Help-4-Mom

Follow up on epidural for pain after broken sacrum

2012-02-04T00:30:00.000-08:00

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,

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

2012-01-22T10:46:00.000-08:00

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.

Be thankful there are people who don't like you...

2011-12-26T12:26:00.000-08:00

Today, the day after a weekend of time spent with family and loving friends, I am left thankful that there are people who do not like me. In fact, the more they dis-like me the better.   The reason is simple: these people are so lacking in moral fiber and have such little thought for the feelings of others, that, if they did like me, I would wonder just what kind of low-life jerk I had become.

My cousin called this morning upset over mail he received from the attorney for his evil step mother.   Getting it brought back decades of hurtful memories caused in large part by her selfish behavior. From the time he was 10, any interaction with her and most interaction with his father left him disappointed, feeling abandoned and cast aside. The evil witch died months ago and her attorney and son, the Executor of her estate, mailed her will just in time for it to arrive on Christmas Eve. Given the history of this woman, it is a fitting action for someone who was so maliciously and deliberately mean throughout her life. It seems that the evil things she did were lessons well learned by at least one of her children - the other wanted nothing to do with her.. I can understand why.

The "inheritance" she left to my cousin was the small sum of $1. I am certain she did it so that there could be no way to contest the estate of her husband, father to my cousins, thus leaving everything to her sons. It's not like there is a lot of cash property to be had and my cousins would not want it anyway because it means hashing up to much pain and disappointment. But, to leave them with $1 and then send a letter at this time of year is just mean-spirited.   My cousins have had nothing to do with her for nearly 15 years, why is it necessary to send anything now?

Years ago in the 60's, this woman decided that she would marry my uncle - never mind that he was already married with one grown daughter and 2 sons at home. She pursued him in a town small enough that most people knew everyone else's business and he was happy to have the additional female attention. Neither of them cared that the eldest son was ridiculed by friends on the main street of town because his father was seen out with another woman. Neither of them cared that his youngest sat and sat and sat waiting the driveway of the other woman's house while my uncle visited her and her sons inside. There were too many times to count that my uncle made a promise to my cousins only to take it back because his girl friend and then wife made other plans.   Most times, she was there to hear the plans and readily agreed yet when the time came, my uncle would cancel at the last minute in deference to her. She knew my cousins would be hurt and disappointed yet she made other plans anyway. After seeing her do this over and over, one can only conclude that she knew EXACTLY what she was doing. We are left to wonder why - there was no threat to her or her relationship with my uncle. His first wife was to tired and busy working to put up a fight. My uncle's siblings were too darned polite to cause a rift between them so why go out of her way to hurt his kids?

Through it all my cousins tried to put their hurt aside and treat their father with respect and kindness. When he died, none of them got a call until after he passed even though he was hospitalized for days. They were denied the gift of simply saying good bye. None of them wanted anything to memorialize him except for small sentimental things - a fishing pole perhaps - yet she responded with mean cursing, name calling and restraining orders. She was always good at playing the victim yet she was the ultimate culprit in hurt and meanness. I've known people who called her, "that poor Pat, the single mother with the sick son." There was nothing poor about her. She wanted someone to take care of her and did it at the terrible expense of 4 others.   I can't let my uncle off the hook - he is just as culpable but I do not believe he was as capable of such malicious planning as she. His are sins of insecurity and thoughtlessness. He didn't realize how much he was loved and needed by his family. His 2nd wife KNEW how much the first family loved and needed him. Taking him away from them made her feel powerful and happy. God forbid someone like that come into my life - or anyone else's for that matter.

It makes me sad to write something like this at a time of the year when we should be appreciative of family but it also sets me free. I am thankful that my family and friendships are genuine and sincere!

More advice on old feet - dealing with "foot funk"

2011-12-18T12:39:00.000-08:00

The older we get the more likely we are to develop "foot funk" - it's my generic term for athlete's foot, toe fungus and generally dry scaly appearance.   With my Mom's feet, there are dry patches on her heels and calouses and then there are overly moist hard-to-keep dry areas between her toes. I also notice that the area between her does almost looked "spongy" at times - the skin was white on top with small holes. When I spread her toes it would stretch and tear, revealing dark pink skin underneath. The top layers of skin would very easily peel or rub off and the skin below could split and become painful. When I first began watching her feet, this happened a lot but over a few weeks time - with diligent attention and a some new practices - we healed up the worst spots and all she suffered was some itching now and then - a huge improvement over the keep cracks and odors.

Poor circulation means that Mom wants socks and shoes on all the time but that means the area between her toes don't get "aired out" and remain moist.   When Mom was home I soaked her feet in a mix of water and white vinegar (4 to 1 dilution), water and listerine (2 to 1 dilution) and tried an occasional massage with tea tree oil after cleaning and drying her feet well. Be warned, I used the tea tree oil ONLY after the cracks on her skin were healed. DO NOT USE TEA TREE OIL ON OPEN WOUNDS! The water and white vinegar once a week seemed to work best.   She had a couple of spots between her two most outer toes that were stubborn and it took a long time to see improvement in the skin. For these I used anti-fungal cream for a couple of months. When I was not there, she was able to put the cream between her toes herself everyday. This helped it to heal so that a mild vinegar soak was able to keep the fungus at bay.    I didn't want to soak her feet until these areas where improved because I thought the vinegar might burn or sting raw open spots between those toes.

I don't think you can ever get rid of this stuff once it's there; it's a matter of keeping it under control.   I've read that there are dietary changes that also help - it's basically reducing sugar intake. Sugar is fungus' favorite food so if you eat a lot of it or if you're diabetic and your body can't process sugar, you might have more problems with athlete's foot - and fungus in other spots like jock itch or vagina yeast infections....but - our focus here is FEET so please read on......

Here are some of the things that worked for my mom's feet: Remember that we had to be diligent about this, it became part of her regular daily routine:
Socks: always use cotton, wool or some of the new materials that wick moisture AWAY from the skin. change socks daily and wash socks alone in small loads. Use hot water and put at least one cup of white vinegar, 2 cups is probably best, in the wash water to help kill fungus. I got the "wicking" socks at REI in the hiking section. If it was especially cold, I'd put those on first then a 2nd pair of wool socks.
Shoes: if possible, let them go without shoes, this permits air to circulate around the feet.   Often shoes for our elders are made of vinyl or other man-made products that don't permit air circulation. My mom used to complain of her feet feeling cold and wet when she wore cheap sneakers - they were, she had poor circulation but her feel still sweated and it stayed there in her poly-canvas shoes. EEE..UUUuuuuu
Powder: We used a spray athlete's foot powder, medicated foot powder, corn starch and baking soda combined - they all helped if used regularly - meaning EVERYDAY. The generic store brands of spray powder and anti-fungal cream from Target were just as effective as the more spendy brands. I recommend avoiding powers with talc; talc seemed to make the deepest problems worse. Be sure to wipe it off with dry tissues at least once a day and re-apply.

DIABETIC readers: PLEASE, PLEASE, PLEASE - don't just take my advice here, see a doctor about your feet and how to best take care of your feet.    If cracks in your skin do not seem to heal, you might need more than over-the-counter medication.

For my original ideas on care of old feet, see this blog post from 2009
2009 article Old feet have special needs

How do i take care of diabetic feet? How do i clean up grandmas feet? how do i trim grandpas toe nails. Old feet have special needs.

I found another Christmas surprise for mom - a "bangle" wrist watch

2011-12-17T23:29:00.000-08:00

Purely by accident, I found the perfect gift for my mom - a "bangle" wristwatch.   This is not just a simple bangle. The watch band is made of two metal pieces that attach to the watch with hinges so they open up wide which will allow mom to put the watch over her wrists with ease.

I'm so excited to find this for her. She's gone through several watches and it's always hard to find one with a face that's medium sized yet has big numbers so she can easily see it.   I really think she'll be pleased.    Here are some photos that show the watch; the watch with the hinges in the normal position and the hinges spread apart a little.

If anyone needs such a watch for a male, there are some very basic designs that would be suitable for a man - plain black watch bands, plain white faces and plain black numbers.   I found this one at Kohls - and it was ON SALE!!

Medium sized watch face with large numbers at all hours not just 3, 6, 9 & 12.

The watch when hinges are "closed" or not extended.

This demonstrates how the hinges open, this is only about 2/3 of the possible width. This permits Mom to open it herself and put it over her wrist. It sort of makes it a flexible size too since her wrist can swell to 2-3 times normal size due to arthritis.

What should I get grandma for Christmas. What's the best gift for grandma for Christmas. what should i get grandma for her birthday.

More ideas for Grandma at Christmas..

2011-12-04T18:07:00.000-08:00

This year I don't face the challenge to get Mom a Christmas gift. She's getting 3 things that will make her life more comfty:

a pencil box full of rectractible pens
several packets of eye glass wipes
a new fleece jacket with a hood.

She loves to do cross-word puzzles and pens always seem to disappear - I know the aides take them since she can't possibly use up ink that fast. I got several packets of pens and used a silver sharpie to write her name on them. I found an "easy open" pencil box in the school department at a local large retailer and voila - gift #1 down. I won't give her all the pens now; I'll stash them at home and mail her a few at a time.

The eye glass wipes are a must. It seems her glasses are always dirty. The aides just don't have time to help residents wash their glasses. So now she can do it herself.

The fleece jacket will go over big. mom's got a couple of them already but they are looking ratting and old. She needs a "dressier" version.   I buy hooded ones for her because of her dowager's hump.   The fabric for the hood wraps up and around her neck to help keep her warm.

Some other ideas for gifts:
A "counter top" wreath hanger to hold photo frames.   This is basically a pole rising above a stand with a hook at the top.   Mom can't hang anything on the walls in her nursing home so I got a couple of these. One sits on the night stand next to her bed and holds a photo frame. The other sits next to the sink and holds seasonal decorations.

A cabinet hook (think kitchen towels) to hang a photo frame, decorations or a jacket or sweater. I found this in the kitchen department. It's supposed to hook over a kitchen cabinet door and hold a dish towel but it's just the right size to go on the cabinet door or drawer front in mom's room too. I got one for her birthday and hung a photo frame from it. Be sure to find the lightest frame possible since you don't want to ruin the hinges on any cabinet doors.

Slippers - especially easy on and easy off slippers.   I got Mom some with velcro closure. It's necessary now since she lacks the dexterity to tie shoes.

Gift certificates to the nearest salon for shampoo and set. I pay for a "resident trust" at mom's nursing home but some families can't afford to do this.   It would be nice if someone gave other residents a $40-50 gift certificate to the in-house salon. This would get them 4-5 haircuts - it goes a long way toward helping them feel better.

Individually wrapped candy bars. Do this ONLY if your elder can have sugar. While these aren't as good as a whole box of chocolates, it means that the candy will keep a long long time. If they're in a nursing home or assisted living, it also gives them something to share with the staff or other residents.

Here's another idea for TIME but comes with something to do: Get a couple boxes of Christmas cards and stamps then spend a couple of hours dictating messages to friends and family for your elder.   Let them sign the cards and then drop them in the mail. It will help your elder feel like they can still do something meaningful for others. And, if they get cards in return, let them know that others appreciate them and remember them.

Help them give something to others: capture your elders favorite recipes and prepare a small book of their recipes for others. If you can, write some stories about their relatives who taught them to cook; to do a craft like quilting or who most inspired them. Have the elder sign all the copies before you distribute them. One thing that means a lot to me is a few recipes that my grandmother actually wrote in her own hand. It might also be nice to have grandma or grandpa write their recipes and scan them in then print them.

Subscription to magazines with large print or some that are good reading: Readers Digest; or something that will stimulate their brains like Popular Mechanics, literary magazines or National Geographic. I recommend avoiding things like Redbook, Ladies Home Journal, or others that are about food, fashion or home decorating - really, it's so inappropriate for someone their age, especially if they no longer live at home.

A clipboard with a compartment for documents.   My mom uses this as a light weight lap desk. It's also a good place to hide pends from the aides!   I attached a strap of ribbon so it's easier to pick up. I drilled two holes in the end opposite the clip, then cut a 7 inch ribbon and poked then ends into the holes. I tied knots at the ends of the ribbon so that they are inside the document compartment.

If your elder is still at home: give them coupons to eat out at a local restaurant. Better yet, make a couple of appointments to take them to lunch and then FOLLOW THROUGH!!!! This is especially important in Jan, Feb and March when it's cold and dark and they might not get much company.

A telephone with volume control on the handset and large numbers. This is especially helpful for those with hearing aides. Hearing aids and telephones don't always work well together.   If they want to remove their hearing aide, the volume control will permit them to hear well without it.

What can I get grandma for Christmas. What can I get for grandpa for Christmas.

Isolation is over but I find other problems at the nursing home

2011-11-15T22:08:00.000-08:00

I finally got in a good visit with Mom. I traveled 7 hours to her home town and got to see her daily for three days. On my first visit, after I hugged her like crazy, I took a good long look around. I looked at the bedding, her clothes, her shoes, her drawers in the night stand - everything, anything... What I found was disturbing and encouraging. All of her clothes and shoes where there, her bedding was clean. ... however.... in the bottom drawer of her nightstand I found a bed pan. This is the normal storage for bedpans in Mom's nursing home; they use them, rinse and wash them and store each in a thick plastic bag. This one was not in a bag and was smeared with something brown.... it's a bed pan, that can only mean one thing.... EEEEEeeeUUUU uuuuu!!!!

So, I asked floor nurse - not the aid - to come to look at "something disturbing".
Me: pointing to the open drawer: "Is that a bed pan?"
Nurse: glancing down, hands on hips: "Yes, it is. We always keep them in the bottom drawer."
Me: pointing to the bed pan and the smear, "What do you suppose that brown substance might be?"
Nurse: suddenly paying close attention, "Oh! that's not acceptable!"
Me: bending over and pointing, "And, those, are those the same bandages you use on Mom's stasis ulcers?"
Nurse: "I'll have someone clean it up right away."

...and she did. The nurse threw the bedpan in the trash and soon housekeeping came to clean the drawer with a bleach solution. I am left wondering how long a dirty bed pan had been in the drawer and if the nurse putting on Mom's bandages would have used them or thrown them away. Someone put a dirty bed pan in the drawer- it could have been the night before or days before. Someone might have been using a dirty bed pan for days. Someone changes mom's bandages daily and should have seen it and done something. It's always "someone else" whenever I find this type of stuff at the nursing home.

Every visit I find something terribly disturbing. It does not leave me confident that Mom's getting good care. This nursing home is ranked fairly well compared to others across the state, I can only imagine how crappy - no pun intended - that must be.

"Exile" continues this time due to shingles.

2011-10-14T22:47:00.000-07:00

Friday, Oct 14. I rushed 7 hours from my home to Mom's so I could attend a doctor visit with her. The prior weekend, the nursing home sent her to the ER for a "rash" on her forehead. The ER sent her home with antibiotic ointment. Two days later it was a larger rash, swelling and a bruise. Today she looked like someone kicked her in the left eye. Her eye was swollen nearly shut and oozing goop.   She has what looks like scabby scrapes on her forehead and into her hair line.

As soon as I saw her get off the bus, I bent and gently hugged her without coming into contact with her swollen face. I lifted her hair to note a couple of "rashy" spots on her scalp. After seeing the doctor, he called in a colleague and they decided that Mom has shingles. Then he turns to me and says, "I hope you've had chicken pox because this is highly contagious..." oh sh___!!! I don't remember having it but did have measles 3 times, we're hoping that one of those was chicken pox and that I have immunity.

Poor mom has only been out of isolation a week and now she'll go back in.   And, I can't go see her until I get the results of a blood test to determine if I'm immune or not.   She was looking forward to my visit and I planned to take her cousin there for a visit with pie and coffee - that's all on hold now.   As for me, I need to stay optimistic and pray the virus away because chicken pox in adults can get bad.

I think the ER missed the shingles diagnosis because it doesn't normally show up on the face and scalp. Mom's had it in the past on her back around her waist. The doctor said they look for "geometry" or lines where the pox appear - it has definite boundaries.   In this case, the pox are quite concentrated on the upper left side of her head. Picture this; the "bottom" boundary is an imaginary a line from under her nose horizontally toward her ear and around the back of her head. The other "line" goes from her left nostril up straight over her forehead and over the top to the nape of her neck.   It was just all swollen and painful looking. She's on a pain patch to help with her arthritis so the infection doesn't hurt as bad as it might otherwise.   So - now we're both in a sort of isolation - she must stay in her room and I have to stay away from others and her - for now anyway. Damn.

Shingles on the face, shingles around the eye, shingles on the head, scabby rash red swelling swollen eye face

MRSA puts mom "in exile" and it demonstrates holes in the rules

2011-10-01T11:46:00.000-07:00

Confined to a wheelchair now, my mom has begun to get stasis ulcers on her lower legs. These are oozing gross wounds that open up on her chins. Apparently these are ulcers are common for people who have limited motion in their lower extremities (legs and feet). My niece, the 25-year career nurse - tells me its caused by poor circulation of blood and lymph fluids. The skin tissue in the legs doesn't get nutrients from blood flow so it begins to breakdown. Mom insists it only hurts when they apply salve but the tissue around these sores is often so swollen, red and angry looking that I can't imagine it doesn't hurt. Since June, I've been concerned about a large on her left calf that would not heal. Over the past 4 months it's improved then become worse and improved again several times. In early September a nurse called to tell me it tested positive for MRSA and Mom would be put into "isolation" to prevent infecting anyone else.

I was very upset because she had the wound for so long and they hadn't tested it for any virus or bacteria. I asked if there was more they could do - different medication, vitamins, better diet...I got no answers. They watched the wound closely for changes that indicate MRSA and finally in early September they "swabbed" the wound and ran tests. The nurse told me they look for discharges of pus and blood and a particular odor that indicates staph might be infecting a wound; once they see it, they test for staph infection.

After the positive MRSA test, they had to put mom into isolation - no room mate, visitors must wear gowns and gloves, a bed side commode but that as long as the wound was covered, she could go to meals in the dining room. I felt good that she'd have someone to visit with now and then. I also asked if she could have a larger TV until her isolation was over. I got no answers even after leaving several messages.

When I was able to visit 2 weeks later, I learned that Mom had NOT been to meals and that she'd been stuck in her room, alone most of the time. "...being in exile, like Napoleon", she said. I was so angry. If I'd know she was NOT going to meals, I'd have sent flowers every few days. I'd have written letters - something, ANYTHING to help lift her spirits. I tried to talk with the nurse on duty and she gave me a different story - that Mom HAD been to meals, that visitors didn't need gowns or gloves to protect them from infection.. Two hours later aides brought meals to mom in her room but before entering they put on paper gowns and gloves!.. I asked about the inconsistency but could not get a straight answer from the aides or nurses. Now I have to call and complain because of these inconsistencies. It makes me so frustrated! How hard is it to train people to know what to do? Infections like MRSA, colds, stomach bugs - are pervasive once they get a hold in nursing homes so all of their staff need to treat the patients the SAME way. Families and visitors need to follow consistent - and best practice - methods to prevent spreading or getting illnesses. I want to know that the staff does the RIGHT things to keep things from spreading - to my own mom, to themselves, visitors or other patients.

I hate that Mom had to be "isolated". All of her clothing, towels, bedding and dining plates and utensils had to be bagged in special red biohazard bags before leaving her room. The nurse tells me that they tried to "enrich" her activities with extra visits from their staff but it's not the same as family or friends. Given the inconsistent messages from their own nurses and other crap that goes on, I doubt they do much "enrichment". My family was quite freaked out and didn't want to visit; they feared mom was exhaling the virus and that they'd become infected. I went anyway because I read enough about MRSA to understand that it was most likely caught quickly and thus a local infection - meaning it was only in the tissue on her leg and not spread throughout her system. I also spoke with the nurse before my visit and learned that the sores on her legs were nearly completely healed. I didn't intend to touch her wounds, bandages or the like so I knew that chances of being infected were very, very small. Visiting my Mom after she'd been isolated for two weeks out weighed my concerns about getting any virus.

This is the definition of MRSA from wikipedia:
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium responsible for several difficult-to-treat infections in humans. It may also be called multidrug-resistant Staphylococcus aureus or oxacillin-resistant Staphylococcus aureus (ORSA).

More on stasis or venous ulcers at wikipedia: http://en.wikipedia.org/wiki/Venous_ulcer

How could my mom get MRSA? Mom has MRSA, can i get it? Dad has MRSA can I get it. What should nursing homes do about MRSA?

Momma Mia made me cry over my own Mom.

2011-07-30T12:01:00.000-07:00

This blog is supposed to be about my mom but often it ends up being about my feelings - I suppose that's natural since I'm writing from my personal point of view and there is so much anxiety and guilt associated with sick and aging parents that it would not be right to exclude that from my various topics.   I've not added any posts since Mom's latest health scare because I've had little to share that's positive. I've not wanted to whine, moan or complain. This morning though, I was overwhelmed by such a deep sense of sadness that I must write about it.

For several years now I've wished so badly that I had the money to buy a big house, hire a staff of 4 to help with Mom and then just live, doing all the things that I enjoy and finding some way to make her a part of it - making jam, gardening, sewing - just those day to day things. My mom is still curious - she wants to watch CNN and PBS, the history channel or animal planet but the set up in her room at the nursing home doesn't permit it. I want to have her at home where she can have HER favorite chair, HER large screen TV, HER 4 walls around her - but she needs so much assistance, I just can't do it all.   I know she's not as happy as she could be; she longs for company from her family but my brothers never see her. The saving grace is a neighbor who's tried to see her at least once a week and a cousin who's gone by now and then over the summer.

My sobbing melt down came as I was reading news and watching Momma Mia on TV. Meryl Streep was singing about loosing her daughter to adulthood. The lyrics have her remembering sitting at the kitchen table with her little girl, spending simple times just eating or doing the day to day things.   It just hit me so hard to think of my mom enjoying those times with me, then watching me get my first car and taking off, leaving her in the house alone. I remember leaving for college; she and my dad weren't getting along and I was in such a hurry to escape it. I didn't think about her and that she might feel abandoned with no ability to drive herself (she had a stroke during my delivery which left her partially blind and with epilepsy), no job, no money of her own - she must have felt awful but that didn't occur to me. I was happy to get the hell out of there, to be free to have fun. I left and didn't look back to see her sad face.   To be fair to myself - I did visit often and called her every Sunday but it's not the same.

Now she's in the same boat - she's stuck there and I end up driving away. At least I always come back! She has people around her but it's a string of different people and she can't do the things she enjoys. All she wants is to sit in her comfy chair with a remote to a TV she can easily see. That's not too much to ask and I can't make it happen. She's never asked for much of anyone yet she's done a lot for others just by creating a home where we could all feel welcome and supported.     I hate that I can't do that for her. Even taking her to her little house isn't possible - it needs so much repair and would require total remodeling to accommodate her wheelchair.

As for me, I also miss my mom but the "mom" I miss doesn't show herself often due to pain, hearing loss and naps. She has a good sense of humor; she's smart and witty. She's done so many things and remembers how to do most of it - she's a wealth of information!! She's also wise - which I miss, she always has good advice for me, though now I don't ask much because I don't want her to worry. There's just so much I want to know about her, about my dad, my grandparents- I want so much for her to look forward to a good meal, to taste freshly picked berries, ice cream when she wants it not when it's on the menu; to sleeping in and eating when she wants not on someone else's schedule... to sit hear her roses and enjoy their color and scent in the warm sunshine.. this is how growing old should be not in some institution where she's a "client" not a person.

Ah well, my crying won't help her and now I've got a head ache... all I can do is try to get there to love her and make her feel as loved as possible.   If anyone out there reads this - do me a favor - go love on your family. Young or old, listen to their stories and ask them about the most important things in their life.   Talk WITH them and Listen; share things WITH them and you'll feel better about everything!

Got an inheritance? Don't do THIS...

2011-05-20T23:48:00.000-07:00

A friend revealed to me that her mother, age 62, is in dire financial shape two years after the death of her successful husband. I'm shocked, I never thought it would happen. The problem is that Mom didn't have a plan to manage her money and the kids didn't want to hurt her feelings and butt in when they realized she was depressed and spending too much. The reality is hard to understand - Mom went through $600,000 in a little over two years. More than a half a million dollars in 24 months. It's a shame because, if managed well, Mom could have lived comfortably for the rest of her life. Now Mom's renting an apartment and selling off her antiques. Her large home is for sale. She's living on a meager social security payment - her husband died before he began to collect social security so she's collecting earlier than she might if he'd lived. It's nice that the funds are available but the payments would be more if she'd waited to collect later in life.

Here's WHAT to do if you get an inheritance: I write this for people over 55-60 - those who are faced with living on a limited income. The idea is to create stable living conditions, minimizing costs overall so that living on a limited income is manageable and doesn't cause hardship.

