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.

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.

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.

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!

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!

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.

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!