Sunday, February 25, 2007

Mom, The Can Do Kid

Mom, The Can Do Kid
During the weeks that mom was in a cast, then rehab, she needed a lot of help. Help to get her dressed, to get on and off the bed, the potty. Help to get in and out of the wheel chair, and on and off the couch. I'd put my arms around her in a big bear hug, and she would do the same to me. Then I would pivot her to whatever spot she was going to. One day as I was 'hugging' her up off the bed, I told her we have never hugged this much in all our lives!. We're making up for lost time! She laughed and agreed with me.

I continued to move mom from place to place even after she was able to stand and walk herself. I had become fearful that if I didn't help her, that she may fall and get hurt again. But, with increasing frequency, she was getting up and moving about by herself, much to my distress. But the day I realized she needed to get back to doing more for herself, I let her have at it, kept an eye on her, and assisted when needed.

Most of the time, she sits on the couch when she is up. I have put an extra cushion under the spot where she sits, to elevate it some, making it easier for her to get on and off. Problem with that was when she would get an attitude and decide to get up and take off without her walker, holding onto the furniture as she made her way to wherever she was headed. At that time her walker was within her sight and that gets her fired up and charging for it, well, moving towards it in a slowly brisk manner! It is also not safe that she would do that with no one in the room. So we put her walker out of sight in another room, and took the extra cushion off. When she needs to go potty or it's time for a nap, we get the walker for her and set it in front of her.

Now it is a task for her to get up off the couch. Pushing up with her arms, trying to straighten her legs while her butt is up in the air and her head is pointed downward. It is quite a feat to get everything in the proper position and propel herself forward and upward! Once she finally gets ahold of her walker and comes to a stand, she'll look at us and say, "I did it!" or, "The old lady can still do it!" some kind of remark like that.

There are times when she has to try over and over again before she can get up. Attitude and determination play major roles in her ability to get up. If she gets whimpy and whiny and says, "I can't do it...", she won't be able to. Then we have to tell her, " Yes you can do it, you tell yourself you can do it, tell yourself to get up and you will get up." She will start telling herself, "Get up, get up!" and very shortly she will be up and on her way.

It's the I give up, I quit, I can't thinking that will stop her from getting up or doing the things that she actually can do. Even at almost 93, or if she is tired, if she speaks and thinks 'I can do it', she will be able to. Mom has always been a stubborn, strongwilled, determined person. And even now, I won't let her quit and whimp out on herself. She is strong even if she appears frail. It is keeping that positive force at work in her mind that keeps her able to do as much for herself as she can.

Mom, the can do kid!

Independence

Independence
One day this past summer, I realized that I was in fear of mom falling and getting hurt again so I was doing everything for her, dressing/undressing, getting her on or off the pot, just about everything. But something I read plus the realization came that I was doing her no good by doing so much for her. To keep her strength up, to keep her dexterity, to keep her mind thinking, I needed to let her do as much as she possibly could for herself. So, I rearranged her room giving her just enough area to move in from her bed to her potty.

I always had a monitor on when she was in her room. In the first weeks of caring for her, when she needed help all we would hear "Is anybody out there, is somebody out there?" all hours of the day and night! Which sent me jumping and running to her assistance. By letting her have some of her independence back, it has helped her feel she isn't so old and helpless, and it has given me more rest and peace of mind, and peace in the house. Now, she gets up when she needs to, maybe 1 to 3 times, and only calls if she needs help, which isn't to often.

My nights are more restful now and days as well. But this is all a learning process. There are many books to read and articles online to read all have been a help to me, but each situation of parent care is different and must be learned through trial and error. There have been many times that I thought I knew what do do, I had everything under control, wrong. Had to admit to myself that I didn't have it all under control and needed to make some changes. Glad I did.

She can get up as often as needed, she dresses and undresses herself, does her potty thing mostly by herself, it is all greatly improved. She sleeps much more at night then she used to also. I think it has taken all these months of being on an actual schedule for her to get her to sleep more.

