What is Wrong With People?!

Okay, so that's a rhetorical question, in case you haven't guessed. I told a dear friend of mine, "This is why I need Timmy!" Another friend referred to the baby as my "balance."

Tuesday, I got Timmy down for a nap, and my phone rang - Mam-ma Polly. She sounded AWFUL and said, "The nurse just left to go get me some pain medicine... this Ibuprofen is not doing enough." I asked what nurse... and she said Home Health. I asked WHAT medicine, and she said, "Darvocet." I then reminded her that about a month ago, Dr. B said "No more Darvocet," and I removed it from her house - so who prescribed this? She didn't know... but the nurse was headed to the pharmacy. So I called the drugstore, and the clerk asked the pharmacist, and he said, "That prescription has been sitting here for 5 days."

Meanwhile, the nurse arrived at the pharmacy (the clerk said "I think she's standing here at the counter.") and I explained that my grandmother wasn't supposed to have Darvocet, and this was all news to me, and I needed to talk to Dr. B. So the pharmacy people told the nurse there was nothing to pick up, and if there was something later, I would get it. The pharmacy clerk also told me that Calamine lotion had been ordered. I told her I had a bottle of Caladryl in my purse already to take to Mam-ma, and she said, "Well, you certainly don't need the Calamine, then... I'll tell the nurse there is nothing to pick up."

So... I called the clinic, and I talked to the receptionist, who happens to be the doctor's wife. That was before 2:30 p.m. She looked at Mam-ma's chart and said, "Last Thursday, the Home Health nurse called and reported you had had Polly to the ER on Wednesday and she was disoriented and vomiting. She is not disoriented today, but she is in pain. The doctor personally called in a prescription for Darvocet."

Nobody ever let me know about it - and nobody picked it up. I also told the doctor's wife that Polly was INDEED disoriented on Thursday, which is why my sister spent the night with her. So I don't know what story Mam-ma gave the nurse or how she acted. The doctor's wife acted very sympathetic and understood Mam-ma could not take Darvocet with Ativan, and she said she would talk to the doctor herself and call me back. No one ever called back, so at 5:00, I called the clinic again and was put through to a nurse. She said, "Well, we told the doctor you called, and I guess we assumed you were just wanting us to know you weren't going to pick up the Darvocet." I told her no... that the doctor's wife had said she would talk to him and call me back. The nurse started in about how Darvocet was the ONLY thing that would cut the pain of shingles, and "I can tell you, if she has shingles, she is in pain."

I told her I was really upset that Dr. B told us recently she was NOT to take Darvocet, and then last week he called in a prescription for it... and on top of that, nobody told me! So if she made it all weekend without the Darvocet, how bad did she really need it? The nurse repeated for the umpteenth time "All I can tell you is if she has shingles, she is in pain, and Ibuprofen won't cut it... she needs Darvocet." So finally I asked if there was anything in between Ibuprofen and Darvocet, and she said, "Motrin is not going to cut the pain." I reminded the nurse that my grandmother takes Ativan, and Darvocet and old people doesn't go well (much less with Ativan), and we couldn't risk a fall, and she said, "Okay, let me ask you this... do you live in town?" I told her yes, and that Mam-ma lives in town, but we don't live together. She said, "Well, why couldn't you go stay with her for a week or so while she takes the Darvocet?" I told her, "You just don't understand... there are extenuating circumstances, and no, I can't go stay and neither can anyone else. Besides, she doesn't want us there." The nurse said, "Well, then, couldn't you bring her to your house?" I told her again, that no, there were extenuating circumstances, like I live in a 2-story house (not to mention that I keep a 4-month-old baby that can't be exposed to shingles!). She said, "Believe me, I understand, but you have two choices - she can take the Darvocet or be in pain."

Finally I told her I would talk to Mam-ma and if we needed the Darvocet, I'd go get it. I called my mom, who had just gotten home from a trip to Branson, and we talked it over, and we agreed that Mam-ma's body is under stress from the pain, so I should go get the Darvocet. I did, and get this - her Medicare Part D wouldn't cover it, because Darvocet is not authorized by Medicare for coverage for anyone over age 64! So I paid the $13.80, and the girls in the pharmacy told me how shingles REALLY DOES hurt, but they were nervous about the Darvocet... although one of them pointed out it was Darvocet N100 and "very mild." Yeah, whatever... it's still Darvocet!

So I get to Mam-ma's with the Darvocet, and she says, "Well, I'm not takin' that!" So... tell me... why did I get it?*lol* I explained that her insurance would not authorize payment since she is 97, and she said, "I've never taken a whole one - if I get desperate, I might take a half, but I'm taking Ibuprofen every 3 hours instead of 4 and doing just fine." So what was the deal at 2:00, I wonder? I put Caladryl on her shingles and left. Her shingles have broken open and even scabbed over some, so they are moving right along.

