Episode 69 - The long and winding road (the Beatles)

Mom is back at the Care Center.  By Sunday, they had taken away all the meds she'd been put on since leaving our home and by Tuesday she at least knew she was in a hospital.  Medication is such a delicate balance. Agitation, anxiety, restlessness, pain - a different drug (or combination) for every symptom... trying to find the "right mix" that would give her quality of life and also a good rapport with others in a group setting.  In hindsight, perhaps the new surroundings and subsequent meds led to her falls. No one is to blame - not the care center, not the doctors nor for that matter, me.  I've felt terrible seeing Mom go downhill so quickly but realize it's part of her aging process.  We are all partners in trying to do what is best for her.... but it is hard.

The psychiatrist asked me to spend some time Tuesday with Mom, before conferring with him.  He is the one who gave the "med vacation" order.  I hadn't seen her the day prior, so Tuesday afternoon was a pleasant surprise.  She knew most of the answers to the questions I posed to her.  She was still stumped by the year (and why would she care? She doesn't even write checks).  We couldn't have a President with a simple name like Bush, Johnson or even Eisenhower (which she would remember in a heartbeat).  But she knew her name, birthday and that she was in a hospital.  Our conversation was simple and not strained.  I've finally come around to living in her world and not correcting.  She went into great detail about the visitors who had stopped by and their ensuing conversations.  One was a professor from her days at Coe College.  They hadn't spoken in years.  "How nice that he would remember me..." 

"Yes it is," I would reply, wondering how old a professor from her college days (65 years ago) might be now.  Another visitor was her pastor.  What a wonderful visit they had.  She laughed as she gave me a sentence by sentence account of their dialogue.  He told her funny stories and they talked about their church and the many things Mom had done there over the years.  You would think it was a typical hospital visit between clergy and parishioner - except for the note on the bedside table which read: "I stopped by to see you but you were asleep. I tried to wake you but could not. Will see you again soon, Pastor Tom".  Yes, it was a wonderful visit.  Perhaps she heard his voice and dreamed the rest - or maybe she just conjured up the conversation when the nurse read her his note. Mom asked me to be sure to call and thank him for stopping by.

Also in the course of our time that day, Mom told me she would like to get married again.  "Really?" I asked.  "I don't know that you'd want to be married again."

G:  Oh I think I would.  I don't know where I'd find someone. Probably no one would want me.

Me:  Mom, any man would be a fool, not to want you.

G: (laughing)  So what do I do?  Call someone up and see if they want to go out?

Me:  Well, you're a little restricted... to the men at the care center.

G:  Why?

Me:  Because that's where you live and since you can't leave... you know?

G:  Well if I got married again I might have to cook.

Me:  You aren't allowed to cook.  You'd be better off staying single.

G:  I think I'd be better off married.

This warms my heart, in that it proves companionship is a natural, lifelong desire.  DH's Dad had a "girlfriend" in "the home" several years ago.  It put a little spring in his step for the short duration of their romance.  Mom's fantasy of finding an aging Romeo will never reach a 'spring in her step' stage. Even at the care center, there are only a handful of men... none of whom could handle my "handful" of Mother.  

When I finally spoke with the psychiatrist, he said he would recommend Mom be taken back to the care center.  The meds will be monitored and added back slowly if necessary.  She no longer has a "one on one" (patient tech) staying in the room with her, so she would probably be released the next day.  I made arrangements to return the next afternoon to take her back to McVille.

The next day, the discharge went quickly.  The nurse helped me get her dressed in the clothes I'd brought from home.  Mom asked me several times where we were going.  "McVille," I replied each time.  The nurse brought a wheel chair to take her down to my car.  I retrieved the valet parking ticket from my purse and asked Mom to hold onto it for me.  She held it firmly.  When we arrived at the door, the attendant who had parked my car, met us.  I looked at Mom and she handed him the ticket.  As we waited for him to come back with the car, she looked out the large window at the landscaping outside.  She reminisced about helping "put that mulch in." 

G:  Someone helped me.  I can't remember who.

Me:  Probably someone on the grounds department, or facilities.

G:  Yeah... probably.

I wondered if the young nurse bought her story, as she looked outside at the mulch laden beds.  Mom has definitely laid a lot of mulch in her day... though none to my knowledge on hospital grounds.  The car came around and we got loaded and belted up for the 30 minute drive. 

As we drove, she commented on various signs and memories she had.  She talked about Hawkeye Downs and the All Iowa Fair.  My Dad had served on the Fair Board for years.  We passed the Palisades Kepler State Park and several local farms.  She commented on the "new" tractor dealership and the busy intersection just a couple blocks from our house.  I realized it was six weeks almost to the hour from our last trip together down this stretch of highway - when I took her to the care center for the first time.  The golf course, the cemetery where her brother is buried... and finally, Lisbon - her beloved hometown.  I turned right at the second intersection of the highway.  A few blocks later, I turned the car into the cemetery.  We drove slowly and she talked about her best friend, Laura Mae, who died more than 20 years ago.... she saw names she recognized (and even remembered).  We came to my Dad's grave and noted her name on it as well ... across the road from Dad's grave, was my Aunt and Uncle's.  We drove a  little further down the road, past her grandfather's headstone - and further yet, her mother's parents.  Around a couple corners, we drove past my grandparents' graves and then out the other side of the cemetery.  Seven more miles and we came to McVille.  Her demeanor changed slightly, as it had six weeks before. 

