The Last Big Hurdle

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Wednesday evening, I got a response on an application I had submitted to a medical transcription service and I replied indicating my interest.  The recruiter had wanted to set up an interview, and I told her I would be home all day on both Thursday and Friday and that whenever suited her schedule would be fine with me.  I had just sent the email when my mom called, wanting me to go by on Thursday at noon to try to feed him lunch.  Needless to say, when I was trying to boot up my computer Thursday morning to check when the recruiter wanted to call, it wanted to download humpty gazillion windows updates, which took all of ten minutes, and then took another ten minutes to “clean up” afterword.  When It finally got booted up and had downloaded email, the recruiter’s email said that her Thursday schedule was all full, but that Friday would work, and wanted to know if she could call around 11 a.m.  I replied that that would be fine with me.

When I got to IH Thursday at noon, my dad was in the common room in one of their recliners.  He was lying there without his blankie and he was scooted down pretty far in his chair.  They had not put his teeth in.  He was talking but it was unrelated to anything going on around him.  He did know who I was, though.  I had brought the flower arrangement and a “double” picture frame with two photos, one of mom and dad on their wedding day, and one of them on their 60th wedding anniversary and put them in his room on top of the chifforobe.  I switched out the plug strip for one with an 8 foot cord, which worked much better.  The cord was long enough that the plug strip could rest on the bottom shelf of his table.

I got them to pull him up in the chair as he had scooted down so far that his knees were at the end of the foot rest. I got his blankie and covered him up, then tried to get him to eat some pudding.  He wouldn’t eat any more than one spoonful.  He did, however, drink all the iced tea in his sippy cup and then was drinking a cup of his coffee mix with half a packet of Breakfast Essentials in it.  I sat with him a while and then mom came.  We got the attendants to transfer him back to his own lift chair back in his room, where he was much more comfortable as the lift chair had a “gel” cushion in it.  He had finished the cup of hot coffee mix by the time I left.

Mom had talked with the home health service on Wednesday about getting dad on hospice, and when she came Thursday afternoon, she was waiting for someone from the hospice service to come by to see my dad either that afternoon or Friday afternoon.  He was approved for hospice Thursday afternoon, and by Friday, they had sent out a hospital bed with an air flotation mattress and gotten him settled in it.  A hospice nurse would call on him.

Friday, he was not gotten up into his chair at all, but left in his bed.  Mom got him to eat a little.  Saturday was the same.  The hospice attendant was to come by on Sunday as friends of my mom were throwing her a 90th birthday party at 3 p.m. on Sunday afternoon. (Her actual birthday is Tuesday) She went to church Sunday morning; then as the time for the party neared, the heavens opened up and we had a good ol’ fashioned gullywasher.

Typically in this part of the country, when we get rain, we get a lot of it in a short amount of time.  Our city streets are “sculpted” in such a way as to funnel the water into the storm drains; the storm drain system disgorges into a series of playa lakes that the city has set up in parks about town.  The “downhill” streets (or the mild inclines that pass for hills in this part of the country) have troughs at the intersections to lead the water past the cross streets and into the storm drains/playa lakes, and keep the water from pooling at the intersections. (These troughs have the added benefit of slowing down traffic in the residential neighborhoods.) During the actual storm and for about an hour after it, the runoff in the gutters and the troughs across the intersections can get quite deep and one must approach them with caution so as not to stall out one’s car.  Needless to say, pickups with high ground clearance are always tearing through the runoff and sending great rooster tails of spray onto the cars in other lanes as they pass — not just rude, but dangerous as it momentarily obscures a driver’s vision.  (Since my car engine’s distributor is up on top of a wheel well, I was not as worried about stalling in deep water as I was about getting doused by the rude pickups.)

I made it to the party without stalling out, and dashed inside.  The hostess had provided a beautiful two-tier cake with red roses made of icing decorating it, as well as a lovely bouquet with, among other flowers, lovely red roses.  The party was a great deal of fun, and my mom was in her element schmoozing with her friends.  My brother brought his violin, and played “Happy Birthday” while we all sang.  It was a lovely party, and a good opportunity for my mom to be “rallied round” by her friends, who provided her with some much needed moral support.  She had remarked more than once that the past week of having my dad in care had been more difficult for her than actually caring for my dad, a remark I totally understand.  It is very hard to let go.

After the party, I helped my mom load up the top tier of the cake, her lovely flowers, and the mound of birthday cards people had brought and I followed her over to IH to see my dad.  We cut a small piece of cake for my dad and left the rest of it for his caregivers to share.  My mom stood at his bedside and fed him the piece of cake and got him to drink most of a sippy cup of Ensure.  He knew her, but he wasn’t quite sure who I was.  As he always did, he told my mom how much he loved her.  He also mentioned his friend. “She doesn’t have a name so I gave her one, ‘Tallulah,'”  and talked briefly about her — we have no idea whether he was confabulating a real experience with a caregiver, or whether it was a delusion born of his dementia.  We stayed at IH for about an hour, then I followed mom home and helped her carry her cards and gifts inside.

My mom had a doctor’s appointment Monday morning, and I had one that afternoon, both routine well checks.  At about 10:45, my mom called on her cell asking me to come to IH, as there had been “an emergency.”  I hurriedly made sure the cats had ample food and water, got dressed to go out, and drove over as quickly as I could.  When I arrived at IH, a woman was about to ring the doorbell, and I let her in, since I knew the door code.  When I got to my dad’s room, there was a nurse I didn’t recognize standing at my dad’s bedside, and mother greeted me with, “He’s gone.”  A family friend had visited him earlier at about 9 o’clock and found him sleeping.  She didn’t try to rouse him.  About an hour later, one of his caregivers had checked on him and had found that he wasn’t breathing. She had called the hospice nurse and my mom.  By the time I got there, the hospice nurse had already determined that my dad had passed, pronounced him and was preparing to sign the necessary papers.  They also called the ministerial counselor,  who turned out to be the woman I had let in the front door.