So I went to Mom's to tell her this, and she asked me again if I thought Mam-ma could take TWO Ibuprofen at a time. I called my sister-in-law (who is a pharmacist) and asked her, and she said yes - every 4-5 hours, but not every 3. I told Mam-ma that, and she said she would do this if she needed them. I know her BP is up and this is hard on her heart to hurt, but I pointed out to the nurse that we didn't have that Darvocet all weekend because I didn't even know it was at the drugstore, and she made it just fine without it, and the nurse said, "Well, I can guarantee you, if all she had was Ibuprofen, she was hurting." In other words, we are all big heels for being so mean to Mam-ma! I don't think so!

So... Mam-ma has the Darvocets, but so far she has not taken any. My sister-in-law agreed that if Mam-ma isn't remembering to take Ibuprofen every 4 hours, she can't be hurting THAT much... not enough to need Darvocet. AND... she said there are 400, 600, and 800mg prescription strengths of Ibuprofen... so there IS something besides Darvocet! I'm still upset with Dr. B for not paying closer attention to this - and it bothers me that the Home Health nurses can go get medicine for Mam-ma without me knowing about it. Funny they can do that, but they can't take her to the clinic for a dr.'s appointment!

Wednesday, Mam-ma said she took 2 Ibuprofen the night before at bedtime and got a really good night's rest. Wednesday, she only took 1 tablet at a time, but said she would take 2 again at bedtime. However, she said her legs were wobbly - and she blamed it on the 2 Ibuprofen (more likely it was the whole Ativan tablet she took during the day on Tuesday after a half tablet the night before!). I said, "Imagine if you took the Darvocet!" She said, "Now that Darvocet doesn't bother me... and I only take a half a tablet..." But she assured me she would NOT take it.

It is so frustrating dealing with doctors. And I did not need a lecture from that nurse. I think it was a CYA thing, but nonetheless, I was not a happy camper. It just blows my mind the messes doctors can create... and I feel like Dr. B is avoiding me and giving me the runaround... and clearly he is not paying attention. But trying to change doctors at this late stage would be an ordeal, too... and I am not sure it would make any difference. I should have changed Mam-ma to my doctor years ago, and I can't remember for sure why I didn't, but I think she and Mom were not on board with it. Maybe my doctor didn't do rounds at our preferred nursing home. Such complications! Oh, well... If I am sort of on top of this and this much chaos occurs, can you imagine what happens with little old people who have no advocate? Sheesh!

Meanwhile, I did get my grandmother to the beauty shop yesterday, and she had made a grocery list... milk, buttermilk, orange juice, a big bag of Three Musketeers bars, corn meal, apples, and Cokes! I was surprised her Chips Ahoy Chewy Chocolate Chip Cookies were not on the list... hopefully she still has a stash! I dispensed her medicine for the next 2 weeks and noticed that it doesn't appear she has taken the doses correctly for the last week, but I'm not totally surprised by that. Anyway, she told me, "Before you leave, you can doctor my places again." So I donned a glove and applied a layer of Caladryl. And the shingles look amazingly better than even 3 days earlier. The red welts are gone, and all that is left is a little patch of scabbed places.

I asked Mam-ma if she was taking her Ibuprofen, and she said no - that she had not needed any all day! She said she was going to take some at bedtime, along with a whole Ativan. I questioned this, and she said, "Well maybe I will take a half a tablet, and if I wake up in the night and can't sleep, I'll get up and take the other half." My thought was, if you have to wake up in order to know you need another, do you really need it? Oh, well... she will do what she will do - even with us standing right over her - so I left her to her own devices. Hopefully she truly is on the mend, and things will start to look up from here. All I can do is try to keep tabs on her medication and pray that nobody does another "end-around" that results in a fall.

Shingles, Part Deux!

The lull is officially over. I realized Wednesday afternoon that my grandmother didn't have enough medicine dispensed to make it to Friday when I planned to visit again and buy groceries for her. I had decided to run to the grocery store and do a couple of other errands for myself, so I made plans to go by her house and do the meds at the same time. My sister Suzanne and her husband Mike were there picking up the okra and tomatoes Mam-ma had called and offered to me earlier in the day (and I had declined). They left, and I did the medicine and was about to leave, when Mam-ma suddenly shuddered and said, "Hand me the trash can, I'm sick." Boy was she ever. She threw up so hard she literally threw out her lower denture! It's sorta funny now, but it wasn't funny then. She fished it out and cleaned it later while I cleaned up the rest of her mess. So, I called Home Health to see what I needed to do, and they said, "Call her doctor." Mam-ma's doctor doesn't work on Wednesday afternoons, so I called back and said, "You have to help me. I think it might be her Valtrex." They said, "You need to take her to the ER... she could be having a reaction. We can't diagnose anything."

