Living on the Greener Side of the Fence

When I began my role as my mother’s caregiver, I gained valuable insight from other folks who were taking the same journey. Friends, close acquaintances and friends-of-friends, and even total strangers. And as I continue traveling this oftentimes challenging road, I have come to the realization that I have the luxury of living on the side of the fence where the proverbial grass is greener.

Now, does my mother suffer from dementia? Absolutely. Does she have medical conditions which limit her physical abilities? Yes, she does. Does she maintain a positive mental outlook on a daily basis? Thankfully, yes.

When I hear stories from those folks who have not been gifted with a sweet-hearted soul like my mother, I send a sincere message of gratitude into the universe. Because my mother is an intelligent and pragmatic woman who has chosen to live her life as a happy camper. She is truly a joy to be around. And that is not only my opinion. It is also the opinion of the residents and staff at the assisted living facility where she now lives. And everyone else she comes in contact with, for that matter.

Now, does she work on my worse nerve on occasion? You betcha. But my mother and I have a lifetime habit of working on each other’s nerves on occasion. Hey, I can still remember those teen years when my gal pals and I were spreading our wings and believed our mothers were clueless. Yet, my mother and I survived those years, as well as other difficult times, and we came out the other side as friends, and with a greater appreciation for each other.

A number of years ago, my mother made the observation that if you are a pleasant person when you are younger, the chances are you will continue to be pleasant as you get older. On the flip side, if you were nasty in your youth, you will most likely get nastier as you move into your elder years. As I learn of the experiences from other family caregivers, I realize my mother was right in her assessment.

Like my friend whose mother could have been a poster child for the “It’s All About Me” life philosophy, choosing to put her own desires ahead of her husband and children, fully expecting her family to see to her needs first. So when this mother became elderly and needed assistance, common sense tells us that her demands on her family would increase. And they did. With remarkable speed and with an intensity that almost knocked me off my chair when my friend shared the stories of being a caregiver for this mother.

Or the tales of those folks who feel the need to sit in their car after a routine visit with an elderly parent, and shed tears of frustration and anger before they feel calm enough to drive home. Or those folks who feel the parental verbal abuse they have experienced all their lives is simply their burden to bear in life, no matter that the abuse has only escalated to new levels as their parents age.

Yet, I am also reminded there is another side of the coin which is just as sad. Those elderly folk whose families place them into a facility and walk away, severing all contact. With the exception of maybe a phone call on a birthday, or a token half-hour visit a few days before Christmas. Oftentimes these elderly folks have spent entire their lives lovingly taking care of their children and their only crime is living longer than their families thought they would. I have seen this more times than I wish I had.

And once again I am reminded how truly fortunate I am. To live on the side of the fence where the grass is greener. With a mother who is happy and healthy and lives in a safe environment. And when I see her bright smile, all the challenges of my journey quickly fade away.

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Thwack!

Yes indeed, that is the sound of my mother hitting her fire-engine-red “Panic Button”. And how timely it should occur the day after I posted my “Not-So-Easy Button” entry. However, this particular panic attack was not due to her concern regarding the location of an object. But rather a routine dental appointment scheduled for next week, and what she perceived to be another snowstorm heading our way. Which, in her mind, meant she had to cancel the appointment because of bad weather. But she wasn’t sure how to go about doing that. So she called me. Hey, no problem, right?

The odd duck thing is, I didn’t even know she had a dental appointment until a few weeks ago. I first heard about it during a casual chatty-cathy conversation with the head nurse at my mother’s assisted living facility. Which was quite the surprise, since I schedule all of my mother’s appointments and have an arrangement with her medical professionals as the point person for my mother’s care. And not because I am a control freak. But because my mother is almost 94 years old and suffers from dementia. And we never know how mentally capable she will be on the day of any appointment. Or if she will even remember she has an appointment. We do know she will need assistance and I am the provider of that assistance.

And I would not have scheduled a routine dental cleaning appointment at the end of February, when the weather in my part of the world can be a bit dicey. I would have scheduled this appointment for sometime in April, when I know it would be safer for her to travel.

Apparently, there was a glitch in my carefully-planned strategy to manage my mother’s routine healthcare. More to the point…a glitch with the administrative staff at the dental office. For some wack-a-doo reason, they completely ignored the instructions they have been following for the past two years. They called my mother instead of me and told her she needed to come in for a cleaning, and scheduled the appointment with her. Ooops.

So…in the middle of my work day, while I was putting out three different fires with three different clients for three different and amazingly tight deadlines…I had to stop what I was doing and field my mother’s calls. One after another, after another, after another as she kept hitting her fire-engine-red “Panic Button”.

