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!

Does Anybody Really Know What Time it Is... Does Anybody Care?

When I took my grandmother to the cardiologist last month, I wrote about the mix-up in scheduling and how the doctor's office contacted my grandmother's ALF about her appointment. So when I arrived at Mam-ma's apartment to help her dress for her appointment some 45 minutes later, she was already sitting in the waiting room at the hospital, where she had been transported by the ALF driver.  The end result was a very long wait... and an exhausted grandmother.  I spoke to the nurse and a couple of other people and told them that I was the only person they should contact about my grandmother's appointments.  I gave them my mailing address and my telephone number.  I told the nurse, "The only phone call Mam-ma should get is the one to check her pacemaker by telephone."  She assured me this was handled.

Last week, while looking for two letter openers that Mam-ma insisted someone in the ALF had stolen (yes, we're back to that again... and yes, I found them very near where she normally keeps them), I found some mail that had been delivered to my grandmother at the ALF.  In it was a letter from the cardiologist's clinic telling Mam-ma that her pacemaker would be checked by phone in a couple of days - at 11:30 a.m.  I brought the letter home with me and tried to call the person listed on the letter as a point of contact.  I got an answering machine and left a message, asking her to please telephone me.  She has yet to call.

The day of the pacemaker check, I arrived at Mam-ma's appointment about 30 minutes early.  I wanted to get her device out of the drawer, help her get set up, and be sure we were ready at 11:30 a.m.  We were ready well before this time.  The call never came.  At 11:40, I began using my cell phone to try and contact someone to determine why we were not called.  After three phone calls, several "run-arounds" and returns to the switchboard and messages to three separate "in-boxes," I still had no answer.  However, in these messages, I had stated that "We went through this last month, and someone on your end arbitrarily decided that my grandmother did not need to have her pacemaker checked and canceled the call.  It's now almost noon and time for her lunch, so unless you call immediately, the box is going back in her drawer."  To my knowledge, no one has called, and it's been three days.  I left my cell number for call-backs... no one has called.

However, while waiting, I did find another letter... this one telling of a physical pacemaker check on February 15th at our local hospital.  I told Mam-ma, "We'll deal with this then.  Clearly your pacemaker is working just fine.  Don't worry about it."  We put her testing device back in it's box and returned it to her drawer, and I walked her to lunch.  I cannot understand why something so simple has to be so complicated... and why there is such a level of ineptness that is so widely accepted these days.  At this point, I am picking and choosing my battle, and a telephone pacemaker check was not high priority to me, so I'm letting it go.

The last two weeks, Mam-ma has seemed to make steady gains, although she doesn't show them much to me.  Last week she spent a few days in bed, for the most part... or so she said.  When I questioned the nurse, I discovered that on at least one of these days, she had zipped up and down the halls all day, gotten her hair done, and had a pedicure from the visiting podiatrist... none of which she volunteered on her own.  And indeed, for the most part, her speech does seem slightly better.  At least she can get out a few sentences from time to time.  And Mam-ma is eating well, according to a table-mate and friend who is much younger and has taken quite an interest in her.  So we are coasting at this point... aware that all could change in a heartbeat.

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Meanwhile, my brother-in-law and his wife visited last week, and my sister-in-law is now dealing with the aftermath of a fall suffered by her 95-year-old mother, which occurred shortly before Thanksgiving.  The fall resulted in an arm broken at the wrist and above the elbow, and now this lady is in a nursing home for rehab while the breaks heal.  A couple of weekends ago, she became belligerent, upset and confused... and later it was determined she had suffered a mild stroke.  My sister-in-law is realizing that it may not be feasible for her mother to return home after rehab.  We talked at length about her options.

During the conversation, my sister-in-law mentioned the mountain of paperwork.  "Yes... I know," I replied.  She mentioned a Do Not Resuscitate (DNR), and indicated that her mother does not have one - nor a Living Will.  I was astounded.  I told her that even my husband and I have Living Wills.  And I learned recently that DNR is not the same as a Living Will, so now both are in place for my grandmother.  Given that, I still must tell every doctor and nurse, "Polly is a DNR."  Apparently this information does not always carry through on the records, and my grandmother would not want to inadvertently be placed on life support.  My sister-in-law reasoned that her father had neither of these, and "they just asked us what we wanted to do, and we told them."  However, she lives nearly four hours away from her mother.  I pointed out that she very well may not be there when something happens to her mother - just as with the stroke - and by the time she arrives, life support could already be in place.