So, I got Mam-ma changed into some pajamas, because she threw up all over her clothes, and I called my Mom and Suzanne (both of whom were shopping) to alert them to what was happening, and we headed to the ER. Suzanne and Mike were still in town, so they met me at the ER. Mom had said she would come when she and her husband, Lee, got done with some shopping... she never made it, because luckily, we were in and out. We saw a great ER doc who has seen Mam-ma before, and he said, "She is having and adverse reaction to Valtrex... not necessarily an allergic reaction." He also said that Valtrex can sometimes speed up the healing of shingles, but it is not a cure, and it wasn't worth it in this instance. He says that shingles is "a nursing problem" and we just have to try things like aloe vera gel, Aveeno, Caladryl, etc. - whatever works and alleviates the discomfort. He also said Mam-ma is still breaking out, and that can last 2-6 weeks, followed by months of pain.

So I took Mam-ma home, and Suzanne's husband picked her up and took her home. Mom offered to spend the night last night because she and her husband are supposed to go to Branson for several days. So she said, "Let me help while I can." I stayed until she arrived about 7:15 p.m. She said she finally got my grandmother into bed around 9:00, but she was soon back up for chocolate chip cookies (Mom said, "I didn't know this was a night-time ritual." Neither did I, but I'm not surprised... I know I buy cookies nearly every week!)

The thing is, Mam-ma was totally out of it, and we're not sure why exactly. Her BP was very high - 182/83 at the ER, and then 201/94 at home. That is probably pain. She says she has barely been able to see for 2 days now - that everything is blurry and out of focus. And when my sister called last night to check on her, she told her she had shingles and had been to the ER. Suzanne said, "Yes, Mam-ma, I know... I was there." Mam-ma said, "Oh you were?" I was sitting beside my grandmother saying, "That's Suzanne you're talking to..." but she didn't realize it, I guess. It really rattled my sister, but mostly, it just concerned her how confused Mam-ma was.

She was so wobbly it was like she was drunk. And yet she was having a FIT because one of us spent the night with her. I was heating soup on the stove, and she hobbled into the kitchen on her walker. I looked around just as she took a step and lost her balance, and she braced herself on the stove... literally INCHES from the open flame. She never realized it. I quickly grabbed her hand and moved it. She thought I was just offering a gesture of affection and smiled at me.

So, today... I had planned to go with Greg this morning to some meetings with our broker and insurance agent. However, our phone rang before 7:15... it was my sister. She said my niece was dizzy and had possibly passed out at home... my sister and her husband were taking her to the ER... could they bring the baby to us? Of course! So by 7:30 a.m., I had Timothy in his crib here, and I had called Home Health and asked could they send a nurse to check on Mam-ma? They said they would.

Mom e-mailed and said Mam-ma fixed her own breakfast - she insisted - and Mom hoped that was a good sign. Then Mam-ma promptly threw up what she had eaten in the kitchen sink! Mom was upset with her... seems Mam-ma took her morning meds BEFORE eating anything and insists she does this all the time. Mom has harped on her for 3 days to eat BEFORE she takes any medication. At 97, what are the odds she will change?

So the day is only a few hours old, but it's already shaping up to be a crazy one around here. My sister had said she would stay with my grandmother tonight, if needed... that may be out the window. We're just taking it one minute at a time. I knew that lull wouldn't last!

I rocked Timmy to sleep in his crib and sang "Over the Rainbow" - his Uncle Tim's favorite song. Timmy smiled and looked at me with eyes that gently drooped shut. Even after he drifted to sleep, his mouth formed a momentary wide grin. A friend commented yesterday that "little ones provide balance." God must have known I needed balance this morning... and He sent a perfect angel my way.

Shingles Again!

Here we go again with shingles... this time it is my grandmother. A little over a week ago, I suddenly got sick on a Sunday. I think it was the flu, but I didn't go to the doctor for a test. Since the CDC recommends that those who think they have the flu stay home and follow standard treatments for symptoms of the flu unless you are high risk, I stayed home and in bed. Honestly, I didn't feel like doing anything else for a few days. So by the end of the week when it was time for my grandmother's beauty shop appointment, I had prevailed upon my mother to drive her there. Thankfully Mom was home and not away on a trip.

Meanwhile, there was a "big limb" on the roof of my grandmother's porch that was driving her nuts, and on Wednesday, my husband took his ladder and went to retrieve what turned out to be a very small limb. Mam-ma said, "Well, that's not as big as I thought it was!" While my husband was there, Mam-ma told him all about how sick she had been for three days with diarrhea... and then she offered him peanut brittle she had made that morning! He politely declined. He told her I was sick and in bed, and that my mom would be handling the weekly errands.

Later that day, Mam-ma called, "to see how you are feeling." When I told her I was still sick, she quickly moved on to how bad she had felt... she had just been so sick. I told her that I heard she was getting better, and she said, "Well, maybe." She complained of a pain in her side... "up kinda high under her shoulder blade, near her chest and down her shoulder a little." She told Mom the pain was "in my side."

Thursday, she called and asked if I was better. I told her yes, a little, and she immediately moved on to her ailments and how bad she had felt. Again she complained of this pain in her side. This time it had moved... down her side. It moved every time she told one of us about it. We suggested she pulled something - she insisted she didn't.

