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.
Fortunately, 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.
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.