Seek advice from a banker or financial professional. There are plenty of funds where you can put money that will generate interest or receive dividends even if the annual payoff is low. It might not be as much as riskier investments but it's steady and you won't risk the principle or bulk of your money. Think if it as a source of long-term annual income: Let it sit in a special fund and at the end of a year 1 , you could have 20-30-40,000 to spend during year 2 while your nest egg sits and grows money for year 3. (I've discussed this scenario with representatives from Edward Jones Financial, but any reputable financial firm should be able to help.)
Seek to make the money LAST - don't go on spending sprees. Don't do a bunch of cosmetic work on your home to make it look prettier.
Seek emotional counsel if you have the urge to buy and buy and buy - this is a sign of depression. I believe we get a little spike in endorphines when we spend money - this feels good so we do it a lot when we're depressed. This is RISKY - try to resist the urge to shop; if possible avoid the mall, don't watch shopping channels and don't splurge.
Consider setting up a trust or annuity for yourself - this will ensure that someone doles the money to you over time.
Invest in things that will make your life more stable: Pay off credit cards then CUT THEM UP. Pay off your house and make repairs that will ensure it's in good shape for the long term. Note that I said REPAIRS not improvements - only make improvements if it make it safer or will increase the selling price.
Buy or pay off a quality car that will last you a good long time - consider a brand that will require minimal repairs and will last miles and miles. Be sure it's a size that you'll be SAFE driving - think automatic transmission, 4 door-sedan not oversized SUV with 4-on the floor!

What NOT to do:

Don't go on vacation after vacation without consulting a financial adviser. Understand if you can AFFORD a lot of travel. Spend it on travel ONLY after you've made arrangements for the long term.
DO NOT LOAN money to kids, grand kids or friends. Often people have every intention of paying money back but when all you have is one big chuck of money, it's value is in the potential it has to earn more. Don't whittle it away a few thousand dollar loans at a time; before you know it, the funds are gone and collecting those loans is probably impossible.
Don't make a lot of cosmetic changes to your home - unless you'll sell soon and you are SURE it will pay off big! Example: if your living room is painted dark brown, it might be wise to paint the walls a neutral color before showing it for sale - the brown color will make the room look smaller and won't suit everyone's tastes.
Don't buy a lot of flashy gifts. you don't have to buy off family or friends, they should WANT your long term financial security not a bunch of "stuff".

What should I do with dads life insurance? what should I do with my inheritance?

Great site for special needs clothes!

2011-04-24T23:27:00.000-07:00

Find clothes is so hard for mom now that she's weakened due to arthritis. I just came across this site when I searched for clothes for a "dowagers hump"... Though some of the things are spendy, I think there are some good options here - especially for easy-on slippers. I will also look at the clothes in depth to see if I can modify any of mom's existing cloths for easier dressing (think off and on) or just to look better in general.

The name of the online store is Silverts, found here: http://www.silverts.com/default.cfm?adv=AAA

Clothing for the elderly, clothing for dowagers hump, clothes for dowagers hump, shoes for old feet, shoes for arthretic arthritic feet, shoes for hammer toes

Grandpa came through - sort of...

2011-04-24T23:09:00.000-07:00

Update on my last post of March 30 - my friend grandfather WAS as sharp as we expected. "G" went to his bank to advise them of this death and look for outstanding checks. She learned she was his one and only beneficiary on several accounts. She has also been in touch with insurance carriers who advise her that she is the beneficiary of those accounts as well - it's enough to put her two youngest kids through college and start a nice retirement nest egg for herself.

The two things Grandpa did not take care of - the title to his trailer home and brand new Lincoln - will require that she go through probate in the state where he lived and died. The attorney tells her that it will, by law, go to her father but she's okay with that. She was so appreciative for the savings and insurance that she will not argue over these assets. In the end, she almost feels sorry for her father because of what he missed not knowing his dad. She's taking the high road and I'm proud of her. I'm sure her Grandpa is too.

A friends kids miss out if she can't find grandpa's will

2011-03-20T01:25:00.000-07:00

This weekend I've spent all my time with a friend whos' grandfather just passed away. She tried hard to quickly travel across the country to be with him in my town before he passed away. Unfortunately, she was 3 hours too late. She's never dealt with the business side of a death. There are all sorts of things one must do - find wills, life insurance policies, savings or checking accounts, conduce probate, bills and funeral expenses.   It's detailed and things must be done legally..

My friend, we'll call her "G", was close to her grandfather and held his Power of Attorney for medical care. For years he told her that he wanted her to have all of his savings and that it should be used to put her two youngest kids through college.   G never asked about wills, or amounts, or locations because she didn't want to be rude. She respected and loved Grandpa and didn't keep in touch with him because of this potential inheritance. Her grandfather was really sharp until the end and had a good head for business; she assumed he'd taken care of it all....

So today, only 8 hours after Grandpa passed, I helped her search his home for important papers and we found one document - a bank statement from January 2011.   Her son searched his computer for anything that might give a clue to his income and debts - life insurance, check register, bills, car titles, deeds, - anything that might help her understand Grandpa's financial status.   Nothing. Just one bank statement with checking and savings and a small charge card balance. Damn.......I thought about all the legalities necessary..... "Double Damn." Then an "oh shit!!" moment......

We sat down for a break and it dawned on me - if Grandpa did nothing, even though he told G what he wanted to happen,...... if Grandpa put nothing in writing. If Grandpa didn't NOTARIZE anything, then, ... "oh shit!!" ... everything would go to his son. EVERYTHING. Everything would go to a drug addicted, low-life that had not seen his father for more than 20 years. Everything would go to a guy who did nothing but cause his parents deep hurt and take advantage of them.   I didn't want to say it out loud but I could not let G begin to conduct this business without that knowledge.

I called some friends and got a reference for an attorney. She called the bank to understand what they needed to set up an checking account for Grandpa's estate. She can't do anything with out two things: 1. Death Certificates and 2. being named by the county as the Personal Representative for his estate.    Damn...

The bottom line is that Grandpa died without a will and this WILL cause a huge mess. . Unless he was astute enough to name her as beneficiary on his accounts and his life insurance then the law of the state prevails.     So now, she'll become his "personal representative" and start the probate process.

The lesson for anyone else is clear: write shit down!!! Notarize it! Have it recorded at the county clerk/assessor!!! Make a will! Fill out the beneficiary forms for life insurance, savings, checking, retirement accounts. Don't wait, it could cost your loved ones and your wishes might not be honored.
Does grand pa grandma need a will? Grandpa died without a will. Why should i do a will.

completing a POSTfor Mom - the hard part about having Power of Attorney

2011-03-13T21:25:00.000-07:00

During Mom's hospitalization, I had to fulfill the uncomfortable part of being Mom's Power of Attorney. I filled out a form called a P.O.S.T - Physicians order for scope of treatment. It is intended to provide medical directives if a patient becomes incapacitated. Normally completed by a patient and their doctor, I filled it out as Mom's Power of Attorney. It is not something I ever wanted to do for Mom but it was clearly necessary at the time.   The POST replaces the DNR, the do not resuscitate order and living will.   With the form, Mom's doctor will work to ensure she's comfortable but no extraordinary measures will be used to prolong her life.   She's told us over and over that she wants no "tubes and wires" so this will ensure that no medical provider - not the nursing home, the hospital or the ER - will go to extraordinary measures to keep her alive. The form is easy enough, I checked off a few boxes and made some notes after talking with her doctor.

This is the hardest part of being a Power of Attorney. It is not something I want to do for Mom but it is something I agreed to do when I became her PoA. She trusted me to carry out her wishes and look out for her best interest. I believe that if a medical professional spoke to my Mom now, she would tell them to do "everything they can". However, given her increasing forgetfulness and the combination of narcotic pain killers she's taking, I am not certain she could understand exactly what "doing everything" means.   I based my instructions on the POST based on conversations I had with her a few years ago and on her current condition.

This is the sad part about being her PoA. I signed papers giving instructions to her doctor about the end of her life.   It means that the end could happen at any time, for any reason that might be minor for someone younger and healthier. It really hits home how grave her condition is.

What is a POST? What is a physicians order for scope of treatment.? What is a DNR?

Suggestions from "youngsters" are just so annoying...

2011-03-13T15:11:00.000-07:00

Over the past couple of weeks people have tried to be kind but it in the end, I come away completely annoyed and want to smack more than a few faces...   I should be more grateful of their attempts to be supportive but people are just so, well, stupid. ..And, they don't listen.   Friends, coworkers and even my own family, ask about Mom and what happened to her.. They nod, looking me in the face, as I speak, they seem to understand. Then they say something like, 'Well, can YOU move to take care of her? Why don't you move her here, closer to you..." .I want to scream, ' SHUT UP DUMB ASS!! Don't you think I've considered it? That I've investigated all the possibilities? Don't you think I would if I could get some financial help? Do you know how hard it is to find a doctor willing to accept a new patient who's this old and on Medicare?"

Then there are those who think they know about medical care - they recommend ibuprofen, Ben-gay icy packs or hot bathes. Hot bathes? Ibuprofen? Come on, it's all I can do to keep from doing a huge eye roll. Mom is so very far beyond some simple fix like Icy-hot. Her sacrum is broken! That's in her lower back! It's connected to everything! Any movement is excruciating!!

She's on narcotics for crying out loud! Ibuprofen won't help her now. Nothing that simple will ever help her again. They act so smug, like it should be so easy and clear cut.   It's not easy and the solutions aren't simple.   Old people have old bodies and old bodies require special care. No hot bathes, that means hot water and it could burn their thinning and sensitive skin.   No heat packs, that might also burn.

This stupidity is due to ignorance; they are uninformed about old people. They don't know what they're talking about and they don't wait to listen for an answer or explanation. This means that they really don't care.   They're just making small talk. Really, I wish they'd just talk to me about something else less emotional.   On a much larger scale, I wish people knew more about the elderly. I wish people realized the limits old people face. I wish they understood the issues old people face. I didn't until I began helping elderly uncles and my parents . I had no idea the complexities of medical coverage, drug interactions or the basics of tending to an aging body.   I wish there was some module in health class in high school that described what parents and grand parents might go through; drug interactions, narcotics and Medicare Part D. They might have an easier time helping their own parents and would be less self-righteous when others are trying to do the same.

Wanting to take Mom home and angry at the system

2011-03-13T12:40:00.000-07:00

Damn - I wish I could take my mom home. I wish I could be there to see her daily. My cousins try to be supportive and urge me to let go of the guilt. At at the same time they admit to terrible guilt that they couldn't care for their mother at home either. It just takes SO much - money, time, lifting, coordination. Someone's got to be there with her all the time since she can't do anything alone. It's a lot of extra washing, cooking, running to the doctor - it all takes time, generally time away from work. To hire help takes money - more money that any of us have. We can't afford to quit working to stay home and care for her; even working we can't afford to pay for our own expenses and hire someone to help her. It seems so wrong that the state will pay so much - over $4000 per month - to let someone else take care of Mom. I'd do it for less if I could get the help. I'm not greedy, I just need enough to get by, enough to hire some help when I'd have to run errands or something and then enough to get my life back on track after she passes.

Keeping life on track - that's another source of guilt. I've got another 15-20 years of work ahead of me. In my 30's and 40's it was derailed by my fathers illness, my marriage and moving to meet a husbands military obligation. I'm just now, at 49, beginning to rebuild - a home, savings, a career.....I COULD go take care of mom but the long term sacrifice would make it much much harder to start over. I'd be that much older, technology will move ahead quickly and my ability to keep up will be dulled. Mom used to say, "It's hell to get old". She's right. She's in her own hell - a horrible state with no options and I'd be dammed if I do and dammed if I don't. Damn.

Mom's condition, financial need and doctor's requirements leave us with no choices

2011-03-13T12:31:00.000-07:00

Mom will move back to the nursing home on Monday and I'm sick over it.   This is the same nursing home that failed to fix the brakes on a wheel chair THEY own, the name nursing home that failed to take her increasing pain seriously and tell someone... and there's nothing we can do about it.

There are several things that limit per options: First, she can't be at home and we can't care for her there without a major remodel and we'd need to hire someone to help with the lifting and washing, which none of us can afford. She needs medicaid (state aid) to supplement the cost of the nursing home. Her physician has approved only 2 nursing homes in the city where she lives and one of those won't accept medicaid.   Thus, she must go to the ONE nursing home he'll approve AND that accepts medicaid.

My brother and I aired our concerns to the staff - they nodded as though they understood but none offered explanation or ways to improve things.   My brother and his wife are so concerned that they want to create a schedule to ensure someone from the family visits daily. They want to divide up the week between themselves, their daughter ( my niece), my 2nd brother and my nephew. They want me and another niece to split up weekends so that we can visit on a Saturday and Sunday to give them weekends off. I'm not opposed to this and hope they'll hold up their part of the bargain.   I'm ready to hire someone to visit her 3 times a week; no set schedule, just drop by and report back to me. I think it's the ONLY way to ensure that Mom's well cared for.

I don't want mom to return to her room and current room mate. Mom says she WANTS to return to it but she doesn't realize that it's not necessarily the BEST option. If she had a different room, she could have a larger TV and a phone that's easier for her to use. If she had a different room, she'd have some exposure to the outside, some sunshine perhaps. As it is now the room faces east and a tall thick hedge 3 feet from the building.   Her roommate refuses to go to another wing because in this one she gets free TV and phone. It's also a "medical rehab" wing, where most of the residents are fine mentally but going through rehab with the intent to return home. So she's stick again but she'll be back in a familiar place. That's important on some level too I suppose. It's not the BEST solution, but it's the only one we can muster for now so we must make the best of it.

Mom has a good day and we split up the visits

2011-03-07T19:27:00.000-08:00

God bless my niece! She's visits my Mom every day before she heads to work. I can't be there during the week so I know that either of my nieces or my sister in law are the next best thing for Mom. It helps SO much that one niece is a veteran nurse (25 years) and the other is a nurse in training. When the weekend rolls around and I get to town, I'll take over momma-duty so my niece can have a break.

Today my niece gave me a good report on Mom: she woke up hungry and ate 75% of her lunch. She's asking what happened and how she can get better. The physical therapists helped Mom to the commode and into a chair. She was in the chair for 1.5 hours and the nurses told my niece that she was pretty uncomfortable for the last 45 minutes, laying on the call button - but they let her sit there because it's part of her therapy. It's a good thing that I wasn't there because I'd have put her back to bed myself. I hate that she's hurting but I'm thankful her appetite is back. For her to stop eating and drinking enough now would surely be the end of her.

For the first time since I heard that Mom was being transported to the ER, I'm a little hopeful - hopeful but guarded. I don't expect anything as far as she's concerned. I will say that I'm so thankful for my family - brothers, nieces, nephews and cousins - they've all called and visited to show support. We help each other when we need it - that alone would make my mom happy and proud.

What caused Mom's broken sacrum? - spread the blame...

2011-03-05T08:36:00.000-08:00

Mom's flat on her back in the hospital, full of painkillers and unlikely to sit up soon - if ever again. Her prognosis is poor and my instincts tell me she will live a while but won't come back from this incident. I've been racking my brain trying to understand the "one" thing responsible for Mom's broken sacrum and thus her excruciating pain and poor prognosis. After days of guilt, I've come to realize that it's a combination of things that caused this, though that doesn't make my sense of guilt go away.

The "fault" lies with all of us who SHOULD have noticed Mom's increasing pain and thus her vulnerability and worked to PREVENT a break or fix it as a hairline fracture.    The primary cause of this break is Mom's age and physical condition. She's 90 with has bad osteoporosis. This fact alone should make anyone more careful as they move her and more sensitive to her complaints of increased pain. For years she's refused to exercise, to take calcium or vitamin D and small estrogen supplements to maintain bone strength. The brake could have occurred if she sat down too hard or was constipated and had to strain during a BM.   Mom asked that aides, my neice and myself rub her lower back to help her pain. The location where she wanted us to rub was very near her sacrum. We, in our attempts to help her, might have aggravated her break without knowing it.

I feel some responsibility for her current state because I didn't visit for nearly two months. I live 7 hours away and didn't want to drive through snow and ice.   Had I gone there, I'd have listened to her; I'd notice her pain. Had I asked questions, had I understood that her pain was increasing, I could have pushed for an MRI earlier. Had I called the nurse at night instead of just calling Mom to visit, I might have known something was up.

I blame my brother because he lives in Mom's home town and got 2 calls about her being "assisted to the floor" after her wheelchair rolled out from under her as an aide sat her down. He didn't call me, he didn't call the doctor. He just told the nursing home aides TWICE to fix the brakes. After the 2nd "assist to the floor", the nursing home used a portable x-ray to look at her hip but never looked further to her back. This is an elderly person with KNOWN osteoporosis - it's absolute neglect NOT to look at BOTH hips and her back. I'd have insisted on an MRI then - 5 weeks ago when her pain was controlled with tylenol and rest. Obviously the break was not as bad then and perhaps something might have been done that would cause her less pain and NOT cost her life.

I blame the nurses and aides at the nursing home for their failure to simply pay attention. I'm REALLY angry about this and plan to complain to the state after Mom passes away. After learning of these "assists to the floor", I visited her. I spoke with the night nurse on 2/18 who told me that she's noted an increase in Mom's pain for 8 weeks - that's 2 MONTHS and no one did a thing. The night nurse DID HER JOB; she wrote down her concerns so the DNS - director of nursing services - could see it and take action. Yet, there are NO reports to her doctor, NO calls to family until something happens that might be a liability to the nursing home.   When something DID happen - the brakes on the wheelchair failed, they called the family to fix it when the chair belongs to the nursing home! They KNOW this yet they called my brother anyway.

I blame her doctor for insisting that she be in this particular nursing home because "none of the others communicate with me as well."... Hmmm... I hope he'll reconsider THAT opinion NOW that they've caused my mom a painful death.   I blame him for a failure to act sooner, he waited two weeks to order an MRI and during that time her pain became worse. Thus the trip to the ER and the failed attempt at a, literally, heart stopping MRI.

I know I need to let this go. I know that my regrets don't help Mom now but by talking about it, by making people aware, I hope something positive will come out of it. My Mom is suffering and I am so sorry. I want so badly to prevent this for someone else. Listen to their pain and act to prevent problems as soon as you can.

Dead in the MRI and broken sacrum = long recovery IF mom can make the trip at all

2011-03-05T08:10:00.000-08:00

In the past 5 days Mom’s died once, received 9 IVs and one epidural. Last Friday, Mom was in so much pain that the nursing home insisted she go to the ER. They called her doctor to meet her at the ER but he was too late to stop the ER doctor from attempting an MRI. They did an EKG before the MRI but didn’t look at the results before giving her propofol (Diprivan) as a sedative. Though they only gave her a small amount –about 1/5 the “usual dose” for an adult – it was enough to stop her heart. If the ER doc had looked at the EKG, he’d have seen that she was in atrial fibrillation – her heart was beating erratically and not in regular sinus rhythm. The technicians gave her epinephrine (also known as adrenaline) and did chest compressions to successfully restart her heart in normal rhythm.

She was transferred to the ICU and hooked up to every monitor known to man and medicine. I arrived in town to find her confused and begging for God to deliver her from such torture. She was on a fentanyl patch and 2ml (milliliters??) of dilaudid (hydromorphone) every 2 hours. The nurses in the ICU were great; they came in every hour to give her 1 ml and were quite attentive to her every need. They even tried to feed her but she would not budge – she wanted no food at all. On Monday she was in and out of it, she recognized us all but had a hard time focusing on a thought.

The doctor developed a whole plan to administer certain drugs on Tuesday to complete an MRI to see exactly what was happening with her back and hip. The results were poor – cracked sacrum, severe osteoporosis and arthritis that is compressing her sciatic nerve and causing extreme pain. Tuesday was a rough day. She was terribly confused by the drugs and didn’t want to go into the MRI machine. Luckily, she made it through just fine but the drugs she had to take made her feel awful well into Wednesday. Every 5 minutes she repeated that “everything is backwards”. It was as though she developed severe dementia overnight. She told me that she saw God sitting next to her while I had some lunch. All afternoon I had to share my chair with God. It was the only chair so I had to sit on the forward part of the seat so that he had room to sit down with me. If I tried to move back she’d correct me and tell me to leave room for God. She realized it sounded crazy and said she was embarrassed to tell me; she could not actually see God in the room but she was certain he was there. As the day wore on, I wondered if it was metaphorical and if she really was trying to tell ME to become more spiritual; that I should make room for God... What ever the purpose, we laughed about it a bit and she remembered it the next day on Wednesday.

Wednesday morning Mom was less confused but still agitated. She was scared and wondered why she had to suffer so; why they could not fix her pain and return her to “normal”. She was tired of laying down and wanted to sit up but it hurt too much. In the afternoon she went for an epidural and returned changed – more alert, more at ease and less agitated. During the epidural, my brother and I sat nearby and heard her yelling out. We nearly cried, believing she was in pain. Soon after the yelling the doctor came out and told us that she was yelling because they had to move her into a bath and it was cooler than she wanted. On the way out of the epidural, again, she was asking “why” – “I’ve been a good girl, all my life… why must I suffer like this…” It was hard to hear but she looked so much better that we still felt relieved.

The “pain” doctor had good news and bad – the epidural went well but…. The fracture in her sacrum was worse than we thought, it was in pieces and healing was unlikely. Generally, they could glue a crack with surgery but there is no way they’d put mom out again. Given her osteoporosis, it might just break again soon anyway. He said she’ll have constant pain for the rest of her life; laying flat or sitting probably won’t hurt but moving up or down will. So – how do we tell her that? Having to tell her is worse than learning she had the break… dammit! My poor momma!

Mom's heart stops in the MRI and now narcotics won't touch her pain

2011-02-26T22:24:00.000-08:00

Since my last post Mom's been through a lot - the worst part is that, even with narcotics, her pain is increasing and she's often in great pain.   I went to see her on Presidents Day weekend and found her pretty uncomfortable.   I and the aides did what we could to help her and when I left town, she seemed fine. Because the pain came and went, we thought it was her sciatic nerve; massage and change of position relieved the pain. That changed after I left town. By Wednesday evening, she called my brother to ask that he come take her to the ER. A call to the doctor and more pain meds helped. By Thursday the Nursing Home called me to say that she's in such pain, that she's suffering so much that they must send her to the ER. I agreed, of course I agreed. Once there, the ER doctor ordered an MRI. Mom died in the MRI tube before it could be completed.

They revived her quickly with some chest compressions and -"some shot" as my brother tells me. Her doctor tells us that her heart beat was erratic - not in regular sinus rhythm - and when they sedated Mom is caused her heart rate to slow so much that it stopped. They only resuscitate her because they did not know if she or her family signed a DNR (do not resuscitate order).   That evening she was resting comfortably.. but the next morning was hell.. Mom woke up in great pain. She yelled, she asked what they were doing to her; she called them all devils and demanded to return to the nursing home. The pain began again and they've increased her pain medications 3 times.   The nurse tells us that the amount of medication she's getting now could slow her heart or cause long term issues with her memory or cognition.

So, now I'll rush home and hope we'll find something to make her comfortable or that she'll find some peace.   By writing "find some peace" I guess I mean that she'll pass away. I DO NOT WISH THAT MY MOM WILL DIE!! But, to see her suffer is so awful. It's as excruciating for us as it is for her. I'd gladly take her pain for myself if I could. She told my niece - a CNA - "no tubes, no surgeries, leave me alone". She won't tell us because she doesn't want us to worry and get all emotional but she'll tell my niece -perhaps it's just too emotional for her too. I realize it's only a matter of time. She's 90, something will cause her death sooner than later but I'm not ready for her to go. I've been preparing for it for 5 years but when the reality is right here, right now, I don't want it to happen. Perhaps her suffering is for us - making it easier for us to let her go to find peace.    I can imagine life no visits to nursing homes, life without depends or wheelchairs or dentures on the bedstand but I can't imagine life without my Mom.   I miss her already.

Mom falls and I get no calls... guess what hit the fan..

2011-02-13T22:31:00.000-08:00

Last week was pretty rough - in 2 calls, I learned that Mom's in a lot of pain; had 2 falls and no one's called to tell me what's going on. I had to "put the bitch on" and demand that I get calls from now on.   I learned of these falls on Feb 8 when the transportation coordinator told me that Mom's doctor made an appointment for her the next day at 330pm. "Why?" I ask.. "well, he just wants to check up on her.." is the vague reply. Her regular check up is not until the end of February so I asked to speak with the nurse. The nurse was also vague with details. It was like playing 20 questions. The nurse told me mom had an "assist to the floor" - it's basically where an aide has a hold of my mom but she still ends up on the floor. The fact that she ended up on the floor is not the reason for the doctor visit.   The nurse finally said that she requested the doctors visit because Mom's "just not herself".   "What does that mean?" I'm ticked now because I have to push for these details.. She tells me that Mom's had back pain, that she's not felt well enough to go to the dining room, that she's asking for pain pills in the morning before she gets up.

This is very distressing because my mom has a high tolerance for pain. She's not a baby, she's not a whiner; she doesn't do this for attention. She's hurting and they've let it go on for nearly a month! I called my sister in law to see if she or my brother could meet mom at the doctor and learned that Mom had 2 falls not 1. The first was about Jan 10 and the second - the one the nurse told me about - was Jan 21. Apparently the brakes on Mom's wheel chair failed and it rolled away from her as an aide was helping her to sit down - they both ended up on the floor.   It happened again two weeks later. My brother went up to investigate and pointed out the bad brakes - they're fixed now but at what cost to my mom?   Sister in Law also told me that Mom has a bad bruise and open wound near her armpit - no doubt a skin tear where the aide had a hold of my mom. None of these details - requesting pain medication, refusing to go to meals, the would, the 2nd fall -were in the fax that the nursing home sent to the doctor. I had to write a letter and fax it to him to ensure he gets the details. I also feel it's necessary to point out to him that she's asking for pain medications - which she'd normally not do. I asked that he order an MRI or CAT scan - something to figure out if anything was broken or misaligned during these "assists to the floor". ARGH!!

