Saturday, June 3, 2006
I still don't know why that emergency room story...
...discussed in the immediately previous post, was on my mind last night. It remains so today. I have, though, been doing some more thinking about it and want to post some afterthoughts.
This experience causes me to consider that dementia, at least those states in which long term memories become present reality, needs to be considered when working with or treating the demented. Those of us whose brains work "normally" are quick and agreeably oriented enough to, for instance, immediately register the difference between a gynecological exam and what might be the memory of a past, abusive sexual encounter. We don't need coaching to suppress a distressing memory in order to cooperate with an unrelated but potentially evocative procedure.
Interestingly, the same night as the previously posted experience my mother had a demented (yes, she had developed vascular dementia previous to the transfusion experience) flashback (questionable, though, whether it was a genuine or created memory) that I had to negotiate before she would allow herself to be tranfused. You can read about it in this paragraph, if you care to.
I'm not sure how successful a heightened sensitivity to demented creativity within the present moment would have been with the woman discussed in the previous post. I remember that my maternal grandmother had never had a pap smear, thus, I assume, never had any gynecological testing or treatment, until she was screened for admittance to the nursing home wherein she spent the last months of her life. By the time the nursing home became necessary, though, she was so far into her particular dementia (probably Alzheimer's but we'll never be sure) that she spent most of her time in a fetal position and was inarguably dead to the world. Although I can't be sure, I doubt that she was even capable of being aware enough of any present moment to connect it to a past incident. Speculating from this, my guess is that it is not uncommon for many Ancient women alive today to not have experienced any gynecological exams until a full medical work-up becomes necessary in one of "today's" medical facilities. My mother has had plenty of gynecological exams from middle age on but this is because she has been under the auspicies of military medicine, for which preventative testing is a hallmark.
At any rate, dementia can obviously be a tricky road to negotiate when having to medically treat the demented one. The treaters can never be sure from where the demented one's responses are generating. One of the aspects of dementia that renders it especially tricky is that simple calming techniques aren't necessarily going to work. I think it might be advisable for studies and observations to be made in order to determine how to work with the demented perception even when the contents of the perceptions aren't clear.
Regarding my mother's present, yesterday was a strange day for her, thus for me. Her body seems to be a bit stressed and I can't yet determine the cause. We'll be going in for both a CBC and a BMP on Wednesday. I'm especially curious about her renal results. I'm wondering if her kidneys have progressed in their failure to the point where we're entering a new phase. I've considered, on a daily basis, administering furosemide again over the last few days because I'm wondering if she's retaining torso fluid, although her feet and legs remain fine and I can't determine, from the appearance of her belly and face, whether she needs it. I'm being especially careful because furosemide is particularly apt to knock the wind out of her when she's not feeling well. Her thirst has been tricky so, overall, it's fair to say that she is, again, "running a bit dry", but I've been pushing fluids in food as well as cups and she seems to be doing okay. Her allergies are bothering her, lately, which is no surprise. She did some hacking yesterday but, again, it was impossible to tell whether this was caused by torso fluid retention or sinus drainage. She hasn't been gasping for breath, though, or indulging in lots of mouth breathing. Her spirits have been middling, she's been slightly weaker than usual and she's been insisting on lots more sleep than usual, too, over the last few days; thus, she's been a bit hazy when awake and definitely not interested in movement. I've been allowing this, even though I have to fight myself to do it. I'm not yet considering doctors, per the advice in Sick to Death and my own instincts. Unless her blood tests tell me she's building up to a crisis, I think we'll sit this one out at home. I'm hoping she's just going through a cyclical slowdown and will rev up or, at least, plateau soon. One step forward, two steps back time, I guess.
I haven't gotten around to updating The Dailies yet for yesterday. I'll probably do that later. As well, I need to start compiling a two month report for her doctor for the occasion of next week's blood draw (I didn't send a report last month...just wasn't into it and everything was more than fine, anyway, which would have been obvious to the doctor from the test results). I also plan to experiment with a different template for this journal...not too much different, just some changes that keep the archives from diconnected floating on short post pages. As well, I've decided to fast today and possibly tomorrow and detox myself with a variety of cleansing teas. I just feel like my body could use a good flushing.
Later.
This experience causes me to consider that dementia, at least those states in which long term memories become present reality, needs to be considered when working with or treating the demented. Those of us whose brains work "normally" are quick and agreeably oriented enough to, for instance, immediately register the difference between a gynecological exam and what might be the memory of a past, abusive sexual encounter. We don't need coaching to suppress a distressing memory in order to cooperate with an unrelated but potentially evocative procedure.
Interestingly, the same night as the previously posted experience my mother had a demented (yes, she had developed vascular dementia previous to the transfusion experience) flashback (questionable, though, whether it was a genuine or created memory) that I had to negotiate before she would allow herself to be tranfused. You can read about it in this paragraph, if you care to.
I'm not sure how successful a heightened sensitivity to demented creativity within the present moment would have been with the woman discussed in the previous post. I remember that my maternal grandmother had never had a pap smear, thus, I assume, never had any gynecological testing or treatment, until she was screened for admittance to the nursing home wherein she spent the last months of her life. By the time the nursing home became necessary, though, she was so far into her particular dementia (probably Alzheimer's but we'll never be sure) that she spent most of her time in a fetal position and was inarguably dead to the world. Although I can't be sure, I doubt that she was even capable of being aware enough of any present moment to connect it to a past incident. Speculating from this, my guess is that it is not uncommon for many Ancient women alive today to not have experienced any gynecological exams until a full medical work-up becomes necessary in one of "today's" medical facilities. My mother has had plenty of gynecological exams from middle age on but this is because she has been under the auspicies of military medicine, for which preventative testing is a hallmark.
At any rate, dementia can obviously be a tricky road to negotiate when having to medically treat the demented one. The treaters can never be sure from where the demented one's responses are generating. One of the aspects of dementia that renders it especially tricky is that simple calming techniques aren't necessarily going to work. I think it might be advisable for studies and observations to be made in order to determine how to work with the demented perception even when the contents of the perceptions aren't clear.
Regarding my mother's present, yesterday was a strange day for her, thus for me. Her body seems to be a bit stressed and I can't yet determine the cause. We'll be going in for both a CBC and a BMP on Wednesday. I'm especially curious about her renal results. I'm wondering if her kidneys have progressed in their failure to the point where we're entering a new phase. I've considered, on a daily basis, administering furosemide again over the last few days because I'm wondering if she's retaining torso fluid, although her feet and legs remain fine and I can't determine, from the appearance of her belly and face, whether she needs it. I'm being especially careful because furosemide is particularly apt to knock the wind out of her when she's not feeling well. Her thirst has been tricky so, overall, it's fair to say that she is, again, "running a bit dry", but I've been pushing fluids in food as well as cups and she seems to be doing okay. Her allergies are bothering her, lately, which is no surprise. She did some hacking yesterday but, again, it was impossible to tell whether this was caused by torso fluid retention or sinus drainage. She hasn't been gasping for breath, though, or indulging in lots of mouth breathing. Her spirits have been middling, she's been slightly weaker than usual and she's been insisting on lots more sleep than usual, too, over the last few days; thus, she's been a bit hazy when awake and definitely not interested in movement. I've been allowing this, even though I have to fight myself to do it. I'm not yet considering doctors, per the advice in Sick to Death and my own instincts. Unless her blood tests tell me she's building up to a crisis, I think we'll sit this one out at home. I'm hoping she's just going through a cyclical slowdown and will rev up or, at least, plateau soon. One step forward, two steps back time, I guess.
