Chat @ Care-giving: The Post I didn’t Get to Write

Can it be just weeks ago that I told you about A Place for Mom and had hopes of moving my mom into an assisted living facility? Yes, it can.

When I started the process, hospice wasn’t even in the picture.  Mom sent me on my assisted living search with very strict guidelines concerning geography and high standards concerning lifestyle.  That made the list very, very short.

In fact, there were only two facilities that made the cut and one of those was just outside Mom’s geographical boundaries.  First I have to tell you about the geographically undesirable one, because geography isn’t so important to me and it’s where I’d want to go if I had to be in assisted living.

The first thing I liked about Parson’s House was that it didn’t look like an assisted living facility.  I had the address in my GPS, but when I arrived I didn’t realize I was there.  It looked like a large private home with extra parking out front.  When you walked inside the illusion continued.  Yes there was an office off to one side, but it was easy to ignore.  The feeling of home overpowered everything else.  Maybe it was because I could smell the evidence of lunch being cooked, but whatever it was, I liked it.

The dining room wasn’t the largest or the grandest or the most beautifully furnished, but something about it, maybe the style of furniture said this was a good place to be.  Over to the side was a grouping of sofas and chairs.  They looked comfortable and showed signs that they were actually used.  That was something unique.

See, most of the other places I visited were pristine.  They had the very latest in furnishings and the best word I can think of to describe them is opulent.  But I’m not opulent.  The chic furniture groupings looked like they belonged in a furniture showroom, not someone’s home – and that’s what assisted living is, someone’s home.

Don’t get me wrong.  Parson’s House is very clean and their furnishing are top quality. Things just didn’t seem so opulent.  I didn’t feel as if I would be upsetting the balance of the world if I actually sat down on the sofa and read the paper.  There was evidence that someone had done just that not too long before.  I liked that.

But what I liked best was that residents were outside on a large patio, having a resident meeting.  They were planning their activities for the next month.  What a concept!  All the other facilities gave me a list of the activities an activities director had planned for the residents.  At Parson’s House, the residents got together and decided what they wanted to do and it looked like they were having fun doing it.  A variety of dogs were helping with the meeting and one of them was a Shih Tzu named Precious, just like my Shih Tzu.

And get this, instead of a professionally maintained landscape masterpiece, they had a vegetable garden maintained by the residents.  The patio was decorated with hanging baskets, each the proud responsibility of an individual who lived there.  I don’t even like gardening, but it gave everything a much stronger feel of home than any other facility.  I was hooked, but the tour wasn’t over.

They had a little of everything needed at Parson’s House, exercise, crafts and like, but a feeling of participation, rather than mere availability, pervaded.  The hoops used for one class were leaning against a wall.  Nothing was messy or cluttered, it just looked natural and normal, instead of pristine.  Pristine can be very cold.

On the other end of the facility from the exercise and crafts was the media room, but it looked more like my den.  They may have actually had the latest in technology, but what was more important to me was that someone was actually sitting there reading a book.  People lived here.  They weren’t locked away in their apartment waiting for the next meal.

As they showed me an apartment, I couldn’t help but be dismayed.  I just couldn’t imagine Mom living happily in one room.  Where would she put all her clothes?  That’s when “we can do that” showed up.  Everywhere else I’d been, they told me how my mom would live. At Parson’s House, as I explained what I thought would best suit Mom, I was told, “we can do that.”  Sure, they could put a door between two units and they offered other possibilities.  I liked that.  Would the alterations cost me money?  Sure they would, but how do you put a value on happiness and comfort for someone you love.

OK, I was sold.  I knew it was outside Mom’s geographical zone.  I doubted that I could convince her to move there, but I’m telling you, it’s where I’d want to be.   In a couple of days, I’ll tell you what I picked out for Mom.

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Chat @ Caregiving: Downhill Fast, But Not Fast Enough

Some things happen fast. Some too fast. Others not fast enough.

A week ago I made a deposit on an assisted living facility. Today I’m trying to wrap my mind around the idea of palliative care. The changes are coming more quickly than I can grasp, but not fast enough to bring my mom the peace and relief she’s longing for.

After my midnight ramble last Thursday night, my husband and I slept in.  We were enjoying our morning coffee ritual, the one where I make him coffee and we spend about half an hour together trying to focus on the positive aspects of our life. Our brief interlude was interrupted by a couple of phone calls.  Mom had been suffering from nausea for several days and nothing seemed to help it.  One medication would put her to sleep, but it didn’t get rid of the nausea.  A crisis was brewing.   The doctor was coming after one and there were decisions to be made. Coffee time was over.

