Saturday, June 24, 2017

I can choose to be a victim of the world, or an adventurer in search of treasure.  Its all a question of how I view my life--Paulo Coelho
I am back from my adventure to Israel and Jordan.  Every trip we would come back from, I would always say "That is the best trip yet!"  But this one truly was.  I have wanted to go there for so long.  We had reservations to go there for our 50th anniversary, but then when I looked more carefully at the itinerary and the comments about how strenuous the trip was, I knew Bob could not do that.  So God in His wisdom made me wait, and this trip with all the Biblical connections in spoken word and wonderful violin music (hymns) made the footsteps of Jesus come much more alive.  So it was a spiritual journey, as well as a physical journey (rigorous at times with the heat).  And the group was so compatible, and included from ages 7-80, with 8 teenagers that kept things lively.  I only heard one "discouraging word" and that was from a teenager as we were climbing a steep hill.  Her mother just told her to look at the 80 year olds that were doing it, and to get going!  And God sent my roommate to me as well in a miraculous way.  We were talking about my upcoming trip during our monthly retired nurse's luncheon, and she looked at me and said "You are going to Israel? When I responded in the affirmative, she said "I am going with you."  I needed a roommate, and it couldn't have worked out better.  We never felt afraid, except maybe a little uneasy when going through security coming home from Jordan.  I was afraid I could get upset with the agents when they completely unpacked my carryon bag that was packed to the hilt!  And they did it twice within 40 feet of each other.  But we didn't get patted down as some had.
I didn't worry about Bob while I was gone.  The extra care layer of hospice also worked out to "the good of those that love the Lord" and turned what could have been perceived as a negative experience into a positive one.  The nurse would call our daughter Valerie with a report after she had seen Bob, and then Valerie would message me.  We just had to keep aware of the time difference!  When I got back he is very much better than when I left.  He was having to be fed when I left, but now he is much more aware of his surroundings.  Valerie and her family came for Father's Day weekend and we all went out together.  He obviously knew who they were for the first time in a long time, and called me "his wife Betty."  He couldn't say their names, but tried to carry on a conversation even though it didn't make sense.  I don't know what to attribute that to. Before I left, hospice asked if they could give him a round of Cipro, an antibiotic.  He had been tested at least twice for a urinary tract infection, and everything always came back he didn't have one.  But they felt he might.  I don't know if that is what made the difference.  Wouldn't it be wonderful if Cipro is the cure for Alzheimer's?!  I cannot say enough good about having hospice on board.  The equipment is furnished, and also the incontinent supplies are paid for.  The bed has a foam mattress that comes up on the sides (not the forbidden restraint of side rails) so he can't get out, and they lower the bed to the floor at night, in case he would get up, he wouldn't fall.  He seems to be getting stronger as well, and tries to get out of the wheelchair.  And the other evening when I went, he was happily eating an ice cream bar by himself.
I will end this post with something I have been wanting to address.  Sometimes it seems that people avoid talking to a family member because they don't know what to say.  I totally understand that.  I have wondered recently if the phrase "I am sorry for your loss" has become a cliche.  For me, "How's Bob?" is fine.  I love to talk about him.  But you can just say sincerely to someone "I am here for you and I care."  Or just a hug will be welcomed!  Valerie told me two that she liked.  One was "I've been thinking about you.  How are things with your dad?" Another one was "I am so sorry.  Please know you are in my thoughts and prayers."  Be warned that any of these may elicit a few tears, but that is OK too!
The Chattanooga grandchildren will be here in about an hour, and 7 year old Libby will be here for the rest of the summer until school starts, so I don't know how much blogging I will get done.  I am anxious to see if Bob remembers them as well.
Have a great summer!
Betty