Saturday, Mam-ma called and asked, "Are you better?" I told her yes, I was slowly getting better. She said, "Well...." then after a short pause, she said, "Well...." and, knowing what she wanted, I asked, "Are you better?" She said, "Well, no I'm not." She began to tell me again about the pain in her side and all around... shoulder blade, chest, neck, shoulder. I suggested she had pulled something and didn't realize it... she insisted she had not. She said, "I tried to go to the doctor yesterday, but they couldn't see me." I asked if the doctor was in clinic on Friday, and she said, "Well I guess... they told me he was so busy I would have to come and just sit." I suggested maybe she would be better by Monday and reminded her that with so much flu, she really didn't need to sit in a clinic... that I personally knew people in town who had been told by clinic staff, "DO NOT COME to the clinic... we have too many people here with flu and you shouldn't be exposed." I suggested she rest over the weekend and maybe stay home from church, telling her I planned to stay home on Sunday.

On Sunday, my mother told me that Mam-ma was at church. I assumed she was better. Sunday evening, she called me and again asked, was I better. I told her yes. She said, "Well, I am suffering so. Something has got to be done." She said she was still hurting, and again, I suggested she might have pulled something, and she said no, and she added, "I think it's my colon and my bowels." I told her that IF she went to the doctor for that, he would put her through GI tests. She said, "Oh, I don't want that." I didn't think so. She kept saying, "You just don't know how I'm suffering." I told her I was sure that was true, but I didn't know what to do for her... especially on a Sunday afternoon. I suggested she try to call a nurse on Monday, even though it was Labor Day. Mom and I hoped someone might be "on call." I told her that I could not risk sitting in a clinic and being exposed to the flu... and she shouldn't be either. She did not like that, I'm sure.

Sunday evening, Mom called... "I think I know what's wrong with Mam-ma. She has just called, and she has a rash under her breast and around her back. I think it's shingles." We both agreed that was probably the culprit, and Mom told her to put some Kenalog cream she had in her medicine chest on it and call her nurse the next morning.

Labor Day - no nurses! Mam-ma was beside herself. She called me and said at least 3 times, "You just have no idea how I am suffering!" I told her I was sorry. I asked her, didn't she have shingles once before? She said, "Well, I thought it was shingles, and the doctor said it wasn't." I said, "Maybe this isn't either," and she yelled, "Are you KIDDING?!" I can tell you, this is shingles! We finished our conversation, and later I had to call her back to ask her something, and she answered the phone very strongly, as if nothing at all were wrong. As soon as she heard my voice, HER voice dropped, and she began to whine and almost cry. It's always like this.

Mom and I both told her repeatedly to call her nurses first thing Tuesday morning and see if the nurse could diagnose the shingles and call the doctor for her. Thankfully, that's what happened, and Valtrex was ordered. My mom went and got it for her. Mom said she suggested Mam-ma eat when she took the medicine. She reached in the refrigerator and got out a bowl of some kind of chicken -she said dumplings. Mom suggested that she eat a peanut butter sandwich. She said that was a good idea, and then began mumbling about she hoped she had crackers. And she reached on top of the refrigerator and sat down a box. Mom asked her if she wasn’t going to make a sandwich with bread. “Well, I could,” she said. And she did. Mom suggested that she always take the pill with half a peanut butter sandwich. Besides, that’s some extra protein for her. We will have no clue whether she follows through with that or not.

Tuesday night, Mam-ma called my mom and asked if she could take a whole Ativan - said she was hurting and the Ibuprofen was not doing the trick. Mom called me to consult, and I double-checked the medication list... yes, she could take a whole pill and go to bed.

So this morning, Mom phoned to check on Mam-ma, and the Home Health aide answered and indicated Mam-ma was not feeling well. Then I got a phone call - Mam-ma - and she sounded horrible (and also like she doesn't have her teeth in!), and she asked what I was doing today. I told her lots of things, and I asked what she needed. She said, "Well, I was wondering if you want to come get some okra and tomatoes." I told her no. She indicated she has had this food for a few days and couldn't remember who brought it to her. I told her I could get it Friday when I take her to the beauty shop. She said she would not be going to the beauty shop this week. I told her I would still come and shop for her groceries, and she said, "Okay, I will see you tomorrow." I pointed out that tomorrow is Thursday... not Friday. She said goodbye, but then I noticed it took her nearly a minute to hang up her phone. I'm thinking she may be overmedicated on Ativan - or hung over from taking that extra half tablet.

Meanwhile, we are keeping Timothy on Tuesday and Thursday afternoons while his mother attends her algebra class. He is adorable, and it's the best 2 hours of our day! He sleeps so peacefully, and when he is awake, he talks and laughs and smiles and KICKS! He is pure and unblemished and just plain fun! He is also even more dependent on us than a 97-year-old woman, which puts things in perspective. We are truly "sandwiched" these days... and it's an experience!

Are Home Health Care Agencies the Next Business "Bubble?"

