Tag Archive | elderly

Field trip!

Happy to report that Mom was feeling quite chipper when I visited yesterday morning. We took a “field trip” to a local park with a large man-made lake, where she enjoyed the fresh air, the relaxing scenery, and the many varieties of birds. I pushed her wheelchair on the paved path all the way around the lake, which was good exercise for me. lol And a little challenging when we came to this rustic wooden bridge…

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… but we bumped our way across without incident, though I was grateful that her chair comes equipped with a seatbelt.

I had wanted to get a photo of Mom feeding the ducks, but she wasn’t keen on the idea… and then it turned out that the ducks weren’t keen on the grapes I’d brought to feed them either.

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Except for the mallard in the center, these are actually coots, which aren’t ducks at all.

 

There are SO many birds living around this lake! We saw two kinds of herons, a red-tailed hawk, swans, several breeds of geese and ducks, seagulls, and dozens of the coots.

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The swans were Mom’s favorites

 

Halfway around the lake, we stopped (for me) to rest and sat for a while enjoying the sunshine. The air was full of birdsong, and I counted at least seven different songs in addition to the ever present quacking and honking of the water fowl.
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Though she was ready for a nap by the time I got her home, Mom enjoyed our field trip a lot. As we move into a season of warmer (but not yet hot) weather, I’m hoping I’ll have more opportunities to take her on outings like this. It was good for us both.

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She gave me a scare

I called to check on Mom this afternoon. The phone was answered by the caregiver who speaks only broken English, so instead of asking for an update, I just asked to speak to Mom. I heard her saying “It’s Lira” and then Mom mumbling “What do I do?” After a longish pause, she said hello. It sounded like she had a mouth full of marbles.

I asked her how she was doing and she mumbled something. What was that? “Tired!” she repeated, loudly. I asked if she had been sleeping and there was a long pause again, then she said no. I asked her if she wasn’t feeling well and she answered, “No, I’m not. I’ve been sick all week. Will you come and take me out of this place?” She sounded quite distressed, so I replied (as calmly as I could, considering the adrenalin that was now coursing through my veins) that I would be there in about half an hour. “Good!” she said firmly. I asked if Maria (the head caregiver) was there, and she replied “No, nobody’s here. It’s just me.” I repeated that I would be there soon and we hung up.

I had started to make myself lunch, but I put everything back in the fridge and grabbed a protein shake instead. I texted the owner of the care home, asking why no one had called to tell me that my mom is sick, and then I started gathering up what I would need for a trip to Urgent Care or the ER — Mom’s folder of health info, my phone charger, water bottle, etc. The owner texted me back to say that she had been at the facility all morning and Mom was fine, that she had been napping when I called and that’s why she seemed disoriented. It was a relief to hear that, but I headed over anyway to see for myself.

Sure enough, I arrived to find her sitting in her recliner with her favorite blanket over her legs, drinking coffee and eating a donut. I kissed her on the forehead and asked how she was feeling. “As well as can be expected at my age,” she answered cheerfully. She seemed tired but otherwise perfectly fine, and she had no memory of talking to me 20 minutes earlier.

Damn, Mom, don’t scare me like that!

 

 

Easter Monday Update

We made it to church for the Easter Sunday service, though Mom complained in the car that she “hurt all over” and was still so weak that I had difficulty getting her out of the car on my own. This was our first service back in the newly remodeled church sanctuary, and I was so grateful to see that they shortened one of the pews near the access ramp to make space for wheelchairs. I don’t think she could have managed transferring into a pew and back out to her chair.

It was good to be back in the church with everyone, and Mom especially enjoyed the choir… and all the people who stopped by her chair to shake her hand or give her a hug around the shoulders and wish her Happy Easter.

On Friday I picked up some urinary tract infection test strips at the drugstore and gave them to her caregivers. This morning they were finally able to get a good urine sample to test (it’s tricky with full incontinence), and the test confirmed what I’d suspected, She has a UTI. I called her primary care doctor, who called in a prescription for antibiotics, which she is starting this evening. I’m hopeful that she’ll be back to her old self again in a few days.