Friday, May 26, 2017

Writing this blog soon after the previous one, but some may still be wading in deep water, and there are a few more points I want to add to help you avoid the sinkholes.  Also, when I return from Israel, I will have 7 year old granddaughter Libby for the rest of the summer, so I may have trouble organizing my thoughts as well!  When I met with the staff at The Piper, they said I was bringing up things they had not thought of before.  So I hope this blog will help you as you care for a loved one or even yourself.
A couple of days after the incident I related in the last blog, I locked myself out of  the house for the first time in my life!  Fortunately my wonderful neighbor Mary was home and she called a locksmith.  While we were sitting on her deck enjoying a cup of coffee while we waited for the locksmith, I could envision The Piper needing me, and calling on both of the phones that were locked in the house.  When I got in the house about an hour later, yes, every phone was lit up with several messages.  They were from The Piper, but also from daughter Valerie, since they had also called her when they couldn't reach me.  Bob had gotten up from his wheelchair and had fallen and had 2 gashes on his head.  It is their protocol and I think everyone else's protocol that when there is a head injury they are required to take the resident to the hospital to check for subdural hematoma.   But Steve, the nurse I am on a first name basis with, told me he figured he knew what my wish would be since he was on when the other incident occurred, but he had to hear me say it.   I totally understand this policy in this litigious society.  But Valerie had asked what Bob was doing, and they said he was sitting there happily, so we both said, no, don't take him to the hospital.
Which brings me to something you need to be aware of.  In our county, there is a wonderful ambulance service, Johnson County Medact, which was started by, and originally trained by, SMMC doctors.  They have a form that you fill out and keep on your refrigerator called "file of life."  If they are called to your home, and you are unresponsive, they look for that paper.  It tells which hospital you would like to be taken to, and where your DNR papers are in your house.  If you call 911 and ask for an ambulance, and it is not an emergency, please tell them it is for "transport only" if you do want to be taken to the hospital and have the DNR papers ready to give them.  Otherwise they are required to resuscitate you in the ambulance if need be.  Another service they provide is to help pick people up off the floor at home if they have fallen.  It is better to call them to do it for you if you are caring for a loved one, so you don't hurt your back trying to pick them up, and also they can assess for injury before moving a person.
One more pitfall I am hearing about that I want to mention is that when you go to a hospital (even an emergency room), you go where your insurance covers your care.  But there is a potential for "out of network" doctors to be working there.  I have heard of it occurring in the ED, and also anesthesia departments, and of course you don't think to ask, especially when there is an emergency.  If it happens to you, dispute the bill (which will be much higher of course).  Another thing The Piper and I have talked about is how to identify the residents that are DNRs.  And  not all the residents in the memory care units are DNRs.  They have talked about putting a sign in the room, but what happens if the arrest happens in the common areas?  Now the list of DNRs is kept in a notebook, and all staff is to be oriented as to where it is.  But I know in the heat of the moment, things get forgotten.  All nurses say for them personally, it will be tattooed on their chest.  But for me that is not good enough.  Clothes aren't always removed when resuscitation is started, so I am going to have it tattooed on my forehead....Anyway, for Bob, I went to the hospital and got a bracelet for him.  It has changed since I worked at the hospital and now is a different color and says DNR/AND.  I didn't know what AND stands for, and neither did a lot of the hospital staff, I found out!  But it stands for Allow Natural Death.  Then I wish facilities had a form to fill out about what the family wants to be called for, or what they want their family member taken to the hospital for.  The Piper does not have one, so I wrote one out myself and signed it.  At first I just wrote to take him to the hospital for a fractured hip or other bone.  Then I got to thinking of all the other scenarios that could cause severe pain--kidney stones (Bob has had 2 of them) and gall stones, etc, etc!  So I added the words "Or anything causing severe pain."  But now that is kind of a moot form, since Crossroads Hospice is on board.  I cannot say enough good about hospice care.  I know it has a negative connotation for some, as they think end of life has to be within a certain period of time after hospice care is implemented.  But they reevaluate every 90 days, and Bob could potentially come off hospice care and then be readmitted.  But with the steady decline that is common with dementia patients, they can requalify easily for the most part, and stay on hospice care for a longer period of time.  Hospice is the first one now called for any need that Bob has, and they are coming out to see him frequently and are also helping with his physical care, as well as medical care.  The staff from The Piper and Crossroads Hospice and I had a family meeting, so everything is in place to work together for Bob's very best care.  They call me with a report after every visit.
I posted this to Facebook, but I will repeat it here for those of you not on Facebook (and because I really like it).
The journey of dementia is a journey like no other.
Dementia makes you realize that there's no time to waste.
Each moment is precious, a treasure in its own way.
We all know the last chapter in the book.
Dementia taught me that all any of us really has is today.
---Leanne Charmes, Memory People