So…I called the dentist office. And guess what? The dentist office was closed for the day. On a Friday. As I reached for my “Can You Believe It Button”, the phone rang. Yup…you guessed right…it was my mother. Again.

So…I found myself having a disjointed and frustrating conversation with my mother, while the call-waiting feature on my phone was constantly beeping in my ear because my clients were trying to get a hold of me. Gotta love some Fridays, right?

At the end of the day, my clients were happy campers and all deadlines were met. My mother finally accepted the fact her appointment would be rescheduled in a timely manner, because the matter was now in my capable hands.

My evening came to a close with an after-dinner cuppa tea in hand, and my always-supportive husband and our two sweet-hearted canine companions snuggled nearby. I breathed in the scent of the tea and exhaled a long sigh. Then reached over and tapped my deep-azure-blue “All Is Well With The World Button”.

The Not-So-Easy Button

There is a television commercial which has gained popularity, from a large office supply store promoting a magical device called the “Easy Button”, which will promptly and easily solve all your office supply needs with a single tap of your hand. And as could be expected, this ad campaign has inspired numerous other types of buttons among my circle of caregiver friends. But none of them could remotely be defined as “easy”.

We have the “Dementia Button”, which is the most popular. And the “What Now Button”, which is a close second. Immediately followed by the “Not-So-Easy Button”, which is the one I have embraced.

Every now and again my mother, who suffers from dementia, hits a bonafide “Panic Button”. I have yet to determine what is the catalyst for her hitting that button. There is no real consistency of events leading up to her reaching for it, with the exception of when she and I go on an excursion. But rather it is some random thought which enters into her mind, causing her to go into panic mode. And always over an object and its location.

When I pick her up at the assisted living facility for an appointment, we start with a process that has evolved into a regular routine. This consists of her sitting down on her bed with her wallet in her lap, methodically pulling out all the cards from their slots. Healthcare cards. Credit card. Photo ID card. And then insisting that I have taken some of her cards and demanding I return them to her. But she cannot identify what cards are missing.

I have tried various response methods over the past few years. When she first started this routine, I would calmly go through all of the cards with her, explaining what each card was and assuring her that each was current. But as she would repeat the process over and over and over, I do admit to having my patience sorely taxed. Sometimes to the point where I would lose my temper with her. Which I quickly learned only made the situation worse.

As I am wiser and more experienced now in dealing with the effects of dementia, I have learned to mentally give my “Not-So-Easy Button” a quick tap to gain perspective. When the routine begins, I explain to her that she has everything she needs and what she does not have…I do. I give her the luxury of repeating the cycle three times, then abruptly change the subject. Usually by asking her if she has to go to the bathroom before we leave. While this verbal prompt is effective, it does put her into the repetitive mode of going in and out of the bathroom…a minimum of six times and a to-date-maximum of 15.

Hey, I get it. I get the constantly-going-potty part, because she is almost 94 years old. And I get the where-is-my-stuff part, because my mother is an intelligent woman with an analytical mind set. She always took pride in being organized and having all her ducks in a row. So this obsession with the contents of her wallet before she leaves the assisted living facility makes logical sense.

It just ain’t easy to deal with sometimes. Honestly, it ain’t easy to deal with all the time. It is emotionally draining. And mentally fatiguing. And sad to witness.

Whether it be the contents of her wallet…or a 50-year-old winter dress coat that it is now so big on her that it drags on the ground…or a 35-year-old pair of high-heeled winter boots she can no longer walk in…or a 20-year-old watch that no longer runs…

Hey, I get it. Sometimes stuff is important. She fell in love with that winter coat 50 years ago and splurged to pay the asking price for it. And 35 years ago those winter boots were another simply-to-die-for splurge. And most importantly, 20 years ago that watch was a gift from an old and dear friend.

So who cares if that coat and those boots reside in a suitcase in the back of her closet and I drag it out now and again to show them to her? Or if the watch that sits in the bottom left drawer of her jewelry box gets removed from its velvet box on occasion? I certainly don’t care. But she does.

So what if I tap my “Not-So-Easy Button” from time to time. Okay, maybe a lot more than just from time to time. Someday I will retire this button. But until then, I will just keep on tapping it. As many times and as hard as I need to.

Seasonal Sanity

This is my second winter season since my mother moved into an assisted living facility back in October of 2012. And with the wild and wacky weather we have been experiencing in our part of the world this year, it is a relief to know she is safe and cared for 24/7.

The last few years of her living independently weren’t my easiest years, especially during the winter months. Heavy snows, ice storms and severe cold posed seasonal challenges with maintaining her care. Would she lose power and not have any heat? Did she have enough food and medications to last until the roads were clear again? If there was a medical emergency during a storm, would we be able to get to her?