G:  I wonder what this town will think of me being here.

Me:  You're not really "in town" Mom - the care center is sort of a community in itself.  It just happens to be in McVille.

I thought about taking a loop through the McVille cemetery where her parents are buried, but decided instead, to drive down Main Street.  She ooh'ed and oh'ed about various businesses and storefronts.  Her family had had a gas station in town here when she was a young girl.  She didn't mention it.  As we turned north to head toward the care center, she turned and looked out the car window and announced, "That's where we lived."

Me:  Where?

G:  Right there. (pointing to a house on a corner)

Me:  Really?  (I slowed down and studied the house.  I think she's right. Somewhere in a corner of my mind, I recall as a child, her pointing that house out to me.  It may have been fifty years ago, but this recollection was far more plausible than her college professor dropping by.)

Me:  I'm glad we came this way.

We arrived at the care center a few minutes later and I parked in the drive outside the entrance.  I told her I'd be right back with a wheel chair.  By the time I found a nurse (90 seconds?) and we went back toward the front door, we spotted Mom, almost to the building.  The nurse set off the alarm in an effort to get to Mom quickly.  She (Mom) wasn't sure what all the fuss was for - but took a seat in the wheel chair in short order.  We took her back to E3.  Ethel sat quietly in her wheel chair.  The nurse continued to "check her back in" taking stats, etc.  I went out to the nurses' station to give them the  paperwork from the hospital.  I talked a few minutes with another nurse and the center administrator.

We discussed medicine and safety.  Per my request, they will have a doctor call me before changing her medicine again and because of her "fall factor" - they will put an alarm on her bed and chair, to sound if she gets up. We talked about the possibility of her not being able to remain there if her confusion worsened again.  The nurse who checked her in said she is much better now (on her med vacation) than she had been last week.  The next couple weeks should give us an idea of how she'll settle back in. 

I titled this episode "The long and winding road" - that song kept going through my mind as we drove back from the hospital yesterday.  The route itself (from the hospital to McVille) is a pretty straight shot (less the detours through graveyards and small town 'Main Streets') - but the journey of the aging process is not a straight path.  It starts at birth and if we are fortunate, spans several decades.  Those first years of life are guided by the loving hands of our parents and the final years, God willing, by the loving hands of our children.  I'm finding this to be harder than raising babies, at least emotionally.  The babies grow up - and someday will experience parenthood themselves. Then they will hopefully understand, that whatever their parents did - it was their best.  It's all any of us can do.

I remember as a child, when asked what I wanted for Christmas or a birthday - responding "a baby brother or sister..."  It's the gift I wish I had gotten. Being an only child gowing up was lonely.  Being an only child as an adult, is as well.

(que music) "Many times I've been alone and many times I've cried, anyway you'll never know the many ways I've tried."

I'll always be the daughter of a woman who "made things happen".  My feelings of helplessness now, leave me tired and sad.  I need to feel in control of something.  So I decided I'm going to take a day of vacation tomorrow to do just that.  I think I'll clean the house.  There's nothing like eliminating soap scum and dust bunnies to empower a person.

So ends Episode 69

Episode 68 - I'll meet you at Luke's place

What a week. The evening following my last post, I got a call from the care center about 9:15.  The nurse said Mom had fallen.  No one had witnessed the fall and though she didn't appear to have any injuries, they couldn't rule out that she may have hit her head; she wasn't making a lot of sense and they felt she should go to the hospital.  My first response was, "making a lot of sense compared to what?"  Mom has been on a downward spire the past couple weeks when it comes to 'making sense'.  The nurse said she just had a gut feeling she should be checked out.  Of course I agreed.  She said they would call an ambulance (standard procedure) and we could meet her at St. Lukes Hospital between 10:30 and 10:45.

DH and I arrived at the ER at 10:30.  I checked in at the desk and was told the ambulance was still about 10 minutes out.  We took a seat.  I kept an eye on the drive-up for flashing lights, but nothing.  Ten minutes turned to twenty, then thirty and finally forty minutes.  We'd been in phone contact with my oldest son (Belle's Daddy) while waiting.  He, in turn, had called the Care Center to verify the time she'd left and called us back. 

BD: She should be there.

NM: We've been sitting right here the whole time.  No ambulance has come yet.

BD disconnected and called us back a few minutes later.

BD:  She's there Mom.  I talked to her nurse.