I haven't gotten around to updating The Dailies yet for yesterday. I'll probably do that later. As well, I need to start compiling a two month report for her doctor for the occasion of next week's blood draw (I didn't send a report last month...just wasn't into it and everything was more than fine, anyway, which would have been obvious to the doctor from the test results). I also plan to experiment with a different template for this journal...not too much different, just some changes that keep the archives from diconnected floating on short post pages. As well, I've decided to fast today and possibly tomorrow and detox myself with a variety of cleansing teas. I just feel like my body could use a good flushing.
Later.
This evening...make that this morning...I am haunted by a peculiar memory.
In June of 2004, when my mother was visiting the hospital because her hemoglobin was dangerously low and it was believed she needed a blood transfusion (which she did and she received), we spent hours in the Emergency Room before she was admitted. Her transfusion began in the ER, in fact.
Occupying the partition next to us (and clearly heard) were two Ancient women, one of whom had brought in the other. The Delivery Ancient was alert and literate, although, not having been present at the onset of her companion's health crisis, was limited to descriptions of observed symptomatic behavior rather than descriptions of what happened. It seemed clear to my mother (she was as attentive to the play unfolding next to us as was I) and me, though, that the woman who needed treatment was also suffering from dementia, probably aggravated by this health crisis.
Although I'm not sure why, the Delivery Ancient was not able to stay with the one physically distressed. Both women homed at an assisted living facility, although the name was never mentioned. All we heard was that there would be a gap in attendance demarcated by the Delivery Ancient's departure and the arrival of someone in a medical supervisory capacity from the facility.
Within minutes after the Delivery Ancient left a decision was made to perform a procedure on the woman 'suffering' (as, that's what it sounded like, although not necessarily and only the fault of the medical staff) that apparently involved a gynecological exam. The attending male staffer (probably an RN) was attempting to prepare the patient for the procedure. The patient, whose health crisis and dementia were now compounded by having been abandoned in an emergency room without a familiar advocate, immediately and loudly began resisting the ministrations of the staffer. Her resistance was so startling Mom and I stared at each other: The woman seemed to mistake the RN for someone who was attempting to rape her. She was yelling such things as: "Don't touch me there! No one is supposed to touch me there! My mother told me not to let anyone touch me there!" These cries were punctuated by vocalizations very much like those exhibited by Sally Field when she one of Sybil's multiple personalities who misunderstood a benign sexual approach from Brad Davis' character and thought she was about to be sexually abused.
It was excrutiating for my mother and me to listen to this woman's tangle of fear and memory turn what needed to be a healing experience into a theater of fright. At first, it sounded like the RN was stunned and at sea. He tried to talk sense to this woman, who was clearly senseless. Then he sharpened his voice and tried to order her into cooperating with the procedure. I doubt she understood anything he said but his voice raised her levels of fear and fight (yes, "fight", not "fright"). She resisted all the more. Finally, the RN, without apology but also without personal investment in the procedure or the patient, ordered that the woman be strapped to the gurney.
It sounded like the assistants were strapping down a wild animal. My mother and I both winced.
The assistants became frantic. The RN lost control of the atmosphere. All of them decided to abandon the woman and seek a doctor's opinion before continuing. They left a frail, vulnerable woman alone in complete confusion to try to sob and wail herself into some sense of her situation. My mother was wheeled out soon after for some kind of test, I don't remember what. I followed. When we returned, the woman, and the pandemonium, were gone.
After my mother and I returned to the emergency room we talked about what might have been going on in that woman's mind and what past experiences and acquired wisdom had informed her interpretation and reaction. We continued our consideration of the incident throughout the next few days while my mother remained in the hospital for observation.
Coincidentally, a day or so later I was at a video store with a friend taking a break from protecting my mother in the hospital while she napped. As I milled about surveying the stock, I overheard a woman much older than I, perhaps the same age as the woman in distress in the emergency room, asking about the video version of Sybil. The woman insisted that she wanted "the theater version", not "the television version," the one, she elaborated, "with Sally Field and Joanne Woodward." Because I had recently been reminded of the movie and still had it on my mind, I stepped up to correct and inform both the customer and the clerk in the store. I proceeded matter-of-factly and thought the customer would appreciate the information. I even delivered it with a tone meant to reassure the woman that whatever "version" (there is actually only one) of the movie the store had, if it involved Field and Woodward it would be the version she wanted. For some reason, this information inflamed the woman to attempt an irrational argument with me. I was too alarmed to engage. I stepped back into the aisles to locate my friend.
Then, the day after my mother returned home from the hospital, we were channel surfing and noticed that Sybil was airing on a cable channel, truly unusual since it's not one of those perennial repeats. We glanced at each other, eyebrows raised in amused surprise, and spent the evening watching the movie, then talking about what each of us remembered from reading the book.
I don't know why I've been fixated on these series of related incidents tonight but they've been on my mind so hard and so long this evening that I decided to mention and describe them.
Not unexpectedly, I suppose, I suddenly have a desire to see Sybil, again.
Occupying the partition next to us (and clearly heard) were two Ancient women, one of whom had brought in the other. The Delivery Ancient was alert and literate, although, not having been present at the onset of her companion's health crisis, was limited to descriptions of observed symptomatic behavior rather than descriptions of what happened. It seemed clear to my mother (she was as attentive to the play unfolding next to us as was I) and me, though, that the woman who needed treatment was also suffering from dementia, probably aggravated by this health crisis.
Although I'm not sure why, the Delivery Ancient was not able to stay with the one physically distressed. Both women homed at an assisted living facility, although the name was never mentioned. All we heard was that there would be a gap in attendance demarcated by the Delivery Ancient's departure and the arrival of someone in a medical supervisory capacity from the facility.
Within minutes after the Delivery Ancient left a decision was made to perform a procedure on the woman 'suffering' (as, that's what it sounded like, although not necessarily and only the fault of the medical staff) that apparently involved a gynecological exam. The attending male staffer (probably an RN) was attempting to prepare the patient for the procedure. The patient, whose health crisis and dementia were now compounded by having been abandoned in an emergency room without a familiar advocate, immediately and loudly began resisting the ministrations of the staffer. Her resistance was so startling Mom and I stared at each other: The woman seemed to mistake the RN for someone who was attempting to rape her. She was yelling such things as: "Don't touch me there! No one is supposed to touch me there! My mother told me not to let anyone touch me there!" These cries were punctuated by vocalizations very much like those exhibited by Sally Field when she one of Sybil's multiple personalities who misunderstood a benign sexual approach from Brad Davis' character and thought she was about to be sexually abused.
It was excrutiating for my mother and me to listen to this woman's tangle of fear and memory turn what needed to be a healing experience into a theater of fright. At first, it sounded like the RN was stunned and at sea. He tried to talk sense to this woman, who was clearly senseless. Then he sharpened his voice and tried to order her into cooperating with the procedure. I doubt she understood anything he said but his voice raised her levels of fear and fight (yes, "fight", not "fright"). She resisted all the more. Finally, the RN, without apology but also without personal investment in the procedure or the patient, ordered that the woman be strapped to the gurney.
It sounded like the assistants were strapping down a wild animal. My mother and I both winced.
The assistants became frantic. The RN lost control of the atmosphere. All of them decided to abandon the woman and seek a doctor's opinion before continuing. They left a frail, vulnerable woman alone in complete confusion to try to sob and wail herself into some sense of her situation. My mother was wheeled out soon after for some kind of test, I don't remember what. I followed. When we returned, the woman, and the pandemonium, were gone.
After my mother and I returned to the emergency room we talked about what might have been going on in that woman's mind and what past experiences and acquired wisdom had informed her interpretation and reaction. We continued our consideration of the incident throughout the next few days while my mother remained in the hospital for observation.
