Wednesday, December 26, 2012

At the nursing home and back in the kitchen on Christmas Eve

As simple as it was, this year made for quite a memorable Christmas Eve for me.   For the first time since Mom's been there - nearly 3 years now - we all gathered to spend Christmas Eve with her.  At Mom's request, my sister-in-law and my niece made stew and we all met at the nursing home to share a simple supper with mom.  We thought we arrived early enough to get a nice spot near the fireplace in the "living room" but we were too late.  We asked an aide for help finding some place private - mainly because we're loud not because we didn't want to be with others - the only place free and large enough was the rehab kitchen.  It's a large room with a big table and all the basic stuff  you find in any home - range, fridge, sink, microwave....  We were a little frustrated not to find a better spot but we aren't complainers so we settled in to eat and talked and gave each other a hard time.  It was quite relaxing and soon 2 hours had slipped away.

About then I looked at Mom and she was smiling with tears running down her cheeks, she said, "It's just like home, Christmas Eve in the kitchen...", we all got quiet for a minute and laughed.  You see, my parents home was small but their kitchen was huge - it really dominated the house.  The table was oak, sturdy and probably five feet in diameter. At the holiday's we'd cook, family would bring extra food and we'd lay it out on the cabinets, the sink, the appliances -  every flat spot - for a buffet; then we squeezed around each other to fill plate and down to eat at that big table. It made no difference to us what it looked like as long as everyone got plenty to eat. 

By arriving a little late Fate and that aide put us in just the right spot to make mom feel more at home than she has in 3 years.  It's a simple thing, to feel "at home" but when someone is in an institution like a nursing home, it's huge. For her it felt "normal" again; she'll remember that feeling for what's left of the rest of her life.  It might be enough to sustain her mood, help her feel content and loved.  At this point, it's the greatest gift we can give to her.  
Christmas in Idaho, Mom's last christmas.

Sunday, October 21, 2012

Cold feet DO sweat and still require preventive powder

I've noticed an odd thing about Mom's feet over the past few years - they always seem cold yet she still seems to get athlete's foot fungus between her toes.  It seems odd that cold feet would sweat enough to release moisture that would enable growth of fungus but it happens.   Her feet are in pretty good shape these days because the aides apply non-talc powder to her feet each morning.   They also try to apply power to other locations that may retain moisture - under arms, breasts, behind her knees.   It seems to work very well.  It's a preventive measure to ensure the fungus doesn't start to grow.   It helps ensure dryness to existing fungus may be "healed" by the body - though the chance it will return always exists.  

I've definitely noticed that non-talc powder is easier on Mom's skin.  When we used spray foot powder and talc or talcum powder at home Mom's skin remained red and peeled.  Switching to non-talc powder, or corn starch, the redness disappeared and peeling stopped virtually overnight. 

To see other posts on skin or feet, read these:
post from 2009
post from 2011

old feet have special needs, care for old feet, grandmas feet, grandpas feet

Thursday, October 18, 2012

Tragedy in North Dakota, do I tell mom?

Today I learned that Mom's home town was burned to the ground - the WHOLE town. It was a little wide spot in the road surrounded by farms.  There was only a grain elevator, a small Lutheran church and a few old houses left. The school, small shops and half the houses were abandoned and turn down long ago.   The heart breaking thing is that two homes consumed by the fire belonged to my great grandfather and my great aunt and uncle.  The homes were old and sat near large old barns, corals and small out buildings.  It was like going "home" for my mom and for me.    Though the town had seen more prosperous times, we could still go there and feel the presence of our elders.  A few years ago when my husband and I drove from the mid-west to the north-west we stopped to see the farm. Though the house was locked up, we sat on the front porch and had a picnic.   I could see my great grand fathers hat and jacket hanging near the door like it had for the last 25 years, as though he'd just left.  For supper we traveled to my cousins to have "hot dish" and salad.   That won't be possible any more, there is nothing left at either place.

My brother and I spoke a bit tonight about whether we should tell Mom. I think she'll probably know all about it soon. She watches the news and reads every syllable of the paper so it won't escape her.  I know she'll feel so very badly and she has no one to discuss it with; she's the only one left of her immediate family; all of her aunts and uncles have passed and most of her cousins.  She can't hear on the phone any longer so I can't even console her that way.  I think I'll call a former neighbor who sees her weekly and ask if she can let me know if Mom's heard the news.  Then I can send some flowers and a letter and see her soon to talk about it.  I'll plan a trip to see her in a couple of weeks.

In the mean time, I'll grieve some myself for the little town.  Like  Mom, I'd probably never have gone back to visit again, there was something that made me feel good to know it was there, just as I remembered, just as my grand parents and aunts and uncles left them.  It was like a little bit of them was left too but now it's truly gone for good and that makes me very sad.