It's now 11:15 and NanaMama's wrath is coming to the surface.  I approached the woman we'd spoken with when we first entered.  I'll spare the exchange other than she told me my mother was probably dropped off at the rear entrance.  Who knew? AAUUGH.  We were taken back to a room where mother was lying on a bed, dozing.  This would be her state for most of the stay.  We later learned she had fallen out of bed at the care center.  They did a CT scan and x-rays, all which checked out OK.  She was taken back to McVille by another ambulance.  DH and I returned home about 1:00 a.m.

I called the care center the next morning to see how the rest of her night had been.  She was still sleeping but they thought she was doing fine. They had changed the timing of her medication the previous day, to help her sleep better at night and hopefully be less anxious during the afternoon. I wondered if the heavier sedation contributed to her falling out of bed.

DH and I put in a long day, having gotten to bed late - work and then topped off the evening with CeCe's late volleyball practice, getting home after 10:30.  The bed felt good - but sleep was cut short when my cell phone rang at 4:15 a.m. 

Deja vu ... the nurse on the other end of the phone informed me that my mother had been found on the bathroom floor.  She had fallen about 3:30 and was en route to the hospital by ambulance.  This time, she definitely hit her head and had a large hematoma. 

We dressed, filled our coffee mugs and set out for the hospital. We decided we should drive two cars which in theory, was a smart choice.  Unfortunately, upon exiting my car, I promptly locked the keys inside it.  It wasn't even 5:00 a.m. yet ... my day could only get better.

This time, the ambulance beat us to the hospital and Mom was alert when we found her.  She answered the usual questions posed to her by medical personnel.  In response to the 'what's your name' inquiry, she slowly recited her first, middle, maiden and (first) married name.  She stopped before saying her current last name... and never did remember it.   When asked about her living situation... she said, "I have two houses" - Dr. H. said, "Do you live in a nursing home?" to which Mom said, "No, I don't live there, I just help out."  (I'm sure this perspective would explain a lot to the staff ... Grandma is the merely 'Site Manager')  My favorite response was to the question about the President's name.  Grandma responded confidently: "Plattenberger" (my maiden name)  I said aloud, "Dad would be so proud."  

Another CT scan, another set of x-rays and though there was no head injury or broken bones, she was admitted for 23 hours of observation.  DH went back home and got the extra set of car keys and another mug of coffee for me.  I stayed with Mom as she was moved to a room on the 5th floor.  A couple hours later, it was determined that she had a UTI and was started on IV antibiotics.  I was actually relieved to get this news, as I've heard UTIs are a common cause of confusion in elderly patients.  Perhaps some of her confusion had stemmed from this infection.  I guessed that time would tell.  The 23 hour admission was changed to a standard admission due to the UTI. 

Mom was fidgety and not happy with the IV, catheter and monitor.  I asked the nurse if she could possibly put Coban wrap around the IV to keep her from pulling at it.  (Coban is that colorful stretchy wrap they put over a cotton ball when they draw blood from your arm)  She did.  She also discovered that the alarm on the bed wasn't working properly, so she called maintenance. (Since Mom is a fall risk, the alarm will blast if she gets out of bed).  About this time, a friend of mine from work stopped up to the room.  (She came bearing edibles.)  We visited for a short time in the 5th floor lounge (after grabbing coffees from downstairs).  I bid her goodbye and headed back to Mom's room. 

When I got there. I found a nurse checking her email by Mom's bed.  She asked if I was going to stay for a while and I said I was.  She left.  It was then I noticed Mom no longer had her IV.  Something told me this hadn't been a miraculous healing.  Sure enough... I learned she had managed to pull out the IV and also get rid of the heart monitor. This occured while the maintenance fellas were re-arming the alarm on her bed.  She's a sly one, she is.  So for this reason, Grandma was now the subject of constant monitoring - no solitary confinement for her.

The next IV was wrapped more thoroughly in Coban and then a sleeve placed over her arm.  From that point on, a patient tech was on duty in Grandma's room if I wasn't with her.  One day we arrived to find her sitting at the nurses' station in a wheel chair. They didn't have a tech available... so had wheeled her out there.  She was busy popping bubble wrap, which she said made her laugh.  Her confusion continues.  She's not sure where she is, but if she "doesn't get to feeling better, she's going to have to go to the hospital." 

It's been five days since the first fall.  We're hoping she is released soon to return to the care center.  I know there are still medication issues that need to be figured out but I'm sure she'll be happy to be back with the other Golden Girls and the things that have become 'new normals' for her. I've been thinking about her return though.  When she does go back to the care center, I may propose they wrap her in bubble plastic, secured with a roll of Coban wrap.

So ends Episode 68

Episode 67 – Sundown, you better take care (G.Lightfoot)

Three more weeks have gone by.  In that time, Mom has become progressively more confused.  About two weeks ago, we visited one evening after work – before her supper, for about 45 minutes.  In that time, she never once said anything that made sense.  She spoke of “meetings” and “decisions” with a myriad of “regarding to’s”, “for the purpose of’s”, and “as it pertains to's”.  Somewhere in my mother’s mind – there are committee meetings going on and she is the chairman of the board.  She speaks with an air of authority that would cause other CEOs to stop and listen – only to soon turn to one another, scratch their heads and say, “What is she talking about?”