There’s been a lot of doctors in my life lately.  There’s Dr. Alan Kaye, Mom’s personal physician.  There’s another doctor, at the nursing facility, we call Dr. K, because her last name is unpronounceable.  Then there’s Dr. M.  I’m not trying to be mysterious. It’s just that no one can pronounce her name, either.

Dr. M had been the physician who dropped by during my midnight ramble.  Dr. K was the one I was supposed to meet with.  Dr. Kaye is the one I know and trust.  So I put a call into Dr. Kaye and got myself ready to go to the facility.  The next few hours were awful.  Mom was really sick and thanks to the wonders of modern medicine, no one could do anything.

I wasn’t sure what to do, because I was waiting on a call from Dr. Kaye and waiting for Dr. K to show up.  Mom just wanted someone to knock her out, but it wasn’t quite that easy. The nurses on the floor couldn’t do anything without Dr. K’s say so. Taking her to the hospital might have gotten her a little pain medication, but would have opened up another can of worms.  I didn’t want to open that can without Dr. Kaye’s approval.  For all the advances of modern medicine, I longed for the day when the town doctor just dropped by daily and administered laudanum.

To a certain degree, Mom didn’t care what category her health givers put her in, she just wanted some relief.  She was only sure of one thing, she didn’t want that relief to be called hospice.  In her book, that relief was synonymous with giving up and Ruth Cave doesn’t give up.  I have rarely felt so helpless in all of my life.

Finally, at three, Dr. Kaye’s assistant returned my call, but all she did was get the details to pass on to Dr. Kaye.  Within twenty minutes he called.  One thing he was sure of, Mom should not go to the hospital.  He peppered me with questions and I turned him over to the charge nurse. While he was on the phone with the nurse, Dr. K breezed in.

I’m very respectful of the medical profession – from the aides to the doctors .  I respect the training they’ve gone through and appreciate their desire to be in that line of work.  I know I’m not equipped for it.  I’m also very respectful of the fact that these people have lives and cares of their own.  However, I didn’t have much respect for Dr. K.

Dr. K had requested that I be there to discuss my mom’s situation after one.  It was almost four, when she arrived.  I didn’t think Dr. K was showing me much respect.  And when I said she breezed in, I meant it.  I was at the nurse’s station listening as the head nurse talked to Dr. Kaye.  I saw a woman with long blonde hair, a white gauze Indian shirt with beading and clogs.  She looked like she didn’t have a care in the world and I wondered who in the world she might be. As she flung her long blonde hair over her shoulder, someone told me she was Dr. K. The nurse turned Dr. Kaye over to Dr. K, who disappeared around a corner. The charge nurse returned my phone and I was dismissed down to my mother’s room.  Surely something would happen now.

Something did.  Dr. K came in and decided Dr. M had been wrong to put Mom on an IV for dehydration.  I heard her order the IV stopped and lasix to be dosed intravenously.  Some RN came into do that, but he decided the fluid should continue and added the lasix to the drip.  I gave the LVN with him a significant look and as soon as the RN left the room, she shut off the IV and went for help.  She returned with another pair of RN’s who removed the IV and gave the lasix as the doctor had requested.  Can you imagine how my head was whirling?  All this while, Mother is moaning in misery.

Lasix aside, what were we going to do about Mom’s nausea?  Dr. K returned.  I don’t remember her exact words, but she certainly didn’t approve of Dr. Kaye’s opinion of things. She gave me a list of things that she thought could be excuses for overriding Dr. Kaye.  I’ll spare you, but I reminded her that Dr. Kaye had been Mom’s personal physician for decades and that Mom had just been in the hospital.  They said there was nothing else modern medicine could do for my mother and all we were looking for was some relief from the nausea.  Dr. K told me she had other patients she had to see about on another wing.  She stopped at the door and turned to me.  I do remember what she said there, “Hospital or hospice – you’ve got a tough choice.”

She was gone before I could say, “We already made that choice.”  I looked at the clock and it was five.  Five on a Friday afternoon.  Friday on Rosh Hashanah and Dr. Kaye is Jewish.  I sat down to talk to mother.  I laid it all out for her and she said, “I’d put up with anything to get some relief.”  I said,”Then I’m going to call hospice.”  Her only reply was white noise.

