the car...the child to make sure he/she does not dart into traffic and is securely fastened into the car seat while traveling...and Grandma to make sure she doesn't slip and fall - and that her seat belt is securely fastened before we depart!  I watch all of them get in and out of the pool - and keep a close eye on them as they "swim".  The children become more brave and confident in the water with every visit to the pool.  Grandma becomes a little more bold with her moves, also!  The children are always eager to go to the pool for a swim.  Most days, Grandma eagerly agrees to go "get her swim on", also!

We are blessed to have a wonderful Community Center and Aquatic Center in our town.  The fee for unlimited use of all facilities for our family of five is $25/month...and as I noted earlier, Grandma's fee is $25 annually.  That is a tremendous bargain. We can swim year-round in this indoor pool...7 days a week, usually. The pool rarely closes, unless there is thunder in the area!  For those who are more adventurous, there are water aerobics classes, water Zumba classes...and a wonderful class that meets several times a week in the therapy pool that is geared toward seniors with arthritis.

The only drawback I have found for the little ones is that they are not allowed in the therapy pool unless they are taking a swim lesson with a certified instructor...and the "big pool" is four feet deep at the shallow end.  None of my children are that tall yet, so they cannot touch bottom...and this has affected their confidence level.  They are all three still wearing life preservers...but I am seeing progress and hoping that soon, they will be swimming like fish - all on their own.

I realize that not all communities have indoor pools.  And I am sure that walk-in tubs have their place and are great for some folks.  But this did not seem like a viable solution for our situation...and in doing our homework, we came to the conclusion that these tubs may not be all they're cracked up to be!  Thankfully, we had a "Plan B"...at least for a while.  I know people who are well past age 95 and still using this therapy pool...so hopefully, Grandma E and the kids and I can all make the frequent trek to the Aquatic Center for many years to come yet!

There is something therapeutic about water...and water exercise.  It's good for the body, mind and soul...and we are living proof.  When was the last time you took a dip?

A Few New Ingredients... A Few New Sandwiches...

I answered the phone to hear a desperate plea from Beth, my friend since childhood… “Mom had a bad car accident at church yesterday and did a lot of damage.  She says the men of the church told her not to worry about it… that it was no big deal.  Why on earth would they tell her that?”  First of all, my friend’s name is not really Beth, but since I don’t want her to have to go in to the Witness Protection Program, I’m somewhat protecting her identity with a fake name.  So I won’t use her mom’s real name either.  Secondly, I told “Beth”… “In the first place… what happened?  And secondly, you don’t know that the men really said that to your mother.”

Beth began to relay that her mom pulled into her regular parking space at church on Sunday morning (I know the space- a “handicapped” parking area out front), and she apparently hit the gas pedal instead of the brake.  I’ve driven by the church and seen the damage, and for the life of me, I cannot begin to explain how the accident “went down” as it did… but “Lucy” managed to jump the curb, cross a sidewalk, hook a hard right, and plow into a metal railing that is (or was) secured in concrete.  This railing lines a retaining wall that adjoins a playground for the church daycare… one story below!  Probably four to six bars of the railing were mangled and literally pulled up out of the concrete.  But had they not stopped Lucy’s car, she would have plowed head first to the concrete floor below that once housed the church basement… and she could have been killed.  Had it been a weekday (and she does visit the church campus during the week), she could have hit and/or killed toddlers playing there.

I have not seen the car, but I understand that there is significant damage to her front grill.  As I told Beth, I suspect that men rushed to soothe the ruffled feathers of an 88-year-old woman in distress and lovingly told her, “Don’t worry about it… everything will be okay.”  But Lucy told Beth, “All I need to do is pay an extra $50 to the church, and those men will make the repairs.”  Beth made a trip to the church campus to survey the damage, and the office staff told her, “You need to call your insurance agent.”  The scary part is that less than an hour after the accident, my mother saw “Lucy” in the church restroom before morning service began, and Mom said she was “cool as a cucumber.”  Mom had no clue there had been any sort of accident – until I told her days later.