My mom had been at her appointment waiting to be seen by her doctor when they called her.  As she went out to her car to go to IH, she got out her little list of phone numbers (like my brother’s home and cellphone numbers), only to have the wind snatch it away from her.  None of the numbers had been put in her cellphone (she doesn’t know how to do it, and never asked me to although I would gladly have done so).  Fortunately, I had some of the same numbers in my cellphone and was able to call my brother, EL, one of my dad’s nieces, and CK, who had given her the birthday party. My brother’s shop is closed on Mondays, and fortunately he was at home.  He quickly joined us.

The hospice ministerial counselor contacted the funeral home for us, and two very personable men from the funeral home eventually came out.  We left at that point as my mom didn’t want to see him being taken out.  I followed her to her house, and we began the task of notifying the family and making the arrangements.  I made my mom drink a bottle of Ensure, and later I insisted that she eat something, so she microwaved a chicken pot pie to eat.

It just so happened that one of my mother’s nephews, JP, who is her oldest sister’s son, had called last week and had wanted to come over from New Mexico to take her out to lunch for her birthday.  The day they had agreed upon was this Thursday.  Unfortunately, that is the day when my dad’s funeral will be held.  We tried calling him, but according to the message my mom got, the phone lines were being worked on and the call couldn’t go through.  In the meantime, the associate pastor of our church came by, as well as a dear family friend (who was born on the day my parents got married).

After the big rain Sunday, I had noticed something dragging underneath my car, and thought it might be a tree branch or a piece of trash, but while it was parked in the driveway Monday, my mother’s neighbor J, who is always so good to her, rang the doorbell and asked to speak to me.  Her husband had seen something stuck under my car and pulled it out.  It was, unfortunately, attached to my car.   I had planned to get my oil changed — I really needed to get it done before cold weather set in — so I put the piece of plastic in my car.  By then it was nearly 4 p.m.  I went on to get my oil changed — only to be informed there would be a 45 minute wait, so I went home and saw to the kitties, fixed myself a sandwich, called my friend JT, who had helped me take the table to IH for my dad, and told him the sad news.  The recruiter of the medical transcription service had sent me a job offer, which I went ahead and accepted.  (I’ll be working Friday, Saturday and Sunday evenings from 3 p.m. to midnight — starting this weekend! — and hope to work more hours later.)

When I went back to the ExpressCare, I was ushered right into the bay and got my oil changed and my car serviced.  The piece of plastic proved to be from the back of my bumper and was a very noncritical bit.  The Crayola is 27 years old.  So long as no important bits fall off, I’m happy.

Once I got home, I took refuge in housework, changing my bed and washing two loads of clothes.  Now I’m going to take my bath and try to get some sleep.  I’m meeting mom at her house at 8 o’clock in the morning.  We will go to IHOP for breakfast and then meet my brother at the funeral home to finalize arrangements.  My mom will have to take clothes for my dad to be laid out in, as well as provide information for the obituary (She already has one prepared for him and one for herself, with the pictures she wants of each of them, and has had them on file for a number of years.  My mom is very organized — and tries to be as prepared as she can be for any eventuality.)  The viewing will be Wednesday evening and the burial and memorial service will be Thursday morning.

Both mom and I managed to keep it together today.  I’m afraid if I lose it, mom will lose it (and vice-versa, no doubt).  I’m bracing myself for Wednesday and Thursday.  I don’t do well at funerals — even if it’s for somebody I barely know.  Thankfully, my weather widget shows no rain in the forecast for either day.  I have no idea what I’m going to wear.

 

One Hurdle Gotten Over, But Others Loom Ahead

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We got my dad to IH Monday.  I went over about 8 o’clock and he was lucid enough and mobile enough that mom had gotten him up and dressed and he was in his chair eating Malt-O-Meal. Mom had called IH about our change in plans. She had explained to him that she was no longer able to take care of him by herself and that we were going to take him to a place where he could get the care he needed.  It’s difficult to know how much of it he really understood, or how aware he was of things.  He seemed to accept what she told him.

We waited until about 10 o’clock for the going-to-work and going-to-school traffic to die down.  I had two suitcases and his shower chair in my car.  Mom had his transfer wheelchair, his walker and a bunch of bed linens and pillows in her car.  We got my dad in the car.  We got him in and settled in one of the really nice recliners they have in the common room, where they also had a TV on.  Once we got him settled, we moved all his stuff in and mom put his clothes and stuff away in the chifforobe that was in his room.  That and the little single bed they had provided until his hospital bed comes, was the only furniture in his room.

When she had gotten his stuff squared away, she came in and sat with him.  At one point he did ask, “When are we going to be done with this?” obviously meaning when were we going to put him back in the car and take him home.  My mom, in her instinctive wisdom, told him, “When you get stronger.”

I went back to my mom’s house to wait for the chair guys who were coming to move my dad’s lift chair.  While I was there, one of her church groups that she had had to give up when he got to the point where she daren’t leave him alone brought her by a meal.

Then his nurse JME from the home health agency called for mother.  I filled her in on what was happening and that we had decided to move him early.  We talked a bit and she broached the idea of hospice, which can provide a higher level of care for him, and when we came back to IH with the chair,  I told mom later that JME had called and had mentioned hospice, and that mom  needed to talk about it with her.

We got his chair moved in, and got it set up, and that one thing made things better for him.  It’s his chair.  He’s used to it, and it was a piece of home.  My mom stayed through lunch and trying to feed him, but he couldn’t chew the food, and coughed and choked per usual trying to eat and drink.   She stayed with him most of the afternoon.  She is still all in a heap about this, accepting that he needs to be where he is, but unable to surrender his care to others.  She knows in her mind that they are not going to provide the one-on-one care that she provided, but in her heart, she just can’t let go.  I can appreciate the struggle she is having.  He has been the love of her life for 69 years.

Tuesday, my friend JT came by with his pickup and we loaded the table I had covered with the table cloth on.  I led the way and over we went.  We got his table set up and it is just right.  I’ve known JT him for over 30 years (where does the time go?) and he is fighting his own war with grief, having suddenly lost his partner of 33 years two years ago.  It’s an uphill battle that cannot be won, only fought to a draw.  The three of us, mother, JT and I, sat and visited for a while.  We could not communicate to my dad who JT was, and at one point he though he was my BFF.

