Wednesday, April 23, 2014

My Last Day, Part Two

He was seated on the couch, waiting for the EMTs to arrive. He "dismissed" me, as is his habit. He never wants anyone to waste time on his behalf. But I stayed right there with him while we waited.

His wife and I gathered a few things and prepared to go to the Emergency Room and meet up with him. We decided to take two cars.

Once you're at the Emergency Room, time seems to stand still. Every little thing takes forever. I believe we arrived at about 4:30, and it wasn't until after 9:00 that he was situated in a room. The doctors were puzzled - knowing something was wrong but not sure just what. Once he was comfortable in bed, his wife and I left to get some dinner. LATE dinner, for sure! We split a meal at a Mexican restaurant. It was so good.

We got back to his room, and he was still awake. His wife planned to sleep on the little bed under the window. He looked at me and gestured as if to say "Where will you stay?" I laughed. I said "I'm not THAT good! I want to go home tonight!" He thought about it, then said "You have three more nights. You have Wednesday, Thursday, and Friday." As if - it would be fine for me to give up Tuesday night to stay at the hospital. How amazing is THAT!  But I said no, that I really had to go. He said "Oh, you have to feed the cows!"

I gave him a hug, gave her two hugs, and made my way home.

This evening I got a call from her. Today is Wednesday, and all of this stuff happened yesterday.  She said he was still in the hospital, and that they would be putting in a pacemaker tomorrow. His heart beat was so irregular, and even stopped at times. Well, no wonder he's been weak and getting dizzy and falling!

What if? What if a caregiver had not been there? What if nobody asked him to stick out his tongue? What if he EMT crew hadn't come? What if nothing had been done?

Lesson for this day: If something seems out of the ordinary, pursue that thought! Get educated about what signs to look for. Ask questions. Observe. Test.

I am so thankful that a major incident was avoided.


Do you have a way to support yourself, as a family caregiver? You can work from home, like I do. Check out what I'm doing here. I'd love to meet you.

My Last Day

I arrived at their house at the usual time, bearing baked chicken and a potato salad from the local deli. I was greeted warmly. She wanted to make me a sandwich, and have all of us eat lunch together. It was to be my last day with them.

He stood at the back sliding glass doors, looking out into the yard. We talked about lawns, and mowing, and I mentioned that we've got 1/3 of an acre, but I am afraid of the riding lawn mower. "Really?" he said, surprised. "My mother is 83 years old, and she mows her lawn with a riding lawn mower."  This was highly unusual, because he has been oriented to the present pretty much every day in the past few months. "Well," I said, "I better get a little bolder, then, and try that, too!"

We had lunch, which was pleasant, and I started on some of the basic chores I do each time I'm there. Soon, he decided he needed to go outside, but he had difficulty verbalizing what he wanted to do. "I need to find some stuff to... put some stuff in.... I need to take that...." I said "I bet you're going to try to fill up the yard recycle bin again, aren't you?"

"YES!" (relief)

As always, I kept tabs on where he was outside, and watched him as I went from room to room. Just before 3, I saw that the wheel barrow was standing by the living room window, but there was no man. In fact, I said that to his wife. "There's a wheel barrow, but no man." She called and whistled from the front door and the back. No answer. I was getting ready to head out to check when a rapid doorbell ring started us. I opened the door to find a worried neighbor. "The man - your husband? He's fallen out here, and I can't help him."

We found him, seated under the overhang beside the house, straddling and holding onto a post. He was trying with all his strength to get himself to stand. The neighbor stood by, concerned but baffled as to how this was going to work. I coached him to scoot his bottom back about a foot to give us a little working room, then had the neighbor plant her foot in front of his right foot, to keep it from sliding as I would help him to stand. One, two, three, up. He was more weak and shaky than I've ever seen. I had him hang onto the post for a while and get his "sea legs". He stood in a weird position, which was also concerning. We made our way into the mudroom and I helped him sit on the shower chair stored there. "Do me a favor." I said. "Stick your tongue out at me." He did, and that tongue pointed completely to the right, rather than being centered. To his wife I said "This isn't just a simple fall, please call his doctor." The doctor asked that 911 be called immediately.

She had brought a set of sweat clothes, and was, herself, planning to help him into them. He's very "private" was the reasoning. Yes, and she is walking with the assistance of a cane. So - no. I told him "I'm going to help you change your clothes now. I'll use your walker to help you stay steady while we get those muddy pants off." He looked at me, with a puzzled and maybe a little embarrassed look. "I do this every day." I said. That was sufficient, and the job was quickly done.

Once we arrived at the hospital, the long part of the day started. I'll tell you about that on the next post, because this is already too long and you're getting bored. Just know that my day didn't end until after 10:30 PM.

