Apologia for these journals:
They are not about taking care of a relative with moderate to severe Alzheimer's/senile dementia.
For an explanation of what these journals are about, click the link above.
For internet sources that are about caring for relatives with moderate to severe
Alzheimer's/senile dementia, click through the Honorable Alzheimer's Blogs in my
links section to the right.
The Mom is in the hospital, but don't freak.
"It's a good thing." [Thank you, Martha Stewart, she said slyly.] It's late, so I'm not going to go into my usual extreme detail, not now, anyway (I promise, and warn, as well, that I will later, though), but while I wind down from the day with a cup of instant decaf with a touch of almond extract and some cream, I figured I'd better get the word out.
Essentially, on Wednesday night, after some weeks of becoming incrementally weaker despite the epo shots and the final increase in iron back to her former levels as of two weeks prior (that's a story in itself...I don't think I've mentioned that one, yet), Mom's legs just stopped working for her. We'd had an increasing number of half-wheelchair days just prior, but she always seemed to recover for the next half. Not Wednesday night. So, I made an executive decision that was horribly unpopular with Mom, overrode her protestations, called the paramedics and had her taken into the hospital. Turns out her blood work was near her normal levels but the last three months of recalcitrant anemia and increasing weakness had taken their toll. As it stands, now, she's spending three nights (Medicare's requirement) in the hospital then being transferred to her second skilled nursing facility 10 day to two weeks intensive rehab here, locally, on Sunday. I'm thrilled about this, even though Mom is not. The whole episode is practically a repeat of The Low Sodium Episode [the series of posts for which begin here and continue on for some weeks] almost four years ago, without the low sodium. As her hospitization doctor put it, "She needs some buffing up." Absolutely.
This time, as well, she definitely qualifies for Home Health Care, which will begin with an evaluation of our home which I've requested to be done during her SNF (by the way, I learned that the pros refer to these in conversation as "sniffs", a handy-dandy little vocal acronym) stay and which will include specific recommendations for making our home and our equipment easier and safer for my mother to handle, as well as recommendations for further equipment, if necessary. As well, the rehab, itself, will be specifically designed to the requirements of our home; the steps she needs to negotiate in and out of the living room, for instance. I'm very excited about all this.
Mom, of course, as usual, is not, but I'm talking it up positively in exactly the same way I did in August of 2004: It's a combination of rejuventating spa/bootcamp for her, will require work from her but no more than of what she's capable, and, when it's all over, we will have turned another corner in her life and care and should be able to continue much better prepared for whatever her future holds.
She is less sure of herself, and my decision, this time around, but, hey, let's face it, she's 90, not 87, three and a half years more Ancient than before, and that much more dependent on me. She intimated to me, tonight, before I left her for her night sleep at the hospital, that she is not at all assured that she will be coming home, or that I will be by her side through all of this. I took some time to assure her, unequivocally, that no matter what happens, no matter how she performs, no matter what the results are, we'll deal with anything and everything and our life together will continue here in our home. I was surprised I had to assure her of this, especially since, because she's being treated locally, I am much more "on the scene" this time than last, since I don't have to spend all that time driving up and down the mountain. It was sobering for me to realize that over the last three and a half years her dependence (and, I might add, our interdependence) has, little by little, increased to a level where, however much she needed me then, she needs me even more, now. It has happened so slowly that I just wasn't aware of this. This consideration, alone, will have a lot to do with how I approach this rehab event in her life. Although I will remain out of the way during her actual rehab because she performs much better for others than for me, especially when I am out of sight and mind, I will see to it that she has significant contact with me every day, and this will be easy, since I don't have to commute. As well, I realized that I'm going to have to make sure my expectations are not the same as they were for the last rehab event. Although she remains as willful and determined as she was in August of 2004, the ensuing years have taken their toll on her body so I'm quickly adjusting my expectations to suit a different set of possible outcomes.
For one thing, realizing that it's entirely possible that she will need to rely on my body more and more, I've been actively participating in her care at the hospital so that I can pick up as many tricks of the trade as I possible. My intention is to do the same with the "Sniff", while she's there, and really press Home Health Care for all the technique and help I can get from them. Thank the gods that I'm am absolutely sure, now, that Home Health Care will not turn us down this time. She can, now, legitimately be considered "homebound".
So, anyway, I think I'll relax, pay attention to our cats, sip my soul warming treat, watch a taped episode of Law & Order: Criminal Intent [Did I mention that of all the L & O shows, I've gravitated toward this series almost exclusively? Yeah, I think I did.] and hit the sack. More to do, more to learn, more to experience, tomorrow, starting early.
Final thought: Once again, in the months prior to this event, I had begun to do the caregiver drag, doubting my ability to come through for my mother, despite my desire and intentions. Once again, when the crisis hit, I was able to depend on the automatic transmission that's been refining itself throughout the last several years, and once again, it surprised the shit out of me. I even responded, without hesitation, to our assigned case worker, when she said, in the way of elicitation, "I'm sure this has been scary for you,": "I'll tell you, my mom and I have been through so much in the last 14 years that nothing scares me, now." And, suddenly, as I pronounced it, I realized, yikes, despite my intermittent of fears of the future, especially my most recent one when I mentioned I was "terrified" of losing yet another doctor, when push comes to shove and I'm in the moment, this is true...nothing scares me.
Hallelujah! Now, if I can just remember this during my more anticipatory moments...of which I expect there are many more to come...
Again, it's been awhile...
...and I'm not really in the mood to really write, yet, although, so you'll know, things are proceeding relatively smoothly. I want to mention, though, especially since a devoted visitor has been trying to get into them, that I've fixed a few of links to the 2006 archive: Primarily, the links to transcripts of podcasts, the links to Caregiver Bootcamp posts and the links to an argument for medical advocation.
Of course, at some time in the near to not-too-far future those links, I expect, will change, again, but, they are good for the time being.
Later, probably much.
All material, except that not written by me, copyright at time of posting by Gail Rae Hudson