Bob has been at his new residence, Hillside Village, for almost a month now. Oh, and now that I have been exploring around the town of De Soto, Kansas (not Missouri!) I think I know why it is called Hillside Village. The whole town is on a hillside above the Kansas River. I love little towns, but Bob liked the big city. So it is ironic that he is now living in a little town, and I live more in a city! He is getting along so well. I am so sad that I didn't think about this before, as it had been talked about, but never acted on before. He was on the medication Resperidone for agitation. It was mentioned by the director of nursing when he first moved to The Piper that it probably should be weaned off, but then she quit, and it never was addressed again. When he was admitted to Hillside Village, immediately they asked if they could wean it off, as they didn't like their residents being on that type of medication. I readily agreed, and now it seems that Bob has become more alert, more talkative, and isn't sleeping as much. Plus he really reacts to the friendly staff.
I am going to talk about one more interaction with The Piper, and then I will forever move on from that subject. Right about the time I had told them I was moving Bob, an article was posted on their Facebook page about conflict resolution. I found it rather strange that it happened at the same time, but they assured me that an independent company took care of such. One paragraph stated that "the residents may be perfectly happy where they are, but it is the families that are not." I submit that Bob could not have told me if he was unhappy, so I had to be the advocate and use my powers of observation to perceive what was going on. Another paragraph: "It is important to move slowly so that decisions are not made from an emotional state." I had made excuses for the way things were for a long time, had made complaints, but nothing ever changed, just got progressively worse. Another statement was that they could not force the residents to shower. Yes, I agree. But when a resident is asked if they want to take a shower, they are always going to say "no". So then the staff can chart "resident refused" and move on. And they cannot be dragged in to shower. If the staff has proper dementia care training, and approach the resident the right way, maybe several times the same morning, and make a game of it, they would have better success.
I asked for an appointment with the owner of The Piper. I took 2 dear friends along, who had also observed for themselves what was going on, with the lack of staff. We all talked for over 2 hours, and the owner paid very close attention. I truly think he had no idea how bad it had become. At the end I told him that I hoped he would take what we said to heart, and make changes. He said "I will." As a sidelight, the article on Facebook on conflict resolution was taken down the next day. As I have said before, he has his job cut out for him. All these beautiful facilities are being built all over town with no one to staff them.
Let's go back at Hillside Village. They told me one day when I went out that they had put Bob on the toilet and he had had a large stool. When I voiced how happy I was to hear that, the young man said simply "It's all about dignity." I remember when my mother was in the nursing home here in town. I came in one day to check on her as I did regularly. She was crying and I asked why. She said she would ask them to put her on the bedpan. They would tell her just to go in her diaper as it was easier to clean up. Yes, it is all about dignity. And the following incident happened at the hospital where I worked. I was a team leader one night and asked my CNA to go give a patient some water as she was unable to get to it herself. The CNA told me she wasn't going to do that till end of shift as the patient would wet herself, and then she would have to change the bed. I will leave you to imagine all I said, but it was along the lines of "I can't believe you just said that to me..."
I would like to suggest that you can "train" a person thoroughly in classes, but true caring comes from the heart.
The Director of Nursing at Hillside Village, Peg Wessel, was presented an award Thursday at the facility for excellence in nursing. Nurses from the Kansas state legislature were there, and there was a nice little party with the residents and families with cake and punch. If anyone deserves it, she does, as she leads by example.
In case you hadn't heard, the Kansas City Chiefs won the Superbowl! The whole city was ecstatic and came together to celebrate. Why can't this kind and gentler spirit last the rest of the year???
In the meantime, please be kinder than necessary. (per Suzel!)
Betty
Friday, February 7, 2020
Saturday, January 11, 2020
The snow is gently falling and quiet except for the sounds of the snowplows and salt trucks going through periodically. The bears have it right--hibernate when the snow falls. Except they don't eat, and I don't go along with that. Everything is so peaceful and I am more at peace than I have been in several weeks.
I had been observing for awhile that Bob's care had gotten too heavy for the facility that he was in. When he first was admitted there, almost 3 years to the day, he was ambulatory and it was a good fit. But now that he is total care, it was just too much for the amount of staff they had. They limped along and made it through the holidays only because students were home from school periodically and picked up a few shifts of work. But then one of the regular staff was off after having surgery, and it brought to a head how little resources there were. Staff were working 12-16 hours a day and were exhausted mentally and physically. And the night shift staffing got to be in the critical range. I certainly sympathize with the problem, as in this area many glorious new facilities are being built with no thought of who is going to staff them. By the way, when a place starts intensely advertising and saying how great they are, BEWARE.
So with a great friend in tow, we started frantically searching for a new place. It was breaking my heart, as I love the staff (all 2 of them) at the place where he is now, and I love the residents and I love the other families. You all bond and become like family. But the search only highlighted the problem. We learned very quickly that you couldn't trust the rating and the comments on a facilities web site. How some comments about the same place could be at the opposite end of the spectrum was baffling! I got to the place I felt like some of the glowing ratings were fake. And medicare would even give a place a 5 star rating and when you walked in the smell of urine was overwhelming. Cross that off the list right away! The website "A place for mom" was helpful, but they readily admitted that places paid to be on their list. A person from the Alzheimer's Association that spoke at the funeral of a husband of a friend from our support group was kind enough to talk to me about how to pick a place. She said to just pop in a mealtime. See how the workers are interacting with the residents. See if they are talking to them. See if they are taking the time and patience to feed them properly. I felt the urgency of finding a new place quickly, so I had all kinds of people praying for me. Some of the places were deplorable. And I am so sad to say that one of the places that has a red flag for neglect and abuse is run by Advent Health (the new corporate name of Shawnee Mission Medical Center where Bob and I worked, and the hospital we loved.) I am so embarrassed by this that I could spit. They are building brand new sparkling sports medicine centers, and the nursing facility with a desperate need is in that condition? The aging population is now the greatest need and they are totally missing the boat in that area. I know 2 families that have their loved ones there and they are having to do all the care. I had almost come to the conclusion that I would have to move him to a place right down the street from me and just step into the hands on caregiving role. We got as far with one facility that they came to do an assessment on Bob, but they said right away that his level of care was too high for them. He doesn't need Alzheimer's care now, just good nursing care. When I had told them exactly at the facility what equipment etc. that he required, they assured me that "Oh we can do that!" But God shut that door and at support group I found out how thankful I was that He did, as one of the other ladies had had her husband there, and couldn't wait to bring him home. I knew bringing Bob home wasn't an option, as I would have died before he did. My mind would run wild at night. I thought of bringing him home and putting the hospice bed in the living room, and hiring my favorite CNA from The Piper to care for her and she could live in the spare bedroom. But then who would take care of the residents at The Piper!?