                I know they have changed her medicine.  Perhaps it is the cause of the increased confusion.  Likely not, says one nurse.  From experience – she tells me that Mom is ‘lost.’ She is trying to adjust to her new environment, but it is different and difficult.  It's not to say she won't adjust.  It will take time.

                I went in for a patient family conference recently.  I wasn’t sure if it would be like a parent teacher conference or a parole hearing.  It was neither (not that I’ve ever been to a parole hearing).  I met with a nurse and the activity director who reported their observations to me and I shared my own.  We are, of course, all on the same page and want what is best for Mom … to help her become comfortable in her new surroundings and find enjoyment where she can.  They told me she tends to become anxious shortly after lunchtime, emptying the contents of her nightstand drawer and depositing it into the basket of her walker. “She’s packing up to ‘go home’ – and she’s restless”.  I mention that maybe putting her music on would help.  The Gaithers air at 2:00 for a couple hours.  They are on the INSP station which is channel 58 on her television.  The activities director writes it down.  They said her anxiety usually subsides after supper.  It must be then that she unpacks and decides to spend another night.  They say they have a name for these patients – Sundowners.  My heart is heavy as I leave my conference but my mind is assured that she is in a safe place where she is well cared for. 

                I saw Mom sitting in the dining room at a table with Harriet when I came out of the meeting.  She was smiling and happy to see me.  I told her I needed to get back to work but would be down the next evening.  It was late morning – she was in good spirits.  I needed that mental picture as I left the facility. 

                People ask me how she is doing… how we are adjusting… do I feel guilty? Relieved? Free?  I don’t know.  I’m tired.  I remember one night last month, when DH took CeCe to volleyball practice and I was home alone.  All alone.  For the first time in a year, I was in my home, by myself. 

We went to Omaha a couple weeks ago for a three night stay (again, volleyball).  As I was getting things around for the trip, I thought to myself: “What if Mom was still living here?”  I was quickly reminded of the planning and preparation it took whenever we left her.  Someone to stay, meals, meds, schedules, notes, back-up plans….  more notes.  I would be lying to say it wasn’t a relief and a bit freeing to be able to go and worry just about myself.  (I mean that literally too… DH and CeCe packed for themselves… he forgot his prescription medicines and she left part of her uniform at home).  It was unfortunate – but not my responsibility or fault.  I’m not my brother’s keeper… or my mother’s, husband’s or daughter’s. 

DH and I rearranged the basement apartment.  Most of Mom’s furniture is still there, along with more of our own.  I have flashbacks to a year ago… cleaning out D1 – what a difference a year has made.  I remember how foreign the basement first felt, filled with Grandma’s things. Now twelve months later, it seems odd without her. …

I know this wasn’t one of my usual light humored episodes.  I’m still processing.  I’m still sad.  Sometimes I cry.  The Golden Girls at the Care Center still give me reason to smile and even to laugh – and I’ll share more of those in another episode soon – but this is my therapy and if you can’t be honest in therapy… what’s the good of it?  Thanks for listening (and saving me $75).

So ends episode 67

Episode 66 - Period of adjustment

It has now been two weeks since Grandma went to the care center.  I try to call her twice a day and we go visit two or three times a week.

Last Sunday, DH and I took both Sammy and Ginger to see her.  We were met with many smiles as we paraded in with the two pooches.  Grandma was not in the dining room when we arrived, but we made a loop to allow the residents a gratuitous pat on each dog's head.  As we started down the East wing, we saw Grandma come out of her room.  She turned her wheeled walker (her 'pusher') toward us and eyed the dogs... then let out a yell, threw up her hands and the pusher shot out in front of her.  I'd say she was glad to see them.  I'm happy to also report, they were on their best behavior.

Grandma still has some confusion regarding her living arrangements.  Each time we talk, she thinks she is "going home" the following day.  I tell her:

Me:  You are home Mom.  This is where you live now.

G:  So I'll stay here again tonight?

Me:  Yes.  And tomorrow night too.

G:  Did you hear that Ethel?  I'm going to be here tomorrow.

It takes time to get adjusted. 

The roommate situation couldn't be better.  Grandma and Ethel have hit it off very well.  When Harriett is added to the mix, we have a new generation of Golden Girls.  (Well, maybe it's the same generation... but these girls are still alive).  Out in the hallway, as Harriett and her walker approached Grandma and her pusher, Harriett sided up - bumped the other walker, wiggled her hips and said 'chica chica chica'.  Grandma responded in kind.  Then they laughed.

One evening while I was visiting, Grandma and Ethel were waiting to go to supper. Ethel was fiddling with something on her wheelchair.  Frustrated, she stopped abruptly and said, "This is as worthless as tits on a boar."

