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!

Where Has Another Month Gone?

I knew it had been a long time since my last post, but almost a month... really? That should tell you something about how things have been going. It has at least seemed like an unusually busy month, and certainly there has been no time to get bored! But isn't that the life of all of us who are members of this Sandwich Generation?!

My sister finished her CNA classes and began a job at a local nursing home, working the 6:00 a.m. to 2:00 p.m. shift. Thankfully (and to my amazement!), the daycare that Timothy attends opens at 5:15 a.m. I asked his teacher, "Do you really have children come that early?" She nodded her head and said, "Oh, yes!" So Timothy arrives at 5:30 a.m., and my sister picks him up in the afternoons, sometime after her shift is over. So far, he is doing well... he certainly enjoys that late morning nap for 2 hours or more! But he is thriving at the daycare and really loving his teachers and his new friends.

When I last posted, my grandmother had just had her monthly visit from the facility physician. She had given him the same complaint she has given me for years, "I can't pee." If you have followed this blog for a while, you know that we even made a visit to her previous family physician for this once, and he tried to explain that she takes Lasix and does not need to go on the hour, every hour, all day long. But still, she continues to complain. So in an effort to appease her, the new doctor ordered an "in and out cath" to see how much urine she retains after going to the bathroom... and to show her that she is really emptying her bladder.

When I arrived for a visit, she said, "The doctor has been here, and he told that nurse they would do surgery." I questioned her... "Surgery? On what?" "Well, on my kidneys... I can't pee." That's when I found the doctor in the facility making rounds, and he assured me it was not surgery - just this "in and out" procedure.

The catheterization showed little urine in the bladder. But in the words of the LPN who administered the procedure, "It looked nasty." A culture was ordered, and we were told that there would probably be medication forthcoming... but not until Monday.

Meanwhile, Mam-ma began to complain of burning and being uncomfortable. The nurses kept telling me, "The doctor cannot prescribe any medication until the cultures are conclusive as to which bacteria is involved... and that will take 3 days." It took roughly four, since the pharmacy that serves the facility did not deliver any medication until late Monday night, and somehow there were no orders from the nurse (or any that were seen by an aide) for the medications to be administered. I now have a box of AZO tucked away in Mam-ma's bathroom that the LPNs or I can administer for the burning, if she has problems again.

In retrospect, this is what has been dragging my grandmother down for weeks. She had a UTI in late July/early August and was on antibiotics. When she became dizzy and disoriented in late August and we transported her to the ER, the attending physician's first idea was, "She has residual infection." But the labs came back clear. Now we realize that this test was probably a "dip stick" in a cup of urine... and without a culture, the underlying infection was not discovered.

At any rate, injections of a very strong antibiotic were ordered for 7 days, accompanied by 7 days of oral antibiotics and something for burning. And... over the weekend, the nurse telephoned and said, "We think Polly has pink eye. Her eye is red and swollen this morning. It's either that or allergies... or she slept on it wrong. We're ordering an antibiotic for that, too!" For seven days, Mam-ma took THREE antibiotics. Now she says she feels better from the UTI, but she is still trying to recover from taking so much medicine.

During all of this, we continued to keep Timothy a day or two here and there. One Saturday morning, I took him to his first birthday party... for a fellow daycare attendee who was turning three. This was a "prince and princess party" - about four little girls in princess attire, and two little boys. Timmy did not go in costume. The party was held at a local playground, and the parents had added a "bouncy castle" and a pinata, as well as a craft project, a cake that looked like something from the Food Channel programming, and party favors that went on for days. The bar is set high for future parties!

My 2 favorite boys... Timothy's
first football game!

Timmy had a ball, but he came home exhausted and really cranky and ready for a long nap. We've also taken him to a couple of local high school/junior high football games lately, and he has loved that... especially the band. It seems that we're learning to take him along wherever we go and continue with our plans as much as possible... knowing full well we may be leaving early. One night we didn't make it to halftime... Timmy fell asleep in my lap during the 2nd quarter!