But then one day God flung the door open wide, just in time as I was getting exhausted and depressed. Another friend that was looking frantically also for a place for her mom with Alzheimer's told me she was going to go visit a place in Desoto, KS. She was given 3 days to find a place for her mom after she went off rehab. The hospice nurse practitioner had casually mentioned this place, but I had crossed it off my list as it is further away than even the drive I had to The Piper. It takes 25 minutes to get there and it is 25 miles away, but through beautiful Kansas farmland. Oops, no more zipping down the interstate at 80 mph....The name of the facility is Hillside Village of Desoto. I don't know why, as it isn't on a hillside, but the grounds are beautiful, and Bob has a beautiful view out his window instead of parked cars. The OWNER of the facility met us to give us the tour. There 87 beds, 49 on the rehab and long term care side and 38 on the assisted living side. We started off on the assisted living side where his mom is a resident, after fighting him when he had to move her from DesMoines, Iowa. As we continued the tour, I knew immediately that this was the place I wanted Bob. There was staff EVERYWHERE! There was a nursing station ON THE UNIT! Activities were going on, the place was being CLEANED! I asked the owner about halfway through if there were any private rooms available and shut my eyes and prayed while he was thinking. He messaged the director of nursing whose office was ON THE UNIT! Soon she came running down the hall, and told us at first she didn't think they did, but she had found a way to make it work. I immediately said "I'll take it!" It took a couple of days to do the paperwork, and they WORKED WITH hospice (instead of against them as before) to coordinate the move. Hospice got their new bed with an alternating pressure mattress to the new facility, picked up their old equipment at The Piper, and the facility picked Bob up in their transport van Thursday. I met him there, and it was lunchtime. They asked if he was hungry, and he said "YES!" They have since remarked how good an eater he is! And I took his prune juice along, and they looked at me funny and said "Why are you bringing that? We have plenty of that here!"
I am not going there today because of the weather. But I don't feel that I have to, and I can rest knowing he is being well cared for. When folks ask where he is and I tell them, EVERYONE says nothing but good about it. The director of nurses is roaming the halls, if you can believe that. She is friendly, the staff are friendly and everyone asks if you are looking bewildered "Can I help you?" Maybe they have been taught to do that, but they have been taught well. I can't help but think that maybe because it is a small town, and the workers are mostly from around there, that maybe it gives them a sense of community, and a desire to work together. Everyone from the shift nurse to the CNAs come in and sit down and chat to get acquainted. The OWNER roams the halls! He saw me as I was leaving the other day and gave me a big hug and said "You did it!" I said, "No, God did it!"
The administrator was wearing a Chiefs shirt yesterday. His office is right down the hall from Bob's room. You have heard that the Chiefs are in the playoffs Sunday, right? The director of nursing was wearing a Chief's shirt. Her office is also right on the unit. The nurse's office is 2 rooms down from Bob. His evening CNA had a Chief's shirt on. He is going to the game Sunday and tailgate. OK, maybe there are a FEW crazy people that work there.....
Thanks to all my friends who have supported me through all of this. I think this was even more traumatic than it will be when Bob dies. I am somewhat prepared for that. I was not prepared for this and the stress it would cause. But again, if it can be helpful to someone else, it was worth it.
Go Chiefs!
Betty
I had been observing for awhile that Bob's care had gotten too heavy for the facility that he was in. When he first was admitted there, almost 3 years to the day, he was ambulatory and it was a good fit. But now that he is total care, it was just too much for the amount of staff they had. They limped along and made it through the holidays only because students were home from school periodically and picked up a few shifts of work. But then one of the regular staff was off after having surgery, and it brought to a head how little resources there were. Staff were working 12-16 hours a day and were exhausted mentally and physically. And the night shift staffing got to be in the critical range. I certainly sympathize with the problem, as in this area many glorious new facilities are being built with no thought of who is going to staff them. By the way, when a place starts intensely advertising and saying how great they are, BEWARE.
So with a great friend in tow, we started frantically searching for a new place. It was breaking my heart, as I love the staff (all 2 of them) at the place where he is now, and I love the residents and I love the other families. You all bond and become like family. But the search only highlighted the problem. We learned very quickly that you couldn't trust the rating and the comments on a facilities web site. How some comments about the same place could be at the opposite end of the spectrum was baffling! I got to the place I felt like some of the glowing ratings were fake. And medicare would even give a place a 5 star rating and when you walked in the smell of urine was overwhelming. Cross that off the list right away! The website "A place for mom" was helpful, but they readily admitted that places paid to be on their list. A person from the Alzheimer's Association that spoke at the funeral of a husband of a friend from our support group was kind enough to talk to me about how to pick a place. She said to just pop in a mealtime. See how the workers are interacting with the residents. See if they are talking to them. See if they are taking the time and patience to feed them properly. I felt the urgency of finding a new place quickly, so I had all kinds of people praying for me. Some of the places were deplorable. And I am so sad to say that one of the places that has a red flag for neglect and abuse is run by Advent Health (the new corporate name of Shawnee Mission Medical Center where Bob and I worked, and the hospital we loved.) I am so embarrassed by this that I could spit. They are building brand new sparkling sports medicine centers, and the nursing facility with a desperate need is in that condition? The aging population is now the greatest need and they are totally missing the boat in that area. I know 2 families that have their loved ones there and they are having to do all the care. I had almost come to the conclusion that I would have to move him to a place right down the street from me and just step into the hands on caregiving role. We got as far with one facility that they came to do an assessment on Bob, but they said right away that his level of care was too high for them. He doesn't need Alzheimer's care now, just good nursing care. When I had told them exactly at the facility what equipment etc. that he required, they assured me that "Oh we can do that!" But God shut that door and at support group I found out how thankful I was that He did, as one of the other ladies had had her husband there, and couldn't wait to bring him home. I knew bringing Bob home wasn't an option, as I would have died before he did. My mind would run wild at night. I thought of bringing him home and putting the hospice bed in the living room, and hiring my favorite CNA from The Piper to care for her and she could live in the spare bedroom. But then who would take care of the residents at The Piper!?