G:  What? You need a board? (Silence)

G:  (to me)  What did she say?

Me:  She said it was as worthless as tits on a boar.

Grandma gasps.

Ethel instantly recants, "I did not!  I didn't say that!"  (Give me a break Ethel... I heard you ... but I remain silent)  Grandma looks at me accusingly for having suggested Ethel said such a thing.  I want to defend my hearing as well as tell them it isn't even a true statement.  Having spent a few years around the hog industry, I know for a fact that "teets" on a boar can be passed down to the piggies they sire... so are not worthless... but far be it for me to go into a livestock lesson with Rose and Sophia.

DH and I were visiting with the roomies one night this week when the subject turned to the weather.  

Me:  It is so cold outside.... you don't realize it when you see the sun shining but when you step outside, you sure know it.

Ethel:  You think this is cold?  If we were in Iowa, it'd be 10 or 12 below.

Me:  Ethel... this is Iowa...

And in the same visit - Grandma introduced us to Ethel (again):

G:  This is my daughter and this (pointing to DH) is our husband. 

Yup... a roommate match made in heaven.

Care centers are required to call family whenever the doctors make changes in medications.  I've had two voice mails from nurses asking me to call them back.  My stomach is always in knots as I return the call.  I think I have flashbacks to the school principal calling me regarding my boys.  I fear Grandma is in trouble (if not causing it).  I suppose I'll eventually get used to hearing from them and not be alarmed. 

It takes time to get adjusted.

So ends Episode 66

Episode 65 - Groundhog Day

At one time, I thought Episode 64 would be the end of Life with NanaMama's Mama.  Grandma no longer lives with us... the essence of my blog is over - but our life with her, is not.  The Occupational Therapist (Episode 63) and I talked about my blog.  I told her it was a coping mechanism for me - she said she was sure it was (or would be) a help to others as well.  What more could I ask?  So until we read Grandma's obituary, or NanaMama's ... the blog continues.

It has been a week since Grandma moved to the Care Center (room E3).  I have seen her three times since last Wednesday.  I went down the day after her admission and visited her.  Ethel was once again, happy to "meet me" and the two of them together, made me think of another Ethel and her friend Lucy.  Grandma told me about a toilet overflowing that morning (it was down the hall) and how she (thought) she saw water all over their floor.  She got out of her chair to demonstrate, pointing to the floor where the supposed water had been.  I looked at the shiny linoleum and broke the news to Grandma that she was merely looking at the sheen of a finely polished floor.  Granted, she had not seen anything remotely as clean at our house... but the 'glossy' finish did have a 'wet' look to it.

On Saturday, DH and I went down to visit again, along with Belle and her parents.  Belle's Daddy had loaded Grandma's glider chair into their SUV.  She was happy to have it, as well as to see all of us.  I greeted Ethel as we walked into E3. 

Me:  Hi Ethel!  How are you today?

Ethel:  How do you know my name?

Uh oh... another short term memory issue with Ethel.  I would explain that this is the fourth time we've met... but it would likely be forgotten soon anyway.  We had a nice visit with Grandma, but having five of us visit was almost overwhelming.  She commented about the sweatshirt she was wearing... she didn't think it was hers, but it had her name in it.  Did I know anything about that?  I assured her the shirt was indeed hers... and had been a Christmas gift.  She seemed relieved, as a couple other ladies evidently had their eye on it.

I call Grandma a couple times each day.  She's usually a bit confused about what day I'm coming to visit next.  I try to write it down on her notepad so she can remember it.  Occasionally, she calls me.  OK... 'frequently' she calls me.  She sounds a little more confused but then I realize that she was "more confused" when she first came to live with us.  There's always a period of adjustment.  I did notice she started calling Ethel: "Lavonne".  When I corrected her, she paid no attention, but continued to call her Lavonne.  When I called her out on the error in names again, she merely said, "Oh whatever."

DH and I went to see Grandma after work this afternoon.  We found her sitting in the dining room, at her table, with Harriett.  We pulled up chairs and visited with the two of them.  Grandma left the table, I could tell, on a mission.  She caught up with an aide to tell her we'd be staying for supper.  I caught up with them both, to say we wouldn't.

Harriett asked if we were having dinner with them.

Me:  No, we'll go home and eat. 

H:  Really?  How far do you live from here?

Me:  Oh, about ten minutes.

H:  I thought you lived out west.

Me:  We are west of here.  Did you mean western Iowa or way out west?

H:  Way out west, but I must have you confused with someone else.

Our conversation continued.  We talked about the blizzard we'd had this week, the birds in the glass house and what neither of them could remember they'd had for lunch. Grandma could remember: mashed potatoes and gravy, carrots and gravy.... and something else.  She was elated to have gotten chocolate milk (her favorite beverage).  Harriett remembered none of it, saying she's just glad she doesn't have to cook it and is happy to simply eat it.

Harriett again asks if we'll be staying for supper.

Me:  No, we'll go home and eat. 

