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.

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!

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.

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.

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.

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.

Cookies Are Done!

Christmas comes with its usual traditions, none so urgent in our family as making sure that all the cookies we usually bake are ready. Originally that was Nana's job, one she loved and guarded jealously. I'd handle the other, less important things such as decorating the house, putting out Christmas towels, putting up the tree and directing the placement of the indoor and outdoor lighting.
When Nana's medieval cookie press became too hard for her increasingly arthritic hands to handle, it was time for me to help with the baking. Under no circumstances did that give me any right to do anything even vaguely associated with the baking of the cookies any differently than Nana had always done it. The spritz cookies that called for ground almonds would be made with ground walnuts since almonds were much too expensive, back in 1952. And we most certainly could NOT buy already ground walnuts; we'd buy them in the shell, and sit there days ahead of time using the ancient finger-crippling nutcracker to open each one, diligently dig out the meat and finally put it through the nutgrinder you had to clamp onto the edge of a chair, using child labor to crank the handle while feeding in the nuts one handful at a time. And so our cookie baking traditions remained unchanged for, almost, ever.
I've finally started making a few changes, not to break tradition, but to ensure we'd actually have cookies ready, on time, for Christmas. The cookie baking process had slowed to a crawl while I watched Nana struggle with every little thing. When actually finding the ingredients I had carefully arranged on the counter became a chore, it was time to step in.
I'd sneak in a batch while Nana was crawling through her list of Christmas cards, eliminating those Scrooges who hadn't bothered to write back in response to hers last year. I'd bake once she'd gone to bed, praying the smoke detector wouldn't go off and send everyone scrambling when I burnt the odd tray. And I'd have her dot the Raspberry Nut Balls with jam once they'd come out of the oven.
I've survived another Cookie Baking Season having bypassed potentially hurt feelings and indicators of inadequacy. I've deviously started using pre-ground nuts, any kinds I want, to bake the Spritz cookies. I've discovered that my food processor can get the walnuts that go around the Raspberry Nut Balls chopped to just the right size, no cutting board or butcher knife required, entirely eliminating the need to vacuum the kitchen post-chopping to gather up all the nuts that went flying during this hateful chore. And who knew my beloved stand mixer could churn out the most beautifully perfect dough for each and every recipe. I'll bet I could teach it to use a rolling pin for when I make the cut-out cookies if I tried hard enough.
Now when Nana asks if 'we're' making the same cookies we make every year, I can confidently say 'of course 'WE' are, Nana', and happily task her with sampling what 'we've' baked, so that she's still involved, just like always.
Now if only we could find a way to keep the tree from falling, the way it does every year at Christmas. Ah, traditions! Gotta love 'em.