We're Not Ready...

My friend and her four siblings have been taking turns sitting with their 88-year-old mother, who recently returned home following rehab for a mild stroke.  Dementia began to set in several years ago, but things were not so bad that the siblings didn't feel they could leave their mother unattended while the baby sister - who has lived with her mother for nearly 20 years - worked at a "day job" in this community.  All bets were off when Sue* suffered the stroke.  Now she has to be reminded - and often prodded - to dress, brush her teeth, and eat.  Other times, she will do these things repeatedly.  My friend told me one day recently, "Mom brushed her teeth three times this morning."

At her wits' end, my friend came to me recently and asked for help... what did she need to do to get the ball rolling for her mom to enter an assisted living facility.  I told her I would be happy to help her "navigate the waters."  I inquired a couple of days later at the Assisted Living Facility where my grandmother resides and discovered there was a room vacant right across the hall from Mam-ma.  "But she better hurry," the administrator advised.  I relayed this information to my friend that evening, and she sheepishly looked at me and said, "We're not ready."  I nodded and told her I understood... I've been there... but she needed to be aware that the clock is ticking.

Two days later, my phone rang.  My friend asked if I could meet her at the ALF and show her around... let her see Mam-ma's room and answer a few questions.  I told her I would be glad to do that.   We agreed on a time to meet, and I thought she said her sisters were coming with her.  When she arrived, her husband and one sister were with her... along with her mother.  She said, "I told Mom we were going on a little outing."

We toured the facility, I answered questions, and we visited with Mam-ma, who gladly showed them her apartment.  I had visited with the administrator before the entourage arrived, and she told me to visit the vacant apartment across the hall.  We did that, as well.  I showed them menus for the week and the monthly calendar.  We opened closets and drawers and everyone commented on how spacious the apartment seemed... perfect for their mom.  Several people poked heads out of doorways and realized that they knew Sue and her family... and many came to greet us.  Sue hugged my grandmother as she left and said, "I may be back real soon, and we can visit."

The next morning, my friend called and dejectedly told me that her mother had thrown a fit in the car.  She was NOT moving in with a bunch of people.  I reminded my friend that we had toured that very same apartment one October, and the next day Mam-ma declared, "That's not for me.  I'm not moving down there."  Less than a month later, she was ready... and the apartment was gone.  It would be several more LONG months before we were able to secure an apartment and officially make the move.

Meanwhile, I see the toll this is taking on my friend and her siblings.  Three of them are trading off days... sitting with their mother while the youngest sibling works.  This woman is responsible for her mother each evening.  I can only imagine how tired she must be after working all day... and how confined she must feel.  Even if her mother eats dinner and goes to bed, this woman can't go out or do anything socially.  She probably doesn't feel comfortable to do much entertaining in the home, either.

I told my friend that I fully understand her dilemma, but I suggested she continue with paper work and basic preparations, in case things change suddenly.  AND... I reminded her that she is dealing with a problem we did not have... dementia.  At some point, it may be necessary for the siblings to force this issue - for the sake of all concerned.

Later in the day, while shopping, I ran into the other sibling who had come to the ALF with my friend.  I told her that I had heard that her mother was not pleased.  She said, "Oh, mother was SO upset.  She is not used to being alone like that."  I know I looked perplexed, and I said, "Your mother would NOT be alone at the ALF... there are people everywhere."  She replied, "Well... yes... but she wouldn't participate in any activities.  She would just sit in her room all day."  I agreed that some residents do this... but she would always be given an opportunity to socialize and participate in activities.

Then I told her that she and her siblings are going to wear out if they continue to provide all of the necessary care.  She said, "We may have to get someone to help us a little, but if so, that's what we will do."  I mentioned the sister who works and lives with her mom.  "Oh, she's used to that," she replied.  I suggested it was terribly confining, and she said, "That's all she knows... she's lived there almost 20 years!" 

I realized in that instance where the real difficulties lie.  The siblings are not all on the same page.  Their mother may not be ready to agree to move to an Assisted Living Facility... but some of these children are most definitely not ready.  And as long as there is dissension among the siblings, nothing will change.  Their mother may have already surpassed her mental capability to make this decision... but these siblings are not emotionally ready to say, "This is best for Mom - and for us."  Until this happens, they will continue spinning their wheels and making themselves crazy on a daily basis as they attempt to meet their mother's needs - and demands - in her own home.

I fully understand that this is a difficult decision.  And thankfully, my grandmother was mentally capable of deciding on her own to make the move.  But we don't all have that luxury.  My maternal grandparents were somewhat "manipulated" into moving into a nursing home by convincing each one that they were going because the other one needed to be there.  So my grandfather would say, "I'm only here because Mother needs to be here."  My grandmother would tell others, "I'm just here until Daddy gets well and we can go home." My grandfather was virtually blind and deaf... my grandmother had Parkinson's disease.  Neither one could care for themselves - much less each other - in their their own home.

I strongly suspect that this family will be like countless others ... they will rock along in their current situation until something else happens.  Their mother will suffer another stroke and either lose her life or be so incapacitated that she has to go to a nursing home... or she will fall with the same results.  Hopefully the outcome will not be such a toll on the caregivers that their own health suffers.  And I am not saying that the ALF would be better.  Sue might love it... or she might be perfectly miserable there and make everyone else miserable in the bargain.

All I can do is be encouraging and supportive... and share my own experiences in hopes they will help someone else.  For the moment, my grandmother is doing amazingly well.  She even managed TWO "I tell you whats" for me yesterday... more than she has spoken in months.  However, she totally ignored me as she tried to wheel herself to the bathroom... so I know that another fall is always just one mis-step away.  And I have accepted this.

I had to laugh as I checked out at Wal-Mart yesterday - I had diapers for Zola, our great-niece... and diapers for Mam-ma.  We've been at this a while now.  Timothy is three and has been out of diapers for about a year.  Hopefully Zola will follow suit soon... but Nathan is only six months old, so we will have baby diapers in the mix for a while yet.  And one of Mam-ma's friends is 103 and a half... and another is 106... so who can say how much longer we will be buying the bigger variety, as well! 