So, I'm still wearing that 'caregiver's coat' after a year and the pockets are stuffed with notes of 'did this wrong' and 'did this right'.

'Shedding Water'

'Shedding Water'
I have no idea where mom ever got that phrase from, but she used it one night when she had to get up to, 'shed water'! That night was a doozy! She got up at 12, 1, 2 at 4:15, 6:15 and then at 7:45! I wanted to get her up for breakfast between 7 and 8 but i was so exhausted form all the trips to mom's room to help her during the night and early morning, I couldn't get myself up and going until almost 9:00! So, I got her up shortly after that. I explained that nights events to her, to which she was appalled! She never remembers come morning how many times she gets up during the night, but I sure did!

These were days that I was basically doing everything to assist her, after she had broken her ankle. Even once she was mended and mobile again, I kept on doing it all. I realized later on, that I was in fear of her falling if I wasn't right there to help her move around. The next night after she went to bed at 9, I did some research on the sleeping problems of the elderly, to see if there were changes we could make to help her change the habit of waking up and going to 'shed water'. I found a number of sites that gave me very good information. So, the next day we began to implement the necessary changes to hopefully help us all to get a restful night sleep!

Mom spent her life consuming very little water. Staying hydrated is very important for the elderly, so we were very serious about getting as much water in her as we could throughout the day. Mom is a sipper, we have to encourage her to take 'real' drinks, guzzle that water down. Well, maybe not guzzle, but you know what I mean. More recently, when she drinks, she may cough a lot, because she holds the water or juice in her mouth then swallows it and breathes at the same time. So, we have to tell her to swallow it right down, don't hold it in her mouth. She can take 4 to 6 hours on a large glass of water, with us telling her repeatedly to drink. Her evening glass usually takes her till bedtime to finish. 'Hello'! That means 'shedding water' during the night of course! Also, some of her meds have a diuretic, which also adds to the problem. But, to get up that many times to 'shed water', is just not the norm at all. Time for new plan! All juice and water is to be drunk by supper time, and trips to 'shed water' done about every 2 hours.

The other issue has been her bad sleep habits. She has slept when and if she wanted to for years, establishing a real problem with night time sleeping. I set a regular bedtime or 9 for her, which is later then when she is used to going to bed. I cut back on her nap time and also changed her morning get up time. The day changes worked out pretty good, but the nights continued to wreak havoc at that time. So, new plan, up earlier in am, which will vary upon what the night before was like. No naps during the day, which is a tough one for her to deal with. She actually did pretty well with the changes. She dozed off in the rocking chair instead of crawling into bed for a nap. She still needs to get some kind of rest during the day, although there have been days where she does actually stay up from morning till bedtime, or later! The goal in all this is for her to get a decent nights rest, and me too!

Ok! That plan didn't work! Keeping mom up all day just added to my daily stress, and took away my afternoon quiet time, and didn't change her night pattern at all! For some reason she has to 'shed water' at night more then during the day. Where have been a few occasions where she has slept 4 or 5 hours straight, and I do mean few! It was suggested to m by a couple of nurse friends to try her on Melatonin or Benadryl. I tried both, they each worked well once or twice, allowing her to sleep maybe 6 to 7 hours each time, and that was it. Then it was back to the usual patterns. I went back to having her taking a nap in the afternoon. She needed it and so did I! Summoning me to help her every 1 to 3 hours, every night was very tiring. Something needed to change and I didn't know how to change it.

In August, I made 2 trips to the emergency room for high blood pressure attacks, now I'm on medication for it. Lack of sleep, not enough exercise, eating to much, stress, all contributors to that condition. Had to get rest at night. Had to make changes.

Who Am I - What's In A Name?

