Wednesday, August 18, 2010

Ups and downs ...

... we all have 'em. There are few things in life that stay the same for long. Anything and everything can change in the blink of an eye. Now we can't be ready for every little thing that comes along. All we can do is take things as they come.
Nana's been feeling reasonably well for quite some time. Her recent visit with gerontologist Dr. John confirmed what we'd been thinking: for her age, she's in really good shape. Next thing you know Nana's having trouble keeping her food down, which means she's not able to take the pills she needs to keep her as well as she has been. A quick visit to emergency confirmed there was more to her sudden change in health than we first figured. She has a urinary tract infection that is probably contributing to her not feeling well.
Once the emergency physician was able to diagnose Nana's condition he sent her home with more pills for the infection in hopes that she was well enough to take them and get better soon. Unfortunately taking pills when you aren't feeling well is not so easy so we had another brief stay in emergency, long enough to administer some medication by intravenous. We're back home and feeling a little better. Better enough to sneak some pills into Nana with a light meal. And to keep her sipping as much apple juice as she wants.
Nana's still weak, tired and not quite over her infection but here's where slow and steady wins the race. Time and plenty of TLC will have her feeling better real soon.

Monday, August 9, 2010

Mining for Gold

Finding the right doctor sometimes seems like mining for gold. You dig and dig, getting sidetracked, discouraged and frustrated until, if you're lucky, you finally hit gold.

Dr. John R. is gold. A gerontologist, aka specialist for seniors, Dr. John saw Nana for the first time last Friday. On our way to her appointment she asked me where we were going and who he was at least 29 times in the hour it took us to get there. She was as unsure as I was as to how he could possibly help her. Nana figured that you can't turn back the clock and that whatever her health issues are, she's stuck with them. I am a firm believer in searching for help with whatever ails her, or anyone else in the family, until I find it.

We made it downtown, grabbed a great parking spot right out front and found our way to Dr. John's office. We only had a short wait before we were called into an examination room. The doctor stuck his head into the room to introduce himself and asked if it would be alright for him to see one more patient before us, so that he could take his time with Nana during our first visit. That kind, simple gesture was a hint of exactly what this doctor was all about: he is genuinely interested in his patients. Of course we didn't mind waiting, which took no time at all.

Nana now belongs to Dr. John's fan club. They had a nice get-to-know-you chat. He recommended new medication to control her chronic pain, that would be longer lasting and easier to swallow, two of her most pressing problems. He was impressed with her overall health and encouraged her to keep doing what she was doing. Her short term memory issues may not be dementia but simply age related. He told us to call him to let him know how the new meds were working. And he'll see Nana again in a few months but would be happy to see her sooner if anything else comes up.

Seems to me, we struck gold!

Friday, July 30, 2010

Patience with a capital 'P'

Do things seem awfully slow these days? They do to me and it's no wonder. Slowing down is a huge part of ageing. What's the worst part about it: getting used to it. Is it a problem: depends on how you handle it.

When Grampa George goes for a walk, whoever walks with him must slow down to a crawl because that's as fast as he can go. It might take some adjustment since many of us are used to rushing from place to place as fast as we can go, often multitasking along the way. How to handle it: walk at his pace and enjoy the scenery. We've seen eagles sliding through the sky on the breath of a mere breeze that we might have missed otherwise. We've watched squirrels chase each other like kids on a playground then suddenly stop, face each other and chatter like celebrities on Twitter before resuming the chase. We've seen dragonflies dance through the humidity hanging over a pond, their cellophane wings sparkling like precious diamonds. It was worth the slower pace to see what we saw. After all, it means Grampa George is out and about, actually walking. And somehow conversation comes easier when you're not going a hundred miles an hour and gasping for breath.

At mealtimes it's normal for everyone to enjoy their food. Most meals take a good ten minutes to inhale, add ten seconds to put down your utensils and another five for Grampa George to slurp up a stray noodle from his placemat. And then there's Nana. A Nana-sized mini-meal takes her about an hour or so to consume. It took some time but I've learned to let the world go by and wait patiently to let her finish at her own pace. If that's all she needs to manage a meal, then sitting nearby in quiet solitude is fine by me. Miraculously, here's Nana taking pleasure in her food, still eating unassisted, and I'm able to watch her do so.

Attitude is a wonderful thing if you take the right one. The slower you count your blessings the more you'll think of how many you actually have.

Saturday, July 24, 2010

The Truth, the whole truth and nothing but...

Reality can be hard to face, especially if it concerns something we'd rather avoid. As a kid, facing the harsh truth about not being able to have that cookie five minutes before dinner was catastrophic. As a newlywed, facing up to the fact that my cooking didn't taste anything close to the delicious food my husband was used to from him mom, was hard to stomach. It took time, but slowly my cooking improved and so did the reviews. As seniors, new challenges that bring about changes to how 'I always did this', can feel devastating. With time, we face up to what we must and move on.

Grampa George was pretty calm about losing his driver's license when the doctor told him she'd be sending in the paperwork to keep him from driving anymore. In the back of his mind he figured if he only drove locally, close to home, he'd be just fine. After all, he'd been driving for so long, what could possibly happen? When he had to be reminded that no driving means absolutely no driving, at all, anywhere, anytime, he was quite depressed and withdrawn. Can't blame him, really. It's a big thing to give up the privilege to drive, especially when it's not a matter of choice, but forced. He'll have to get used to it, period. There is no way to ensure he can drive safely given his medical condition and so better safe than sorry. After all, he's luckier than most, he has friends and family to get him where he needs to go. Some people have no one.

Nana can't walk around on her own anymore. Her lack of balance and previous falls mean that she could end up falling again. The risk of falling and getting hurt more seriously than before gets worse as time passes. While she thinks it's a bother to call someone to walk her to where she wants to go, I tell her that ending up in an ambulance on the way to hospital is worse. Telling her that we want her around for as long as possible helps briefly, until a new thought enters her mind and she's forgotten what we just discussed.

Facing the truth, especially about our own individual limitations is tough. As one of the faithful 'glass half-full' preachers, I remind myself, and those around me, that giving up something we've taken for granted could be a whole lot worse. I try to dwell on the good things that I still can do rather than mourn the things I'm no longer able to handle. We really are lucky, if we remind ourselves of it, from time to time.