With the routine of daycare and my sister's job in place, we were actually able to take a few days to help with a conference that was held in our community by the company we developed and sold six years ago. We still stay in touch with the new owners and try to keep up to speed on what is happening with our "baby," and this gave us a chance to renew some relationships and see firsthand how the business is doing today. But it was a hectic, tiring string of days/nights, and then it was back to our "routine" with our own family and household.

After several days of bouncing back and forth between caring for Timmy and seeing about Mam-ma and the conference, I had a chance this week to finally work on our house and get it cleaned and back in some semblance of order. I realized that it had been several weeks since I had actually done laundry for us, so that in itself took a full day or more. When you are washing towels and baby clothes and pajamas every day or so, it is easy to lose track - until you don't have any clean underwear!

We kept Timmy for a couple of days last weekend while my sister worked, and all day Saturday, he was fine. Saturday night we were watching videos on the computer when he suddenly erupted... vomiting everything he had eaten for three days, it seemed. Greg helped me get him stripped and to the bath tub, then watched him while I changed MY clothes and cleaned up the mess. Yes, if you are following this posts, this is twice this month that we have had these events.  This little boy has had a rough few weeks!

After that, Timmy seemed subdued, but okay... until the next morning, when he was sick again. I watched him closely all day and monitored his food and drink, but by Monday morning, he was better and fever free, so I took him to daycare. He did pretty well all day, but that evening, my sister said he threw up all over HER... her first foray into this side of our precious charge! Bless his heart... he is so pitiful when he's sick... and it scares him - he does NOT understand what is happening. My sister had Tuesday off, so she kept Timmy at home and made sure he was feeling better.

I managed to get our house cleaned, laundry washed and ironed, and everything in place before the weekend. Greg had cousins visiting from out of state, and we were planning to spend time at with his family. I made a visit to the ALF to make sure Mam-ma was okay. I picked Timothy up on Friday afternoon at the daycare and brought him to spend the night with us. Greg's family came to our house for a visit and take-out pizza, which made it much easier with the baby. Yesterday we went for a brief visit at Greg's brothers... Timmy in tow... before my sister picked him up when she was finished working.

Today my mother has taken my grandmother for an afternoon drive to see the fall color, which will help her spirits tremendously. Tomorrow, Timmy will Trick-or-Treat at her apartment (I left candy there for her to give him), and next weekend, we will take her to lunch to celebrate her 99th birthday on Saturday. I am hoping that the days in between will be uneventful. The doctor will return for a monthly visit on Friday, and I anticipate that he will declare her to be greatly improved... if not completely well.

I feel like for the moment we are settled into something of a routine... helping with Timothy as needed while my sister works... checking on Mam-ma several times a week... and trying to have a life in between. My husband is so good to go and visit my grandmother, refill her bird feeder, and spend a few minutes with her - just the two of them. She loves that. I already know of at least two people who are planning to visit her from out of town on her birthday, and that will be huge, also. For now, we're trying to make the most of every day... savor the special moments with our little nephew AND my aging grandmother. So far, so good! Yeah, what am I saying?!

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On another note, I still have some checking to do, but it looks like I will not have to change Medicare Part D Prescription Drug Insurance providers for the first year since the program was implemented! Thank you, LORD!!! I think I have had five providers, so far...and that doesn't count the one that Medicare so nicely switched me to on their own the first year! (I got it switched back, since their plan covered virtually NONE of Mam-ma's drugs!) I am glad that at least once, it looks like I won't have to go through all of the shenanigans that are involved to transfer to yet another provider. I will make a call to the pharmacy to doublecheck this tomorrow, but it is looking pretty good at this point! Yippee! See how little it takes to make us Sandwich Generation "fillings" happy?!

AND... a cousin recently suggested to me that I needed to have a DNR order handy for my grandmother, so that no heroic measures will be taken to keep her alive, should something happen. These are her wishes, and I mistakenly assumed that the Living Will covered this. It does not! So... we now have a DNR (Do Not Resuscitate) order on file at the ALF, along with a copy of her Living Will. With both of these in place, no life-sustaining measures should be enacted, were she to have a stroke or heart attack, etc. If you do not have these documents for your aging loved ones, I encourage you to get them. You can download the forms online, or talk to your attorney and ask him/her to supply them.