So Beth did call her mom’s insurance company, and she discovered that Lucy had cancelled everything except the minimal coverage our state requires for motorized vehicles.  In a panic, Beth called attorneys, the sheriff, and anyone else she could think of for advice.  She provided credit card information over the phone to increase her mother’s insurance coverage, and she talked to the collision repair guy and asked, once again, to be informed of any visits by her mother.  Lucy has had several “fender benders,” and she has asked the local collision repair shops NOT to tell her daughter and son-in-law that her car was repaired by them.  Of course, they have not complied, realizing the seriousness of this situation – and valuing their friendship with Beth and her husband.  In fact, Beth saw my husband last week at a local sub shop, and she said Lucy had taken the collision repair guy a box of donuts and asked him NOT to tell her kids about any more accidents.  Clearly, he did not honor her request!

Beth paid her mother a visit and suggested it was time to stop driving.  Lucy went ballistic.  In fact, she became quite angry and combative and all but ordered Beth from her home.  Beth forbade her mother to drive out of town (knowing it was only a verbal threat). Her mother continued to have a fit!  Probably a decade ago, Beth’s mother was diagnosed with “vascular dementia” - which mimics Alzheimer’s in many ways.  Beth was given a mountain of information about vascular dementia, including a checklist of common behaviors associated with this condition.  She said, “Mother checks everyone on the list now.”

Upon the advice of our local sheriff, Beth contacted the DMV, who referred her to a “Driver Control” office in a nearby city.  The person there recommended that Beth ask her mother’s physician to write a letter stating that Lucy was no longer physically capable of driving safely.  The doctor readily agreed.  He told Beth, “I do this all the time… and I’m glad to do it.”  Now, lest you think this doctor is a little too eager to get elderly drivers off the road, consider that his late grandfather practiced medicine until nearly his 96th birthday.  This doctor is very “senior friendly.”  But as he pointed out to Beth, “I have to think about what sort of drivers are on the road with my wife and four children.”  So he wrote the letter and sent it to driver control.

Fast forward a week or so, and Beth’s mother was supposed to play cards one evening with some other seniors.  However, she was unable to attend, because she was so upset over a letter she had received in the mail about her driving… and she was quite sure her kids had instigated it!   I talked to Beth the day after the card party and asked her about the letter… her mother had not mentioned it to her.  So Beth called and “played dumb,” and her mother said she had gotten “something about the insurance,” and never admitted that she had heard from Driver Control.  However, she had been summoned for a hearing… and that has subsequently taken place.  Apparently more information will be required from her doctor in order to determine whether or not she can continue driving.  Failure to attend any hearings or to comply in any way results in immediate suspension of one’s driver’s license.  Lucy is livid!

My friend Beth has her own “sandwich” going on… her second oldest son just returned home for the summer after his freshman year of college, and she has a nearly 16-year-old son who will be a high school sophomore this year.  She works close to fulltime in her husband’s business, in addition to shuffling the duties of caring for her family and her mother - and working in her church.  The day she called me, she had been to some sort of meeting three out of five nights that particular week.  She has begged her mother to move into an Assisted Living Facility – or even to move into a condo on the grounds of the Assisted Living Facility - so that she could avail herself of some of their services.  Her mother flatly refuses.

I am not sure how this is all going to be resolved.  Lucy adamantly maintains that she will not stop driving.  And I know it is a real problem.  Some of my grandparents and elderly relatives politely laid down their car keys… others gave up kicking and screaming.  A dear friend of mine who is probably in her late 70s is currently dealing with this dilemma with regard to her husband, who suffers from dementia and cancer.  This once-brilliant man can no longer remember where he went when he leaves home in the car… or who he saw while he was out.  He went for a haircut recently, and when he returned home, he could not tell her which barber had cut his hair.  Lately, the doctor has told this man he can no longer drive.  He commented to his wife, “If I can’t drive any more, then I will just shoot myself.”  I don’t know how she copes with the worry that she might indeed find him dead someday.