Monday, July 12, 2010

Homeward bound vs. Housebound

We've been staying close to home lately. It's become too difficult to go places since simple things like climbing in and out of the car, using stairs, being more than a few steps from a bathroom, and so on are just too much for Nana. Even with someone walking her, she's too unsteady on her feet to make going out worthwhile. This, and Grampa George's unscheduled dizzy spells, have kept us relatively housebound except for any necessary appointments.
Nana's pretty contented to stick close to home. Grampa George is getting claustrophobic. In order to cope with the boredom he naps. Alot. And it's not fair.
Since Grampa George can't drive anymore, he relies on me or other family to take him out. When I'm not home, someone at home has to take over for me, keeping a close eye on Nana so that she doesn't wander around on her own and risk another fall. It's time for a change.
Grampa George is going home. He's not so sure about the changes and was reluctant to admit that sitting around here waiting for an opportunity to get out and about was not good for him. But there is a better way.
We agreed that he'd have his very own housekeeper/caregiver/ take care of him, his medications, meals and showers daily. She'd also take him to appointments as well as any outings he wanted to go on. Now that we've found someone who introduced herself as his 'personal assistant' he feels like a VIP and is no longer housebound. He's homeward bound.

Sunday, June 27, 2010

The Magic of Music

It's been ages since Nana's played the piano. Since her fall in March, she's slowed down more than ever in both mind and body. I compensate by helping her with all the little things she used to do by herself. She no longer walks alone, even for short distances. She needs prompting to get ready in the morning once she's up, and Monday to Friday her trusty Personal Support Worker, Glenda happily helps her. She finds it more and more difficult to get all of her pills down, or even to take them all some days. It's nothing major as long as she has help.

Nana's advancing dementia means she's having more and more trouble remembering what day it is, how to read her watch and whether we've had lunch or not already. She's still pretty good with many of the faces in the photographs she loves to look at with Glenda and remembers most people's birthday's, especially those who've passed away already. The pictures we've taken more recently don't seem as familiar, which isn't unusual with dementia.

When Glenda stopped in front of the piano during her daily 'in-house' walks with Nana I had the urge to step in front of it to hide it from view. Glenda happily listened to Nana talk about how she used to play and even teach when she was younger. When Glenda urged Nana to sit down and play something, I cringed, afraid Nana might not be able to anymore.

I was impressed and relieved when the glorious sounds of Nana's familiar favorites rang out miraculously loud and clear. Nana's gift of music has not faded one little bit. She might not remember that she's played the same tune a few times over, but she still plays beautifully. Glenda has helped her rediscover something I'd almost assumed she'd lost. What a wonderful thing!

Saturday, June 12, 2010

The Curse of the Pink Blob

There are all kinds of brands, types, flavours and miraculous claims to fame about the variety of dental adhesives available now. Grampa George calls his dental glue, and will use whatever's on sale. Nana insists upon her tried and true favorite brand that barely keeps her teeth in while she's talking. I marvel over how much of it goes down the drain every day.

Grampa George probably swallows most of the dental adhesive he applies to his dentures since over the course of a day he re-applies at least once per meal and again after his afternoon coffee. While others at the table keep their 'eyes on their fries' he won't hesitate to slip out his lower plate to demonstrate that, once again, there's nothing holding it to his gums. He's taken to carrying a tube of 'glue' in his pocket, but I've managed to convince him to apply it to his dentures in the privacy of his bathroom.

Nana could stretch a tube out to last her nearly six months. Once proud of this accomplishment, it opened my eyes to the fact that she'd been applying it so sparingly that it's no wonder her teeth wander around her mouth all day. Now that I'm the one preparing her teeth for adhesion I use a more reasonable amount. The downside of this is the mess of pink refuse that ends up going down the drain. We haven't had a clog yet, but the little knob that lets the sink stopper go down hasn't moved in months. I can't watch most evenings when Nana uses the end of her toothbrush to stab at the globules of pink goo that gather around her sink drain until they've gone down. I can only imagine the millions of sinks swallowing mounds of the stuff every day the way ours does.

Then again, this stuff has been around for decades. And more importantly it plays an absolutely vital role in day to day life at our house. Grampa George and Nana can still enjoy a nice meal because of it. A good set of teeth and some paste to hold them in place make this possible. Meals are events at our house. They are an opportunity to sit, eat and spend some time together marveling over the weather, good or bad, comparing aches and pains or just chewing. Meanwhile, Guten Apetit!

Tuesday, June 8, 2010

B is for beautiful burden ...

Some days, especially right after being washed, rinsed and dried in the shower, helped into a fresh change of clothes and settled back into her recliner, Nana asks is she's a burden. The answer of course is always a resounding 'No!' Actually, it's having to hear that particular question that 'burdens' me.

I'm ready, willing and able to take care of Nana's needs, no matter what they are. I do my best to handle every task, big or small, with a smile and without resentment. I try not to ask too many favours from the family if I can take care of it myself so as not to infringe on their time whenever possible. We'll always burden one another on occasion. It's part of life.

Being given an opportunity to help someone with some tiny, everyday thing feels good. It means doing unto others, freely, giving back with nothing except a warm feeling inside in return. It's a beautiful burden to bear. One that needs no return on investment. It's a sweet feeling of having done something useful for another, without being asked to do so.

Caring for each other is no burden. It's being asked if it's a bother that bothers me, because naturally, it is not.

Thursday, May 27, 2010

Cook softly and carry a big fork

Cooking to suit both Grampa George and Nana's varying diets means cooking more than one meal per meal, so to speak. Matter of fact we'll often end up with three different meals on one dinner table: one for Grampa G., one for Nana and one the rest of the family could eat.

Grampa George's recommended no-salt meals are a no-go. Enjoying a good meal is one of the few things he can still do with gusto and so I compromise: he eats low salt, but really small portions. And he's fine with that. When we eat out, he chooses anything on the menu he likes within reason, and the satisfaction it brings him is worth the toll it takes on his already compromised system.