Who Am I - What's In A Name?
As mom has aged these past years and her memories have traveled back and forth through the decades, I have always said as long as she knows my name, knows who I am, it's all ok. Then one afternoon this summer find the word. She knew that she knew the answer, but she just couldn't locate it in her archives! then I asked her...what's my name? She named my oldest sister Joyce, who has past away, I said nope, then she named my other sister Lois, who has also past away. Again I said nope. She said I just can't remember! That's ok mom, I'm your daughter and my name is Donna. Donna! she said as if to firmly plant it in the memory banks so as not to forget again!

Today, my husband asked her who I was and she said with a smile, "That's my baby!" What's her name, he asked her, "Donna Mae!" she said very emphatically! She never uses my middle name, so that was kind of funny for us. Shoot, I'm happy for her to just remember my first name!

When I left her room the afternoon she couldn't remember my name, it was one of those moments. A moment that only a parent caregiver can understand. The one who named you, cared for you as a child, helped you as a young adult, and now dependent on you for her care, has forgotten who you are. It was a moment, probably due to the fact she was tired combined with her meds, and it passed. But the effect it had on me, was a bit longer lasting. It's all still ok, but I know that each day that comes, could be one of those moments, that she knows that she knows me, but who are you?

So, what's in a name? A lifetime.

When Mom Stops By

When Mom Stops By
The days that mom stops by for a visit, she is treated like a guest. Served a breakfast of eggs, toast, banana and juice. Entertained by a variety of t.v. shows or maybe a good movie. She watches more so then listens. Visuals are more important these days. At lunch time she has a light meal, never ate a big lunch. Maybe some cottage cheese and fruit. She often stays for supper, I prepare a special dinner just for her. A piece of cake or some icecream rounds it all out. You sure get treated good here, she will sometime say.

At some point she will say, "Well, it's about time I be getting back." Back where, I will ask her. The answer will vary, well to the old house next door,(that's where I lived and it burned). Or, it's to the other place, but she doesn't know where it is. Or, the family will be coming to get her, or who will bring her home?

Obviously, mom did not come to visit. It is one of the days we deal with in the life of mom. I have to remind her, mom, this is your home and you have lived here almost 20 years. The house next door, had a fire and we had to move in with you and now we take care of you. She will shake her head, look down a bit, knowing she isn't remembering some important things, and not understanding why. But sometimes she will say, I'm just getting old and I forget some things. Who told you you're getting old, they are lying! We'd chuckle and off she'd go to get ready for bed. It was a nice days visit with the family.

Mom and Me, Remembering Some Special Times

Mom and Me, Remembering Some Special Times
As a child, going downtown with mom was a treat. We would catch the bus down the block from our house and in minutes, (though it seemed much longer to me in my excitement), arrive downtown. We would go to J.C. Penney's, maybe Zahn's and then almost always, a stop at Woolworth's and their soda fountain, for a strawberry sundae! It came in one of those tall shake glasses. I remember lots of times I couldn't finish that big sundae, but I sure gave it a try! Those strawberries were so good! To drink, I would sometime have a orange soda, maybe it was Crush. That was the only kind of soda I could handle, and even that was hard for me to drink. The carbonation would always burn my throat. But I wanted to have an orange soda anyhow! Woolworth's, a memory intact and a store long gone.

As a young adult, mom and I would run around town doing various things, that's after she finally got her driver's license at 50 something! One of our favorite stops for lunch was the Big Boy's restaurant. I don't recall my favorite food there, but I do know my favorite desert! Cheesecake! Loved it! Had to have it everytime we were there! The best cheesecake I have ever had! Big Boy's, a memory intact, a restaurant long gone from this city.

Some of those various things we would do are go rummaging and go to craft fairs. Mom was a very crafty lady in her later years, maybe 60's on up. She took up tole painting and painted many lovely items. She would shop the rummage sales for wood items that she could put her touch to with her painting. She also took up quilting and made some beautiful items of all sizes, and most of them were very difficult to, not just patchwork. And her sewing! She did most of her sewing by hand! Making microscopic stitches that just boggled my mind, and even, they were even in size and spacing! Amazing! Skills that have long since been let go of as the years cloud into the mind.