I have to visit the nursing home next week to discuss their failure to call me. I was very pointed - nearly yelling - when I spoke to the nurse - "CALL ME, I HAVE MOM'S POWER OF ATTORNEY, I PAY THE BILLS. MY LOCAL FAMILY DOES NOT COMMUNICATE WITH ME. YOU MUST CALL ME." She wrote it on a post it and promised to put it in the file.   A lot of good that will do - post it's fall off, the glue goes bad.   She promised to tape it in place. Right. I'm not convinced. I believe they'll blow it off - they'll blow ME off.   It really makes me distrust them and the kind of care they're giving to my mom.   I feel powerless to do anything - I need them to be good to my Mom. I need them to keep her there or her doctor will insist she find another physician. It's an awful situation and Mom suffers for all of it. Hopefully, I can make it a little better during my visit next week.

No calls = a lot of guilt!

2011-01-23T20:14:00.000-08:00

I feel awful. I have not talked with my Mom since December 26 - that's nearly a full month - and I feel terribly guilty because I've not tried harder to reach her. I have called but when I don't get her on the phone, it's almost a relief - then I feel guilt over the sense of relief.

My mom's not terrible to talk with but talking with her for more then a few minutes is a lot of work. She can't hear the phone ring so to reach her I must call the nurses station and ask that they transfer the call then send someone down to answer the phone for her. Once I get her on the phone, she's excited and wants to tell me all kinds of things - usually it's the same 3-4 things that she says again and again. She tries to ask about me but she can't hear my replies so then she begins telling me how much she dislikes "this place" and she asks to return to assisted living. She's also started saying, "I wish I could be home but...." and she trails off. At least she realizes that she's in no shape to live in her little house. After about 10 minutes on the phone her voice sounds a little farther away - it's my cue that she's let the phone slip down to her cheek or neck and doesn't realize it. She just keeps talking and I try to yell - literally SCREAM - to put the phone to her ear, that I must go, that she can't hear me... anything to try to get her attention so I can say good bye.

She has a pattern - I have to tell her in 3's that I need to get off the phone. Usually she's willing to let go in the first 3 attempts but lately, it's harder to get off the phone politely.   I have to say, I've got to go now, over an dover.. She hears me each time but asks just one more question.. so I hang in there and keep talking.   I don't want to be rude and I don't want her to think that I've hung up on her.

I have all kinds of "reasons" why I can't call - I can't call from work, the boss will get mad and I can't yell at her from my cubicle.   I can't call too late or too early from home because my yelling will disturb the neighbors. I can't call in the morning because the staff is too busy getting everyone up and to breakfast then back again. so, I don't call and the guilt remains. I know it would do her a lot of good to hear from me. It's one of the few things that she'd enjoy but, dammit, I hate yelling into the phone. I hate hearing the same complaints all the time. I hate that she asks for things that I can't do or can't provide.

These are all symptoms of a greater issue - I hate that my mom has to live in a nursing home. I hate that they don't give a damn about her quality of life. I hate that the staff is too small. I hate that I can't move to her home town and live with her and tend to her.   The guilt over the phone calls is a component of a larger, more hurtful matter - I want to help her, I want to make her happy, I want to spend loving time with her but I can't afford it. All I can do is spend a weekend here and there and try from afar to what I can.   It's not enough to make her happy or me guilt free but it will have to do.

CAUTION: Sores that won't heal may be skin cancer!!!

2010-12-29T23:32:00.000-08:00

I've had several family members with skin cancer and can share several stories to drive home the need for regular skin cancer screening but a recent event does a much better job. I hope that the following story will prod anyone to get a check up ASAP for themselves or their loved ones. The short story: a friend's mom had a Moh's procedure to remove all the skin on the side of her nose. For 2 years, she asked her doctor about a sore spot and he told her it was due to sensitive skin. He was clueless and it cost her a lot in medical procedures, pain and suffering - especially the pain and suffering.

The long version: A friend called in a panic just before Christmas - her Mom had skin cancer on the side of her nose and they had to operate immediately.   She was especially upset because she'd asked her mother's doctor about the sore for more than 2 years.   She finally moved her mom to another state and took her for a check up. Before her Mother sat down in the doctors office, he asked about the sore on her nose and sent her down the hall to a dermotologist. She was in surgery within a couple of days. It was a severe basil cell melanoma and had nearly spread to the skin around her eye.

The surgery and subsequent reconstruction were gruesome and hard on her 84 year old body. After all the the skin was removed from the side of her nose, ( Did you HEAR ME???!!!ALL THE SKIN!! from the side of her nose *OH MY GAWD!!)) she had to have a flap of skin grafted from her forehead to her nose. The bad part is that the flap had to remain partially attached to the forehead AND stitched to the nose. It remained this way - an open bloody wound - for 3 weeks. The flap permits blood to flow to the tissue to keep it alive while the graft grows into the skin surrounding the surgical wound. Eventually the grafted skin will get enough blood supply from the skin around the nose so the flap can be removed.

This was hard on her Mom, it was hard to make her understand why it was necessary and what happened to her. She's a sweet kind woman and has become quite forgetful so it was hard for her to process it all.   The really sad part is that it could have been avoided, literally, years before if her doctor had taken it seriously. All the doctor had to do was refer her to a dermotologist. Why he didn't is a mystery but he deserves to be charged with malpractice.   My friend is in the process of filing complaints in 2 states where he sees patients - Washington and Idaho.

This sort of skin cancer is NOT reserved for the elderly and years of sun exposure. My own nephew, age 27, had the same surgery two years ago. He had a recurring pimple on the side of his nose and he let it go a long time before seeing a dermotologist. Because it was "just a pimple", he thought he'd get a prescription for a topical antibiotic or a chemical peel, he had no idea it was skin cancer.   The sore would erupt like a pimple then get red, bleed a bit and heal up. This sort of cancer was new to all of us in the family. We knew to look for dark spots that were not symmetrical. We new to suspect anything that grew in size or had various colors - we didn't know to look for a wound like a cold sore. Since his original Moh's procedure - removal of a whole nostril, a skin flap and reconstructive adjustments to the skin - he's had two smaller spots removed. These were caught in time but he'll have to be vigilant - and watch the skin all over his body - for the rest of his life.

So - the bottom line is simple - CATCH IT WHEN IT'S SMALL - the treatment is simple and relatively painless. Wait, and you'll have to suffer a gruesome surgery and reconstruction - or it might cost your life.

Here's a link that should scare you into a visit to the doctor early on: CAUTION: This site contains VERY GRAPHIC IMAGES that may disturb you. It shows patients after surgery for skin cancer and before reconstructive surgery. Some of these are really, really, gruesome and nearly made me sick but if it gets you to the doctor - then I did my job:
http://www.newyorkfacialplasticsurgery.com/FacialReconstructiveSurgery.htm

I have a cold sore that won't heal, what is it? Grandma has a sore that won't heal. Grandpa has a sore that won't heal. Do I have cancer sore soar that won't heal.

Finding Mom in the dark makes me SEE RED!!!!

2010-12-28T19:26:00.000-08:00

My good mood over having Mom home on Christmas Eve disappeared quickly when I went to see her Christmas Day.   I found her sitting in her room in the DARK! She was trapped, sitting in her wheel chair with nothing to do and no way to get out of the room. Her call button was no where to be found - I found it wedged under her pillow and completely out of her reach. Her roommate was asleep and her wheelchair was between Mom and the door, Mom's TV (which is on a swinging arm) was above her head, off and out of her reach. The lights were off - switches also out of her reach - and there was a table wedged between her and her dresser which holds her reading materials and pens.   She was just sitting there in the dark like some blanket they laid down on a table top.

I was so mad - and so hurt for her.   There is no excuse for this - I told the aides who were circled around the nurses station how I found her and they said "she can call for help". They didn't want to believe where I found the call button and that it was out of her reach. They are so freaking clueless!!!! They all looked young and I'd never seen any of them before - a new crew, probably the newest hires since they were working Christmas Day. It should not matter. I expect an experienced nurse or aid on duty to prevent this kind of crap.   They might have thought she was asleep but they should have put her in bed or her easy chair NOT left her sitting in the wheel chair.

So - before leaving town I wrote a letter to the administrator and left it in her office.   She's had 2 days to read it and I've not heard a thing.   (She dislikes me already because I - justifiably - complained about the size of Mom's wheelchair and a worn out pad that meant she slipped forward and fell out of it. ) Tomorrow I'll call the social services office and see what they have to say.    If it happens again, I'm called a friend who works for the state department of medicaide and ask for an inspection. If they're slipping up on basic things, then larger more severe problems are probably hidding in there too!!

Oh how I wish I could win the lottery so I could hire some help and take her home!!! If I could, I'd buy a big house and invite a couple of her friends to live with her. They could all have such a good quality of life with the right care givers and the right layout in a home. They could sleep in or stay up late if they wished. They could be active - they could do things they enjoy and only do as much as they could with help and continue to feel like they have something to offer. UGH!! These nursing homes are just too large, they are run by huge for-profit companies that don't care about their residents.   It's immoral. it's down right immoral!!

What do I get Grandma for Christmas?

2010-12-18T21:51:00.000-08:00

Buying gifts for elderly people is tough - they have health conditions that limit what we can give them. They might want goodies but we should use caution given the rise in diabetes. This year I'm giving Mom a lighted magnifying glass, some thick fleece socks to keep her feet toasty and a new hooded sweatshirt. I'm also having her old watch reconditioned so she can wear it daily. No only is it useful, it's some thing very familiar that she had for years. I hope it will provide her with some comfort.

I've surveyed some friends to find what they're doing for their parents and grand parents. I hope you'll find some useful ideas here:

sets of blank cards, "fat" pens and stamps so they can keep in touch with friends and family
a new address book - then help them transfer the names and addresses
photo albums with old and new photos - consider pictures of grand kids on the left page then a photo of the same grand child as an adult or with their family. This can help jog their memories too
Calendars with family photos. You can easily up load photos to several services (Walmart, Kodak, Windows) layout the calendar and have it mailed to them. It takes all of 30-45 minutes!! Thank Gawd for technology!!
Photos of them with friends and family - my Mom loves her photos with her and her great granddaughter
Calendars with their favorite flowers
If your elder is in a nursing home they;d probably appreciate anything that replicates the things they had at home - family photos, photos of pets or flowers.
People in nursing homes also need practical things: lotion, socks, sweaters, undershirts, slippers, tissues to clean glasses, pens and paper, fanny packs or other bags that can easily strap on to walkers or wheel chairs

If you're still stumped call the nursing home and ask the social services or activities director if they have suggestions.

what can I get my grandma grandpa for Christmas? Grandma is in a nursing home what can i get for her. gifts for nursing home residents. gifts for the elderly .

Sharing Christmas with Mom - what she really wants is time - my time now and her old times too..

2010-12-18T21:40:00.000-08:00

The older Mom gets the harder it is to find meaningful gifts for her. She is very content with so little and I usually buy things as I realize she needs them - new sweat pants, a hoodie, socks, etc.... I'm always stumped at Christmas time - it doesn't help that she insists she needs NOTHING and won't give me any ideas. I did pick up on a couple of little things that might make her happy - her old large faced watch from home and a magnifying glass.   She always says she can't find the wall clocks throughout the nursing home and complains that reading the paper hurts her eyes. ( I am beginning to wonder if her vision is failing but that's another blog post...)

So - I found her old watch at home and I'll have it cleaned and the band repaired for her.   I'll give it to her at Christmas so she'll know the time. I also found a light weight magnifying glass with a light. I think it will help her read the paper and anything else she can find.   When I found it and realized how much it would help her, I bought 4. I'll leave the extra three with the social services or activities office so that they can give them to the residents who need them most.

The other thing I'll give Mom this Christmas is time at home. We'll arrive in my home town on the 23rd and I'll go to get her the 24th. We can cook together and then we'll sit down to eat together for Christmas Eve.   I hope she'll feel up to attending church that evening but we'll see.   The next day - we'll do it all again but we'll be at my nephews home. These plans mean a lot of work for us - we have to lift her in and out of the car, to the bathroom and wheel her around but we gladly do it all.    When I think of how she feels living away from home, I WANT to make her happy even though it's only for a few hours at a time.   I want to give her some normalcy - I want her to feel the way it was years ago when she cooked for a houseful of people and we all sat down together to eat and drink and talk loud.   I miss those times too so if we can re-create them for a day or two, then all the lifting and wheeling is well worth it.

Finding gratitude on the roof over Thanksgiving weekend..

2010-11-27T08:40:00.000-08:00

This holiday Thanksgiving Holiday is a rough one for me. For the past couple of months, I've been really, really stressed out and finding something positive in each day has been tough.   It seems that anything I attempt is the wrong thing or gets way-layed by something totally out of my control. Even my Thanksgiving plans were up-ended by snow and bad weather. I planned to drive 6.5 hours from my home to take my mother to her little house for a meal on Thanksgiving afternoon. The roads were so icy that the drive took more like 9 hours and it was so very cold that it was not wise for me or anyone else to take Mom out in the wind. I felt terrible that she'd probably sit in the nursing home with no family on Thanksgiving Day. Now comes the gratitude part...

After realizing that I would not make it to see Mom until late evening, my sister in law and nephew went to join her for lunch. It was a huge meal with all the Thanksgiving trimmings. They had a good visit and left Mom with candies, decorations and lots of love and hugs. I was so relieved she had visitors and that she felt loved and remembered. Throughout my drive my 2nd other brother called every hour to check on me, it was nice to know someone was concerned about my safety and had a warm house and food waiting for when I got there.

Finally getting home to Mom's I got bad news from the 2nd brother (he lives in Mom's house and pays the bills, which is also something I found to appreciate), the roof had leaked in a couple of places. A wind storm a week before blew off so many shingles that water seeped through and had stained the ceiling. Given the cold and wet forecast, a new roof can't be done until after the new year which means more leaks and damage and long term problems.   When my eldest brother learned this, he suggested that we patch the roof until it's able to be replaced. I was worried because this brother is nearly 70 and known for his wild ideas that don't quite work out too well, if they get completed at all.   But, I had no choice so we made a plan on Thursday night. On Friday we made a quick trip to Home Depot for some basic supplies - black tar paper in rolls, 2x4's and lots of nails.   We grabbed a spare nephew and the three of us spent 4 hours on the roof, unrolling, over lapping and nailing and nailing this black felt paper. It was warm enough when we started but the longer we worked the colder it got. Icy snow blew into our faces and it was hard to hold the nails and hammer but we got it done. 2nd brother stayed on the ground and handed up things we needed - more nails, another roll of tar paper.

Half way through I realized I was actually ENJOYING myself. We were teasing each other, working together and laughing out loud WITH each other.   In doing something WITH someone else and FOR someone else's benefit, I'd forgotten my stress. I felt thankful for family that would pitch in to help like that in frigid weather. I felt good to be doing some physical work and happy that I hit the nail head nearly every time - no smashed thumbs at all!!

It helped me to look at all the positive things over the past couple of days - I had a safe drive home when many other drivers ended up stuck in the ditch; my family pitched in to help mom when I couldn't get there, my family pitched in to make her house (and where my brother lives) weather proof and we found something to laugh about. I found my Thanksgiving on the roof in the cold, cold wind!

Kids gloves make Mom's wheels feel better...

2010-11-11T21:28:00.000-08:00

Since Mom's been using a wheelchair she complains that her hands hurt from using the wheels to guide herself around. Her hands are also dry and her skin is smooth, it's actually "slick" and hard to hold the wheels on the chair. She's asked for "kid" leather driving gloves over and over but I'm hard pressed to find those. She remembers them from the 40's and 50's when she still drove.

I finally found the remedy in the Christmas department of my local Fred Meyer store - grey knit gloves with rubber gripping "snowflakes on them. The snow flakes are supposed to be decorations on the back of the gloves but putting them on the palms made all the sense for my mom. Now she has something that protects her hands AND helps her grip the wheels much better. I had to make one alteration. I cut the fingers off so she can still feel things easily and hold her pends for her crossword puzzle.

What can I use to help mom's grip on her wheel chair.

Veterans benefits may be available

2010-10-08T19:29:00.000-07:00

I was surprised to learn that there are veterans benefits available to provide for disabled veterans OR their spouses. Called the Aid and Attendance Pension, it's intended to help vets and their families when they are unable to care for themselves.

Here's the text from the VA web site. To see more follow this link: http://www.veteranaid.org/program.php

THE AID & ATTENDANCE PENSION

The Aid and Attendance (A&A) Pension provides benefits for veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature. It also includes individuals who are blind or a patient in a nursing home because of mental or physical incapacity. Assisted care in an assisting living facility also qualifies.

To qualify for A&A it needs to be established by your physician that you require daily assistance by others to dress, undress, bathing, cooking, eating, taking on or off of prosthetics, leave home etc. You DO NOT have to require assistance with all of these. There simply needs to be adequate medical evidence that you cannot function completely on your own.

The A&A Pension can provide up to $1,632 per month to a veteran, $1,055 per month to a surviving spouse, or $1,949 per month to a couple*.

Eligibility must be proven by filing the proper Veterans Application for Pension or Compensation. (Form 21-534 surviving spouse) (Form 21-526 Veteran.) This application will require a copy of DD-214 (see below for more information) or separation papers, Medical Evaluation from a physician, current medical issues, net worth limitations, and net income, along with out-of-pocket Medical Expenses.

Can my Mom get veterans benefits for my dad's service? How can we get veterans benefits for my dad?

Tough moment with a tough old gal at Mom's nursing home

2010-10-07T21:43:00.000-07:00

I had a rough visit at mom's nursing home a couple of days ago. Walking down the hall, a relatively new resident reached out to me and asked for my help. She had lived at Mom's assisted living facility and I remember meeting her there; Irene was her name. She was relatively lucid then so I took her hand and asked what she needed. She began to cry and said she had to get home. "Oh no.!" I thought to my self..." here we go...how do I get out of this?" All I wanted to do was run away but that would be cruel. She gave me a whole run down - her kids put here there; her daughter in law is lieing and manipulative, rented out her home to her grandson; she could walk at home but they force her to stay in the wheelchair now. She asked me to make calls for her, first her son in Vancouver, BC then her minister. When I tried to move away from her she grabbed me again, "Won't you be my friend!? Please don't leave me alone here. I don't know anyone!!." More crying but I noticed no tears even though she dramatically dabbed at her eyes.

I knelt down beside her to ask about her life - where she lived, what she did and who her kids where. I was surprised at the change since I'd seen her last in February. Her legs were now so swollen they were four times their normal size, her eyes were dull and didn't seem to follow me well. In February she didn't look or act her 97 years - perhaps 75 - but she sure looked it now. I felt so bad for her. I'm sure her fears and emotions were absolutely real. Dementia is so damned cruel to leave her like this, in this child-like state, feeling abandoned, afraid and isolated. Even though she's not my relative it made me feel bad that I felt even more guilt that my Mom lives there. I used to think that my mom's situation would be easier if she were more forgetful but at least she can understand that she has visitors, family who love her and friends who stay in touch. And, she has made new friends and enjoys joking with the aides and staff. Irene, can't do that. She forgets who they are; she remembers her kids as young people not the aging adults who manage her affairs. She can't understand the physical conditions that make her legs and feet swell. I feel even more concern for my mother and fear that she'll reach the same state as Irene. That will be so difficult to watch her suffer or if she didn't recognize me any more... OUCH! I must keep in mind that, though it will be hard on me it's worse for her.

Mom's party is a hit; old friends made her feel remembered and loved

2010-09-23T21:12:00.000-07:00

As I planned Mom's birthday party I really worried that there was no one left to come but I was wrong. I'm SO GRATEFUL that I was wrong!!!   We held it at her church so a few of those people attended, then a couple of her cousins came from out of town and some old neighbors just happened to be in town on the same weekend. After the cake and ice cream we all went to her house for a family meal. More neighbors came from down the street and made it a special evening.

Mom was thrilled to see them all. I felt bad that it was a relatively short open house, only 4 hours and she only had a few minutes with each person; she would have loved more time to visit. However, I have names and addresses now so we can go to see them!!   And I WILL take her.   She has different memories and stories to relate with each one of those people. And, what nice people they are!!

Mom's lived in the same town since 1936 and the same house since 1943. Decades!! I can't say that I've lived in one place that long. I worry that I won't have the long-time friends and relationships like she's had. While I wouldn't trade my experiences for much of anything, I envy her stability. She and my dad created a satisfying life in the same place. They were involved in their community and made lasting relationships; they were - they ARE - respected.   They might not have had lots of money, didn't travel or have expensive toys but they had something much more precious.

There's a special place for those who steal from nursing home residents!

2010-09-15T23:13:00.000-07:00

Hell has a special place for those creeps who steal from nursing home residents!!! And, trust me - it will be FULL!!

I already wrote about Mom's brand new go-with-everything pants in brown and navy - but I have two new examples to gripe about. Mom's roomate is a sickly little gal who is getting sicker all the time. She is a dwarf and has suffered from physical problems and constant pain all her life. She has no family and has very few personal possessions so when something goes missing she is especially distressed and hurt. She has no way to go looking for it and no money to replace it.   One of her favorite things was a quilt made JUST for her by a friend of her long-dead mother. It was white with embroidered red roses and red bands between the white fields of flowers.   She went out of town for a biopsy and it was gone from her bed when she returned. The aides gave her their standard answer, "It must be in the wash.." Any dope would know you don't "wash" a handmade RED quilt!!!   Three days later it was still missing and she was quite upset. She cried and cried. I felt so very bad since there was nothing I could do.    She has NOTHING! - nothing to her name - just this one thing that made her feel loved and remembered and it's gone.   She also told me that she is missing a few dollars but that is all secondary to her quilt.

Another resident - who is on medicaide and receives $40 per month for "personal" needs - told me through tears how her DVDs disappeared while she was away for an appointment.   She had saved and gone without things for months and months to buy a few movies to watch on a borrowed DVD player and now it's all gone. Someone had to have known when she was out and gone in to her room to take them.   They knew just where to look, only the DVDs were missing, nothing else was disturbed.   If I had the money, I'd buy replacements for her AND a locking cabinet for her closet so her things would STAY PUT.

I am flabbergasted that anyone could be so very LOW DOWN and evil that they'd steal from such vulnerable people.   Often nursing home residents have nothing; their homes are sold off, furniture given or donated away and friends and pets long gone. Some don't have enough room to hang a photo or put a chair near their bed. To take things from them is the WORST sin possible.

Birthday party is a family affair - THANK GAAWWDD!!!

2010-09-15T22:32:00.000-07:00

Mom's 90th birthday party is taking a little more coordination, planning and buying than I expected. But - I salvation - COUSINS!!... and my husband. I'm blessed to have the kind of family who, when invited to anything, immediately asks, "What can I bring?" Instead of asking for things, I asked for their time. Which at this point is much more important to me. I'm also blessed to have the kind of husband who, when told about the party is brilliant enough to show up, shut up and do what he's told!

Dan will help me run around all day Thursday and Friday cleaning house, making food, picking up cakes and flowers. He'll help me place table clothes, decorations and chairs... and I know he won't yell or fuss at me because he knows there's a lot to do - he might give me a little attitude but it's generally all in fun. We've been married long enough now that we sort of compliment each other when we're preparing to have people over or fixing something.

I know getting Mom dressed will take at lest 30 minutes longer than I expect and her hairdresser will be there at 11am to touch up her hair. I asked a cousin to go to the party early and start coffee and make punch before we arrive. She'll also bring a couple of side dishes for a family meal afterward. Other cousins are coming to the party and will help clean up. My sister in law will arrive early to great guests if we're late getting to the church hall.

I've made a schedule of things to do on Thursday and Friday so we can do our errands in "loops" instead of running back and forth from stores to church and stores to the house again. I'm excited for the party but mainly excited to get help from FAMILY. It means so much to know they'll help when needed. They are a blessing and I MUST remember to tell them so!! I hope I'm a blessing in return..

Colon get's the all clear.... whew...

2010-09-09T22:59:00.000-07:00

A colonoscopy at 90 is a HUGE deal and Mom had one two weeks ago. It wasn an ordeal for her - "cleansing" liquids all evening after a day of clear liquids and then more "cleansing" at the hospital before the procedure. Long story short - she had 2 benign polyps and everything else looks good.

The original cleansing was awful; the stuff is basically soap or some kind of soapy tasting salt solution. It really goes through the human body fast so she had to "go" within an hour and go again and again. I sat with her in the evening while she drank all the stuff down and ensured that the aides responded quickly to her potty calls. I actually helped get her up and down a couple of times - better that than have a mess and ruin her dignity. When we were sure her colon was good and empty, she went to sleep and I went home for the night. I met her the next morning at the hospital for the in-patient procedure. She drank down more of the nasty goop and sat on the commode some more. She was exhausted and cold. The nurses at the hospital brought warm blankets and we wrapped her up as she sat there. After a couple of hours, she laid down and slept for a while. She was up and down a couple more times before the procedure. The colonoscopy itself took 30-40 minutes then she was in recovery for clean up and dressing. She was starved so I fed her two small servings of custard and called the nursing home to hold some supper for her.

