Some Days the Gap Seems Wider Than Others...

February 18... the phone rang around 2:30, and I recognized the number on Caller ID right away... the ALF.  The nurse told me that Mam-ma Polly had fallen and hit her head.  She had a nasty cut, and the nurse thought it needed stitches.  "Do you want me just to put her in my car and take her to the ER?" she asked.  I told her no... that I had signed papers saying that Mam-ma is not to go to the ER.  She said, "Then we need to call Hospice... and you can revoke those papers at any time."  I asked if I should come down to the facility, and she said, "It wouldn't hurt."

I was preparing for a workout, so I was not dressed.  I quickly pulled myself together and headed for the ALF.  I found Mam-ma with at least 3 facility staff members, sitting in her wheelchair beside her bed.  The workers animatedly began to tell me how she had "bled all over everything."  The bleeding had stopped, and she did indeed have a large cut above her right ear... just a little forward of the injury she received two Christmas Eve's ago on our driveway.  I saw blood on the carpeting and her oxygen compressor... but it did not seem excessive.

I told the staff that I realized it seemed like a lot of blood, but she bled so much more on our driveway - and she only had a small puncture wound from that.  The staff kept saying, "But she soaked an abdominal pad."  Yes... she soaked every rag in our house and the blood continued to run down the driveway.  This was not good... but I didn't see anything that I felt merited a trip to the ER.

We determined that an aide came in to ask Mam-ma if she wanted to attend a musical performance in the dining room.  Mam-ma was in bed at the time... napping.  She said she wanted to go to the performance, so the aide said, "I'll be right back to get you up and help you to the bathroom first."  Apparently, when the first note of music was played, Mam-ma helped herself up... and fell into her oxygen compressor.  The aide said when the first number stopped, she could hear Polly hollering... and she found her sitting in the floor with blood pouring.

The Hospice nurse came and cleaned the wound and Polly's hair - now read instead of it's beautiful snowy white.  The facility RN and two LPNs looked at her.  Neuro checks were ordered every 30 minutes for 24 hours.  Mam-ma basked in all of the attention.  The Hospice nurse lectured her sternly about not getting up without help.  Then she helped Mam-ma to the bathroom, and as they crossed the threshold, I heard the nurse yelling, "Wait!  Wait!"  Mam-ma had grabbed the rail beside the toilet and was already trying to help herself!  She will NOT listen - nor cooperate - and I am fully convinced that she knows perfectly well what she is doing.

I told everyone that when Mam-ma fell on our driveway, they did not suture the wound... they covered it with a gauze pad and wrapped her head like a turban.  It oozed and was ugly for quite a while, but it eventually healed.  A CT-scan was done, and she was given some pain medication she probably didn't really need - which made her woozy and very nauseous.  She spent two nights in the hospital... the first one vomiting every time they moved her.  For those reasons, I did NOT want to return to the ER.  Mam-ma seemed fine.  She was not complaining of anything.  The staff finally asked her enough times if she was in pain that she said "Yes," and they gave her one of her regular pain pills.  I told them, "If this controls things and she remains stable, this is the best option."  Some of them acted like I was Satan for not rushing to the ER, but I've quit caring about what anyone else things and now focus solely on what is best for Mam-ma Polly.  And this was best.

I stayed until Mam-ma was safely placed in the dining room for supper, and I left.  I told my husband later that I was totally exhausted... and I couldn't figure out why.  He said, "You spent two hours or more at Southridge!  That's exhausting."  And he is right.  It is... it was!

I knew fully well that my grandmother could have a more serious internal head injury - that she could even die in the night.  I was prepared for this.  After all, Mam-ma is 100+ years old and on Hospice... and she is living life on her terms.  I am done trying to add days/weeks/months/years to her life by artificial means... even medical ones.  I even wonder on some level if this stubbornness about getting up and around by herself is a self-conscious attempt on her part to speed things along.  We'll never know... Mam-ma couldn't tell me if I asked... and she might not even realize this herself.  I just know she is old and tired... and sick of living like this.

My mom visited Mam-ma the following day and could barely locate the wound, which had measured 1.25" long by .25" wide and seemed deep.  She came to see me afterward and said, "You definitely made the right call."  And indeed, she has not missed a beat since.  Cousins from Oklahoma visited on Friday, and she enjoyed their company and the chicken legs they brought her from KFC.  On Sunday, she could not even visit with me because she was so focused on her ham and turnip greens lunch... and Thursday, she was sitting under the hair dryer getting her weekly "do."