Nana's various lifelong digestive issues have her quite used to a relatively bland diet. It's only lately that she's suddenly reaching for the salt and/or sugar to top any dish in front of her. Seems those 94 year old taste buds are slowing down and yearning for a burst of something to wake them up. Unfortunately she's also having a great deal of trouble swallowing. To combat this sometimes scary situation, I'm cooking soft for her now. And she doesn't seem to mind.

Creamed soups, mashed potatoes topped with creamy salad dressing, scrambled eggs with not much else but a few finely chopped herbs, goat cheese mashed with a fork, whatever makes it easier for her to enjoy a meal is fine by me.

In the end, as long as everyone leaves the table satisfied, then so am I. Tomorrow: mashed fish and chips with extra tartar sauce. Mmmmmmmmmm!

Tuesday, May 18, 2010

Ever do anything reaaally idiotic like ...

... get your hair cut? If you're like me, you usually come last, meaning unimportant things like getting your hair trimmed can always wait. Sometimes they even wait for months on end, even up to a year. Yup, that's me. I usually manage to get a hair cut once a year on our anniversary.

This year was going to be different. Super Man's Mother's Day gift to me was taking over with the caregiving while I went out the Saturday before Mother's Day so that I could go to the salon. No biggie, really. Until I got home.

It turned out a little shorter than I had planned, mostly because the ends were so ruined by now that the stylist, Jennifer, told me she'd have to do an intervention to rescue what she could. She did a great job and I hurried home feeling beautiful.

Luckily everybody liked my new hair and they weren't even pretending! What a great Mother's Day gift.

And then there's Nana: she absolutely adores my new hair. A little too much almost. Not only do I look great, I look alot younger, alot less tired since it hides the bags under my eyes, and a whole lot prettier than ever before. Clearly I should have done this years ago. Nobody said a word, but now I know that prior to my daring trim, I must have looked absolutely atrocious, completely haggard, ugly beyond belief and about a hundred years old.

Well, I guess I can deal with a few compliments. Trouble is that every morning Nana re-informs me of how disgusting I looked before I had my hair cut. Now that I look fourteen again, she's convinced I could pass for one or both of my daughters and giggles just thinking about how everybody else must see the same thing.

I guess I can live with this daily assault on my self-image. On second thought, when I go out to pick up our next load of prescriptions at the pharmacy later today, I'd better wear a bag, in case somebody recognizes me.

Tuesday, May 11, 2010

Wonder Woman

If we all had superpowers, something small, like the ability to detect the location of lost pairs of reading glasses in a single glance, the world would surely be a better, happier place.
I can't honestly say I have any such ability as I'm barely able to detect whether I've got my contacts in or not at any given moment, however I am surviving.
But some days, I am Wonder Woman, not because of any superpower, but because I wonder about a good many things:

I wonder if I'm ever going to be 'not tired' again.

I wonder if I'm doing the right thing by balancing Grampa George's salt intake via smaller portions on his plate that have a bit of salt in them rather than cooking with no salt at all and having him miserable.

I wonder if I'm being devious when I tell Nana that it was her doctor who arranged for a PSW to visit every day to make sure she doesn't fall again, because Nana still resents and denies that she needs help with everything.

I wonder if Grampa George knows I know that he's been sneaking forbidden pickles and undiluted cans of juice concentrate from the refrigerator.

I wonder if I did the right thing by hiding Nana's scale under her bed so that she'll stop trying to weigh herself, by herself, with no one helping her balance on the little six by six inch surface that barely accommodates her eight by eight inch crippled and arthritic feet, especially since she can never figure out how to turn it on seeing as it's digital.

And I wonder if my stove will get condemned if anyone notices I haven't cleaned it in weeks.

Better get right on that!

Sunday, May 2, 2010

To Sleep, perchance ... uninterrupted!

I used to look forward to a good nights sleep. Now I spend my nights listening. I listen for Nana to get up to go to the bathroom and forget to call me, hence inviting another possible fall. I listen for Grampa George to wake up in the morning, notice I'm not up yet, and head right for the sofa to take a nap five minutes after he just got up. And I listen for my alarm clock to make sure I don't miss getting my son to the train station so that he can get to school on time.
We haven't missed a train in a while, knock on wood, especially since I'm usually sleeping with one eye open lately anyway, so no biggie.
And there's really no permanent harm that'll happen to Grampa George if he happens to take one more nap per day. He'll still be just fine, and maybe a little more rested than me.
But nights spent listening for Nana have become downright epic. When sleeping in shifts with my dear Super Man was wearing us both out, he installed two different alarms in Nana's room to warn us when she was up.
One alarm senses motion and worked fine unless she happened to swing her arm out of bed setting the dinger off no less than 14 times a night. Not really helping, until my Hero moved the alarm out of range of any wayward appendages.
The other alarm goes off when Nana steps on it, as when she's sitting on the edge of her bed trying to stand up on her own. So far so good.
The two alarms are a God send and yet I'm up several times a night. When I set my alarm clock to wake me approximately when she needs to use the facilities at night, she decides she doesn't need to go. When I don't, the motion sensor goes off to send me running to catch her before she wanders off in search of the bathroom. Some nights, she's getting up to look for me, thinking she heard me calling her, when I'm not. Other nights she figures it's four pm, when it's really four am and she's waking up from an afternoon nap, raring to go when I'm not. I get pretty excited when I'm only up three and a half times between midnight and six am. It's our current record right now.
So far so good, with tracking Nana's nightly forays. If only I could find a way to keep the bags under my eyes from turning into suitcases now.

Monday, April 26, 2010

If at first you don't succeed ...