But then one day God flung the door open wide, just in time as I was getting exhausted and depressed. Another friend that was looking frantically also for a place for her mom with Alzheimer's told me she was going to go visit a place in Desoto, KS. She was given 3 days to find a place for her mom after she went off rehab. The hospice nurse practitioner had casually mentioned this place, but I had crossed it off my list as it is further away than even the drive I had to The Piper. It takes 25 minutes to get there and it is 25 miles away, but through beautiful Kansas farmland. Oops, no more zipping down the interstate at 80 mph....The name of the facility is Hillside Village of Desoto. I don't know why, as it isn't on a hillside, but the grounds are beautiful, and Bob has a beautiful view out his window instead of parked cars. The OWNER of the facility met us to give us the tour. There 87 beds, 49 on the rehab and long term care side and 38 on the assisted living side. We started off on the assisted living side where his mom is a resident, after fighting him when he had to move her from DesMoines, Iowa. As we continued the tour, I knew immediately that this was the place I wanted Bob. There was staff EVERYWHERE! There was a nursing station ON THE UNIT! Activities were going on, the place was being CLEANED! I asked the owner about halfway through if there were any private rooms available and shut my eyes and prayed while he was thinking. He messaged the director of nursing whose office was ON THE UNIT! Soon she came running down the hall, and told us at first she didn't think they did, but she had found a way to make it work. I immediately said "I'll take it!" It took a couple of days to do the paperwork, and they WORKED WITH hospice (instead of against them as before) to coordinate the move. Hospice got their new bed with an alternating pressure mattress to the new facility, picked up their old equipment at The Piper, and the facility picked Bob up in their transport van Thursday. I met him there, and it was lunchtime. They asked if he was hungry, and he said "YES!" They have since remarked how good an eater he is! And I took his prune juice along, and they looked at me funny and said "Why are you bringing that? We have plenty of that here!"
I am not going there today because of the weather. But I don't feel that I have to, and I can rest knowing he is being well cared for. When folks ask where he is and I tell them, EVERYONE says nothing but good about it. The director of nurses is roaming the halls, if you can believe that. She is friendly, the staff are friendly and everyone asks if you are looking bewildered "Can I help you?" Maybe they have been taught to do that, but they have been taught well. I can't help but think that maybe because it is a small town, and the workers are mostly from around there, that maybe it gives them a sense of community, and a desire to work together. Everyone from the shift nurse to the CNAs come in and sit down and chat to get acquainted. The OWNER roams the halls! He saw me as I was leaving the other day and gave me a big hug and said "You did it!" I said, "No, God did it!"
The administrator was wearing a Chiefs shirt yesterday. His office is right down the hall from Bob's room. You have heard that the Chiefs are in the playoffs Sunday, right? The director of nursing was wearing a Chief's shirt. Her office is also right on the unit. The nurse's office is 2 rooms down from Bob. His evening CNA had a Chief's shirt on. He is going to the game Sunday and tailgate. OK, maybe there are a FEW crazy people that work there.....
Thanks to all my friends who have supported me through all of this. I think this was even more traumatic than it will be when Bob dies. I am somewhat prepared for that. I was not prepared for this and the stress it would cause. But again, if it can be helpful to someone else, it was worth it.
Go Chiefs!
Betty
Sunday, December 29, 2019
I have thought long and hard before writing this blog. How much do I tell? Do I even broach the subject? I have consulted with other people. I have made rough drafts. So it is the most difficult blog yet. I was on the ethics committee at the hospital where I worked, but we talked about ventilators and open heart surgeries and more acute things, since that is the setting that a hospital presents. Things like this never came up. And if you are not involved in the medical field at all, you may be as horrified as our kids were when they found out what was going on. But it is serious enough to cause death, and it had caused death in 2 of my friends the week before it happened to Bob. So maybe that is why it was so much on my mind. It is a most indelicate subject, so if you are at all queasy, you might not want to continue. But if I have made you at all curious, plunge right ahead! I finally decided that if my blog is to help others, they need to know that this can and does happen. It is embarrassing, but would have saved some of my friends a lot of grief if they had known. And since the purpose of all my blogs is to tell the true story, I need to be transparent, and not just pick the sweet topics. I have no doubt that Bob would not be alive today if I hadn't intervened. Not that I am so smart, but I have just had experience. And the other patients are more mobile than Bob, so maybe this isn't your usual problem where Bob is. He had never had a problem with this before, so it was a shock, and came out of the blue.
I will not accuse anyone, as some of the nurses didn't know this could happen because they had not had experience with it. But if you have worked in a nursing home setting, you cannot help but know about it. I took nurses training where part of the facility was acute care, and the other half was more like a nursing home, where we got basic nursing skills. So though it had been more than 60 years, I had not forgotten the signs and symptoms of a bowel impaction. Every evening the laxative tray was passed. We called it black and white (or brown cow)---milk of magnesia and cascara cocktails, if you please. Then the next morning it that hadn't worked, the patient was either given an enema or the stool that was impacted in the colon was manually removed. And of course the students got to do that! So when I was notified that Bob was having runny stools, a bell went off in my head. When a stool impaction occurs in the lower colon and isn't emptied, the more liquid stool from the upper colon just runs around it and the stool is continually running out. So I asked if Bob had been checked for an impaction. I was told "no." I asked both hospice and the facility to please do it, but it wasn't done. They said they had to have a doctor's order and then WHO on earth was going to do it? I finally said that well, I didn't have to have a doctor's order, and this little red hen was going to do it herself. I told them that I knew Bob was going to die, but I didn't want him to die of constipation. Everyone was quite taken aback by that proclamation! So I asked them to put Bob in bed, and took another old time nursing friend (who had also done the procedure many times) along with me for support. But with both of us, it had been over 60 years ago! Just as I expected, I found a huge impaction. Now, this makes the term "full of shit" become quite a literal thing. I couldn't reach it all, so then I knew it had to be moved down from the top. I got some prune juice (which doesn't need a doctor's order) and milk of magnesia (which they did get a doctor's order for.)
Thank goodness, I remembered the story a friend told the support group. She was caring for her husband at home, when the very same thing happened. The doctor didn't recognize the classic symptom of the runny stools, and ordered a colonoscopy. The prep from the colonoscopy wasn't enough to move it down, and she was up all night trying to keep things cleaned up. When he went for the colonoscopy the problem of the massive impaction was found. It took 3 weeks of laxatives to get the problem resolved, and then of course they didn't do another colonoscopy!
