Shoes and clothes actually MADE for mom!!

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

Financial assistance for caregivers hard to come by...

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? 

Excess Vitamin D poisoning especially concerning for diabetics

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

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....

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

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.

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

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

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

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.

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

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.

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.

Too much OJ leads to crisis and hospitalization

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

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.

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

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

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.

A simple pole helps Mom be more independent.

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!

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....

I submitted an application for Medicaide (State 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.

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

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...