I followed the van back and helped her eat and get into bed. She was fast asleep by 8pm. Given the "cleansing the evening before, it was a long day - 9am to 430pm - but she was a trooper. The aides and nurses were so very kind and helpful. I am sure they'd have been just as professional and caring even if I'd not been there. It was a lot to put mom through - 1 day of little food, 1 day with NO food, hours of diarrhea and a sore behind - but it's better to know if something is wrong. I was worried about dehydration and low blood sugar which can cause a seizure given her epilepsy. They gave her some IV fluids before the procedure and some dilantin to prevent an episode. I don't think they'd have given it much thought without my questioning it ahead of time. I just wanted to prevent a seizure when she was so vulnerable and it worked out fine.

Whew!
Should my elderly mom have a colonoscopy? should my elderly dad have a colonoscopy? am i too old for a colonoscopy? How old is too old for a colonoscopy?

Family wedding gives me a guilt sandwich

2010-09-06T19:13:00.000-07:00

We attended a beautiful family wedding over the weekend and it left me feeling awful. Mom would have loved to attend but it just was not possible - getting her around in the wheel chair would have been a terrible pain for us all. I feel guilt because I didn't do all i could to take her to most likely the last wedding she'll ever attend. I feel a sense of relief NOT to have taken her so I could relax and enjoy visiting, my own supper and dancing without worrying about her needs and comfort. Then, I feel guilty for feeling a sense of relief! Guilt - relief - guilt... my guilt sandwich...

We would have been able to get her around the venue but it would be difficult, cumbersome and meant lifting her wheelchair up and down stairs. There were also no grab bars in the restroom which mean I'd have to do all the lifting to get her off and on the commode - my back can't take that much any longer. We talked about it weeks in advance and she said she'd go ONLY if it was easy to wheel her to the bathroom. I toured the venue a week in advance and it was, clearly NOT set up for any sort of handicap. She let me off the hook and insisted on staying home.

Even though we had this discussion I feel terrible guilt and I know there is no way I'll feel better. I must accept that and let it go but that's really harder said than done. I speak with so many friends who go through the same thing so I feel better knowing I'm not alone. I have to be content that I take her out for rides, lunch and we'll soon have her 90th birthday party - it will have to be enough.

New sink and vanity might help prevent falls...

2010-08-22T22:20:00.000-07:00

Today I noticed that my brother is leaning on a small bathroom sink for support and I worry it's risky. He's probably 190-210 pounds and the sink is a 40's hunk of heavy vintage porcelain that's attached to the wall with a couple of large screws. Mom's house is pretty old and the sink wavers just a little bit when I attempt to wiggle it. Given my brothers health issues, he'll likely lean on it often and with a lot of weight. So - it's time to replace the sink with a vanity and lighter porcelain that will support his weight.

So - we'll add that to our "safety list": remove old sinks and those with pedestals that might topple when leaned on. The idea of a heavy porcelain sink falling onto my brother or my elderly Mom is just horrific!

how can i make the bathroom safer for mom? safer bathrooms for elderly

Taking Mom for a ride and screaming inside

2010-08-22T22:06:00.000-07:00

Getting Mom out has become a character building experience for me. I try to take Mom for a ride at least once a week when I visit her home town. I make a point to take her some place where she has good memories and ensure we have a good treat along the way. The past few months she seems to have trouble remembering where we're going and continually asks where we are all along the way. She marvels at things as though it's all new to her. When I tell her where we are she replies, "Really??!! I'd never have known; it's so different." I'm left wondering, "Different from WHAT?"

I suppose she is beginning to remember the familiar streets of town as it was decades ago - really, she's FORGETTING many things about her town and region. She remembers buildings and landmarks that are long gone. As we drive she gives me a running commentary about how staying in her "coop" makes her forget and how much things have changed. It's a constant thing when we go out now and it's making me nuts!! However, I NEVER let her know it's making me crazy. Though I'm screaming inside, "YOU SAID THAT ALREADY!...and you said it last time and the time before that, can't you just accept it??!!!!" I don't say a word to her about it. I speak slowly and deliberately so that I don't have so much as a negative tone in my voice. I calmly explain the changes she sees and I make excuses to make her feel better.

She realizes that things have changed a lot and this makes her wonder about her own memory. She says, "Have I really forgotten that much?" I try to make her feel better with excuses about how quickly things change these days; how little she gets out and how much she has to remember after all of her 90 years. I remind her that she remembers MORE than many, many people - often ME included. Then I try to change the subject and ask her about something that I know will bring back good memories. Most of the time, she tells me some story that I've heard by this time but now and then she reveals a gem - something that she and dad did together or some funny story about family or friends. The new stories alone are worth sitting through a lot of rambling. I'll continue to take her for drives and listen to the stories - old and new - because it's good for both of us. I've not been the most patient person throughout my life so this is good practice I suppose but mainly it's good for my Mom. She needs the change of scenery and to relive the good memories we find along the route.

The state of denial is a weird place to live...

2010-08-18T12:42:00.000-07:00

I am watching someone live in a state of denial and it's hard to keep my mouth shut. The past couple of weeks I've been staying at my Mom's home where my brother is living. Mom's in a nursing home so it's just the 2 of us there. Normally he's an impatient jerk to family members but this visit, he's been pretty nice and that makes me wonder just what's going on.. He's been visiting a nurse practitioner about high blood pressure and they want to run stress tests in a couple of weeks. I can tell he's anxious about it all.

I can also tell he's suffering from bad emphysema and he mentioned something about COPD - chronic obstructive pulmonary disease. I also worry about colon cancer since it runs in both sides of our family and he's never been checked. At 66, he's terribly short winded and he can barely do anything requiring exertion. He has an ugly cough that rattles from deep within his chest. He can't walk to the mail box without stopping to catch his breath. He looks at least 10 years older than his age. However, he talks about things as though he's much younger and more able.

He talks about fishing, moving to the mountains and buying a boat. He talks about travelling to see friends in the Philippines, seeing beaches in Hawaii and Mexico in winter. He talks about others in health with disgust and complains about how they treat their bodies but still drinks several beers a day and finishes off one pack of cigarettes by evening. I'm quite realistic so it's hard for me to listen to this. I want to scream, "Look at what you've done to YOURSELF!" "How can you even think of buying something at your age in your condition?!" But I don't, I keep my mouth shut. I say nothing to prevent arguements - for his sake, it's the last thing he needs and, selfishly, I just don't want to deal with his vile temper. I know he can't have long, a year, perhaps 2 at most. I wonder how much his body can take. I patronize him I suppose but it's easier on him and on me. I went through this with an uncle years ago. He was terminal and we all knew it but we let him live in denial. He had hope for every day. He was interested in things and happy every minute. I can only hope the same for my brother for every day he's got left.

Waiting for a crisis - one thing we'll all do sometime

2010-08-18T12:06:00.000-07:00

Speaking with a friend last night I realized that there is one basic thing that nearly all of us share when it comes to dealing with elderly family - that is the waiting for some crisis event which forces a change for our loved one. We wait for the fall that puts mom or dad in the hospital and then the nursing home. It's the stroke or heart attack that signals the start of their decline. Or, it's the car accident that means the loss of a drivers license and cancellation of insurance.

Elder care professionals call these "sentinal events" - some event that is often a tragedy and that means a big change in the living conditions of our loved one. Most often the outcome of these events means drastic change or a tragic outcome Think of the stories we read of elderly people found wedged for days between their toilet and the wall or someone who's fallen and never got up. After waiting for so long we can only react to the circumstance; there are only a few options left by the time an event occurs.

Why do we end up waiting? It's because we have no other option. The parent/elder is not sick enough to be hospitalized or might have a chronic condition. She or he might be right-minded enough to say "leave me alone" or there just are no funds to help provide any assistance to prevent the incident. We WANT to respect our elders so we respect their need for independence. We don't want to hurt their feelings or pride or our relationships so we let things be. We know something will happen, it's usually only a matter of time. We wait and wait then deal with the outcome.

The waiting is hard. We see the decline, the weakness, the potential; we know something is coming but we don't know what or when. We grow anxious, we get stressed, angry or frustrated but there's nothing we can do. In some ways the waiting is easier because if we let things go long enough the options for our elder are limited. Their condition may be such that a nursing home or hospice is the only option. I have to ask myself if this is so bad. We might do things that prolong the life of our elders but what about the quality of that life? For me, I'm glad my Mom was in her home for years and admitted to a nursing home late in life. She was surrounded by her family, her favorite sentimental things, her own roses and friendly neighbors. The house didn't get as clean as I'd like, the lawn was under-watered and the flowers often gangly but she didn't care. She was simply happy to be there. So I had to be satisfied that she was content and worry less about the time she had left. We chose to put her immediate happiness first. It was hard and I often worried but looking back, I'd do it again the very same way.
What is a sentinal event , when should I move mom dad , mom doesn't want to ove what do i do , dad doesn't want to move what do i do ,dad won't stop driving what do i do

Keeping mom's house as is...are we crazy or sentimental?

2010-08-09T11:39:00.000-07:00

I've decided to make some changes at my Mom's house and I'm feeling a wee bit guilty. Mom moved into assisted living more than a year ago and we've kept her house just as she left it. My brothers and I never discussed what to do with the contents for several reasons. The two most important were that we knew mom would visit the house and we wanted her to feel it was still "home". We didn't want to cause family issues because arguments over "who gets what" will surely follow.

My decision to start making changes is two fold - I want to get rid of the junk no one would want later and I want things better organized. Mom was a very organized person and she had a place to store everything. She didn't accumulate a lot of "pretty' stuff or knick knacks - everything had to be useful; it's the art of living well on a limited budget I suppose. As she got older putting things in their "right" spot became less important as finding the most-used items at arms length. She couldn't bend over, kneal down or stand on a stool to reach things anymore - everything ended up on counters, shelves and table tops. When she moved I got rid of half that "stuff" now it's time for the rest to go too.

Since she's 90 I intend to spend more time with her and this means more stays at her home while I'm in town. I can't stand living around the junk anymore so it's got to go. As I type this I realize that I'm trying to talk myself into feeling better about tossing, giving and storing her things away. I know there are practical reasons too which helps make me feel better. When she needs more of my time and attention I'll worry less about cleaning her home and yard if I get rid of clutter and get it clean now. When she finally passes away, going through things will be faster and easier if three's less to do and if she's already designated who gets what.

As I sort things, I can hear her voice telling me where it came from and pointing out that this or that still has some useful purpose. It's still Mom's house, it will always be Mom's house and I'm sad to have to make changes but it's necessary. If I must continue to stay here and if my brother continues to live here with his own set of health problems, we've got to make the most of the space with some extra cabinets and clutter removal. Living at Mom's will always feel like her home but it will just be an improved version.

Medicaide not covering some prescription costs due to missing info.. ARGH!!!!!

2010-07-28T11:28:00.000-07:00

I just found several bills for 3 months worth of Mom's prescriptions at the nursing home - this is for her portion of prescription costs after payment by her supplemental insurance. I was told that these would be covered by Medicaide but OHH NOOOOOOO!!! No one told me she MUST be enrolled in Medicare Part D to get this co-pay covered!!!

Generally, if a person is on Medicaide, their Medicare premium is paid the the state (Medicaide) and their premium for Medicare part D is greatly reduced to $1-$5 per month. Long story short, the Social Security Administration which administers Medicare has no communication from Mom's state Dept of Health that she's been approved and receiving medicaide, there fore, she can get Medicare Part D to cover this co-pay but until the SS office gets word from the state - her monthly premiums and deductible are MORE than the co-pays!! I learned all this after four calls this morning. I was especially preturbed that I spoke with a woman at the Medicare-Medicaide service call center - I assume she's paid by the federal government or employed by a contractor of the federal government - who took down all kinds of information then suggested a specific PRIVATE company that would best meet mom's needs for the least amount of money. This choice is based on her prescriptions - it seems that private companies are diving up the pie.

I HATE this confusing BS and it really makes me want to advocate for ONE SOCIALIZED system - as it stands now her expenses are covered by two government programs, one private program and I need to get her enrolled with a 2nd private company to pay what the other 3 (2 public/government and 1 private) will not. It means 4 sets of paper work, 4 sets of billings, 4 mailings, 4 account numbers - IT'S INSANE!!! It's no wonder that Medicare fraud is so easy! I don't want to reduce American jobs but I wonder just how many people are employed to manage this mess? How many people are employed by doctors offices and nursing homes to wade through this mess? If it were in ONE program, might it cost less money to administer? I get especially frustrated when I consider the number of people to manage this bureaucracy and the waste versus the needs of patients and the push to drive down the cost of their care. If it were all under one umbrella plan, perhaps it could cost less and my Mom wouldn't suffer the indignity of the cheap solution!!

Lost clothes at nursing home a COSTLY pain!

2010-07-06T18:05:00.000-07:00

Last month I noticed that two pair of Mom's pants were missing. I alerted the staff and called social services with the brand names, size and color. Today (3 weeks later) I called to check on it - the pants have been declared officially lost.

This REALLY ticks me off so BAD! They can't loose the cheap sweatpants Mom wears most of the time. They have to loose the nearly BRAND NEW nice soft slacks that I bought for her last fall. She had them at the assisted living facility but only wore them for a few special events. I waited to take them to the nursing home because I wanted to see how she settled in.. I took them there one month ago, a week later they were MIA. I took 3 pair to her - light blue, dark blue and brown. The dark blue and brown pair disappeared in one week. ONE WEEK!!! This makes me quiet suspicious. I doubt she even had a chance to wear them. They were a size 14, soft on the inside and out with pockets for her tissues. They would be a good basic item in anyone's closet - obviously they are a good basic in someone else's now!!!

The nursing home apologized of course and said they'd reimburse me replacement cost. But replacing them is probably impossible. First, it's middle of summer, so I can't replace these until late August or September when the fall merchandise comes in. Second, the fabric - soft on the inside and velvety soft on the outside will be hard to find. AND - third - pockets! Elastic waist pants with POCKETS are hard to find. GRRRRR.... I am SO SOO MAD!!!

The social service rep that called me said "unfortunately, this happens more often than we'd like..." My reply - THEN FIX THE PROCESS!!! Obviously something is not working so analyze it and FIX IT!!! How much are they spending on replacement clothes? How many angry families are out there like me? What if a family can't afford to replace the clothes? After our conversation, I could tell I made the gal angry - I told her I was ticked but ticked at the situation NOT at her. It didn't seem to matter. I always get the same answer - "You could write a letter to our executive administrator.." The Director already hates me because I gave them hell for leaving mom in an uncomfortable wheelchair for two months!!! She hated that I was right about the pad in the chair being all wrong and letting mom slip all over. She'll really hate me now that I all but told social services that I think someone stole mom's pants. I should have kept my mouth shut but it's just too suspicious to me!!!

Shoes and clothes actually MADE for mom!!

2010-07-01T10:27:00.000-07:00

Finding clothes and shoes - especially SHOES!! - for Mom has become really difficult. Often I have to run to several different places getting one item at each store. I finally found a catalog called National, that has all kinds of comfy and practical shoes for Mom as well as clothes she finds attractive. She has arthritis in both feet but one is worse and made wider by bunions. To fit her well, I'd have to buy two different size shoes. National has shoes with velcro closures that also open really wide to get off and on easily. This enables her to get her own shoes off and on - THAT makes her feel more capable - anything that makes her feel capable is terrific!

I find their clothing rather conservative but they have a variety of suits, house coats and easy-dressing tops and pants. National also has stuff that I might consider "old lady" products - old fashioned girdles, plain white garter belts, large size bras that close in front, sleeping caps and shawls with pockets! While I wouldn't wear these (not yet), I can see where these would be helpful to my mom or to women with her limitations.
Where can in find tops for dowagers hump? shoes for arthritic feet, shoes for wide feet, easy on shoes, easy off shoes. clothes for old ladies, house coats for old ladies, robes for old ladies

Catalog with sentimental things for mom (me too)

2010-07-01T10:09:00.000-07:00

Mom often longs for familiar things from her childhood and trying to find them is really difficult if not impossible. I did find one catalog, Vermont Country Stor e, that has a lot of things that she enjoys. I found licorice, ribbon candy, soap and other things that bring back warm memories of her youth. I've even found some things that I find useful and enjoy - a hand cranked food mill, replacement lids for pans, glasses.... all kinds of stuff. I find that I like to get a catalog first then browse through the web site. I also take the catalog to Mom in case there's anything she might want to order.

Where can i find old products that mom likes? where can i find ribbon candy? clove ribbon candy, cinnamon ribbon candy, old-fashioned old fashioned products for mom dad grandma grandpa

The catalog every caregiver needs....

2010-06-27T09:11:00.000-07:00

Need things that make your elders life easier? There is a one-stop shopping location: Gold Violin. They have all kinds of things - from clothing to safety items to transport chairs with wheels - that make your elders life easier and safer. I originally began looking for small items that would help mom continue to do things she always did - like can openers or door handles. As she aged we needed more specialized items like hand holds for tubs or chairs for a bathtub. You'll find this and more in this catalog. I can't recommend it enough. If nothing else you'll see what's out there and you can take it to your local pharmacy to see what they can help you find.

Note: The link below is repaired after a kind reader let me know I used the wrong URL. ;)

On line, you'll find them at this Gold Violin site or www.goldviolin.com
There's also a toll free number if you wish to order a catalog: 877-648-8400
Where can i find products for my elderly arthritic mom? where can i find products for arthritis? where can i find products for aging in place? where can i find bathtub aides? where can i find bathtub safety products? where can i find bathroom safety products

Missing "Mom" and her understanding, wisdom and advice

2010-06-24T15:37:00.000-07:00

Having a parent that is old and vulnerable is hard from many different angles. Mom needs someone to conduct all of her business. I'm advocate for her health care and quality of life issues. I nudge family to go see her and help her write letters to distant relatives. I made the hard decisions to move her, and broke the news to her. I try to make her happy and minimize her stress. The latter means that I don't share sad or stressful things related to my own life. In short, I paint a happy picture for her even when it's really hard.   I've been doing that lately and it makes me realize that I really miss being able to talk to my Mom. I miss her advice, crying on her shoulder - literally her hugs and whispers that everything will be okay.

At those times when I had nothing or no one else, my Mom and Dad were always there. They couldn't do much financially but I knew I was loved and that they believed I could do anything. I knew that someone was always made happy just to hear my voice or see me talk through the door. I know I'm lucky to have had parents like that, everyone SHOULD have parents like that.   Today I find my self grieving the loss of "that" Mom. She would want to know that I'm upset; she'd try to make me feel better. I won't tell her, I don't want to upset her. Perhaps she'd even forget easily but I don't want to risk it.

Today, I hate this; it's really hard. I feel like I've been grieving the loss of my Mom for a long, long time.   It will continue so I've got to find some bit of advice, some wise words - probably some that she shared long ago - to lighten my mood and help me see something positive.   That's what she did so many years ago with her own mother, so I'll have to follow her example once again.   What a fine example she is.....

Medicare versus Medicaide

2010-06-23T16:11:00.000-07:00

In the past week I've had three calls from friends about the difference between Medicare and Medicaide. Basically, one is a federal insurance program for the elderly and the other is a state program that helps indigent - or poor - residents.

Disclaimer before you read further:   This information is based on my experience and knowledge of Medicaide in two separate states. Each state is different; to find out the specifics of your state, do your research. I suggest that you search "(name of your state) AND medicaide" or contact the your state agency for health and welfare.   The Area Agency on Aging within your local area is also a good resource to help you begin to understand Medicare and Mediciade in your state.

The basics: Medicare and Medicaid are BOTH paid for by tax dollars - and you didn't think the USA has socialized medicine....
Medicare is government supported health insurance for the elderly, it DOES NOT PAY for nursing home or long term care.   Citizens 65 years and older pay premiums directly from their social security. You may select any doctor who accepts this as payment.
Medicaide is government paid nursing home (long term) care. It may also help pay for Medicare premiums and for prescriptions. Most of the funds for medicaid come from the federal government but the programs are administered by each state.   Each state still has to contribute something toward Medicaide.

Medicare is a federal insurance program available to US citizens over 65.   To pay for this plan, the federal government takes premiums directly from social security payments.   Most of us will be covered by Medicare at some point.   Even if you have health coverage as a retiree, those programs usually defer to Medicare once you turn 65 and you're likely to need more medical attention, prescriptions or procedures.   In some cases, the primary insurance you had through a pension plan or employer becomes your supplemental plan, meaning that it pays some of what Medicare does no. Medicare does NOT pay for long term care in assisted living or nursing homes. They will not pay for on-going home health care or aides for elderly either.   They will pay for up to 120 days in a nursing home provided the patient shows improvement and any therapies administered help the patient improve to return home or return to assisted living.   As a citizen, you automatically qualify for Medicare and, near your 65th birthday, you will receive a letter advising you of your status.   As of this writing, June 23, 2010, there are many doctors across the country who refuse to accept Medicare payments so use caution when selecting a doctor.

Medicaide is a state program (it may be called something else in your state) generally administered by the State Department of Health and Welfare. Medicaide is not limited to the elderly and may also cover children of poor families, people with physical or mental disabilities or the most poor citizens.   It generally does not include dental or vision but in some states eye exams and dentures are covered one time during a set period, like onc every 5 years. Medicaide DOES pay for long term care in assisted living or nursing homes and there are certain criteria to meet before an elderly person may receive Medicaide.    Generally these are:

Spend down to $2000 or $2500 in assets. This means that the elder MUST use all possible assets before they may receive medicaide. They must consume all cash, CDs, stocks, bonds and savings. Note that if at anytime, an elders assets grow to MORE than $2000 or $2500, they may be disqualified from Medicaide until that money is spent. If you know this will happen, you can plan for it and buy something that they need like depends, lap robes, eye glasses, dentures (medicaide will pay for eye glasses & dentures but only once every few years). Here's a link to an article about the Medicaide spend down on Agingcare.com.
Look back periods: These can get you in to a lot of trouble. Each state has a defined period where they look back at expenditures to determine whether someone qualifies. This is to prevent transfer of ownership of valueables, gifting of cash, stocks, bonds, etc or deeding of any property before an application for assistance. The object is to ensure that assets are used to provide for someone, that they consume their resources before receiving public resources for their support. Some states have a look back period as long as 7 years!! so be sure to thoroughly understand this before accepting anything from your elders.
Homes may be exempt: The elder may own a home and the state will not force the sale of it if a spouse, dependent child or other relative lives there. The state may also permit the home to sit - without being sold - if the elder plans to return home.
Financial recovery: most states seek some kind of financial recovery from an elders estate. First they will put a lien on a home or proprety so that when the elder passes, the state will expect to recoup funds spent on care. If the home/property is occupied by a surviving spouse the state may not use liens. The state may also try to recover funds by forcing the sale of cars or other valuable possessions such as art or antiques.
Pensions and social security must be spent toward care: Any monthly income received by an elder must be spent on their care, this is often called a co-pay or care contribution. In my mom's case, her social security and pension are deposited directly to her checking accounts and I write a check for her contribution each month. The state pays the rest directly to the nursing home, I don't have anything to do with that.
Monthly personal allowance: Most states permit each elder to keep between $30-50 a month for their personal use. This isn't a lot at all so I supplement when necessary. I do not give the money directly to her but do pay for her hair cuts, permanents and regular hair appointments.

Some other things to consider about Medicare and Medicaide:

Medicare is your PRIMARY insurance after 65 but Medicaide helps: You'll still have to pay a monthly premium if you go on Medicaide but Medicaide will pay the premium for you. So for doctor bills, procedures, tests, etc. Medicare pays first, your supplemental plan (if you have one) pays second and Medicaide pays third. Without a supplemental plan, Medicaide probably covers it all or the doctor may write off some of the charges.
Medicaide can start and stop payment so WATCH THEIR BANK ACCOUNTS!!: If an elder is hospitalized, their care may be paid my Medicare for that period and for a time (sometimes as long as 120 days, 3 months) AFTER they return to a nursing home. BE CAREFUL and watch their funds during this period. If their monthly income is NOT used for a nursing home while Medicare is paying, it can build up over the $2000 or $2500 in maximum assets. This nearly happened to my Mom so I bought some personal items for her to ensure that she did not accumulate more than $2500. I also started a burial fund - allowed by her states' Medicaide program) and plan to contribute to it if/when she begins to accumulate more than $2000. On a personal note: I don't feel like I'm ripping off the state or being dishonest in this case, she would have been only $250-300 over the $2500 but that relatively small amount would cause all kinds of headaches and I'd have to redo her medicaide application all over.

What's what is the difference between medicare and medicaid medicaide? what is the medicaide medicaid spend down spenddown? can mom dad give me money and still get medicaide medicaid? Will medicare pay for nursing home.

Newly diagnosed anemia could mean bigger issues for mom

2010-06-22T14:48:00.000-07:00

Mom's doctor called today and wants to schedule a colonoscopy- the reason: Mom's red blood count has been steadily falling over the past year; she is anemic.   She has no internal bleeding or other symptoms to indicate why she's anemic. He fears she might have an ulcerated colon polyp. She's had polyps in the past and should have a colonoscopy every 5 years to catch polyps before they become cancerous.   The doctor wanted my opinon on whether mom would want the colonoscopy and if she could stand the "preparation" for the procedure.   We agreed that it's best to do the prep at the hospital before the colonoscopy. The prep is a complete cleansing of the colon with really strong laxatives; it can be nasty. It means sitting on a toilet for long periods and possible dehydration.   Given her age and tendency to be slightly dehydrated it's best to do it at the hospital where they can quickly diagnose and address any complications.