Meanwhile, I've been like a switchboard operator... trying to keep everything rolling along.  Mam-ma's laundry has been in a shambles of late, so I've spent the last two visits sorting her closet and drawers, looking for HER items and returning more than I can count that did not belong to her.  I've also been coordinating appointments for my niece with the elementary school to enroll Timothy in HIPPY, a program for preschoolers that helps the parents learn how to become more involved in the child's educational growth.

I've also acquired several children's car seats, cleaned them and washed their covers, so that my mom, niece and I all have our own equipment for transporting the children. This will make it easier for Mom to help out with caring for the children... and we won't have to be constantly shuffling car seats.  I feel like something of a rocket scientist now after removing all of the strapping and reinserting it in no less than six car seats in the last couple of months!  Once you get the hang of it, everything is pretty straightforward... but those first two or three were doozies!

In the midst of all of that, Timmy, Zola, my niece and I have battled some sort of upper respiratory bug... and we've had overnight visits from both of the two older children, which were a ton of fun.  I've also worked on finding a suitable Pre-K for Timothy for this coming August, and we've put out what seemed like almost-daily little "fires" of some sort between the youngsters and Mam-ma Polly.

In the "down time," we've tried to maintain a "normal" live... exercise, eat, sleep, handle our own personal business, and spend time together as a couple.  We even found time to attend our high school's local regional basketball tournament.  My husband's great-niece will be on the Senior Girls' team there next year, so we try to support her activities, as well.  It's been a very busy three weeks!

Shortly after Valentine's Day, my sister, niece and I attended a women's ministry luncheon with Mom at her church... the church in which we were reared.  Timothy and Zola spent this time in the nursery with three very attentive sitters who were thoroughly entertained.  Timmy returned the next day for Sunday school and "Wee Church."  When it was over, he did not want to leave... in fact, he cried!

While my husband and I now attend another church in town, I was delighted to see so many ladies I've known since I was a toddler.  It was great to see a mix of ages... from young mothers my niece's age to the ladies who are my grandmother's friends, and every age in between.  In my own church, we have created a "Middle Contemporary Praise and Worship" service in a separate building.  This service is held at 9:30 a.m. and is geared toward young families.  There are some grandparents who attend... and a few folks like my husband and me... but by and large, the age demographic is 40 and younger.

There are a lot of older church members who attend services at 8:30 a.m. or 11:00 a.m. in the sanctuary that I never see any more.  And that saddens me.  One of my friend's moms, who is 88, said, "We never see children any more."  When all three services were held in our church sanctuary, we at least saw each other in passing as one service ended and another began.  I am not sure what the solution is to this dilemma, but I can say with certainty that there is definitely a generational gap in our church... and we are smack dab in the middle of the Sandwich Generation on this one!  If you have encountered this in your own church setting, I would be interested in hearing how you are addressing it.

I share this information to emphasize that I am feeling "sandwiched" on all sides... and in most every area of my life.  And there are plenty of challenges on any given day.  Whether we handle them well or not remains to be seen.  I don't have time to quit trying... and you probably don't either!

There are dozens of aspects to this I would not trade for the world.  We absolutely adore our great-niece and nephews.  We take incredible delight in watching them grow and hearing what they have to say.  Nothing beats a hug, snuggle or a blown kiss from our little ones.  We revel in watching our niece and her husband learn more each day about how to be good parents and to nurture and encourage these babies.  And we are blessed to see the children enjoy the privilege of a close interaction with their great-grandmother and her husband, whom they call "Granny and Pap-pa Lee."

How many children can say they knew their great-great-grandmother?  While we have not taken them to visit Mam-ma often in recent weeks, Timothy and Zola HAVE visited... and I believe Timmy, at least, will remember her.  My mother's paternal grandparents died when I was in 5th and 6th grade or so... I still remember them and visits to their farm.  I know that Timmy, Zola and Nathan will remember visiting their Granny's home... and that is priceless.

So I keep on playing "Switchboard Operator" - arranging for Mom to keep one child while I keep another or so as my niece attends appointments or runs errands... scheduling visits to Mam-ma Polly and making sure that everybody gets where they are supposed to on time.  This is my purpose for this season of my life... and I pray God continues to give me the strength and energy to bridge the gap!

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

Are You Really That Busy?