Part of my consolation is that I am amassing a wealth of knowledge that just might help the next person... like my friend and her siblings.  There has to be some redeeming purpose in all of this... and maybe that's it!  If/when my friend and her siblings ARE indeed ready... I'll be here to help them.

*Name changed

The Scouts Were Right - Be Prepared!

In the last few days, I've been thinking a lot about preparation.  My niece will give birth to her second child on May 31st, if not sooner.  This means that Timothy will come to stay with us for awhile until she recovers from her C-section delivery and gets on her feet.  I figure he will be with us for several days, at least.  I know that this means I will get virtually nothing done while he is with us.  So I have been in "preparation mode" - stocking the pantry and planning meals, cleaning the house, doing laundry, and catching up on some writing projects... along with working out and trying to rest!

Thankfully, my grandmother's virus was short-lived, although she is still sore from her fall in the closet.  Her bruises look pretty mean, but she is up and about... taking walks outdoors, exercising and attending all of the regular activities at her retirement center -  and even shopping at Wal-Mart... so I know she is okay.  She has had quite a bit of company lately, and that has brightened her days, as well.

Our little Timothy - dirty face and all!

Aside from thinking about our own preparations for the new arrival and Timothy's visit, I've had conversations with several friends in recent days who are in some stage of caring for an elderly loved one... and each time, the focus has centered on preparation.  In a couple of cases, virtually no preparation had been done for the "what ifs"... what if Mom/Dad falls ill and has to move to an assisted living or skilled-care facility?  What if we need money for their care?  What if they refuse to cooperate?

I'm very thankful that my grandmother was at least somewhat cooperative.  My grandparents transferred ownership of their property to my parents in the 1970s, when the laws were different and there was concern that a sudden illness or disability could result in a move to a nursing home... and the loss of their homes to cover the costs.  The laws have changed now, and while I am not current on how they actually read, I do know that there are options... particularly if there is a spouse still living in the home... and the sale of the property may not have to be sold - at least not right away.

Meanwhile, I have advised my friends to start coaxing their loved ones to take some preliminary measures...

• Encourage your loved one to designate a Durable Power of Attorney who can assist with major decisions - both medical and financial.  Believe me, virtually no one will talk to you about your loved one without proof of Power of Attorney - from medical staff to the utility companies.  Without this document, you will have a long, rough road to travel as you handle your loved one's medical/business affairs.
• Add someone you trust to your loved one's checking account.  If you have a Durable Power of Attorney, this person is the logical choice.  Just this week, I cashed a refund check for my grandmother, and because she was not with me at the time, I had to add my signature to her endorsement on the backside of the check.  This was verified to see if I was, indeed, listed as a signee on her checking account.  You'll also need to be able to write checks on your loved one's account for everything from utility bills to the monthly payments to a skilled care facility.  This signature  authorization is vitally important!
• Try to persuade your loved one to begin thinking about designating - and dispersing - valuable assets.  If your parent/grandparent has an heirloom pocketwatch they plan to leave to someone in the family, why not give it to them now and get it out of the drawer?!  Don't risk having these valuable family treasures come up missing - or squabbled over - if the senior has to move to a facility.  And certainly do not risk having these treasures "lifted" at the facility. 
  
  When my maternal grandparents moved to a nursing home, my mother substituted a very nice cubic zirconia drop necklace for my grandmother's real diamond necklace.  They looked exactly the same, and my grandmother could not tell the difference.  But the concern of having her "real" diamond lifted or misplaced was alleviated, and everyone was happy.  You may have similar valued jewelry that can be "traded out" for less-expensive look-alikes.
• Understand that any assets your loved one has are subject to liquidation to pay for medical care, skilled care facility stays, and more.  While many seniors are stubborn or leery of suggestions to help manage their assets, there are things that must be done for their own protection.  The cost of consulting a lawyer to set up a Living Trust is well worth the investment.  This can help to protect many of your senior's assets, should a catastrophic event occur.  Long-term care insurance may also be appropriate.  It's expensive, but depending on the age and physical condition of your loved one, it may be worth the cost.
• At best, sit down with your loved one and try to get a handle on what assets he/she has.  Make a list of these assets - important policy numbers, at least an estimate of their value, and where important paperwork associated with them is located. Is there property, such as a personal home, rentals, and/or vacant land?  Does the senior have life insurance?  What about a pre-paid funeral plan?  Is there a safety deposit box... and what sort of valuables are stored in it?  Does the senior have CDs, an IRA, and other investments?  Does he/she own a car, boat, recreational vehicle, tractor, or other motorized vehicles?
• Make a list of "contacts" - people to notify in case of an emergency, the housekeeper, the person who cares for the yard, insurance agents, pastor, and more.  Once when my grandmother was ill, I completely forgot about a cousin who checks on her often.  Several days later, he phoned me - very upset - and wanted to know why he was not notified that my grandmother had been hospitalized.  It totally slipped my mind.  Now I have a list, and I carry it in my purse.  If/when something happens, I don't have to rely on my memory to make the appropriate calls.

I realize I am treading in delicate territory here.  Some of these questions may seem premature, at best - and downright intrusive.  But in order to do the best for your loved one... to provide the best care for him/her and to protect any assets... some plans must be made - TODAY!

Here are some links I found that might provide helpful information.  Please understand that this list does not represent my endorsement of these websites or their information.  I am merely providing you with some search results.

• AARP info - Ask Ms. Medicare
• Guarding Your Wealth
• SeniorJournal.com
• Medicaid Asset Protection Plan

Don't wait until there is a crisis.  Don't wait until you are in the shoes of one of my friends... paying thousands each month for residence in a retirement facility, the money quickly running out... and a parent who won't cooperate.  Start taking measures now to protect your loved one and yourself.  Be a good Scout and be prepared!