The next two hours were excruciating.  Thankfully, I’d followed Dr. Kaye’s request and signed up for hospice without indicating a start date during the week before.  Within minutes, Mom was on hospice, but it was five thirty on Friday and we were waiting for Bernard.  Though I’d been doing everything I could for Mom since I got there at eleven, she was still miserable.  I can’t blame her for her anger and accusations as we waited for Bernard, but that didn’t take the sting out of them.

When he arrived, he got the smile and sweet words I’d wished for all day.  After taking a few vitals he got on the phone and started the ball rolling.  When he left, Mom still hadn’t gotten anything for the nausea, but she felt like something was finally happening.  A continuous care nurse showed up.  I wasn’t sure what that meant, but I was glad for her.  I finally gave up and went home.  Mom wasn’t talking to me anyway.

The next few days were a blur.  Exhausted, I was operating on pure adrenalin.  Were I put on the witness stand right this moment, I could not provide a time line.  I could relay a number of vignettes, but they don’t make any sense.  I know I was there Saturday for a while, but there were no sweet moments for me to cling to.  I know that Saturday night  they called me.  Mom’s temperature was at 95 and her feet were mottling.  We thought this was the end.

I went through all of the motions I’ve been told to go through.  I told her what a good job she’d done in all of her roles.  I told her I loved her.  I told her everything was in order, just as she’d requested.  I told her it was OK for her to let go.  She’d done her job well and she deserved her reward.  But she wasn’t ready to go yet.

I stayed with her through the night.  For a while, I held her hand, hummed her favorite hymns to her and continued the one way dialog about the excellence of her life.  Finally, exhaustion took over and they brought me a recliner.  I went to sleep holding her hand.  I’d done the same with both my father and my aunt during their ordeals.  This felt familiar.

But Ruth wasn’t through.  Her temperature went back up, her feet were no longer mottled and another day began.  For lunch she wanted me to go to Wendy’s to get her a hamburger and a frosty. I fulfilled her request and she had a bite or two.  How many times was Ruth going to go to the brink without letting go?  I took a few hours away from the hospital, but then I packed up a bag and went back for the long haul.  When I returned, they said she’d been asking for me, but now she had nothing to say to me.

Monday morning I handled a few pieces of business and picked out a room on the third floor.  I’d been frequently reminded that Mom was still on the recovery floor and they weren’t really staffed for hospice.  Monday evening the continuous care ended and I was left alone with Mom.  Sure there were nurses out there, but they didn’t seem any better equipped to deal with the situation than I was.  Meanwhile, Mom floated along in a drugged state, rousing occasionally to go through the farce of a meal.  We’d get her up, put on her bib and give her a few bites that she’d chew on but rarely swallow.

Tuesday, around lunch time, they moved her.  I’d been told they would move her on Saturday and so I’d packed everything up.  We’d already lived out of suitcases for three days and by ten thirty I was tired of it.  I got ugly, but I got her moved.  On the nursing floor, I expressed my concern over the way they’d been medicating her. I feared they were over-medicating and she was in there somewhere cursing me.

So they backed off the drugs a little, but if she had been in there, she wasn’t anymore.  She was desperate to leave – telling me her girls would be home from school.  She remembered me as someone she knew, but she sure wasn’t certain who that someone was.  Before the night was over, we were back on morphine.  Less this time, they’d been giving her too large a dose, but it was still her only friend.

In the morning, I met with hospice and put her on palliative care.  I still don’t know if anything I did was right, but God knows, I’m doing my best.  I slept in my own bed with my husband last night.  I must balance the checkbook before I go check on her.  This has all happened too fast, but the rest is not happening fast enough.

Chat @ Caregiving: They’re Not Just Things

Today is moving day. We’re not sure where Mom will be moving to, but we do know it won’t be back to independent living.  Under those circumstances, her apartment would be a very expensive place to store things.  The business part of me understands that, but the emotional side is having a tough time.

See her stuff is not just stuff.  Her belongings are a memorial.  Don’t get me wrong.  Mom’s life means a lot more to me than the things she has managed to obtain, but the furnishings of her life do represent the things she loves best. Take all those wardrobe boxes of clothes.  I know right now that she won’t be able to get all of them into the closet of an assisted living apartment, but how do I go about choosing which ones to keep and which to throw away?