Ads for Home Health Care agencies are all over the Classifieds sections of local newspapers these days. Not only are these businesses wanting you to hire their caregivers to assist you our your loved one at home, they want YOU to work for them! Suddenly, the market for Certified Nurses' Aides (CNAs) is huge, and training sessions are springing up everywhere to prepare those who wish to enter the workforce in this capacity.

This is good news, right? With so many people out of work, hasn't the boom in this market has come at a great time? The answer is both "Yes" and "No." CNAs can make between $7 and $10 or more an hour, working in nursing homes, assisted living facilities, and private homes. But not everyone is suited for this work. And therein lies one of the "rubs." Working as a nurses' aide is not glamorous, by a long shot. It is hard work, with lots of heavy lifting and sometimes unpleasant duties. While there are situations where CNAs care for delightful patients who are a daily joy, CNAs often clean some big bottoms and deal with every bodily fluid imaginable. Patients who are suffering from dementia may be violent, or at best, unpleasant and unruly. Facilities are notoriously understaffed, so a CNA may be in charge of the care of well over a dozen patients during a shift.

There are those who become CNAs because they truly enjoy the work... and/or, like my niece, they are working toward a nursing degree, and this job is great experience and helps pay the bills. For countless others, this is "just a job." The difference between "just a job" flipping burgers at McDonald's or stocking shelves at Wal-Mart and being a CNA is that CNAs are caring for someone's parents or grandparents. And let's be honest, we all want our loved ones cared for as well as possible. Should we come to a point where we need extra in-home care for Grandma or Poppa... or worse, they require nursing home care... we expect high-quality treatment. So we want CNAs who are working with our loved ones because they WANT to be there and enjoy caring for them... not those who needed a job and this one paid best. And we don't want this care managed by a company that is impersonal and cares more about the "bottom line" than the quality of services rendered.

While there ARE legitimate, well-run, caring businesses opening to provide caregiving services, particularly home health care, this business trend also shows signs of becoming the next "bubble." Our population is aging rapidly, and as baby boomers begin to get their AARP cards and enter the world of senior discounts, Medicare, and retirement villages, all sorts of markets are developing to meet their needs. And high on the list in the years ahead will be services and care that can allow seniors to continue to live in safety and good health within their own homes.

This trend has not escaped the notice of entrepreneurs who see an opportunity to start a new business venture and, hopefully, make a nice chunk of change. So we see Bob leave the real estate company where he was an agent to start a Home Health Care agency. He gets all of the requisite permits and hires a dozen or so CNAs to represent him and actually do the work while he manages the office. Sounds simple enough, right? Maybe... but this situation is ripe with opportunity for misstep.

A person with a good business "sense" and organizational skills may very well be able to surround himself/herself with qualified people who will "make the company look good." But suppose Bob doesn't have a Registered Nurse on staff or the consultation services of other qualified medical personnel. Who will check on the CNAs in the field to ensure that their work is appropriate, caring, and meets standards and guidelines for quality care? Will Bob have the knowledge and skills necessary to comply with all insurance regulations, bill clients fairly, and troubleshoot problems? Will Bob be genuinely concerned with providing quality care for his clients at a fair rate? Or will he charge $25 an hour, pay his aides minimum wage, and pocket the difference? Will the aides who work for Bob be experienced, caring, professional assistants? Or will they view their work as an hourly wage position that requires showing up, doing the least that has to be done, and collecting a paycheck to feed their family?

Do not misunderstand me. I am a huge proponent of home health care. Without this service, my 97-year-old grandmother would have been placed in a nursing home more than a decade ago, and I am quite sure she would not be alive today. Quality home health care is invaluable, and my grandmother has wonderful, caring, professional CNAs who see to her needs several days per week. Her aides work for an agency managed through our county health department, and Medicare pays for their services. Sadly, the aides do not get as much of the hourly rate paid by Medicare as I feel appropriate, but that is another debate completely. My grandmother's care also includes frequent visits by registered nurses who assess her health in-depth, administer necessary injections (B-12, flu, etc.), and notify her doctor when anything seems amiss with her physical well-being.

A private-care franchised Home Health Care company recently opened for business in my community, and all reports indicate that qualified, caring CNAs on staff are providing excellent care to local residents. The fee is $15 an hour. I have no idea how much of that is paid to the caregiver and how much the business pockets, but at such a low hourly rate, neither can be getting rich. But I am happy to hear that those in our community who need this service now have another option.

So what are we to do? When we find ourselves needing home health care... either personally or for a loved one... where do we turn? Here are some questions to ask potential Home Health Care provider companies as a starting point...

1. How long has the company been in business?
   
2. What is the owner/manager's background for operating such a business? Does this person have personal experience with Home Health Care?


3. Is this person a Certified Nurses' Aide and/or a Registered Nurse? Does the owner/manager have other medical background?
   
4. How large is the staff? What are the qualifications of the staff? Is everyone certified? Does the staff include nurses and other medical personnel? Is everyone properly certified and licensed?


