We're All In This Boat Together

Several times lately (twice in one recent trip to Wal-Mart), I have commiserated with others who are balancing the care of an elderly loved one with their own lives and responsibilities... and to some extent, the care of grandchildren or other little ones.  Some are dealing with similar issues to mine with my own grandmother - the challenges of aging, dementia, depression, and grief over the loss of peers. Just since the first of this year, five residents of my grandmother's ALF have passed away... and four of those were her close friends.  Another dear friend who lived across the street at the skilled care nursing facility died last week.

Losing five friends in less than five weeks is enough to drag anyone into a deep depression.  So it comes as no surprise that my grandmother has not thought clearly in recent weeks.  One of her table mates sunk into a deep depression over the loss of their dear friend, Ruth, who had been a next-door neighbor to this lady when they were still living at home.  I visited with the grand-daughter of this sweet lady one afternoon at Wal-Mart.  She said, "We could write a book!"  I told her... "My mom already has!"  I also shared a link to this blog, and she has e-mailed me to say she read several posts, and she felt better knowing that others were having similar experiences to hers with her own grandmother.

So I thought this would be a good time to mention my mom's book again.  It's called When Heads and Hearts Collide, and it chronicles much of the journey with my maternal grandparents, both of whom lived out their days in a skilled care nursing facility.  I have shared this book with several friends, and to a person, they have all said, "This could be me!"  So many of the themes of the book are universal among those caring for elderly loved ones.

I would also like to mention a phenomenon that is quite common among the elderly, and that is something called "Sundowning."  Information found at www.mayoclinic.com says that... "the term "sundowning"  refers to a state of confusion at the end of the day and into the night. Sundowning isn't a disease, but a symptom that often occurs in people with dementia, such as Alzheimer's disease. The cause isn't known."  The website lists several contributing factors:  fatigue, low lighting, increased shadows, and disruption of the body's "internal clock".

An article at AARP.org defines "Sundowners Syndrome" as "a cluster of signs and symptoms that occur as darkness falls. The onset can be abrupt and the behavior can have a paranoid quality to it. The person may have delusions they are being watched. Very often they become severely agitated and argumentative. It is common for them to lash out at their caregiver as well. There also may be pacing, wandering, cursing, yelling and hallucinations."

Not all people who "sundown" are what I would consider "elderly."  The husband of my mother's cousin is experiencing this condition in his early 70s, following chemotherapy for lung cancer and other medical procedures.  But the symptoms are very similar...and one of the worst for caregivers is agitation - often to the point of beligerence.  My mom's cousin said that during a recent episode, her husband required medication to calm him... and it took more than one person just to administer the medication.  This can be extremely trying for the caregivers and other loved ones who are standing helplessly nearby.

There are a couple of things that we should remember...

1. Fatigue may play a big role in "Sundowners Syndrome."  Ask yourself whether your loved one has been unusually stressed... perhaps hospitalized and out of the normal routine... or overly tired or run down from an illness or injury.
2. Don't take it personally... even if your loved one lashes out and says it's your fault.  Remember, your loved one is not himself/herself for whatever reason.  This behavior is not deliberate... nor something either one of you can necessarily fix.

I am continually surprised when I talk with others and discover how amazed they are to learn that others experience much the same thing.  There are a lot of you out there who are lonely and isolated... and this is really sad.  Look around when you visit your loved one.  Find someone who is visiting another resident and strike up a conversation.  See if maybe you can befriend each other.  If you know of someone who is dealing with much the same situation as yours, reach out to them.  We really are all in the same boat... and somehow, knowing that we aren't alone is of critical importance.

My  mom's book can help, too.  You can order it from her blog by clicking here.  Look on the left-hand sidebar for the order button.  And sometimes it helps to share your own story.  Please feel free to contact me and tell me about your experiences.  If you permit, I will publish some of them here.  Sharing your own frustrations and loneliness might be the turning point for someone else who is walking this journey... and maybe keep a few of us from jumping overboard!

Happy Mother's Day!