Mom grew up in the Depression.  It was tough for everyone, but several things made it tougher for her than it was for some other folks.  Her clothes were the armor she wore to face the world.  If she managed to dress like everyone else, then she felt she would fit in better.  She never told me this, but after decades of her fanatical interest in what I had on, I figured it out.  Multiply that mindset by a career in retail and you know why she has eight wardrobe boxes of clothes, a rolling rack and a couple of boxes and suitcases.  I know it’s been years since she wore some of them, but she’s like the armorer in a castle.  You don’t throw away perfectly good swords just because they go out of style.  You never know when they’ll be just the thing for a certain battle.

Maybe this would have been easier if it hadn’t been just a couple of years ago that I went through the process of downsizing my parents from a house to  a two bedroom apartment.  Now Dad’s gone and the independent phase of Mom’s life is over,  I have to sift through it all again.

In some cases it feels like chopping off my hands.  Dad was a snorer and had long ago been exiled to a separate bedroom.  In the apartment, he slept on the bed they shared during all the years they did sleep together.  I joke that it’s the bed I was conceived in, and Mom’s never corrected me, so maybe I’m right.  To the rest of the world, the bedroom suite is a not-so-gently used collection of mid-century Early American furniture.  Nobody except a homeless shelter had any interest in it. To me, it’s the first time my dad ever bought anything on credit.  He didn’t want to go into debt, so he got a second job to pay off the loan early.  To me, it represented home in all the houses we lived in, as we moved around due to Dad’s job.  I can only imagine what it meant to Mom.  When she asked me what was being done with it, I had to tell her the truth and I could tell it was a physical blow.

Letting go of other items feels like ripping out my heart.  My dad was a sports fanatic.  Not in the sense of being a fan of any particular team.  He was interested in everything from peewee football to the senior golf tour, but baseball was his particular favorite.  He liked to watch baseball, but he liked to hear the commentary on the radio.  How many hours of my life have I watched my dad cheer on the Rangers?  He’d have the TV on and in his ear would be the plug from the radio.  Long before there were sports bars, my dad would line up all the TV’s in the house in the den and have various sports on them – and the earplug would be in his ear.  The radio is in the room of items we plan to donate, but I don’t know if I’ll actually let it go.

And you ask, “So what’s the big deal?  Why don’t you just keep the radio?”  If you did ask that then you’re one of the folks who doesn’t realize just how much stuff I’ve collected from my family in the last few years.  First, from Aunt Edie and then from my parent’s house.  There really is just not enough room for me to keep anything else… but maybe the radio wouldn’t take up so much room after all.

See, the radio has other memories attached to it.  My dad faithfully listened to Rush Limbaugh.  I’m no fan of the self-important blowhard myself, but my dad was. George didn’t use the earplug to listen, so bits and pieces of Limbaugh’s loud mouth opinions were impossible to avoid.  I confess, I now listen to Rush, if he’s on when I’m in the car.  Even if some (certainly not all) of his Conservative views do line up with mine, I detest his presentation.  However, by listening, I can imagine the conversations Dad and I would have – therefore, I listen.

So, it’s moving day today and I know that I’m holding on to more than I should, but how can I let more go?  After all, they’re not just things.

Chat @ Caregiving: SSUURRRRE You’ll Be Back

You know it’s the small stuff that makes you crazy and I’m beginning to think making you crazy is the primary purpose of health care facilities.  Why else would hospital employees wake a patient numerous times throughout the night to draw blood, weigh, take vitals, etc. etc. etc.?  Now that Mom’s moved over to skilled nursing, there’s a little less of that going on, but they haven’t abandoned the most frustrating phrase in all of medicine, “I’ll be back.”

The medical world introduces you to various forms of this promise long before you find yourself in a nursing facility.  Like when you’re sitting in that paper gown on the end of an examining table. “The doctor will be right with you.” Yeah, after I have frostbite.  At least when you’re at the doctor’s office they do eventually appear.  They like to clear out the office before they go home.

In May, this medical odyssey began with a broken arm.   The arm had to be belted to Mom’s waist, rendering her virtually helpless.  Helpless and Ruth don’t belong in the same room.  Theoretically, she was supposed to call someone every time she got out of bed, but once she figured out that she could maneuver the wheel chair with her feet, she was through with that.  However, the task of dressing herself was a little more than she could manage.