Every day is a work in progress, so we acknowledge, adjust and accommodate as things change. We take on new tasks and handle them to the best of our ability.
One of my newest tasks includes helping Nana manage her dentures. Trouble is I seem to be hindering more than helping her right now. What to do: keep trying.
Nana's lower 'teeth' have been re-lined to fit against her gums properly, twice in the last year. They still meander around in her mouth but it doesn't seem to bother her. Matter of fact it means that she can just sort of spit them out into her tooth glass at bedtime. The uppers take a bit of tugging to get out, but sit quite well over the course of her three meals a day, and mid-afternoon snack. Once they're safely swimming in their overnight bath of effervescent dental soak we don't need to worry about them until the next morning.
Now mornings are still a bit of a challenge for me. I can handle scrubbing the leftover dental adhesive off her 'teeth' with her toothbrush. I dry them off, just the way she likes it. I can even get just the right amount of dental adhesive onto each half moon of choppers. Once that's been accomplished I really have to watch out.
No matter how careful I am, she manages to foil my best efforts to get them in the right way. We've ended up with her lower teeth firmly pasted to her upper gumline, or the uppers in with the lowers planted over top of them. Even when I hand her the upper set and help guide them to her mouth, she manages to turn them upside down and plant them in her mouth that way.
We're getting better at this new two-woman venture. Using a combination of hand signals, show and tell, verbal instructions and careful guidance we manage to get Nana's teeth in the way they need to be. My new technique of doubling up the dental 'glue' on her lower teeth actually keep them in her mouth at least until noon most days.
If at first we don't succeed we do try, try again. This means we sometimes lose some of the 'glue' meant for the dentures. As a result we've run into the slight problem of how to get Nana's lips apart once they're stuck together with dental adhesive. It's not life threatening, but can make having a clear conversation a bit of a challenge.
Lucky for me, Nana's been a good sport about the whole thing and simply smiles with her lips together some mornings.

Sunday, April 18, 2010

When the going gets tough ...

When the going gets tough ... you call for help! The question is, who do you call?
Since Nana's fall and Grampa George's recent issues with loss of balance I find myself facing new challenges that are, well, challenging. Nana's not supposed to walk by herself which means I must be with her at all times, or at least nearby. Grampa George's loss of balance is random so I find myself running to catch him when it happens to keep him from falling and injuring himself as well. Also, it's not fair for me to hurry Nana through her breakfast then hustle Grampa George into the car without bothering to change out of his slippers when I take him to the lab for his weekly blood tests.
As both of my favorite seniors slow down, I assist them with whatever their increasing needs are including: showers, hair care, skin care; laying out of fresh clothes then helping to put them on; providing meals according to different dietary needs; ensuring each takes their prescribed medications (once they've been ordered, dispensed,picked up and sorted); assistance in the bathroom and/or with incontinence needs; the usual household chores such as laundry, tidying up and making beds; making, confirming and keeping appointments; as well as taking them on regular outings and to social activities, all of which don't leave much time for the needs of the rest of the family even when they're all pitching in.
My call to Nana's and Grampa George's case manager at the Community Care Access Center prompted a reassessment of both their situations. With recommendations from the nurses in emergency after Nana's fall, her family physician, the wound nurse who came to tend to her wounds, and the nurse manager who followed up with me, as suggested by our Personal Support Worker, I now have several hours of assistance for both per week. This is not just respite for me, it is a huge relief when it comes to the health and safety of both Nana and Grampa George. It means I can tend to one with my full attention while their PSW happily tends to the other.
The CCAC also arranged for an Occupational Therapist as well as a Pharmacist to assess Nana's and Grampa George's needs, make recommendations and provide guidance that helps me improve their daily care.
It takes a village to raise a child and it takes a community to care for a senior. Lesson learned: ask and you shall receive. It you do not, ask again or try another source, for help is available if you look for it.

Monday, April 12, 2010

The Hazards of an Un-Happy Camper

Nana's mad at me, really, really mad. I've betrayed her by asking for help with her care. She thinks it means we're looking to put her in a home and nothing I said could convince her otherwise.
I knew this was coming as soon as I'd mentioned that someone from the Community Care Access Centre was coming to see how she was doing.
Grampa George had been a little leery when someone came to the house to 'see how he was doing' after he'd come home to us from the hospital. His take was that they were assessing his mental acuity to make sure he still had all his marbles. I was able to explain that since he'd been 'this' close to not making it out of the hospital, his doctors had recommended he have help at home, at least until he was fully recovered.
He'd been okay with that, needs even more help now and has been enjoying his one hour per week with his Personal Support Worker (PSW) ever since. They walk, they talk, they laugh and they get along just fine. He's got supervised exercise, social interaction, one on one care and someone to listen. He feels better when someone other than me reminds him that he's still living at home, with family and doesn't need to worry about whether he's taken his pills or not.
Nana did not appreciate my explanation that I'm only making sure she and Grampa George have the best of care, something I can't always do on my own. She's decided she doesn't like having someone hover over her, and that certainly she doesn't need that much help at all. I should know better, but what she thinks hurts.
Nana felt a little better after her son, my husband talked it over with her. She agreed that Grampa George is on the decline and will need more and more attention as time passes. She still thinks she doesn't need much help but there's no sense in arguing about something she can't comprehend. Matter of fact later that same day, she'd forgotten there'd been a PSW here today at all. She was back to her cheerful self. Until tomorrow morning when Glenda arrives to help her with her morning routine.
My first instinct was to cancel all the help I'd just finished arranging, to bow to Nana's wishes to be helped only by me, the way I've always done.
Not a good idea. I need help, real help to ensure I'm taking proper care of my two favorite seniors, with or without their approval. Their safety and care come first. Nana may get mad at me, again, and again, and again, until she gets used to having Glenda around, but she's not getting any younger and neither am I.
And so, with the help of my trusty PSW, we'll manage to keep our campers happy, whether they like it or not.

Friday, April 9, 2010

Plan B

Ever since Nana's fall two weeks ago, we've been terrified she'll fall again. Standard operating procedure: walk with her whenever she's up. Unfortunately this is easier said than done. Sure we can keep tabs on her during the daytime. We take turns checking up on her and walk her even short distances. So far so good!
Nights are not quite so simple. Nana's dementia now makes it impossible for her to remember to call us when she needs to use the bathroom during the night (and most other times). And once she's in the bathroom, she might not remember where she is. She's tried to lay down on the floor when she's done, thinking she's back in bed already which is clearly not ideal.
Now I don't mind getting up to help her, if only she'd wake me. We tried bells on the bed that were supposed to dingle as soon as moved. Didn't work. Wind chimes, that required less movement to wake me: same deal. We resorted to sleeping in shifts. Super Man would take the midnight to 4am run, then wake me to deal with 4am to 9am. After a few days we were both too exhausted to stay awake for our shifts and came dangerously close to falling down ourselves. There had to be a better way.
It was Super Man to the rescue again, with his brilliant idea to set up a motion sensor in Nana's room. Sitting right next to her bed it triggers an alarm next to my pillow as soon as she swings her legs out of bed. Brilliant!
Now all I have to do is make sure she doesn't end up hanging her arm out the side of the bed, like last night when she set the alarm off by mistake about 14 times. We are living and learning!