I did some brief research on anemia in the eldery and am more concerned for mom.    The immediate worry is cancer or pre-cancerous polyps.   If that is NOT the cause of the anemia then we must worry about finding the cause and the secondary effects of low iron in Mom's blood. For healthy younger people anemia meand fatigue and reduced endurance. In the eldery it can mean increased risk of heart attack and has been linked to vascular dementia - confusion and forgetfulness resulting from decreased oxygen to the brain. Long term effects of anemia are organ failure and even peptic ulcers.

I hate the idea of a prolonged diagnosis of the cause of this anemia. I find myself almost wishing it is some polyp that is easily removed so she'll be fine but I can't help worry that there's something else wrong. If it's not polyps then tests and procedures will wear Mom out and make her worry.   For now, I will tell her only that it's time for her regular colonoscopy and that I'll be there to help her through the prep and the procedure. The rest we'll handle as it comes.

Mom has anemia what does that mean? anemia in the elderly causes of anemia in the elderly dementia from anemia. Can anemia cause dementia? can anemia cause alzhiemers?
colonoscopy in the elderly , anemia in the elderly should my mom have a colonoscopy.    , colon cancer in the elderly. grandma has colon cancer.

Medicare takes a while to "buy" wheelchair -

2010-06-19T02:21:00.000-07:00

Mom's "free" wheelchair wasn't so free after all and no one knew it - apparently, she had to pay for some of it even though deductibles and co-payments on her part had been met. The whole situation has me frustrated and demonstrates that people just don't know all the rules and regulations about payments when dealing with Medicare and Medicaide. I believe there may be some confusion over billing and with the three parties involved but I'm so frustrated with the matter, that I'll end up paying the $58 myself.

When Mom got her wheelchair we were told "Medicare will buy it.." "Outright, completely, 100% paid for by Medicare?", I asked the assisted living facility? "ABSOLUTELY", the staff at the ALF assured me several times... Well, that's absolutely WRONG! Medicare pays for the rental of a wheelchair for 16 months or so. If the patient still needs the wheelchair by then it's considered paid for, so it's a rent to own program. When Mom transferred from assisted living to the nursing home, we didn't know the wheelchair had to go back to the medical equipment rental company so it went into storage. After two months they reached me and I took the chair back immediately. At that time, I was disgusted with the whole process and asked for some kind of receipt; they were reluctant to provide it but I insisted. Good thing I listened to my gut, because 2 days later I got a call asking when I planned to return the wheelchair!!! At that time, I asked about outstanding bills, payments, co-pays ANYTHING and was told it was paid in full....

They're FULL OF IT alright..... yesterday an angry accounts receivable clerk from the rental company called wanting the $58. It seems she's been sending invoices to Mom at the assisted living center. The ALF gave a forwarding address at the nursing home but they've received no money. The nursing home finally told her to call me as the Power of Attorney (PoA). Medicare has taken back two months worth of rent from the medical rental company because Mom was in a nursing home where wheelchairs are provided. Medicare wouldn't pay for the two months that the chair was in storage. Thinking the chair was Mom's property, we put it in storage and that will cost us $58. It's not a HUGE amount of money but it's money I'll have to take from her savings. It's inconvenient. It's frustrating to talk to people who assume you're trying to run-out on a bill. It's frustrating that the "experts" don't know the process yet speak with certainty. I've found this same situation over and over, things are so complex with billing Medicare, Medicaide, supplemental insurance, Medicare for health care, Medicare for prescriptions, Part B, Part D - never mind what happened to Part A and C!!- payments made, payments rescinded... It's all just too complicated. I wish they'd put people to work figuring out how to make it easier, or put in some regional offices with case workers. UGH!!

Will medicare buy mom dad a wheel chair? How can I get medicare to buy mom dad a wheelchair? Wheelchair rental for the elderly.

Death isn't so scary if you believe in something greater.

2010-06-12T08:17:00.000-07:00

I've seen two people die - my uncle and then my father - and learned a lot from both.   Neither death was horrific but peaceful; neither left me a weeping mess because I expected it.  Both situations were very different. My father had been home for weeks gradually declining and in pain. We moved him to the hospital to better control his pain; we knew he'd never come home. He lasted 2 1/2 days after he was admitted and we stayed with him the whole time. My uncle was diagnosed with terminal cancer and in a nursing home. We expected he'd have another few months but got a call one evening that he was in rapid decline for unknown causes. We rushed to the hospital to find him unresponsive with no idea how long he would last. I opted to stay with him and sent my Mom, father and brothers home for the night and he passed away 2 hours later as I sat with him.

My uncle died first and I was amazed just how easily it was for him to simply sleep and not wake up.   I didn't hear a last gasp, I didn't hear a thing. The nurse came in and said his heart was barely beating and his breathing was very shallow.   He was very cold yet his internal temperature was quite high. The nurse disconnected the monitors, the oxygen and then his chest just stopped moving.   He looked at peace for the first time in a long time.  The year before his death had been emotional due to his anger and frustration. He refused to address the fact that he was terminal. He refused to discuss his business affairs, to tell anyone about debts, savings accounts or anything like that. He bought woodworking tools from HSN and QVC, wood and materials from catalogs, magazines and Christmas gifts. He was in denial and we didn't have the heart to force him to face the truth. After he passed, his peaceful appearance actually made me feel better; I was relieved for him.

When my father died we were all exhausted.   My family and I had gathered at their home daily for a week or so. We knew my father didn't have long so we wanted to make the most of it.   When it was time to go to the hospital, my nephews, my Mom and I went with him. My brothers and sister in law were waiting there for him. He knew we were all there and it made him feel better. We created a plan to ensure he was not left alone and then began our "shifts". My Mom would not leave his side so we tried to tend to her as well. She is an epileptic and prone to grand mal seizures so we - and my father - were very concerned about how she'd handle things; we worked hard to ensure she felt loved and supported.   My father had terrible pain in his shoulders due to tumors and had to receive ever-growing doses of morphine to keep him comfortable. ( I often wonder if he didn't pass from morphine over dose but that's another blog post...) After 2 1/2 days, he would not respond when we spoke but he squeezed our hands now and then.   About noon on day 3, a nurse came to me and said his heart was beating so seldom that he would soon pass. I did not want Mom to see his moment of death so I positioned myself between her and my dad, holding his hand. My nephew was on the other side of the bed.   After taking my dad's hand, I noticed that it slowly began to turn grey. Then the grey color quickly traveled up his arm across his shoulder and to his neck. As it traveled up into his face, he began to gape - his mouth opened then the grey color moved from his forehead down to meet the grey color that moved up from his hand. At that moment I felt something rise up from him and move past me. His body exhaled deeply and his mouth closed.

I remember this so vividly and 14 years later can still see it in my mind but it lasted only a seond or two.  My nephew who was right there didn't see it, he was focused on my mother. I am sure I witnessed his soul passing from his body. A week after his death, I dreamt about him each night. In my dreams we talked about many, many things.  After the dreams I felt there was nothing left unsettled between us and I only felt disappointment that I couldn't enjoy his humor and ask his advice - for now.    This experience left me sure in my heart that this existence is temporary and that there is a spiritual world - our REAL existence - just beyond our ability to physically see, hear or feel it.    Our loved ones are all there, close by, waiting for us. I am in no rush to leave this lifetime to get there and I would hate to have a lingering illness on the way to that place.

The next death I witness may be completely different but I will try to approach it with love. I will be confident that the person will soon be with other family and loved ones and that I will get there some day too. The most important part will be to ensure my loved one feels loved and supported.   There are all kinds of ways to do that and it really depends on the person. I've found some good advice in all kinds of places. One place where I find great spiritual support is Hay House Radio or Hay House Publishing.

Here's a link to a Hay House Publishing online webinar that might help us understand what someone needs as they "pass over" from this physical life to the spiritual. Though Hay House does not produce materials for any specific religion, the information found there is loving and kind, thoughtful and helpful for anyone.   I suggest that you copy and paste this link, or if it's broken go to www.hayhouseradio.com and search for "death and dying".
Hay House seminar on death and dying
or
copy and pate this:
http://www.hayhouseradio.com/liveevents/index.php?show_id=192&episode_id=5848&schedule_id=52332

what dan i do for my dying mom, how can i help my dying parent, what happens when we die, What should I expect as mom dad dies?

Emphasyma & lack of oxygen can cause confusion & seems like early dementia

2010-06-10T11:09:00.000-07:00

Lately I've noticed my brother (18 years older than me) struggling to make sense of basic details and I fear that emphysema limits his ability to get enough oxygen. He seems confused easily; he has difficulty remembering conversations, newer businesses around town and where he put things. He seems less able to understand basic issues related to his medicare coverage and banking. He is also struggling to breath after even the most limited activity, like walking up a few steps or to the mail box on level ground. He was diagnosed with COPD - Chronic obstructive pulmonary disease, a less scary term than emphysema - last year. He was surprised at the diagnosis though it was clear to those around him for a long time. He's been a heavy smoker since age 19, worked around all sorts of chemicals and vapors and has bad allergies. I believe his confusion is caused by a lack of oxygen due to his severly diminshed lung capacity. If he can't get much air into his lungs, he can't get much oxygen into his blood stream.

He went for some breathing tests last week and said they want to do more tests. I urged him to follow through and not to be afraid to discuss using oxygen or a small oxygen concentrator especially when he goes out. I looked him straight in the eye and said, "It's better to use oxygen and be able to get around the store yourself instead of waiting for someone to do shopping for you." We can't have direct conversations about his condition - or failing condition. He just ignores me or he gets angry and leaves, so this indirect approach must suffice. I can't lead him to water, so to speak. If he doesn't realize that he's ill, that he's become severely limited, I won't push it. To do so might be too cruel. It might mean he passes away sooner than later but it's his choice. Deep inside I trust he knows something is wrong and perhaps he doesn't want anything that will prolong his life and his struggle.

Read more about emphysema or COPD on Google

Death and emphysema? Death from emphysema. Does emphysema cause dementia? Does emphysema cause alzheimers disease?

Talking on the phone good for Mom but makes me crazy!!!!

2010-06-09T21:22:00.000-07:00

When I can't visit my mom I try to call every couple of days. This has become torture for me and those around me because Mom just can't hear. She won't wear a hearing aid and the longer she talks the farther down her face - and away from her ear - slides the phone. After 15 minutes I end up screaming the same things over and over, finally saying "never mind". When i want to hang up it's a three stage process. Stage 1, I tell her I need to get going for what ever reason then she asks what we'll be doing for the next few days. Stage 2, I tell her I need to get off the phone for what ever reason, then she tells me what she's been doing - this is all after about 30 minutes of the very same conversation. Stage 3, I tell her again that I'll have to hang up and she asks again where we'll be going next, her voice waivers and I can tell she's ready to cry. By stage 3, she is asking, what? what? again and I'm yelling the same thing over and over... I'm ticked off, my voice is louder and the tone lower. Anyone around me is ready to grab the phone from my hand and slam it to the floor.

It's like having a little kid, I can't be mad at her because she just doesn't understand. She NEEDS the calls and the company. She can't hear well, she's just happy to have a conversation with someone she loves and she knows loves her. How can I rush that? How can I hang up? How can I NOT feel like crap for getting so frustrated. I can't; it's just one of those things I have to live with . I try to call her only from home where the only ones bothered are my husband and me. I know it will take 3 tries to get her off the phone and I know she'll get weepy so I brace myself and get ready for the stages. When she gets to the point that we DO NOT go through all 3, I'll know something is really wrong.

Financial assistance for caregivers hard to come by...

2010-06-07T10:04:00.000-07:00

Caring for elderly parents often means financial hardships and sacrifices for the elders and their families. In my own sphere of the world I've spent more money than I can count on travel to help my parents. My husband put a new roof on his mother's home and bought appliances as her old ones gave out. Friends have taken their parents into their homes, paid supplemental insurance premiums and prescriptions. Now some purchase clothing, shoes, personal care items and goodies once their parents go on medicaide. Medicaide permits the elder to keep between $30-50 per month for personal expenses but often it's not enough even for a little splurge.

I read articles and questions/answers on Agingcare.com and just noticed that they have a special section specifically for care givers and finances. See it here: Aging Care, financial articles. Remember that financial resources for care givers are FEW, someone might find some assistance so I feel it's important to share.

Can I get paid for taking care of mom dad? Can i get paid for staying home with husband wife? Can daughter get paid for taking care of grandma grandpa grandmother grandfather? Will medicaide medicaid pay me to stay home with mother? will medicare pay me to stay at home with parent spouse?

Sliding shelf makes storing and sorting canned foods easier

2010-06-04T23:47:00.000-07:00

My husband just installed a handy device for my brother - a sliding shelf inside a kitchen cabinet. My brother is not doing too well, is over weight and suffers from emphysema. He has a very deep kitchen cupboard where he keeps all kinds of canned goods and miscellaneous stuff. Visiting last week I noticed that it was chock full of canned goods so I went through it. I found multiple cans of the same few items - canned spinach, beans, soups - with expiration dates as far back as 2007. We sorted the food into really expired, recently expired, about to expire and okay. The first two categories went to the dump and the "about to expire and okay" went back in the cupboard. Then I tackled the CAUSE of the build up.... My brother is too fat and too weak to dig into the back of the cupboard. Rather than find what's there, he just buys more.

To make his search easier my husband installed a shallow drawer on slides. The drawer sits on the shelf and has a drawer pull so he can it out to see what's there. This way he doesn't have to bend down low or reach into the back to find canned goods. We were worried about the weight of the drawer and slider mechanism but they weighed far less than the 40 or so 15-20 ounce cans of food that we tossed away. I also reorganized the cupboard so that little-used items are on the bottom shelf - trays, a blender, baking pans, electric fry pan, etc.... My brother will never use these things again so they went to the bottom and the food and few items he'll use went on the higher shelf and sliding drawers where it's easier to reach.

Just when I thought Mom was adjusting...

2010-06-04T23:36:00.000-07:00

On Memorial Day we visited more dead relatives than live ones... there were 14 graves and 10 people for lunch. I returned Mom to the nursing home and she seemed okay. However, when I returned the next day, she asked me "Do I have to stay here until I die?" Each time she asks my heart sinks. I never say "Yes, STOP ASKING!!" I use my mantra: "Your safety comes first, your house won't accommodate a wheelchair. The halls and doors are too small, the bathroom is too cramped. You can't be alone since you're so weak...." Then I change the subject, a distraction technique that parents use with little kids.

This time she came back to her point. She got teary eyed and said that she helped everyone else stay home. She kept my dad at home. Other elderly people simply say, "Take me home." My Mom wonders where she'll die.   It's heart wrenching and I wish she could be home. I wish I was able to take her home but I just can't do it. I've GOT to work.   Deep inside I realize she knows this, we began talking about it 15 years ago and she told me then to save for my own future. If her doctor told me tomorrow that she only had a few months left, I'd take her home and live with her there. I'd do anything she needed but, she's in great shape for a 90 year old and could live for several more years.

In this case, I just knelt next to her chair, put my arms around her and hugged her. We both cried a little then she changed the subject. I guess she's used the distraction tactic too.   It worked well enough for us to have an affectionate moment and say a loving good bye. I know she'll ask again because her memory is starting to fail and home is always there where she was capable, had lots of familiar people around and where she felt best.
Mom constantly asked asks to go home what do I tell mom when she asks to go home?

Memorial Day at Mom's house was nice, she didn't mind returning to care center

2010-06-01T22:37:00.000-07:00

Mom's been asking to see her little house and yard but we've been afraid to take her home. We didn't want any sad crying scenes or to send her into a seizure if she became too upset.   We've tried to avoid excuses and honestly, it's been too cold or too wet for to take her home until this weekend.   My cousin came over, we picked flowers from her garden and made bouquets for family graves then went to get Mom. She sat in the car while we left flowers on graves. She got to see each bouquet and know that roses grown in HER yard honored all those we loved. It meant a lot to her. We joked briefly that we placed more bouquets on graves than we had people coming for lunch - a sad statement...

After the cemetary we went to her house where my brothers and other family were waiting. We had a nice lunch and all sat together at the table with Mom at the honored "head" spot.   She was very happy and ate a good healthy plate of food. She was especially happy to have coffee and pie after supper - she doesn't get much pie at the nursing home.

When talking with her before going to her house I used my mantra: "it's not safe, the wheelchair is too big, the bathroom too small, the doorways to narrow, you can't be alone anymore..." She can't argue with these..   Mid way through the day she had to use the bathroom so I helped her. I had a plan to do it and walked through it a couple of times the day before. My plan meant moving her from the wheelchair to a seat on a walker then onto the toilet. We did the same routine backwards to get from the bathroom back into the wheelchair. I was concerned since each transfer means a risk of falling. It was SO much work and I was so worried she'd fall or that I'd drop her. She tried to pull herself up to stand at the sink but could not. She ended up falling back onto the toilet and sitting there for a few minutes.   After getting her re-routed from toilet to walker to wheelchair she said, I guess you prooved your point, I can't use the bathroom. She was calm, not too upset but just matter of fact. I didn't say I told you so, I just said, .."yup. I wish it was different but your safety is our priority."

When it was time to go, I told her we'd have to deliver some supper to a nephew, look at his new house and then take her "back". I feared she'd become upset but she didn't. She was just fine and willing to go. It was a huge relief for us all.   This evening, a day later, she asked again, "How long do I have to be here? Do I have to spend the rest of my life here?" I applied the safety mantra again then changed the subject. I have a feeling that I'll be using it weekly from here on.
Mom says she wants to go home all the time, she makes me crzy nuts.   I am so sick of hearing Mom demand to go home.

Let go - realize what you CAN do versus what you WANT

2010-05-29T09:55:00.000-07:00

The past year I've learned a lot of hard lessons, the most important is that I can't do everything - I must let some things go. I can't keep up our home & yard in another state, a full-time job, Mom's house & yard, take mom for outings and doctor appointments, mind her finances AND exercise and eat right. Something is always getting dropped, most often it's something I want for myself - a lunch with the girls, a hobby or craft, a trip to the salon for a haircut.... I am not complaining, but I am confessing that I've become okay with letting some things go for my own sake and my mom's. I had to prioritize: People have become important and my relationship with my husband has become the most important thing. He's been wonderful and patient and I don't know how I'd do this all without him.

After the past year here are my new priorities:

1st: my husband and my own emotional needs
2nd our financial well being - don't go into debt for others not even Mom, be thrifty & don't sacrifice your ability to save for your own long term care, pay our bills on time
2nd Mom's physical needs, is her environment safe? is it clean, clothes cleaned & replaced often, does she get meds on time and in a manner that she's happy with ( she needs to take pills with milk or she gets nauseous)
3rd Mom's emotional needs (does she feel loved and get enough mental stimulation?)
4th Mom's finances
Maintaining our relationship with friends and family, keep in contact somehow, forget those who are demanding, fail to understand that you can't do everything
Our home and yard
Mom's home and yard

This list has served me well. I've learned that a few weeds here and there aren't the end of the world, that the roses look just as good without constant deadheading. I've also learned that it's okay if Mom doesn't have visitors every day, that she WILL survive a brief check up at the doctor on her own and that she will get enough to eat with out my prodding. She has not changed, my attitude is what's changed. I've learned to give up some control and stop worrying about what others think of me or of the condition of our home or of her little house and yard. It's not possible to do it all without killing myself and Mom would not want that. She'd want me to spend more time visiting with her or taking her out and less time breaking my back.

Certain aides make life bareable for Mom - my thanks to them

2010-05-29T09:32:00.000-07:00

Since Mom's been in assisted living (ALF) and now a nursing home, I've found that certain aides make all the difference when it comes to her sense of well being. At the ALF there were a four aides that really made Mom's life better. At her nursing home there are a couple that tell me she's special to them. All have the same thing in common: they were firm but patient, spoke to her in a loving yet NOT condescending manner and showed her affection. The MOST important trait common to all of these wonderful people is this: they realize that old age is hard and have empathy for the condition of these people. They understand that they are frustrated by an inability to move or breath easily. They realize that people WANT to do things for themselves but the body is unable. They give hugs and don't make the residents feel rushed even though there are too many people and not enough time.

Don't get me wrong, not all of the aides and staff that deal with our elders are kind and thoughtful; I've seen plenty of jerks but for the most part, they are kind and try to do right by our elders.

Post vacation - Big "whew" as Mom seems great

2010-05-19T06:30:00.000-07:00

After three weeks of vacation out of state I was anxious to see Mom and was relieved to find her very well and content.   I spent more than two hours with her catching up on things she reads in the paper, her friends and sharing stories from our travels.

One concern continues with Mom: How long do I have to stay here? She means the nursing home of course... My answer is always the same:   Well, you can't be at home and you need more help than an assisted living facility can offer. This is the safest place for you right now... then I ask about something she's read in the paper or if she's talked with a certain friend lately. This tactic seems to work well for now and I hope it will be enough next time and the next and the next.

Mom seems more content in this nursing home. She's willing to ask for help and willing to stick up for herself if she feels things aren't right.   I think the time in assisted living actually made her MORE willing to request help and let the aides know when she's unhappy about her treatment.   Sharing a room seems good for her too - even though she always insists she needs a room of her own.   She has table mates that are alert and able to carry a conversation. She made a friend in a lady that was there to recouperate from a stroke. I am concerned though if her friend is able to move to assisted living or home with her family. Who will take her place at the dining table?

Ah well... we'll just have to work on that matter when it happens. For now, there is spring yard work, roof repairs and cleaning to do at Mom's house, plus planning her 90th birthday celebration.   She doesn't want to do a thing but it's a milestone we can't let pass.
Getting Mom used to nursing home how do i get mom to stop asking to go home

Brothers health might stretch my support thin...

2010-04-23T04:26:00.000-07:00

After a few hours of sleep I'm wide awake and worrying in the wee hours of the morning. My husband and I spent the past week at my Mom's house with my brother who's 18 years older than me. He's living at her home now, paying all the household bills and tending to the lawn, etc. It's beneficial for Mom and also for him. I don't care for some of the things he does and sometimes I don't care much for him but this morning, I'm really worried about him. He seems different and weak and vulnerable. I am afraid something is wrong and that some day, I'll have to tell my Mom that her son is seriously ill. What's worse than learning that your child is ill or dieing? It will be tough for us all.

I can't help but think about my brother and feel for him - just WHAT I feel is what's keeping me awake. My brother is not what I'd call a nice guy - at least not to those in his family. He's been kind, generous and even loving to friends and even total strangers. To us he's most often mean and impatient. He speaks with NO regard to people's feelings and drinks WAY too much which makes his attitude even more rude and crude. Yet....no matter how much of a jerk he is, when any of us - parents, siblings, cousins, nieces or nephews - has really needed something or someone, he's come through. For all his hurtful crap, he's as dependable as the morning; sometimes that's a cold, grey morning but it's still morning. His attitudes indicate he doesn't like people, wants nothing to do with them or with us, yet lately he's showing some tenderness here and there that makes me reconsider what's really important. His tendency to push everyone way might just mean that he needs some support all the more right now. I won't do it because I care deeply for him or because he's been loving to me but I'll do it for myself. It's selfish I suppose but I couldn't feel good about myself if I left him feeling that no one gave a damn. I feel I owe him something, although I consider all "debts", both figurative and literal, well paid in full. I just can't let him be completely alone and without a soul to care. My husband and I fear that fate someday - no children and nieces and nephews scattered and busy with their own lives, who'll give a damn about us? We'll have to be secure knowing that someone REALLY, REALLY loved us and cared dearly one point in our lives even if one of us ends up alone. My brother doesn't have that to comfort him so I'll do what I can and feel good that I was able to show kindness to someone who could not show it to his family. Some people might call me a martyr for that attitude but let them. They don't have to live with ME. I have to live with me, I have to look myself in the mirror everyday and I'd see something really bad if I weren't there for him.

Mom's adjusting better at nursing home than assisted living

2010-04-22T22:20:00.000-07:00

Mom's been at the nursing home for 2 1/2 months now and she seems to be adjusting better to it than she did to assisted living. It's a combination of things - she has friendly tablemates that do not suffer from dementia; she's more likely to ask for help and used to it by now, and she likes the food and view at this nursing home much better than the assisted living facility. It's amazing what we might call minor changes will do. Another BIG difference is that she's sharing a room. She seems to do better when there's someone else around her all the time. They share a soda each afternoon and some chocolates each evening. Mom also has empathy for her roommates condition and wants to help make her feel better.

Mom's also getting around better in her wheelchair with a new pad that prevents her from slipping down in the chair. She's able to pull herself along with her feet and uses her hands to guide the wheelchair easily. She's also starting to make jokes and pranks with other residents - which lifts her spirits. On Monday an older gentleman got ahold of her wheelchair and pulled her down the hall to the dining room after she'd worked her way to her room. She said he laughed the whole way. So today, she quietly rolled up behind him and got a hold of a strap on his wheel chair, she put on her breaks and held onto the strap. When the guy tried to move he was stuck; his feet just slid on the floor. He was not able to turn around far enough to see what was holding him back so he just kept "running in place". She let him go after 20 minutes or so! I hope she doesn't get in trouble for harassment!! It's all in good fun.