I talked with Mam-ma about the DNR paper to be sure these were her wishes. She insisted they were, saying she did not want to be a vegetable. "And besides," she added... "the sooner I'm off your hands, the better!" I told her emphatically that she is NOT "on my hands," but I had assumed she was after a "one-way ticket." She said, "Well, I AM!" Gotta love my grandmother!

I hope things are well in your "Sandwich" this week!

Who Goes First? Reflections on the Seasons of Life

Palm Sunday began for us with a glorious worship service at our church, where young children from age 2 to early teens paraded up and down the aisles waving palm branches while our Praise Band sang a glorious anthem regaling Jesus' arrival.  It was heartwarming - and moving - to see these little ones in such numbers glorifying God.  I reflected on how blessed I am that God has seen me through the challenges of the past months, and now my grandmother is safe, healthy and happy in her new residence.

The rest of our day was equally good... a delicious lunch at a local restaurant with my husband and his mother... an afternoon nap... and a good, relaxing Sunday.  But all of that changed as my husband and I sat down for dinner.  The phone rang... an urgent message from a friend of mine... please call him immediately.  Since he and I are mutual friends of my cousin, Carla Lou, I feared something had happened... perhaps to Carla's dad, my cousin Carl, who is 87 and has recently undergone a major surgical procedure to repair a hernia.  Carl is also in the early stages of Alzheimer's.

I phoned my friend Scott, and he began to talk about Carla, a friend named Mark, a hospital, a brain bleed... and it was all running together for me.  Carla lives in Columbus, Ohio.  Was she in Arkansas?  I had heard she was coming... but then I heard she wasn't going to come, after all.  Was her friend injured?  Did Carla need a ride to her dad's?

Finally, Scott was able to make me understand that my cousin, Carla Lou, age 46... young, vibrant, beautiful Carla... had suffered a brain bleed and was in grave condition in a Little Rock hospital.  She was sitting on the patio with friends when she became incoherent and then collapsed.  She had been in our state for a few days, attending the 25th reunion of her college class.  She was planning to make the hour-long drive from Little Rock on Monday to visit her dad, and possibly other relatives and friends.  She never got here.

Carla Lou died in the early hours of Monday, April 18th.  Because her classmates were all talking about this on Facebook, Carla's brothers and I scrambled to get things in place to tell her dad - and my grandmother.  Carla's maternal grandmother, Bessie, was my Mam-ma Polly's older sister.  Just to complicate matters - and possibly confuse you - Carla's paternal grandmother (her dad's mother) - and my great-grandmother were sisters.  We are "double cousins."  I spent a lot of time late into Sunday night on the phone with Carla's friends and her two older brothers.  Early Monday, I dressed and headed for the ALF to deliver the news to my grandmother before someone from our little community called and told her over the phone.  My cousin was sitting on his dad's doorstep to deliver the news in person that Carla was dead.

I got to the ALF as Mam-ma finished her breakfast.  We sat and talked while she ate, and then I said, "Let's go to your apartment... I have something to tell you."  We walked back to her room, and I sat her down and delivered the news.  She cried, but she took it very well, all things considered.  I think there is an extra blessing  for older persons... a sort of insulation against the shock of such horrible news.  For my cousin, Carl, the shock of hearing that Carla was dead, along with the frailty brought on by his age and illness - not to mention his Alzheimer's - all served to temper the impact for him.  I am not sure how much of this he will ever be able to fully internalize... and that's a good thing.

We memorialized Carla Lou on Wednesday with a graveside service attended by dozens of friends and family members.  Carla's fiancé, David, had flown in Sunday night on a chartered plane to be by her side before she passed.  David's two brothers had flown to Arkansas to be with him for the service - and another service held in the evening on the college campus of Carla's alma mater.  Carla's ashes were buried beside those of her mother and paternal grandparents.