After I left, I went to get a piece of glass cut for the picture that fell off the wall, and then to get groceries, and I got in about 7 o’clock and put my groceries away.  I had told mom that I needed a day when I could sleep until I got tired of it, and that today would be that day.  I had a good long sleep with a long lie-in and I feel much better.  (If I could just get her to do the same . . . ) We had talked about “what day I was going to go over to IH and sit with him” so that she could have a day off, but we hadn’t decided which day that would be.

Our friend CK, who is throwing her 90th birthday party for her, had urged my mom to let them feed him, and to just go for a couple of hours at a time, but when she went by this afternoon, he was sitting in the common room in his undershirt and was “responding to internal stimuli” again.  (He was concerned that my mom had been put in jail because she had stabbed somebody.)  The IH attendants had put him in the common room so they could keep an eye on him.

He has hardly been able to eat anything since he’s been there, and he is no doubt dehydrated.  Mom took his dentures out (they don’t fit, they can’t be made to fit, and the upper ones fall down every time he opens his mouth) and was able to feed him some pudding.  She made the comment that he ate better without them, which is a no brainer, if you ask me.  All his dentures accomplish is to get in the way.  If they left his dentures out and fed him pureed food, it would be a lot easier for him and everybody else, and he would get more food, but he is so attached to having the dentures in, even though they are useless to him.  Personally, I think mom needs to bite the bullet and tell them to stop putting them in and leave them out all the time.  But I know part of the reason she doesn’t is that it makes his face look all sunken in around his mouth.  It’s hard to look at him like that, but there it is.

I heard about all of this new development when mom called me at about 4 o’clock on her cell phone and told me about it.  She sounded upset, which is not surprising, and she was clearly on a guilt trip about the situation (how could she not be?).  The IH people seemed to think that it’s partly due to the disorientation of being in a new place and the shock of bringing him there, but he’s been going in and out of this state for months now, and they have been slowly but surely increasing in frequency, which is what prompted putting him into care.  Lately, they’ve starting to happen at least once a week, and his periods of lucidity in between are growing shorter.  She had been undecided whether or not to go to choir practice, but she finally decided she was going to go, which she needs to do.  She has long-time friends there and she needs a little rallying around at the moment.

This whole business with my dad is and cannot be anything other than a no-win situation.

Now that we had gotten him in IH, and I was not having to be “on call” to go stay with my dad, I had put out some applications to medical transcription positions and I was right in the middle of answering a recruiter’s email to set up an interview when she called this afternoon. Mom insisted that I go ahead and take the job if it was one I thought might suit.  When I do interview, I’m going to just have to lay my cards on the table and tell them the situation.  I’m afraid we’re reaching the point where he’s going to go downhill fast.  Hopefully, arrangements can be made with hospice and/or the VA and things can be set in motion quickly.  My poor mom needs some breaks here.  I called her house at about 8 o’clock and left her a message to call me.  Right after I hung up from leaving her a message, I thought, she’s going to freak when she sees the message light on the phone, and I wish now that I had waited to call after choir when I knew she’d be home.  Oh, well.

Last night, I got a plugstrip with a longer cord — the plug is so high up on the wall and the cord on the one mom took over Monday is so short that the plugstrip just dangles on the wall.  I’m taking it over in the morning, as well as a nice placemat I got for the table.  It’s not for him.  He can’t see it.  It’s for the caregivers.

It was fairly clear for Monday and most of Tuesday, but Tuesday evening, it started raining again.  It was dark and lowering all day today, and about 5 o’clock, it started raining in earnest, complete with lightening and thunder.  It’s calmed down now, though.   Here directly, I need to take my bath and wash my hair, and then I need to commit a flower “derrangement” to put in my dad’s room.  Again, it’s not so much for him, as for the caregivers.  A way to say, we care, so you care, too.

I’ve had this earworm for almost a week now.  If you’ve got to have an earworm for a week, I can think of many pieces of music much worse than this little gem from Wolfie:

A Change of Plan

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Because my mom has been worried that my dad won’t be ambulatory enough and IH, the assisted living facility (ALF), won’t take him, the game plan of taking him over on Tuesday has been changed.  He’s going this Monday morning. He slept through the night Friday night and Saturday night, and he’s gotten a little more mentally alert.  He is responding more to us, and not nearly as much to things in his own head, and his responses are context appropriate.  Part of it is that my mom has been insisting that he drink more water, as dehydration has been part of the problem. That’s helped.  He’s also been eating better the past two days.  I went over Friday night and Saturday night to help get him to bed just in case he fell.  — He doesn’t actually fall.  His legs just give out on him and he crumples to the floor.  However, the result is the same.  He’s on the floor and it takes two people to get him up.  Fortunately, he didn’t fall either night.

I’m going over this morning bright and early at 8 a.m. to help get him up, get him dressed and to his chair for breakfast.  Then I will load the stuff that’s going in my car and we will take him out and put him in mother’s car.  He’ll go into the ALF in his transport wheelchair as he will never in the world make it up the long wheelchair ramp on his own. Once we get all his stuff inside and get him settled somewhere, I’ll go back to their house and wait for the lift chair guys to come get his lift chair, take it over and get it set up in his room at the ALF.   They’ll make sure it’s set up right and is working properly.

While I was over there a couple of hours ago ago (Sunday night; it’s now about half past midnight) and after we had gotten him in bed, mom said that she hadn’t mentioned anything to him during the day about going to the ALF tomorrow.  She said, “I just couldn’t do it.”  She is still wondering aloud, “I just don’t see how they’ll be able to take care of him.”  She has been taking care of him for years now, as he’s slowly but surely declined and required a higher and higher level of care, and she’s just so totally involved in it, that’s all she can think about.  In the last month or so, as his “bad spells” became more and more frequent, she’s spent practically every waking moment focused on watching him like a hawk lest he try to get up without help, fall, etc., etc.  Right now, she’s just running on nerves.  She is about six inches away from being a nervous wreck.

Frankly, she should have done this a month (or two) ago, while he was still fairly lucid most of the time, was still able to follow directions and required less help to get to his feet, but I think she just couldn’t face making a decision until circumstances forced her into it.  Now the combined stress of dealing with him and worrying about him, plus not getting good sleep has just worn her to a nubbin.  She’s running on nerves right now.  (Did I mention she’s a Virgo and is a born worrier?)