Monday, April 5, 2010

Bells will be ringing ...

As time goes by I find myself facing increasingly interesting challenges and having to think fast to come up with just the right solution for each one. Everybody's different and what works for Nana doesn't always work for Grampa George. So, what to do? Get innovative.
When Grampa George first discovered urinary incontinence can't be stopped by wearing two pairs of underwear at a time, we tried pads. Lo and behold: new found comfort and no more leaks.
Now that it's no longer safe for Nana to walk even a short distance unescorted, one of us always walks with her. It's a solution that comes complete with it's own problems but for now it's a work in progress. During the day time we simply check on her, constantly. Sure, she can call us if she needs something, if she remembers, which is seriously not happening any more, no matter how often we tell her to.
Night time is another ball of wax. Super Man and I sleep in the room right next to Nana's, our headboards practically touching but for a thin wall of drywall. The door adjoining our rooms is ajar, I'm talkin' fully and she still manages to make it to her bathroom (that's right next to her bed but still dangerously easy to fall, rather than step, into) before I realize she's up. We banned WD40 in the house, letting the obnoxious ten decibel squeal of her bathroom door alert us to her whereabouts, but it's still not enough.
We're trying something new tonight: bells. I've got this cheerful string of red and green Christmas bells I hang over a doorway during the holidays. The perfect thing to hang, just underneath the bedskirt, out of sight but ready to jangle up a storm the moment she swings her legs over the side of the bed. As long as I don't confuse it for the sound of one of the cat toys, it could work!?!
And if it doesn't I'll have to take the advice of my oldest, who suggested I simply sew them to the hems of her pajama bottoms: she won't be able to take a step without me running to the rescue!

Wednesday, March 31, 2010

Feelin' Lucky?

I'd called the CCAC recently to arrange for some assistance with Nana's care. The first order of business, of course, is an in-home assessment of a new client. Luckily, even though there was a waiting list, I managed to snag an appointment within a week. The assessor kindly went through her list of questions, diligently took notes and was happy to announce that Nana was fortunately eligible for two hours of assistance from a PSW per week.
While I do appreciate that budgets are tight everywhere and that we all have our jobs to do within some pretty slim restrictions, it seemed almost more trouble to try and figure out how to fit two hours of help per week into a schedule already overflowing with appointments, daily caregiving 'musts' and the unexpected for both Nana and Grampa George.
Nana's dementia means that space and time often meld into one. This means she might get up at eight am, wondering if she's missed dinner on a sunny Monday morning and get up at eleven am the next day announcing that she hadn't slept a wink all night, when her snoring was long and strong over the monitor in her room, since midnight the night before. That makes it very difficult to fit in help from a PSW with Nana's morning routine, when she needs the most help but certainly any help is better than none at all.
My biggest concern was that Nana's mobility was not considered an issue even though we must walk with her whenever she's not sitting down. I'd been especially worried since she's had two serious falls over the last year and a half and some very close calls recently.
The weekend after Nana's assessment, she had another serious fall. It meant calling 911 and a ride with her to hospital in the ambulance. Luckily she only sustained extensive bruising, several broken facial bones, stitches to her forehead, and bandaging of a three inch cut on the upper arm that couldn't be stitched. We were in hospital from one am Sunday and discharged at nine that same morning. The care was quick and kind, helpful and much appreciated but everyone who helped us felt that two hours a week of help at home was not nearly enough, given the circumstances.
Luckily, now that I can truthfully say that Nana's had a fall within the past 90 days, we may well be eligible for a few more hours of care per week. With any luck, whenever our trusty PSW is there, I'll be able to take a leisurely stroll to the bathroom to answer nature's call instead of running in and out with my fly undone for fear that Nana's wandering the house without an escort when I'm not looking.

Thursday, March 25, 2010

Railing about Railings

We have a little problem with the lovely double door entrance way at the front of our beautiful senior-friendly bungalow just outside of the big city: we can't use it.
When Grampa George moved in with us he settled in quite nicely. He'd been in hospital for some serious breathing difficulties that revealed water in the lungs as well as considerable enlargement of his heart among many other issues. Once he was back with us, feeling better and able to walk more than a few feet at a time, he developed this charming habit of wandering up and down the halls (no problem, good exercise!) then stopping at the front door, opening it nice and wide (a little fresh air is always good!), then raising his shirt to scratch his belly for a good three to five minutes, then backing it up and s-l-o-w-l-y closing the door again, fumbling with the lock to get it to close properly (good for him for being security conscious!) and once back indoors, wandering some more. Ten minutes later, he'd do it all again.
We all have our little habits, no biggie, but this simple situation was a problem. For one thing, our indoor only cats figured this was a great opportunity to see what was outside in the great beyond. The two older cats had never been much interested in leaving since the doors to outside were never open long enough for them to bother. Our recently rescued six month old kitten, appropriately named Rebel, thought this was an invitation to take off. No amount of discussion, notes on the door reminding everyone to keep it closed, even close calls with the cats or rising utility bills since Grampa George was heating the outdoors about eighteen to twenty times a day, did anything to curb this growing annoyance.
Then Nana started wandering which presented a whole new problem. Nana's wandering, due to her dementia, had her trying doors to different rooms as well as the front door, on her way to no where in particular. An early evening attempt to leave the house caused alarm bells to ring, both at the door and in our heads. It was time to deal with this issue head on.
My very own Super Man came to the rescue: he drilled a hole between the door frame and the door, slipping a good sized bolt into both holes to prevent the front door from being opened unless you know to remove it (no tools or key required in case of fire or other emergency). Since Grampa George and Nana are never left alone, this is safe. We now enter and exit the house using the side door that leads from the house into the garage, then open the garage door to get in and out.
Two little steps lead into the garage from the house. Those two steps were dangerous for our two favorite seniors even with a good strong caregiver to hang onto while navigating them. Super Man came to the rescue again by immediately installing two sturdy, and very nice looking railings, one on either side of the steps.
It's not quite as elegant as our pretty front entranceway, but much, much safer in so many ways. Grampa George is now able to look out the windows of the front doors, but must use the side/garage door to scratch his belly out of doors. And Nana can wander, but is not able to make her way out of the house all by herself. Problem solved, thanks in no small part to one Super Duper Man!