So my admonishment to everyone is... get these documents signed and in place NOW!  We never know what is going to happen, and this could save tremendous stress and heartache in the long run.

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Speaking of paperwork, I got the re-evaluation papers to complete for keeping my grandmother in the ALF with Medicare/Medicaid coverage.  In essence, everything I provided last year had to be provided again... the investigation goes back five years.  So while I sufficiently proved last year that she qualified, I had to prove it again this year.  This meant that I had to fill out five forms and provide copies of a current bank statement, proof of her pre-paid funeral plan, and documentation that we had surrendered her life insurance policy.  The only thing I did not have to provide this year was receipts to prove we "spent down" her assets to under $2000, because we did that last year, and she doesn't have any money left!  If she makes it to this time next year, I will have to do all of this again, so I kept copies of everything.  Just so you know... this is an annual event! 

In the scheme of things, I cannot complain. I am so grateful to have my grandmother at the ALF, and it wasn't nearly as bad or as time-consuming as what we went through last year.  Additionally, the case worker who was so horrific last year is no longer evaluating admits to the ALF in our county, because of the volume and severity of complaints lodged against her.  So I am told that this process should be fairly smooth sailing this time around with a competent caseworker.  Let's hope so!

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As I visited with my sister-in-law, she expressed several frustrations, all of which are normal - and common.  In particular, she said her mother was complaining that she was not happy and wanted to go home.  I advised my sister-in-law that her mother may never truly be happy again, and the best thing she can do is to make sure her mother is well cared for and do what is best for her - and for herself.  Unless she plans to move back in with her mother, she has to do what is going to make sense long-distance... and ensure that her mother's basic care is well-managed.  An ALF may make the most sense in that regard.  And should her mother be placed where other friends from her community reside, my sister-in-law might find that she is happier there than she will admit.

At the end of the day, I told my sister-in-law, "Your mother is no longer in control... and quite frankly, neither are you!  You must do what is best for all concerned and be satisfied with that."  Believe me... I'm learning this the hard way.  I told my husband the other day after talking with my grandmother, and then her nurse - and hearing two conflicting reports - that I feel fairly certain that Mam-ma is "playing" me... but I'm not sure whether she even realizes it any more.  There was plenty of time when she knew good and well what she was doing, but now I am not so sure... and it really doesn't matter.  The worst of it is that I don't know when she is truly in need, so that makes it hard to gauge how to respond.  For the most part, I just sound sympathetic, pat her hand and hug her, and tell her I'm sorry... and it will all be okay.  So far, that seems to be working fairly well.

I'm also learning to make time for myself... and make no apologies for doing so.  I get in my almost-daily workouts.  I've spent several days lately sewing... making clothing for little nieces and nephews.  I've even read a few books in recent months... something that had slid way down my list for a long time now.  I miss Timothy and his family terribly, and keeping busy helps.  And I am actually making more frequent visits to my grandmother's apartment.  The difference is in my attitude.  I do what I can while I am there, and I "leave it at the door."  I've advised my sister-in-law to do the same, just as I was advisedby someone this time last year... knowing full well it is far easier said than done.

I have come to the conclusion that the only salvation we have at this point is to stay diligent about paperwork and preparation... to try our darnedest to stay one step ahead of the bureaucrats and our loved ones... and to work hard at maintaining some semblance of a life - and preserving our own sanity.  Some days are better than others!

We've Lost Your Grandma...

I visited my grandmother yesterday shortly before noon.  She had worked on hanging baskets of geraniums that morning... removing dead stems.  She asked the maintenance man, James, to lower the plants onto a bench, and she sat and removed the dead stems and flowers.  Now, she was resting before lunch... her feet propped up on her bed as she sat in a chair.  She seemed fine.

I left the ALF and went to my mom's to help her with a computer issue.  Then I shopped for groceries, and I returned home around 2:30 p.m.  My husband's niece was supposed to bring her two children for a visit around 3:00. 

Our niece and her two children no sooner got in the door than the phone rang.  It was the nurse at the ALF... "Is your grandmother with you?"  "No... I was there around noon and saw her. Why?  Is she missing?"  "Well, yes... she wasn't in her room when they went to get her for her beauty shop appointment, and she isn't in the building... and she didn't sign out to go anywhere."  I suggested maybe she was outside walking?  "No," the nurse replied... "a lady sitting on the front porch said she saw Polly get in the car with another lady."  The nurse suggested maybe my grandmother was with my sister?  I told her that was highly unlikely, but I would check and make a couple of other calls. 