Coincidentally, a day or so later I was at a video store with a friend taking a break from protecting my mother in the hospital while she napped. As I milled about surveying the stock, I overheard a woman much older than I, perhaps the same age as the woman in distress in the emergency room, asking about the video version of Sybil. The woman insisted that she wanted "the theater version", not "the television version," the one, she elaborated, "with Sally Field and Joanne Woodward." Because I had recently been reminded of the movie and still had it on my mind, I stepped up to correct and inform both the customer and the clerk in the store. I proceeded matter-of-factly and thought the customer would appreciate the information. I even delivered it with a tone meant to reassure the woman that whatever "version" (there is actually only one) of the movie the store had, if it involved Field and Woodward it would be the version she wanted. For some reason, this information inflamed the woman to attempt an irrational argument with me. I was too alarmed to engage. I stepped back into the aisles to locate my friend.
Then, the day after my mother returned home from the hospital, we were channel surfing and noticed that Sybil was airing on a cable channel, truly unusual since it's not one of those perennial repeats. We glanced at each other, eyebrows raised in amused surprise, and spent the evening watching the movie, then talking about what each of us remembered from reading the book.
I don't know why I've been fixated on these series of related incidents tonight but they've been on my mind so hard and so long this evening that I decided to mention and describe them.
Not unexpectedly, I suppose, I suddenly have a desire to see Sybil, again.
Friday, June 2, 2006
I just published...
...another essay, a little diatribe I scribbled as a draft maybe a week and a half ago when I was in the mire. I didn't publish it at the time because I figured once I'd pulled myself up and out I wouldn't feel what I wrote.
I reread it today and decided, well, I do feel better, definitely, and I also feel the essay is self-justified. It's one of those "bad patch" essays that might be hard for some to read, but it's what this caregiver found herself thinking when overwhelmed. And, I believe, it has merit.
I notice it's showing up on this page's links section. It may not show up on some of the other pages for awhile, as this journal is so large that when I attempt to publish the entire contents in order to change the template globally (which is where the links section exists) I often encounter publishing glitches before the template is able to modify all its "countries".
Later.
I reread it today and decided, well, I do feel better, definitely, and I also feel the essay is self-justified. It's one of those "bad patch" essays that might be hard for some to read, but it's what this caregiver found herself thinking when overwhelmed. And, I believe, it has merit.
I notice it's showing up on this page's links section. It may not show up on some of the other pages for awhile, as this journal is so large that when I attempt to publish the entire contents in order to change the template globally (which is where the links section exists) I often encounter publishing glitches before the template is able to modify all its "countries".
Later.
I switched my archives back to "weekly",
regrettably. It seems that the indexing targets in those sections already published as weekly (which includes all but the last archive) are extremely hard to access when a robust archive is confused with a change of layout.
Later.
Later.
Thursday, June 1, 2006
Just a note to inform you...
...that I've changed the Archives from weekly to monthly. I was looking up some past stuff last night and realized that not only is that long list unwieldly but I was much more successful at remembering the month and year of a particular issue than the week. I'll be changing the archives at other areas to monthly, as well.
My motivation and fair day spirits are returning, with one exception. The Adult Day Care Program I mentioned in the last post? I still have to confront dealing with two bureaucracies on that one: The VA (for funding purposes), which is going to be a bitch, seeing as how the freeze is still on, and her doctor's office. She needs a "complete" physical to qualify for placement and I devised a way to do this based on my word and records, since the office is day trip away. I actually don't think there'll be a problem, but I checked on the progress of having the faxed form signatured twice and, wouldn't you know it, as of my last call yesterday the office seems to have lost the form. I faxed it again. We'll see what happens. As a sidebar, the staff member to whom I talked was "surprised" that she needed proof of a physical in order to participate in Adult Day Care.
It took me awhile to find this place, obviously. None of the others I've visited knew about this one, although my understanding is that the one I visited in a neighboring town over a year ago and rejected is now allied with this one. There aren't very many elders attending this Center, which is nice. Individual attention per client is more than satisfactory. The program is full of activity, Mom really enjoyed herself, the "complimentary lunch" that was served was both tasty and nutritious and contained no cheap, starchy fillers. The cost is $50/half day, $60/per day. A "day" is from 0900 - 1600; a "half day" from 0900 through lunch. Most of the "clients" attend for half a day and most of the up-and-at-'em activities take place from 0900 until 1400. Each day includes a current events period, some sort of inside activity (the day we visited it was what I would call floor bowling), a "Sittercise" session to music which is very active, a crafts session, a gardening session...and there are a variety of other activities going on in case someone decides they want to sit out group activity. The day we visited one gentleman spent the entire time working on a jigsaw puzzle.
The Center has a large screen television but movies and old shows are shown only after lunch, during the "After Hours Club", which involves a fair amount of sitting-up napping. The clients ranged in age from newly old to very old; their abilities ranged from very facile to barely facile. Interaction with one another and the staff is encouraged. Extra help (for instance, my mother will require such in managing her oxygen and her walker; luckily there is plenty of enthusiastic, watchful staff on hand) costs extra.
I'm seeking funding (Vets are eligible for a sliding scale co-pay, based on income) because I'd like her to be able to attend more than once a week. Even at once a week, half day, over a month we'd be pushing it. I have absolutely no intention of putting us in the same financial straits we were in when we owned the mobile home in Mesa and, beyond once a week, we'd be right back where we were floundering.
When I initially visited the Center and picked up pamphlets and brochures, I noticed the main selling point was directed at caregivers: Consider this a way to get a few hours "respite" a few times a week. Yeah, right. Frankly, a few hours here and there isn't "respite" for me, anymore. More than likely, I'll be using the time to do errands that I normally do while she's sleeping or napping. "Respite", for me, would be an entire carefree week in which I don't feel the necessity to check up on the quality of care my mother's receiving. When Mom and I went for our scheduled "tour and complimentary lunch" (during which Mom enthusiastically participated in all the activities going on during our visit) I carried a side-arm of cynicism in case someone decided to try, yet again, to sell the Center to us based on the possibility of "respite" for me. Much to my surprise, unlike the brochures, the staff was much more sensitive about this issue and the subject of caregiver "respite" never came up.
I know. I need to get my butt in gear on this. I'm so tired of wrestling with bureaucracies, though, and my motivation for everything, including facing down yet another example of bureau-stupidity, has been caught in my internal garbage disposal, lately, although it seems, recently, to be regurgitating. It may seem as though I've been too easy on myself in regards to performing on my mother's behalf, lately, but, let me tell you, when you've been doing this as long as I have there is no such thing as being too easy on oneself. Every move, every perception, even when one's care recipient is slumbering, is tied to one's care recipient and being a caregiver is so automatic as to be unavoidable. It's truly miraculous when those days hit when one's caregiver self throw's up her hands and says, "Wait, I have to slow down here, I need to take a few breaths for myself for awhile."
Luckily, with or without the Center, my mother's doing fine. I'm hanging in there. I'm no longer having the "Abandoning Fantasies" in which I was indulging a couple of weeks ago; they served their purpose and I'm settled where I am, again, pretty much, anyway.
Time to peak in on The Mom. We're coming up on 12 hours since her light went out last night.
Later.