H:  (looking surprised) How far do you live from here?

Me:  Just about ten minutes.  (I turn to look at a smiling DH)

H:  Hmmm, I thought you lived out west.

Me:  Western Iowa or way out west?

H:  (laughing) Way out west.

Me:  You must have me confused with someone else.

 Grandma asked me if she would be staying "here" again tonight.

Me:  Yes, this is where you are going to live.

G:  That's right.  This is our house isn't it Harriett?

H:  What?

G:  This place.  It's our house, right?

H:  Yes.  This is our house.

Happy Groundhog Day.

So ends Episode 65

Episode 64 - Transition - Part 3

I can't remember the last time I shed as many tears as I did Tuesday.  I was exhausted, sad and traumatized and although sleep came, I was wide awake at 3:30 a.m.  That is when I wrote Episode 62.  Blogging is therapeutic for me.  As the words poured onto the page, some of the tension left my body. 

I had been hopeful as we'd left Grandma the previous night.  We had talked about McVille, the care center and "the plan."  I remember when we talked, saying to her: 

Me:  Harriett is at that care center, you know.

G:    Harriett who?

Me:  Harriett.  Your good friend from when you lived in D1.

G:  I don't remember her.

My optimism may have dimmed but my resolve was strengthened.  We were making the right decision - but "right" is not always "easy."

Wednesday morning, DH and I got things around at home to take with us to the care center.  I spoke with them on the phone and with the floor nurse at the hospital.  The care center would like her there by 11:00 - the hospital says we are at the mercy of the doctor coming by to release her.  At 10:00, we decide to go to the care center, take her clothes and survey the situation.  

We arrived and I mindlessly opened the alarmed door, without reading the sign and entering the code to disarm it.  Loud ringing signaled our arrival.  Note to self: Don't do that again.  I know why I had been distracted though and it was because through the window in the entry door - I had seen, sitting at a table in the dining room, none other, than Harriett.  I went over and spoke to her.  Yes, I looked familiar... but she didn't really remember me, my mom or even Sam, who she often looked after.  Still, I told her that Grandma would be moving in later that day and she smiled.  I couldn't wait for these two strangers (old friends) to be reunited.

The room was fine - I marked all her clothing with her name and put them on hangers in her closet.  Her new roommate was there in a wheelchair.  I asked her name.  "I'm Ethel"  We visited with her as we worked and she told us she was only there for a short while - until she was well enough to go home.  I asked her about her family, life and typical get-acquainted questions.  I learned she was 77 years old and had three sons.  As we prepared to leave, I told her we would be back with her new roommie a little later.  Her parting words:  "Does she have her right mind?"  I laughed and said, "Sometimes."

By noon, we hadn't heard from the hospital so we just decided to go and wait there.  We had loaded a TV, stand, and a few other items into the car, to take with us to McVille, after getting Grandma. 

She wasn't in her room when we arrived, but was brought back a short time later (from a CT scan which showed no sign of stroke).  We spent the next three hours waiting... Grandma dozing... watching Food Network.  Occasionally, mention was made of the care center... but Grandma appeared to have forgotten about "the plan."

Since Grandma was a "fall risk," they had an alarm tethered to her chair and clipped to her gown.  She wasn't happy about it. A couple times she took it off.  It seemed to really agitate her.

Me:  Mom - you can't do that.

G:  Yes I can. There's no reason for it.

Me:  It's for your safety.  They want to know if you get out of the chair. 

G:  They can't make me wear it.

Me:  If you want to get up, let's push the button and they'll come help you.

Grandma was good with my suggestion and pushed the button.  I could tell the person responding to it would be the subject of her wrath.  A few minutes later, a young nurse entered:

N:  What can I do for you?

G:  This thing.  (anger rising)

Me:  Yeah... that alarm seems to be really pissing her off.  Can we remove it?  (Shock!  And no - the "p" word is not part of NanaMama's usual vocabulary... but at the moment, it seemed appropriate and added a little levity to the situation.)

The nurse and Grandma both chuckled and permission was granted to remove the alarm as long as we with with her. 

Although she didn't stop by to see Grandma, the doctor did arrive on the floor about 3:00 and signed the papers to release her.  We had left one of our cars in the parkade the previous night so we drove separately to the care center.  Grandma rode with me.  We chatted as we made the half hour trip.  Several times I had to remind her where we were going.  As we passed through Lisbon - her hometown - her demeanor changed. 

G:  What do you think of this McVille thing? I don't think it will work.

Me:  Well for now Mom, it's going to have to.  They wouldn't let you go without a plan... and this is the one we have for now.

G:  I can't live in McVille.  Lisbon is my town. 

Me:  But Lisbon doesn't have a care center.

The seven miles from Lisbon to McVille were filled with chilly silence.  I mentioned our having been there earlier and that Harriett was excited to have her there.  Silence.  As we turned off the highway at McVille, Grandma looked out the car window at the snow covered landscape.

G:  This town has nothing for me.