My last post was one month ago today, and honestly, not much has changed in the last four weeks.  Mam-ma has had good days and bad, but mostly she has remained the same.  Her table-mate and a lifelong friend of my maternal grandmother, Evelyn, passed away on January 19th.  The nurse called to tell me - and to let me know that Mam-ma was having a major meltdown... uncontrollable sobbing...asking "Why not me?"  She said she was giving my grandmother an anti-anxiety pill to calm her. My little niece, Zola, was napping - and my husband was not at home to babysit.   So I called my mom, and she went to the ALF to see about Mam-ma.  When Zola woke up 45 minutes later, we went to the facility, also.

Mam-ma was sitting in the dining room with her other table-mate, Bessie, and Mom. She was subdued and never even mentioned Evelyn.  She did reach for Zola several times with a gloved hand.... fingers wriggling.  This scared my 20-month-old great-niece half to death, and she cried and cowered on my lap.  Mam-ma has always done this with little ones... she has no clue that she is frightening them.  It's her way of trying to amuse them, and it has a totally opposite effect.

I attended Evelyn's service last Monday, and afterward, I took the funeral program to Mam-ma.  Cousins had come to visit, so we chatted a while, and I left the program for Mam-ma to look over at a later time.  The administrator has advised me that she doesn't think Mam-ma will last long now that Evelyn is gone... she says she has seen it over and again.  The resident is physically fine but shuts down emotionally.  I thought this, too, but after this week, I think Mam-ma is taking Evelyn's death in stride like she has countless others in the last two years.  I honestly believe she could defy the odds and live another year or better... or she could be gone tomorrow. I've quit trying to second-guess it.

Meanwhile, we are up to our eyeballs in babies.  Zola spent two nights with us last weekend.  I had forgotten what it is like to chase a 20-month-old baby who doesn't talk in sentences yet!  She flits from one thing to another, has little to no interest in television or reading books, and loves to throw things!  On the up side, she is an angel at naptime and bedtime.  All I have to do is put her in the playpen, wind up a musical lamb, and she is OUT for the night or a 3-hour nap!  She also eats everything I feed her.  I have begun to wonder if she and Timothy are truly brother and sister, because he is totally the opposite!  BUT... he will occupy himself with blocks, a movie, or story books or puzzles for quite a while, and he can tell me what he wants and needs.

I love these babies, but when they go home, we are exhausted!  And we have yet to keep 6-month-old Nathan!  As I was leaving the funeral service last week, my piano teacher stopped me and asked if I was still teaching.  I'm not sure what she meant by that question, but I told her no, and she began to tell me how hard it is to find substitute pianists for church.  She really needs me to help fill in when she needs a break.  I told her I was absolutely too busy.  She wanted to know what on earth I was doing!  I told her I was up to my ears in babies and taking care of Mam-ma Polly, and she said, "Well, you could work up some pieces in your spare time and have them ready!"  I tried to tell her that I really don't have "spare time," and she looked at me and asked, "Do you really keep the babies that often?"

I had just dropped Zola off from her two-day stay that morning... in time to go home and shower for the funeral service.  Zola stayed two nights and 3 days because her brothers were sick with fever, and her mother wanted her out of the house in an effort to keep her well.  I took her home Monday morning, and she promptly ate a handful of dried cereal and threw up in the floor.  We were afraid she was getting sick, so on the way to the service, I stopped back by to see if I needed to pick up one of the boys ... or Zola... instead.  All were well, and napping.  We decided that Zola stuck her fingers too far into her mouth and gagged herself... hence the vomiting.  But I never know from one minute to the next when my niece will call for help with the children... or the facility will call with a problem about Mam-ma.  And it almost never fails that Mam-ma's problems occur when we have at least one child in our care.

Don't misunderstand... this busy, crazy life is full - and full of joy for the moment.  I really am at a comfortable place with my grandmother's care... save the fact that we cannot communicate and there is virtually nothing for us to talk about.  I have made peace with taking "busy work" to do while I am with her... or cleaning her apartment and sorting her drawers... or just sitting in the dining hall with her and staring at her smiling face.  And I love, love, love these babies and watching them grow and develop.  But this is just about all my husband and I have time for these days.  And we are 100% okay with that.


It used to bother me that others judged me... that people thought I should have time for church ministries, social outings or whatever.  But I am past that.  I don't know what is happening in their lives either.  I just know that mine is something of a roller coaster on occasion... and certainly never dull!


Table-mates Evelyn, Mam-ma, and
Ruth (my 3rd-grade teacher). 
Mam-ma is the only one still living.