 

Easter 2018

Happy Easter from three generations of strong women!

 

If it’s not one thing…

Friday was one of those days. Mom had her first session with the physical therapist, and it did not go well. He had her lying on her back on the bed doing leg stretches and she was having trouble breathing, and he got snippy with me because I “undermined his authority” by responding to her needs without clearing it with him first. Even with the oxygen cannula in, her sats didn’t get above 91 and she was laboring so hard to breathe that he cut the session short and let her go back to sitting in her recliner.

I was so relieved that she already had an appointment with the cardiologist that afternoon because I felt sure it was a CHF (congestive heart failure) episode. But the cardiology PA who treats her didn’t hear any congestion in her lungs or heart. They had the results of Monday’s labs sent over and noted that she’s almost dangerously anemic, which might explain the difficulty getting enough oxygen even when the fluid build-up is gone. Since we are seeing the kidney specialist next Monday, and this is something he’s been tracking, cardiology PA left it for him to determine the best course of treatment. I took Mom home and she almost immediately fell asleep in her recliner.

Worn out from a stressful day, at 9:00 p.m. I got into my pajamas, poured a glass of wine and settled in for a West Wing marathon on Netflix. At 9:30, I got a call from the owner of the board and care: Mom had a nosebleed that thet couldn’t stop and they were taking her to the ER. I met them there shortly before 10:00, and it was a LONG night. They got her into triage very fast, considering the unusually large number of people in the waiting room, and had a quick temporary fix to stop the bleeding.

Mom nosebleed ER picBut then, as you can see in the photo, they sent us back out to the waiting room. Where we waited… and waited… and waited. It was cold in that room and Mom was thankful for the cozy flannel pajamas, though she was a little embarrassed about being out in public without her dentures in.  And though she complained that the clamp on her nose was uncomfortable, I would have been thankful to have one myself when a young woman sitting across from us suddenly vomited.

It was three hours from the time we were checked in until Mom saw a doctor. He removed a massive blood clot from her nose and thought that would solve the problem, but the bleeding started up again. The culprit, a broken blood vessel, was too high up in her nose for the doctor to see or cauterize, so they had to insert a balloon catheter in her nose to stop the bleeding — a last resort because it’s “uncomfortable” (the doctor’s word). Mom cried out in pain when it was inserted and kept exclaiming that she couldn’t stand it because it hurt so much.  It was 3:00 a.m. by the time this happened, and 3:30 by the time we were leaving the ER. The owner of the care home and her husband had waited with us the whole time, and they drove Mom home once she was discharged. I got in my car and immediately began to sob from exhaustion and helplessness at not being able to ease her pain.

I got about five hours of sleep before I got another call from the care home telling me that Mom had pulled the balloon halfway out during the night. I drank a big mug of strong coffee, threw some clothes on, and headed over there. The balloon catheter was supposed to be left in place until Monday, when we had been directed to see an ENT doctor to remove it. I called the ENT office and left a message for the on-call doctor, who called me back quite promptly and said that we could leave it as is unless it started bleeding again. Thankfully, that did not happen. And the balloon didn’t hurt when it was only half inserted, so Mom was much more comfortable for the duration of the weekend than she would have been otherwise.

All’s well that ends well, I guess.

It happens…

We saw the neurologist today. When Mom was in the SNF and would complain about feeling “quivery inside,” when her hands shook as she tried to hold a glass of water, when she couldn’t keep from bouncing her feet constantly… I kept thinking, “It’s OK, Dr. O will help her with this.”

Dr. O spent all of five minutes with us, and when I described Mom’s complaint about feeling quivery inside, she merely nodded and said “It happens.” The medication Mom was taking at bedtime before for restless legs made her too sleepy (so it was difficult to get her out of bed before 10:00 or 11:00 a.m.), and we agreed not to put her back on that unless the restless legs become intolerable. We are going to try increasing her dosage of Sinemet to see if that helps the tremors — but Dr. O said the caregivers will have to watch her closely because if the increased dose is too high for her body, the tremors will get worse instead of better. So grateful she lives in this small board and care home with attentive staff who WILL notice any changes. Otherwise I’d be back to camping out with her almost 24/7.