Thursday, May 5th, Southridge Retirement Center hosted a Mother's Day Luncheon.  Guests were invited.  I attended with Mam-ma Polly.  Because of the guests, the seating arrangements were something of a "fruit basket turnover," so we were seated at a different table than the one where Mam-ma usually dines.  Our table companions were a lady named Maxine, and a very nice gentleman from our community, Captain Claude Shaw.  Capt. Shaw is retired Navy, and he is a delightful man who has worked hard for several philanthropic organizations in our area.  After his retirement, he spent hours tending 105 rose bushes in his yard... and sharing the bounty with shut-ins and others throughout the community.  He was always buying bud vases at thrift stores and garage sales to use as vessels for his beautiful flower deliveries.


My Mam-ma Polly and me.

Before the lunch began, Mam-ma and I walked around and snapped some photos of her with a few of her closest friends.  One lady who was a guest of Mam-ma's friend, Mrs. Viola, snapped our photo, too!

Mam-ma's friend - Mrs. Viola - with her guest, Shirley.

Mam-ma Polly with her dear friend, Mrs. Viola.

My grandmother with her table-mates, Mrs. Evelyn
(a lifelong friend of our family), and Mrs. Ruth Garner
(my third-grade teacher, and a dear friend, as well).

The tables were set with tablecloths, nice appointments, vases of red roses and purple flowers picked from the beds that grace the facility grounds, place cards at each setting, and more.  Each mother received a carnation tied with a ribbon, and we all got candy kisses.  The meal included Waldorf salad, fried chicken, mixed squash, navy beans (which my grandmother calls "white soup beans" - and loves!), cornbread, and peanut butter pie.  The staff was busy serving coffee, tea, and water... and everything was quite lovely.

For the first time, my grandmother didn't have a SINGLE complaint!  The closest she came was telling me that she could not chew the apples in her salad.  Everything went well... she looked beautiful, the food was delicious, and the conversation was engaging.  Mam-ma had a great time visiting with Capt. Shaw... and long-time friends were seated at the adjacent table, so she visited with them, as well.

I realize that today could be altogether different.  Mam-ma is, after all, halfway to 99!  But I felt like we had significantly turned a corner yesterday.  I saw her engaged and active in her new surroundings.  I saw how the staff reacted to her as one of their more able-bodied - and clearheaded - residents.  They adore her... and she loves that!  Her needs are more than being met, and that is a huge comfort to me. 

Hopefully this trend will continue, and we can enjoy the next few years with each other.
I left her planning her next trip to Wal-Mart to buy gardening gloves, so that she can plant her prized pole bean seed as soon as the weather permits. 

I did feel badly for those mothers who had no guests to dine with them - and there were more than a few.  It seemed so sad to me that families can't find time to stop for a couple of hours and share an Easter or Mother's Day meal with their loved one.  I realize these special occasions have been held on a weekday, rather than on the actual holiday... perhaps because it's easier to have all staff members available to assist.  But still... could someone not come sit with these dear people on this day?  It astounds me.

The dilemma we faced this Mother's Day was a gift for my grandmother.  What do you get for someone with limited space and needs?  Mam-ma has enough cologne to last her several years. She has plenty of body lotions and toiletries... and she doesn't need clothing!  She doesn't have room for books... and the library has plenty of choices. Our solution was to give Mam-ma "spending money" to buy some things she wants... like gardening gloves... on the weekly trips to Wal-Mart.

But here are some suggestions for items that might be suitable for your mom or grandma:

• a big shady hat for wearing when he/she goes outside to sit in the sun or get fresh air
• cosmetics - incidentals add up, so if you know that your grandma needs extra face powder or make-up foundation, this might be a good time to replenish her stock.  Or fix a little basket with shower soap (or regular soap), toothpaste, shampoo, and a long shower brush for scrubbing.  There are some great plastic containers that are perforated - intended to be kept in the shower, yet allow water to drain - and they would be perfect as your "basket".
• note cards and stamps - if your senior is still able to send an occasional card - a book of postage stamps, and even some return address labels (even a sheet or two printed on your computer) would be helpful
• a subscription to a pretty magazine... Birds and Blooms, and Country Woman have been favorites of my grandmother.  They have little copy and lots of pretty pictures... and when she is finished with them, she can share with other residents.  Reminisce is another good one.
• a small photo album filled with family photos.  Make prints of some of your most recent photos of the family and start an album.  As you get more, you can fill in the remaining sleeves on subsequent visits.
• a decorative chain or lanyard to hold eyeglasses or the resident's "call button".  My grandmother doesn't like to wear her button around her neck, but if she had a pretty chain for it instead of the lanyard with medical advertising, she might be more inclined to do so.  And how many times has your mom or grandmother misplaced her eye glasses?  Perhaps a decorative chain to secure them - or one of the little pins that you can loop them through when not wearing them - would be in order.
• a large-print calendar, with important family dates (like birthdays and anniversaries) marked on them.  At the Easter luncheon, I was telling my grandmother about a funeral I had just attended for my cousin.  Mam-ma's friend, Ruby, said, "I'm so glad you tell Polly things and keep her informed.  If you don't tell us things, we lose touch."  Sharing important dates and keeping your senior informed can help to keep them aware of what is happening and feeling like they are "in the loop!"
• sunglasses.  My grandmother recently purchased a pair of sunglasses at Wal-Mart that slide on over her prescription glasses.  They are called "Solar Shields" and come in a couple of different styles and colors - retail cost is around $19.  She can slip these on easily when she steps outdoors... the clip-on style is too difficult for her to manipulate any longer.
• lipstick.  My grandmother still enjoys wearing a pretty shade of lipstick... and at around $8 or more a tube, this is not something she is inclined to purchase often for herself.  If your loved one is no longer interested in a lip color, consider a nice lip balm.
• Books on tape.  If your loved one has vision difficulties and can no longer see well enough to read, consider giving her a device that will play books on tape.  There are some fairly simple models available that most seniors can manage.  Check out http://www.amazon.com/ for options.
• a bird feeder and bird seed.  We put a small shepherd's hook outside my grandmother's window and hung a simple tube feeder.  My husband sometimes uses this as an excuse to drop by - he carries a container of bird seed and replenishes the feeder.  We also got my grandmother a simple book on songbirds and their care, so that she can identify what birds visit her feeder.  More than once, she has called me to tell me that a "hairy woodpecker" or a "red finch" were feeding there.

You have to think outside the box to come up with a suitable and clever Mother's Day gift for someone who lives in a residential facility... but it can be done.  While they may have plenty of food and the basic necessities, this doesn't mean that a gift and a simple card are not still appreciated - even coveted.  Our loved ones went to a facility to get the care and attention to their personal needs that was required.  The enhancements to their quality of living come in great measure from continued contact with family and friends.  Holidays are an especially important time to be sure to remember these dear seniors... and to give them a gift that says, "Happy Mother's Day - we still love you!"

Where's the Beans?

Einstein said the definition of insanity was repeating the same thing again and again... and expecting different results.  Maybe that explains why we have told my grandmother more than once that everything is gone from her house - sold/shared/donated -  and the house itself is under contract to be sold... yet she continues to ask where certain things are.  This is the same person who said as we packed the things to take to the Assisted Living Facility... "Just stick a match to the rest of it!"

So one afternoon last week, Mam-ma left a message on our answering machine... "It's Mam-ma... I was a wonderin' what y'all did with the stuff in the drawer of that cabinet out on the back porch."  Click.  That was it.  I called her back, but she was out of her apartment, so I left my own message.  "I am not sure what you are wanting from the drawer, but everything is gone.  There is nothing left in your house, and it should be sold in the next couple of weeks."

That evening, Mam-ma called again.  "Well," she said, "I was a lookin' for them bean seeds that were out in that drawer.  What did y'all do with 'em?"  I told her I had no clue... they did not come home with me. Now, I vaguely remembered my mom's husband, Lee, coming into the kitchen with an envelope or jar of beans and asking me about them... and I'm pretty sure I told him that there was no telling how old they were - and to toss them!  Mam-ma continued.  "Well, who got the things in the freezer?"  "We divvied them up amongst us," I told her. 