I will end this post with a thought to ponder.  As I sat at Evelyn's service and listened to her grandson (who happens to be a Methodist minister) deliver the message, he spoke of how his grandmother always loved her family so deeply... and showed it.  This woman was in a coffee club with my maternal grandmother and great-aunt, my neighbor, and several other ladies.  These women were a huge part of my childhood... and some, like Evelyn, were lifelong influences.  Until just about a year ago, Evelyn never failed to kiss me when she saw me.  It didn't matter if it was at church,in a local store, or even at the ALF...she always greeted me with a kiss.  Now, I have no doubt that Evelyn kissed everybody... but she made me feel loved and important with this simple gesture.

I have thought about that a lot this week... how this single, seemingly insignificant act was filled with impact.  And I wonder... are we making such an impact on those in our lives?  Do we greet others with love and kindness?  Do we make them feel important?  Are we showering our children - and our elderly - with love and kisses?  Or are we so caught up in the "busyness" of our daily lives that we barely even greet one another?  I am determined to take a page from Evelyn's book... to make a concerted effort to offer up hugs and kisses - to the babies and children, to the elderly, to friends and family members - and to tell them just how much they are loved.  This should fill up any remaining "spare time" I might have.  I can think of no better way to spend it... can you?

Getting Your Face on a Smucker's Jar...

When it appeared fairly certain that my grandmother would live to see her 100th birthday, I did a GOOGLE search for Willard Scott and found his website and the requisite forms to complete for submitting Mam-ma Polly's name for consideration as one of the centenarians featured on Willard's segment during NBC's "The TODAY Show."  Sponsored by Smucker's, the celebrants' photos are superimposed on a Smucker's jelly jar label, and Scott tells a little something about the honoree. The information on the website stated that the forms had to be submitted at least six weeks prior to the actual birthday.  Since Mam-ma's birthday was November 5th, I sent the forms in early September.

The information also stated that either we would receive a phone call to let us know that our centenarian would be featured... or the honoree would receive a card in the mail.  Neither happened.  Shortly before Christmas, I cleaned off my desk... and I threw away all paper work related to this endeavor.  I decided I must have failed to complete the forms correctly or something. 

December 22nd, our telephone rang, and Caller ID said the number was "PRIVATE".  Since this is what shows when the Hospice nurses call, I feared the worst... but I answered.  The caller was a gentleman from Willard Scott's office.  He apologized for the delay, explaining that they were behind on airing the segments, but my grandmother was scheduled to be featured on Monday, December 24th, between 8:00 a.m. and 9:00 a.m.  He asked about our time zone, and I told him we were on Central Time.  He explained that the segment would air on the East Coast between 8:00 and 9:00 - and repeat for us the following hour.  He said, "Set your DVR for 8:00 a.m. to 10:00 a.m."  I set mine for 7:00 - 11:00!!

So I let EVERYONE know!  I made sure all televisions at the facility would be turned on and set to the appropriate channel.  My mom let the church administrators know, and they made a BIG SPLASH about it Sunday morning at Mam-ma's church.  I think everyone in our community of about 7,000 people sat glued to their TVs Monday morning... along with family members and friends from coast to coast.  And Willard Scott was not on.  They did segments on all sorts of things, from ugly Christmas sweaters to revealing the sex of a baby expected by an Olympic volleyball champion... but no Willard Scott.

So we regrouped and set the DVRs for Christmas Day.  This time, Scott was on... and a long segment aired, featuring several centenarians... but no Mam-ma Polly!  Would she ever be featured?  That afternoon, the phone rang again, and the same man apologized and said they were still very behind, and he thought that Mam-ma's segment would air on December 26th.  I told him how disappointed we were, and he kept saying, "We have no control over what they do... the segments are pre-recorded, and we don't know when they will air."  So we regrouped once again.

Wednesday morning, a friend posted on Facebook that she was spending the holidays in New York City, and she had just seen Mam-ma Polly on Willard Scott's segment!  So I started letting people know that we WOULD see the feature.  Sure enough, somewhere around 8:30 a .m., Central Time, Willard Scott's birthday feature aired... and there was Mam-ma on a Smucker's label!  Soooooooooo... in case you missed it... here is my Mam-ma Polly... now forever known throughout America for her peanut brittle!  I hope you enjoy it!  (Watch all the way... she's almost the last one featured!)

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They's a Lot Worse Things Than Dyin'...

All of my adult life, I've heard my Mam-ma Polly say this... "They's a lot worse things than dyin'..."  Now, it's her turn.  I had made plans to accomplish two things today... get the laundry done, and visit Mam-ma.  I started laundry, worked at my desk, then did a workout, showered and dressed.  Somewhere around 2:30 p.m., I headed for the Assisted Living Facility.  My mother had visited Mam-ma yesterday and thought she was pretty good... so well, in fact, that she planned to take Timothy and Zola to see her tomorrow.

