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.