How can I help Mom adjust to her nursing home?

Medicaide should help but for a few months will put Mom's accounts in the hole!!

2010-04-21T13:42:00.000-07:00

Mom just began getting Medicaide to supplement her rent for a nursing home and for a few months she won't have enough to cover all of her expenses. I'll have to chip in about $100 a month. Mom must pay nearly all of her income (social security and pension) to the nursing home. She gets $30 for her personal needs and $200 for her supplemental insurance premium. The deficit happens because Medicaide considers ALL of her social security - the grose amount BEFORE deduction of premiums for Medicare part B. Medicaide is supposed to pay the premiums now but it takes a while for the Federal government to get the message and stop the withdrawals. So for a few months Mom is required to pay out what she doesn't get. I spoke with Medicaide and they said she will get reimbursed for the Medicare part B premiums but it could take 3-5 months until it's all said and done. So, I'll make regular deposits in Mom's account and continue to make calls if it doesn't happen by July.
Medicaide wants more than Mom dad gets Medicare premiums are still withdrawn medicare premiums put mom dad in the hole medicare premiums cause over drafts over drawn

"Everyday" medications may be source of confusion in the elderly

2010-04-20T09:21:00.000-07:00

I suffer from allergies and fear what my future elder years will be like. The more I read about eldercare, aging and drugs the more anxiety I feel. Though I have yet to find data from large clinical trials, I read small articles and abstracts that list medications - everyday basic meds used by daily by MILLIONS - that cause confusion and memory loss in the elderly. Loratadine is one example. I take two of these daily for allergies. It is the ONLY thing that keeps me from getting sinus pain and pressure that turn into dibilitating migraine headaches. These articles indicate that even benedryl - which will cause sleepiness - causes confusion and memory loss.

I can see where care givers and doctors would believe that confusion and forgetfullness are simply part of the aging process. They might continue to give these medications to keep the patient comfortable and treat these chronic conditions without realizing the cognitive impacts to the elder. Additionally, I wonder about the long term effect of using these drugs for years and years. I hope I don't have to make a choice between being able to function now and retaining my wits in 30 years!! I'll keep researching and will report back as I learn more.

If you want to learn more or find helpful information, try these links for some basic information:

Consumer Reports: http://www.consumerreports.org/health/prescription-drugs/dangerous-drugs-for-older-people/overview/dangerous-drugs-for-older-people.htm
Food and Drug Administration, Drug information for consumers
www.fda.gov/cder/consumerinfo/DPAdefault.htm

The Peoples Pharmacy online: http://www.peoplespharmacy.com/ and look at their GUIDES link for more information on the drugs that cause problems and treatments that might help.

Another decline - visiting Mom after 2 month abscense

2010-04-19T09:54:00.000-07:00

I've been away from my home town and my Mom for two months and I definitely see a difference in her. It's not drastic but it is enough to notice. She is more stooped. Her arms and legs are thinner and weaker; she is unable to stand on her good leg for more than 20 seconds and has more difficulty with memory. I hate to see this "drastic" decline but I guess I could call it typical for her and her family. We saw that same thing in my grand mother and her sisters during the last couple years of their lives.

As much as it pains me to see this I am glad I notice because it helps me prepare for the inevitable. It leaves me wanting to be more loving, more supportive and to spend more time with her because I can see that her time is short. How long "short" will be is up to God and to Mom. Sometimes I feel she's giving up and waiting but then she gets some unexpected visit and it really enlightens her spirit. During a visit the other day we met other residents. Turns out she was acquainted with them in some way over the years; it made her feel better. She also got visits from a couple of male aides that work at her assisted living facility. They showed up with a cold soda pop and had a chat with her. She felt so good to be remembered.

I continue to be amazed at Mom though. She is rarely despondent and rarely says "why me" out loud. She is concerned about her roomate's welfare and how she feels. She watches her struggle and cry in pain and feels so bad that there is nothing she can do. I hope I can be as caring when I become as limited as my Mom.

New pad & old chair ...but now the Exec Director hates me...

2010-04-19T09:37:00.000-07:00

A family counsel meeting between the staff at the nursing home, Mom, me and my brother went well overall - until the Executive Director joined in.... The social services staff at Mom's nursing home regularly requests meetings like this to discuss the residents' needs, wishes and to understand what's possible as far as care, comfort and support.   It's a good thing to do but often when bad news is involved emotions get heated. I admit that I was hot headed over this pad situation but I was calmer and it was addressed to my satisfaction before the meeting. At the family conference I realized that they were all worried about criticism directed at the therapists and didn't understand the significance of the pad in the wheelchair.

We started the conversation by discussing Mom's health issues and asking her what would make her comfortable. She had a small list - her chair (a rocker/recliner that no longer reclines), her 28" flat screen TV and less "man-handling" when she's getting help to the bathroom.     The TV can't go into her current room, the "recliner" was a no-no until we explained that it no longer reclined and she didn't have the strength to do it anyway. The "man-handling" will be an on going issue that retraining aides will help but we all have to watch closely for rushed and rough treatment.   We discussed re-arranging furniture in Mom's shared room to accommodate the chair, bed and wheelchair... all easy fixes.   Mom, being her thoughtful self, said she didn't want to make adjustments if it upset Judy her room mate. Mom is worried that Judy is in constant pain and said "she has it worse than me."   Mom fails to realize her weaknesses and limits but remains thoughtful of someone who's just as limited. Judy is a dwarf with severe arthritis in her joints and hands. She goes to dialysis regularly and seems to have some developmental disabilities too.   I am proud that Mom wants to consider her wishes but will continue to push for Mom's comfort.   We agreed to try different ways to arrange the room to meet Mom's wishes.

We were all happy about the progress of things until I brought up the wheelchair....They were ready for this - they immediately said, "We'll have to get our Executive Director for that!" then ran down the hall to get her.   She is a large imposing woman, probably near 6 feet tall, wide shoulders and a booming voice. She entered, quickly made the usual niceties and immediately began talking about how she'll "defend" her therapists, that mom refused treatment, that they did all they could....   I let her finish and then stood up, raised my hands in the "halt" position and said, "Stop, I'm not complaining about your therapists. I believe the did all they could for her, I know Mom will refuse therapy and won't exercise, her arthritis limits that. My issue ( I really emphasized this word - IS-SHOE) is that my Mom has spent TWO MONTHS in pain! For TWO MONTHS barely able to move, unable to right herself in a wheel chair because the pad was absolutely wrong and the wheelchair just a little too big. She was sitting like this (I demonstrated by sliding down on my tail bone and sticking my arms in the air) ON HER TAILBONE which caused pain in her lower back. Her shoulders rested on the back of the chair. This pushed her arms up to the point that she could not reach the wheels to move herself around.    I noticed this immediately! I spent two days watching her and helping her before I said anything because I wanted to be certain of the cause.   If I had not brought the other wheelchair to demonstrate the fit, no one would have listened to me." I remember speal this because I practiced it over and over before I went to this meeting. I was READY. I continued, "She has suffered because of a simple pad, A PAD!! that was easily changed but no one took the time to consider. It's a minor tweak but made a huge difference." I added something about everyone blaming it on her bad posture and failing to look beyond that to find a way so that Mom was able to right herself.

At this point the nursing director chimed in, "She's right. I've watched Elvina during the meeting and she is able to push herself back in the wheelchair now. Her posture is better." At that statement the Executive Director softened and began to discuss things WITH us not AT us. It all ended positively with an appointment for me to take Mom's chair in at 11am the next day. She left but I could tell she was steaming on the inside. I believe they WANT us to think they care about Mom's comfort but only time will tell. I will continue to visit daily for another week.   I am also more resolved to move closer to my Mom so I can see her on a more regular basis. I can't go more than 4 weeks with out a visit. Once I'm working again, I will try to hire someone to check on her every couple of days.

I have a greater fear that the Executive Director hates me now and will make Mom suffer for it. She might transfer that "she's a pain in the ass" attitude to my Mom.    I will not be made to feel guilty because I find ways to make Mom comfortable and enable her to do as much as she can. I will not feel bad about making the people who are getting paid to care for her do these things too. I realize they have many people to tend to and need some repeatable methods to save time. I realize they can't remember every little detail about every single person but I CAN and DO expect them to apply some common sense.
wheelchair pads, how do you communicate with nursing homes

Wrong wheelchair leaves Mom in pain and uncomfortable...ARGH!!!

2010-04-16T09:39:00.000-07:00

I had not seen Mom in two months due to travel and a visit to my home out of state. When I finally got to her I was angered all over again because of the way Mom was left sitting in a wheelchair that's obviously too big for her.    The size means she slipped around and was unable to sit up. She slid so far forward that she could not use the arm rests. Without the ability to use her arms AND her legs at the same time, she could not push herself back up in the seat. The moment I saw her it was obvious to me that the wheelchair was a poor fit.    She was slumped down so that she was "sitting" on the back of her hips and some of her weight was on her shoulders.   This position will aggravate the arthritis pain in her lower back and hurt her upper back where she's stooped with a "dowagers" hump.   I was immediately INCENSED that she would be left sitting in a position like this.

I didn't rush to judgement or yell at anyone but I sure wanted to!!! It took all of my will power NOT to come unglued on these people. I spent two hours with her, watching her move about in the chair and helping her get "adjusted" to a more comfortable position.   It became clear, as I watched her, that the pad in the chair was the problem. It was thick and spongy, it felt like a bag full of wet noodles. When Mom slid forward, the bulk of the pad bunched up behind her preventing her from pushing herself back to a more comfortable position.   So - two days later I took a smaller wheel chair to the nursing home and MADE the therapists put Mom in it to compare the "fit".   They DID NOT want to do this comparison. They bull-headedly argued that she needed a pad, that she had poor posture and was "just bent this way now". They said she wouldn't TRY to push herself up.   I had to yell at them to listen and to take a good look at her in the chair and pad.

With the original "noodle" pad, it was not a good fit, the seat was not deep enough. I complained about the pad and an "aide" - NOT ONE OF THE THERAPISTS - suggested using a different pad - it made all the difference!!!   With a firmer pad she was able to use her arms and legs to push herself back when she slid forward. The new pad also had a slight rise in the front that prevented her from sliding so far forward that she was able to push herself back BEFORE getting so far down in the chair.    So - she ended up in the same chair - tho it's still a bit too big - and a new pad. Now she's comfortable but I wonder what damage was done in the two months she spent "bent" in the large chair and bad pad.   For a weak 89-year old, two months like that can do lots of harm - she could loose what little strength she had to help herself.

Next - a meeting with the social workers and administrator to discuss Mom's overall comfort and this damned "Chair situation"!
wheelchair pads

Therapist FINALLY gets it but it's too late to help Mom

2010-04-06T21:30:00.000-07:00

After finally getting Mom's therapist on the phone, some changes are made but I'm wondering if it's too late to do good for Mom. I learned a lot from talking with Mom's therapist. Mom's supposed to go to therapy for an hour a day. The doctor ordered 30 days of it then a review to see if it's doing any good. The therapist is frustrated with Mom because she thinks Mom's not trying to get stronger. The therapist spent 10 minutes complaining to me about how uncooperative Mom was. "She'd rather have a Pepsi with a friend than go to therapy." She seemed pretty upset over the whole situation. The therapist didn't realize Mom is 89 nor that she's grown increasingly weaker over the last year. She didn't know Mom was successfully using a lift pole in assisted living. She didn't know Mom was complaining about her wheelchair, that she couldn't work the phone or TV, or that she was willing to try using the bathroom by herself. I was ASTOUNDED and mad as hell because this information wasn't transfered at the time Mom was transferred to this joint! (One that her physician INSISTS is the best in town.) This time it was MY turn to get mad and frustrated. I had conversations about her history, abilities and such with the Executive Directior and with Social Services staff, and, a few days later, the nurse on mom's floor. All of them said they'd "spread the word". None of them suggested that I speak with the therapist. They all knew she was there for 30 days of therapy!! It's quite logical to me that the therapist would need to know a LOT about Mom to judge her improvement. Unfortunately, I didn't realize they would not communicate. I never expected that I would have to DO THEIR DAMNED JOB!!

Unfortunately, this seems all too common. No one seems to have the time to do more than the immediate task in the moment. Being a process person, and one who's made a living moving data around into usable information - I am VERY frustrated by this and wonder how much harm has been done to my Mom because of their inability to see that they need more understanding. They need processes to look at a patients WHOLE condition and history when they arrive. They need to orient the patient/resident to their surroundings VERY well and spend some extra time for a few days to get the resident/patient out of their shell and involved. They need to ask lots of questions of the patient/resident and family. They need to LISTEN to what each says. The therapist didn't realize how old my Mom was for crying out loud!!! How can she provide good therapy if she didn't think to look at her age. It doesn't give me much confidence in the ability of this place. I'll finally get to visit next week so they'd better get ready - the inquisition is about to begin!

Mom's small room inhibits her ability continue to do for herself

2010-03-24T21:30:00.000-07:00

Since Mom's move to a nursing home we've see declines in her strength yet her cognitive ability remains pretty good.   We're concerned about her loss of strength and I believe that the actual facility is partly to blame. She's in an "old style nursing" home - it's been around for at least 35 years. Her father, my grand pa, died there; her brother was there after a stroke so we're familiar with it. The rooms are small and the bathrooms even smaller. There are no grab bars, no handicapped showers - nothing that will enable her to help herself.   There is no room for a transport bar (see previous post ) so she can pull herself up from the wheelchair. The TV is small and attached to some contraption on her bed; it's hard for her to change the channel so she doesn't watch it. She can't have her recliner so sits in the wheelchair which is bad for her back.   I fear it will leave her even more stooped and bent over.

I am really distressed by this - she LOVES TV news, CNN, PBS and animal planet. This is good brain food for her and helps keep her current.   She might be physically weaker but if we want her mind and spirit to remain strong some changes need to be made.   I am really ticked off at her physician. I'm sure his intent is very good - he wants her to get better care than he felt she received at the ALF BUT the tiny, crammed conditions are bad for her spirit. She can't do the things she enjoys. Her physical needs are met but the spirit is repressed. I don't know what to do - complaining to him will fall on deaf ears; he'll dig in his heels and get more stubborn about where she lives. I plan to call the physical therapist at the nursing home to talk about Mom's progress and what she has to do outside of these daily PT sessions. The administrators and social workers SAY they are very concerned with her quality of life there and WANT to make her happy but I'm dubious until I see / hear of some changes.

Contacting this joint is another problem for me. I call and I call - no answer.   Mom doesn't answer, most of the time the nurses station on her wing doesn't answer. Today I called the main switchboard and an old tired man answered. He was quite polite but it was obvious that he was confused.   Given all of this, I'm really concerned for my Mom. All I can do is make phone calls and plans for my next trip to see her.   She'll have to hang in there until after Easter. Poor dear.

Getting paid to care for grand parents... Approach with CAUTION!!

2010-03-15T16:24:00.001-07:00

I just read this question on a care giver blog: "Can I get paid to take care of my elderly grand parents?" I had to respond, here's a summary of what I said: The short answer is "Perhaps".. it depends on who is doing the paying and which state you live in. Sometimes family members can be paid by the state to take care of elderly or disabled family members. The amount depends on the state. Contact your local medicaide office, or state department of health, to see what's possible.

If your grand parents pay you then there are tax issues that you as the payee need to address. You can act as an independent contractor, a sole proprietor or set up an LLC. The easiest - yet most expensive way - is to call yourself an independent contractor and bill them monthly. This means YOU must pay all federal, state and medicare and social security taxes. Be advised that the state and federal governments want you to pay estimated taxes on a quarterly basis and the federal portion alone is nearly 16%. Be assured that when ever money changes hands, the state and federal government want their share. To understand the requirements in your state, contact an accountant to learn what's possible and what's the most least costly option. ALSO be cautious about insurance - specifically liability insurance. If you're responsible for their care - lifting, dressing, bathing - then YOU might need insurance. If you're driving them around in YOUR car, then you might need added liability insurance. If YOU are hurt lifting them, then will their home owners insurance cover you? If you drive their car, are you covered?

From a personal perspective, caring for family members is probably the most stressful of all situations. Because it's FAMILY all of the dysfunction and behind-the-scene expectations come into play. Will your parents, aunts and uncles TRUST you? Will they help? Will they provide respite care if you want a day off? Who will handle the finances as these people age? What if one needs to go to nursing home and the other is left? Will you get paid half then even though you spend the same number of hours care giving? You need to think of all the things that can go wrong; of all the people who will help you or make it difficult and have a plan to deal with EACH. I would also suggest that your grand parents complete a Power of Attorney, living wills and other documents that outline EXACTLY what they want should they become incapacitated or die. It should be detailed and include WHO GETS WHAT - down to each stick of furniture and fork or spoon. This will protect them and YOU especially if you want your family relationships to outlast your grand parents. Sorry if I sound pessimistic but I've seen way too many of these situations get really ugly, really fast. I always hope it works out and in most instances it's fine but there are always issues because you're dealing with people going through change and every one has a different opinion of what to do.

getting paid to take care of grand parents, getting paid to take care of handicapped getting paid to care for grand parents grandparents

Getting sneaky to do what's best for our elders

2010-03-04T06:23:00.000-08:00

Dealing with family members while your parents or elders are aging is often THE most frustrating and hurtful issue we face.   I hear all kinds of terrible stories about family who take advantage of elders or who are in charge of money and health decisions but don't care what the elder wants. After being so protective of my own parents for so many years, I have an immediate and physical reaction when I hear bad stories. I get passionate and angry. My blood pressure rises, and at my age that means hot flashes and nausea. My reaction is also because I just can not comprehend how someone would steal money or belongings, or fail to consider the emotional and "quality of life" issues when making decisions about elder or sick people.   I just can not understand how people could take advantage of the vulnerable and the lonely.   It's all greed and lack of a conscious I guess.

The situations I hear about most are caused by financially strapped people who think an older person doesn't need much anymore so they feel entitled to Grandma's money. Because Grandma or Grandpa says, "yes", when asked to a request for money doesn't mean they have it to spare. And, it doesn't mean Grandma or Grandpa understands that "yes" will compromise their finances. Some people also seem to believe that their idea of what should happen is better than that of anyone else; they have huge egos or a control freak personality. They want control and will manipulate, lie, coerce their elders or siblings to become the decision maker, have control, get money or belongings.   When I've talked with such people, they often have sane-sounding reasons for doing what they do but they look at situations from THEIR filter and don't consider what's best for their specific parent or elder.

Sometimes the lieing and manipulating must be done by the "good" party - someone who comes into save the elder from another who's taking advantage.   An acquaintance of mine recently had to do a lot of work to get her mother out of a bad environment. A grandson and his pregnant girl friend were living with the 78 year old. The grandson completed credit card applications with himself as an authorized user - not responsible for paying the debt. He ran up more than $50,000 of debt in less than a year and grandma quickly fell behind on payment because he tossed the bills.    Grandma was buying all the groceries, including their cigarettes and alcohol. When her daughter brought it up, Grandma felt that the kids needed her help and that they were there helping her. She didn't s notice the dents in her car, piles of laundry, the dirty ashtrays everywhere. She didn't comprehend the added costs in water, heat and electricity.   She seemed relieved that grandson was "taking care of those details now..." Actually, Grandson had not paid bills in months and Grandma was close to loosing her electric and gas service. My friend was wise to collect more than 3 months of bills, canceled checks and receipts. This was the hardest thing of all - to quietly collect information while someone was taking advantage of her Mother, but it was necessary. Before doing anything she saw an attorney about filing bankrupty for her mother. She also contacted the local county authorities about charges she could bring against her nephew for elder abuse and fraud. She was armed with information about the charges she could bring against her nephew and she got a restraining order.

After collecting enough information, the daughter immediately went to work. She took Grandma to spend the week with a cousin and had Grandma sign a complete and durable Power Of Attorney.   With that she went to the bank and changed all of Grandma's accounts. She closed the charge cards and changed the billing address for all bills to her own.   While the Grandson and Girlfriend were out, she put their belongings in garbage bags and placed them in the car port. She changed the locks on the apartment and warned the neighbors and land lord that they were evicted. She found him and told him he could not return to Grandmas and gave him a copy of the restraining order. She gave him $1000 in cash and told him that would help them get settled elsewhere.   Once that week was over, she still had more work to do - there were legal issues with her Mom's debt but Grandson/Nephew was gone so dealing with Grandma/Mom was easier. She sold her Mothers car, moved her to assisted living and now handles all of her business affairs.

This case took some sneaky work and it was the right thing to do on behalf of Grandma/Mom. I suspect that the daughter glossed over the details of the Power of Attorney. I doubt she told her Mother just how much power and control it would grant over Mom's affairs. I suspect the Daughter realized her Mom was forgetful and becoming needy. In the strictest legal sense, Grandma/Mom was probably not 100% competent which might nullify the PoA if it were challenged, but WHO would do that? Grandson/Nephew didn't have the funds or know how to challenge anything. Grandma/Mom's competence was borderline and experts could probably be found to argue either way.    The Daughter is doing the right things at the expense of the relationship with her nephew and her Mom's grandson. However, the relationship was not positive for Grandma, it was a life-sucking parasite. Even though Grandma misses that part of her family, she is safer without them and that's the ultimate goal.

Sneaky family hurts grandma, how can i keep my brother sister from stealing from mom, sister brother lied to get POA power of attorney

Urinary tract infections in the elderly, hard to spot but cause big trouble

2010-03-02T20:01:00.000-08:00

Urinary tract infections (UTI) are very common in elderly people and can cause secondary problems. A UTI is a term that covers bacterial infection in the bladder, urethera, kidneys and the tubes that connect these organs.   Generally symptoms are burning and frequent urination; sometimes there's a need to pee with little or no urine discharge. Your elder might also have low fever and urine with a strong odor and bright color. Often, there are no symptoms at all. If the infection spreads to the kidneys there can be back pain below the ribs.   UTIs are treated with a variety of antibiotics and when caught early, are easily treated. In my Mom's case, the bacteria is drug resistant ecoli and it is slow responding to antibiotics.

When undiagnosed, a UTI will weaken the elder's immune system and can mean that elders are more susceptible to other infections. I've heard several reports of grandma or grandpa's confused or mean, aggittated state going away after treatment for UTI. I've also heard first hand accounts of elders getting confused or seeming demented when taking strong antibiotics for UTI. In my own experience, I believe my Mom's UTI weakened her system, which meant her epilepsy meds weren't absorbed normally. This meant she had a lower than optimum levels of the medicine leading to a grand mal seizure. For this reason it's probably good practice to test for UTI -or other infections - regularily. I definitely suggest it when you see sudden changes in your Elder's personality. If they are suddenly confused about current events, people or things around them, or if they become argumentative, hostile or agitated - ask that they be tested.

It's been my experience with Mom's assisted living facility that I had to push for things like this; they were not proactive unless the resident complained of pain or the family was assertive.. My Mom complained of strong colored and smelling urine for weeks but she was taking multi-vitamins which could also be the cause. She always has pain in her back due to arthritis so a new pain might go unnoticed. Given this, there was no reason for the assisted living staff or me and family to suspect a UTI. It was discovered when she was hospitalized for the seizure.

Because I'm not a physician or nurse, I feel it's important to include information from a trustworthy source, I copied this information below from Web MD. If you're concerned about yourself or your Elder, please talk with your physician immediately about being tested.

From Web MD: Urinary tract infections (UTIs) in older adults

Urinary tract infections (UTIs) are common in older women and men. Factors that make older adults more likely to develop UTIs include:

A reduced ability to control urination and bowel movements (incontinence), which increases the chance of getting bacteria into the urinary tract.
Hospitalization or residence in a long-term care center, where the person may have a urinary catheter inserted, making bladder infections more likely.
Problems with the bladder dropping down out of its normal position (bladder prolapse or cystocele). When this happens, the bladder cannot empty completely, making infections more likely.
Lack of estrogen in women who have gone through menopause. Lack of estrogen may allow bacteria that can cause UTIs to grow more easily in the vagina or urethra and cause an infection in the bladder.
In men, partial blockage of the urinary tract by an enlarged prostate.
Other conditions, such as diabetes, lack of activity, poor hygiene, or problems releasing urine.
Use of medicines that can cause difficulty urinating or a complete inability to urinate. If you think your medicine may be causing urination problems, talk to your doctor.

Older adults also are more likely to have conditions that complicate UTIs, such as a lower resistance to infection. They may require more thorough evaluation and longer antibiotic treatment than do young adults with uncomplicated infections.

Author	Monica Rhodes
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Avery L. Seifert, MD - Urology
Last Updated	June 8, 2009

Use caution when moving your parent to a new state

2010-02-24T16:39:00.000-08:00

Moving your parent to an ALF or nursing home near you seems ideal but it could cause financial duress and mean your parent doesn't qualify for financial assistance. Some states will not approve financial assistance (medicaide) until a person has established residency. In my Mom's state, that's 30 days and proof that she intends to stay. In another state it's six months! At $3-5000 a month, that's a substantial amount to pay until they qualify.

The best practice - do research LONG before your parent or elder might move closer to you. Contact your state medicaide office to understand VERY clearly the residency requirements, asset limits and application process.