Live life, and each moment, to the fullest!
Betty

Thursday, May 18, 2017

Just when you think it is smooth sailing, the storm appears very suddenly and it takes all your being to navigate.  Before I begin this blog, I want to make it clear that what happened is no way the fault of the facility where Bob resides, The Piper.  Also, I want to say that I have never before met a Nurse Practitioner, that I have seen professionally, or as a friend, that I didn't like.  They are generally so competent and well prepared in their profession.  Some doctors rely on their more current knowledge!
It was a gorgeous day, and I worked happily in the yard for 5 hours, not even coming in to get something to drink.  When I came in, I was washing my hands and my mobile phone rang (I didn't have it out in the yard with me).  All I can say is, GOD WAS WITH ME, and made me go in the house so I could answer that phone.  It was the Nurse Practitioner that is employed by the doctor that serves The Piper. She told me that Bob had had a stroke and needed to go to the hospital immediately.  I told her "wait a minute" and told her that this was the third time this very thing had happened, and it happens when Bob is absolutely worn out, and he just falls into a very deep sleep, and can't be aroused.  She said, no he has had a stroke and we need to go to the hospital NOW.  I asked what would be gained by going to the hospital, and she said it was too late in the window to do tPA, (the clot busting drug) but at the very least they would need to give him fluids and probably do a brain scan.  I told her no, that I didn't want any extraordinary measures done, to please not to do anything till I got there, and I was on my way.  She then said, "Because you are refusing care for him, you realize that you are saying it is OK to let him die.  Is that what you are saying?"  I thought to myself that it was a rather blunt way of putting it, but to her I said "Yes, that is what I am saying."
As I pulled into The Piper parking lot my phone rang again and it was her, asking if I was there yet.  I told her I was just pulling in, and she said "I will meet you at the door."  Of course that made me think he had already died.  But when I ran in, she introduced herself, and instead of comforting me, started babbling on.  I took a deep breath, assured myself that he wasn't indeed dead, and turned around and headed for his room with her following.  When we got to the room, I looked at Bob and he was lying there, sleeping peacefully, but he didn't rouse when I shook his shoulder and called his name (no sternal rub....).  She then informed me that he had a normal temperature that morning, but that it had spiked to 101 degrees and that she suspected meningitis.  I asked her why she suspected that.  She said because when she was called to assess Bob, he was slumped over.  She had tried to raise his head to assess his pupils, and he had groaned like his neck was sore.  I told her "Oh, please!  Bob always wakes up from a nap with a krink in his neck, and has for years."  She said no, she was sure he had meningitis, and she was going to send him to the hospital for a spinal tap as she had to protect the other population of The Piper.  I told her she wasn't going to do any such thing.  She then told me to call the family as it wasn't going to be long.  I told her our daughter and family that live 4 hours away had gone camping and weren't available by wifi or cell phone service.  She then said, "Well then.  We need to call hospice for you so you will have some support."  