Me:  Mom, you're not going to be part of the community, it will be OK.

G:  I don't think so.

A few blocks later, we pulled into the circle drive of the care center.  Fear could now be heard in her voice.

G:  Oh... this is not a good place. 

Me:  Yes it is Mom.  It's a safe place and for now, it's where you need to be.

Somehow I had enough sense to press in the code, avoiding a fanfare for our entrance. 

Me:  Look Mom...  It's Harriett!  (pointing to the other side of the room)

G:   Yes, I think it is.  I'm going to go talk to her.

A nurse changed Grandma's course as they began processing her in... weight, height, etc.  Many sets of eyes were on us, as the other residents checked out "the new chick."  DH stayed with Grandma as I went to do paperwork with the center's social worker.  He later joined me.

DH:  She's talking to Harriett. 

G:  That's good.  The trip over wasn't great.

While completing the paperwork, the nurse came in and said she was concerned that Grandma's BP was quite high.  I told her it had been elevated in the hospital as well.  She said it was 190/120 and she wasn't at all comfortable with that.  I said to the nurse, "Did I mention she doesn't want to be here?"  The nurse said she'd contact the doctor.  She left but returned a while later... with Grandma.

G:  There you are.  I thought you'd left me.

Me:  No - we haven't left yet.  Just working on some papers.

G:  What kind of papers?  I can't stay here.  Does my family know about this?  (Referring to her grandsons)

Me:  Yes, they want you to be safe and they know this is a good place.

G:  Oh.

Me:  Mom, I'm taking care of some business and I need you to go back to your room.  We'll be there soon.

G:  I don't have a room.

Me:  Yes you do.  It's E3.  Have you met Ethel?

G:  Ethel who?

Me:  Your new roommate.

Grandma and the nurse left and we completed what I considered a massive amount of paperwork.  The social worker said, "It takes some time to adjust." 

We found Grandma out in the dining room, visiting with her new friend, Harriett.  She told me she was ready to go home.  I said, "Well, let's go down to your room then."  She had clearly meant she was ready to go to the car, but begrudgingly got up and walked with us to her room.

When we got to E3, Ethel was visiting with her son.

Me:  Hi Ethel... we're back with your new roommate. 

Ethel:  Who are you?

Me:  My mom is your new roommate.  We were here this morning.  We brought her with us this time.

Ethel:  I've never seen you before in my life.

Uh boy... I guess "right mind" is a relative term.  We made introductions and tried to settle Grandma in as much as possible, showing her where things were and discussing her gliding chair we would bring down.  The objections she voiced fell on my deaf ears as I made the best of this situation with all the strength and determination I had seen my mother model in her lifetime.  Yes, I am a wimp - but even a wimp has her moments.  It was time to be firm. 

Ethel announced it was almost time for supper.  We walked Grandma to the dining room and looked at the beautiful glass bird display.  We found an aid and were given Grandma's table assignment.  We gave her hugs and said we'd see her soon.  Things would be OK.  We would bring Sam to visit.

DH and I let ourselves out the alarmed door and walked to our cars.  I was tired and relieved.  It had been a long week, but the transition from "caretakers" to "patient's family" was now complete. 

So ends Episode 64 

Episode 63 - Transition - Part 2

Grandma wasn't sure why she was at the hospital.  Some of the time, she wasn't sure she was at the hospital or where it was.  She got the same questions from various people.  What year is this?  Where are we?  Who is the president?  After spending what didn't seem a very long time with her, the doctor took DH and I outside her room to say he was going to run some tests but she was mostly showing signs of dementia.  They would do x-rays to be sure she hadn't broken any bones in her recent fall.  She'd be meeting with physical and occupational therapists.  If all went well, she'd be released Tuesday.  Grandma wasn't too keen on spending the night but perked up when they brought her supper.  DH and I left a short while later.  I would be back tomorrow.

My plan for Tuesday included a stop at the bank and the assisted living/nursing home located a couple blocks from our home.  My bank business was swift, allowing more time at Cherry Ridge.  I spoke with the manager, got to see a room and was disappointed to learn that there were no openings and in fact, a wait list of 25 people for the 12 units.  The nursing home side didn't even have an opening for a female, but a wait list of 7 or 8 women.  Maybe this was a sign I had been praying for.  There is no room, because Grandma is supposed to stay with us.  I drove on to the hospital.

Grandma lit up like a Christmas tree when I walked into her room.  "There she is!!  There's my daughter!"  She told me she'd slept well, had taken a walk, had breakfast and answered some questions, though she really needed me to help with some of them.  Her nurse came in and said the doctor would be in later, but she would probably be released that afternoon.  A bit later, another staff member entered, identifying herself as an occupational therapist.  She had been the one who posed the questions to Grandma earlier.  We chatted with her for a few minutes, before the physical therapists came to work with Grandma.  Then we moved to a lounge to discuss the results of the morning's tests.