Thursday, March 18, 2010

BIG White Lies

I love the people I take care of, I really do. I enjoy being able to care for them, to try to anticipate their needs and to bring contentment as well as happiness to their lives. But caregiving, as with everything, comes with its share of challenges.
Lately I am feeling those challenges present themselves more strongly. Some days I almost feel a teensy bit overwhelmed, go figure. That means it's time to ask for help.
Grampa George has a PSW (personal support worker) come to the house one hour per week. She's absolutely lovely and he truly benefits from her weekly visits. Since I take care of Grampa George's personal needs, including helping him shower, choose clothes, keep his medications in order, handle all of his appointments, his meals and his daily routine, Glenda comes to keep him company. They share an hour of conversation over coffee during which Grampa George can share stories from the past or complain about how many pills I make him take every day. Glenda does her best to make him take a walk with her, laughs at his jokes and reminds him of how lucky he is to be able to be with family, unlike many other seniors. It's great therapy for him even though I can't seem to squeeze enough of my chores into that one hour to help me much.
Of course Glenda always asks about Nana and when I tell her, she asks me when I'm finally going to apply for some assistance with her increasing daily needs.
Nana's assessment by the Community Care Access Centre is Monday at 11:00. I still haven't told her about it, but will, some time before then. I can't just admit I need help with Nana's care, since that would feel, to her, that she's some kind of burden. I'll be telling her that since Grampa George is getting on in years, (he's a mere sixteen years her junior), he's going to need more help and have more appointments over time. When I'm at appointments or helping him, she'll have someone with her, to make sure nothing happens while I'm not there. In reality I hope Nana is eligible for more assistance than Grampa George is because I'm spending more and more time helping her re-set her still loose dentures in her mouth, cut up her food before she eats it and watch her take her pills instead of fumbling them under her place mat, than ever now. Her unsteady gait and poor balance have me running to catch her whenever she leaves her seat for fear that she'll fall. And the tear in the muscle in her shoulder have made the use of her right arm limited.
Even if it sounds selfish, I'm hoping getting help with Nana gives me a little 'me' time, because Glenda's right: we (my husband and I) don't have a life. Who knows, we might even be able to take a walk together again sometime soon.

Wednesday, March 10, 2010

The Direct Approach

Caregiving is all about giving care. And it's not just about physically taking care of the needs of another; it includes caring for their emotional welfare as well as their dignity.
I do my personal best to ignore any little faux pas or boo-boo that's not worth talking about. There's no need to point out the mountain of crumbs left under Grampa George's spot at the table that the cats enjoy squabbling over once we're done eating. It's not really that important that Nana's sweater is on inside out. Neither will hurt anyone unless I call unnecessary attention to it.
It's a whole 'nother ball game when something more urgent comes up. I will most certainly let Grampa George know when six feet of his favorite scarf are hanging out the bottom of the car door before we hit the road. And I will help Nana change when she decides to put on her pants before her underwear in the morning.
I wasn't quite sure of how to handle a different sort of issue I'd noticed of late, something I felt was a delicate, rather personal topic that Nana seemed not to notice. It started with a subtle slurring of all her t's when she talked. Soon after her s's sounded like ssshhhh's. It became extremely apparent that she was having trouble with her dentures when her lower teeth would appear randomly, coming out to greet us during conversations, like a cash register drawer opening and closing at will.
For a while I wasn't sure of how to mention this little distraction since it didn't seem to bother her in the slightest. My husband didn't think it was such a big deal. That morning at breakfast he simply said: "Nana, it looks like your teeth are just about to fall out of your mouth."
Clearly this was news to her, since she reached up to check. "No they're not," she insisted, and promptly caught them in the palm of her hand.
Long story short she'll be seeing the denturist asap. And I should have said something weeks ago.

Thursday, February 25, 2010

Pills, Glorious Pills

We all have to take 'em sometimes. Most of us don't like 'em, but we're sure glad there are all kinds of medications available to us when we need them.
And so it goes for most seniors as well. It seems the older we get, the more pills we have to take. It's kind of a given since in order to keep well and to live longer our bodies need assistance. If we all exercised and ate right, certainly we could avoid some of the conditions that make it necessary to take as many medications as we do, but lets be honest, many of us don't for any number of reasons.
Regrets and good intentions aside, if we need meds, then it's important to take them, on time and in the proper dosages. It is also important to keep regular contact with the doctor prescribing them.
I'm the 'pill sorter' for Nana and Grampa George. They each have a pill case, labelled and put aside in a safe place the cats can't get to, that gets refilled regularly, as required. Its an important part of their daily lives to ensure that they take the right pills at the right time in the right quantity. And all of this changes constantly.
Grampa George figured that once he had his defibrillator implanted he'd be cured of all that ailed him, fit as a fiddle. He also figured he could toss the many pills he'd been taking, never to have to swallow another one in his life. It's been tough to convince him that there is no way to fix what fifty years of smoking and other general wear and tear on the body has done to him. He still needs all of his pills, some in lower dosages, since his heart does have some assistance now, and some new ones since we now know how seriously damaged his prostate is, from lack of proper diagnosis and medication. He still has high cholesterol, still needs his blood thinned to prevent stroke and/or heart attack, water pills to keep his lungs (and the rest of him) clear as well as anti-anxiety medication that lets him sleep nights and remain calm days when he worries too much about how sick he really is.
On good days, he realizes that it's a small thing to take a few pills when those are what's keeping him reasonably active and enjoying life. He's not in pain, can still walk and talk, enjoy a good meal, share a few jokes and laugh a little.
Nana takes her share of pills too, mostly to keep her blood pressure steady and to manage the pain of arthritis that's been plaguing her for a long time. She's on stronger pain meds lately since we discovered she has a tear in a muscle in her shoulder that could have come from something as simple as stretching to reach for a pen she'd dropped. While the new meds have caused her some constipation (not unusual for these types of medications), her stomach and appetite have not been affected (also not unusual for a patient to experience nausea and/or vomiting). The pain is a little better but still there and so next in line is physiotherapy since at her age surgery is not recommended as it would likely bring with it other serious complications. We're also diligently applying a new topical pain medication (absorbed by the skin) four times a day, since every little bit (hopefully) helps.
Pills: a big part of daily life here at the home of the Carefree Caregiver, and I'm sure glad we have 'em to help out.