How can I move my parent to a new state? moving my parent near me, state aid and moving my parent,

Excess Vitamin D poisoning especially concerning for diabetics

2010-02-24T16:31:00.000-08:00

A friends Mom died from too much of a supposed "good thing" last year. She was a diabetic with poor kidney function and an overdose of vitamin D meant she suffered a lingering illness and painful death. Given the increases in diabetes we see in the US, I feel that sharing her story here is the responsible thing to do and I hope to prevent the same tragedy.

Before I continue I must include a disclaimer: I am NOT a health care provider - no dietisian, no nurse, no physician. I am an educated middle-aged woman with some common sense and desire to share information. I urge any reader - anyone for that matter - who has questions about Vitamin D to talk with their health care provider or do their own research. There are several very credible sources (Mayo Clinic for example) that post more information about the benefits and risks of Vitamin D and other supplements, please seek them out.

Vitamin D is necessary for many functions in the human body and especially important for elders since it helps the body absorb calcium and retain bone mass. Too much vitamin D can have painful side effects - the most severe - and risky to elders - are high blood pressure, kidney stones or a build up of calcium in soft tissues like the heart and kidneys. In My friend's case, her mother died of kidney failure due to calcium build up. She had so much calcium in her blood that her kidneys worked like mad to filter it out. The calcium built up there in her kidneys. She had reduced kidney function due to the diabetes and the increased demand was more than her damaged kidneys could tolerate.

What was the source of the vitamin D? Her supplements, her vitamins. For several years, my friends Mom ordered special vitamins from a pharmacy out of state. Due to an error at the pharmacy too much Vitamin D was added to a certain batch that was shipped to this elder. The vitamins looked just the same as always. With no way to know about the excess vitamin D, she took her pills faithfully as she'd always done. After a couple few weeks she began to feel bad; after three weeks she ended up in the hospital with kidney failure. No one had anyway of preventing this error, except the pharmacist that made her vitamins and his supplier who changed the wholesale packaging and concentration. Had she known about the risks associated with her supplements, she might have been in tune to slight symptoms before she was too ill to recover. I hope that anyone with diabetes, will learn the risks and subtle signs of early vitamin D poisoning.

Being a necessary pain in the ass - my latest role

2010-02-24T15:56:00.000-08:00

I am a pain in the ass - or at least I'm made to feel that way all too often. The past few weeks with each call I make on Mom's behalf I get attitude, impatience and the brush off. My latest situation is Mom's dentures. Nearly two weeks ago her lower denture was lost at the nursing home.   The social worker there assured me they'd take care of all the arrangements to get a new denture - except payment of course.

Without the denture Mom can't eat many things and I worry that she's passing over nutritious food.   She can talk fine but when tired she is not clear. We want her to meet others so speaking clearly is important when those hear by are hard of hearing. And, for the sake of her dignity, she wants her teeth back; she doesn't want to appear like a "toothless old crone". On Monday I started to call the social worker (SW)about the appointment. I leave 2 messages - Nothing. Tuesday I call twice and leave messages. Nothing.   Tuesday late afternoon I reach another social worker who tells me that Mom's SW has been out sick. (Note no back up to check her messages or forward the phone! BAD, bad) She checks and says they are waiting on the Transportation Coordinator to schedule the appointment. Coincidentialy, the Coordinator has left for the day (it's 2pm where Mom lives :\).

Now it's Wednesday and I call again. I called the main number and get the Exec Director on the line and learn that the Transportation Coordinator is probably gone already, again... Hmm..."I've called for two days now. I really want to know if she's made an appointment for my Mom" (translation, I'm not hanging up until I have an answer). The ED agrees to "go to the other end of the building to check." (Heavy sigh) Next thing I know, the phone rings and Pam answers.   I have to explain things all over to Pam and ask if she's the Transportation Coordinator. "Yes. Why!?"   Her tone is immediately defensive even though I politely say, please and thank you and "I know you're busy, but ...". She tells me they are waiting on the denture service to verify Mom's status with Medicaide.    I say, "that's fine but I'm willing to pay because I want her to have teeth so she can eat". Pam doesn't care. Pam insists that they are waiting on the denture service; it's "their fault." even though I've not said anything negative about the delay. (I'm beginning to understand why they let her leave early everyday.) I ask for their number. This time I get a "tsk and ugh" and I could feel the eye roll through the phone. I hate TSK's... I'm not some whining child - I'm a grown woman who's trying to do something for her Momma!!

I call the denture service and get more attitude.   I finally say, "Look, I just want to get my Mom in there so she can eat; I'm worried that she's not eating enough because she can't chew most foods well." The woman's attitude softened a little.   So - the woman there asks if I'll hold, "As long as you need." I tell her..... I hear her talking to someone, "open, now bite down. That needs to sit for a few minutes. I'll be right back..." She comes back to me rather out of breath and apologizes, "There are only two of us to do everything..." She explains that they are waiting for medicaide to confirm Mom's status and if they'll pay. I tell her that it's okay, I will pay for the teeth. If Medicaide comes through before the appointment and billing are done great, but it doesn't matter. With that news, she's nicer. She's willing to call the nursing home to make an appointment for the next week.   She's trying to rush me off the phone by now but I don't let her get away until I ask that the appointment be after 2pm so my brother or sister in law can be there with Mom. I also tell her I'll call the nursing home to confirm the time. (Honestly, I don't want to talk with Pam again but I do want to be a bother to her since she was sort of rude. Passive aggressive perhaps, but I don't care.)

So - 3 days, 5 messages, 4 phone calls later - someone will call someone else to set an appointment for Mom's teeth. Though Mom still doesn't have an official appointment, I believe it will get done. If it's NOT done by tomorrow afternoon, no one will be surprised when I send attitude, tsk's, heavy sighs and eye rolls through the phone. (I've actually learned that silence after a question, especially "WHAT??!!" is really, really effective. It's like they think you're ready to blow up.) They immediately get nice and escalate your issue to get attention of someone who can actually DO something about it.

I've learned NOT to get pissy and mean even though often I really, REALLY want to. I've learned to politely tell people who I am, why I'm calling and what I need.    I generally do not say "I want", I say "can you help me with..insert topic here ". I always say please and thank you - always "thank you" even though you don't mean it. Don't include any sarcasm in the "thank you" they can feel that immediately.   I keep logs of who I speak with and note who will take what action by when.   When I call them back I remind them, very politely, " After we spoke last week, I hoped Mom would have insert concern here by now. How that's coming?" I never blame; never say "you". When it's necessary I will say, "Someone should be accountable for this....insert your topic here." That only comes after lengthy discussion of the facts, dates, details - so they are not surprised when I expect someone to take responsibility. When I, or someone in my family has made an error, I own up to it immediately and I work to fix it. They can't accuse of us being unreasonable.

All of this is really discipline. The discipline to take detailed notes, to keep every thing straight, to be responsible. Discipline to call or show up when I say I will. I pay when I say I will.   Thus I get especially frustrated when I'm dealing with people who make this sort of thing their profession and they are rude or can't get things done. I get frustrated when they act as though my calls about Mom's care are a surprise and inconvenient for them.   They should expect calls and be prepared to answer in a professional manner.   They should NOT treat family members like a pain in the ass!

It ticks me off, it's hurtful and I HATE it but I must take it. They are in the power position; they are there working with my Mom. They are there with her daily and I don't want them to take their frustration with me out on her. I must say that has happened only ONCE after she had surgery years ago - I'll save that for another day.   95% of the time Mom's care givers are nice, patient and respectful. I'll deal with their attitude as long as she's content and feels good.

What's the "best truth" for our elders? The state of denial ain't so bad....

2010-02-18T10:33:00.000-08:00

I regularly read several online publications about care giving and lately I really want to smack a few authors and a whole lot of commentors.    A very common question is "How do I get Mom or dad to stop asking to go home?" or - "How do I get my dad to be nice" or "How do I get Mom to face reality?"   There's always some dope who comments like this: "If you respect your parent, you'll tell them the truth...you'll make them see that they need help."..."Tell them their behavior is unacceptable; force them to change."

( Some major eye rolling and HEAVY SARCASM intended) - Yea, right... obviously they do not have an elder in their life and they've never spent more than a day or so helping an aged and sick loved one. That is the absolute WRONG advice. WRONG, WRONG, WRONG!!!!!! Nothing will make your elder and you - but ESPECIALLY YOUR ELDER - more miserable.   I've been through this over and over with uncles, grand parents and now with my own parents. It is a rare - I REPEAT A RARE elder, who is realistic about their situation and their abilities. To force them to face reality is simply the cruel, mean thing to do.    The truth is harsh and inevitable - joints, eyes and hands all failing; blood pressure and blood sugar up and down; lungs or kidneys working at greatly dimmished capacity; bones that will break with the most minor fall - the inability to make new memories and someday, relatively soon, choices about life support, caskets, cemetery plots and burial clothes - this is the truth, this is the reality. Simple but fearful and painful.

In our culture we insist on truth. We place great value on it; we equate truth with respect. The two do go hand in hand but not in the case where you are dealing with an eldery (and perhaps demented) person in the last stage of their physical life. The truth of their situation is too much to bare. They can't understand that they need multiple medications to maintain their existence. They want to be where life meant the most - at "home" where they felt loved, comfortable and surrounded by the things they earned for themselves.

We - their loved ones, family and friends - are not comfortable with this truth - that they are failing, that they are frustrated, that we can't fix it. There is no logic, there is no pill, no amount of therapy that will help. So why tell them? Why make them understand the gravity of their situation? We will only have to say it again and again. They won't remember so we only frustrate ourselves. We can only make their current existence more tolerable. We can only love them as best we can. We can help them live in a state of denial and it's okay. It's the respectful thing to do; it's the loving thing to do. We tell them that "home" is there just as they left it, waiting. We tell them that when they're better, we'll help them get there. We lie and it's okay.

Years ago my uncle was dieing from lung cancer but in his mind, he would re-couperate. He'd get disability and have all of his time free. He would set up his dream wood working shop and make lovely furniture. We knew the outcome; he had only months, most likely weeks, to live. His surgeon called me one day angry that he was not "moving through the stages to acceptance" of his terminal condition. My reply: "Why is that necessary?" The surgeon could not answer. He could not tell me how my uncle would benefit from the harsh reality that he would soon die. I and my family helped my uncle live his lie. We watched videos of New Yankee Workshop and discussed wood working techniques.   We read wood working magazines with him, we planned furniture. Each visit he had hope and looked forward to something. He was not a spiritual man but I know deep down inside he knew his fate. He was distracting himself with another truth - he kept his mind busy dreaming of what he'd do at "home". After all of these years, I know he is "home" and he's busy in his wood shop. He is in the home he dreamt of during that final time of his life. I'm glad we helped him live that lie because it meant that we laughed, continued to share and that he felt good about every one of his last days.

Mom's better and new teeth are in the works

2010-02-18T08:14:00.000-08:00

After several days of illness, Mom is on the mend; her teeth however, are gone for good. After calling for several days, I finally got her on the phone today and she sounds much much better. I am so relieved. They have not found her bottom denture so we assume it was tossed into the garbage. The social worker at the nursing home will make an appointment with the denturist, arrange to get her there in their van and tell me whom to call about payment. I used to feel pressure to make all of Mom's appointments and then be there to go with her - I've given that up. These facilities - assisted living & nursing homes - are getting paid REALLY well so they can do it. I have decided to take FULL ADVANTAGE of their expertise. I will ask that they arrange these sorts of things and then get Mom to the appointments. They have the knowledge of providers in Mom's home town, they have the van with the doors and safety equipment to get her there easily. They also have people who will go with her if I or other family cannot make it. It's one less thing to stress me out and thus I can be more carefree in my conversations and visits with Mom.

I decided not to make an issue out of the missing denture because Mom was due for a new one anyway. I believe the loss is their fault, their staff should be more aware of things like that but it's an understandable mistake. The denture was wrapped in tissue and Mom probably didn't tell the aide what it was when she said, "please put this away...". The aid was likely more concerned about safely getting mom to bed or to the toilet since it happened while Mom had upset stomach, a cold and diarrhea.

Old people often need dentures every few years even though they don't get them. Without teeth the bones that make up our gums gets smaller so there is nothing there to hold the dentures in place - thus the need for all those commercials for denture goo, pads and gels - "adhesives" is the proper term I guess. Mom refuses to use them. She might not have a choice after this next appointment.

Mom's latest dilemmas - three illnesses at once and lost teeth

2010-02-15T16:47:00.000-08:00

Talk about bad days, Mom's had a whopper yesterday . She sounded bad on the phone and bravely said, "I feel a bit better than I sound, and I'm on the mend."   Long story short, she has a urinary track infection, a cold and diarrhea. To top things off, she's lost her bottom denture.   These infections leave her weak so she requires assistance to get in and out of bed and to and from the toilet. She hates being so dependent on someone else. Though she's weak, her spirit sound strong. I'm relieved about that anyway.

Lost dentures are pretty common in nursing homes. Residents take them from each other. If someone's tired they just take them out and put them down, leaving them in weird places. In Mom's case, she was trying to be polite. Her lower gum hurt so she took them out, politely put them in a tissue and handed them to an aide. She asked the aide to "put these away for me..." - they most likely ended up in the trash. She didn't want to hand some ugly teeth full of spit so she put them in a tissue. I called the nursing desk today, a Monday, and they were unware of the missing teeth. It's been 7 hours and they still can't find them. So now the question - who pays for the replacement teeth?   Honestly, I don't care - it's really a minor thing to fuss over when I'm more worried about these infections. She needed a new bottom plate anyway so this just means it happens sooner than later.

I'll work with them to ensure she gets "soft" foods until she's able to get to a dentist for replacements. I'll also try to talk with Mom even more to make her feel better, to understand that we'll deal with the new denture as soon as possible and let her know she's loved.   It's about all we can do for now.

Moving a parent to your state could cost A LOT!!

2010-02-15T16:20:00.000-08:00

Before moving your elderly parent to your state be very careful about finances. If your parent requires financial assistance from the state for medical expenses or long term care, you might NOT be able to move them. Assistance programs like this are intended for STATE RESIDENTS, not transplants from other locations. Your parent might have to establish residency in the state BEFORE they are eligible to get any assistance. Each state has different residency requirements so check those out thoroughly before moving your elder.

The best advice I can offer is to move your parent close to you BEFORE they might need the assistance - long before. If you don't do this, you might have to pay their expenses or have them live in your home until they establish residency and qualify for assistance.

When Mom forgets you called, don't take it personally

2010-02-10T21:04:00.000-08:00

Mom is forgetting that I call her and I must tell myself over and over not to take it personally. She's been at the nursing home for a week now and I've talked with her at least four times but she doesn't seem to remember. I get the same questions: "How did you know I was here? ......How did you get the phone number so quickly?......Who sent me here, the doctor? .... How long will I be here?" I just answer and don't tell her that we discussed it the day before or that we've discussed it three times before.

Intellectually, I know I should not take this personally but it's my MOM and it's hurtful that she doesn't remember talking with me. It also concerns me very much since I worry that her memory will only get worse. I think she's not remembered our talks for some months now but I didn't want to admit it to myself. She would seem pleasantly surprised when she heard my voice on the phone and each conversation would be just the same. For a while I told myself it's because she didn't have much to talk about but the hard truth is that she doesn't remember.

She DOES remember visits. My cousin saw her last week and brought flowers, she's told me about it each time we talk. I'll just have to get there so she remembers seeing me. That should make both of us feel better. I remember my Mom's reaction when her own mother failed to recognize her. Grandma thought my Mom was her sister, Alvina. She asked about the kids and who was caring for them. The "kids" were my Mom and her brother. Grandma thought she was hospitalized after surgery and looked forward to returning home to her husband and kids. My Mom was hurt that her own mother didn't recognize her but took heart that she was eager to return to her home, her kids, her daughter. Now I have to do the same and realize that Mom is happy when I call even though it's bitter sweet for me.

Epilepsy in the elderly, subtle symptoms hard to spot

2010-02-08T09:54:00.000-08:00

My Mom has epilepsy and this complicates her care. She is fortunate that her epilepsy has been easily controlled with one type of medication; others are not so fortunate.   In the big scheme of things Mom has had few grand mal seizures but when she does it's a doozy. Her blood pressure shoots way up and the risk of stroke is huge. She didn't always have epilepsy; her condition is the result of brain damage after a stroke during childbirth at age 42.   Her grand mal seizures present the same symptoms she had during the stroke: terrible headache, vomiting, left side numbness followed by paralysis and finally unconsciousness. As she ages we have two main concerns; one is a regular schedule of medication to maintain an adequate level of dilantin in her blood stream and, secondly, we want to ensure that she's closely monitored for changes in her seizure process.

I use the word "process" because it seems that her seizures have always followed the same pattern. If we ( my dad, brother or myself ) could intervene early enough in the process, we could prevent the seizure. She might still have a headache, some "wavering" in her voice, some disorientation but no grand mal seizure. We generally gave her another pill, perhaps something sweet to eat, a drink of water, some TLC and rest. She would most often be just fine. Now that Mom's cared for my others, there is a chance they won't recognize the subtle signs of an oncoming seizure. If her seizures become less violent and more frequent, we want to know that someone is aware of the change.   At home, we quickly noticed Mom's slight disorientation, her failure to respond quickly to questions or discussion, the dazed look in her eyes. All of these now seem like typical "old age" to someone unacquainted with Mom. She also realizes something is wrong and would tell us early that she didn't "feel right". My great fear is that her request will be attributed to a "lonely old lady" and she'll be ignored.

On a few occassions in the past 5 years I've noticed more subtle seizures. Mom would look dazed and bob her head up and down yet still be able to hear and talk. When asked a question she would try to focus her vision on me but could not; she just seemed "out of it" and her grip on her left hand would be very week. I'd try to get her to eat something sweet, have a drink of water and a rest.   Usually after 40-60 minutes of sleep she'd wake up and not remember our discussion or that she had a snack.    The frustrating part about this change in her seizure activity is that we can't easily make care givers aware of these symptoms unless we are there as it happens. There's also high turnover in aides and some times nurses, so we have to repeat this over and over.   Lucky for Mom, I'm tenacious. I will tell them over and over. I ignore the eye rolling, the smart ass remarks and tell them, how serious this is for Mom. It's a matter of life or death for her so I expect them to do their best. I don't expect miracles but I do expect them to respond to her requests and her symptoms.

Move from ALF complicated even with lots of calls...

2010-02-08T09:18:00.000-08:00

Moving Mom into assisted living took a lot of work, I don't know why I expected her moving out to be less stressful.   All-in-all, it went fine but I still had a few frustrating moments.   Given that I had to coordinate things from a distance, things went pretty well.   People WANT to be helpful in situations like this and, since it's a small town and I know people, no one tried to take advantage.

My sister in law was really good about going to Mom's apartment for clothes, shoes and a few personal items that Mom would need immediately. She also packed up a few precious things like photo albums, pictures and an antique quilt and put them in storage at Mom's. All of us, Mom especially, would feel bad if these were not well cared for. I contacted a moving company to pack up the simple furniture, appliances and other belongings. They had it packed in an hour and spent another hour loading up and storing it in the garage at Mom's house. It was easy enough, until the ALF called about a table left in the apartment.

The table became a bone of contention; the ALF Executive Director called to tell me the movers left it. The movers said the Marketing Director told them it was ALF property. The Marketing Director told me my brothers said it was ALF property. My brothers told me the ALF maintenance man said it was ALF property...   That's 5 calls already all over a cheapie table! I probably spent more in long-distance calls than I did on the table.    Long story short, I told the ALF Director that I had receipts for it and that someone would get it; she ended up having their van driver take it to Moms - another advantage of a small town -it was not far nor time consuming to do this.    But! the frustration it caused was maddening - people don't like to be given in accurate information and everyone felt bad over one piece of furniture.

I think things like this could be avoided if the ALF had better move-in and move-out procedures.    They are very eager to promise a lot of help and organization before move-in but their follow through seems lame. It's not because they are bad people, it's simply because they have too many residents and not enough staff.   Looking back, I would keep a detailed inventory of everything moved into Mom's apartment, anything I added over time and anything broken or removed and WHO removed it. (As I write this I'm wondering about pictures on the walls, towels - anything I purchased that my family didn't know about; they might have told the ALF it's not Mom's because they didn't know or didn't recognize it.) I would provide a copy of this inventory to the ALF for Mom's file, to family members and to the movers. I'd also try to keep it updated when family members bring items or take things home. This is an easy way to ensure that all of Mom's belongings don't get left and the ALF staff doesn't get blamed for something outside their control.

Mom's settled in nursing home but still wondering...

2010-02-05T08:14:00.000-08:00

Mom moved into a nursing home Monday afternoon and shows some improvement each day.   I've called her daily and with each conversation she sounds perkier. She is happier with the food, her table mates and the proximity of people in the hallway. She misses her recliner, can't quite figure out the telephone and hates the view of a broken down wooden fence but overall seems content. She's gone to physical therapy a couple of times and is very appreciative of their support to get her to the bathroom more often.

She arrived at the nursing home with a urinary tract infection so has to go often and hates to ask for their help.   Urinary tract infections seem to be common among the elderly - both my in laws had them often.   Such infections can be hard on an older body because it weakens the patient making it harder to manage other conditions like blood pressure. I wonder which happened first the seizure or the urinary tract infection? She is responding to treatment so I'm hopeful that she'll continue to feel better. She had a catheter for 3 days during her hospital stay so I wonder if the UI resulted from that or eased her pain and suffering? I'm not there so I can't ask these questions - which I HATE but must deal with it. I can only trust that she is getting the good care she deserves. My brother, sister-in-law and niece ( a nursing student) seem confident so I trust them as well. I'm facing my inner control freak and have to let it go.

In each conversation she says "I don't know how long I'll be here or where I'll go after therapy." As she improves I hope she has no desire to return to assisted living because it will be up to me to tell her no. Upon learning she'd go to a "rehab center" (code for nursing home) she was upset and mad but realized it was necessary. If it becomes an on-going question, I plan to blame it on her doctor. It's not a lie; he says "absolutely NOT, she stays put."   We've moved her things from her apartment to her garage and told the ALF that she will stay at the nursing home.   I hope I'm not repeating my reply several months from now but I suspect I will. It frustrates me to tell her the same things over and over, I'm not ashamed to admit that. But - a frustrated me is better than an upset mom so I'll learn to deal with my frustration and try VERY VERY hard not to let that show to her.    As long as I can be loving and supportive WITH her, I figure I can be frustrated in private later.

One event changes everything... Mom must move again.

2010-01-29T19:12:00.000-08:00

Since yesterday things have changed and I'm not sure it's for the better. The change means that we must admit Mom's even slower, that she's declining and there's nothing we can do about it. She's improved since her seizure but is still not 100% and arrangements are in place to move her to a nursing home on Monday morning. We - the family - did not have to make the call to move her. Her physician told her he wants more nursing supervision of her care and she can't get it in assisted living. He insists she move to a nursing home. She accepted this coming from him; it's doctors orders so she will comply. It doesn't mean she will understand tomorrow and that she will want to comply next week or any week after.

So now we worry about the physical and the emotional. Mom's dilantin levels were way too low so they must figure out why such a dramatic drop occurred when she's been taking meds regularily. Physically Mom's better but not 100%; she still has numbness in her left arm and leg. Some physical therapy will help get her moving again. We've also got to deal with the details of a move - canceling the phone and paper; moving her clothes to her nursing home and her furniture and belongings from the apartment to the garage at her home. Luckily, I have a classmate who manages a moving company and he can squeeze it in on Tuesday.

As for her emotional state, we are concerned and will be concerned for a few weeks until she's settled in. My niece talked with the doctor about depression and anxiety so he will try some anti-anxiety meds in conjunction with her dilantin. My brothers, neice and sister-in-law will see her daily while she's hospitalized and once she's moved. I am making plans for a return visit to check on her and see that she has everything she needs. I believe an old friend of hers is also at this nursing home so I'll ensure they are connected and can visit back and forth regularily.

While I'm feeling really stressed and have had a headache since the first call, I am feeling really grateful to my family. They've all stepped up to help Mom; she's been their priority and they've given up sleep, work and school to be with her. They've been good about communicating with each other and with me. My brothers - both over 65 - were ready to step in to quickly move mom's stuff from the ALF apartment. I appreciate their willingness to work but want to spare their energies so that they can visit Mom so I called in the movers who can have it done in a couple of hours. So - together we're helping her; from near and far, we're getting things done. I may not feel good about what's happening with my Mom but I do feel good that we're all coming together to help and support her.

That call we dred - something's wrong with Mom and I can't get there...

2010-01-28T16:06:00.000-08:00

My brother called this afternoon and I knew it was probably something bad.   He doesn't call unless there's something wrong or he has an important question.   Long story short, Mom was on her way to the hospital and he was going with her. He and my niece, his daughter, had been at the ALF with Mom for a few hours and they decided to take her to the hospital. I'm waiting now for him to call me after he speaks with the doctor.

Things began this morning when they got a call that Mom didn't feel well and she wanted him or his daughter to come stay with her.   Mom was feeling really anxious; we're always concerned about this because it means she's prone to a grand mal seizure. The ALF gave mom another of her anti-seizure meds but it progressed to numbness on her left side anyway. Mom didn't experience shaking or loose consciousness but she also didn't improve so after an hour they called an ambulance and away she went.