We’re in the  home stretch.  Now, if we can just get through Monday, Monday night and Tuesday.

I’ve been spending so much time at my folks house here lately that when I come home, I get clustered by kitties.  After Tuesday, I don’t have anything on my schedule until Sunday the 21st, which is my mom’s birthday party, and my yearly checkup at the VA on Monday.

The weather has been rainy and cool for the past week or so and is forecast to remain so at least until Friday.  We’ve really needed the moisture and having the cooler weather has been a refreshing change.  Fall is upon us, I’m afraid. The equinox is week after next.

Now that Dad’s going into care, I’m going to start looking for a medical transcription job.  I talked with the benefits counselor, and as long as I don’t make over $15,000 a year, I can work full time without impacting my retirement benefits, which is good.  A full time position is easier to find than a part time one.  Seeing as how the Crayola turned 27 this past May, it would behoove me to start a new car fund.

 

An Uphill Climb

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As I mentioned, at his doctor visit Thursday, my dad got a flu shot — and a very mild case of the flu as a reaction to it, as can happen even with robust, healthy people.  However, balanced on a knife edge as his functional status is, this minor reaction made things very problematic for my poor mom.  He had a bad night Thursday night, got up to go to the bathroom and fell.  Mom had a choice of calling 911, and getting an ambulance and a fire truck, two emergency medical techs and four firemen out to help her get him up, or calling the neighbor lady J, (who is a saint, by the way, and so good to my mom).  J, bless her, came over at 1 a.m. and they got my dad up and back in bed.  Friday morning, she like to never got him to his chair.  I came over, per SOP* to stay with him while she went to the beauty salon, got her car serviced, and got groceries.  It was an ordeal.

She had put a pad on him, which he soaked, as well as his briefs and pajama bottoms.  I changed pads three times (small payback for untold numbers of my diapers he changed!).  He unbuttoned his pajama shirt because he was hot, and all the time, he was responding to internal stimuli — and most of the time his false teeth, which don’t even pretend to fit anymore, made what he was saying unintelligible as well as incomprehensible.  Around noon, mom took his temperature and he was running a degree or so of fever, which is not surprising.

I ended up staying the whole day Friday until the home health lady came at 4 o’clock to give him his bath.  Mom and I got him to and from the bathroom one and 9/10ths trips.  The second trip, he missed the chair and ended up on the floor.  (We both had hold of him at the time, so it was a “controlled descent.”)  Between us, she and I were able to get him back in the chair, but he scraped the skin off a place on his back when he missed the chair.  Once the home health lady came to give him his bath, I went home to get some supper, tend to the kitties, and try to do a little work, but I went back at 8:30 to help her get him from the chair, to the bathroom, to bed — thankfully uneventfully.

My poor mom has been beside herself.  He has to be ambulatory, or the assisted living facility won’t take him.  She’s worried herself into a tizzy because she’s afraid he won’t be ambulatory enough, they won’t take him, and then what will she do?  As I pointed out to my mom several times yesterday, in the ALF, he will be required to walk at most 12-14 feet round trip to get from his chair to the en suite bathroom of his room and back, versus the 150+ foot round trip  he is required to walk from his chair in the den to the en suite bathroom back in the back bedroom at home.  He was able to do that nearly twice Friday — although it took both of us, me in front leading the walker and her behind him maneuvering, to accomplish it.

They’re going to have to get him into the ALF in a wheelchair anyway because he’ll never be able to negotiate the wheel chair ramp.  Tuesday is three days away.  He’ll be over his reaction to the flu shot by then.  Now if we can just get him into the ALF before my mom worries herself into the hospital.  Once he’s in, he’s in.  There’s a thundershower icon on my weather widget forecast for Tuesday.  I just hope it’s not pouring down rain while we’re trying to get him from the car to the wheelchair to get him in the ALF.

IMG_0849It’s been chilly and rainy here for the past couple of days, into the 60’s F/15+C to 70’s F/20’s C here.  Looks like Fall is upon us.  It’s supposed to be cloudy and rainy Monday and Tuesday, but up into the low 80’s F/24+C Monday.  Our predicted low for tonight is 56F/13.3C. I made my first carafe of hot tea of the season this morning (and the first in my new digs — another milestone!) I’m also wearing socks for the first time this Fall.  I’ve still got a summer house dress on, but I’m wearing my circular shawl.  Making it was time well spent.

I haven’t spoken to my mom yet today, but last night, I started transcribing a 1 hour and 57 minute long document which, once submitted, will net me nearly $100.  I need to get it finished and submitted before 7 pm today so it will fall into this pay period (which is deposited Monday) and I can pay my electric bill on time.  I’ve got 11 minutes of it done, but there’s still a long way to go, so I need to get cracking.

 

*Standard Operating Procedure

Tuesday Is The Day

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Mom has made arrangements for the lift chair guys to come get his chair Monday afternoon.  They will take it over to IH, which is the place he will be going, move it in and set it up, and make sure that it operates properly.  She’s going to have dad sit in her chair for the duration. Then Tuesday morning, we will take dad over to IH.  The home health people won’t be able to get him a bed until week after next, but they have an extra one at IH that he can use until the home health people can get one in.

IMG_1726Fortunately, I never got around to putting an ad in Craigslist for the end table that I’m no longer using as a printer stand.  I had two tables just alike, but the other one was donated to the world shortly after I moved in and saw that I would not have room for them.  This one was in my office being used as a printer stand and as a place to put the plastic file storage box where I was having to keep my personal files because the movers tore up my filing cabinet.

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Now that I have a nice new metal filing cabinet (see right), I don’t need this table any more. It will be perfect to go beside dad’s chair.  It’s nice and big, and it’s just the right height to fit right up against the arm of dad’s chair so when he tries to set things down on it, he won’t miss the table and have things end up on the floor — especially one of his sippy cups full of cappuccino*.  I cut a piece out of one of those vinyl tablecloths that was big enough to cover the top of the end table, turned the end table upside down on top of it, and “upholstered” it onto the top of the table using my staple gun.  Now, if something spills on it, the table top will be protected and the spill can just be wiped up. There will be plenty of room on it for a box of tissues, a lamp, his radio, and whatever else needs to go there.