I felt a throwback to the elementary school parent-teacher conferences.  Looking at "my child's" papers, I could see clearly she was not at the top of the class.  She could pick out the triangle... and she knew what year it was (she should know by now... everyone keeps asking and correcting her if she's wrong).  Her comprehension and memory skills were below average if not failing.  She scored 7/30 which ranked in the "Dementia" category.  The OT was sweet.  I shared some stories and tips on how we've kept afloat the past fifty and one half weeks while Grandma lived with us.  As we parted, she told me we were doing a good job and the social worker would work with us to come up with a plan to best keep Grandma safe.

It was probably just past noon when the social worker came into Grandma's room.  The three of us talked about our house, schedule, what Grandma's routine was and so on.   Grandma was still picking at her lunch when the social worker said it had been determined that Grandma needed supervision all the time.  It was not safe for her to be alone.  "We work, but I'm only a few blocks away."  The SW asked me if I thought Grandma knew enough to push her lifeline button if she needed help.  I hesitated.  "No."  Her balance is poor.  She is subject to falls.  She could lie unconscious, bleeding or with broken bones until someone found her.  It was unacceptable and Grandma would not be released until a we had "a plan."

The SW gave me a list of agencies that provide in home assistance.  There were four pages, but none in our community.  No senior daycare where we live either.  I know from experience that Grandma does best with consistent routine and surroundings.  Having someone come into our home would likely be best - but the average cost of unskilled in-home care was $20 an hour.  That would be $160 a day with no provision for evening or weekend activities or respite.  I was numb.  "We need to have a plan," the SW said gently.

Dr. B's (the doctor from the previous night) nurse came in to talk about Grandma's release.  "Do you have a plan?" 

     "We're working on it," the SW responded.

     "I'll be back in a few minutes then," said the nurse.

A few minutes to come up with a plan. A plan that could alter the course of my mother's life forever.

     "I need to use the restroom."  I grabbed a tissue from the box and left the room.  I called DH and Belle's Daddy.  I had one on my cell phone and the other on the lounge's landline.

Me:  They won't left her go until I have a plan.

BD:  We can get a second opinion.  If Grandma was in her own environment, she'd get a lot more answers right.

DH:  There's no room at Cherry Ridge?

Me:  They don't offer 24/7 supervision in assisted living.  She needs more.

BD:  I can come down and have lunch with her everyday.

DH:  Is there any other care centers you'd want to check out?

Me:  I have to have a plan....

Two of the most important men in my life, trying to help me find a solution.  I'm crying.  Another visitor brings me tissues.  Why am I an only child?  I was barely allowed to make decisions growing up... I hate restaurants with menus... I can't decide what to wear and now I have to come up with a plan for my mother's well being.  What happened to my signs?  They have been reduced to a dollar sign and the fact that we cannot afford to bring someone into our house while we work, go to church, volleyball and live life.  We've likely left Grandma in harm's way the past many months when she had been home alone.  It has been a burden I've wanted to carry... but as in the words of my friend a couple episodes ago... I'm in over my head.

DH texted me the phone number to a reputable care center in McVille, a town 8 miles from where we live.  I called and was told they had a room for a female resident. I gave them my name and said I'd be back in touch.

I returned to Grandma's room where she is finishing her lunch.  I quietly tell the SW(through tears)  that I can get my mother into a care center in McVille.  She tells me in that case, Grandma can spend another night in the hospital and be released to go to the nursing home the next day.  This would give me time to get things ready for her move. 

The SW left and over the next hour, I went back and forth from the hospital room to the lounge.  Belle's Daddy checked the care center out online.  He gave approval on behalf of himself and his out of state brothers.  I went through multiple tissues each trip, returning puffy eyed to sit with Grandma while she watched TV and dozed.  Eventually, I sucked it up and spoke the words I had never wanted to have to say to her.

Me:  Mom, they won't let you leave here until I have a plan to take care of you.

G:  You need to make one.

Me:  They are telling me that you have to have someone with you all the time. Whenever we aren't home.  We'd have to hire someone to come into stay with you.

G:  Who's it going to be?

I cried the entire time I explained to her that as much as I wanted to, I couldn't keep her safe any longer.  She asked me why I was crying and I said because I wanted to take care of you. 

Grandma's response was similar to what any of us (as mothers) would have, seeing our child obviously distraught.

G:  It doesn't sound like you have any choice.  This is best.  I think your Dad would agree.

She was gracious, understanding and empathetic.  I probably could have told her I had to put her in a cardboard box and she would have said OK.  So although I had broken the news to her ... I would later learn her comprehension score had truly been 7/30.

DH came to the hospital when he got off work.  He made arrangements to take the next day off for the "move."  We told Grandma she was staying another night in the hospital, which was met with no opposition as soon as her supper arrived.  Since I hadn't eaten since breakfast, DH and I left at 6:00 to get dinner ourselves. 

The next day (Wednesday) would be hard - though I couldn't imagine any more difficult than this day had been. 

So ends Episode 63