Each day, whether by phone or in person, our first conversation of the day included a frustrated rant about people who promised to be right back, but weren’t.  They’d wake her up to give her meds and then promise to help her dress, but they’d never return.  She spent the whole day scheming about how she’d trick them into helping her dress on the following day, but those pesky aides would find yet another way to avoid her.  I began to think it was a part of the rehab program:  frustrate the patient enough and they’ll figure out how to do it on their own.

She did go home after a few weeks, at which time the rehab case manager informed me Mom was a little stubborn.  Oh really?  What was your first clue?

Then there was the first bout with congestive heart failure.  At the rehab facility, some anonymous person would come in and tell her something. Then my job would be to find out who it was and make them do whatever it was they said they were going to do.  The most elusive was a female doctor in a hijab.  In all the weeks Mom was at this particular facility, I never saw a hijab, but every time the woman came to see Mom, she’d leave some question hanging.  Mom put a marker in her brain and would wait impatiently for her return. Had the nurses not confirmed there was indeed a doctor in a hijab caring for my mom, I could have been convinced Ruth was hallucinating.

We’ve been in and out of the hospital a few times since the hijab, but folks are still falsely promising to return.  Mom’s current venue is not ideal.  I bet the “I’ll be back” thing works with a lot of the patients.  I’ve hung out with them.  I’m not trying to be cruel, but the fact of the matter is, some of them don’t know who they are, much less where they are. As soon as they hear “I’ll be back,” they forget it. But that’s not Ruth.

Yesterday was shower day.  Mom hates dressing for breakfast and then undressing for her shower, so she requested breakfast in her room.  When the aide delivered the tray, she asked, “Do you want your shower now or later?”  DUH!!  Who wants to get a shower while their breakfast is chilling in the next room?  So, the aide said she would be back.  Someone else came to pick up the tray and Mom was back in “be back” hell.

Since we seem to be able to regulate everything else when it comes to healthcare, I propose that we regulate, “I’ll be back.”  It should never be an open ended statement.  It should be, “I’ll be back in ten minutes,” or “I’ll be back at seven thirty” or something measurable – and then they should be back.  Heck, the world is so electronic, why don’t the have a channel on the TV that shows where the patient is in line.  Imagine how many calls to the desk that would eliminate.

I can hear all the healthcare personnel defending themselves and I’m not unsympathetic to your plight.  With who knows how many patients, all demanding your attention, I don’t know how you get anything done, but that little “I’ll be back” is part of the problem.  I was only there for a short while, but Mom talked to at least five people about her pending shower.  I have no idea how long ago the shower had been promised, but it was almost ten and breakfast is served between 7 AM and 8:30.  She’d been waiting more than ten minutes.

Someone might argue, “What’s the big deal?  It’s not like she’s going anywhere.” Right – with that attitude you probably have a great future in the geriatric healthcare industry.

OK – I’ll get down off my hobby horse.  “I’ll be back,” isn’t the only phrase that should be erased from human communication.  “No problem,” “Have a nice day,” “How are you,” and “I’m fine” are all pretty useless, too.  Every time a waiter tells me what I want is “no problem,” I know they’re cussing me all the way to the kitchen.  And there’s a new one, “My pleasure.”  Sure and I’ll be back.

Chat @ Caregiving: A Place for Mom

It’s been a long week. For most of it, I’ve been with Mom over at Presbyterian Hospital.  Chest Pains, ambulance, emergency room and admitted for observance – the usual.  Or at least it’s becoming the usual.

One of the first things her cardiologist suggested was assisted living, but he got the same reaction I’ve been getting over the last few weeks when I made similar noises.  Then everyone who walked into her room had the same suggestion.  The universe was definitely sending her a message.  By happy hour, Mom had gotten it.

I didn’t know what the immediate future held, but I did know I’m traveling in mid-September.  If she’s moving, I had to get on the stick.  After the early morning scare and the day at the hospital, I was pretty ragged, but I couldn’t put off the urgent need to start considering assisted living facilities.  When I got home, I sat down at the computer and googled “assisted living dalllas.” The first result was A Place for Mom.

I’d heard of them.  A lady faced with just what I was facing decided the available resources weren’t resourceful enough.  She started a nationwide referral service for elder living solutions.  I’d found the place where Mom currently lives on my own, so I knew I could do this, but I didn’t want to.  I  filled in a few blanks and clicked “Start Your Search”.  I had the “what can it hurt” attitude.  If there was a way to make this easier, without adding to the cost of it, then I was all for it.  I thought I’d get a list, but what they did was promise to call.