5. What are the rates for services? Are staff members adequately compensated? Is experience and good job performance rewarded?


6. Are references available? Can current clients be contacted for feedback?


7. What is the mission statement of the company? Is the goal of the business to service its clients with utmost quality and care, or did this simply seem like a good new business arena to enter?

The Home Health Care business is just one of many that will "ride the bubble" of meeting the needs of an aging population. Others will surely follow... and this is a good thing. But we must be diligent in ensuring that our goods and services are worthy of our hard-earned dollars... and that our needs, and those of our loved ones, are met with care and professionalism. Home Health Care may indeed be a "business bubble," but it appears to be a service that is here to stay. How well these services are delivered will be mandated in large part by the recipients. Over time, we can hope that the cream will rise to the crop, and those wishing to merely make a quick buck will fall by the wayside.

All That Is Left...

This is pretty much all that is left of a family dinner that my grandmother prepared last night. She phoned me early afternoon and said she was preparing dinner for my mom and her husband, Lee - did Greg and I want to come? I told her I would check with Greg, and she said, "I don't know what you and your momma will eat (mom is diabetic - I have a corn allergy). I'm fixin' green beans, corn, sweet potatoes and a lemon pie." I asked her if I could bring some chicken, and she said, "Well your momma is bringing ribs. I told her I would just go out and get some ribs, and she said she already had ribs cooked." (How did Mam-ma think she would "go out" and get ribs? Mom says she never mentioned getting them to her... Mom offered to bring ribs, and Mam-ma accepted.)

I called Mam-ma back to tell her we would come for dinner and that I would bring some roasted chicken breasts, and I had checked with my mom, and she said she would take Mam-ma some potatoes to cook (Mam-ma's comment was... "I only have 2 Irish potatoes.") We hung up, and Mam-ma called back ... "You can't eat cornbread, can you?" "No, but that is okay," I assured her, and she said, "Well, now... I'm gonna make a pan of rolls, too." Now, for those of you who make homemade rolls, you know what a process this is! Granted, the more you do it, the faster you become, and Mam-ma has done it for 90 years, probably, but it's the stirring of that stiff dough that gives us trouble... and for someone nearly 97 with limited arm strength, it's a definite challenge - or should be. But as you can see, the results were light, fluffy, melt-in-your-mouth delicious... and she sent the leftovers home with us! Yippee!!!

Call #4 was to ask if my sister and her husband were babysitting grandson Timmy. I told her I didn't think so, and I asked, "Can you not reach them on the phone?" She replied, "Well, no, but I haven't tried... I wondered if they would want to come to supper, too." I told her to call and ask them, but... "do you have enough food?" She said, "Well... I don't know... but if we don't, at least we'll all be together." When we arrived, not only were my sister and her husband there, but my niece Jasmine and baby Timmy were there, too... and we had more than enough!

Such a seemingly simple thing as a family supper... such a day-long chore for the woman who prepared it. Mother and I cleaned the kitchen as Mam-ma tottered in and around us, finding containers for a "dab" of this and a "dab" of that to save as leftovers. I showed her the leftover roasted chicken breasts and broth I had brought and suggested she combine all of the vegetables with the meat and create a stew... a dish she seems to be enjoying of late because she can chew everything in it. The dentist says her jawbones are eroding after years of grinding food with her dentures, and her "teeth" now slip and slide and create blisters on her gums frequently. So she likes soft foods that are easily chewed, and the stew is hearty and nutritious for her. Mam-ma put everything into the refrigerator individually, but hopefully she will make a stew today.

One day I think that my grandmother is declining... and she is... and then I look at all she still does for "96 and a half," and I am amazed and bewildered... and extremely grateful. As she sat and held Timmy in her arms last night - all 15+ pounds of him - and never faltered, I thought, "Her arm strength may still surpass mine!" I was reminded that hard work is good for the body - and the soul - and we must never quit! I probably need to make more rolls... but then, that perpetuates the need for even more "work!"

So it was a good evening. We gathered, we ate, we played with the baby. We were together, and truly, it was enough.

All a Matter of Perspective...

I've been catching up on correspondence with others on the Caregiving forum at www.AARP.org... keeps me humble and helps me to appreciate the situation I have and how relatively well things are going with my grandmother - at least now. These posts and the genuine problems of others also point out to me that even when things are operating smoothly, my grandmother will somehow find ways to try to create a problem! Maybe she is one of those people who thrives on chaos!

Thursday we were headed down a neighborhood street as we returned from the beauty shop. We passed a tree service crew cutting pine trees in front of a home, and Mam-ma said, "I sure would like to have that cedar tree in my back yard cut. Ricky (my cousin) says someone who knows about electricity and all would have to to it." I reminded her that the tree is really my mother's to deal with, and that her plate was so full right now that I doubted she would consider it. (Mom owns the house in which my grandmother resides.) Then when we got out of the car, she pointed to that pine tree where her outdoor light and flower bed are, and she said, "And that tree needs to be cut down!" I asked why, and she said, "It's dead!" I looked at it, and it is NOT dead... and I told her, and she said, "Well, every time it storms, limbs come out of it." I told her that's just how pine trees do... every limb has green needles on it... it is NOT dead.