Alas, the table is too big to fit in my car (it came over in the mover’s truck with the rest of my furniture). One of our friends with pickups has been recruited to come pick it up at my house and bring it over to IH on Tuesday afternoon.  I’ve not seen the room, so I don’t know how it’s to be set up.  I am assuming that there will be room for it — the top is 23″ x 27″ in size.

This afternoon, we took dad for his assessment and checkup, got him a flu shot, and got the prescriptions that the home health agency will require for his hospital bed and bedside commode.  The building where his doctor is located is “wheelchair accessible” but the wheelchair ramp is halfway around on the other side of the building.  Pushing a wheelchair from the ramp clear around to where his doctor’s office is would be no big deal, but to expect a man who’s doing good to be walking at all to walk such a distance is absurd.  So, instead, we have to park as close to the doctor’s door as we can get, and then we have to get his rolling walker and then him up the curb and onto the walkway (he nearly fell going back to the car).  It’s a real challenge, especially since he is functionally blind and can’t see where he’s going, he’s is hard of hearing, and even when he can hear the directions, he doesn’t always understand them. Of course, I was late to the party, so to speak.  I only helped get him in and out of the car at home and at the doctor’s office.  My mom had already gotten him dressed and ready to go.

Today just underlined the necessity of getting him in care. It’s a struggle to get him in and out of a chair never mind getting him in and out of a compact car, and maneuvering him over curbs and past obstacles like “airlock” entrances into buildings.  When we got home and got him settled back in his chair with his blankie on and a cup of cappuccino to hand, mom made the comment that she was exhausted — she had mentioned earlier he’d gotten up three times to go to the bathroom during the previous night, and whenever he gets up, she has to get up to help him, so her sleep suffers.  And, needless to say, she sleeps with one ear open, so what sleep she gets is of poor quality.  She also made the remark that she lay awake during the night last night worrying about what kind of care he was going to get at IH.  No wonder she’s exhausted.

The next big hurdle is going to be getting mom to surrender his care to the attendants at the IH. Her main worry, and she has expressed it several times, is that he will be in his chair, decide to get up, attendants will be busy elsewhere and/or or won’t notice he’s gotten up, he won’t be able to see where he’s going or what he’s doing, and he’ll fall and hurt himself.  It’s a legitimate concern and one that IH will have to address to her satisfaction. Even though the attendant to patient ratio at IH is low compared to larger facilities, the attendants can’t be everywhere at once.  At night, he will be in a bed with side rails, and won’t be able to get out of bed, but during the day, when he’s in his chair, he’s always just gotten up when he decides he needs to without letting anybody know he’s getting up (hence the need for her to be constantly vigilant).  Mom has never been able to get him to quit doing that.  Then there’s the communication problem.  His hearing is so bad that in the first place, it’s difficult to know if he’s accurately heard what you said, and in the second place, even if he has heard you accurately, it’s problematic as to whether he’s comprehended what you meant.

Frankly, as dementia patients go, my dad is way, way over on the innocuous end of the spectrum (touch wood!).  He gets confused, and responds to internal stimuli, but his response is mild and easily redirectable.  He doesn’t yell or curse.  He’s not combative and he’s not argumentative or obnoxious.  He doesn’t really have any problematic behaviors except his penchant for suddenly deciding he needs to get up.  He spends 90% of his time sleeping.  Compared to most dementia patients, he’s a sweetheart.  He is usually verbally appreciative when people do things for him (or at least he is toward us — and knowing how good his manners have always been, he is likely to be so toward the IH attendants) and it’s just human nature to be a little bit more attentive when your efforts are being acknowledged and appreciated.

Mom is going to have to come to terms with the fact that dad is not going to get the one-on-one level of care she’s been giving him.  It’s just not going to happen.  The job she’s paying them to do is to keep him clean, fed and safe. It’s a job they are trained for, and have experience doing.  The IH attendants are going to be anywhere from 40 to 60 years younger than my 90-year-old mom.  They are a good deal stronger than she is.  They can lift, move, and otherwise physically handle my dad a lot easier than she can, and they are trained in the body mechanics that will enable them to do so without hurting him or themselves.  They are also used to handling patients with dementia. What’s more, they do not spending every waking moment 24 hours a day taking care of their patients, to the point of mental and physical exhaustion.  They look after them for eight hours and then they leave.  They go home to be with their families.  They go places and have fun with their friends.  They can get a good night’s sleep.  And when they come to work, they are well rested and alert.

This is going to be an exercise in letting go.  My hope is that my mom will be able to accept that the lion’s share of the burden of my dad’s care is being shouldered by others who are competent to assume that burden, and that now that she’s not taking care of my dad anymore, she can start taking care of herself. The thing she needs most right now is not love and support, but sleep.  Good, deep, restorative sleep. I’m afraid that instead of losing sleep because my dad keeps her up, she’s going to be losing sleep worrying about whether he’s getting good care. It’s a legitimate fear.  My mom’s a Virgo.  They’re born worriers.

*It’s an instant mix that comes in powered form; you stir it into hot water.

It’s Happening

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This past week has finally convinced my mom that the time has come to place my dad in care.  Friday, she started calling around to the various assisted living facilities (ALF) that their home health service had recommended to her to see if there were any vacancies and, if so, would they take a patient with a colostomy. She had had her heart set on one of the places that was near Indiana Avenue, as many of the places she goes to a lot are located on or near this main north-south artery, and it would be so convenient for her to drop by and check on my dad.  Sunday afternoon, on my way home from daddysitting, I also checked out the facility that is across the street from the duplex I moved here from, and their home health aide had told my mom about a place she knew of on Avenue Q that was just opening up. There were only two places that had vacancies:  one of the ones off Indiana and the one on Avenue Q (which just happens to be in the same block but one street up from where my brother used to live.)  Both these facilities had private room vacancies, and both of them would take patients with colostomies, but the one on Indiana was more expensive.

