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

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?

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

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.

No calls = a lot of guilt!

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.

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

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!!

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

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 adjusting better at nursing home than assisted living

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?

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

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!!!

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

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

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.

Mom's better and new teeth are in the works

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

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.

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

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.