Today was totally different.  The Hospice aide - and a dear friend of our family - was there bathing Mam-ma.  And the oxygen machine was running... hose strung across the room and into the bathroom.  Shelly (the aide) hollered to me, "She's really wheezing!" I told her she has been wheezing for a couple of weeks.  But Shelly said, "I could hear it when I got here." And I could hear it.  Shelly said, "I am wondering if I should have showered her... she's not doing good."  Mam-ma was shaking... and she had an ashy color.

Shelly got Mam-ma dressed in some sweats and insisted she get into bed.  Mam-ma started to protest... and even had Shelly put her in the wheelchair... but then she thought better of it and agreed she should be in bed.  Shelly stayed while I checked with the facility nurse.  When the Hospice nurse had visited around 1:30 p.m., Mam-ma's pulse ox was 80.  Normal for most of us is somewhere around 95 to 100.  They start to worry at 89-90.  So this was a low reading, hence the oxygen.

Mam-ma was clearly in distress.  She and I had a long talk, as she tried and tried to tell me something, but could get out no more than an "Oh, I want... or "Oh, I'm going..."  I asked her... "are you ready to go home?"  She raised up in bed, looked me squarely in the eye, and adamantly said, "YES!"  I told her it was okay to go... that we were all okay.  Then I began to tell her how my mom had said just this morning that some of her friends had announced to their children that they were no longer to prepare a big Christmas dinner... and that "honor" would have to transfer to the children.  At least one of those children said, "Fine!  We'll eat out!"

I reminded my grandmother of my cousin Carla, who died suddenly about a year and a half ago of a brain aneurysm at age 46.  Her parents went to a franchise restaurant one year for Thanksgiving, and she had a FIT!  I told Mom, I could see Carla's eyes rolling at the very thought that we would not have a home-cooked Christmas dinner.  Then our conversation turned to Christmas dinners... and who all would be sitting at our family's table in Heaven vs. the table here.  I told Mam-ma, "There will be a whole lot more of us there than here... and you should be with them."  She began to cry.  I soothed her and said, "Now, we're not going to cry about this... this is a glorious, wonderful thing, and you deserve to be with... (and I named everyone from her sisters and best friend to my grandfather, dad, brother, cousins and aunts and uncles who have shared our table's bounty - and our lives). 

Mam-ma settled fairly quickly... at least she stopped crying.  My sister and my niece arrived to check on her... and then my mom came.  As each person came, Mam-ma tried desperately to tell them things, clasping their hands, grabbing for their shirt sleeve, or cupping their face in her hand.  The only words I understood beyond the "I wants" and the "I'm going tos" was "Greg" - my husband's name.  Mam-ma has been very worried about my husband and me ever since we moved my niece and her three children home a couple of months ago.  I smiled and said, "Greg is fine.  We are both fine... and we're going to be okay.  You don't worry about us... we are both okay."

A few minutes later, the door opened, and my sweet husband came through.  He walked over and kissed Mam-ma, and she gripped his hand.  He was just what she needed.  The Hospice nurse told me to ask the facility nurse for an anti-anxiety pill for Mam-ma.  One hour later, she was still agitated... the pill had not worked.  The Hospice nurse had arrived to see for herself what was happening, and she ordered a pain pill for Mam-ma.  The facility nurse gave Mam-ma the pain pill, and about a half hour later, she was calm and resting better.

We decided to grab some dinner, and then I would return to the facility.  We were probably gone 45 minutes, and when I got back, aides were changing my grandmother and putting her bedclothes on her.  She was coughing more, and one aide took her vital signs.  The pulse ox was normal, thanks to the oxygen, but she now has a low-grade fever.  The Hospice nurse suspects she has some bronchial "something" going on.  BUT... as soon as Mam-ma was dressed for bed and settled, she drifted off to sleep immediately.  The aide on duty offered to come back after she finished her rounds and sit with Mam-ma until she was sound asleep, if necessary.  I sat with Mam-ma for about an hour, and my mom returned for a few minutes, as well.  Mam-ma never roused. Her brow has been furrowed in a frown all day... a sign that she is not comfortable... but she slept nonetheless.

So I asked the aide to be sure that Mam-ma continued to sleep.  Give her another anti-anxiety pill if she wakes, and don't encourage her to eat.  She refused supper... I'm hoping she will refuse breakfast. She had trouble swallowing water for her pain pill, and I do not want her to choke. I reminded the nurse and aides NOT to insist that she eat... to offer food, and let her decide.  The Hospice nurse, who is also a dear friend, keeps telling me, "You're doing great!  You're saying the right things.  You did well in talking to her.  Let her know it's okay to go."  So we are doing all these things.