Sunday, October 7, 2012

Mom's lectures about bones are saving me right now...

Last week I learned that all my mom's lectures about bones and health helped me even though she might not have followed her own good advice.  I had a quick and easy bone density test at work and learned that at age 50, I have the bone density of a 24 year old woman - that's someone half my age.  It was such a huge relief!

The test was so easy; it took only 1 minute and was completed by a machine the size of a large back pack.  The machine had a groove down the center where I put my foot.  The machine used sound waves to judge the thickness of my heel bone; it was pain free.  The nurse told me that heel bones are very similar to the large bones in our hips so testing it was a good indicator of the density of the large bones that support our frame - our hips.

I am in a high risk group for osteoporosis - or so I've been told...So for more than a decade, I've taken Calcium with vitamin D each morning and Calcium/Magesium/Zinc each night after I brush my teeth.  I also eat a lot of yogurt and cheese.   Years ago a doctor told me that due to small bones, white hair at an early age and  half Scandinavian heritage - I had a higher risk of osteoporosis.  I don't know if research continues to support those risk factors or not but, once my Mom heard that she began to nag me about calcium, Vitamin D and eating enough healthy food.  "Take care of the inside first. Don't worry about the outside; it won't look good of the inside's not healthy."  She's so right.

I must also give credit to my gynecologist who realized that my hormones where out of whack and started me on low dose estrogen at 46, two years before a full hysterectomy.  Though I've fretted about my weight over the past 3 years and been lazy about working out for the last decade, I wonder if my 30 extra pounds has actually helped me.  Has the weight meant that my frame - my skeleton, my bones - had to be stronger to hold it up?  I don't know but I don't think it hurt me.

Going forward though, I must be SURE I'm healthy from the inside out so I'll take my mom's advice and also do something she didn't. Mom had a large yard and garden that she tended all year long.  I hope to do the same after I purchase a house in a month or so.  In the mean time and even after I get the  house,  I MUST be deliberate about exercise. I must life weights to strengthen and do yoga / stretching to maintain my flexibility and balance.  I believe it's those things - along with a good diet - that will ensure I avoid osteoporosis and the pain that goes with it.

How do i prevent osteoporosis?  Easy bone density test, how do they test bone density? prevention of osteoporosis, prevention of weak bones, risk factors for osteporosis

Tough little momma is hanging in spite of broken femur

I just re-read my post from March 2010 when I was reasonably certain my Mom would quickly fail and pass away after suffering a broken sacrum.  Well, it's 1 1/2 years and she's still with us.  Her latest ailment is a broken femur; suffered when she slipped from her wheel chair as she tried to reach a newspaper that fell to the floor.

Though she seems smaller and weaker each time I see her, her spirit is still strong and her mind is still curious.  She  reads every syllable in the news paper every day;  she wants to watch educational PBS programs on the outdoors, animals and science.  She wakes up to have hope for something positive every day.  That's how I want to approach life.  I wish I'd realized it sooner, the first 50 years would have been much more fun and less stressful.

So - what to do about the broken femur. The goal is to keep her pain free; it's unlikely the bone will heal well enough for her to put more weight on it.  The break is along a diagonal line about 2 inches above her left knee and at 92, there is little that doctors can do for Mom. They can't put her under for surgery since the amount of anesthesia would likely kill her.  If they tried to perform surgery they'd attempt to screw the broken piece of bone to the larger piece above but her doctor is worried that any screws would simply shatter either piece of bone making for an even worse break and more pain.  SO -the plan is to keep it immobile for 8 weeks hoping that it will knit together enough to keep the broken piece in place and avoid pain.  Mom can never put weight on the leg again.   If it doesn't work, I asked the doctor if it could be glued into place.  I'm hoping it might be done with a local anesthetic.  My aunt had part of her spine glued when she chipped a vertebra, my cousin had a knee cap glued.. so, I'm hoping....  He didn't say "no" but he didn't say it's possible either...  All I can do is hope and pray for my little momma...

What caused the broken femur?  There are 2 obvious causes - osteoporosis and mom falling from the wheel chair.   The osteoporosis is a natural occurance of aging and the fall from the wheel chair is inevitable - but BOTH could have been minimized.  If Mom had remained more active, taken calcium and vitamin D and low dose estrogen her bones might be in better shape.  If the nursing home aides had helped mom to her recliner instead of leaving her in the wheel chair, she'd never have slipped out of it.   Again, it's another thing about to complain to the state but it's unlikely to change.  There are just too few aides to take care of too many patients.