When you say the numbers out loud, they don't make sense.  My cousin Carla celebrated her 46th birthday on February 27th.  She wasn't supposed to die before her dad... or my grandmother.  But of course, we don't get to choose the circumstances - or date - of our death.  And while my husband and I have made what we feel are thorough and detailed plans in the event of the death of either one of us, the death of my cousin Carla Lou had us once again reviewing our plans... crossing T's and dotting I's.

My husband has always maintained that the odds are in favor of him dying first.  My mother has maintained for several years that her health conditions will result in her passing well before her husband.  I have maintained to both of them that we simply cannot be certain of this.  I think now they might be starting to believe me.  I know this has sparked discussions among several people about planning for "the day" when they are no longer alive.  It's tempting to bury your head in the sand and pretend that day will never come - or to say, "My kids and family members can figure it out when I'm gone."  But that is simply wrong thinking - and selfish, at best.

I am so thankful that I got my grandmother settled.  Should something happen to me today, I know that her care could now be far more easily managed by someone else... and her needs would all be met.  I am thankful that we have settled her estate, streamlined her paperwork and finances, and settled her in a place where she is happy, healthy, and safe.

But others have not made the same arrangements... and some are finding out firsthand what the results of a lack of planning can be.  A friend of mine was called to her winter home in Michigan recently to attend to her father, who was not well and refused to see a doctor.  My friend's parents divorced years ago, and she had developed a closer relationship with her mom... but when she was in Michigan during the summer, she had lunch with her dad about once a week.

My friend found things worse than expected, and her dad was declining rapidly.  In the course of about three weeks, things continually became more critical, and ultimately, my friend's dad was hospitalized and placed on Hospice.  Her brother flew in from Arizona to assist her with decisions, and together they selected a skilled nursing facility for her dad.  Two days later, he died peacefully.  The rollercoaster of emotions and challenges have certainly tested my friend.  Thankfully she has had the support of her brother... a true blessing.  Often all of the care and decisions fall to one family member, regardless of how many are capable of helping.

Every situation is different.  Often the seniors are either not capable of making rational decisions... or they are uncooperative.  They worry about people meddling in their business - and stealing their money.  They think they are invincible and "it will never happen to me."  Or they simply choose not to think about these things at all and "let the chips fall where they may."  But for those who face the challenge of making decisions and hard choices, this can be a daunting, scary time.  When you are suddenly faced with making decisions on the fly about long-term care, medical procedures, Hospice, funeral plans, and more, the challenges can be overwhelming.

So my advice to each of us today is... GET YOUR "HOUSE" IN ORDER!  Make plans... spend the money to get good advice and make a will or get a living trust.  Get a Living Will, investigate Power of Attorney, and consider pre-arranging funerals... or set aside money to cover the cost when needed.  The elderly aunt of a friend told her, "I don't need a will... the lawyer said when I die he will handle everything!"  Of course he will!  He stands to make big bucks off of probate and all of the work needed to settle an estate without a will.  A Living Trust generally costs less than $2000, and it is worth every penny!

Pre-arranged funerals lock in the price.  If you select a "package" for $5000 today and live another 50 years, the cost to your family will still be $5000.  There may be a few incidental add-ons, such as flowers, but the basic cost of the funeral will not rise... and your loved ones will not be faced with making decisions about your wishes at what is already a difficult hour.

If you have children in your care, the need for you to make thorough plans is doubled.  You not only need to help your senior plan for his/her future... you need to plan for your own - and that of your children.  Now is the time for action... not when someone falls over dead on a patio. This is one of the most selfless acts of love you can demonstrate.  What are your plans?

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On Thursday, April 21st, my grandmother's ALF hosted an Easter luncheon.  Guests were invited, and Mam-ma's friend, Ruby, and I attended.  There were decorations, a lovely ham dinner, party favors, and more.  Everything was delicious and served by staff and volunteers.  Here are a couple of pictures.  I am in one photo with Ruby (left) and my Mam-ma (right).  In the other photo, Ruby and Mam-ma are on either side of Mrs. Ruth Garner... my third grade teacher, who also resides at Southridge.  And the last photo is of Ruby and Mam-ma - two best friends.  Don't the ladies look great?