I told her to please call Crossroads or Ascend Hospice.  She left, and I headed for the car to get the bag I had packed with a toothbrush, a snack, and a book.  When I came back in, she was in the common area.  I asked if she had gotten ahold of hospice, as I was going to put that on hold, and she said yes, she had called Encompass.  I asked why she had called Encompass when I had told her the two I wanted, and she said, "Because they can get here faster."  I told her to cancel that.  I went back to the room, again touched Bob, and he responded. So I put a straw to his lips to give him a drink.  He drank 2 glasses down without stopping.  I went out and told her that he was responding and drinking water like he couldn't get enough of it.  She asked "Did he choke?"  I told her that he did not.  I went back to the room and was met by the nurse from The Piper and the director of nurses from The Piper.  I told them what had happened, and asked what would have been done had they not been able to get ahold of me.  They said that they would have taken him to the hospital per her direction.  And I am sure it would have been Providence Hospital as it is closer, and not to Shawnee Mission Health where all his records are, and where I had written all over the chart that SM was where he was to go.  Again I told them that God was with me, as taking him to the hospital could have been disastrous.  Bob drank 4 more 12 oz glasses of water and was responding well, so I went home late that evening after telling both nurses he was not to go to ANY hospital, and please let him sleep.   Of course I couldn't sleep, so I got up early and took a shower, and was at The Piper before 0730.  Here was Bob, sitting at the breakfast table, happily eating breakfast.
After this incident, I spoke with our wonderful family physician and asked if she could take over Bob's care at The Piper.  She said certainly, but she would like to think about hospice care instead, and asked if she could send in a consult to Crossroads Hospice.  I said of course, but would he qualify?  She said he would qualify on at least 2 counts--loss of mobility and loss of weight.  So Crossroads came to evaluate Bob on Tuesday.  He has gone from using a cane in December, to a walker in April, to a wheelchair in May.  His weight has gone from 183 in the doctor's office in September (too high) to about 175 in December (fighting weight) to 163 now (too low).  So Crossroads accepted him immediately.  I am so happy.  He got a new bed, with a foam bolster so he can't get out of bed and fall, a new snazzy wheelchair, all incontinent supplies, and all for free.  They will take over his entire physical (including bathing) care, and medical care.  It couldn't be better to give me peace of mind while I am in Israel and Jordan in June.  I still pay for him to stay at The Piper, and they also help care for him.  I met with the hospice nurse yesterday, with the chaplain and social worker today, and we have a family meeting with Piper staff tomorrow to make sure everyone is one the same page.  So I hope the boat is upright again!  I am sorry this is so long, but I don't want anyone to experience what I went through.  It came out of the blue so quickly I couldn't believe it was happening.
In closing--May the Lord walk beside you to comfort you.
                  May the Lord walk above you to watch over you.
                  May the Lord walk beside you to keep you safe.
                  May the Lord walk before you to show you the way.