Come for Tea at Eight

Last night my husband and I sat down after dinner to watch some sitcoms we had recorded on DVR.  A little after 8:30, he woke me and said, "Do you need to go to bed?"  I had been dozing for the last couple of 30-minute episodes.  I was even more tired than I realized, and I had no trouble falling asleep for good... or sleeping through the night.  A little after 6:00, I had tucked Mam-ma into her new bed in her new home, and told her, "Welcome home!"  She said, "Y'all have done a wonderful thing today."  I knew she meant it.

Friday, I took Mam-ma to the beauty shop, and I returned to her house to sort and pack.  After she returned from the beauty shop, we sorted some more items - the medicine chest, some jewelry and cologne, and more.  At almost 5:30 p.m., she was exhausted, and so was I.  We declared it a good day, and I left, suggesting she get some rest. 

I decided on Saturday that I should go back and pack a few more things, feeling the more we had packed and ready to roll on Monday, the better.  When I arrived at Mam-ma's before 2:00 p.m., Ruby was entering the house, and she was all dressed up.  Another friend, Geneva, was picking them up to go to Southridge to visit friends.  "Go ahead," I told Mam-ma.  "I'm going to pack and sort things here, and you go have a good time." 

I did all I could to get things organized, labeled, packed and ready, and at 4:00, I vacuumed the carpets and walked across the street to visit a next-door neighbor who is also a dear friend.  About 4:30, I heard the familiar scraping of Mam-ma's walker being dragged across concrete.  I walked to my friend's front door, and there stood Mam-ma.  "You've locked me out!" she said.  I reminded her that she had her remote control garage door opener, and she said, "Yes, but you locked the interior door."  Indeed, I had done that out of habit.  So I unlocked the house and let her inside... and I realized right away that she was completely spent.

Apparently these little ladies had walked from one end to the other of two facilities at Southridge - the assisted living center AND the skilled care nursing facility.  Mam-ma was so tired she could not even put a sentence together.  I quickly showed her where I had put her underwear and asked a couple of questions, and then I seated her at her dining table and heated some food for her dinner.  She took her night-time medicine and said, "I think I'll go to bed."  I turned down her bed, laid out her pajamas, and sat with her while she ate.  The food helped, and she began to rally a bit and was able to speak in rational sentences.  I offered to help her put on her pj's, but she sat down on her couch and said, "I think I will rest here for awhile."

Sunday, I did not leave my house - and neither did Mam-ma.  We rested for THE BIG DAY.  But she phoned me at 9:15 a.m. - "WHERE is my underwear?"  She did not remember most of what I had told her Saturday evening.  I reminded her it was in the dresser drawer - ready to go to Southridge.  Oh, yes... now she knew.

Yesterday morning, my husband and I left home at 8:00 and headed for Mam-ma's, where we loaded her furniture into our vehicles and a utility trailer.  We then went to Southridge and unloaded the furniture, getting everything in place.  A local furniture company was to deliver a new mattress set after lunch... we had the bed frame in place and ready.  The mattress set arrived promptly after lunch.

After that, Greg went to deliver Meals on Wheels, and I returned to Mam-ma's to get her medicine dispersed into the daily compartments - see if any needed to be ordered - and to load her clothes and toiletries, etc., into my vehicle.  It will take a week or more for the pharmacy associated with the ALF to begin sending medicine for Mam-ma, so we needed to do this one last personal dispensation.  I went back to Mam-ma's new room and unloaded the clothes, toiletries, and other items.

I was scheduled for a mammogram... of all days, on this morning at 11:30.  So I drove up the hill to our hospital and checked in at the radiology lab.  Greg met me there and waited while I had the procedure.  The beauty of small towns is that we know so many people.  Fellow church members were my admissions clerk, and my radiology technician, and they whisked me in and out quickly and with little fanfare.  Greg and I grabbed a quick, delicious lunch at our hospital cafeteria (the best food in town!), and then we returned for another load of odds and ends at my grandmother's.

My sister met us at my grandmother's, and we loaded pictures, lamps, plants and other items into the cars and made another trip to Southridge.  This time, the maintenance man - James - met us and helped my husband connect and program the television.  He also hung ALL of the pictures for me - I would hold one up and point, and he would hang a nail and the picture - and he hung a little cabinet/shelf unit over the toilet in the bathroom.  James was wonderful... but then, so was all of the staff - many of whom dropped in throughout the day to say "Hello" and "Welcome!"  My sister and I made the bed and straightened the room.

By about 2:00 p.m., we were ready for Mam-ma.  Her room looked like she had lived there for years.  The bed was made... her pictures (many of which she painted herself) were hung on the walls... our family mantel clock was tick-tocking on the dresser, and her family Bible was on the coffee table.  Everything was in the drawers... pretty dishes held cosmetics on the counter in the bathroom, and her Mylanta and creams and ointMENTS were in the bathroom cabinets.  A decorative corner cabinet sat just inside the door - with seven shelves laden with family photos.  The room screamed "Mam-ma Polly!"

Greg and I drove to Mam-ma's house, and she was pretty well "locked and loaded."  She had turned out the lights, locked the doors, and she was ready to go.  She looked around... but not much... and Greg helped her to the car.  Earlier that morning, she had picked up a pocket-knife and handed it to Greg... her eyes filling with tears.  "This was Truman's," she said.  Truman was my grandfather.  "Would you like to have it?"  Greg sweetly told her, "I will hold onto it until Timmy is big enough to have it... and then I will give it to him - how's that?"  She replied, "That'd be okay."

I fully expected a tearful scene as we left for the last time.  There were a few tears and sniffles from the back seat... but really very few.  And the reaction when we presented her with the new apartment was priceless.  She was astounded... and thrilled.  You could see it on her face.  It was HERS.  Everything was familiar.  We had used all of her things, and she felt so comfortable.  She asked a few times, "Now, where is this or that?" and we showed her, but she settled into a chair and was grinning from ear to ear.  Greg showed her how to use the thermostat, and we got a list of the television channels so he could go over those with her and find "Wheel of Fortune" and the Fox16 nightly news.