Friday, February 12, 2010

The Power of a PSW

Personal Support Workers, also known as PSW's, are a godsend. They can help with anything from trimming fingernails to bathing and showering and the world is a better place because of them.
When Grampa George finally agreed to move in with us, he needed hospitalization immediately. After a long seven day stay that included the necessity of signing a DNR (Do Not Rescucitate) Order due to the seriousness of his condition he was able to come home. The urgent and constant care he needed after being discharged from hospital included the need for a wound nurse to come see him daily over the course of several weeks since he'd developed huge blisters on the tops of his feet since they'd swelled up as a side effect of his heart condition. While a wound nurse is no PSW, she taught me how to care for his 'wounds' which have healed beautifully since.
The CCAC (Community Care Access Centre) for our area sent a representative to interview Grampa G, gather a history on him and arranged for a PSW to come see him two hours a week for the first six months he was here. Now Grampa George is a most pleasant man under most circumstances, but was clearly apprehensive about some woman coming into our house, a home he was just getting to know, to badger him about keeping clean and staying active.
We were very lucky to have Glenda come into our lives and Grampa George just loves her. Not only is she agreeable to whatever he wants to do, or not do, she's the most cheerful person you've ever met.
Now when we met, Glenda dutifully asked how she could help during the two hours per week she was available to us. Many of her clients are alone and need help with meal preparation, personal hygiene or ordering their prescriptions. Those are all MY jobs here, both for Nana and for Grampa George, not that I couldn't use a hand with those things. What was more important was for Glenda to be here for Grampa George, in any way that would help him feel better.
Glenda's hours have been cut to one hour per week by the CCAC, but it's an hour that Grampa George looks forward to every Monday at 2pm. They sit at the dining room table and chat, while I serve coffee and a little something sweet. Their conversations run from what we had for lunch to the philosophy of Aristotle and they really connect. She listens and lets him talk. He'll tell her that he hates taking his pills and she reminds him that he needs them to stay well. When the weather is better they'll start taking walks again, but only if he feels like it. And she's become a good friend.
Nana's not quite sure why Glenda comes over to see Grampa George every week, but I am. Her visits make him happy, lift his spirits, give him a new perspective and are good medicine. Thanks Glenda!

Saturday, February 6, 2010

Hair Today, Gone Tomorrow

I have no formal training as a hairdresser but have been cutting, setting and perming the hair of a number of my family members for years. Certainly there are obvious dangers in such a daring pursuit, but my victims aka customers have come away relatively safely over the years.
Nana's single attempt to trim her husband's hair once, long, long ago did not turn out so well, and so she was never asked to repeat her performance. The story of how she neatly shaved off all the hair on the back of his head, with what turned out to be one of those newfangled pet hair trimmers he'd bought at a flea market, remains in the family archives as one of the funniest things she ever did in her life.
Not much more than a year into my marriage to my darling husband, when we were still living with his parents, I walked in on Nana's bi-weekly self-directed wash and set. Aside from the numbness and tingling in her hands from keeping them suspended above her head for about fifty tiny rollers her shoulder was acting up from long term osteoarthritis. Naturally I offered to help and ended up as her regular hairdresser.
I graduated from washing, conditioning and setting her hair, to home-cutting and perming thanks to 'Toni'.
My tried and true method of simply cutting off the same length of hair from each section that had grown out worked to keep her simple halo of curls in check and to keep my husband with the same universal cut he's had since the day I met him. (His numerous bad hair experiences with barbers who wouldn't listen kept him from going to professionals, and yet had him trusting me with his doo, go figure.)
I don't trim Grampa George's hair, but do apply gel and comb it out for him after I've toweled it dry after every shower. And I've trimmed his mustache now and again when it begins to interfere with mealtimes.
My children have long outgrown the haphazard bangs trims and other hair experiments I've doled out over the years, but look back lovingly on family and school photos to remind me of my limited scissors skills. They always look amazing now since they trust the professionals to keep their tresses trimmed.
Nana still gets her three to four perms a year, her hair the same tough dry consistency it's always been. There aren't any bald spots though it tends to flatten at the back since she sits and sleeps a lot. It grows fast enough to force me to do regular spot trims along her collar line, but she's a happy customer who always give me a tip when I'm done: rinse well, dear.

Friday, January 29, 2010

The Art of Waiting, Patiently.