Mam-ma was fairly confused Thursday about a few things... she told me she had fixed a gift for a couple who is having a Golden Wedding Anniversary celebration - Bill and Gail - "you know, they are Sis's mother." Sis is actually BILL's mother! But I let that one slide. As I left, I voices talking. I started to get into the car and still I heard voices. I looked around and finally walked back into the garage, and Mam-ma was stepping out her door and talking away. I went back and asked what she was saying, and she said, "I was just wondering what you spent your money on." I realized she was asking about the birthday money she gave me a month ago. I told her "odds and ends... some scrapbooking things I wanted and such." She said, "Well... whatever (her reaction to many things)... I didn't know if you would buy something big with it or what." She gave me $40 and another $20 "for you and Greg to go out to eat." I felt bad that I couldn't tell her something specific I bought with it, and I said, "Hmmm...well...I bought a blouse yesterday, so maybe that was it." She said again, "Well whatever." I guess I should have made a point to tell her SOMETHING that I bought. Forty dollars is a lot of money to her, so it was a big deal. Maybe I can come up with something to show her that I've bought recently and say it was with my birthday money. I'm getting a thank-you card ready to stick in the mail. I will say this for her... she almost ALWAYS mails us a thank-you card when we give her a gift for her birthday, Christmas, or any other holiday.

Mam-ma had wrapped up a little china cup and saucer from her cabinet for the anniversary party, because they were rimmed in gold and it is the Golden Anniversary. And she had me buy two towels at Wal-Mart today for another shower on the 29th - for the daughter of her church's Minister of Music. We got them all bagged up and ready to go. It tok forever, but Mam-ma hobbled to her spare bedroom and gathered a sack full of gift bag options and another bag filled with tissue paper. In my opinion, little ladies like Mam-ma shouldn't even be concerned with taking a gift, but you know that would never fly! And Mam-ma was adamant that the wedding anniversary bag had to have a gold bow... "because it's the Golden Anniversary." So we got both bags filled, tissued and ribboned, and she was satisfied

Bless her heart... Mam-ma is just declining - no two ways about it. She looked awful when I picked her up, and she said, "I'm havin' this mess (her hair) cut off today." And the hairdresser did give her a short haircut, but it looks very nice. And she had not taken her medicine Wednesday night OR Saturday night. She said Saturday night she got busy with the wedding (and domino party that preceded it!). I admit, I should have thought to remind her to take her meds, since she went from that domino party to the wedding. But I don't know what happened the other night. She had complained almost the whole way to the beauty shop about how she didn't sleep the night before and kept getting up and reading and just didn't know what was wrong. I pointed out it could have been not taking her medicine... that was a Coreg for blood pressure, her Nexium for acid reflux, and her Synthroid for her thyroid. She said, "Well, I"ll take it tonight." I told her to only take the medicine for THIS night... not to try to make up for lost ground!

Mam-ma also had me get bow-tie pasta for her at the store... she said she can no longer roll out her dumplings for chicken and dumplings. My sister told me afterward that you can buy really good frozen dumplings at Wal-Mart. I didn't know that, but I will investigate. (My friend Karen is amazed that she is 97 and has eaten chicken and dumplings all her life. I pointed out she has also cooked with LARD! Longevity is obviously not solely about the diet!) I've made Mam-ma stew a couple of times with bow-ties, and she had never eaten them before, but liked them. She has pretty well NEVER eaten pasta in her life until recently, and she has always said, "I don't like spaghetti." I never even knew her to enjoy macaroni and cheese. But she asked if I thought the bow-ties would work for dumplings, and I told her they would not thicken like dumplings, and she said, "Well, I'll add some flour and water." So I bought her two boxes. I told her if she plans to have leftover chicken and dumplings the next day, don't add too much thickener, because the noodles will absorb liquid overnight. So we will see how this goes. I should be cooking for her more often... I say I am going to, and then "life" happens and I don't, but I must really make a concerted effort to do that.

So now my mom is home from her summer Workamping assignment, and Mam-ma is busy conjuring up things for Mom to do. It started with a funeral over the weekend that Mam-ma called Mom about and mentioned in a forlorn voice that "I should go, but I don't have a way." Mom didn't even know that my grandmother knew the person who had passed, but he was Mom's classmate, and she was going, so she offered to take Mam-ma along. Almost instantly, Mam-ma thought of several reasons she SHOULDN'T go... the heat, the crowd, and more. All she really wanted was to "yank the chain" a bit and make Mom feel like she was neglecting her! She did NOT go to the funeral. And Mom said she was completely miffed when she learned that Mom is going to Branson for a few days this week. Nothing changes for Mam-ma whether Mom is home or away, but she makes a really big deal out of it... I guess it has some "guilt" value!