I certainly believe He was with me in these last 2 weeks as the ship was floundering!
Betty

P.S.  Because I can write better than I can talk, and because it was therapeutic for me, I wrote an email to the NP.  I asked her to please listen to the family when they tell you something, as they know them much better than you do, and know their idiosyncrasies. I told her not everyone fit into a mold, and Bob is one of them.  I asked her to please think before she jumped to conclusions.  I asked her to please consider the clients she was serving--she was serving dementia patients, not ED patients.  I asked her to please learn from this experience (she has only been employed 2 weeks but I don't know if she is a new grad. She is not young).  On a side note, I was told by a Piper staff member that the very same thing happened to someone else a few days later and her response was "what are the family's wishes?"  Yay!

Friday, April 21, 2017

Bob is now basically in a wheelchair.  It is another loss of independence, but everyone (including Bob) is happy about it.  I cannot determine if the loss of mobility is due to the fact that his brain is not telling his feet to move anymore, or if his legs are just too weak to hold him up.  The assistant and I were walking him back to his room a couple of weeks ago with his walker, and I didn't think we were going to make it to his room without lowering him to the floor.  I asked if she thought it was time for a wheelchair, and she said "Oh, yes, it would be so much easier."  I was able to get the one a friend Grandpa Mac had used before he passed away and took it out the next morning.  It is just a transport wheelchair, so it is small and portable, but it fits under the sink and the table, so it is wonderful for what they need it for.  He rides in it like a king in his chariot and now he is so much more co-operative with cares when he needs them when he doesn't have to walk all the way back to his room.  Could it be that he just went on strike?  Hmmm.
This post is going to be about the 3 kinds of grief nobody talks about.  It is brought home to me every time I go visit, as a friend from the support group visits his wife in the room across the hall from Bob.  She is on hospice as she suddenly took a turn for the worse.  I look every time to see if her name is still on the door.
1.  The first is the loss of the person we once knew.  They are still in your life, but not in the way you remember them or once knew them.  Dementia changes people.  The ties that bind us to one another, the shared memories, and even the personality are no longer accessible.  Other illness create a similar sense of loss--a traumatic brain injury or stroke, or a loved one who is drug or alcohol dependent.
2.  The loss of a person we haven't yet lost.  "Anticipatory grief" is a term that refers to the grief felt about someone with a life-limiting illness; friends, family and caregivers often experience it in anticipation of an eventual death.  These losses are significant.  We lose our assumptive world.  All our plans, thoughts, our sense of the future--even our safety and security--are now challenged.  The future we know is not the one we once imagined.  As any illness progresses, we continue to experience additional losses and grieve each one.
3.  Loss of the person we used to be.  Everything changes as you age.  Some changes you take in stride, but others affect you deeply.  Consider the birth of a child.  You may have anticipated this event for years and be overjoyed.  But you also know life will be different now; over the next couple of decades, your own freedom will be limited, and so will your sleep.  Each transition in our lives--no matter how positive--has an undercurrent.  The thrill of passing your driving test and earning your license held so much meaning, a mark both of accomplishment and maturity that promised new freedom and adventure.  Now, imagine the pain and grief when, through age or disability, you are forced to surrender than license and all it has meant.
Remember:  Grief is not always about death, but it is always about attachment and separation.  You need to have your grief acknowledged and understand the validity of your emotions.  You are not the only one to have mourned, and you are not alone.
The above are excerpts from "Grief is a Journey" by Kenneth J. Doka, PhD.
 So many of my friends have lost their loved ones to death recently, and are going through all the stages of grief that Elizabeth Kuebler-Ross identified.  I grieve along with them for their loss, and can identify as I am going through "anticipatory grief".
The following is authored by Claudia Minden Weisz.  Thank you to Yara Young for sharing it with me.
I asked God to give me happiness.  God said, NO.  I give you blessings, happiness is up to you.
I asked God to take away my habit.  God said, NO.  It is not for me to take away, but for you to give up.
I asked God to spare me pain.  God said, NO.  Suffering draws you apart from worldly care and brings you closer to Me.
I asked God to make my spirit grow.  God said, NO.  You must grow on your own, but I will prune you to make your beautiful.
I asked God for all things that I may enjoy life.  God said NO.  I will give you life, so that you may enjoy all things.
I asked God to help me LOVE others, as much as He loves me.  God said...Ah, finally you have the idea.
The sing-alongs we are doing at The Piper are going well.  The residents and staff both ask me, and whoever is with me, to sing when we come.  Sometimes we haven't planned on it, but when it is such a bright spot in their lives, how can you deny them?  Bob usually sings lustily along, and the residents seem to get such pleasure from being able to read the lyrics Arlene Magruder printed out for them.  We went out on Easter Sunday not planning to sing, as we thought the residents would have company.  But NO ONE did, so we had a real song fest!  I know it gives us more than we could ever give them. (More people had company after the Royals game was over...)
I have found that I have always needed something to anticipate.  So rather than focus on "anticipatory grief" I am anticipating something else.  I am going to fulfill another wish on my bucket list and take a trip to Israel and Jordan in June.  It is lead by Andy Nash from Southern University, and I have heard so many good things about the trip that I am really excited.  Now if world leaders will just cooperate and keep things to a dull roar, that will be good.
May God give you the grace to face life's challenges, and may He give you LOVE.
Betty