This is not easy, by any means.  Mam-ma is right... "they's a lot worse things than dyin'..." and watching her like this is one of them.  While we were eating dinner, I told Greg, "I don't know why dying has to be so hard."  He reminded me that even though Mam-ma is ready to go... she is incredibly tough!  This could take a while.

Tomorrow, the Hospice nurse will consult her doctor and see if anything further can be ordered at this point to keep Mam-ma comfortable.  I'm hopeful.  Tuesday, December 18, will mark 80 years since my grandmother and grandfather married. My Pap-pa has been gone since August of 1984.   I would love nothing more than for the two of them to celebrate this anniversary together... in heaven.  I know I don't get to tell God how to run things... but I do believe He hears requests.  I'm just hoping He honors this one.

Making a List... and Checking it Twice...

This week, I had to sign a paper at the Assisted Living Facility saying we do not want any more antibiotics to be given to my grandmother.  When I went to the administrator's office to sign the paper, I noticed that there was also an option (with a check box) for not taking the resident to the hospital Emergency Room for treatment.  That box was unchecked. I  asked, "Don't we need to check that box, too?"  The administrator asked, "You mean you don't want her taken to the ER?"  "No!" I replied adamantly.  "Hospice has assured me they will keep her comfortable in her apartment, and she does not want to go back to the hospital... for anything! 

The administrator nodded and said, "Then yes... you need to check the box."  Now honestly, I assumed this was already understood... and covered by the fact that my grandmother is under the care of Hospice. I was wrong!  So while I would have been able to refuse an ambulance (if I were called in time), one very might have been called if necessary.  For instance, the day my grandmother had the "coughing spell," the administrator said she almost strangled.  Had she lost consciousness, I am sure they would have called 911.  When she broke her hip last spring, the EMTs had already loaded her into the ambulance by the time my husband and I arrived... and we live five minutes from the ALF!

I am sharing this information to tell you that you cannot assume ANYTHING!  Ask questions... be sure you know what is documented... and that all agencies involved are coordinating efforts.

In a different vein, I've had some "fun" with other agencies recently that I'd like to share.  I had it on my list to call the insurance provider for my grandmother's Medicare Part D and verify that all of her medications are covered by this company.  Believe it or not, after having to change companies some seven times in six years (including one year when Medicare just arbitrarily changed us to a company that we did not select - and one that did not cover Mam-ma's medications), we have been with HealthSpring for 2 years now... and we will be with them again for the coming year.  The Medicare.gov website showed that all medications were covered again.  But I like to hear it from the company to be sure.

So I called HealthSpring to verify this, and the rep told me that "I'm sorry, but I cannot discuss this with you, because I do not see your authorization."  I explained that I was my grandmother's Power of Attorney... I've been calling this company for three years now and talking about her case, and a copy of the Power of Attorney is on file with them.  She insisted it was not... I insisted it was, because I've always gotten this information.  The lady told me several times that she could not discuss anything with me.  I tried to explain that Medicare.gov says that all of my grandmother's medications are still covered by their company.  I was merely trying to verify this with HealthSpring.  Finally, the rep said, "Did you say she has been our customer for two years?"  I told her yes, this was correct.  She continued... "Then all of her coverage will roll over to this next year."  "All of her medications will still be covered?"  "Yes, they will roll over."  I thanked her and said, "That's all I needed to know."

Now for the record, this is not necessarily always true.  Just because a company covered your meds last year doesn't mean they will this coming year.  This is why we moved from company to company so many times.  Some of the medications my grandmother took along the way were quite expensive, and companies loved to drop them from the formulary as quickly as possible.  So when I would get the formularies for the coming year, those expensive drugs would no longer be covered.  I still don't know what happened to the record of my Power of Attorney... but at this point, I have what I need, and I'm not going to pursue it any further.

Last week, I tried to pay my grandmother's pharmacy bill online, and I put in the wrong password on the account and got locked out. Usually, I call an 800# for the main bank (in another city), give them the info, and they unlock the account. This day, I got a girl with attitude who told me that she could see I was listed on the checking account, but the online account was in my grandmother's name (DUH) and only SHE could talk to her. I said, "Look, she's 100, she's on Hospice, she cannot talk, and she is dying. I'm trying to pay her bills." The girl got pretty curt, and I asked to speak to someone else and she said there was no one else to speak to. So I had to set up a whole new login/password account in MY name... and I lost all of my auto bill pays. The girl kept saying, "Let me try to explain this to you in a way that you can understand."  Really?  By the time I hung up, I was in tears, and the girl said, "Have I explained this in a way that it makes sense?" I told her no... but not much of anything makes sense right now!