Let's go back to the aforementioned friends who had died the week before this happened with Bob. I had just been to one of the funerals the week before and her husband told me what happened. His wife's colon had become so full of stool that it had perforated (torn) and although she was taken to surgery, it was too late.
So I was quite frustrated, and 5 days after I had removed the initial impaction, the facility was still talking in a committee meeting about how to solve the problem. To make a long story short, (Ha!) I worked with the med aide on the unit and we developed a program of daily milk of magnesia and prune juice (which works even better when heated) and then every other day remove manually what had moved down. The stool was very hard, but fortunately there was still enough bowel motility to move it. So he is back to being able to do it himself, but as with my friend's husband, it took 3 weeks to accomplish. And we have developed better documentation with a paper chart kept in his room. Formerly they were just charted on the computer where they are out of sight and out of mind. With the other residents it is more difficult to keep track of, as they are more mobile, and if you asked them if they had had a stool today, they wouldn't remember!
I have checked with people that work in nursing homes, and impactions are still removed manually. So the practice is not a prehistoric dinosaur of my day! Eliminating waste is a basic body function along with all the others. I have no doubt Florence Nightingale would have addressed it, but she was busy on the battlefield.
I guess my message and the moral of this story would be to be persistent and don't be afraid to speak up for yourself, or be an advocate for your loved one about any medical problem. I wish the doctor's would listen more, but they have so little time with their patients that they are looking for the quick fix and are not experienced in elder care. There are no quick fixes there! It takes time and patience which Santa does not bring!
And now it is the New Year. My wish for all of you is a very happy, healthy, and regular 2020.
Betty
I will not accuse anyone, as some of the nurses didn't know this could happen because they had not had experience with it. But if you have worked in a nursing home setting, you cannot help but know about it. I took nurses training where part of the facility was acute care, and the other half was more like a nursing home, where we got basic nursing skills. So though it had been more than 60 years, I had not forgotten the signs and symptoms of a bowel impaction. Every evening the laxative tray was passed. We called it black and white (or brown cow)---milk of magnesia and cascara cocktails, if you please. Then the next morning it that hadn't worked, the patient was either given an enema or the stool that was impacted in the colon was manually removed. And of course the students got to do that! So when I was notified that Bob was having runny stools, a bell went off in my head. When a stool impaction occurs in the lower colon and isn't emptied, the more liquid stool from the upper colon just runs around it and the stool is continually running out. So I asked if Bob had been checked for an impaction. I was told "no." I asked both hospice and the facility to please do it, but it wasn't done. They said they had to have a doctor's order and then WHO on earth was going to do it? I finally said that well, I didn't have to have a doctor's order, and this little red hen was going to do it herself. I told them that I knew Bob was going to die, but I didn't want him to die of constipation. Everyone was quite taken aback by that proclamation! So I asked them to put Bob in bed, and took another old time nursing friend (who had also done the procedure many times) along with me for support. But with both of us, it had been over 60 years ago! Just as I expected, I found a huge impaction. Now, this makes the term "full of shit" become quite a literal thing. I couldn't reach it all, so then I knew it had to be moved down from the top. I got some prune juice (which doesn't need a doctor's order) and milk of magnesia (which they did get a doctor's order for.)
Thank goodness, I remembered the story a friend told the support group. She was caring for her husband at home, when the very same thing happened. The doctor didn't recognize the classic symptom of the runny stools, and ordered a colonoscopy. The prep from the colonoscopy wasn't enough to move it down, and she was up all night trying to keep things cleaned up. When he went for the colonoscopy the problem of the massive impaction was found. It took 3 weeks of laxatives to get the problem resolved, and then of course they didn't do another colonoscopy!
Let's go back to the aforementioned friends who had died the week before this happened with Bob. I had just been to one of the funerals the week before and her husband told me what happened. His wife's colon had become so full of stool that it had perforated (torn) and although she was taken to surgery, it was too late.
So I was quite frustrated, and 5 days after I had removed the initial impaction, the facility was still talking in a committee meeting about how to solve the problem. To make a long story short, (Ha!) I worked with the med aide on the unit and we developed a program of daily milk of magnesia and prune juice (which works even better when heated) and then every other day remove manually what had moved down. The stool was very hard, but fortunately there was still enough bowel motility to move it. So he is back to being able to do it himself, but as with my friend's husband, it took 3 weeks to accomplish. And we have developed better documentation with a paper chart kept in his room. Formerly they were just charted on the computer where they are out of sight and out of mind. With the other residents it is more difficult to keep track of, as they are more mobile, and if you asked them if they had had a stool today, they wouldn't remember!
I have checked with people that work in nursing homes, and impactions are still removed manually. So the practice is not a prehistoric dinosaur of my day! Eliminating waste is a basic body function along with all the others. I have no doubt Florence Nightingale would have addressed it, but she was busy on the battlefield.
I guess my message and the moral of this story would be to be persistent and don't be afraid to speak up for yourself, or be an advocate for your loved one about any medical problem. I wish the doctor's would listen more, but they have so little time with their patients that they are looking for the quick fix and are not experienced in elder care. There are no quick fixes there! It takes time and patience which Santa does not bring!
And now it is the New Year. My wish for all of you is a very happy, healthy, and regular 2020.
Betty
Wednesday, November 13, 2019
Bob has had a total of 4 seizures now. He had another one two weeks ago Saturday, and while no one witnessed it, the classic post-seizure symptoms were there--drooling, snoring respirations, and unresponsiveness. This past Saturday he had another episode, and was again unresponsive for 4 hours, but this was unlike any seizure he has ever had. This time there was distinct drooping on the left side of his mouth, but nothing else. His blood pressure was normal, so rather than say he had a stroke, the hospice nurse called it a "neurologic event." Leave it to Bob to mix things up a little. He is getting harder to feed, as he keeps falling asleep while I am trying to feed him. Except when dessert comes, and then he opens his eyes and his mouth, just like a little bird! He is especially partial to ice cream, so ice cream it is!