Sunday at church, our new pastor was asking me what Greg and I do, and I told him that one of the on our list is to care for my 97-year-old grandmother who lives at home alone. He was stunned... "Ninety-seven, and she lives at home alone? I have to go SEE her!" I told him we could arrange that - that she is a hoot - but she attends the Baptist church. (We are Methodist.) He quickly shot back, "I don't care... I still want to meet her." I told him what I meant was that she will try to recruit him for HER church! He laughed and said, "That's fine... I still want to meet her!" So we will do that sometime, and I have no doubt that Mam-ma will ADORE Bro. Tommy. However, it will not score any points for her pastor, Bro. J.R., who is already "on her list" because he doesn't visit her at least once a month! Now, he probably sees her every Sunday at church, but she feels he should take time out from all of his duties to stop in and SIT with her for an hour or so at least once a month. I wonder... has she considered he would have to schedule an appointment between HER other visitors, phone calls and galavanting?!

So today I am praying for those on the Caregiving forum and others who are dealing with extraordinary challenges... like the woman who is trying to manage the care of her three teenage boys AND her 70-something mother who is physically debilitated and in need of daily assistance in order to function on a basic level in her home. I am thinking of those who are sitting in a hospital with an ill or injured family member, uncertain of the future, while their own family struggles to make it through the day back at home. I am thinking of a 50-something grandmother who is caring for her new grandson on the weekends so his mother can work, while she is also managing the care of her husband, who has cancer of the liver. Somehow in the scheme of things, wrapping towels and teacups, making a stew and writing a thank-you card for birthday money don't seem all that important.

Enjoy the Lulls...

We are once again in a "lull" at my house, meaning things are going fairly well for the moment, and I am not complaining! So last week I took advantage of an extra hour to check up on messages in the Caregiving forum to which I belong on www.AARP.org. If you have never visited this website and investigated some of the forums there, you should do so as soon as possible. Great information - great people and suggestions - a winning combination for all of us! As I read through the messages, I was particularly struck by the post from a woman who is the main caregiver for her 73-year-old mother, who is on oxygen, uses a walker, has arthritis, scoliosis, heart problems, and has been plagued by severe depression and anxiety all of her life. There is a housekeeper, but the daughter is basically trying to manage this woman's care. In addition, she is rearing her own three sons, who are ages 18, 16 and 12. The oldest son has suffered from depression since 4th grade, and the middle son has high functioning autism. AND... she has a job, as well! Feeling better about your situation?

This woman was inquiring on the forums about hiring a CNA for in-home care. Her mother was concerned that there would not be enough work for an aide to spend four hours per day with her. I was still trying to digest that she is only 73 and has such serious problems. My own mother celebrated her 70th birthday this spring just before setting out for a summer of Workamping at an Opera camp and conducting interviews in the area during her spare time for articles to contribute to the half-dozen or better magazines for which she writes. And did I mention that her fourth book has just been published?! So being so debilitated at age 73 blew my mind for a moment... until I remember how debilitated my own maternal grandparents were in their 70s.

I also thought of my mother-in-law who is 83 and has recently taken a train trip to visit her 100-year-old aunt in another state. Additionally, she restored four antique trunks in recent months. And we haven't even gotten to my grandmother, who is "almost 97," as she points out readily. Last week when I visited, she had cooked cornbread, green beans, and a chocolate pie (and we're talking scratch here - no pudding mix for her filling!). So this really made me stop and think about how relative age is... and how easily someone can end up in the "Sandwich Generation" - especially if the health of a parent fails early in life or suddenly. I am truly grateful for my own situation and the relative health and activity level of the seniors in my life!

Saturday, my grandmother played dominoes all afternoon with her "buds" - a group of ladies who are almost all in their nineties. The party was hosted by a sweet little lady who has to be in her eighties at best and suffers from some form of cancer that is steadily taking her life. She is taking chemo treatments and spent the entire week in bed, but she rallied to host this domino party - she said getting ready and preparing snacks and desserts kept her mind off how badly she felt! Mam-ma got home from the party about 4:30 p.m., and I picked her up for the wedding of a young friend of my niece's at 5:30. The bride has been like another great-grand-daughter to Mam-ma, and the family had delegated a special seat for Mam-ma at the wedding and the reception... next to the family. Mam-ma had a ball and when I took her home at 8:30 p.m., she declared,"I'm really not all that tired... all I've done is sit!" I bet she slept like a baby! And speaking of babies, my great-nephew Timmy made his wedding debut Saturday night. The photos are of him with his mother AND his great-great-Mam-ma!!!




















Speaking of family... the bride's mother is a single mom who reared this beautiful 19-year-old girl with the help of her parents. Now these parents are facing their own health issues and caring for their two adult sons, both physically and mentally challenged since birth and now in their late 40's or early 50's. Imagine planning a wedding while working nights as an RN and helping your parents care for these men and attend to their own failing health! I am thinking the mother of the bride may be ready for a straight jacket! And I am counting my blessings - aren't you?!