Here’s what surprised me.  It was past usual office hours, but before I could make another click my phone rang.  It was them.  They were ready to help.  As I answered all their questions, I was looking for my “Been Here, Done This” t-shirt.  How many times over the last few years have I explained my Mom’s situation to a caregiver of some sort?  I really wish I had a recording I could play for them.  Problem is, the details change almost daily, but I get so tired of this phase of the process.

Then I got Frankie Radabaugh.  If you contact A Place for Mom, you may get someone else, but Frankie is my new best friend.  Frankie and I went through a list of facilities.  She knew some I didn’t.  I knew some she didn’t.  We hung up and I had dinner.  When I came back to the computer, Frankie had emailed me my appointment list.  I was so relieved I wanted to cry.

Back in my do-it-myself days, I’d worn myself out playing phone tag and then I played the “tell me something about your Mom” game until I was blue in the face.  It literally took DAYS to make a handful of appointments.  Then when I arrived at the appointment, we spent more time playing “tell me something about your Mom.”  In the A Place for Mom world, I showed up for the appointments and was in-and-out in thirty minutes, generally. How do you spell relief?

In the days since, I checked on a couple of places that weren’t on Frankie’s list, but she streamlined the job more than I can explain and the one’s that weren’t on her list probably aren’t going to be my answer anyway.  Mom has a couple of more days in the hospital and then she’ll be in rehab.  No one can make this decision for us, but without Frankie and A Place for Mom, I’d still be trying to set up appointments.

In case you’re wondering, A Place for Mom also handles dads, aunts, grandmas or whoever else you may need to find help for.  It’s just called A Place for Mom, because the lady who started the company was looking for her mom.  Maybe you’ll never be faced with a task like this, but if you are, start with A Place for Mom.

Chat @ Care-giving: A Vote for Continuing Care Facilities

A few years ago, when I began the search for a retirement facility for my parents, I had a preference for continuing care.  No one else did. So we struck the criteria from the must-have list.

Eventually, we found a great independent living facility and even though Mom moaned and groaned about giving up her home, Whiterock Court proved to be a good place for them – for awhile.

Fast forward a year.  Dad fell and after a month-long hospital battle, he passed away.  Suddenly, Mom’s complaints about “giving up her home” turned into gratitude.  My primary reason for getting them out of the house had been the realization that I could lose either of them at any time.  They were barely getting along in the house together and I knew if I lost either of them, neither of them could stay at home by themselves.  I wanted to avoid having either of them adjust to concurrent lifestyle changes – losing both their life partner and their home at the same time.

For exactly six months I had the luxury of hearing I’d been right to get them out of the house.  Mom realized just how lonely that house would have been without Dad.  She ate meals with her friends, joined a travel club and enjoyed playing bean bag baseball and chickenfoot dominoes.

Then she fell and broke her arm.  A few weeks later, she had congestive heart failure.  For three months our lives were a circus of emergency rooms, hospitals, rehab and skilled nursing.  Now she’s back in her apartment juggling home health care and I’m remembering when I agreed to take continuing care off the must have list.

See, Mom’s not quite ready to give it up and move to assisted living, but she’s not exactly up to independent living either, and the parade of home health care providers marching through her apartment is about to drive her crazy.  Were she in a continuing care facility, the trauma of moving between independent living, assisted living, skilled nursing and rehab would be much reduced.  The services she needed would already be right there.  Home health care is great, but it’s not the same as walking into a fully equipped rehab facility.

When I moved Mom and Dad out of their house, I knew I did the right thing, but I wish I’d stuck to my guns when it came to continuing care.  Mom needs to be monitored more closely than home health care can provide, but the mention of assisted living sends her into fits.  I know her emotional stability is as important, if not more important, that her physical condition.  I can’t bring myself to upset her apple cart anymore than it’s already been jostled.

It’s just a matter of time now.  Congestive heart disease is an enemy you can fight, but you can’t win, unless you’re young enough to have the necessary surgery.  Someday, probably sooner rather than later, I’m going to have to disrupt my mother’s life again.  I have to rip her out of a place she’s learned to call home and take her someplace else.  I’ll be disrupting the lives of other people, also.  Fourteen of her friends have moved to Whiterock Court because Mom is there.  It would be so much easier if I could just move her to another part of the facility and know that, if she did improve, we could move her back.  It would be nice if her fourteen friends could walk across a courtyard to see her or have a meal with her.  Instead, they’ll promise to come visit her, but the enormity of the task will keep them away.  They’ll feel guilty and Mom will feel forsaken.