Collections! She collected frog stuff and owl stuff and painting stuff and quilting stuff and recipe stuff and stuff stuff! These days she likes angels and large porcelain angel dolls. Most things are insignificant to her. Just the basics are important.

One of our once a year favorite stops was Long Grove, IL. This was an old fashioned little town whose homes and buildings were turned into all kinds of shops. There was a wonderful confectionary, a bakery, (the smell!) and our always favorite, the Apple house where you could, at the right time see them make apple cider. And you always had to buy some fresh cider, especially in the sippy apples! Fresh baked apple treats were always available as well, and be sure to have a sample of their featured bakery item! Oh! and the herb shop! What an explosion to the senses! Even if we didn't buy a thing, we had to go in there and breathe deeply! I almost forgot, the 'Irish' store, where the best homemade Irish soda bread ever exists! We always bought 1 or 2 loaves of that! There are antique shops, toy shops, craft shops, on and on. It is such a fun place to go, and a very busy place to go during the tourist season! We've taken the kids with, taken the husband with, but the best times were with just me and mom.

We took a trip almost every summer, it was mom's way of escaping my grandma, whose house we lived in! We would return to her home town in Ohio, or go out to Oregon to visit relatives. My favorite memories are riding in the double deck train through the mountains, seeing the majestic Mount Hood rise out of the lake as we rounded the bend. Going to the redwood forest in Calif. during our Oregon visit and standing inside the huge redwoods. My mom telling the man in front of me, as we were getting off the bus somewhere, "Could you please move and let her through, she is going to be sick!" He didn't... and I did... be sick... all over the back of his nice suit. She warned him, right?

Most are wispy memories now, except these few I have shared with you.

She's A Wanderer, She's Just A Wanderer.......

She's a Wanderer, She's Just a Wanderer, She Roams Around, Around, Around..
I can't say how many times I would get up during the night or early morning hours, look over at mom's house and see lights on, not just in her bedroom, but in the front room too. One time, my husband happen to be getting back late in the evening, and saw her kitchen light on. he went to check on her and she was getting ready to eat breakfast, at midnight!

Day and night, night and day, it all blended together for her most of the time.
with no one here to schedule her days and nights, she did her own thing. when she woke up, if she decided it was time to get up, even if it was still dark out. She would get dressed and go and have breakfast or go sit in the front room and read or watch tv.

Living next door, we checked on her in the morning and during the day as we could and then again in the evening. we did the things for her that she could no longer do. But keeping her in bed at night, that we couldn't do because we weren't physically living in this house. She also spent a lot of hours napping during the day, basically because no one was here and she would get lonely or bored. so of course that didn't help her to sleep during the night either.

When we had the fire, the only thing we could do was to move in here, or we would have been homeless. A new chapter in our lives, from a book we never thought we would be reading. That was my grandma's house. She raised her children there, dad and mom raised their family there, (that would include me!)
And i raised my 4 sons there, and all but one of my 7 grandchildren had spent time there as well. so, that which contained my lifetime of memories, was destroyed.
But, we were well, and now faced with the job of making this little house habitable for the three of us.

We have to sleep on the hide-a-bed in the front room, and many times during the night we would be awakened by the "wanderer". She would wake up, go potty, and decide to get dressed and come out of her room, turn on the kitchen light or walk into the front room, (where we of course are trying to sleep, funny), go into the bathroom, turn on that light and put her teeth in, then proceed back to the kitchen or her room. Now all this could occur in any sequence and at any time of the night or early morning. Every night we were "chasing" her back to bed at some point! Every night we would waken to the dreaded metallic sounding 'click, click, click' as her walker makes it's way across the kitchen floor, knowing that confrontation was soon to begin again. Sometimes she would just walk into the kitchen, look at the time, turn around and go back to her room and to bed, yeah! However, that was few and far between. This was the nightly routine for about 6 months. Nightly sleep interruptions. Those were the easy nights! I'll share about the really fun ones later!