Thursday, March 30, 2017

This post could be called "Life at the Piper," or Peyton Place Piper, or any number of names.  I have mentioned before the little lady that has taken a liking to Bob.  She looks so sweet and innocent, but in her chest beats the heart of a cougar.  Her normal self would probably be horrified at this turn of events.  I will call her "Kitty" to protect the guilty (sincere apologies to a nursing roommate and still dear friend named Katherine, aka "Kitty"!)  The last time we visited the Piper when friends Janet and Leonard were here, we were all in the sunroom.  Leonard, being such a nice guy, answered Kitty as she engaged him.  All of a sudden Kitty opened her sweater and flashed him.  Fortunately she had a blouse on underneath.  Then she went over to her rival, Janet, and flashed her as well.  As Janet was staring dumbfounded at her abdomen, Kitty said "Look a little higher.  You aren't looking high enough."  Under normal circumstances I would take offense at my husband being stalked, but now I just try to find the humor in it, and Janet is as well.   One of the other residents, a dear lady, has warned Kitty to keep away from Bob--"he is Betty's husband."  And that HAS seemed to help.
The soap opera continues.  One of the newer residents has a dog, and she is such a cute little thing.  The owner is well enough to take some care of the dog, but when she takes her outside, she forgets to put the leash on, and the little Shit(zu) can scoot under the fence.  This happened one day while I was there, and there was no one to chase her.  So add dog-catching to my list of talents.
We are continuing with the impromptu singing for the residents.  I want to emphasize that it is by no means a performance, and leading the singing while Gail plays the piano is NOT one of my talents.  I have sung alto for years, and the melody to most of the songs is really high.  But the residents seem to enjoy it so much and ask for us to sing when we come, so we do it just to please them.  Some that never interact in any other way participate, and have beautiful voices. Many thanks to Arlene Magruder for printing out the lyrics to the songs, and anyone that happens to be there for handing them out and picking them up.  One of the hymns that they really seemed to enjoy was "Never Part Again".  Then I looked across the page at the hymn "In a little while we're going home" and immediately decided not to sing that.  One day I was singing and playing the piano both as no one else except Arlene was there.  I sang the song "Shenandoah" and Arlene told me that Bob started crying.  I am glad my back was to him, otherwise I would not have been able to finish the song.    Our memories of Shenandoah (National Park, not the river) started by going there on our high school senior class trip.  We camped, as that was all anyone could afford, and a bucket of water froze overnight.  After we were married and lived in Maryland we went there tent camping with the children, and would end up carrying them back from hikes.  In later years we went back with them and stayed in cabins in the park, and did NOT carry them back from hikes.  After they left home, Bob and I went back for a few anniversaries during trips to Maryland.  One weekend we stayed at The Inn at Little Washington" which, if you live in the area, you know is about as far from tent camping as you can get.  But it is right outside the park, so we went back in to the park to do the traditional hikes.  So Bob must have been remembering the fun times we had there.
Kim, the director of the Piper, had the Alzheimer's Association download many of Bob's favorite CDs on to an iPod type device.  It gives him about 7 hours of listening.  He is not able to play it himself, but I started it for him the other day, and he seemed to enjoy it.
Sincerely, life at The Piper seems very homelike, and the staff is very pleasant and competent.  I want to thank them all, as they have to be so patient to do that kind of work.  I could not do that day after day.  I like it there as it does not "feel" like an institution.
While we are talking about music, I would like to close with a song the Righteous Brothers made famous, "Unchained Melody".  It has special meaning for me now, and I am sure it also strikes a chord with others who have already lost their mate.

Oh my love, my darling, I've hungered for your touch
A long lonely time
And time goes by so slowly, and time can do so much
Are you still mine?
I need your love, I need your love,
God speed your love to me.

Lonely rivers flow to the sea, to the sea,
To the open arms of the sea.
Lonely rivers cry, wait for me, wait for me
I'll be coming home, wait for me.

Lyrics by HyZaret, music by Alex North

Leonard Marsh's favorite saying is "when life gives you lemons, make lemonade."  He went a bit further after our last songfest when he was here (with his baritone voice, never missing a word, even though we didn't have the lyrics all printed out yet.)  "When life gives you Alzie, go ahead and Waltzie" he proclaimed.

Thank you Leonard.  I will try to remember that.