Several staff members came and went, introducing themselves and welcoming Mam-ma to the facility.  I took the medicine box to the R.N. and went over the medication schedule with her... and I almost danced back to Mam-ma's room - glad to be relieved of that responsibility!  Around 4:00, Greg and I went home, and I started calling utility companies and cancelling services.  The first call I made was to the telephone company.  The very helpful rep I was assigned told me that no technician was required (although she was completely unable to remove the $45 connection charge - and she tried several times), and that phone service would be switched from Mam-ma's house to her apartment by 10:00 a.m. today... no later than 8:00 p.m. tonight.

I called the cable company and cancelled Mam-ma's cable TV service.  She has a rebate coming for pro-rated, and unused service.  By now it was almost time for dinner, which is served at 5:00 p.m., so I decided I should go back and help Mam-ma get to the dining hall and acclimate for her first meal there.  For the record, we live about ½ mile from Southridge.  My grandmother's house was on the other end of town, probably almost five miles from our home.  So this is not inconvenient at all for back-and-forth trips.

I located James and asked him to help me plug in Mam-ma's phone, so that when the switch was made today, everything would be in place.  James did this, and I recorded a new message on the answering machine.

I helped Mam-ma to the dining room, where she sat at a table with Charley and Kathleen... two very nice people.  Charley is a retired minister from Texas, and he didn't seem too interested in visiting a lot, but we did make acquaintance.  Mam-ma's friends were seated at other tables, and the administrator had told us that some of them have agreed to move to a new table today and sit with her.  So she will have a group of friends to share conversation with over her meals now... something she has not had in years.

I had ordered soup from the menu for Mam-ma - the "daily dinner special" was fish sticks, and as luck would have it - that was her last Meals on Wheels lunch entree!  So she had a big bowl of chicken noodle soup, a cornbread muffin, buttermilk, and banana split pie with whipped cream and fresh strawberries.  And she ate heartily.  As she scraped the last bite of whipped cream from her dessert, she laughed and said, "If they feed us like this every meal, I don't know what I will do!"  I told her we'll buy her a muu-muu - this is her time to live it up!  Truly, the food appears to be wonderful - the menu was extensive and sounded delicious. I gained five pounds just reading it!

Before dinner, one of Mam-ma's long-time friends and fellow Sunday School class members Ms. Viola, came over to welcome her again to Southridge. Ms. Viola is one classy little lady - and she has lived at Southridge for eight years now.  She will be a tremendous friend to Mam-ma.  She patted Charley's arm and said, "Charley, this is my good friend.  You be nice to her."  Charley shrugged and said, "Okay."  A few minutes later, another life-long friend, Ms. Evelyn, came to her table, and she shouted across to Charley, "She is my good friend... you be nice to her!"  Charley again said he would do that.

During dinner, the R.N. came around and dispensed medications.  Mam-ma will get her meds with each meal... and someone will watch her take them.  Yippee!!!  After dinner, Ms. Viola came over to the table and told Mam-ma, "Now, I know you are tired tonight, so we won't expect you to come out and do anything.  But tomorrow night at 8:00, some of us are gathering for a cup of tea, and we want you to come."  Mam-ma said she would.

I helped Mam-ma back to her room, and she said she was exhausted.  We turned down the bed, and she put on her pajamas.  I helped her find her denture cup, face cream, and other things in the bathroom. She fussed that she wished she had her "sleeping pill" - an anti-anxiety medication she takes "as needed."  I told her all she had to do was punch her little life alert button, and a nurse would bring it.  She wasn't happy that she can't keep that in her room, but it's a controlled substance and must be locked away safely.  I said, "Let's just test this..."  She pressed her button, and an aide unlocked her door pretty quickly and came to see what was needed.  Mam-ma told her, and soon, a nurse was back with the pill.  Mam-ma fussed about liking to take one "in the night," and the nurse assured her that all she had to do was buzz, and someone would bring her another any hour of the night or day. (And they will document this, so we know when she takes them - and how often - WHEW!)

I was getting ready to leave when my cousins arrived - just to stop by and make sure all was well.  They were amazed and impressed with the room and how nice things were.  And then, Mam-ma's phone rang.  At first I thought I had imagined this... but I answered, and a friend of Mam-ma's, who she knows from the dance hall, asked how she was doing!  Thank you, Lord... my grandmother was without phone service less than 3 hours!  I told Mam-ma - "This is a miracle!"  She agreed.  I also told her, "You now have EVERYTHING you need.  If you figure out something that we've missed, I can get it from your house any time."

My cousins left, and I tucked Mam-ma in and told her, "You're home, Polly."  That is when she said, "Y'all have done a wonderful thing today.  I bet Greg is tired!"  I told her I am sure he was, but he would survive it.  I have the most amazing husband, and he never complained about a single thing all day - was there to help me at every turn - and thought of things I completely forgot in my tizzy to get this all done!  As I opened the door to leave, I told Mam-ma I would return today, and she called out, "I love you!"  "I love you, too, Mam-ma," I replied.  I locked the door and shut it, knowing she would be asleep in no time... and not only would the staff watch over her, but clearly, Someone else was taking great care, as well.

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

This morning, I phoned Mam-ma around 9:15.  She said she slept well... was up a few times because "My air conditioner was blowing cold air."  Now, Greg adjusted the unit, and he showed her how to adjust it, but we'll have to review that again today.  She said she had a "wonderful" breakfast - scrambled eggs, bacon, coffee, juice and more.  And she was headed for exercise class at 9:30 a.m.  I told her to have a good time, and I would see her this afternoon.  Greg is going to surprise her with a bird feeder placed just outside her south-facing window (the room is very sunny!), and she will love that.