The weeks following when she broke her ankle, and had the black out episode were very taxing, emotionally and physically. They had affected her mental and physical abilities greatly. She did recover well from the ankle break and walks with her walker again, but must always have someone near by. Her mental acuity is what it is, and we deal with the 'fuzzy' moments, repeating conversations or information as often as we have to.

She has been totally depended on us since that time, although she will state, "I don't need anyone to look after me!" She still has a great sense of humor. She loves to watch The Chronicles of Narnia, Jumanji and she gets a good chuckle at the Three Stooges! And I can get a good out of her from time to time also. She said one day, "We sure do have fun here don't we?" and another time she told me I was more fun than a barrel of monkeys! That was months ago, and the realities of caregiving have long sense set it. But we still try to keep the humor going, you have to do that for everyone's sake.

I know the years of sleeping whenever she wanted to, plus her age plus possible side effects of her meds, all have contributed to her wake/sleep cycle being so confused. I have done much study on the matter, trying to find a solution. I did try various things to help and I will talk about them in the next 'chapter'.

Time to go tend to mom. She is watching Narnia, and needs to get her cranberry juice finished before she takes her nap.
Until next time!

Wednesday, February 7, 2007

Transitioning From Daughter To Caregiver

At 92 years old, mom is fragile and strong, smart and sometimes 'fuzzy'. She has a great sense of humor with a twinkle in her blue eyes, and if she gets mad she could give you such a whop, if she wanted to...which she doesn't.

We had been looking after mom for quite a few years. Living next door made that pretty easy. Each year we had to take on more and more of her responsibilities, laundry, shopping, paying bills and so on.

She continued doing some simple cooking, fixed microwave meals and of course had a dish of frozen yogurt before bed! That was her daily 'fix'! I started getting meals on wheels for her when the cooking became something that she really should avoid doing. She could just pop that meal in the mic, she could handle that ok.

She was still able to take care of her nature calls herself. She had a port-a-potty in her room for when she was in there, or she would use the regular bathroom when she was in the front room.

But bathing was being eliminated more and more, so I needed to step in and assist with that, as well as doing her hair and nails. No problem, we lived next door as I said, a few feet away. You do what you need to do.

November of 05 our home burned, and we had to move in with mom. Now what.....


The day of the fire, we moved into mom's house next door. Thank God we had a place to go. We slept in the front room on the hide-a-bed. Since we were living here now, we could tend to her much more effectively and frequently. She was still able to look after herself during the day while we were at work. But that would come to a halt before to long.

Mom had been living alone for many years and as a result had established very bad habits and routines, or I should say lack of routines. As she got older her once very routine day turned into a do whatever, whenever or not at all! The included sleeping, eating, bathing and so on. She would get up at all hours of the night, sometimes getting dressed and having breakfast at midnight! Well, needless to say we lost a lot of sleep for awhile until we could get her into a good routine, for all of us! I got her on a schedule of when to get up, eat, nap and go to bed. She still frequently rebels against the routine, "I will go to bed when I want to!" Having a routine was necessary for our sanity and even though she doesn't realize it so very beneficial for her.

Now we make sure she gets a good breakfast, at breakfast time! She gets her correct meds when she should have them, and make sure she drinks enough liquids, which she always fell far short of all her life. Water consumption is critical for everyone, but certainly for the elderly. She usually takes 2 to 3 hours to eat her breakfast so most of the time she doesn't eat lunch, maybe just a light one. Then I fix the three of us supper. Which is a challenge. Getting accustomed to her kitchen took me awhile. I lost my creative cooking edge for a time, but of course I still had to cook. Cooking for mom has been the real challenge. She can't taste or smell and many things she cannot chew up. So, I have had the task of finding foods that she can eat, that are colorful, have the right texture, good for her and make up menus using them. Has been a chore.