Betty





Friday, March 3, 2017

Bob has been at The Piper for almost 2 months now.  He is doing very well.  He has started physical therapy through Shawnee Mission Medical Center, and they think it is making him stronger, and able to balance better.  Our son Ron was in town last weekend and went to see him.  He and a CNA tried to get Bob from the dining table to an easy chair so they could visit better.  Bob was moving the walker, but not his body.  They told him that he would have to take a step, as the walker was getting farther and farther away, and he was going to fall flat on his face.  He told them forcefully "I don't have to take a step."  What is the saying?  "Mind over matter"?  When Bob first went there, he was having tremors so bad that I was starting to have to feed him.  When the head nurse Karen Berning, did the intake assessment we were talking about the "whole lot of shaking" that was going on.  She said the protocol was to give the minimum dosage of a drug, and asked if it was OK with me if they tried decreasing the resperidol that he was taking for agitation.  I said, "Well, he is here now, so you will have to deal with the consequences!"  She said they would decrease it to once a day instead of twice, but could increase it again if need be.  I asked about adding depakote, which is normally given for seizures, but it is also given to decrease the extrapyramidal (outside the columns of motor fibers that run on each side of the spinal cord) side effects of  resperidol.  But Bob is very sensitive to drugs, so adding that could increase the chance of a whole new set of side effects, among them abnormality in thinking and tremors!  I had asked the neurologist at the last appointment if the tremors were the beginning of Parkinson's disease, and he said no, just the progression of Alzheimer's.  He knew Bob was taking resperidol, but did not pick up that the tremors were possibly a side effect of it.  The tremors have almost stopped now with the decrease.  So kudos to Karen!  It pays to have someone that works with this all the time take over!
I have been playing the piano sometimes for the residents when I have gone out, and with friends Harry and Gail and Heather Janke and Arlene Magruder have done some sing-a-long type activities.  Some (including Bob) really belt out the songs, and I can hear residents in other rooms singing as well.  Arlene found a wonderful book of oldie but goodie songs that everyone will know, and the same group is going out again tomorrow and do it again.  Bob is adapting very well to the "household" and it is fun to see the residents watch out for, and help each other.  It is also wonderful to find out about the life stories of others that are there, and they are eager to tell you!  Maybe with some embellishments!
I am so happy Bob is in a good facility, and the atmosphere there just seems so calming.  There is a web site you can look up "Nursing Homes Abuse Advocate.com" and it tells the facilities in each state that are cited for abuse and/or neglect.  It is refreshed every month.  If you have questions about a particular facility you can go to them and ask to see the paperwork.  They are required by law to show it to you.  It may just be a complaint about a policy, or it could be much more serious.  When you go to the site click on "menu" and then "offender by state."  It is very interesting.  Huge prices don't always mean good care.....
A little more "taking care of business" that some may be interested in.  I watched a special on PBS about Alzheimer's disease that is now really a disease of epidemic proportions.  They were talking about the state of Florida with it's aging population.  When a person applies for Medicaid (NOT Medicare) there, it can take up to 5 years to be approved, they are so far behind.  What do you do in the meantime?  If you apply too soon, you won't be approved!  It is having disastrous consequences in Florida, as after paying out Medicaid, the state has no funding for roads, education, or anything else.  On the other hand, New Hampshire put a moratorium on building elder care facilities years ago as they could see the handwriting on the wall.  Some facilities will tell you that they do not take "medicaid pending" patients as the person may not ultimately qualify.  And what if a facility has a waiting list to get in?  The timing can be very tricky, and you should enlist the help of a social worker or elder care attorney that "knows the ropes."  However, when you are approved, the payment is retroactive to when you filed. Again, you have to cover it in the meantime. Some facilities require a nonrefundable downpayment when you are applying, others it is refundable.  And what if you are private pay and then run out of money?  Some facilities have a foundation that takes over and pays when that happens, but anyone please correct me if I am wrong, but I think that typically happens when you have bought into the facility.  Another resource is veteran's benefits, and they are very helpful.  I just found out when I filed my taxes this week that respite care and care in a long term care facility is tax deductible.  There are some qualifications and fine print to this, but at least that is some help as well.
I am leaving in a couple of weeks on a grandchildren tour again while they are on Spring break, but it makes it so much more enjoyable when I don't have to worry about Bob while I am gone.  And the cats will be well cared for as well, by Denise, who is a mutual friend of their former "mother" and me.  She comes to the house, so they don't have to be stressed by moving.  They have pretty much taken over the house....I just live here.
In closing, this has become my mantra.  "Jesus will not give me everything I want, but He will give me everything I need."  And I see daily evidence of His leading me in this journey.
Until next time,
Betty