I am worried about Mom but know that my brothers and their family will do all they can for her. Her physician warned me that her epilepsy would change as she aged so other hospitalizations are expected but that does not make it easy to get this call. I WANT to be there. I want to help comfort my Mom but I'm on vacation on the other side of the country. I just can't get there easily and I'm worried and feeling bad.   If I hear that there's something else wrong, that it's not a seizure that will pass, then I'll get on the next available plane.   I can't be worried about the cost or the timing, I'll just GET THERE.

Too much OJ leads to crisis and hospitalization

2010-01-27T08:21:00.000-08:00

A friends father recently had a health scare due to OJ - yes, orange juice, that healthly bright beverage that Florida citrus growers push into trees and onto grocery shelves.   The problem comes when the OJ is fortified with vitamins and minerals - it can be too much for a body to handle, especially an elderly body that already contains medications and supplements.

Here's what happened: My friends father, age 84, had heart surgery about three months ago and, after a three of weeks in a rehab facility, was well enough to be home alone. He was warned about eating right and getting enough vegetables so he thought some fruit or vegetable juice would be good for him; he'd get fluids and the benefit of the fruit (fiber, vitamins, minerals, etc.). He drank one 16 to 20 ounce glass of OJ a day.   After 5 weeks he had trouble breathing, was retaining fluid and his potassium levels were sky high.   His orange juice of choice was fortified with calcium, multiple vitamins and minerals plus added sugar, preservatives and flavors. With his existing prescriptions and supplements more than a few ounces of this OJ was the LAST thing he should have. Eating the oranges would be fine with the natural benefits.

After more than 5 days in the hospital, he was fine and back to normal. To help him understand what and how to eat better, his daughter in law requested a meeting with a dietician to identify drug-food interactions and what might be helpful or beneficial for him.   The lesson learned are:

when it comes to supplements - in food or in pill form, we really need to be mindful of interactions
after surgery and before your loved one goes home, ask to speak with a dietician about drug interactions, special foods to avoid or add to a diet, be there when they talk with your loved one and try to get the doctor to join in too
Ask the dietician to WRITE IT ALL DOWN - this might be hard but tell them ahead of the appointment that your elder needs written instructions, copy these and send a copy to their regular physician
Create a food and prescription schedule for your loved one. This doesn't have to be a minute by minute play by play of their day and you can include a variety of things they can or should have for each meal.
Help your loved one shop and, if they select "banned" things, remind them of the interaction and possible consequences; if possible, get them to put it back.

Little gizmo helps Mom hear better on the phone

2010-01-20T23:09:00.000-08:00

Mom's got some hearing loss and it seems to get worse all the time. She has a hearing aid but using it on the telephone causes distortions that bother her. Talking with family and friends on the phone is a major source of support and entertainment for her so I've been really concerned when I know she can't hear me talking to her. I end up yelling into the phone yet she still can't seem to hear me. I want to talk WITH her not just listen to her ramble; knowing what's going on with us helps keep her in the loop and she enjoys it.

Before I go out and buy a volume controlled phone - the best start at $100 - I thought I'd try an in-line amplifier first. Mom complained of echos and static on the phone so I hoped this would fix that and it did. I spoke with her for more than 20 minutes and only had to yell once! It was a huge relief. I still need to get a phone with volume control on the handset or receiver but this will help reduce distortion on the line and boost the volume for Mom too.

I found the following product at walmart.com. I usually don't like to shop Walmart but they had it for the best price and I could have it sent directly to Mom's apartment. I should add that it takes a couple of AAA batteries but the first ones are included with the amplifier. I also liked that she could adjust the volume on the unit.

Clarity CE-125 High Frequency Portable Telephone Amplifier, US$14.82.

Please note that I am not receiving any sort of compensation for listing this product on my blog. I have not been given any products or samples by the manufacturer or distributor. I've posted it simply because it is a useful tool for my mom.

Pop wants to get hitched? Shacking up is easier!

2010-01-19T16:57:00.000-08:00

I spoke with a flabbergasted friend last week and I've debated whether or not to blog about it.   My need to point out the variety of scenarios and possibilities for our elders and offer some practical advice won out.... so here it is:

My friends widowed father, age 82, wants to marry a woman he met through his church.   I encouraged her to support him. Provided his finances are in order; his needs will be met without monetary penalty and with an iron clad Power of Attorney for medical care.   It's a good situation for both of them, they are of similar ethnic heritage so they like the same foods, have the same memories of growing up in the US with immigrant parents - it's all similar history. They want to move in to an apartment in an assisted living center in the town where each raised their kids, went to church, have doctors and mutual friends.   Another important factor - both are comfortable financially and don't have any dependents that need to inherit their money. They've also downsized and both have few "heirlooms" to argue over. It's just a great situation and each will be happy. I've heard other, far less happy scenarios (and, you know you're going to hear about it now...)

My sister in law suffered a great deal of hurt after her grand father remarried and died soon after.
"Grandpa" was actually the second husband of Grandma; he'd been married before but had no children. He married Grandma when the daughter was a young woman. He was a good husband and when a step-grand daughter came along, he wished to be called "Grandpa".    Grandma and Grandpa each brought their own houses, furniture, funds and mementoes into the marriage. Among the four of them, they had an understanding that all of the things each (Grandma and Grandpa) brought to the marriage would go to their respective family should anything happen. Some years later Grandma passed away suddenly. Grandpa was lonely afterward and step-daughter didn't want to take anything from the home for fear of upsetting him. Just three months passed and one day Daughter got a call from Grandpa's neighbor - he was married! Daughter went to investigate and learned that it was true, Grandpa married a woman he met at his "club" and she had already moved into the house. Daughter wanted to gather some of her mothers things only to see that many had been tossed out and the new wife refused to let her take antique furniture, photos of her family - nothing. This began a very contentious and mean spirited exchange of visits, calls and even a couple of calls to police! In the end, the Daughter and Grand Daughter got nothing and it was crushing for them. They wanted the mementos from their mom, grand father and great grand parents that were with the step-grandpa. After the shock of loosing Grandma, they left things to help him feel a sense of continuity and family and now his lonely heart was more important. He died a few months later - no will, nothing written down and the "new" wife got it all - Grandma's house, Grandma's furniture, dishes, even the doilies. Legally, there was nothing the Daughter or Grand Daughter could do. Grandma died with no will so everything went to Grandpa. When Grandpa died with no will it all went to his spouse.

Now if Grand Pa had just shacked up with the new woman, they would have legal recourse. ... That is what I would propose to an elder if they wished to share their life with some one rather than be all alone.   There are all kinds of things to consider when elders marry:

In most states a spouse can be forced to provide some kind of support for necessities - no matter how long the marriage.
The legal act of marriage can also tie up funds if a spouse incurs debt after saying "i do". Debt, funds and property acquired before the marriage are not likely to be considered community property but it all depends on the state.
Should one spouse need state assistance, the state can put a lien on a home even though s/he only spent a short time there and didn't contribute to the upkeep - it all depends on state law.
Widows pensions might also stop if a woman is remarried, to retain income, stay single!
The contents of a house are generally considered the property of the home owner unless it's a high dollar item like artwork, jewelry.
Elders should give away heirlooms SOON or specifically call out distribution in a will. Even if the remaining spouse remarries, the original heirs will have a legal standing to obtain things if it's written down.

I've also seen wonderful examples where families are co-operative, where grandma or grandpa WANTS to downsize and passes along heirlooms to be enjoyed while they are alive. It seems that the painful examples are those we remember most. I am by no means an attorney or legal expert but I do know that isolation ane loneliness are strong motivators. If you love your elder, help them to feel less lonely, encourage them to be honest. If they want to share their lives, help them do it in a way that feels best for them and maintains relationships with their kids and grand kids. Also try to form a friendship with the new "significant other"; they probably need some love and support too.

Medicaide letter confuses but ALF clears it all up...

2010-01-19T16:07:00.000-08:00

We received a letter from Medicaide that said Mom's aid level was about $390 a month. It's good news that they processed it so quickly but I still have questions.   The letter arrived at my mothers house where my brother lives so he read it to me.   He's not very patient so I didn't ask him to read it over and must trust him when he says "it's a short letter and there's no other discussion or facts."

Luckily, the director of Mom's ALF called this morning to tell me about the information they received from Medicaide. She was very clear about the details, and long story short: Adding Mom's income and Medicaide, she will be $1125 short each month for her rent. Since we paid her rent for January, that total amount is considered a credit with the ALF. We'll divide that balance by two and use it to pay for January and February. Come March, Mom will have to share a room.   Her room is already very small so they will try to move her to a larger room. I expressed concern about mean or aggressive roommates and she assured me they will work with us to find someone who mom will enjoy. I am also concerned that the room will be too crowded. Nearly all of the residents have walkers, so with two beds, two walkers or wheel chairs and a couple of rockers or recliners and the room will be chock full!   I HATE that she has to share a room but she complains about lack of company so perhaps it will be good for her.

Now more work for me - getting things set up on direct deposit for pension checks, payment of rent and payment of pharmacy bills.   Ugh!

Mom's regrets influence me now

2010-01-12T11:00:00.000-08:00

For the past several years Mom has expressed regrets about things in her life. Each time we're together for more than a couple of hours she comes around to talking about them. She's told me so often that I can almost quote, word for word, what she'll say about each instance. Th regrets aren't about physical things she didn't have, not about places she didn't visit nor things she didn't do for herself. Her regrets are about things she did not do for others. Her regrets are about the people in her circle of friends and family that she could not or did not help.

She regrets her parents divorce even though she was an adult; she knows how lonely each was in their elderly years. She regrets not pushing grandmas doctor to treat arthritis pain in grandmas back. She regrets that she didn't do more for a sister-in-law with chronic and painful migraines. She regrets that my cousin could not have moved in with them. She wishes she'd done more for her grandchildren, nieces and nephews.... and on and on....

To understand why she didn't act, you have to understand a bit about my Mom. Unless she gets really mad, she is not a confrontational person and she tries to be very polite. At the time these events were going on, she felt it was rude, nosy or outside of her comfort zone to question, to comment or to act. She left things alone - and that's often her biggest regret because she saw events take an emotional and physical tole on people around her. She regrets not acting to ease their discomfort or pain. She regrets not saying or doing things to make people around her feel loved and supported.

It's a difficult situation for me to understand because I saw her do so much for others. I try to live "up" to her good example with family and friends. I don't understand why she's so hard on herself so I tell her just that. I begin each response to each regret with "You're too hard on yourself; you did what you could at the time." Now that we've made hard decisions about Mom and her care - now that I am primarily the one making the decisions and telling her about them - I hear my husband and family repeating the same things to me and to each other. While I regret that I don't see her more often; I regret that she's not in her own home; I regret that she's no longer agile and strong - I won't regret moving her some place where she's safe and where the helpers treat her with affection and respect. And, I'll learn from her regrets to show love and support when I can.

Additional information requested by Medicaide

2010-01-10T14:39:00.000-08:00

Two weeks ago I submitted a Medicaide application for Mom to her state Department of Health and Welfare. Last week, Wednesday to be exact, I got a call from a lady reviewing her information. She needs MORE information from me. I expected this request but didn't know exactly what she'd need. Long story short, she needs information that specifically identifies Mom's expenses for medical insurance and prescriptions. This is necessary so the state can very specifically determine how much of Mom's money will go to her basic needs, her assisted living facility, her medical insurance and her prescriptions. Then the state will determine exactly how much they will contribute toward her room and board at the ALF. This leaves me really stressed about two things:

First: We need to get a signature on a form, called an "Intent to Return Home". My brother and I are really worried over getting her signature on this form. We fear that she'll believe it means that she can go home then we'll have to tell her all over again, why she can't.

Second: I worry that the state will pay so very little that the ALF will require her to share a room. I worry that she'll get a disruptive and mean roommate. I've heard awful stories from friends and acquaintances about room mates stealing money, clothing, pooping in beds, locking themselves in share bathrooms and the like. Yikes!!! All I can do is pray for the best and try to make plans to reduce her stress if she gets a room mate.

Why is this "Intent to Return Home" form necessary? Because, without it, the state might force the immediate sale of her home to pay for her care. If my brother didn't need a place to live, if the market were better and we'd get more money for it, we'd gladly do support her. But! the reality is that my brother, with his own health issues and need for low-cost housing, needs to live at her home. She would also be heartbroken to know that her home is sold; she would loose all hope. We are letting her live in a state of denial. It keeps her happy and supports her sense of well being. The state WILL recoup the money they spend on Mom by forcing us to sell it upon her death. The state will place liens on it each year for the amount paid on Mom's behalf and collect when it sells. I have no problem with this arrangement; it means we will probably get nothing from her estate but that's okay. She should pay her way and this way she will. This gives us a means to ensure my brother has a home andshe feels good that "home" is there just in case she may return and the state gets it's money.

The "Medicaide Lady" also asked for a print out of her pharmacy expenses for the past quarter, October 1 through December 31; a copy of her Medicare Card and copy of her last pension check stub. This seems like a pain because I provided her with a list of these expenses and an average of her prescription costs based on what the pharmacy has been charging to my credit card. But, she needs evidence and she's in charge so we comply. I understand why and it's really in Mom's best interest, she wants to ensure there are no extra prescription fees, no extra premiums for Medicare Part D and the like. So - I have a couple of things with me and my brother will gather some of the documentation and we'll send it in. The next hurdle will be a visit from a nurse to gauge Mom's need for assisted living and nursing care.

\

A simple pole helps Mom be more independent.

2010-01-07T11:37:00.000-08:00

NOTE: This was originally posted with title that's a bit cheeky (it referred to "pole dan cin') but I got all kinds of nasty automated comments advertising porn sites so I changed the title and reposted. It really erks me that I'm trying to do something beneficial and those rotten bastards mess it up.

Mom's ALF installed a great new device for her. It means that she can be more independent and I have something to tease her about. They put in a "pole" next to her chair. The center of it has a rubberized "sleeve" that gives her something to grip as she rises from her chair. She still has good arm strength so can pull herself up to her feet, then she takes a small step or two and, still hanging on, pivots into her wheelchair. It means she's able to get herself into and out of her wheel chair without help. She feels better since she doesn't have to call for help as often and I worry less about her falling.

The pole itself works like a giant tension rod between the floor and ceiling. There is a flared sort of stand on the floor and a larger piece at the top where the pole meets the ceiling.

Here's a photo of the "stand" where the pole meets the floor. It's relatively flat and not wide so Mom won't trip over it: (The news paper looks pretty messy but it's mom's favorite past time )

Here's the top of the pole, where it meets the ceiling:

I tried to find some brand name on the pole but could not. There is a label about a distributors name but it's in the United Kingdom. If anyone is interested in finding one of these for their home, I'd suggest asking a physical therapist or a pharmacy that also sells wheelchairs shower chairs, handholds for the bathroom and other "safety" products. I'll try to find out more from the ALF and will share it here as I can.

Finally!! Mom had a good day!

2010-01-03T22:39:00.000-08:00

This evening I finally heard the attitude in Mom that I've been praying for. Mom told me that she had a good day and that she enjoyed the young people that worked at the ALF! Today, for the first time in 7 months, I left her room without feeling guilty. I will leave town after a weeks' visit without feeling guilty. I know she'll still have some bad days and bad moods but for now I am so VERY, VERY relieved. It's an enormous weight off my mind.

Her good day started with good conversation. Her tablemate's son visited during breakfast and they had quite a talk about the railroad and the men - my uncles - who worked there. She also had some fun with the other women in her dining room; they schemed about practical jokes that they could play on other residents and the aides. It's refreshing that her spirited side can still come through.

Mom seemed to sense that I needed to hear something positive from her. She's missed having people go in and out of her home; it's been a long time since lively young people ran in and out. She enjoyed the aides that came in to plop down on her bed for a few minutes to take a breather and check on her. She likes that they feel comfortable enough to stretch out on her bed or sit for a coffee or soda with her. I'm liking that she's feeling at home and so comfortable with the other residents and staff.

The medicaide application is IN! Now we wait....

2009-12-30T18:06:00.000-08:00

I submitted an application for Medicaide (State of Idaho assistance) on Mom's behalf today.   This means we've exhausted her existing cash resources and we are asking the state to contribute to her rent/care at the assisted living center.    Before compiling all the relevant paperwork I tried for four months to get some information from the State of Idaho about a couple of things but I got know where. We have an odd situation concerning Mom's property - which I'll save for another post - so I wanted to understand what the state would do. Starting 4 months ago, I began emailing, calling and contacting friends who work for the Idaho Dept of Health and Welfare. I got little information other than a standard reply, "we must consult our manuals and get back to you". Well, I heard nothing until I bugged just the right person and got a number for a "customer service center". They readily found someone who could actually answer my questions. I called them three times to see if I'd get a consistent answer. I did so figured it was safe to submit the application.

I'm not trying to "game" the system but I needed to understand how the State would approach some jointly held property and just what evidence the state wants to see regarding taxes and assessed values. I felt pretty good after submitting an 1 inch thick packet of material, that is until I spoke with the Director at her ALF. My mood quickly soured. She told me some not-so-good stories about applications getting lost, delayed more than 60 days and in general, made me concerned. I kept copies of everything so I can resubmit the materials if necessary but I'm just worried about paying for her care until Medicaide kicks in. We worked out a plan to use Mom's Social Security and pension plus some funds from me for the time being but I can't contribute much for long.   So - I'm left waiting again. At least I have a short-term plan until we know more.

I must admit to having qualms about being so open that Mom's applied for state assistance. On one hand, she's proud and I'm proud; I hate to admit that she's broke. On the other hand, she's never taken a dime from anyone else and my parents worked hard to provide for themselves, their parents, their kids and other extended family.   Often they went without and lived simply. They never let anyone go without food, shelter and the basics even when it meant they didn't save a thing. In her old age, she's paying for that "take care of your own" attitude.   What's worse, to let many go without years earlier or have one person accept some help now?

This is by no means a free ride. The state will ensure that she contributes all she can (social security and pension) and will permit her to keep $90 a month for her personal needs. She's spent just about that much on hair appointments and minor things each month. It's not a lot so I'll have to supplement for things like clothes, shoes, treats or soda pop. I'm happy to do that for her; it's relatively little money and if it makes her happy then it's worth it.    Her sacrifice years ago meant that I and our family had what we needed so now we can give up some to ensure she's comfortable.

Reverse mortgage - approach with CAUTION!!!

2009-12-29T22:14:00.000-08:00

A friend recently helped her mother get a reverse mortgage on her home. Though I'd hear of them, I didn't know the specifics until she shared some details with me. Some company offers to give you money for "ownership" of the home. The home owner gets to live in the home for as long as they wish - but I believe there's a 10 year maximum on this one - and when they move or pass away, the bank sells the house to recover the amount. It all sounds terrific until she told me about the $11,000 in fees and that her mom was still responsible for upkeep and property taxes. I suppose the fees are no different than a standard mortage one would take out to buy a house. By the time you add realtor fees, "points" and a down payment, it could be more than $11,000. BUT to take it for something like this; from elderly people who need the money, just seems mean and WRONG.

I have another concern about this situation. I learned later that my friend's mom used $40,000 of the $100,000 she received for cosmetic "fixes" to the house. This really disturbs me because the only one to really benefit from the beautification is the bank; they'll reap the added equity and the elder won't. She will be more comfortable with her surroundings and will worry less about what the neighbors think. Some of the $40,000 went for "real" repairs to keep it safer and cleaner which is readily understandable. If it were my mom, I'd try to be very cautious and to maintain as much of the original principle as possible. The remaining $60,000 or so will only pay for 2 to 2.5 years in a quality assisted living center and much less in a nursing home. That $40,000 might be greatly missed later.

Worry, worry, worry....hot flashes and indigestion, you'd think I have teenagers

2009-12-29T08:13:00.000-08:00

For the third night in a row, I woke up about 4am and just could not return to sleep. My mind races. I wake up with all sorts of worries on my mind; here are a few

paying for Mom's needs/comfort as her funds run low and I have no job
paying off the debt I've incurred for Mom's comfort over the past 6 months
how she'll get in/out of her room now that she's wheel chair bound
upkeep of her little old house and yard now that it's temporarily occupied by my brother
property taxes for her house

I've always considered myself a worry-wort but until now I was able to handle it. I tackled stressful things by DOING something - I'd make a plan to fix the matter or I'd make something to take my mind off it. Those approaches just aren't working this time because there is little that I can do for Mom other than BE there. Being there is difficult because I've established my life in a different location. Jobs in the region where she lives are scarce . I worry most about paying for everything but the bigger concern for me is keeping my MOM from worry. I don't want her to go without the basics, especially things like new socks, undies, warm slippers or hair cuts. I want her to always have her favorite cookies on hand because it's a simple indulgence that will enhance her quality of life and make her feel at home.

Getting all worked up at my age means two things - hot flashes and / or indigestion. So far the hot flashes pass quickly but the indigestion lingers and fails to respond to anything like tums, milk or water. I've remember my Dad going through the same thing. I'd wake up in the night and hear tinkling glasses in the kitchen; he was after milk or tums to kill his heartburn. He'd lay awake at night and fret over work issues, adult kids and their kids, things he had to fix around our home or his parents or in-laws. Friends tell me their worries about (and FOR) their teenagers and young adult kids - paying for college, helping with first cars, recovering from illnesses or surgery. It's all part of being human I guess... we want good things for those we love; being unable to help them get it is painful. I feel the need for the old prayer:

Lord, grant me the ability to change the things I can,

the strength to endure the things I can't

and the wisdom to know the difference.

My parents quoted this often in various forms. Dad worried in silence and told the rest of us NOT to worry. Mom worried out loud and worked at fixing things but she always slept well and never needed tums. I am trying to follow her example but my nature is more like my Dad. I'd better stock up on the Tums...

Names on bank accounts - approach with care

2009-12-25T13:58:00.000-08:00

A few years ago my Mom added my name to her bank accounts. I didn't give it a second thought until tax time when I got statements for earned interest. She didn't make enough to pay taxes but I did. I had to report it as income on my tax returns!

That impact on me is relatively minor but it made me think - the risk to my Mom is much greater. She ADDED me as a secondary owner of her checking and savings accounts. This means if I were to file bankruptcy, I'd probably have to list half of the value as MY asset. I wonder if creditors could go after half of HER money to pay my debts? What if I were elderly and needed to apply for medicaide - would they make her use half of her funds for my medical expenses?

I've not asked her attorney about it because it was a relatively small amount and it will be consumed for her rent at the ALF soon enough. However, if my financial situation were less stable I'd be quite concerned.

1st Christmas in assisted living is ho hum...

2009-12-25T13:53:00.000-08:00

Mom's first Christmas Eve in assisted living was bitter sweet. She was full of "bah humbug" attitude when we went to pick her up. Even a couple of days before Christmas she was excited for the season. She had some goodies and wanted to share them with hot coffee and good company.   We did that on the 23rd. On the 24th the bright mood she had faded into the blues. As I helped her get dressed she complained about everything - she's sick of the Christmas tree and decorations; the aides ate her little candy canes too fast and didn't leave any for her; the food at lunch was too tough to cut and she's sick and tired of their under cooked rolls. She didn't want to go in the wheel chair, she's embarrassed to use it; she could walk if it weren't for "that thing". She wanted her fancy black shoes (forgetting that her feet are too swollen to fit any longer); her hair was mess....etc, etc, etc.   There was nothing to say that would lighten her attitude so we didn't try. We bundled her up and got her in the car.

At my brothers house my husband and nephew sat her ON the walker and hoisted her up the 3 steps. (She weighs about 90 lbs now so lifting her isn't bad.) Once inside a hug and "hi gamma" from her great grand daughter (age 2 1/2) lifted her spirits.   We took turns sitting with her and talking. We got her a plate of hot food, soda, pie and gave her lots of hugs and kisses. We opened gifts and made fun of each other. She was like a different person and enjoyed herself.   On the drive back to her ALF, she got a little weepy and returned to her theme - "If I were home, I'd be fine. People would come over and I'd enjoy the holidays again."   Over the past two months she's said this more and more. There is nothing we can say to make her agree that she can't be home. It takes a fall or something else like that to make her say - but only once or twice - that she feels safer the ALF.   We don't push it with her and perhaps that's the best gift we can give her - to NOT argue with her.

We never tell her she's forgetful; we never tell her she's weak. We DO tell her that her house and bathroom aren't safe for her any longer. We ensure that she's as comfortable as possible, we take her out, we go for drives, we visit. We tell her she's loved and we make her part of things. It's hard to do without getting upset ourselves.   We don't want to see Mom unhappy, feeling isolated or abandoned but at this point in her life, there is very little we can do to make her happy. Even if she were home she'd complain about the same things - she DID complain about the same things and we all felt guilty because we couldn't do anymore. The fact that she's living in the ALF just makes us feel even more guilt. Leaving her there room is still very difficult but we also feel some relief knowing that she has help 24-7. I think we need to work on giving ourselves the gift of REASON and realize that we DO a lot for her. We try as best we can and that's enough. We saw our Mom do the same thing for her parents and in-laws. We know she felt guilty then and that the woman she was during that period WOULD NOT want us to feel guilty now. It's a gift we must realize and accept from her but it's a hard gift to take to heart.