When I examine my day, I'm amazed at how much time I spend simply waiting. I wait for Grampa George to get up in the morning, now that he's learned that it's alright not get up at the crack of dawn; I wait for him to get up from his naps (yes that's plural because there are at least 5 and a half naps per day depending on his mood) so that I can serve breakfast, lunch or dinner; I wait for Nana to come out of her room in the morning because she thinks she has to stay in there until she hears someone else up and about so as not to disturb anyone, except that we've all been up for hours, since she's needed a hearing aid she refuses to get; I wait in waiting rooms at doctor's appointments, labs and senior's centres; and every day I wait while Nana finishes eating.
Sure I could just wake Grampa G. and Nana whenever I want them to get up, make them stick to my schedule and toe the line. Actually, I don't have the heart. One of my philosophies as a caregiver is to allow the dear people trusting me to care for them to have as much freedom and dignity as possible. One of their rare freedoms is to be able to sleep if and when they want to, within reason. Who am I to barge in on someone napping, just to plate their lunch on time. A few minutes here or there won't hurt anyone, and so I wait.
Waiting at appointments of any kind is a given that doesn't even phase me anymore. Matter of fact when others waiting alongside me start fuming, I tend to extend a smile and some gentle humor to ease their distress if I can. And I always bring my knitting. If I'm deep into a ten yard afghan, I take along some other quickie project that's more portable. The Needlework Guild of Canada is always happy for donations which they distribute to the long list of charitable organizations they support, and they have an amazing wool exchange program to help offset the cost of supplies to their members. And knitting is soooooo relaxing. Grampa George and Nana prefer to people watch, or doze, between washroom breaks, while waiting at an appointment; worst case, if they get antsy, I haul out a large print Readers Digest I carry for emergencies.
Waiting for Nana to finish eating, anything at all, has proven to be a challenge at times. While everyone else at the table polishes off their meal in record time, she carefully chews and pre-digests every mouthful before cautiously swallowing. Certainly I could walk away, fold laundry or take a short nap myself if I wanted. But to leave her sitting there at the table all by herself, like a little kid in trouble, would be extremely rude. So I sit with her, however long it takes, until she's done. The daily paper is dog eared by the time I'm done with it, from the front page to the obituaries, as I've taken to reading everything in it including the classifieds. I know every new massage parlour and tantalizing personal ad, each breeder with a new litter of Rottweilers and the shots they've had, and who's paying big for stamp collections in any condition. Between bites we chat. We're big on weather, Nana and I, taking bets on how many degrees below zero the temperature will fall overnight. And we examine the adorable Kittens and Friends photo on the daily calendar I've put next to her placemat to help her remember what day it is.
Waiting, like anything else, takes practice. I've had plenty but still have days when I get fidgety and heave the occasional silent sigh, wondering how long she'll be today. Then I remind myself of how lucky I am. I've been blessed with the privilege of being able to give back to someone who's given me so much. What a wonderful thing! If Nana needs time to enjoy her meal, then time is what she shall have and I will patiently wait, reading, chatting, musing at how something so simple is really no trouble at all.

Monday, January 18, 2010

Hygienically Speaking

In most developed countries, hygiene is relatively matter of fact, or it should be. Frequent handwashing is the most common and one of the most effective practices to keep from spreading germs and other unmentionables.
It's out there: we're being bombarded with messages, advertisements and admonishments from all the experts. And so a large part of the population is learning. Good for us!
Training someone who's hygiene habits are more than seventy five years behind is not so easy. Nana's handwashing is relatively reasonable, particularly post-bathroom, the most important time. She still scoffs at the very mention of washing fruits and vegetables though, whether they come from the grocery store after who knows how many hands have touched them or whether they've just been plucked from the garden, soil laden and bug buzzed. When she was growing up they'd dig up carrots by the fistful, simply swishing the soil from them in the stream the neighboring farmer's barn effluent would leak into; yummy.
Grampa George's habits are a little more concerning. Handwashing was a commodity, not a responsibility when he was growing up, since water, food and many other things we consider necessities of life were often not available. Toilet paper being one of those meant you'd wipe your butt with a handful of leaves, grass, or hay or if you were really lucky some torn up newspaper hanging from a nail.
To cut to the chase, he doesn't wash his hands after using the toilet and no amount of reminding has helped change that nasty habit. Unfortunately it means that anything he touches gets 'contaminated'. Nobody's died yet in our household as a result of this, but it's gross.
Greeting anyone with a handshake means passing on whatever's on his hands. Eating something as simple as a salt-free cracker he's handled means ingesting what's there. If there's no spoon available he's been known to nonchalantly stir his lukewarm coffee with his finger. Could be worse, right? Absolutely.
Grampa George's unwashed hand ended up reaching into the pickle jar to grab a baby dill when it happened to be standing on the counter open and unsupervised. Had to toss it, half-full; sorry starving people around the world, but it was too much for me to handle.
What to do? Keep reminding him, gently. (No need to insult the man.) And put out an abundance of antibacterial hand sanitizer bottles. Drawn to them in doctors offices and hospitals whenever we go for appointments or tests, Grampa George has learned to reach out and squirt some into his hands from time to time. It's a start and better than not doing anything. Now all I have to do is try and co-ordinate the hand sanitizing with his bathroom visits. And keep all pickle jars safely secured.

Thursday, January 7, 2010

Eat, drink and be wary.

Watch your back, folks: Sheriff Sodium is on the prowl!
We all gotta eat, but when part of staying alive and well means crucial dietary restrictions someone has to be in charge.
Nana's used to staying away from certain foods. Once you've had a near death bowel obstruction, and she's had six, you become almost afraid to eat. Can't blame her, really. She stays away from raw fruits and vegetables, particularly the cruciferous kind that can cause excess gas, bloating or in Nana's case possibly fatal flatulence.
To Nana there is no such thing as 'al dente'. She prefers her food overcooked, relatively bland and not too much at a time. This meant that any meal she cooked was perfectly enjoyable for her. The others at the table would often spend their meal doing their darndest to catch soupy spaghetti with their spoons. It wasn't too long before I'd cook two meals for every breakfast, lunch and dinner, cleverly tabled as one so as not to hurt Nana's feelings.
Now Grampa George is another story. Stage four of congestive heart failure for him means staying as far away from salt as possible. Enlarged and disfunctional, his heart has enough trouble keeping his circulation going. This means that the rest of his organs are barely keeping up with their own jobs. Retaining water is one of the biggest problems. Before he moved in so much water had gathered in his lungs that he could barely breathe and had to sleep sitting upright. Even more water pooled in his feet, the intense swelling finally causing huge blisters to open up that took months to heal.
Nana's pretty good about keeping to her diet and now that she's 'forgetting' more, she's occasionally trying foods she's sworn off for years. Grampa George is having a hard time of it. Now that he's feeling better he's hungry. He's allowed a reasonable amount of food but still gets up from the table unsatisfied. Keeping his meals salt free was impossible. It's easier to limit the salt in his food and limit his portions. There's no reason to torture the man. We all live finite lives and taking away all food enjoyment just isn't right. We try our best to stick to healthier, limited snacks and tasty favorite meals.
What's helped a lot is serving soup for either lunch or dinner on most days. Also, meals are not dished out at the table where everyone can help themselves, but doled out by me, one plate at a time, right from the stove. Second helpings are allowed since first helpings are reasonable in size and give me the advantage of mind over matter. Since carrots and celery sticks don't go well with dentures, I've substituted red, green and yellow peppers with great success and a sprinkling of balsamic vinegar to hide the empty spaces on the plate.
Now if only I could keep Grampa George from grabbing a handful of mini dills while gliding past the kitchen counter after dinner to put his empty plate in the sink.