I hung up and called my mom. I knew Mam-ma was not with her, but I thought she might have a cell phone number for one or more of Mam-ma's friends via the church directory. She didn't.  I told Mom, "I hesitate to call these ladies.  If Mam-ma is not with them, they will worry - and if she is, they won't be at home!"  So I decided to wait.  I did phone the nurse again and gave her the name of a man who lives across the street at the skilled-care nursing facility.  His wife is in Mam-ma's Sunday School class, and Mam-ma frequently walks over and visits with him.  The nurse said they had checked that building... but not a specific room.  I assured her that Mam-ma had not run away (which she knew) and that she was probably at Wal-Mart, or at a friend's looking at a flower or plant in the garden, or something like that... and she would return soon.

Meanwhile, my sister called... she had gotten a call from the nurse, also.  She wondered if I had found Mam-ma yet.  I told her no, but I would let her know when she was located.
Our company left about 4:30, and I phoned the ALF.  The nurse said she had gone to a secure wing of the facility, but she would page Mam-ma's floor and see if Mam-ma had returned.  When she came back on the line, she said, "She has just come in.  I'm headed down there now to give that little girl a talkin' too!"  I laughed and told her to go for it!

I honestly don't know what happened.  Mam-ma's story is that she told the ladies at the front desk she was leaving.  But she admits she did not sign out on the little sign-out clipboard.  She went with her Sunday School friends... they drove her across the street to play "Chicken Foot" dominoes with another Sunday School member who resides there.  Mam-ma said, "James put my walker in the car... he knew where I was."  In defense of the facility, James was mowing and working in the yard when I left at noon - I'm guessing the staff didn't think to ask him if he saw a little old lady get in a car and drive away! 

At any rate, Mam-ma didn't seem that upset about it, thankfully... so if they got onto her for it, she took it well.  And I am so thankful to know that the staff is that attentive - and that concerned.  Mam-ma said that someone told her they would try to reschedule her for a hair appointment today.  She said, "It doesn't matter if I get my hair done or not!"  Now, there was a time when that was not the case... but I guess a good game of "Chicken Foot" trumps even nice hair!

This little situation resulted in numerous phone calls - back and forth to the ALF... to my sister and my mom to let them know that all was well... and to Mam-ma to check on her and make sure she was okay.  My mom even called Wal-Mart and had my grandmother paged... and she called Mam-ma's friend, Ruby, to see if Mam-ma was there.  Thankfully Ruby didn't answer - she was with Mam-ma playing dominoes!"  I had told Mom that I didn't want to call Ruby, in case she was at home alone and didn't know where my grandmother was.  I knew that would upset her.  But Mom called her anyway... and of course, Wal-Mart...where they paged Polly.  Of course, she didn't answer the page... she wasn't there!

I later told my mom... "It is uncanny that the minute I get busy with someone else, there is a 'crisis' with Mam-ma.  I'm thinking of her stomach bug the afternoon of Timothy's birthday party... and now just as our little niece and nephew arrive from Missouri for a visit, she goes missing!  How is that?!"  Just another reminder that I'm still smack in the Sandwich Generation... and there don't appear to be any changes on the horizon!

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On another note, a dear friend from my church suggested I read a good book on "boundaries."  I selected Boundaries... When to Say Yes, How to Say No to Take Control of Your Life by Henry Cloud and John Townsend, from Zondervan Press.  I'm almost halfway through the book, and I can already see that it will help me tremendously with a number of relationships.  I am recognizing some of the comments made to me last summer by a gerontologist, i.e. "What makes you think you are responsible for the care of all of these people?"  I am also learning why I have a hard time saying "No" - and how to change that!

I downloaded this book to my Kindle, but this title is available in several formats from Amazon.com, and I highly recommend it.  I think this book would be a great resource for any member of the Sandwich Generation and those who are struggling with the issues of caring for aging loved ones.  I'm sure I will be reading it again and making many notes for reference.  If you think you have no issues with boundaries, you might still find this book helpful.  This could be just the resource that helps you maintain smooth sailing... and preserve your sanity for the long haul!