Read my next post on how to prevention of osteoporosis...
How can i prevent osteoporosis?  How did mom break her femur How did dad break his femur  broken femur in elderly

Tuesday, August 21, 2012

Mom's wisdom

I saw my mom last weekend after 6 weeks - it's WAYYY too long to go between visits.  She remains philosophical about life.  Here is her latest wisdom:
Too soon old, too late smart she says, as well as:
- don't regret being compassionate or affectionate, neither are shameful things
- you'll think more about both when you're old and have all this time to sit and reflect
- fish more or grow more and shop less

Saturday, February 4, 2012

Follow up on epidural for pain after broken sacrum

Mom suffered a broken sacrum just about one year ago but now she's relatively pain free and we're so thankful.  Mom's broken sacrum caused excruciating severe pain for several reasons - it's in a location that is the base of the body's core so key nerves pass through the sacrum.  The break was near the sciatic nerves, those that pass from the spine down into the legs.  The area was bruised which means broken capillaries; the problem is that nerves HATE blood and send pain signals to the brain in response to blood.  So - broken bones, swelling pushing the bones into sciatic nerves and the presence of blood around the nerves was just unbareable. Now mom's relatively pain free but she is much more bent and has no strength in her legs at all.  she can no longer roll over in bed either but that's probably safer since she can't roll out of bed.

Mom's doctor treated her with a combination of drugs and the miracle epidural right in the nerves.  She had immediate relief.  A year later, she still has a pain patch and takes a certain pain medication that works specifically on "nerve pain".  I don't know what that means or what it does but I don't care - Mom's pain free.  If it turned her hair purple, we would not care - anything is better than the torture she suffered last year.

Cause of pain due to broken sacrum,

Sunday, January 22, 2012

Fall from a lift and mom's high tolerance to pain leave me worried

Mom's had another incident at the nursing home that will leave me worrying for a couple of weeks.   The aides use something called a "sit to stand lift" to move her from chair to toilet.  Apparently, she lost her grip and she slid out of the lift; the aid saw it coming and caught her and "sat her on the floor".  They said there's no bruising, no broken arms or legs and no pain so she seems fine. My fear now is that something more is wrong but the signs will be so subtle that it will go ignored or unnoticed until she's in excruciating pain; that's what happened last year about this time.
I worry that Mom will have pain but won't feel it.  Since her broken sacrum was diagnosed in February 2011, Mom's been on pain medication that works on her nerves (those little things that transmit pain to the brain) and she wears a pain patch.  To make it more complex, I believe that she has an increased tolerance to pain after a stroke during my birth.  I've seen her burn her hand canning and not realize it until her fingers are full of big blisters.  At that time she was un-phased and just kept working; she said "It doesn't hurt, it can't be that bad."

She "seemed fine" after the "assist to the floor" last January yet she ended up dead in the MRI machine.  I told the nurse who called to tell all the aides to look for "crankiness", impatience or asking the aides if it's time yet for another pain pill.  These are all signs that she's having more pain that SHE or the aide's realize.  I noticed it in her over the holidays - before the "assist to the floor", a month before her pain became excruciating.  Mom's normally in good spirits and doesn't complain; but at Christmas she was disgusted and griped constantly about everything - gifts, visitors, her shoes, her clothes, the aides, my hair, the beautician.  I realize now this was her pain talking.  We might have saved her from the MRI fiasco, the delerium of the narcotics and the bedridden period she required to "heal".  ( I don't believe her sacrum will ever "heal" but that's another post..)

I'm frustrated because I've expressed concern about this "sit-to-stand" lift for a few months.  It's a lift that uses straps under her arms to raise her up from a chair onto this small platform where she "stands" - holding on - while the lift is rolled right up to the toilet.  There she's lowered on to the commode to do her business.  The process is reversed to get her back to her chair.  

The straps that go under her arms are too loose and lift her from the shoulders than the behind.  I've told them she could suffer a dislocated shoulder; it falls on deaf ears.  She is also very weak in the hands and unable to grip the handles properly so I worry that she'll let go - which she did yesterday - and just fold up and fall out of the lift.  The aides and nurses don't seem to worry - when it comes to this stuff they are REACTIVE not PROACTIVE.  To do anything differently would require 2 aides not 1 - translation: the lift works for a one time price; another aide = another body at work costs too much.  I suppose they rationalize it by saying that they want the patient to do as much for themselves as possible. 

I know they are operating to make a profit but it often seems to be at the expense of my Mom's well being. 

Here are a couple of photos that illustrate the lift.  The one on the second is the type used with mom - the hand holds are black knobs.

sit-to-stand lifts risks, subtle signs of pain in elderly, use of lifts in nursing homes.