I would like to share a story that aired on the local news just recently. It is about a man that Kansas City residents will remember well. His name is Dennis Moore and he was a U.S. congressman, who represented Kansas' 3rd district from 1999 to 2011. He worked with several former presidents and helped pass bills for veterans. He was diagnosed in 2012 and his Alzheimer's is now progressing so he was placed in a home last year. I would like to echo some of the sentiments voiced by his wife Stephene (pronounced Stephenie). She says "A lot of times you hear, 'Talk to somebody', but a lot of people will say, 'Oh, I know what you are going through, because my grandmother had Alzheimer's.' They don't know anything about caring for a spouse." So Stephene now spends time with, advocates for and speaks on behalf of caregivers. After all, she understands the stress, financial worries, loss of dreams and grief that accompany the disease. I could not agree with her more. My father had Alzheimer's. Having a spouse with Alzheimer's is a whole different ballgame. She ended the interview by saying, "Take it slow; take every day for what it is. Live in the moment, lower your expectations, be a good advocate and cherish the moment." She says she knows he needs to be in a home where she can get sleep and know that he is safe. She knows she will need stamina for the long years ahead. I share her journey because I too, can relate to what she is experiencing with so many conflicting emotions. Part of me wants to cherish the moments I still have with Bob, and part of me just wants this rollercoaster ride to be over.
But during this season of thankfulness, I would like to express some of the things I am thankful for.
I am happy I can sleep at night.
I am happy that I still have good health and stamina.
I am happy that Bob doesn't know to ask to come home with me when I leave, like Dennis Moore does.
I am so happy I have such a great support group where I can talk to people that are in the same boat.
I am so happy that I have such a great support network of family and friends.
I am thankful for the care that hospice gives me and Bob. What would I do without them?
I am thankful for the facility where Bob resides and for the loving care that he gets each day.
I am thankful for ice cream. Bob likes plain vanilla. Make mine butter pecan or maple walnut!
And yes, I am thankful for, and cherish the moments I still have with Bob.
And I am thankful that there is a faithful, never-changing God in control. Every day begins and ends with His purpose. Every moment of our lives is in His constant care.
Happy Thanksgiving!
Betty
I would like to share a story that aired on the local news just recently. It is about a man that Kansas City residents will remember well. His name is Dennis Moore and he was a U.S. congressman, who represented Kansas' 3rd district from 1999 to 2011. He worked with several former presidents and helped pass bills for veterans. He was diagnosed in 2012 and his Alzheimer's is now progressing so he was placed in a home last year. I would like to echo some of the sentiments voiced by his wife Stephene (pronounced Stephenie). She says "A lot of times you hear, 'Talk to somebody', but a lot of people will say, 'Oh, I know what you are going through, because my grandmother had Alzheimer's.' They don't know anything about caring for a spouse." So Stephene now spends time with, advocates for and speaks on behalf of caregivers. After all, she understands the stress, financial worries, loss of dreams and grief that accompany the disease. I could not agree with her more. My father had Alzheimer's. Having a spouse with Alzheimer's is a whole different ballgame. She ended the interview by saying, "Take it slow; take every day for what it is. Live in the moment, lower your expectations, be a good advocate and cherish the moment." She says she knows he needs to be in a home where she can get sleep and know that he is safe. She knows she will need stamina for the long years ahead. I share her journey because I too, can relate to what she is experiencing with so many conflicting emotions. Part of me wants to cherish the moments I still have with Bob, and part of me just wants this rollercoaster ride to be over.
But during this season of thankfulness, I would like to express some of the things I am thankful for.
I am happy I can sleep at night.
I am happy that I still have good health and stamina.
I am happy that Bob doesn't know to ask to come home with me when I leave, like Dennis Moore does.
I am so happy I have such a great support group where I can talk to people that are in the same boat.
I am so happy that I have such a great support network of family and friends.
I am thankful for the care that hospice gives me and Bob. What would I do without them?
I am thankful for the facility where Bob resides and for the loving care that he gets each day.
I am thankful for ice cream. Bob likes plain vanilla. Make mine butter pecan or maple walnut!
And yes, I am thankful for, and cherish the moments I still have with Bob.
And I am thankful that there is a faithful, never-changing God in control. Every day begins and ends with His purpose. Every moment of our lives is in His constant care.
Happy Thanksgiving!
Betty
Wednesday, September 25, 2019
Bob has had 2 seizures since I wrote my last post. I was there visiting when he had the first one. The only one I knew of before was in April, and I was there to witness that one. It makes me wonder how many he has had that weren't witnessed, or if he has had petit mal (small) seizures when he doesn't respond to me, no matter what I do to try to wake him. The second one he had was when the hospice nurse was there and she called me. When I got there he wouldn't rouse, and had a lot of gurgling in his throat and chest. I was sure he had aspirated, and the nurse in me wanted to suction him! But the next morning he was fine. The surprising part again is that after the seizures he is temporarily more cognizant. One beautiful day I had taken him out on the patio, and it was just the 2 of us there. I asked him if he liked living at the Piper, and he said "It's OK, but you wouldn't like it." Then he put his arm around me and asked, with all the normal inflections in his voice, "How are you doing? Are you doing OK?" Then we went in for lunch and he was moving his placemat all around. I asked what he was doing and he said "I'm up to no good!" The hospice nurse told me when she visited the other day that she was chattering away about nothing and he said "You're boring me!" But yesterday when we were both there again, he was back to not responding to either of us. All this made me curious that maybe the seizure was like an electrical trigger to the brain, that somehow rebooted or rearranged neurons somehow. So I googled if ECT (electrical convulsive therapy) had ever been used for Alzheimer's. It turned out, that it has, and some it made better, and some people it made worse. Since the way they did ECT in the 1960s almost made me quit nursing school, I certainly wouldn't have that done to Bob! But now it is coming back with sedation and paralyzing drugs, so there are no horrible convulsions. And it is being proven as an effective treatment for depression. And there is also the implanted electrodes deep in the brain to treat Parkinson's disease (a form of dementia). Which prompts me to share some of the other "treatments" that are being touted as "cures" with varying rates of success, of course. They are CBD oil (doesn't that cure everything?!), Metformin (yes, the drug used for diabetes!), statins, estrogen, testosterone, curcumin and COQ10, Vitamin D and anti-inflammatory drugs such as ibuprofen and Advil. But let me caution that many of these are controversial, and as with all studies, it seems you can make it prove whatever you want it to prove!
I promised that I would share some of the interesting concepts that Dr. Jane Murray presented to the retired nurse's at the last luncheon. I will also be quoting some of the summaries from Dr. Dale Bredesen's book "The End of Alzheimer's". Dr. Murray says the brain is like a roof with 36 holes. The disease can enter into any one of those holes--there is not one causative factor. Scientists are beginning to see Alzheimer's for what it really is--a fallout of the brain's protective function--rather than what we thought it was--an accumulation of amyloid plaques. Some people have a large accumulation of amyloid plaques, but no evidence of Alzheimer's. Dr. Bredesen says in his book that Alzheimer's occurs in the course of the brain protecting itself from 3 metabolic and lethal threats.