My motivation and fair day spirits are returning, with one exception. The Adult Day Care Program I mentioned in the last post? I still have to confront dealing with two bureaucracies on that one: The VA (for funding purposes), which is going to be a bitch, seeing as how the freeze is still on, and her doctor's office. She needs a "complete" physical to qualify for placement and I devised a way to do this based on my word and records, since the office is day trip away. I actually don't think there'll be a problem, but I checked on the progress of having the faxed form signatured twice and, wouldn't you know it, as of my last call yesterday the office seems to have lost the form. I faxed it again. We'll see what happens. As a sidebar, the staff member to whom I talked was "surprised" that she needed proof of a physical in order to participate in Adult Day Care.
It took me awhile to find this place, obviously. None of the others I've visited knew about this one, although my understanding is that the one I visited in a neighboring town over a year ago and rejected is now allied with this one. There aren't very many elders attending this Center, which is nice. Individual attention per client is more than satisfactory. The program is full of activity, Mom really enjoyed herself, the "complimentary lunch" that was served was both tasty and nutritious and contained no cheap, starchy fillers. The cost is $50/half day, $60/per day. A "day" is from 0900 - 1600; a "half day" from 0900 through lunch. Most of the "clients" attend for half a day and most of the up-and-at-'em activities take place from 0900 until 1400. Each day includes a current events period, some sort of inside activity (the day we visited it was what I would call floor bowling), a "Sittercise" session to music which is very active, a crafts session, a gardening session...and there are a variety of other activities going on in case someone decides they want to sit out group activity. The day we visited one gentleman spent the entire time working on a jigsaw puzzle.
The Center has a large screen television but movies and old shows are shown only after lunch, during the "After Hours Club", which involves a fair amount of sitting-up napping. The clients ranged in age from newly old to very old; their abilities ranged from very facile to barely facile. Interaction with one another and the staff is encouraged. Extra help (for instance, my mother will require such in managing her oxygen and her walker; luckily there is plenty of enthusiastic, watchful staff on hand) costs extra.
I'm seeking funding (Vets are eligible for a sliding scale co-pay, based on income) because I'd like her to be able to attend more than once a week. Even at once a week, half day, over a month we'd be pushing it. I have absolutely no intention of putting us in the same financial straits we were in when we owned the mobile home in Mesa and, beyond once a week, we'd be right back where we were floundering.
When I initially visited the Center and picked up pamphlets and brochures, I noticed the main selling point was directed at caregivers: Consider this a way to get a few hours "respite" a few times a week. Yeah, right. Frankly, a few hours here and there isn't "respite" for me, anymore. More than likely, I'll be using the time to do errands that I normally do while she's sleeping or napping. "Respite", for me, would be an entire carefree week in which I don't feel the necessity to check up on the quality of care my mother's receiving. When Mom and I went for our scheduled "tour and complimentary lunch" (during which Mom enthusiastically participated in all the activities going on during our visit) I carried a side-arm of cynicism in case someone decided to try, yet again, to sell the Center to us based on the possibility of "respite" for me. Much to my surprise, unlike the brochures, the staff was much more sensitive about this issue and the subject of caregiver "respite" never came up.
I know. I need to get my butt in gear on this. I'm so tired of wrestling with bureaucracies, though, and my motivation for everything, including facing down yet another example of bureau-stupidity, has been caught in my internal garbage disposal, lately, although it seems, recently, to be regurgitating. It may seem as though I've been too easy on myself in regards to performing on my mother's behalf, lately, but, let me tell you, when you've been doing this as long as I have there is no such thing as being too easy on oneself. Every move, every perception, even when one's care recipient is slumbering, is tied to one's care recipient and being a caregiver is so automatic as to be unavoidable. It's truly miraculous when those days hit when one's caregiver self throw's up her hands and says, "Wait, I have to slow down here, I need to take a few breaths for myself for awhile."
Luckily, with or without the Center, my mother's doing fine. I'm hanging in there. I'm no longer having the "Abandoning Fantasies" in which I was indulging a couple of weeks ago; they served their purpose and I'm settled where I am, again, pretty much, anyway.
Time to peak in on The Mom. We're coming up on 12 hours since her light went out last night.
Later.
"Do you think I'm too old to teach?"
My mother's voice was tight with dueling intent. She spat the words "too old" as though they were the the punchline of an unspeakably rude joke. These were the first words with which my mother greeted me when she awoke from her nap today.
I know better, now, than to answer questions like this directly. It's best to first seek the source. "Why do you ask?" I said.
"Every time I talk to [her dead brother] about teaching again, he tells me I'm too old."
I've been doing this long enough so that I'm practiced in proceeding briskly through the facts to the heart of the matter. "Well, let's see," I said. "[Your brother] died in 1977..."
I noticed, peripherally, that the news of her brother's death wrenched her from the Time Zone in which she'd awakened. She winced. I pretended not to notice. I didn't skip a beat.
"...At that time you hadn't yet turned 60. So, yes, he was wrong. You were not too old to teach then."
"Good. That's what I told him."
"In fact," I continued, "as I recall, you made successful enquiries, both here and in Texas, but decided not to teach because Dad wanted the two of you to travel and, besides, he was busy changing residences every two years or so."
A curtain closed over her face, then parted.
Oops, I thought, Dad's not dead yet, either. Or, well, he is now. I'll give her a moment.
Hesitantly, looking up at me as though my opinion would determine the furnishings of her world, "Do you think I'm too old to teach next year?"
"Well. That's a good question. You're 89 now..."
Astonishment. Disgust. "I am not!"
"Oh, that's right. You're still 88. Sorry. Didn't mean to age you prematurely," I joked.
"That's right! Watch that, girl!" Rakish grin. Then a frown. "I'm not 88, though."
I decided to stick to the original subject. "You know, some people teach right up into their 90's. I've heard of some college professors doing that and I vaguely remember a story on some TV news magazine about a woman in her 90's still teaching elementary school. So it would be inaccurate to say that anyone is 'too old' to teach. The question isn't one of age but whether one has retained one's skills and abilities and kept up with the teaching racket."
I expected her to come back with something along the lines of, "Well, then, that's settled. I can certainly still teach." Instead, she surprised me. "Do you think I can still teach?"
Yes or no? Fantasy or reality? Her world or The World? Which will it be today? Something about her earnestness led me to choose The World.
"You know what, Mom," my perpetual preface when I know she's in for a shock, "I'd have to say, no, I don't believe you could still teach."
No verbal response but her eyes were dancing to the tune of, "Well, why the hell not?!?"
"Your short and long term memory and your creative mentality just wouldn't work in a classroom anymore. Not to mention, the instruments are different, teaching involves computers, now, and you know how you get along with those, you'd have to take classes in Arizona History to be certified, I don't think you'd do well in those..."
She dismissed all this with a toss of her head. "Teaching's teaching. None of that matters."
"Well, yes it does, if you want to set foot in a classroom. They're not going to take your word for being a prepared teacher. You're going to have to audition before you perform. Trust me on this: You wouldn't audition well."
She was incredulous. "Well! I can catch up on what you're calling 'the instruments'. That would be no problem."
"Mom, I won't even let you breathe on a computer anymore, since you killed two. Let me give you an example of what you're up against. Let's fill out a pretend application."
"Oh, that'll be a piece of cake."
"What's today's date?"
"Let's see...nineteen..."
"We're in the two thousands, Mom."
Astonishment, again. "When did that happen?!?"
"How about the month?"
"Hmmmm...December."
"No..."
"February?"
"Wrong..."
"March?"
"No fair. You won't be able to turn an application blank into a muliple choice quiz directed at the Department of Education."
We both laughed. Interestingly, once she got the point she didn't ask what today's date really is.