One big selling point for people living in their own homes as long as they possibly can is that the fee for care facilities starts at around $2500(£1553) a month.  A place where you’d actually feel comfortable about leaving a loved one (i.e., one with nice clean facilities and a caregiver to patient ratio of under 1/10) is going to run you anywhere from $2700 (£1677) to $4000 (£2485) a month.  This applies not just to an actual purpose-built facility like a nursing home but also to those that are located in private homes (whether someone’s actual home, or a private home purchased for the purpose) to house and provide care for patients.  Both of these places that mom had narrowed the search to were facilities set up in private homes.  Usually these types of facilities have a capacity of only 8 to 12 patients, depending on the ratio of single occupant to double occupant rooms they have.  Monday afternoon, I went over to stay with dad while mom and her friend CK went to check them out.  They decided they liked the one on Avenue Q best because it was cleaner, newer, and she liked the atmosphere and the caregivers there.  The fact that it was the least expensive of the two just sweetened what was already pretty much a done deal.

My dad will have to have a doctor’s exam before they will let him move in (he has an appointment for Thursday afternoon), just to document his current state of health, and because the equipment he will have to have (i.e., a hospital bed, a bedside commode, an “egg-crate” foam mattress topper to help prevent pressure ulcers, etc.,) will have to be prescribed by a doctor so Medicare will pay for it.  Their home health agency will make the arrangements to get those things.  The home health aide who has been coming to their house to bathe him will continue to do so, and the home health nurses that come by to check on him periodically and take his blood pressure and temperature, etc., will continue to do so. Both mom and I are pleased about this, as we already know and like these people and they know (and like) my dad, so there will be continuity of care.

Because this ALF cares for patients with dementia, they have a keypad entry on the outside doors.  If you were to just open the front door, an alarm would go off.  This is to prevent any of the patients from eloping — doubly important as this place is on the corner and the side street is a wide and very busy street.  Family members are given the key code which allows them to open the door without the alarm going off.  Significant is that there are no set visiting hours.  Family members can just walk in any time and stay as long as they like.  That tells you the level of care is consistent and they are not afraid you are going to catch them out neglecting patients.

It looks like we’re going to be moving him in next week so mom can get him settled in as her friend CK, who took her around to look at the two ALFs Monday, has also been planning for some time to throw a 90th birthday party for my mom the fourth week of September, and mom wants my dad settled in before then.

Obviously, there are going to be some issues that my mom is going to have to deal with once my dad goes into care. It’s going to take her a while to come to terms with and become comfortable with the idea of surrendering the responsibility of the minute-to-minute care of the love of her life to others, and to be able to trust those others to do a good job. Then, she’s going to have to actually do it.  She’s been watching him like a hawk in case he decides to get up on his own and head out somewhere.  She’s had to sleep with one ear open …  It’s going to be hard to let go, especially since she’s a Virgo.  They are born worriers.

Another issue she’s going to have to confront is that once my dad is in care, she’s going to be by herself at home.  This November will be their 68th wedding anniversary.  Both of them retired in the 1980s, so they’ve been at home together all day every day for 30+ years. Now, all of a sudden, she’s going to be alone in that house, and alone in that bed.  She’s going to have to be coming face-to-face with the reality that there is going to come a day . . .  It’ll be like training wheels for widowhood.

What’s going to make it worse is that caring for my dad was consuming pretty much every waking moment of her time.  Once he’s in care, she’s going to have a lot more free time, and she’s going to have to figure out what to do with it. She needs to have a massive garage sale, for one thing.  She knows it, too.  I mean, massive.  She has stuff under every bed in the house, and all the closets are jam crammed.  But when she’s been afraid to be out of sight of my dad for longer than five minutes at a time in case he tried to get up by himself, there was no point in even thinking about it. Now that dad’s going into care, getting ready to have a garage sale, maybe in early October, would certainly keep her busy, and would help her transition through this difficult period. Naturally, I’ll help. But there’s going to be tons of stuff that’s going to need sorting through.

The thing that scares and concerns me the most about this whole business is how much my dad understands about why he’s being put into care, and even if he does understand, it’s not going to be a lasting understanding.  Two minutes later, the memory of the conversation, and whatever meaning he got out of it could just evaporate. It’s been hard enough for my mom to come to grips with the need to put him in care and actually start the process.  That, in and of itself, is going to be guilt provoking enough, but if every time she goes to visit him, she has to deal with him asking her to take him back home, it’s just going to tear her up into little tiny pieces.  Me, too, come to that.

That said, my dad can be quite engaging and charming, even now, and all along, he has always been very grateful for everything we do for him, always thanking us, and saying how sweet we are, etc.  I am hopeful that he will bond with and engage with his caregivers, which will make them inclined to fuss over him, which is just what he needs to help him over this difficult transition.

These next few months are not going to be easy.

Watch this space.

The Filing Cabinet, a Kodak Moment, and a Bouncy Keyboard

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The new wireless keyboard combo came today and I got it to talk to my old Logitech Touch mouse in about a minute and a half, which was one of the reasons I opted for a Logitech Unity combo keyboard + mouse product.  The Logitech Touch mouse scrolls like a touch pad — no moving parts — versus scrolling with a wheel, like most mice do, including the one that came with this keyboard.  I used to go through mice pretty quickly because the buttons and or scroll wheel either wore out, or got tangled up with cat hair, or all of the above.  If you have a pet hair problem, you should investigate getting a Logitech Touch wireless mouse like I’ve got. It takes a little getting used to, but I love it.  It’s sensitive and responsive, and I like that in a mouse. (LOL!)

One of the selling points of the  Logitech “Unity” product line is that the little button that you plug in the USB port can talk to multiple components, so right off the bat, you free up a USB port. The button can talk to any Logitech Unity keyboard or mouse, not just the two it came with, so if you have a keyboard + mouse combo, and the mouse dies, you can just get another Logitech Unity wireless mouse, without having to replace everything. Or, in my case, I didn’t even turn on the mouse that came with the keyboard.  I just started the software that came with it. It “saw” my old Touch mouse, they shook hands, and we were good to go.