Mam-ma is doing just what I expected - jumping in with both feet and embracing this "new chapter" in her life.  I feel like I have just gotten my life back... and I get to keep my Mam-ma, too.  And that's a heckuva sweet deal.

Could Move-in Day Be In Sight?

The Assisted Living Facility told me on Wednesday that she would contact the DHS caseworker again today if she had not been contacted with a move-in date.  Could today be "the day" that we find out when we can move?  I certainly hope so!

Last night when I phoned Mam-ma about her evening meds, she told me she had worked all day on an old table cloth made by a cousin.  Mam-ma found some crochet thread in her sewing room that matched this cloth, and she thought she would crochet a lace border on it.  In order to do this, she has to punch holes in the hem of the table cloth to insert her crochet hook.  The fabric is very tightly woven, and she was having trouble punching holes.  I asked, "How big is your needle?"  Her reply... "I'm using an ice pick!"

I told her to put the pick and table cloth aside, and I will look at it when I am there next (today).  She said, "Well, I've made myself sick over this."  Then she began to cry.  "Have you heard anything from Southridge?"  I didn't want to get her hopes up, but I couldn't lie... "Yes, the nurse has filed her papers for you, and now it's back in the hands of DHS.  We are supposed to hear something from them about what is happening by Friday."  She said, "Well... I told Ruby that if something doesn't happen in the next few days, I don't think I can make it!"

I gave her a pep talk... told her we're too close to moving... don't quit on me now!  She said it was very hard... she just worries and stews and thinks about it all the time.  My mom asked me last night, "What does she have to do except eat her meals, take her medicine, go about her day and go to bed at night?"  I reminded Mom that anyone in her situation would be anxious.  You have no idea what day is your last in your own home, and you are ready, but nervous, and the anticipation and thoughts and questions from friends and family all just piles up and creates stress.  Mom said she had not thought about it that way.  There is really nothing I can do to keep my grandmother from stressing over this... and little I can do to keep her safe from things like ice picks and faulty wireless doorbell ringers!

Meanwhile, we have not seen our little nephew, Timothy, in a few weeks.  He's been sick with a bad cold, and we've been busy with my grandmother's move.  I saw him briefly at a graveside funeral service for a great-aunt last week.  I snuggled him close inside my coat on a very windy, cold morning, and he fell asleep against my chest as I bounced him while the pastor read scripture and delivered a eulogy.  We are missing him like crazy, and very brief telephone chats that include "Hi!", some jibberish, and "Bye!" are simply not enough!  Once we get this move completed, I plan to have several days with this little guy where we can play and read and dance to "Jack's Big Music Show" and have some FUN!

So I am praying that TODAY we receive a move-in date... that by Monday we are moving some furniture, hanging curtains, and such... and that sometime next week we are driving my Mam-ma Polly to her new abode and settling her in the apartment.  My husband still cautiously reminds me it could be another week or two... but I'm only looking ahead a few days... and praying hard!

This Move Can't Happen Soon Enough...

If I told you I wasn't counting the days and hours until we can make this move, I'd be lying.  Last night, I phoned my grandmother to make sure she took her night-time medicine - Coreg for blood pressure, Synthroid for her thyroid, and Nexium to control acid reflux.  She assured me that yes, she had taken everything.  She was adamant.  We chatted about her day, and less than 10 minutes later, she asked, "Why didn't you put any medicine in my box?" 

I asked her what she meant, and she said, "My box was empty... you didn't put in any medicine for tonight."  "Yes, I did, Mam-ma - you just told me a few minutes ago that you already took it."  "NO I DIDN'T!" she argued.  We bantered back and forth several times, and she insisted that she had NOT taken any evening medicine.  "There wasn't anything in that box, and I didn't know what to do," she said.  I told her she always takes medicine... and if there isn't anything in the box, it must have fallen out.  I told her to go ahead and take Friday's medicine, and I would fix the compartments when I came over to her house again. 

I considered telling her to skip the medicine, and when I hung up, my husband said, "You do realize she has probably just taken two doses of her night-time medications, don't you?!"  I told him that was possible, but she was arguing with me that she had NOT taken any medication.

Less than an hour later, Mam-ma phoned me... "What will happen if I take two doses of that medicine at night?"  I asked, "Why?  Do you think that's what you did?"  "Yeah, I think I took that dose in the box before I ate my supper and just forgot."  My husband interjected, "Tell her to drink another glass of buttermilk."  She said she would.  I assured her I thought it would all be okay, and she said she would drink the buttermilk.

Today, with a forecast of snow, I stopped at the store and got fresh milk and buttermilk, bread and cookies for Mam-ma.  When I got to her house, she was dragging like she was on her last leg.  She said, "I feel terrible - all over."  I fixed all of her medicine and got it back in order.  I also showed her a quilt that my mother-in-law had made that we thought might work as a comforter on her bed at the ALF.  I asked, "What do you think?" as I spread it out across her bed.  "Y'all just do whatever you want," she replied curtly.  "I feel so bad, I don't care."  I left the quilt on the bed and suggested she look at it over the next few days and give it some thought.

When I got home, I talked with my sister and learned that yesterday Mam-ma inspected a couple of small chairs in her living room that she is considering taking with her to the ALF and deemed them to be "filthy," so she exhausted herself cleaning them.  I don't know exactly what she did, and my sister really scolded her for wearing herself out like that, but clearly this factored into her condition today.

I relayed to the ALF administrator about the medicine mix-up this afternoon when she let me know that a nurse has been contacted to evaluate my grandmother.  However, it will be early next week before the nurse can work Mam-ma into her schedule.  Snow and freezing rain are forecast for this weekend and again mid-week, so I know weather could change these plans, and I am not telling Mam-ma just yet when I think a nurse might be stopping by to see her.  If all goes perfectly, we could be moving in another 14 days or so.  My husband has cautioned me that this could end up being closer to three weeks, and I know he is right.