"Well, there was another jar of bean seed in the freezer.  I've called my friends Leon and Wanda - they give me that seed, but they don't have any more.  Their daughter Lesa drove to Clinton last week and got some for them... but I'm not a goin' to Clinton."  Her voice trailed off pitifully.  I told her I was not going to Clinton, either.  Clinton is a 45 minute drive across the lake from our community.  I told Mam-ma I was sorry, but the bean seed was gone... like everything else.  "Remember," I told her, "you picked out everything you wanted to take and keep, and we dispersed the rest.  I didn't know you would want bean seed." 

It turns out that the maintenance man at the ALF is helping Mam-ma and some of the residents make a garden... and Mam-ma apparently at least thinks she is "large and in charge."  She told "that girl" (I think she means the administrator), that they needed to plant pole beans, and this person said if she had some seed, James (the maintenance man) would plant them.  So Mam-ma was on a mission to find some bean seeds.  And apparently the ones she got from Leon were akin to gold.

When I related this story to my mom, she said, "I know what she is talking about.  Leon brought her an envelope of bean seed one Sunday, and he handed them to her at Sunday-school, and she quickly locked them inside her purse like they were gold coins!"  Of course, we found several jars and envelopes of seeds - some marked, some not - and we had no clue what some of them were - or how old they were - or even if they would grow anything.  So I am sure many packets were tossed in the garbage - not out of malice, but because we had no idea what else to do with them.

So the following day, my mother e-mailed me and said she had related this story to her husband, Lee, over lunch.  Lee stopped eating and said, "I have some seeds... if I can remember where I put them.  I'm not sure whether they came from Polly's or my brother's."  Lee's brother died a month ago in California, and he and my mom spent the previous month parked in his driveway in their RV... helping with the care of Lee's brother and the subsequent cleaning of his house when he passed.

Mom said she went to walk her dog, and when she returned, Lee had found the seed and was on his way to Southridge to give them to Mam-ma Polly.  Mom said, "I saw the envelopes on the kitchen table - and they were labeled in what was clearly Mam-ma's handwriting.  And I recognized one envelope as the one that Leon had given her at church that Sunday - it said "rattlesnake beans."  I remembered then... Lee had come into the kitchen and asked me about "rattlesnake beans!"  I told him I'd never heard of them... no telling how old they were or where Mam-ma got them... and to just toss them.  He told Mom... "I don't always listen well!"

So now Lee is the "Golden Boy" who saved the bean seed.  However, he will also be the one Mam-ma asks, "Whatever happened to such-and-such?"  Surely if he saved the bean seed, he must have saved other things!

As a footnote to this saga... yesterday, I went to an estate auction. As I was leaving, I saw Leon and Wanda approaching... and as I neared my car, I saw their daughter, Lesa.  I said, "Oh, I have a funny story to tell you!"  I began relating about the bean seed, and she said, "Yes, I know... I've got to dig through the freezer this afternoon and see if I can find another packet of seed for Polly."  I stopped her... "Oh...no, no, no!  You don't need to do that... Lee had saved the seed, and he's already delivered it!"  Lesa was thrilled.  And I was so happy at the Divine Intervention that caused us to meet, because I rarely see my childhood friend.  It had to be a "God thing!"

So we laughed about our parents/grandparents and caring for them, wiped our brows with relief that all is well with the prized bean seeds, and went our separate ways.  I told Lesa, I pity the people at Southridge who are planting that garden, because they will never "garden" to suit my grandmother.  If you've read this blog for any length of time, you know how she is about plants, flowers, and gardening.  James handles Mam-ma pretty well... he's already somewhat "gotten her number".  But when it comes to gardening, things are on a whole other level.  I hope he doesn't "rurn" it... but more than that, I hope Mam-ma doesn't cuss at him!  It may be a long, hot summer!