"Mom," I said, gently, firmly, "it's not your age. It's your state. This is where you are, now. You've moved beyond the classroom." I recalled the short 'morality story' I'd read over a year ago in a Caregiver.com editorial featuring the editor's octagenarian uncle, who had to be coerced against his wishes into going to an Adult Day Care Center but once there discovered 'a new life' that involved lots more activity and, hallelujah, a chance to feel useful again teaching other senior citizens, he was thrilled, all his relatives were thrilled, everyone lived happily ever after, wouldn't you like your Ancient One to be a Pepper, too...and I thought, no, Mom's beyond that, too. I am hoping to have her participate a couple days a week in an excellent Adult Day Care program I've finally found, here, we reviewed and she likes but I know it's not going to be a teaching experience for her. I decided not to embelish the truth with fanciful tales of possible teaching opportunities that may still exist for her. "Mom, you may not be able to teach formally, anymore, but your life is still a teaching instrument. You loved teaching and you made your life into an opportunity to do what you love. You did it well. You loved doing it. You are a teacher in your soul. You still love teaching. You always will. And, you will never stop being a teacher. You can't, even though no one is ever again going to be willing to hire you to teach." I stopped for a minute and silently communed with her eye to eye. "Mom," shit, the tears started, "you are such a teaching fool,"...I hiccoughed a wet laugh...
...she snickered and gave me that "Oh god, you're not going to cry are you! You and your dad!" look...
..."that this will not be the last time you decide you're going to teach 'next year'. And, I will be here to remind you, when necessary, of two things: You won't ever again be teaching in a classroom but, you know what?" Now I was sobbing and my mother was patently amused at my emotional flow. "Through what I write about you and me and our life together, you will be a teacher long after you die. So, you know," sob, sob, sob, "you may not ever handle another classroom, but you'll never stop teaching either."
"Well, that's very sweet, Gail," she said. That's her way of saying, "Jesus, you don't need to work yourself up over this, I'm fine."
And, see, that's the thing. She is fine. She won't remember my sorry little explanation about how she's still teaching. The teaching she's doing through my journaling isn't the kind of teaching around which her heart revolves. She will remember, again, in a few days, a week, maybe a month, that she isn't teaching now and that she'd better get busy if she wants to teach next year, probably in Martelle.
I doubt that we'll have another confrontation like the one we had today. This is the first time she's asked if she's too old to teach. Normally, she'd be convinced beyond any doubt that, of course, she's fit to teach. And, depending on the circumstances, I'll either respond from her world or The World. But, you know, I'm glad I thought to tack on my emotional apologia today because, well, whether or not my mother realizes it, whether she ever comes to grips within herself that, classroom or not, teaching is the axis around which she organizes herself, what I said is the truth. Teaching is her past, her present, her future and her legacy. It's the language of her truth. Even in her Ancient Now. Especially now.
I know better, now, than to answer questions like this directly. It's best to first seek the source. "Why do you ask?" I said.
"Every time I talk to [her dead brother] about teaching again, he tells me I'm too old."
I've been doing this long enough so that I'm practiced in proceeding briskly through the facts to the heart of the matter. "Well, let's see," I said. "[Your brother] died in 1977..."
I noticed, peripherally, that the news of her brother's death wrenched her from the Time Zone in which she'd awakened. She winced. I pretended not to notice. I didn't skip a beat.
"...At that time you hadn't yet turned 60. So, yes, he was wrong. You were not too old to teach then."
"Good. That's what I told him."
"In fact," I continued, "as I recall, you made successful enquiries, both here and in Texas, but decided not to teach because Dad wanted the two of you to travel and, besides, he was busy changing residences every two years or so."
A curtain closed over her face, then parted.
Oops, I thought, Dad's not dead yet, either. Or, well, he is now. I'll give her a moment.
Hesitantly, looking up at me as though my opinion would determine the furnishings of her world, "Do you think I'm too old to teach next year?"
"Well. That's a good question. You're 89 now..."
Astonishment. Disgust. "I am not!"
"Oh, that's right. You're still 88. Sorry. Didn't mean to age you prematurely," I joked.
"That's right! Watch that, girl!" Rakish grin. Then a frown. "I'm not 88, though."
I decided to stick to the original subject. "You know, some people teach right up into their 90's. I've heard of some college professors doing that and I vaguely remember a story on some TV news magazine about a woman in her 90's still teaching elementary school. So it would be inaccurate to say that anyone is 'too old' to teach. The question isn't one of age but whether one has retained one's skills and abilities and kept up with the teaching racket."
I expected her to come back with something along the lines of, "Well, then, that's settled. I can certainly still teach." Instead, she surprised me. "Do you think I can still teach?"
Yes or no? Fantasy or reality? Her world or The World? Which will it be today? Something about her earnestness led me to choose The World.
"You know what, Mom," my perpetual preface when I know she's in for a shock, "I'd have to say, no, I don't believe you could still teach."
No verbal response but her eyes were dancing to the tune of, "Well, why the hell not?!?"
"Your short and long term memory and your creative mentality just wouldn't work in a classroom anymore. Not to mention, the instruments are different, teaching involves computers, now, and you know how you get along with those, you'd have to take classes in Arizona History to be certified, I don't think you'd do well in those..."
She dismissed all this with a toss of her head. "Teaching's teaching. None of that matters."
"Well, yes it does, if you want to set foot in a classroom. They're not going to take your word for being a prepared teacher. You're going to have to audition before you perform. Trust me on this: You wouldn't audition well."
She was incredulous. "Well! I can catch up on what you're calling 'the instruments'. That would be no problem."
"Mom, I won't even let you breathe on a computer anymore, since you killed two. Let me give you an example of what you're up against. Let's fill out a pretend application."
"Oh, that'll be a piece of cake."
"What's today's date?"
"Let's see...nineteen..."
"We're in the two thousands, Mom."
Astonishment, again. "When did that happen?!?"
"How about the month?"
"Hmmmm...December."
"No..."
"February?"
"Wrong..."
"March?"
"No fair. You won't be able to turn an application blank into a muliple choice quiz directed at the Department of Education."
We both laughed. Interestingly, once she got the point she didn't ask what today's date really is.
"Mom," I said, gently, firmly, "it's not your age. It's your state. This is where you are, now. You've moved beyond the classroom." I recalled the short 'morality story' I'd read over a year ago in a Caregiver.com editorial featuring the editor's octagenarian uncle, who had to be coerced against his wishes into going to an Adult Day Care Center but once there discovered 'a new life' that involved lots more activity and, hallelujah, a chance to feel useful again teaching other senior citizens, he was thrilled, all his relatives were thrilled, everyone lived happily ever after, wouldn't you like your Ancient One to be a Pepper, too...and I thought, no, Mom's beyond that, too. I am hoping to have her participate a couple days a week in an excellent Adult Day Care program I've finally found, here, we reviewed and she likes but I know it's not going to be a teaching experience for her. I decided not to embelish the truth with fanciful tales of possible teaching opportunities that may still exist for her. "Mom, you may not be able to teach formally, anymore, but your life is still a teaching instrument. You loved teaching and you made your life into an opportunity to do what you love. You did it well. You loved doing it. You are a teacher in your soul. You still love teaching. You always will. And, you will never stop being a teacher. You can't, even though no one is ever again going to be willing to hire you to teach." I stopped for a minute and silently communed with her eye to eye. "Mom," shit, the tears started, "you are such a teaching fool,"...I hiccoughed a wet laugh...
...she snickered and gave me that "Oh god, you're not going to cry are you! You and your dad!" look...
..."that this will not be the last time you decide you're going to teach 'next year'. And, I will be here to remind you, when necessary, of two things: You won't ever again be teaching in a classroom but, you know what?" Now I was sobbing and my mother was patently amused at my emotional flow. "Through what I write about you and me and our life together, you will be a teacher long after you die. So, you know," sob, sob, sob, "you may not ever handle another classroom, but you'll never stop teaching either."