I left medicine on my grandmother's dining table for her to take tonight, but upon consulting my sister-in-law, who is a pharmacist, I decided to ask her not to take anything else for today... give her system a chance to rest and "re-set."  If the snow doesn't come, I will take Mam-ma to the beauty shop tomorrow and check on her once again.  I'm just going to have to keep fairly close tabs on her until we can get this move accomplished... and pray she stays safe and well enough to actually go - and enjoy herself when she gets there.  If you want to add your prayers to mine, they would be greatly appreciated!

This Belongs To...

We are in a "holding pattern" on the big move to the Assisted Living Facility (ALF), known as Southridge. I have done all I can do on my end... the rest is up to DHS. The life insurance check arrived in the mail yesterday - one more piece of the puzzle is set. My grandmother is getting antsy... she is ready to move, and the longer she sits and stews, the more anxious she becomes.

Today, I am going to my Mam-ma's house to start labeling her clothing and the things she plans to take. In true "Mam-ma style," she started without me. She told me last night she had been labeling her underwear. I questioned... did she use a "Sharpie" marker? No... she didn't know what she used. Now, I know she owns a Sharpie... we use it to write the name of her "nerve pill" on the cap of the medicine bottle so she can distinguish it from the others. I told her, "I hope you used something waterproof, or all of your hard work will come out in the wash." She said, "I hope so, too!" Finally, I was able to determine that she did indeed use the "Sharpie" marker she keeps for her medicine. I asked her not to label anything else... I said, "I'll be happy to do that for you."

I also told her that I will clear a closet today, so that she can start hanging clothing there that she knows she wants to take with her. It will give her something to do. Nearly every day, she is telling my mom on the phone that this is "too much for Debbie." Mom has assured her that it is not... that a lot of the "after" work will be done when she returns in March. And as far as Mam-ma needs to know, that's the truth.

The other interesting dynamic has been the input from others. Almost daily, Mam-ma's Home Health aides are telling her this or that about "how it will be at Southridge." Much of their information has been innacurate. One aide told her that Home Health could still come and care for her in the ALF. If you are a "private pay" resident, you could probably pay Home Health to sent out aides. But Mam-ma is not a "private pay" resident, and her care is included - and provided by Southridge. Another aide told Mam-ma that she did not need to take linens... bath towels, etc. - that these would be provided. So Mam-ma was not happy that I spent her money on new towels. I assured her that our "Resident's Manual" clearly states that bed linens, towels, toiletries, etc., are the responsibility of the resident and not provided by Southridge.

Mam-ma's friends are asking her continually, "Polly, when are you moving?" Polly doesn't know, and this is getting on her last nerve, understandably. I know people mean well... and these people all love my grandmother dearly... but they don't realize that she is already a bundle of nerves, and more care needs to be given to what is said to her about the move at this point.

Hopefully a Medicaid nurse will come soon to evaluate Mam-ma. Hopefully she will deem Mam-ma a suitable candidate for Medicaid coverage for this move. Hopefully the DHS case worker will complete her paper work quickly once the nurse's report is filed. And hopefully, Moving Day will come very, very soon!

Meanwhile, we'll keep labeling...

Paper Pushing...

They say a picture is worth a thousand words, so take a look at this one of the papers I have accumulated for my grandmother. I had misplaced a piece of information, so I sat down in the floor to sort everything and see if it could be located. This was the result of my "sort and purge" - and only a couple of papers were designated for the shredder!

It's been an interesting month. We got the ball rolling for my grandmother to move to an assisted living facility (ALF) the first week of January. My husband and I took her to preview an available "apartment" at the facility – called Southridge. She declared it "beautiful." We paid the non-refundable deposit on December 31st, and I began the process of completing all the papers that filled a large envelope.

There were papers for Southridge... a request for Medicaid assistance for an ALF, a physical evaluation and "orders" to be completed by my grandmother's family physician, and more. I set up appointments for a physical exam on January 10th. The papers were turned in at the Department of Human Services (DHS), and I was given an "interview" appointment for 10:15 a.m. on January 11th. It looked like I could get this ball rolling in just a few days.

On Friday, January 7th, a cousin phoned from a nearby city to tell me that her sister had died... my grandmother's niece. This woman was the daughter of Mam-ma's oldest sister, Minnie. The visitation was scheduled for Sunday evening from 6:00 - 8:00, with the funeral set for Monday afternoon at 2:00. We knew we would be unable to attend the funeral, since Mam-ma had her physical exam scheduled for that same time period. To add to the "fun," a major snowstorm was forecast for Sunday - with snow predicted to begin around 5:00 p.m. in our area.

I told my grandmother there was no way we could go to the funeral, and I really didn't see how we could get to the visitation some 30 miles from home - I was not going to drive in the dark in a snowstorm! Sunday after church, I checked the forecast - snow was still headed right for us. I phoned my grandmother, and she said, "Well, I want to go to the visitation." I told her this was not an option. She had also mentioned she would like to go to my cousin's home and visit with family members. I offered to take her early in the afternoon to visit with family members, but we could not make the visitation work. She started to cry and said, "But I want to see EVERYBODY!" (This included all extended cousins and nieces and nephews she assumed would be at the visitaiton.)

We ended in something of a tense discussion with Mam-ma saying, "Just forget it... we won't go at all." I called my cousin and found out where the family had gathered, and I pretty much insisted we drive down for a visit. Mam-ma's comment was, "No, let's not." I asked why she didn't want to go, and she started to cry again, "Because I can't button my pants." Now I laughed. "Do you not have other pants you can wear?" "Well, yes!" This whole situation revealed itself to me when we returned from the visit and Mam-ma said, "I've got to come out of some of these clothes." She had put on thermal underwear, and the bulk prohibited her from being able to fasten the button on her pants! She found something else to wear, we drove to my cousins' home and visited for a couple of hours, and we barely got back to our own homes before the first flakes of what would be about a 4-inch snow began to fall.