1. Inflammation (from infection, diet or other causes)
2. Decline and shortage of supportive nutrients, hormones, and other brain-supporting molecules.
3. Toxic substances, such as metals or biotoxins (poisons produced by microbes such as molds).
He goes on to say more about inflammation. It can occur when
1. Our immune systems are triggered by the presence of disease-causing pathogens and the immune systems have to keep fighting for so long, amyloids accumulate.
2. When trans-fats are introduced into the body
3. When the intestines are damaged, usually as a result of eating foods containing gluten, dairy or grains. Inflammation is also triggered by consuming a lot of sugar, in which case, insulin resistance is also part of the problem. Extremely high insulin levels lead to our bodies developing a resistance to its effects. And that resistance increases the chances of Alzheimer's in a person. Hence probably why metformin was being tried for the treatment of Alzheimer's? And why Alzheimer's is called diabetes type 3?
SO! What can a person do to plug up some of those 36 holes? My suggestion would be to get a whole new body or at least a new roof! But here are some suggestions both doctors gave:
1. Maintain good dental health and oral hygiene
2. Have a 12-16 hour fasting span between dinner and breakfast
3. Maintain a healthy diet and avoid sugars, such as sugars and candy, as well as starchy foods like white bread, white potatoes, and white bread that cause increased glucose levels. And here I feel guilty. Bob had a sweet tooth, and I loved to bake, and he loved to eat...
4. Take Vitamin D to prevent cognitive degeneration. A ideal measurement of Vitamin D3 is 50-80 ng/ml (Other studies show there is no association)
5. Get adequate sleep and treat sleep apnea. I know this was a problem for Bob. He had trouble sleeping his whole life. I think his brain was constantly thinking of things he needed to get up and do!
6. Engage in an intellectually engaging life. This creates an over-abundance of synapses, enough to lose some to amyloid plaques without feeling it. Luminosity.com is a brain stimulating website.
7. Reduce stress with yoga, meditation or simply taking deep slow breaths. Reducing caffeine and alcohol intake also help.
8. Avoid heavy metals and mold (And I often wonder about pesticides...)
9. This last one I am going to mention blows my mind! Incredibly, low cholesterol puts people more at risk of cognitive impairment than high cholesterol levels. An ideal measurement of total cholesterol for cognitive functioning in a person is more than 150. Evidently why use of statins and the studies that said they caused Alzheimer's was so controversial? Comments?
There are many costly lab tests to determine optimum levels of everything. There is controversy about which things are contributing factors, such as gluten. There is the fact that not just one of the elements provide a "cure". And one must accept that change is not a one day thing! This is just a list to make you think, and hopefully you will come away with something you need to work on changing.
A toast to you! Here's to better total health for all of us!
Or you can just say like my dear friend Mac. "I am 88 years old. I am going to eat whatever the h*** I want!"
Betty
I promised that I would share some of the interesting concepts that Dr. Jane Murray presented to the retired nurse's at the last luncheon. I will also be quoting some of the summaries from Dr. Dale Bredesen's book "The End of Alzheimer's". Dr. Murray says the brain is like a roof with 36 holes. The disease can enter into any one of those holes--there is not one causative factor. Scientists are beginning to see Alzheimer's for what it really is--a fallout of the brain's protective function--rather than what we thought it was--an accumulation of amyloid plaques. Some people have a large accumulation of amyloid plaques, but no evidence of Alzheimer's. Dr. Bredesen says in his book that Alzheimer's occurs in the course of the brain protecting itself from 3 metabolic and lethal threats.
1. Inflammation (from infection, diet or other causes)
2. Decline and shortage of supportive nutrients, hormones, and other brain-supporting molecules.
3. Toxic substances, such as metals or biotoxins (poisons produced by microbes such as molds).
He goes on to say more about inflammation. It can occur when
1. Our immune systems are triggered by the presence of disease-causing pathogens and the immune systems have to keep fighting for so long, amyloids accumulate.
2. When trans-fats are introduced into the body
3. When the intestines are damaged, usually as a result of eating foods containing gluten, dairy or grains. Inflammation is also triggered by consuming a lot of sugar, in which case, insulin resistance is also part of the problem. Extremely high insulin levels lead to our bodies developing a resistance to its effects. And that resistance increases the chances of Alzheimer's in a person. Hence probably why metformin was being tried for the treatment of Alzheimer's? And why Alzheimer's is called diabetes type 3?
SO! What can a person do to plug up some of those 36 holes? My suggestion would be to get a whole new body or at least a new roof! But here are some suggestions both doctors gave:
1. Maintain good dental health and oral hygiene
2. Have a 12-16 hour fasting span between dinner and breakfast
3. Maintain a healthy diet and avoid sugars, such as sugars and candy, as well as starchy foods like white bread, white potatoes, and white bread that cause increased glucose levels. And here I feel guilty. Bob had a sweet tooth, and I loved to bake, and he loved to eat...
4. Take Vitamin D to prevent cognitive degeneration. A ideal measurement of Vitamin D3 is 50-80 ng/ml (Other studies show there is no association)
5. Get adequate sleep and treat sleep apnea. I know this was a problem for Bob. He had trouble sleeping his whole life. I think his brain was constantly thinking of things he needed to get up and do!
6. Engage in an intellectually engaging life. This creates an over-abundance of synapses, enough to lose some to amyloid plaques without feeling it. Luminosity.com is a brain stimulating website.
7. Reduce stress with yoga, meditation or simply taking deep slow breaths. Reducing caffeine and alcohol intake also help.
8. Avoid heavy metals and mold (And I often wonder about pesticides...)
9. This last one I am going to mention blows my mind! Incredibly, low cholesterol puts people more at risk of cognitive impairment than high cholesterol levels. An ideal measurement of total cholesterol for cognitive functioning in a person is more than 150. Evidently why use of statins and the studies that said they caused Alzheimer's was so controversial? Comments?
There are many costly lab tests to determine optimum levels of everything. There is controversy about which things are contributing factors, such as gluten. There is the fact that not just one of the elements provide a "cure". And one must accept that change is not a one day thing! This is just a list to make you think, and hopefully you will come away with something you need to work on changing.
A toast to you! Here's to better total health for all of us!
Or you can just say like my dear friend Mac. "I am 88 years old. I am going to eat whatever the h*** I want!"