I was a little disappointed by the lack of attention we got from Dr. O, but I guess it’s a good sign that she wasn’t too worried about any of what we reported. And Mom was happy to get home. Short trips in the car still wear her out, and she dozed off in her recliner almost as soon as we got her in it. I kissed her forehead and headed out…

… And five minutes later I was ringing the door bell again, after having phoned AAA because my car wouldn’t start. Turned out to be a dead battery, and one hour and $126 later I was back on the road. So thankful it didn’t happen until AFTER I got Mom home! It’s warm and muggy today, and I can’t imagine making Mom sit in the car (or in her wheelchair in a parking lot) for an hour. Much better that I got to spend most of that hour sitting by her side in air conditioned comfort.

(Sh)it happens… But it could always be worse. And we get through it, together.

A Day of Appointments

This morning Mom had the first of several follow-up doctor’s appointments, this one with her primary care physician, Dr. G. It was my first time taking her out with the transfer wheelchair and oxygen tank, and what an adventure we had!

When I loaded the portable oxygen tank into the backseat of my car and attached the tube, I noticed that the tank was reading about 1/4 full. In hindsight, I should have asked right then for the spare tank — but not being familiar with oxygen, I naively thought that it would last the two hours until we got back. By the time we got to the doctor’s office (25 minutes later), the meter on the tank was in the red zone and Mom was complaining that her chest felt tight. At about the same time, I discovered that I’d left Mom’s purse (with the handicapped parking placard) back at the board & care. Cue panic. Well, not quite panic, but anxiety tinged with intense frustration. I couldn’t figure out how to get the foot rests back onto the wheelchair (don’t ask me why the caregiver removed them in the first place) and a nice man was patiently holding the office door for us, so we went on without them and Mom just had to hold her feet up. We got inside, I checked her in at the front desk (and asked them to please not let my car get towed because I forgot her placard), and then I texted the owner of the board and care to ask if she could possibly drop off the second oxygen tank.

When the nurse brought us into the back, she tested Mom’s oxygen level and it was 88. Not too bad yet, but they want it to stay above 90 and I was glad that the full tank was on its way. When the caregiver arrived with the new tank, the front office manager was kind enough to show me how to change it, so that next time I can just bring a spare and change it myself if needed. The doctor went over the discharge paperwork from the hospital and SNF, reviewed her medications, and listened to her heart and lungs. He said he didn’t hear any congestion in the lungs, which is a relief. Mom got her flu shot and some blood drawn for labs, and we headed home. Pulling the oxygen tank while pushing a wheelchair is tricky, but again a kind stranger stepped up to hold the door for us.

I dropped Mom off at home and sped to my yoga studio, arriving just in time for Yin Yoga with my favorite instructor. And I don’t know when I’ve needed a yoga class more! I was SO tense from the morning’s stressors, but it melted away over the course of an hour doing gentle stretches and heart opening postures. I walked back to my car with a smile on my face and a spring in my step. But by now it was 2:15 pm and I was starving, so I grabbed a chicken salad to go from a nearby Trader Joe’s and ate it in the car while I drove back to Mom’s place — because the day wasn’t over yet.

Mom had her physical therapy evaluation, and it went well. Steve, the therapist, looks at his clients holistically with the goal of improving their full function as much as possible. He took her medical history from me, getting a complete picture of her living situation and level of function before she went into the hospital, and he made some recommendations. He wants her to only use the walker with four wheels and the seat, rather than using the two-wheel kind around the house, because he says that’s making her more dependant on the walker than she should need to be. The four-wheel style moves more smoothly and she can’t lean on it the way she does the other one, so she’s doing the work of walking and just using the walker for balance.  OK, we’re all on board with that. And he wants me to buy her New Balance athletic shoes to give her ankles more stability. OK, I can do that.