"Well, that's very sweet, Gail," she said. That's her way of saying, "Jesus, you don't need to work yourself up over this, I'm fine."
And, see, that's the thing. She is fine. She won't remember my sorry little explanation about how she's still teaching. The teaching she's doing through my journaling isn't the kind of teaching around which her heart revolves. She will remember, again, in a few days, a week, maybe a month, that she isn't teaching now and that she'd better get busy if she wants to teach next year, probably in Martelle.
I doubt that we'll have another confrontation like the one we had today. This is the first time she's asked if she's too old to teach. Normally, she'd be convinced beyond any doubt that, of course, she's fit to teach. And, depending on the circumstances, I'll either respond from her world or The World. But, you know, I'm glad I thought to tack on my emotional apologia today because, well, whether or not my mother realizes it, whether she ever comes to grips within herself that, classroom or not, teaching is the axis around which she organizes herself, what I said is the truth. Teaching is her past, her present, her future and her legacy. It's the language of her truth. Even in her Ancient Now. Especially now.
Wednesday, May 31, 2006
"Be afraid, be very afraid."
I guess I'm late on the uptake on this one. I heard a snippet of news a couple of days ago, while my mother was watching it, regarding a possible connection between elderly women watching soaps and talk shows and "cognitive impairment". If you're interested, here's a link to one of several versions of the story.
I was vaguely paying attention and my initial reaction, voiced to my mother from the dinette while I was chopping something, was, "Oh, please! The next thing you know they'll say there's a 'connection' [I mimed quotation marks] between sitting in rocking chairs and cognitive impairment!"
My mother laughed. She loves her rocking chair, even though she never really rocks in it and, thus, I've blocked the rockers to make it easier for her to sit and rise.
To be fair, the version of the story to which I've linked above expresses more confusion about this issue than anything else. Of course, though, the version which I heard was a 30 second oral, declarative exposition, upon which the anchor woman who read it commented, "Ah, that's too bad. I love my soaps."
The way I see it, the truth is that everything we are capable of perceiving contributes, in some large or small way, to cognitive dynamics and the relationships among all these contributors are, at this time, so tangled as to be indecipherable. My mother is a good example. She watches a lot of TV and videos. She likes them. Two days ago, when I suggested, in the middle of an episode of one of her favorite shows, that we read aloud, she told me that she enjoys "[her] TV" and, at that moment, didn't want to be distracted from the particular show. Her preferences are wide ranging and the only specific television shows she watches on a regular basis are those few I watch on a regular basis: Currently none, since all my regulars are on seasonal hiatus. Over the last year, though, the regulars have been, in no particular order:
Frankly, fear permeates our society to the point where I believe it is the cause of many of our ills, rather than the symptom. I'm not immune. I'm afraid of Ancienthood, for reasons I've discussed previously in these journals. I'm also afraid of what my life will be like when my mother dies. Luckily, though, those are just about my only fears, my others, including the fear I'm supposed to have of identity theft, having been met and bested over these last few years of being my mother's companion and fighting many fears on her behalf, thus benefitting, myself, in the process.
I just can't get upset, anymore, about some nebulous, suggested relationship between my mother's love of television, what she watches and the state of her vascular dementia. I can't be bothered. She talks back to programs she watches on TV, sometimes with me, sometimes without me. This seems to have no effect on her cognitive impairment. She does crossword puzzles, although not as often as she used to. This hasn't done anything to "improve" her cognitive impairment. She occasionally seems to be a bit more alert when we're experiencing a period of movement but, frankly, she is also a bit more alert when she's insisted on indulging herself in more than her usual amount of sleep. She reads gossip tabloids (six of them) every week and digests and discusses the stories (usually not the celebrity stories) with an acuity and verve that would make you think her brain was in tip-top shape.
My father, who was a raging (literally; he wasn't a happy drunk, but then he wasn't a happy man, either) alcoholic for many decades, used to wish that he would develop some sort of cognitive impairment, specifically Alzheimer's, so he'd have an excuse for a lot of his behavior, especially his relentless tendency to hate and give up on life. It never happened for him and I believe he was disappointed that it didn't. My mother, previous to becoming cognitively impaired, has always been afraid of it because of her mother's and sister's experiences. Yet, it happened for her and she's at peace with her impairment, especially, I think, since it is of a different type than those of her mother and sister and she lives with someone who responds to it differently than the responses she witnessed to her mother's and sister's impairments. At this time it is unlikely that her cognitive impairment can be improved and she's at the age where the mutual irritation of my attempts to involve her in dubious steps to improvement isn't worth the effort, for her or me.
People, if we don't know what lurks in the shadows we need to peer, with wonder, curiosity and a willingness to refrain from attaching meaning to the murk until we understand its nature, rather than glancing fearfully at the flotsam and imagining monsters where none may exist.
Funny how in a country where we can barely get through a day without hearing someone say, "The only thing we have to fear is fear itself," we appear to be addicted to fear.
Perhaps yet another 12-step program is in order?
And, hey, what about Animal Planet and the elderly? Doesn't that connection seem suspicious to anyone?
Later.
I was vaguely paying attention and my initial reaction, voiced to my mother from the dinette while I was chopping something, was, "Oh, please! The next thing you know they'll say there's a 'connection' [I mimed quotation marks] between sitting in rocking chairs and cognitive impairment!"
My mother laughed. She loves her rocking chair, even though she never really rocks in it and, thus, I've blocked the rockers to make it easier for her to sit and rise.
To be fair, the version of the story to which I've linked above expresses more confusion about this issue than anything else. Of course, though, the version which I heard was a 30 second oral, declarative exposition, upon which the anchor woman who read it commented, "Ah, that's too bad. I love my soaps."
The way I see it, the truth is that everything we are capable of perceiving contributes, in some large or small way, to cognitive dynamics and the relationships among all these contributors are, at this time, so tangled as to be indecipherable. My mother is a good example. She watches a lot of TV and videos. She likes them. Two days ago, when I suggested, in the middle of an episode of one of her favorite shows, that we read aloud, she told me that she enjoys "[her] TV" and, at that moment, didn't want to be distracted from the particular show. Her preferences are wide ranging and the only specific television shows she watches on a regular basis are those few I watch on a regular basis: Currently none, since all my regulars are on seasonal hiatus. Over the last year, though, the regulars have been, in no particular order:
- Big Love
- Boston Legal
- The L Word
- Deadwood and it's reruns (we're gearing up for the new season as I write)
- M*A*S*H
- Walker, Texas Ranger (this is a relatively new, accidental favorite)
- Anything on the Animal Planet Channel
- Any shows about God, Abrahamic religions, the Abrahamic Bible (in any of its many incarnations) or organized spirituality on non-religious channels
- all kinds of drama and comedy, as long as it isn't what she would call "dense", which usually means there's a lot of sexual innuendo and/or slapstick
- historical dramas (especially, lately, about queens)
- she has to know what a particular talk show episode is about before deciding to watch it and refuses lots of them
- a variety of shows on the "scientific" channels, especially those focusing on the history of science, astronomy and geology
Frankly, fear permeates our society to the point where I believe it is the cause of many of our ills, rather than the symptom. I'm not immune. I'm afraid of Ancienthood, for reasons I've discussed previously in these journals. I'm also afraid of what my life will be like when my mother dies. Luckily, though, those are just about my only fears, my others, including the fear I'm supposed to have of identity theft, having been met and bested over these last few years of being my mother's companion and fighting many fears on her behalf, thus benefitting, myself, in the process.