2014_09_04-01I got the filing cabinet “installed” and the files and stuff in the drawers. I had to make some adjustments hither and yon, but it all works now, and so much better than it did.  The paper shredder is off to the side, standing on a little book rack.  That white “nose” looking thing is my tissue dispenser, which actually does have a molded nose on the side, underneath  which the tissues pull out.  The lady who was a transcription supervisor for one of the local hospitals had one, and I just loved it.  I tracked one down on the internet and bought it.  I’ve probably had it for 20 years. Of to the side you can see the little lap desk I got for my keyboard.  I’m going to be testing it out here in a minute after I publish this post.

Yesterday afternoon, when we were having our kibbles, we had a Kodak moment, and for once I managed to get a camera on it.  I think I’ll let it speak for itself.

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Filing Cabinets, New Kitty Dishes, and the Demise and Resurrection of the Pump

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Armoir showing wrackingThe furniture repair guy, complete with assistant, came Monday to repair all the dings and scratches the movers made moving my furniture.  Unfortunately, he could do nothing for my armoire which was racked to the point that the doors are not level anymore and the bottom doors stick. He was a nice guy, and not only repaired the damage the movers did to my sideboard, but some damage that was on it when I got it at a discount because it was damaged in shipment and had no hardware.  He also repaired the big gouge that the corner of the picture frame put in the top of my four drawer dresser (the one my late sister-in-law refinished) when those kids upstairs bounced off a wall and knocked the picture off the picture hanger.  Of course, he could not fix the broken glass in my china cabinet, and he could not fix my filing cabinet, which was particle board.  Once you pull out screws or fasteners from particle board, that’s it.  You can’t fix it — which is why the filing cabinet was put in the dumpster months ago.

IMG_1366In order for the furniture repair guys to be able to get to my sideboard, I had to unplug and move the kitties’ pet fountain.  After they left, I took the opportunity to empty it out, clean it and put in new filters.  When I filled it up and plugged it back in again, nothing happened.  The pump was not working. I tried plugging it into another plug.  Zip.  I concluded the pump was burned out — a logical conclusion, I thought. I emptied everything out again and left it all in the dish drainer, including the pump.  I tracked down a replacement pump on line and ordered it.  Since Monday was a holiday, it is forecast to arrive 5-7 business days from Tuesday.  The black kitty, who adores the pet fountain, was bewildered by its absence.  He kept going over to where it used to be and looking for it.  The other two don’t use it as much, probably because the black one keeps sticking either his head or his front paw into the water.  Yesterday, on a whim, I tried the pump again.  Nada.  I was reaching to unplug it when it rattled, buzzed, and began working.  Of course, it was too late to cancel the order for its replacement.  I hooked everything back up again, filled it up, plugged it in, and it’s been working ever since.  Go figure.  At least I’ll have a replacement pump on hand now.

Tuesday afternoon, there were several loud cracks of thunder, which I found puzzling since there was no thunder boomer symbol on my weather widget. We then proceeded to have a right old gully washer.  It rained a good deal in our part of town, though not so much in other parts.  There was still pretty heavy run-off in the street gutters when I left to go to the knitting group about an hour later.

The knitting group consists of around 13 women, (some of whom were actually crocheters — but we don’t hold that against them!).  It was fun, even though I only knew one person there.  They were mostly empty-nesters or retired, except the one lady who brought her young teen-aged daughter. I’ve decided I’ll go back.

After I daddysat yesterday, I stopped by Walmart to get gas.  Then I went into the store and bought a new metal filing cabinet  for about half what Office Max wanted for it.  There should be more than enough room on top of it for my shredder and my printer, since I can get all the other stuff like tape dispenser, stapler, etc., in the little top drawer.  I also bought two ramekins to use for food dishes for the kitties.  The dishes I’ve used pretty much ever since I’ve had cats are these great honking, heavy, ceramic dog (don’t tell them!!) dishes. Three food dishes and one water dish take up practically the whole top rack of this apartment-size dishwasher I’ve got here, leaving little room for glasses, and  they only fit in three places in the bottom rack, leaving no room for cereal bowls.  These ramekins are only 4 inches in diameter, and four of them will fit easily in the top rack of my dishwasher.  The dishwasher I had at the duplex was full size and had more room for glassware so it didn’t really matter that the dishes were so big.  Of course, the dishwasher here is old enough that the vinyl coating on the rack posts is worn through and the posts are starting to rust out and break off so there are about four places where I can’t put anything because a post is broken off.  Unfortunately, two ramekins was all they had in the store, but I was able to order a set of six on line.  They won’t be here until the 10th, unfortunately.

While I was in Walmart, I saw a guy wearing a T-shirt that read, “I am NOT an alcoholic.  I’m a DRUNK.  Alcoholics go to meetings.”  He looked like the sort of guy who would wear a T-shirt like that.

My dad has not been doing well since the day before his birthday.  He was responding to internal stimuli* again when I was sitting with him while mom was at choir practice last night, wanting to know who that man was over there (it was just him and me), asking me how the violin business was doing (my brother is the one who sells and repairs violins). He has been weak and disoriented.  He has not been sleeping well at night (and has been keeping mom awake, too).  She said that while she was dressing him the other day, he asked, “Who are you?”

I asked mom (again) if she didn’t think it was time to begin calling around to get put on waiting lists and/or seeing if a place is available for him in some kind of a facility.  The home health people want to put him in an assisted living facility (so they can continue treating him, of course,) but mom wants to put him in this nursing home that is really close to where they live. It’s like I told her yesterday evening.  He’s not going to get better; he’s only going to get worse.  It’s exhausting for her to care for him now, and that situation is only going to get worse, too.  Where would he be if she winds up in the hospital?

He has what is known as multi-infarct dementia. He’s had multiple microstrokes (“infarcts“), and is continuing to have them.  His false teeth don’t fit, and can’t be made to fit, so he can’t chew anything. Needless to say, he is very malnourished, — he’s nothing but skin and bones — and that’s not helping the situation eitherl.  He can’t protect his airway.  Every time he swallows, stuff goes down the wrong way and he coughs and chokes and coughs and chokes and coughs and chokes and coughs and chokes.  (A feeding tube is out of the question.  Neither he nor she wants one.)  His mental status is noticeably worse.