So THEN I realized that I had a $700+ payment going out the next day to the ALF. I got worried that if I set up billpay again, as this girl had said I should do... it might pay twice and make an overdraft. So I called back. Guess what?! I got a DIFFERENT girl, who was much nicer...but by then I had set up a login and password for myself on the account. She said, "I can't tell you anything, but if you ask the right questions, I can answer them." So we did determine that YES... that payment was still scheduled to be made, and had I put it in again, we'd be in the hole and have to pay an overdraft of about $30! So much for Customer Service!!  

I get that banks have privacy laws, but the first girl said, "You gave me your name when I answered the phone, and it doesn't match the name on the account, so I know you are not Polly." In other words, if I had lied to start with, she would have unlocked the account. CRAZY!  I gave her the last 4 digits of MY Social Security number, my grandmother's, and other vital information... and she could SEE me listed as a co-signer on the account... and still, she would not help me.

In her defense, this girl was just doing her job.  And I am glad that our banking info is secure.  But it was more her attitude and her unwillingness to work with me in any way.  I told my husband that I guess that LITTLE thing was what triggered my BIG meltdown. I'm okay now... just one more lesson learned. My mother suggested that I should have hung up, called back and pretended to be Polly.  It probably would have worked!  I'm just sayin'!

These are the types of things that make life for those of us in a "Sandwich" so challenging. As if we didn't have enough to do already, we have to deal with Customer Service reps who seem to go out of their way to make life difficult.  I know that this is often a ploy just to distract and deter the elderly.  Somehow, I think that bank CS knew she had not exactly made my day...but never once did she say she was sorry or act the least bit sympathetic. If this had been my mother-in-law or another older senior, the conversation probably would have ended much more quickly. 

You would think that after all of these years, I would be better at "playing the game."  And I had to laugh as I thought of the many times that a CS rep would not talk to me and asked to talk to Polly.  I would call her on my cell phone and hold it up to the land line receiver, and this little woman would say something like "Sugar, you just ask Debbie whatever you need, and she'll tell you."  Somehow, that was acceptable and believable.  Kinda makes you wonder, doesn't it?!

I'll Make Do...

My sister and I shared a Thanksgiving lunch with Mam-ma Polly the Tuesday before Thanksgiving. A few days after Thanksgiving, Mam-ma told my mom, "I don't know WHEN I've seen Suzanne (my sister)."  Mom tried to remind her that Suzanne and I ate lunch with her the previous Tuesday.  She argued that Suzanne was not there.  I snapped pictures of my grandmother and my sister... here is one.

A few days later, Mam-ma fussed that I didn't come often or stay long enough... and that "I'm seeing quite a bit of Suzanne."  I reminded her that yes, Suzanne works as an aide at the ALF on weekends, so she is there Friday, Saturday and Sunday nights.  That did not seem to register.

Last Tuesday, I went to visit Mam-ma.  She was in the hallway near the front door.  She said, "I'm lookin'... I'm lookin'..."  I asked who she was looking for, and she replied, "For YOU!"  I asked how she knew I was coming.  She couldn't tell me.

We returned to Mam-ma's room, and nothing was right.  She needed gloves from home.  I opened a dresser drawer and produced half a dozen pair.  I left some gloves and ear muffs on her table... was she wanting to go outside?  She shook her head, "No!"  I commented that it was realy too chilly anyway, but whenever she needed her gloves, they were there.

Mam-ma cried quite a bit, and told me, "I'm so lonesome."  She then told me, "I've tried to explain that I'm working on it... not being lonesome."  I told her being lonely is not something we overcome easily or at the snap of a finger... that I was sorry she is lonely, and I don't know what to do about it.  She replied, "You don't come often enough."  I tried to explain that I have a lot of responsibilities now... new ones with my niece and her husband and three children... my 86-year-old mother-in-law who had a mini-stroke this fall... my husband and my own household to run.  She cried and said, "I don't begrudge you these things.  I'm just lonesome."  It was a really, really bad visit.  Mam-ma spent most of the time I was with her telling me how I don't come often enough or stay long enough.  She was simply miserable.