There are drawbacks to continuing care facilities, one of them being a large financial investment.  Most of the money is returned to the family after the resident passes away, but letting go of the money was the hurdle my family members could not tolerate.  Now they stand ready to support me in any decision I make.  I wish they’d felt that way three years ago.

Chat @ Care-giving: The Stress of a Stress Test

Have you ever taken a lie detector test? Your brain sends telegrams to your nervous system, “Be cool, we need this job,” and your body completely ignores the brain. You’re sure before the lie detector test is over the police will show up to arrest you, even though you’ve never done anything to get arrested for.  Surely the lie detector technician will discover some crime you’ve committed in your sleep. That’s kind of like my mom’s recent stress test.

One of Mom’s internist’s biggest challenges is keeping her blood pressure down.  Through stents and medication the doctor does a pretty good job, but Mom’s penchant for worry gives him a run for his money.  Her stents are over ten years old, so he watches Mom pretty closely.  At a recent appointment Mom delivered a twin message, she was suffering some pain between her shoulders and she’s going to need some dental surgery.  Ever diligent, the doctor ordered up a stress test for the next Thursday, since it had been three years since the last stress test and Thursday is the day I spend with Mom.

To up the stress ante, Mom went to the dental surgeon the day before the stress test.  I wanted to know what he said, so I took her, even though his office was one she felt comfortable driving to.  The procedure sounded nasty and the results marginal, but with an infection growing Mom really has no choice.  When he gets through, she’ll have a two-tooth gap in her jaw.  We won’t know if he can fill the gap with implants until the jaw heals and we see how much bone is left.

Mom depends on my weekly visits to get her errands run and many of her chores done.  Since the stress test would take most of Thursday, Mom wanted to squeeze these errands and chores in after the dental appointment.  However, she was also afraid of taking up too much of my time – as if raising me hadn’t taken up too much of her time.  Here’s how dear Mom is.  One of the most important errands she wanted to run was to pick up some pimento cheese.  We’d need to have a sack lunch at the stress test and she wanted to take my favorite kind of sandwich.  Now you know why I’m so willing to devote my time to her.

Understanding Dallas traffic, on Thursday morning, I left home with forty-five extra minutes for the trip to Mom’s house.  As is always the case when we have an early appointment, I only needed a few of those minutes.  I can breeze to Mom’s house in twenty minutes on most days, but it will usually take over an hour on the days I most need to be on time – if I don’t leave extra early.  Though I arrived on this day with time to spare, both parents greeted me like a soldier from the war.  Dad had been listening to radio and realized every possible route between my house and theirs had been blocked, but they didn’t know I left before the crashes tied up traffic.

Mom was in a tizzy.  Had she chosen the right thing to wear?  Were we going to forget our sack lunch?  Would the tote bag carry everything we needed?  Would my Diet Dr. Pepper be warm when it was time to drink it?  Would she be cold in the doctor’s office?  Had she correctly filled out the doctor’s questionnaire?  Would my brother-in-law drop by with lunch for Dad as he promised he would?  If she carried the file with all her medical information would she lose it?  Did I remember where the stress test would be?  Was there going to be traffic on the way there?  Well, you get the picture.

Of course we arrived on time and she’d filled out the questionnaire correctly.  The office was cool, but she had a jacket.  I, on the other hand, had left my glasses sitting on my desk.  Thank goodness I could see well enough to enlarge the print on my Kindle, but I had to click the button to turn the page so frequently that I may develop carpel tunnel issues.  Mom is unable to negotiate a treadmill, so she had the nuclear stress test.  She had a rough patch about midway.  Having been through stress tests before, Mom feared her difficulty presaged bad news, but the kind medical personnel assured her the reaction was well within expected results.   I got Mom home and the thought of waiting for results, has caused even more stress.  I’m not too worried though.  When Dad had a bad stress test, they wouldn’t let him leave the hospital without open heart surgery, but I do wish they’d call and relieve Mom of her concern.  This health care stuff is dangerous for your blood pressure.  Don’t you agree?