Betty
Sunday, August 25, 2019
I am back home from my last trip of the summer. The cats even got in my suitcase when I unpacked, effectively letting me know that I am not going anywhere, anytime soon, without them! I took Granddaughter Libby home after a marvelous summer together. My friend and Bob's longtime secretary Judie went with me. From Chattanooga, TN we went on to Hunstville, AL to see the space center, and then on to Memphis, TN for Elvis week. We just totally unplugged from the world there, and relaxed and enjoyed the festivities for not just a week, but 10 days. We took a day bus trip to Tupelo, Mississippi where Elvis was born and grew up. Tupelo was much bigger than we thought it would be. We enjoyed seeing the house he grew up in, the church where he learned to appreciate music and the hardware store where he bought his first guitar. We made instant friends on the bus with sisters from the UK and did several things together and met up with them the rest of the week.
But now we are home to reality--having to fix our own meals instead of going to the scrumptious buffet every morning for breakfast and hitting the complimentary peanut butter and jellies and bananas and milk and hot chocolate bar every evening in the hotel. We are spoiled!
I went out to see Bob as soon as I could after getting home. The first day he was having one of the days where he was sleepy and wouldn't react to me. I should have had Libby there! She could always get him to respond! But everything was different at The Piper as well. Two of my favorite residents had passed away very unexpectedly while I was gone. One was Bill, the husband of my friend from the support group. I will really miss Sheryl being there, and our happy chats together as we fed "our boys"! The next day I went to see Bob he was awake and told me my hair looked nice. I about fell over! Then he proclaimed loudly "I AM A MAN". I told him "I AM A WOMAN", and he laughed and laughed! BUT! I found out from the staff that they had caught him and Mickey holding hands while I was gone! Mickey is a retired RN (Real Nuts, she told me when she was more cognizant.) At least Bob knows how to pick RNs to care for him! Mickey sits at Bob's table as she has to be fed and the staff can feed her and Bob at the same time. She just sits there and smiles (now I notice she is smiling at Bob and that is why she is not focusing on eating her food.) I also feed her if I am there feeding Bob. Well that is the end of that--LOL!
I went to a seminar at The Piper before I left. A radiologist that has an independent practice in Shawnee spoke about using stem cells to treat Alzheimer's. His own father was one of his first patients. He takes the stem cells out of the patient's own bone marrow and abdominal fat and then reinjects them IV. He is not willing to do the double blind testing that requires using a placebo on half of the patients as he wants everyone to get the treatment. Therefore, he cannot qualify for studies that would lead to approval and also get the treatment covered by insurance. The pretesting is very expensive with Pet scans and lumbar punctures as he is trying to catch people in the early stage of the disease. Long story short, his father ended up saying "stop, this is costing too much" and died, and another patient was not helped at all. But 2 others he treated were helped significantly. I know stem cell treatment is the thing now, and he acknowledges that it works better for diseases like COPD. But it is being tried for a lot of things like arthritis, getting people's hopes up, but then having mixed results. And if the stem cells are from another source like fetal umbilical cord blood, infections can occur, and ethical questions are raised.
I am going to leave you with food for thought, and I expect it will generate comments on Facebook or on my blog site. Researchers from Washington University School of Medicine in St. Louis (August 1, 2019) report that they can measure levels of the Alzheimer's protein amyloid beta in the blood and use such levels to predict whether the protein has accumulated in the brain. When blood amyloid levels are combined with two other major Alzheimer's risk factors--age and the presence of the genetic variant APOE4--people with early Alzheimer's brain changes can be identified with 94% accuracy, the study found. It goes on to say that such a test may become available at doctor's offices within a few years, but its benefits will be much great once there are treatments to halt the disease process and forestall dementia. My question is--would you have the blood test? I have thought much about it, since my father had Alzheimer's and there is a genetic risk. But I have decided I would not have it. I want to live every day to the fullest, and not have the threat of that hanging over my head--no pun intended. I look forward to your responses!
I went to another seminar/luncheon last week for retired nurses that is held twice a year at the hospital. The speaker's topic was on things you can do to prevent Alzheimer's. I will leave that for next month's blog, but if you find you cannot wait until then, she recommended the book "The End of Alzheimer's" by Dale Bredesen.
Yours for the best possible life,
Betty
But now we are home to reality--having to fix our own meals instead of going to the scrumptious buffet every morning for breakfast and hitting the complimentary peanut butter and jellies and bananas and milk and hot chocolate bar every evening in the hotel. We are spoiled!
I went out to see Bob as soon as I could after getting home. The first day he was having one of the days where he was sleepy and wouldn't react to me. I should have had Libby there! She could always get him to respond! But everything was different at The Piper as well. Two of my favorite residents had passed away very unexpectedly while I was gone. One was Bill, the husband of my friend from the support group. I will really miss Sheryl being there, and our happy chats together as we fed "our boys"! The next day I went to see Bob he was awake and told me my hair looked nice. I about fell over! Then he proclaimed loudly "I AM A MAN". I told him "I AM A WOMAN", and he laughed and laughed! BUT! I found out from the staff that they had caught him and Mickey holding hands while I was gone! Mickey is a retired RN (Real Nuts, she told me when she was more cognizant.) At least Bob knows how to pick RNs to care for him! Mickey sits at Bob's table as she has to be fed and the staff can feed her and Bob at the same time. She just sits there and smiles (now I notice she is smiling at Bob and that is why she is not focusing on eating her food.) I also feed her if I am there feeding Bob. Well that is the end of that--LOL!
I went to a seminar at The Piper before I left. A radiologist that has an independent practice in Shawnee spoke about using stem cells to treat Alzheimer's. His own father was one of his first patients. He takes the stem cells out of the patient's own bone marrow and abdominal fat and then reinjects them IV. He is not willing to do the double blind testing that requires using a placebo on half of the patients as he wants everyone to get the treatment. Therefore, he cannot qualify for studies that would lead to approval and also get the treatment covered by insurance. The pretesting is very expensive with Pet scans and lumbar punctures as he is trying to catch people in the early stage of the disease. Long story short, his father ended up saying "stop, this is costing too much" and died, and another patient was not helped at all. But 2 others he treated were helped significantly. I know stem cell treatment is the thing now, and he acknowledges that it works better for diseases like COPD. But it is being tried for a lot of things like arthritis, getting people's hopes up, but then having mixed results. And if the stem cells are from another source like fetal umbilical cord blood, infections can occur, and ethical questions are raised.