I just can't get upset, anymore, about some nebulous, suggested relationship between my mother's love of television, what she watches and the state of her vascular dementia. I can't be bothered. She talks back to programs she watches on TV, sometimes with me, sometimes without me. This seems to have no effect on her cognitive impairment. She does crossword puzzles, although not as often as she used to. This hasn't done anything to "improve" her cognitive impairment. She occasionally seems to be a bit more alert when we're experiencing a period of movement but, frankly, she is also a bit more alert when she's insisted on indulging herself in more than her usual amount of sleep. She reads gossip tabloids (six of them) every week and digests and discusses the stories (usually not the celebrity stories) with an acuity and verve that would make you think her brain was in tip-top shape.
My father, who was a raging (literally; he wasn't a happy drunk, but then he wasn't a happy man, either) alcoholic for many decades, used to wish that he would develop some sort of cognitive impairment, specifically Alzheimer's, so he'd have an excuse for a lot of his behavior, especially his relentless tendency to hate and give up on life. It never happened for him and I believe he was disappointed that it didn't. My mother, previous to becoming cognitively impaired, has always been afraid of it because of her mother's and sister's experiences. Yet, it happened for her and she's at peace with her impairment, especially, I think, since it is of a different type than those of her mother and sister and she lives with someone who responds to it differently than the responses she witnessed to her mother's and sister's impairments. At this time it is unlikely that her cognitive impairment can be improved and she's at the age where the mutual irritation of my attempts to involve her in dubious steps to improvement isn't worth the effort, for her or me.
People, if we don't know what lurks in the shadows we need to peer, with wonder, curiosity and a willingness to refrain from attaching meaning to the murk until we understand its nature, rather than glancing fearfully at the flotsam and imagining monsters where none may exist.
Funny how in a country where we can barely get through a day without hearing someone say, "The only thing we have to fear is fear itself," we appear to be addicted to fear.
Perhaps yet another 12-step program is in order?
And, hey, what about Animal Planet and the elderly? Doesn't that connection seem suspicious to anyone?
Later.
Tuesday, May 30, 2006
Everything changes, truly, thank the gods.
I've been sliding into a mire of extreme lack of motivation toward my entire life over the last few days. I guess this is yet another hallmark of "Caregiver Burnout". This afternoon I was at the point where I figured I'm here for eternity, now, I'm going to have to figure out how to live with it, or not, if I can't...oooh, I was in a state.
One of my standards (as in flying a standard) is that, regardless, I always do the minimum, whatever that is. One of these minimums is that if I don't think I have it in me to report in any of my journals, even The Dailies, I always check in on my websites at least once a day, just to see how few people are visiting my sites. Late this afternoon I decided to confront myself online and was met with an informal blessing through the two comments on the immediately preceding post: The Yellow Wallpaper. It's a journal by another single woman who is taking care of her mother who has been diagnosed with Alzheimer's Disease. Those of you who've read me fairly well know that I don't spend a lot of time on the web doing more than writing in my journals or doing research on my mother's behalf. You also know that although I occasionally recommend sites, I've never recommended a caregiving blog and I never include anything but inbound addresses in my links to the right. I was so impressed with The Yellow Wallpaper, though, that I created a special section for it within my links.
The writer of this journal is articulate, thoughtful, excrutiatingly honest, an excellent writer and much, much more prone to edit her thoughts, experiences and writing before publishing a post than I. Her mother's dementia is Alzheimer's rather than my own mother's vascular dementia, so her mother's dementia is a different turn of mind than my mother's; although the writer is a single daughter she retains her own residence although she lives with her mother, works, is going to school and has the support of a sister. As well, her mother is a bit more independent, at the moment, than mine, but from reading the daughter's journal I can tell that this won't be true for long. The writer still feels able to pursue time and activities of and on her own. She is successfully dabbling with visiting care for her mother. She isn't comfortable about the eventuality of assisted living for her mother but bravely confronts the possibility, both from her own and her mother's point of view. She is as brazen as me about recording "bad" days and moments. Her and her mother's journey is different than my mother's and mine for several reasons, yet I sense that our roads are parallel and I'm pleased that each of us has looked up and over, noticed the other and waved, "Hello".
I read through her entire offering in one sitting. Not only was I impressed but encouraged enough to stand on tiptoe and attempt to see over the edge of my mire. I enthusiastically recommend The Yellow Wallpaper for those of you who visit here because of an interest in caregiving [yes, I read the search queries that bring up this site and am endlessly amused and amazed at how many people world wide are searching out "mom hot fuck sex pussy eat" or some derivation thereof; Oedipus lives, I guess] and an affinity for my style of reporting. You won't be disappointed.
One of my standards (as in flying a standard) is that, regardless, I always do the minimum, whatever that is. One of these minimums is that if I don't think I have it in me to report in any of my journals, even The Dailies, I always check in on my websites at least once a day, just to see how few people are visiting my sites. Late this afternoon I decided to confront myself online and was met with an informal blessing through the two comments on the immediately preceding post: The Yellow Wallpaper. It's a journal by another single woman who is taking care of her mother who has been diagnosed with Alzheimer's Disease. Those of you who've read me fairly well know that I don't spend a lot of time on the web doing more than writing in my journals or doing research on my mother's behalf. You also know that although I occasionally recommend sites, I've never recommended a caregiving blog and I never include anything but inbound addresses in my links to the right. I was so impressed with The Yellow Wallpaper, though, that I created a special section for it within my links.
The writer of this journal is articulate, thoughtful, excrutiatingly honest, an excellent writer and much, much more prone to edit her thoughts, experiences and writing before publishing a post than I. Her mother's dementia is Alzheimer's rather than my own mother's vascular dementia, so her mother's dementia is a different turn of mind than my mother's; although the writer is a single daughter she retains her own residence although she lives with her mother, works, is going to school and has the support of a sister. As well, her mother is a bit more independent, at the moment, than mine, but from reading the daughter's journal I can tell that this won't be true for long. The writer still feels able to pursue time and activities of and on her own. She is successfully dabbling with visiting care for her mother. She isn't comfortable about the eventuality of assisted living for her mother but bravely confronts the possibility, both from her own and her mother's point of view. She is as brazen as me about recording "bad" days and moments. Her and her mother's journey is different than my mother's and mine for several reasons, yet I sense that our roads are parallel and I'm pleased that each of us has looked up and over, noticed the other and waved, "Hello".
I read through her entire offering in one sitting. Not only was I impressed but encouraged enough to stand on tiptoe and attempt to see over the edge of my mire. I enthusiastically recommend The Yellow Wallpaper for those of you who visit here because of an interest in caregiving [yes, I read the search queries that bring up this site and am endlessly amused and amazed at how many people world wide are searching out "mom hot fuck sex pussy eat" or some derivation thereof; Oedipus lives, I guess] and an affinity for my style of reporting. You won't be disappointed.
Sunday, May 28, 2006
I finally updated...
...The Dailies through yesterday. I was afraid if I didn't get all the stats in and publish the notes I'd been keeping in draft form, I'd begin to lose BP stats: The cuff only retains 20 readings. Nothing earth shattering over there. During the "As Draft Only" period we had two days of unusual dehydration, one instigated by me when I administered 20 mg of furosemide instead of the usual 10. I did it intentionally (brief explanation over there) and it was a mistake. I'll never do that again. It pulls fluid off her way too fast. I'm not sure what instigated the second dehydration episode, but I recognized the problem immediately in the morning and began treating it even before her bath.