I’m sure my mom is still in denial.  It’s a tough reality to face and a difficult decision to make.  Unfortunately, she’s not going to be able to put it off much longer.  Her health is beginning to deteriorate from lack of sleep and the stress of having to care for him. She’s losing weight.  She’s become sleep-deprived enough that I’m beginning to worry about her safety driving.  She can’t leave the house without there being someone there with him (me).  She can’t get out in the yard to do things.  It’s even hard for her to be in another part of the house for any length of time, like being in the middle bedroom on the computer, for fear that he’ll take it into his head to try to get up out of his chair, start trying to go somewhere (he can’t see), and fall.  When she’s not tending to him or doing housework, she can’t really do anything else except sit in the den and watch TV or read.  She’s beginning to get a little stir crazy.  Something’s got to give, and sooner rather than later.  I just hope it’s not her.

Once my dad has been placed in some kind of care facility, she’ll be able to get a good night’s rest again.  She’ll be able to get on the computer for as long as she wants to, attend as many social and church functions as she wants to.  She and I will be able to go places together, like to the movies or out to eat.  We can’t do that now unless she gets somebody else to stay with my dad.  She said that today she’s going to call up to this one place where she’d really like to put him, and maybe to some other places to start getting on waiting lists.  I hope she does.

*responding to auditory, visual, or tactile hallucinations.

Sneaking Up On Sunday

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Got Mom’s phone set up and all the phone book entries put in for her.  Thankfully, this phone has a “shared phone book.” If you put the listings in one handset, all the other handsets can get to them.  She had fewer than 50 entries, which was all the shared phone book would take, so that worked out all right.  The phone in her bedroom was connected by a four pronged plug as their bedroom still has that kind of phone jack.  I hate to tell you how long it’s been since telephones used that kind of a wall connection. The jack in my bedroom is still the old style.  The connection in the kitchen has been changed to the new kind, though. I suspect that happened when you couldn’t get phones anymore that would plug into that style of phone jack.  The one in what was my brother’s bedroom has been changed to the new style too.

One good thing about cordless phones.  Only the base unit has to be plugged into a phone jack, the one in the kitchen, as it happens.  The other two (or three or four) can be put in any room with an electrical outlet.  The old phone was mounted on the side of the cabinet.  Unfortunately, the way the wall mount for the base unit was on this new phone, once it was mounted,  my mom would have had to stand on a step stool to see to get her messages, so it had to be put down on the counter.  Mom wasn’t happy about it at the time, but I suspect she’ll warm to it.  Now that it’s down on the counter, she won’t have to go around to the other side of the breakfast bar to see if there are any messages, or to answer it.  It’s visible and reachable from either side of the breakfast bar.

Earlier this past evening, I hauled trash out to the dumpster, then stripped the bed and took them to the washer ready to wash after I took my shower and washed my hair.  The first load, sheets and towels, is in the dryer now and the second load, which is clothes, is in the washer washing.  My dirty clothes hamper is just the right size that when it is full, that is enough to make a full load in the washer.  It’s made from wood with inset wicker panels and has a bag made of heavy cloth hung inside it from two metal rods.  I bought it when I first moved in to the duplex.  It is sturdily made and has held up well.  Money well spent.

Rainy Thursday

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Wednesday was payday, so after I daddysat while mom went to choir practice, I stopped off at Walmart and stocked up on all the things I can’t get at Market Street. They had all their stuff out for Tech’s back to school  — little dorm room refrigerators and single sheet sets, and Tech towels, and all that kind of stuff.  But they also had body pillows for $9 and a lap desk for the same price, so I got both. The lap desk will come in handy for transcribing work which I’m going to have to get busy and do because my dental insurance premium is due this month, and the body pillow I had got barfed on one time too many.  The filling is already lumpy and if I wash it one more time, it’ll be like sleeping with a bag of rolled up socks. Putting tennis balls in the dryer works for comforters, but pillows are too thick.  I suppose I could wash my Reeboks and put them in the dryer with the pillow, but I think I’ve reached the point of diminishing returns.  I’ve had it for over ten years and I think I’ve recouped my investment.

Walmart had a six-pack of 500 mL bottles of Gold Peak Sweet Tea.  I only bought it for the bottles.  The bottles are thick plastic with wide mouths and a substantial cap, and the labels come off without leaving a sticky place down the side of the bottle. They will work better for refillable water bottles than the kind of flimsy plastic bottles they sell water in.  Just a word of warning.  If you decide to try the Gold Peak Sweet Tea, it’s made with REAL SUGAR, which is to say, it’s about twice as sweet as I like it (44g of sugar in 500 mL, which is to say 15% of the US’s RDA of sugar).  It reminds me of how my dad used to drink iced tea.  It wasn’t sweet enough for him until about half an inch of sugar had settled out in the bottom of the glass.   Anyway, there’s only six bottles of it and if I load it down with ice, it’s drinkable.

This afternoon we had a right old thunder boomer, and it rained like sixty for about 20 minutes.  We even had chips of hail.  (Thank goodness the hail was no bigger than that.  We don’t have covered parking here!)  It was nice.  We need the moisture.

I downloaded the new beta version of Rhapsody 6.3. Although it’s slower than Christmas, it seems to work much better with the Sansa Clip Zip MP3 player than Rhapsody version 4, which is old, old, old.  For example, I could not get all 52 files of “Welcome to Night Vale” to upload from my PC to a version 4 playlist and was having to use Windows Media Player to download them to the MP3 player, but I was able to drag and drop all 52 files to the playlist I created in verson 6 and they downloaded just fine. Having a “Welcome to Night Vale” playlist in Rhapsody means I can access them from my Squeezebox internet radio and listen to them while I knit.

As I type this, I’m trying out the lap desk I got Wednesday night and it works great.  I’m all set to get busy next week.

I’ve been trying to get a sty at the outer corner of my left eye. I had them badly one summer as a child but I’ve rarely had them before or since.  I’m supposed to go pick up some antibiotic ointment at the VA tomorrow, which I will do on the way home from daddysitting.  I’ll be setting up mom’s phone for her when she gets home. I think they are going to work well for her.  They have black on white readouts, which are so much easier to see  than the black on dark amber readouts on her old phone.

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