Even with the snowfall, I was able to get Mam-ma to the doctor's office on Monday afternoon. He filled out his papers while we waited - an answered prayer - and I marked that off my list. Next would be DHS on Tuesday morning. The case worker began going through my papers and saying, "You'll need this... and that... and something else..." and each time, I'd say, "Got it! Here it is! Yes, that's attached." I have done this three times already over the last 7 years to admit my grandmother to the nursing home for rehab, so I know the drill... or so I thought.

I had gone to the bank and gotten an official print-out of the most current bank statement - for which the bank charged $2 - and I had all of the papers. Because my grandmother is "full Medicaid" - the case worker informed me that she cannot have any assets that exceed $2000. This includes cash, savings, checking accounts, insurance policies, and more. In the past, when Mam-ma went to the nursing home for Medicare rehab, I was told that a small life insurance policy she has did not count. In fact, I was advised to "leave it alone" because cashing it would give her excessive assets and disqualify her for assistance.

Now, it counts. We went back and forth, and I was not successful at explaining that my grandmother’s pre-paid funeral encompasses the burial insurance and it has no cash value. So I left the office with a January 21st deadline to return with proof that my grandmother's insurance policies had either been irrevocably designated toward her funeral or cashed and spent down below $2000 - and I had to have receipts to show how I spent the money.

I understand how some of this works. You can't just cash out your checking account balance and put it in your wallet. You can't write a check to someone and make a "gift." You have to "spend down" the money on things that can be shown... does your loved one need a new mattress or chair? a new coat? We bought things Mam-ma will need at Southridge... Ensure, Depends, new towels and linens, etc.

I left DHS and drove straight to the funeral home and got a letter that stated that there is NO cash value to the burial policies - they are irrevocably tied into the pre-paid funeral plan. Within 30 minutes, I was back at DHS handing this information to the case worker. I wanted her to know I am serious. She had told me that we would see if we could get this done so that Mam-ma can enter the facility on February 1st. If not, she said, "we'll work from February 1" - which means that Mam-ma would get another Social Security check which would have to be "spent down" - and basically, we would start over on the finances.

The other piece of the puzzle is an actual physical evaluation that must be performed in-home by a nurse who represents Medicaid. She has to say that my grandmother qualifies for Medicaid assistance in an ALF in order for us to get any Medicaid assistance... which basically means she determines whether Mam-ma actually can go to Southridge. I asked the DHS worker if she would go ahead and send out a nurse for this evaluation, and she said she would.

I determined that I needed to cash the life insurance policy. Since I knew that this would not happen overnight, I asked the DHS worker if I could drain my grandmother's checking account (showing a paper trail, of course) and prove that when the life insurance check comes, we will not have more than $2000 in assets. She said yes, this would definitely work.

So my goal for the rest of the week was to get the life insurance issue settled and "spend down" the checking account. I called the life insurance company to determine how to proceed, and I was told that they were not authorized to talk to me. "We have to have power of attorney papers on file... and we don't accept any power of attorney that is more than five years old." Mine was issued in 2004. I asked how I was supposed to work with them. The rep said, "I really don't know - maybe get a new power of attorney?" I told her I did not have time to do this before February 1st, and my papers were good enough for DHS and Medicare, so I wasn't sure why they weren't good enough for her company.

I told the rep, "I do not mean to offend you, but I am on a tight time line... is there someone else I could speak with who might know how I could do this?" She put me on "hold" and was gone a while, then returned and said, "We need authorization from your grandmother. I can mail her an affidavit to sign about the power of attorney." I explained we don't have this kind of time. While I was on "hold," I recalled talking once with another case worker at another agency who would not discuss my grandmother's case with me by phone, and we ended up putting Mam-ma on the line via my cell phone, and she authorized the discussion. I asked this rep... "What if you could hear from my grandmother that this is okay?" She said that would work. So I picked up my cell phone and dialed Mam-ma.

I told Mam-ma what was happening and that she needed to tell this lady on the other phone that she could talk to me. I held the phones together, and Mam-ma said, "You tell her anything you need to and ask her anything you need to." The rep said, "All I got was buzzing from the cell phone." However, she offered to conduct 3-way calling with Mam-ma if I could get Mam-ma to hang up, and she would phone her directly. We did this, and the rep asked Mam-ma (who had been napping), "What are the last 4 digits of your Social Security number." "Just a minute," Mam-ma said, setting down the phone and going to find her purse. She could not locate the Social Security card, and she did not know her number.

So the rep asked, "What is your mailing address?" Mam-ma could not remember. I finally prompted with the first digit, and she was able to give the rest. Then the lady asked Mam-ma her birthdate, and Mam-ma said, “November 5, 1912. “ The rep said, "No, that's not right." "Yes, it is," I interjected. "No, that's not what we have." I opened the original policy from 1970 and looked at the information. "I am looking right at the original policy, and the birth date is November 5, 1912." The lady insisted she could not help us because that was NOT what her records showed. Mam-ma became upset. "Well, I know my birthday IS November 5, 1912." I laughed and said under my breath to the rep, "Bet you don't get very many 98-year-olds on the phone, do you?!"

Finally the rep said, "Okay, Mrs. Chandler, is it okay if I talk with Debbie about your policy?" Mam-ma replied, loudly, "Sugar, you talk with her about anything you need to. It's just fine." The lady thanked her... I told her we would talk later, and Mam-ma hung up. I was able to ask two questions... what is the cash value of the policy, and how do I surrender it? The rep wanted me to FAX some info. I told her I do not have a FAX machine at home, but if I had to drive somewhere and find one, I could. She then said she would mail some papers to me for surrendering the policy. I explained again about our timeline, and I asked if she could FAX the papers to me? She said she could, but it would take a couple of days for her to request the proper forms to send by FAX. I told her that I would call two days later and give her the FAX number, and she promised to FAX the papers immediately.