Someone said to me, “Just take the car keys or disable the car.”  My response in Lucy’s case was, “Do you know how many church deacons she would immediately phone to come fix her car?”  As for the woman whose husband refuses to stop driving...and to some degree, Lucy, as well… we are talking about people who are strong-willed, frequently belligerent and combative… and physically powerful when “fully engaged.”  It’s just not that simple.

So what is the answer?  In my opinion, there comes a time when we must realize that our loved ones are no longer the person we knew and loved… they are not responsible for their actions – nor capable of making wise decisions.  We must decide for them what is in their best interest – and the best interest of others, as well. Beth’s mother told a group of friends that none of her accidents until this last one were her fault.  That isn’t true… the collision repair man pointed out to her where she had damaged the underside of her bumpers by running OVER something – which Beth pointed out to her could have been a child that she hit and killed.  But Lucy’s comment to her friends prompted one of them to say, “We just all need to get together and tell that judge that you are a good driver.”  This person hasn’t a clue!  We, as caregivers and children – and responsible adults – must sometimes recognize that whatever decision we make is not going to set well with our loved one… and we must go ahead and do what makes sense.  For some, that means insisting they move to a facility – or get rid of the car.  It’s a tough call… but not much about the Sandwich Generation is easy!

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A few weeks ago, my husband and I traveled to Little Rock to see a movie and do some shopping.  We stopped at Sam’s on the way home.  My husband purchased some storage cabinets for the garage, so we required assistance in loading them into the car.  While Greg went to get our car, I stood with the cart outside the exit doors at Sam’s.  I observed a young woman - with a FULL basket that included a small toddler-as she loaded her purchases into a mini-van.  She opened the passenger door and handed a box with some fresh fruit and a cake or some sort of baked good to an elderly woman.  “Hold these so they don’t get smashed,” she said.  The next thing I knew, the woman was getting out of the van.  The girl gingerly said to her, “Please get back into the car.  I need you to hold your cake so it doesn’t get smashed.”

 

By now, she had loaded the toddler into the back seat, where I could hear screaming and crying.  She muttered, “He’ll be asleep soon,” as she continued loading this mountain of merchandise into the van – tucking things into every nook and cranny.  And did I mention it was incredibly hot and humid for late May in Arkansas?  The poor girl was sweating and out of breath.  I so wanted to help her, but I knew better than to offer and upset her “system.”

 

Finally, I asked… “Is that your grandmother?”  She nodded and said, “Yes.  My mother died two years ago, so now I try to do all I can for her.”  I told her that I understood completely.  “I’ve been right where you are with a grandmother in one seat and a baby in another,” I told her.  She replied, “Well, it wasn’t bad until I had these last two only 2 years apart.”  So she has at least three children… and I realized that TWO of them were in the back seats of that van!  Talk about a SANDWICH!  I wished her well as she slammed the last door shut, and I thanked God for my own little “sandwich,” such as it is!

 

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

Grandma "E" with Nathan

Lest you think my sandwich has lost one of its slices of “bread” now that my grandmother has passed… it seems that my mother-in-law, whom Timothy and Zola call Grandma “E”,  is beginning to do a nice job of filling in the gap.  I’m not complaining.  I love my mother-in-law.  She is a jewel.  She will also be 87 in a few days… and in the last six months, she has begun to feel every single year of that age.  Things hurt that didn’t used to… she has no energy or “ambition” (one of her favorite words)… and her short-term memory is pretty well shot.  We have just completed a two-day yard sale, which was her version of “downsizing.”  My husband begged her not to overdo it.  As I said, we are already smack in the middle of Arkansas heat and humidity.  She decided to concentrate on “only cleaning the garage.”  I cannot begin to tell you what this means.

Grandma “E” spent two weeks working virtually every day in her garage, sorting, setting things out on tables, and rearranging.  She insisted she didn’t work that much, but neighbors reported differently… and we could see how tired she was when we would check in on her.  She found items she has not seen since she moved into this house in 1997… and some probably packed long before that and simply moved to the new abode.  She spent a good part of Friday searching – physically and mentally – for four small dolls “in blue boxes” – only to decide yesterday that she probably sold them many years ago and just doesn’t remember.  When the sale was over, I boxed up what I had left and we loaded it to take to the thrift store.  My mother-in-law plans to repack all of her “treasures” and “tuck it into the corners of the garage.”  My husband told me, “We are never, never, EVER having another garage sale… and neither is Mom!”  He has suggested to her that she have an auction… but she cannot bear to part with her treasures… so that will have to wait.