Since I was living here it was easier to help mom with her personal care, like her bathing. I'd run the water, put her special seat in the tub for her, and what ever other assistance she might need. "There you are, now you can get yourself washed up." "Let me know when you are done or if you need any help." One particular bath night, I had to wake up to the realization that she could not take her baths this way anymore. It was to difficult for her, and she was washing maybe two body parts! So, the next bath night, I had her sit on the end of the seat and do a sponge bath using the sink. I was still trying to allow her some independence and privacy. Truth is, she would just as soon never put water on her body again and she would be just fine with that!

The reality of it all was, I was postponing or ignoring the inevitable facts...I needed to giver her her baths, start to finish. I had been doing her hair at the kitchen sink yet, that worked ok, but it to would change. But this bath thing, I knew she was barely washing at all, but what to do? I knew what to do, I just had a hard time doing it... moving into the role of caregiver.

Realizing and acknowledging was the first step in removing my "daughter's coat" and putting on my "caregiver's coat". When I finally made the decision to take over mom's bath time completely, the coat was all the way on. It is a mental shifting of gears, a pocketing of emotions that only those who have had to do it can understand. It is likened to a death and burial. A changing of the guard. The daughter is now the nurse...dietician...rule maker...comforter...(prison guard!)... companion...all-around caregiver...mom's mom.

Where did the daughter go to? She is beginning to find herself again. It has taken almost a year, but it is happening little by little. Being able to share with others helps me to be somebody, have an identity. My world became very isolated and lonely. That too is changing.

Back tracking again to Easter of 06, mom fell and broke her ankle. That same week she passed out from a tia. That's a little clot that loosens and makes a nuisance of itself then disappears - my medical terminology. Thus bringing more trials to a already difficult situation.....If I don't do it, who will?.....

Going from the broken ankle to the passing out, mom spent several days in the hospital going through a battery of tests, all which showed nothing. They gave her different meds to thin her blood and slow her heart, and changed her blood pressure meds. All of which put her in such a stupor I thought she was actually dying! Being in a strange place, not having someone around her all the time, not being handled in a way that brought her security, combined with the effects of the meds, I really thought I was losing her.

The day I was to bring her home, I took charge, got her dressed, gave her instructions as to how to move, and gave her the security that she had not gotten while there. She responded so well, with understanding and strength I was just a hollering! I had my mom back! I couldn't wait to get her home and give her the care I knew she needed.

So, we learned how to function with her in a cast from her knee down. The first time I moved her, I thought she had gained 50#! But I quickly got used to the added weight. She coped very well with it. When she was in bed she would just flip that leg back and forth like nothing...no pain. See, it had been over 2 weeks before they actually discovered her ankle was broken! That was after Drs. and xrays! A therapist that came to work with her was sure she had a fracture and set up an appointment for her. New xrays and different Drs. found the fracture. So she was going through those days in pain, both here at home and during her stay in the hospital. We were told it was a bad sprain. In the hospital they only wrapped her foot in an ace bandage! We did borrow a wheel chair to use also. She was in the cast for a month and then a month of getting used to putting weight on her foot and ankle. At the end of that month, she stood up and I had her stand with pressure on that foot. I asked her how did that feel, and she said, "It feels like I want to walk!" I said let's go, out to the front room! She walked through the whole house, strong as can be! I told her she was off and running again. she said, "Well I'm off, but I'm not running anywhere!"

I was going to sum this all up, but in caregiving, there is no summing up. It is a job that continues 36 hours a day, day after day, month after month and so on. However long you must where that coat. If it wasn't for my husband, I couldn't even do this, he is the only helper I have. We do have 2 "mommie" sitters that we hire, from time to time so we can actually go somewhere together! It is his love and commitment to my mom that allows him to put on his "caregiver's coat" when he is needed.