This all came together on Thursday, January 13th. I took Mam-ma to the beauty shop to get a permanent, and I went to my old office to pick up a FAX I'd received there and mail the original insurance policy back to the company, via expedited mail. We also had to go BACK to the doctor's office to have Mam-ma's blood drawn - the lab tech was not in the office on Monday because of the snow. Thursday was a raw, bitterly cold and windy day, and by the time I got Mam-ma home, she was exhausted.

Oh, I forgot to mention... on Wednesday morning, my sister had called to say that their household had stomach flu. Timothy was recovering from it, but they didn't want him exposed again... could we keep him a few days? So Thursday, I left Timmy and my husband at home together for four hours while I ran errands with my grandmother. Timmy stayed with us from Wednesday morning to late Friday afternoon... and we loved every minute of his visit! I am blessed to have such a wonderful husband who steps in and does whatever is needed... and who loves Timmy as much as I do! And thanks be to God, neither of us ever caught the stomach bug!

So... I felt I had all of the T's crossed and I's dotted... I paid almost of my grandmother's last utility bills. I bought the Ensure and Depends and other items she will need. We saw the doctor and I surrendered the life insurance policy. I was within inches of getting all bills paid, receipts printed, and papers returned to DHS. The only “fly in this ointment” seemed to be the telephone bill, which is auto-drafted. In December, the draft was on December 17th, but by January 18th, there had still been no draft. I needed to know the amount of this bill to complete my spending.

I decided to get an online account and look at the billing. In order to do this, I had to submit Mam-ma's telephone number, and someone would call her within 15-30 minutes with a "code" that was needed to complete the login and password. I decided it was worth a shot, so I completed the process and called Mam-ma. "Someone from the phone company will call you in the next few minutes and give you a code. Have a pen and paper handy and write it down... then call me." "Okay," she said. More than an hour went by, and Mam-ma did not call me. I knew that my husband had been at her house to deliver her Meals on Wheels and change a light bulb. I thought maybe she got distracted. So I phoned. "Mam-ma - did anyone call from the phone company?" "No!" she answered. "Oh... wait! Yes, someone called, but she didn't speak English, and I couldn't understand her... then a man came on, and I thought it was a sales pitch, so I hung up." I told her that was okay, and I dismissed it. A few minutes later, Mam-ma phoned me... "I think I messed up." "No, Mam-ma, it's okay... don't worry about it."

Later in the day, I decided I really did need that phone bill info, so I thought I would try again. I called Mam-ma and said, "Okay, we're going to try this again. This time, if you can't understand the person who calls, just say so and someone else will come on the line. Write down the information they give you and call me." "Okay," she said. A few minutes later, Mam-ma phoned me... "That man said if you will call 1-800, you can get what you need." "One-eight hundred what?" I asked. "Just 1-800," she answered. "OKAAAAAYYYY!" I said! I decided to move ahead and pray the bill was drafted in a day or two. Soon Mam-ma phoned AGAIN... "Did you ever get what you need?" "Yes, Mam-ma, I have everything taken care of... thank you!" On January 19th, the phone bill draft appeared on the online banking account. Thank you, Lord!

Now I had all I needed. I wrote a letter to the DHS case worker, outlining all of the payments I had made. I printed out a current bank statement and attached copies of checks and receipts to prove that I had spent the balance. I showed proof of receipt for the insurance policy I had surrendered to the company headquarters in Kansas City. I still wanted to show the current cash value of the life insurance policy, and I also wanted to verify that the company DID receive it and all was well. So I phoned the life insurance company again… and again I was told they could not talk with me.

Cut to the chase… get Mam-ma on the line… have her tell the rep I can talk with her. AGAIN, the worker argues that the birthdate is not correct. She says her records show neither November or a five. I told her it sounds to me like someone entered the data wrong on their end, because I am looking at a copy of the original policy – which they now have – and it clearly says November 5, 1912. She said maybe the agent entered the date wrong. I pointed out that this policy was created in 1970 – on what appeared to have been a MANUAL TYPEWRITER! The bottom line was that I had to FAX my grandmother’s ID to the insurance company with proof of her birthdate. I was able to verify yesterday that this FAX was received, and hopefully a check is forthcoming.

Meanwhile, I phoned DHS and asked to speak with my case worker. I also got in the car and drove to DHS and left my letter and receipts. The very helpful receptionist date stamped everything and said she had discovered the case worker was not in the office that day, but she should be back in the office on Thursday, and my papers were atop the case worker’s desk for her review.

It took three days and several phone calls, but I was finally able to speak to my case worker, who told me she had not had time to look at my papers. I explained what I had done with the money. I assured her that there is no money left - I've spent it down and left receipts to prove it!

The case worker had told me on January 11th that she would go ahead and send a nurse to evaluate my grandmother. To date, no nurse has come. I asked if she could please send the nurse. She said that the nurses were doing double duty with another agency, and she just didn't know when the nurse could get there. I asked about the February 1st deadline, and I pointed out that we were in the midst of a second major snow event, and I am on pins and needles that my grandmother will try to get to her mailbox and fall and break a hip before I can get her admitted to Southridge. The case worker said she understood, but she said that she is the only Medicaid case worker available presently - the other worker has been ill and is on sick leave. She said there were several people ahead of us who have been waiting more than a month already.

I asked, "So your comment about getting this done by February 1... is that not still possible?" She was not sure. And she could not tell me if the nurse would be able to evaluate Mam-ma before the end of this month... "If I told you a date, I'd be lying," she said... "because I just don't know." So I do not know WHEN we will be able to move. I told the case worker, "I'm going to hang up and say a prayer." She laughed, but I hung up and did just that.

At this point, I have done all I can do. But I do not underestimate the power of prayer. I have not told Mam-ma that we might not actually move on February 1st. I'm believing that God will work in this situation and fill in the gaps now where I am powerless. If you want to agree with me in prayer, that would be great! Meanwhile, I'm washing new towels, labeling everything with Mam-ma's name, and preparing for the big move in 10 days. I'll let you know how it goes!