Meanwhile, Grandma “E” mentioned to me the other day that her knee was really hurting…her “bad knee.”  She had arthroscopic knee surgery several years ago, but the other knee now bothers her, and the orthopedist says it’s too far gone for anything but a replacement, which she doesn’t want to have done – and I don’t blame her!”  She said, “I accidentally knelt down on that bad knee to get something out of a cabinet, and I almost didn’t get back up.  It hurt SO badly.”  She went on to tell me that she has a hard time getting in and out of the bath tub, and that “I have to get on my hands and knees to get out of the tub now.” 

I repeated this to my husband, and the next day she demonstrated to him how she gets out of the tub.  I didn’t see this, but she actually puts some sort of piece of foam rubber into the tub to help with this somehow.  We talked at length about her tub situation.  My mother-in-law loves to bathe.  She said, “I like to fill the tub so full that the water comes up around my ears.  We talked about walk-in tubs.  But you have to get in, close the door, let the tub fill with water, then sit in the tub while the water drains out afterward.  That all sounds cold and uncomfortable to me, and she was not on board with doing this.

My husband conferred with his brothers, and they agreed that a walk-in shower is in order… the days of bathing are drawing to an end.  I told my husband, “There is a reason there are no bath tubs at the Assisted Living Facility and the senior condos!” We had lunch last week with Greg’s mother and one of his brothers and sisters-in-law, and we talked about contacting a local carpenter and plumber to redo her bathroom.  The brothers may also look into the possibility of placing additional hand rails in the spare bath tub, in case there comes a time that she INSISTS on having a bath.  While we were discussing all of this, my sister-in-law said something about the danger of using bath oils.  I had not realized that my mother-in-law uses those little “pearl” thingies that dissolve and put oil in your bath water.  She loves them!  OR… she uses Avon’s Skin-so-Soft!  Now I don’t know about you, but there is little to no hope of me getting out of the tub safely after using one of these items… it’s like trying to stand up in Crisco!  

So we insisted she stop using these products IMMEDIATELY and start moisturizing AFTER she gets out of the tub. Hopefully the new shower project will happen soon and alleviate this potential danger.  I’d bet you a dollar to a donut she is still using her bath beads, but I can’t prove it.  We were talking about people who lie yesterday, and Greg asked her, “Are you always truthful with me?”  She nodded and replied, “Yes, I never keep things from you… unless it’s something I don’t want you to know!”  And then she giggled.  Greg told me the other day that he thought she had not been honest with him about something – maybe how much she had worked in the garage in the heat – and I said, “You don’t think your mother would lie to you, do you?”  He replied, “Oh, I’m pretty sure she would never admit it… but yes, I’m quite sure she does if she doesn’t think the truth is what I want to hear!”  I just shook my head.

Timothy - now FOUR years old!

Last Sunday, we picked up my Grandma "E" for church… and then we picked up Timothy and Zola.  After church, we went to McDonald’s for lunch.  We ordered “Happy Meals” for the kids (and I got one, too), and Greg got chicken nuggets and fries to share with his mom.  She requested one of those coffee drinks with all the whipped cream on top.  We sat down to eat, and the kids had their meals and Cokes (a special Sunday treat), and Timothy said to Grandma “E”, “Mmmmm… I want one of THOSE!”  I explained that it was coffee, and he said, “I like coffee!”  He did not get any… and he was quite good about it.

Zola - now TWO years old!

But I had to laugh as we drove home. The children were sitting in their car seats, sleepy and ready for naps… and Grandma “E” was sitting in the front passenger seat, sleepy and ready for HER nap!

Yes, our “sandwich” continues… it just has a few new ingredients.

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!

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!