I am going to leave you with food for thought, and I expect it will generate comments on Facebook or on my blog site. Researchers from Washington University School of Medicine in St. Louis (August 1, 2019) report that they can measure levels of the Alzheimer's protein amyloid beta in the blood and use such levels to predict whether the protein has accumulated in the brain. When blood amyloid levels are combined with two other major Alzheimer's risk factors--age and the presence of the genetic variant APOE4--people with early Alzheimer's brain changes can be identified with 94% accuracy, the study found. It goes on to say that such a test may become available at doctor's offices within a few years, but its benefits will be much great once there are treatments to halt the disease process and forestall dementia. My question is--would you have the blood test? I have thought much about it, since my father had Alzheimer's and there is a genetic risk. But I have decided I would not have it. I want to live every day to the fullest, and not have the threat of that hanging over my head--no pun intended. I look forward to your responses!
I went to another seminar/luncheon last week for retired nurses that is held twice a year at the hospital. The speaker's topic was on things you can do to prevent Alzheimer's. I will leave that for next month's blog, but if you find you cannot wait until then, she recommended the book "The End of Alzheimer's" by Dale Bredesen.
Yours for the best possible life,
Betty
Monday, May 20, 2019
I am very happy as I write this blog. One of my friends from the support group has moved her husband Bill to The Piper! Bill is about in the same place in the Alzheimer's journey as Bob, but he got to that point much faster, so Sheryl was faced with finding a place quickly. She has been looking for places for ambulatory residents, but suddenly Bill wasn't ambulatory. She had already been looking around (which I highly recommend not waiting until the last minute) but then her focus had to change as Bill became wheel chair bound. She knew others in the support group (an added benefit of support groups) had been happy with The Piper. She also called me and we discussed her options. She had hurt her back trying to lift Bill, and a room had just opened up across the hall from Bob, so it became a done deal in just a few days! Now they sit in recliners in the day lounge together where there is a TV, and share meals at a separate table in the sunroom. And now Sheryl and I can visit while we feed our husbands, and although they can't join in the conversation, we tease them and they just smile at us!
While we are talking about not waiting until the last minute to make decisions, I have been going with my 86 year old friend Mac to look at different options in case her health conditions would suddenly change, say from a stroke or fall with followup rehab. On our last foray, and with the suggestion of my elder care attorney, we found a wonderful place that we were both very impressed with. They are associated with the Lutheran Church and have been in the same place for years, not one of the newer startups in the area that are having trouble finding staff. They are the only place I have found in the area that takes Medicaid pending, which would be a huge help in the timing of moving to a facility. But they also have about a 6 month waiting list.
I am going to relate two instances of proof of God's impeccable timing since my last blog. The first is about the opening of the new Family Center at the hospital--now renamed Advent Health Merriam. I was having Easter brunch with some friends and Joanne was telling me how she worked closely with the founder of the Infant Development Center, Lee Ann Britain. She said when the flood came and the Center had to move, she asked Lee Ann where she was going to go now. Lee Ann told her "Shawnee Mission Medical Center, but they don't know it yet!" Lee Ann was that kind of person. And Joanne said she remembered Lee Ann talking about a "Bob" that helped her so much. Of course now we know who the Bob was! God's timing of sending a flood precipitated the moving of the Center to the hospital campus exactly at the right time!
The second story involves Bob. I had gone out at lunchtime to feed him, and the nurse practitioner from hospice was there. I had never met her, but she was very nice, and we had a nice chat, and she did a mini physical on Bob. She had no sooner walked out of the door when Bob gave a blood curdling scream and went into a full grand mal seizure, which if you are not a medical person, could also be called an epileptic fit. I have seen many seizures during my career, but it is always a horrendous sight, especially if you are not expecting it. The convulsing of the muscles is followed by a period where they don't breathe, and they turn purple. I yelled for the clinical associate to get the nurse that just went out the door, but then I looked out the window and saw her car drive away. I wanted her to witness it as well. After what seemed like an eternity Bob started breathing again, and I asked the CAs to put him in bed. I called hospice to see if they could get the nurse practitioner back, but they said they would send his regular nurse. While I was waiting for her, I went to Dr. Google and googled "seizures in Alzheimer's patients." It said that about 25% of Alzheimer's patients have them, and it is a progression of the disease. But it also gave a case study that one lady got her full capacity back for about a week after the seizure and knew everyone and could hold an intelligent conversation. When the nurse came and was checking Bob I asked her "May I ask if the nurse practitioner was here to recertify him and was she thinking of taking him off hospice? She sheepish said yes. I told her I didn't know what I would do without hospice. In addition to the moral support they give, they supply all the equipment and incontinent supplies. I asked about that, and she said I could rent the equipment by the month. I was afraid to ask how much it would be, as he has the special bed, the wheelchair, the lift, and the shower chair. I asked if they would take him off hospice after the seizure, and she smiled and said "Not now!" So once again, God's timing was perfect. What if I hadn't been there to witness it? They would have thought he had had a stroke. He remained unresponsive for about 12 hours and then started waking up. And wouldn't you know it, something got rewired during the seizure, and he was much more engaged and talking in sentences again, some of which made sense! The social worker from hospice called me when she was there to see him a week ago and told me he had told her he was going home, was going to apply for a job, and was going fishing. I had just left an hour before, and he had not gotten to that level with me, before or since. Wouldn't you know he would show off for the hospice worker?! The past few days, he has gone down again to about the level he was before the seizure. Another example of the roller coaster ride that is Alzheimer's.
As A.J. Cronin puts it "Life is no straight and easy corridor along which we travel free and unhampered, but a maze of passages, through which we must seek our way, lost and confused, now and again checked in a blind alley. But always, if we have faith, a door will open for us, not perhaps one that we ourselves would have thought of, but one that will ultimately prove good for us."
Would I have thought Bob would have a seizure? Absolutely not! But maybe it was through the seizure that God opened the door to buy us more time on hospice. And it was certainly well timed!
I leave Wednesday to drive to Tennessee to bring back our 9 year old granddaughter for the summer.
I know we will have a great time and be very busy, so I may not write a blog for a couple of months unless something changes drastically. I am not getting on that roller coaster in the meantime! I know many of you pray for us daily. I would appreciate it if you would pray specifically now that Bob will be able to stay on hospice. Also, two of Bob's brothers need your prayers as they are both facing a health crisis of their own.
Thank you, and love to you all,
Betty
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