The third recommendation is going to be trickier to implement, but it’s probably the most important one. She has been spending way too much time in bed, and both Steve the Physical Therapist and Dr. G said that this will make her more susceptible to fluid building up in the lungs. Especially while she’s recovering, Steve emphasized that she should never spend more than 9 hours in bed at night and should be out of bed and sitting up (not reclining) as much as possible during the day. I checked in with Maria, the head caregiver, when he left. They’ve been putting Mom to bed at 7:30 or 8:00 pm, and she’s been getting up around 7:00 or 7:30 am — so we’re looking at up to 12 hours in bed each night. She’s simply not going to get up before 7:00 (frankly, it’s a small miracle that she’s been getting up before 9:00), which means they’re going to need to keep her out of bed later in the evening. And this is a problem because the live-in caregivers aren’t “off the clock” until all the residents are in bed, and they have to wake up around 5:30 am to start their care day, so they WANT to get everybody in bed early. I got Maria to agree not to put Mom to bed before 9:00, but I’m not even sure how long that will last. And if she sleeps until 7:30, that’ll still be over 10 hours in bed. But I don’t know what the answer is.

The PT will be back on Friday morning to start working with her. We see the neurologist on Thursday and the cardiologist on Friday afternoon. It’s only Tuesday and I already need a weekend! I don’t know how the hell I’d be managing this if I was still working full-time, and I’m really feeling the timing of this layoff as a blessing right now.

No Dignity

So, it turned out that winning the appeal only bought her two extra days at the SNF. She’ll be discharged on Saturday. I was all set to appeal again, but what I found when I stopped by after work yesterday changed my mind.

It was dinner time, but she was lying in bed in a borrowed t-shirt, no pants and a soiled diaper. There was feces on the bed sheet. I went running for a nurse, who sent a CNA to take care of it. He (the CNA) also went to the laundry to find her pajamas, returning with the set that I bought her for Christmas. The pants were soiled and I said “Oh, these are still dirty.” He told me no, they’d been washed – it’s a stain. They were in perfect condition when my niece brought them over there a few days ago. Sigh. Though they quickly got her cleaned up when I asked, I wondered how long she would have been left there in a soiled undergarment if I hadn’t come to visit.

Tonight I got there about 5:45, a bit later than usual because I had a chiropractor appointment for the pain I’ve been having in my left shoulder and down my arm. She was lying in bed with the dinner tray untouched on her table. When I asked if she wanted to sit up to eat, she tried to move and winced with pain – telling me her private area was so sore that it hurts to move. Again, I ran to the nursing station. It was the same male CNA as last night who came, and he told me she’s been having diarrhea since yesterday and she says it burns, and it’s clearly aggravating the rash on her backside and between her legs. I asked if they were doing anything to treat the diarrhea, but he didn’t know. Her adult diaper was, again, soiled. The CNA got her cleaned up and put some ointment on the rash — and watching her wince with pain and grab the bed rails while he applied the ointment made me feel as if I was standing by and watching her be tortured.

I asked the nurse on duty for her section if they could give her something for the diarrhea that the CNA reported has been happening since yesterday. She said she would have to talk to the doctor tomorrow, but in the meantime she would hold the stool softeners. Yep, you read that right — she’s been having liquid bowel movements for over 24 hours and they were STILL giving her stool softeners! Y’all should admire my restraint that I simply agreed that this sounded like a good idea and didn’t lose my temper.

Thankfully Mom did feel enough better with the ointment that she was able to sit up and eat a little bit of her dinner, and the CNA was nice enough to take her plate away and rewarm it — since by then it had been sitting out for over an hour. When I left she was cheerfully finishing the last few bites of her banana pudding (the only part of the meal she finished) and looking at the book of word search puzzles I brought for her.  But I will be so, SO glad to get her home on Saturday to a place where she gets the personal attention and care she needs…. and, more importantly, a place where they truly CARE and manage that care in a way that still affords her some dignity.