The curious aspect of giving Mom 20 mg of furosemide and having that backfire on me: The lowest prescribed dosage is 20 mg, as far as I can determine. I almost never give her 20 mg. Usually, if she needs to shed fluid, I give her 10 mg, then another 10 mg in 12 hours if she's exhibiting stubborn retention. Even this type of administration takes her breath away, so to speak, and I can count on the following day being slow and sleep-ridden while she rehydrates herself. On the day that I gave her 20 mg at one clip its effect was almost immediate and she "felt bad all over" most of the day, as she usually does when she's severely dehydrated. As well, because of the medication floating around in her system combined with her typical lack of thirst and the battle I have getting her to drink fluids, it takes a few hours to get her out of this state. She also looks and acts like she feels "bad all over": Her footing is much less sure, she tends to weave and needs a lot of help moving around; what mental acuity she retains is obviously impaired; she has no energy and her body looks like she's feeling under the weather. Interestingly, the way I administer furosemide (once in a great while, only when absolutely necessary and in 10 mg doses) isn't at all the way it's typically prescribed and taken. Most people who are on this stuff take it daily. I can imagine some circumstances wherein this would be necessary: The later stages of Chronic Renal Failure, for instance, and/or frequent episodes of high blood pressure definitely linked to unusual and frequent fluid retention. The problem is that the prescribed "method" is the way it is prescribed for my mother. If I had never gotten involved in my mother's medications in a micro-management way and if I had never had friends who identified what that "TIA" in September of 2002 actually was I would never have questioned the administration of this medication and my mother would be on it daily, just as most people who take it are. I would, thus, be fighting her "feeling bad all over" all the time and wondering why, or maybe chalking it up to old age. I probably would also be fighting this "feeling" ineffectively. I wondered, today, when reviewing all this, how many Ancient Ones "out there" would be feeling and doing a lot better if their medication regimens were scrutinized and manipulated by their caregivers. The 'moral' is, people who care for the Ancient and Infirm absolutely need to educate themselves about the medications they administer. My mother's and my life together is a painfully detailed demonstration that doctors don't think as much as they should, don't communicate among themselves, aren't on the scene intimately in order to note what's happening and think about why, don't communicate well with their patients and those patients' caregivers, thus they often aren't in a position to understand when medications are not only unnecessary but need to be dispensed (both by the pharmacy and by the medication manager, who is usually the caregiver) in a way other than the prescribed/accepted manner. This, readers, is a big fucking deal. If you're a caregiver and you are dealing with someone who feels "bad all over" a lot, you need to be doing your own research, observation and figuring regarding your care recipient's medications. You can't, you absolutely can't leave it all up to the doctors. It is important to inform the doctors with whom you're dealing of your discoveries and permutations concerning your care recipient's prescriptions. It is also important, though, in the face of disagreement, to trust your research, observations and instincts and to be "fearless" [as per Caregiver.com] when it comes to meddling with prescribed medications and their regimens: Trust your observations first and the doctors' recommendations second. Too little is known, at this time, about medicating the elderly (and often medicating others). Lay medication administrators must be extremely active in making observations, thinking about what they learn and observe and applying all this information in making decisions about medication management and dispersal. Yes, you may very well make enemies of physicians. You might even get your care recipient bounced by a few doctors. But, believe me, I can tell you from experience, this is not the worst that can happen.
Today seems to be a pronounced sleep day for her. We've been having more of those lately. I'm not worried about it, just noting it. Otherwise, Mom's doing good, maintaining "her own", as 'they' say.
I think I'm beginning to emerge from my den.
Later.
The curious aspect of giving Mom 20 mg of furosemide and having that backfire on me: The lowest prescribed dosage is 20 mg, as far as I can determine. I almost never give her 20 mg. Usually, if she needs to shed fluid, I give her 10 mg, then another 10 mg in 12 hours if she's exhibiting stubborn retention. Even this type of administration takes her breath away, so to speak, and I can count on the following day being slow and sleep-ridden while she rehydrates herself. On the day that I gave her 20 mg at one clip its effect was almost immediate and she "felt bad all over" most of the day, as she usually does when she's severely dehydrated. As well, because of the medication floating around in her system combined with her typical lack of thirst and the battle I have getting her to drink fluids, it takes a few hours to get her out of this state. She also looks and acts like she feels "bad all over": Her footing is much less sure, she tends to weave and needs a lot of help moving around; what mental acuity she retains is obviously impaired; she has no energy and her body looks like she's feeling under the weather. Interestingly, the way I administer furosemide (once in a great while, only when absolutely necessary and in 10 mg doses) isn't at all the way it's typically prescribed and taken. Most people who are on this stuff take it daily. I can imagine some circumstances wherein this would be necessary: The later stages of Chronic Renal Failure, for instance, and/or frequent episodes of high blood pressure definitely linked to unusual and frequent fluid retention. The problem is that the prescribed "method" is the way it is prescribed for my mother. If I had never gotten involved in my mother's medications in a micro-management way and if I had never had friends who identified what that "TIA" in September of 2002 actually was I would never have questioned the administration of this medication and my mother would be on it daily, just as most people who take it are. I would, thus, be fighting her "feeling bad all over" all the time and wondering why, or maybe chalking it up to old age. I probably would also be fighting this "feeling" ineffectively. I wondered, today, when reviewing all this, how many Ancient Ones "out there" would be feeling and doing a lot better if their medication regimens were scrutinized and manipulated by their caregivers. The 'moral' is, people who care for the Ancient and Infirm absolutely need to educate themselves about the medications they administer. My mother's and my life together is a painfully detailed demonstration that doctors don't think as much as they should, don't communicate among themselves, aren't on the scene intimately in order to note what's happening and think about why, don't communicate well with their patients and those patients' caregivers, thus they often aren't in a position to understand when medications are not only unnecessary but need to be dispensed (both by the pharmacy and by the medication manager, who is usually the caregiver) in a way other than the prescribed/accepted manner. This, readers, is a big fucking deal. If you're a caregiver and you are dealing with someone who feels "bad all over" a lot, you need to be doing your own research, observation and figuring regarding your care recipient's medications. You can't, you absolutely can't leave it all up to the doctors. It is important to inform the doctors with whom you're dealing of your discoveries and permutations concerning your care recipient's prescriptions. It is also important, though, in the face of disagreement, to trust your research, observations and instincts and to be "fearless" [as per Caregiver.com] when it comes to meddling with prescribed medications and their regimens: Trust your observations first and the doctors' recommendations second. Too little is known, at this time, about medicating the elderly (and often medicating others). Lay medication administrators must be extremely active in making observations, thinking about what they learn and observe and applying all this information in making decisions about medication management and dispersal. Yes, you may very well make enemies of physicians. You might even get your care recipient bounced by a few doctors. But, believe me, I can tell you from experience, this is not the worst that can happen.
Today seems to be a pronounced sleep day for her. We've been having more of those lately. I'm not worried about it, just noting it. Otherwise, Mom's doing good, maintaining "her own", as 'they' say.
I think I'm beginning to emerge from my den.
Later.
Reciprocally investing in one another's lives...
...is part of the process of making sure that Ancient Ones' desires toward life are honored.
For some reason, we of this society forget this; that all of us need tangible evidence that others count on our existence.
Why, as well, are we horrified at the thought of warehousing children in order to avoid the difficulty of raising them and yet we barely and rarely question the thought of warehousing our Ancient Ones to avoid the difficulty of sustaining them?
Later.
For some reason, we of this society forget this; that all of us need tangible evidence that others count on our existence.
Why, as well, are we horrified at the thought of warehousing children in order to avoid the difficulty of raising them and yet we barely and rarely question the thought of warehousing our Ancient Ones to avoid the difficulty of sustaining them?
Later.