October used to be one of my favorite times of the year, when the leaves on the trees display their brilliance and the air turns brisk. I love how the seasons evolve in my part of the country, and appreciate each for its own charm. But once I became my mother’s primary caregiver, October took on a different meaning.

It meant it was time to start storing extra supplies for the winter, in case she could not get out, or I could not get to her. As her dementia escalated and the arthritis decreased her mobility, winter became a season of concern. Would she slip and fall when she went out to get the mail? Or would she forget her keys and lock herself out in the cold? Would the phone lines go down and she would have no means to call for help?

Once a season I embraced, I began to dread the approach of winter. Watching the snow fall was no longer an enjoyable experience, but rather became an unwelcome event. Seeing the ice glisten on the tree branches, turning my backyard into a crystal palace, was once a picture I cherished. As my responsibilities to my mother increased, that same peaceful picture triggered nagging and worrisome thoughts in my mind.

And even though I no longer have the same concerns now that my mother is in assisted living, those worrisome thoughts still linger. Like a bruise not yet quite healed. As time passes, I know they will become more like whispered memories, and the day will come when they do not carry as much weight.

Right now I take comfort in the knowledge my mother’s daily needs are being met, no matter the season. And I realize that sometime in the near future I will be able turn the calendar page over to October, and will once again be able to look forward to the approach of a favorite season.

Until that day comes, I will embrace the timeless sight and peaceful silence of a snowfall. And will keep an eye out for the crocuses to bloom, signaling the approach of Spring.

Chandeliers and Instincts

When I started my quest to find an assisted living facility for my mother, I pinged friends and close acquaintances who had already traveled this road. Which gave me the benefit of a variety of opinions, all based on individual personal experiences.

One friend suggested I seek out non-profit versus for-profit facilities, because of his experiences in the area where we both live. He said he discovered a higher quality, and a more affordable, level of care with non-profits.

Another friend suggested I visit the facility during the week as well as on the weekend before I would make my final decision. This would enable me to see if the facility maintained the same level of care throughout a seven-day week. And once my mother was a resident of a facility, I should vary my visitation schedule rather than always coming on the same days at the same times. She said she had overheard conversations at one facility she had been considering for her mother where the staff bragged they only had to be on their best behavior when they knew a family member would be visiting.

Another gal pal, who is a nurse by profession, recommended I check out the ratio of nurses to residents, to ensure the facility was adequately staffed. And another told me if I walked into the lobby of a facility and there was a fancy chandelier hanging from the ceiling and no residents lounging around…I should run away quickly. Very quickly.

I had a giant question mark over my head at that comment. So, I asked for an explanation of his reasoning. He told me that in his experience, there are those facilities which feature luxurious public spaces to impress the family members making the decision of where to place their elderly. But once he investigated further, he found the quality of care was below acceptable standards. Therefore, his qualifier for these types of facilities was a fancy chandelier in the lobby.

Yet every opinion, to a person, told me I would know which was the right facility for my mother when I saw it. And that I should do my research and maintain my due diligence, but I was to trust my instincts above all else.

And they were right. After many months of searching for a quality facility for my mother, I found two which met all my criteria. And while my instincts were leaning towards one facility, which felt right from the moment I walked in, I knew my mother’s vote was as important. So I took her for a tour of both facilities, where she met the staff and was able to see where she would live and have meals and participate in activities.

Turns out her instincts were leaning towards the same facility as mine were leading me. And we were fortunate there was an opening that met with our schedule for her to move from living independently into assisted living.

Funny thing, though. When I first walked into the lobby of the building where my mother now resides, there were no residents lounging about, because of the time of day I was there. I saw a beautifully decorated room with sitting areas and original paintings on the walls. I looked up and noticed an ornate ceiling medallion with an elaborate lighting fixture. And while I wouldn’t consider it to be a traditional chandelier, it did give me pause.

However, once I met with the administrator and toured the facility, and was introduced to other staff members, I knew I was in the right place. I trusted my instincts, and so far…that decision has far outweighed any aversion to chandeliers.

Who Woulda Thunk?

Close friends and family members have often told me I am one of those folks who stays calm, cool and collected during a crisis. I don’t hit the red panic button and run around like the star victim in a chainsaw massacre movie. Little do they know when the crisis is over, I sink into the closest comfy chair and let out a deep sigh punctuated with a rousing “Jeez-la-weez!”