We Have a Date!

It's official! Move-in Day at the Assisted Living Facility (ALF) is Monday!  We are beyond excited... although when I phoned my grandmother and asked, "How would you like to move to Southridge on Monday or Tuesday?" she replied, "Well, it don't matter..."  Oh, yes, it does.  In the words of my witty cousin Natalie, "Oh, yes!  Your 'good clothes' are labeled, and we're moving!"

We got official confirmation from the appropriate offices at Medicaid - in writing - so all systems are "GO" for a move-in on Monday.  My husband and I will start bright and early that morning, and with help from my sister, we hope to have Mam-ma settled in her new apartment by dinner time.

Mam-ma asked me... "Who's gonna help GREG move me?"  I told her, "I am!"  She replied, "YOU are!  Hmmpphh!  Well... y'all just beat all I've ever seen!"  Mam-ma doesn't think I am able to do anything "physical" or "manly".  I assured her that Greg and I have moved numerous times, and "we've got this down to a science!"  She just laughed.  She will not believe it... probably even after we have her settled.

So we are resting and relaxing as much as possible and preparing for a busy week... but one that will have tons of benefits, I'm sure.  Pray for all of us... especially Mam-ma as she makes this monumental move... and I'll keep you posted.

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Meanwhile, the mother of one of my dearest friends has been hospitalized with bleeding ulcers.  At 85, this woman has a number of health issues, and my friend is concerned about her present living conditions.  She said, "I don't even know where to begin to get help." 

I told my friend that admission to an Assisted Living Facility (which would be ideal) could take several months.  Meanwhile, her mother needs help now.  I recommended Home Health services, some sort of "life alert" device, and Meals on Wheels.  I gave her the contact numbers for these agencies.  I also recommended that she begin to get her mother's papers and finances in order.  She was astounded at the list of papers I suggested she assemble, and she made notes accordingly.  I pointed out that she will need these for any applications she makes... and, should something happen to her, these papers would need to be centrally located anyway for the person charged with her mother's care.

Here is the list of things I suggested she have handy:

• her mother's living will - attached to the refrigerator door where EMTs and other official personnel can readily see it
• a complete list of medications and information for her mother, known allergies, past surgeries and major illnesses, insurance contacts and membership numbers, contact information for next of kin, and notice of living wills, DNR orders, etc.
• a copy of her Durable Power of Attorney (DPOA)
• a copy of her mother's birth certificate
• proof of life insurance, pre-paid funeral plans, and other policies/pre-paid items
• a list of all physicians who care for the patient - and their role, i.e. primary care, cardiology, internal medicine, ortho, and more.
• special notices, like "George has a pacemaker" - "Mary wears upper and lower dentures" - "Joan is blind in one eye" - "Pete can't hear without his hearing aids".  I pointed out to my friend that she needed to note her mother's bleeding ulcer, so emergency personnel would not misunderstand excessive bleeding... and her vascular dementia and numerous medications, which could cause slurred speech that might be mistaken for a stroke at first glance.

It would also be good to have a list of all checking/savings accounts - and account numbers, recurring bills - both those paid directly and those auto-drafted, and other recurring payments.  If Grandpa always makes an annual donation to his cemetery board, you need to know when this is done - and how much he pays.

My friend was astounded at all of the paper work that is required for even seemingly simple tasks and applications.  It can be daunting... particularly the first time.  I told her that "this is not my first rodeo," so I guess I have somewhat acclimated to the paper trail demands.  For me, the key is to try to maintain some semblance of organization.  Knowing where the documents are located and how to access needed information quickly is more than half the battle. 

I'm not surprised that my experience with my grandmother is already coming in handy to help others.  In fact, I had hoped that in some way, I would be able to utilize all of this "knowledge" to help others.  I just didn't know it would begin so soon!

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If you have experiences you would like to share that you feel can help others, please contact me.  This needs to be an interactive blog in order to be more effective.  I look forward to sharing your stories, your burdens, and your joys here.  Please come along for the journey!