Thursday, February 2, 2017

Since I took a nap this afternoon and am wide awake, I will share another blog with you.  I find that I am still catching up on sleep.  I think I was not so physically exhausted, just emotionally exhausted.
I am trying to focus on all things positive.  I cannot let myself have a "pity party"!  Bob is still very happy and seems to be enjoying The Piper.  When I visit him and tell him I am leaving,  I always give him a kiss on the lips, but the other day another resident (female) beat me to it, and then I was a little hesitant to follow!  I just have so much to be thankful for.  I still remember the state hospital where we took our psychiatric affiliation in Sykesville MD (should have been spelled "Psychsville").  A few years after we were there, I guess due to lack of state funding, they just opened the doors and let everyone out on the street.  I cannot imagine where they went.  Homeless on the streets of Baltimore?  The only ones that remained were the criminally insane.  I also don't know what happened to whole multistory buildings of micro and macrocephalic children.  So to be able to see Bob in a beautiful facility where he is content is wonderful.  I take photo albums out and he is usually able to identify his brothers and grandmother in the albums.
 I still miss Bob the most, I think, when I am watching football.  We have a long history of football together.  In high school we went together with a teacher to the Baltimore airport at 6am to watch the victorious Baltimore Colts come home.  And he would write down all the plays from Sunday football games, and bring them to school Monday for me to type up.  That was fine, but I could barely read his writing!  We watched games together every Sunday before Superbowls were even thought of!  And in recent months, when he didn't even know which teams were playing, he was still there to watch the game with me.  Thanks to Gail and Harry Janke who invited me over for this Superbowl Sunday!
In this blog I am going to address caregiving of aging parents (I bet our children can't wait to read this!)  Not to negate the ones taking care of their parents, but I have done both parents and spouse now, and it is a whole different ball game with your spouse.  When you place parents in a facility, it doesn't turn your whole world upside down.  My father died of Alzheimer's and my mother was able to stay on her 8 acre homeplace where they retired in the hills of Tennessee for 8 years afterward.  She was still active as a nurse in the 13 bed hospital there, and set up a small surgery department to do minor surgeries.  And she worked in a clinic for an old country doctor.  When she was 85 years old, the doctor was away, and a patient came into the clinic in labor.  Mother told her to go to the hospital in the nearest town, but she refused saying they didn't have insurance.  She promised verbally she wouldn't sue if anything went wrong, and mother delivered the lady's 19th baby in the clinic.  The dad went and got milkshakes for everyone while mother was bathing the baby and the mother, and then off they went, promising to be back for their 20th!  Of course, the 19th baby is more dangerous than the 2nd baby, as the uterine muscles are weak, and may not clamp down to stop bleeding after delivery....A year later I had to move my mother here as she was having TIAs from high blood pressure than wasn't well controlled.  She was in Overland Park Place, a beautiful independent living facility near the hospital where I worked for 6 years.  But as I hear now from so many at the support group, she was not a happy camper, and as is so usual, took it out on her daughter.  Her favorite saying was that she always went to breakfast so she could see who wasn't there, and had died during the night!  She didn't need assistant living as I was her caretaker!  We took her with us on travels, she flew back to TN to visit, and she came to spend the day at our home at least once a week. But she still wasn't happy.  I tried to go every morning after I got off work and take her home cooked leftovers, and biscuits and gravy from the hospital (which she loved) as peace offerings, but it didn't help.  I "got it" then, and I "get it" even more now as I age, how difficult it was for her to leave her home, her flower gardens,  and her friends.  After a bout of pneumonia with complications she had to move next door to the Overland Park Manor, a nursing home which she hated even more.  She had a private room with all her furniture and pictures surrounding her, but she was still feisty!  But at both facilities, people that worked there would pull me aside and tell me "When you are not here, she is the life of the party.  She is just piling the guilt on you when you come."  She was alert until the day she died at age 91.  
I decided I needed another living thing in the house with me.  A cousin told me that when she married and moved from the farm where she was raised, and moved to an apartment in a city, that she bought guppies.  I decided I wanted to go up the scale a bit!  I had a dear friend who died suddenly in September 3 weeks after finding out she had cancer.  Her dying thoughts were about her two "fur babies", and what would happen to them.  I could not care for anything else in September as I was caring for Bob, and a mutual friend, Denise, told me the family (there were not many family) was going to take them.  Then the other day Denise texted me and said they had not been adopted as plans for the family to take them had fallen through.  She asked if I knew anyone who would want them?!  "They" are 2 gorgeous 8 year old kitties, Sadie, who is a tortoiseshell, and Smoky, who is a beautiful grey.  They are sisters.  They had been in Denise's basement for 3 months, as she is allergic to cats, and also has a dog.  Well, God's timing was perfect, so now I am their proud owner. I think their routine was to sleep during the day, and they still are shy and hide during the day.  But in the evening, they are ready to roll!  When I go to bed, they jump on the bed, and have hissing wars as to who is going to get near me.  Both will lay on their backs with every leg up and let me rub their tummies, and then they will do the "kneading" thing on my tummy.  I think they are saying "thank you"!  And I like to think that Ruth is smiling!
I will close with a quote by Gilda Radner.  I totally agree with the first two sentences.  The last sentence I am still working on believing! "Some stories don't have a clear beginning, middle, and end.  Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what's going to happen next. Delicious ambiguity."
I have a cat rolling around on the keyboard...So goodnight!
Betty