The next evening, my mother took Timothy to see Mam-ma.  She had been asking for him and his siblings, who have been sick and unable to visit.  Mom said Mam-ma was overwhelmed... and overjoyed to see Timmy.  They didn't stay long, but Mam-ma was beaming.  Mom said, "It meant so much to her."

Friday, my husband and I collected Timmy and his 18-month-old sister, Zola, and brought them to our house for the afternoon.  We played with toys, looked at the Christmas decorations, and watched Frosty the Snowman and other videos.  Late in the afternoon when the temperatures warmed, we took them to a local park to play.  We had not been there long when my phone rang.  It was the nurse from the ALF reporting that Polly was having difficulty breathing.  She and the facility owner (who is an RN) had both listened to her chest and heard a rumble.  Hospice had been contacted, and the nurse said she thought the doctor would be consulted about an antibiotic.  Mam-ma was also retaining fluid... level 3 to 4, the nurse said.  She told me, "We'll see if the doctor wants to send her to the hospital for that."

I questioned the antibiotics for someone on Hospice and told the nurse we had agreed NOT to send Mam-ma back to the hospital.  She assured me that I did not need to come to the ALF...that she had given Mam-ma an Ativan to calm her, and everything was fine.  A few minutes later, the Hospice nurse called to tell me that the doctor had ordered a seven-day round of antibiotics, cough syrup, and a steroid shot.  Again, I questioned this, and the nurse said even if the problem was congestive heart failure (CHF) and not something bronchial, the medicine might help with her cough - and in that regard, keep her comfortable.  She also told me it would be fully understandable if I refused further medication.

So I visited on Saturday.  The nurse and I talked, and we both agreed that Mam-ma is - as she put it - "ready to go Home."  Mam-ma was coughing terribly, and wheezing audibly.  She complained that her pants were too tight, so I helped her change them.  These were also too tight.  I surmised she was retaining fluid in her mid-section.  An aide came in with a basket of freshly cleaned laundry, and I grabbed a stretchy sweatsuit.  The aide changed Mam-ma into the suit, and as I put her shoes back on her, I said, "I think I may need to buy you some more sweats."  She shook her head, "No!" and started to cry.

I questioned... what was wrong?  She cried more.  I finally asked, "Do you not think you will be here to wear the sweats?"  She stopped crying and took my hands and said, "I'll make do."  I took that as her way of saying she was done, and I nodded in agreement. I stayed a while longer and got Mam-ma settled for lunch, with the understanding that she would nap in the afternoon.  She had worn herself out changing clothes and coughing... and in fact, she coughed so hard at the dining table I thought she might trigger a heart attack.  The nurse had insisted that this is CHF... and if she does have something bronchial, she indeed does have CHF as well.

I struggled with this all weekend.  Mam-ma is like a doll that falls over, and we prop her back up with medication for a while.  She doesn't want to be here any longer.  We are not honoring her wishes.  So this morning, I spoke with our Hospice nurse/caseworker, and then I called the ALF administrator and told her that this will be my grandmother's last round of antibiotics.  She has indicated that she does not want further treatment, and I am representing her wishes... serving as her advocate and speaking for her, because she can no longer speak for herself.  I will sign a "compliance" paper that says that this is what we desire on my grandmother's behalf.

Late this morning, my mother visited again and found Mam-ma doing well.  Mom said her conversation was fairly pleasant, although Mam-ma cried about a few things.  She coughed some, but Mom did not think it was all that bad.  However, my sister attended an inservice this afternoon, and the administrator told her that I had requested that no more antibiotics be administered, and she advised... "She won't last much longer."  She went on to say that Mam-ma had a serious coughing spell this morning in the lobby, and a staff member had to dash to get a drink of water for her to get it stopped.

My sister also told me that Mam-ma has suffered from diarrhea since sometime Saturday.  We agreed that we are not ready to say "Good-bye" to Mam-ma... yet we know she is ready to go to heaven.  It's been a really rough week.  I have struggled with these decisions, knowing fully that my grandmother is tired of living.  I know that we could go to her apartment and ask her point blank, "Do you want to keep taking medicine?" and she might say "Yes"... then turn right around and say "No."  Her answers are no longer dependable... but her demeanor is.  And I am ready for her to be at peace.

My mom said that when she and Timothy visited a few nights ago, Mam-ma kept looking at him and saying, "I tell you what..."  Finally, Timothy said, "Tell me, Mam-ma!"  When Mam-ma Polly gets to heaven, she will be able to tell everyone what again... and that will be the best medicine ever for her.  Meanwhile, we'll handle whatever lies ahead... and do our best to "make do."