So a few months ago when I got the early morning phone call from Head Nurse “Kay” at my mother’s assisted living facility, I calmly listened as she described my mother’s condition. My mother had been found wandering around a part of the building she rarely goes to unless she and her gal pals are heading to bingo. My mother did not know where she was. She did not know why she was there. She was completely disoriented. Thankfully, one of the staff saw she was in distress and escorted her back to her room, then notified Nurse Kay.

Nurse Kay told me she believed my mother had an infection which was affecting her ability to comprehend. And based on her experience, it was most likely a urinary tract infection, which is rather common in the elderly. When I asked Kay how could an infection cause my mother’s mental state to be in such a muddle, she said she really had no definitive answer for me. She could only tell me that it does happen and she sees it happen a lot. And that it happens very quickly. I got the same answer from our family doctor when I spoke to him. Who woulda thunk?

As it turned out, my mother did not have a urinary tract infection, but rather an infection in two of her teeth. And with the assistance of Nurse Kay, within a few hours of that morning phone call, my mother was in the dentist’s office. A few hours after that appointment, my mother started taking antibiotics for the infection. After the antibiotics did their job, she was in the oral surgeon’s office getting the teeth removed. All is well that ends well.

But here is the rub: my mother knew she had a problem. But she was hiding it. From eagle-eye Nurse Kay and her crew. From me when I had visited her a few days before that morning call. From her gal pals. So no matter that my mother was becoming more befuddled with each passing hour, she was still clever enough to hide her rapidly swelling lower jaw.

When I picked her up to take her to the dentist, she looked like a chipmunk with a golf-ball-sized stash of nuts in her cheek. And as we were leaving her room, she asked how bad her face looked. I smiled and told her she looked like an adorable chipmunk. I then asked if she was in any discomfort. She replied her jaw was a bit tender and had been for a few weeks. When I asked her why she waited so long to tell anyone, she replied, “I was waiting for it to mature.”

MATURE? Are you serious? Jeez-la-weez!

With this experience I gained more than a knowledge of infections and how they can affect the mental stability of the elderly, and how common they are and how often they can occur. I learned how dedicated Nurse Kay and her staff are to their residents. And how much they care for them on a personal, as well as a professional level. When I brought my mother back to the assisted living facility after she had her teeth removed, I lost count of the number of staff members who asked how my mother had done during the procedure. And each assured me they would keep an extra eye on her and let me know how she was recovering. Which they did do.

I was reminded there are many medical professionals who are truly dedicated to their patients. Like our family doctor, who stood at the ready should we need his services. And the dentist, who immediately opened a time slot in his schedule to see my mother. Along with the oral surgeon who was patient, polite and respectful with my mother. He told me he enjoys working with patients from the “Great Generation” [aka those who have lived through WWII]. He says they are no nonsense folks. They tell him not to worry about them but to simply get the job done. He says there is a lot we “youngsters” can learn from this generation. And I agree.

I have also discovered that sometimes a rousing “Jeez-la-weez” is in order DURING a crisis, rather than after.

Liar, Liar, Pants on Fire

White lies: those little untruths my mother believes are perfectly acceptable in polite society. Usually involving birthday and Christmas gifts. Or telling my father it was “orange” cake not carrot cake, because she knew he would not eat a cake if he thought those bits of orange in the cake were actually a vegetable. To this day, I am still not sure what she used to tell him about her zucchini bread. Unless she called it her “nutty” bread, since her recipe called for a ton of nuts.

My current challenge is catching onto the little white lies she has been telling me lately. And trying to determine if they are simply a part of her personality profile, or a by-product of her dementia.

Case in point: laundry duty. In a previous post, I illustrated my recent experiences with my mother and the laundry saga. And how I had pinged her repeatedly, inquiring if she now needed help keeping up with the pile of dirty laundry rapidly invading her closet.

She swears she does not need help. She swears she just was not in the mood to do it. And she swore to me that she had done it.

When I visited her the other day and opened her closet door to put away some of the personal care items I had brought her, I tripped over a pile of sheets and pillowcases. The same pile of bed linens that was there during my last few visits. The same pile she swore to me that she had laundered.

So, I found myself on a quest to discover the most appropriate methodology of dealing with the Laundry Monster growing in her closet. And after much deliberation, I have decided to take the laundry with me next time I visit, quietly and without fanfare. And make this a habit during each of my visits.

One thing I have learned when dealing with the beast I have labeled as Missy Dementia, is not to make a big deal out of something if it can, instead, be done without a fuss. But rather, slide it in under my mother’s radar.

Yet I am now faced with a new realization. I seem to fall not too terribly far from my mother’s tree. Seems I have embraced the idea of the little white lie. To allow my mother to keep a sense of dignity while still making sure she is taken care of. And to avoid yet another battle in the war with dementia.