Tuesday, April 1, 2014

"Come on, Cindy!"

I brought them a small order of Fettuccini Alfredo from Panera Bread, for their lunch. It came with wonderful crusty French Bread.

Don was very quiet, and seemed distant, sitting in his chair in the family room. We called him several times to come in for lunch. I wondered if she had told him about my resignation. Finally, he walked into the dining room.


He knows, and remembers, that we are thinking of the day we can move from Sultan, closer to access to my business team. He's been thinking about this a lot. While Ella washed her hands, Don took me to the sliding glass door. He pointed to the neighbor's house below. "See that house? That's our neighbor. He isn't there very much. Sometimes he's gone for a week, then just comes back for one day. Sometimes he is there two days, mows his lawn, cleans up a little, and then he's gone for two weeks. Do you know what Ella and I think?"
"No...."
"Well.... we think maybe he can buy your house!"
I know this means that he thinks David and I can buy this neighbor's house.
"Ah, I get it! You just want cinnamon rolls and coffee every morning!" He smiles, and nods. His smile is huge. By now, Ella is back. I turned to her and explained that Don was plotting to have us buy the neighbor's house so he can have fresh cinnamon rolls every day.
"Let's go ask him", Don suggests. I can imagine what the thought of this means to Don. Someone he knows and trusts to keep him safe, living right there.


But it was time for lunch. I dished up the portions, after they sat down. Don promptly offered me his portion of the lunch. He always does this. He did get me to eat half of his French bread. Lunch was very enjoyable. We chatted about our weeks. I was surprised, at the end of lunch, when Ella immediately suggested that we go for a walk. I said "I guess we can take a walk before I get into my 'Cinderella' stuff " (She has me cleaning house far more than I caregive)  He cheerfully reached for his shoes and said, "Come on, Cindy!"

He apologized for needing his cane today, but he really did need it. Still, we took a nice, long walk. As soon as we leave the house, he starts talking. He tells me everything about everyone in the neighborhood. Today, as most days, he occasionally lost a word he wanted to say. But mostly he did just fine, and gave me the insider info on everyone. "She goes to work at about four. Her husband comes home at six..."  I love that. He wants all of the neighbors to wave and talk with him. He's highly offended if they ignore us. I know these outings are his freedom, and of course my heart hurts knowing there are only three more. With me. Can anyone else do this? My ego wants to think not.


He had an obsession with the recycle bin today. There was a newspaper he was sure I needed. "Don't take the.....  the things. Don't take them out."

While I was cleaning, he went outside and completed his mission.

He came in, triumphant, holding two, a bit worse for the wear, newspapers. He had gone outside saying "I'll be back in a minute". He knew Ella didn't want him rummaging around in the recycle bin. We talked about the horror of the Oso mudslide. He is convinced I live near there, and must know someone involved.


 Ella had tea brewed for us. I'd brought a cinnamon roll from Panera Bread, and Ella had me cut it into thirds. You must know, of course, that between all of this I vacuumed, mopped, dusted, did laundry, cleaned bathrooms, and stripped and re-made the bed! Anyway, we enjoyed tea and the roll and discussed the day. Afterward, I showed Ella how to search for caregivers online, at Care.com. This is very sad for me, but it really makes sense.

The day ended, as it always does, with hugs and admonitions to drive safely. We'll see you next week.







Sunday, March 16, 2014

What do you say to an accusing senior?

Question: My mother who has dementia is accusing me of stealing her pills (which i'm not). What do I do?  My mother has been progressively getting worse, and she has been accusing me of stealing her pills. I've already tried to tell her she's taken them, or sometimes she drops them. I don't know what to do, and I don't know how to convince her I'm not taking them.    B   
   

My Answer:
Validation.  Say -"You believe I've taken your pills." This, alone, may break the cycle in her mind. "I understand that you believe this. It looks like that's making you upset." I find that a firm touch, such as holding her hand or wrist, and looking directly into her eyes, helps this communication. "I'm sorry that you believe I have taken your pills. I know this is upsetting. This is hard, Mom. This is very hard." Then to direct her to something else like tea, or a walk, or something she enjoys, would be my next step. I really think that the validation - re-stating what they have said to show you understand - goes a long way. Unfortunately it is so much like reasoning with an 18 month old. But even THEY feel better when you clearly understand what they're trying to communicate. You think I took your pills, and you're mad!!! Try this one other thing that's worked for me with Dementia clients. "Mom, your doctor ordered me to keep these pills in a very safe place, and make sure you took the right ones at the right time. I am following your doctor's advice, you can be sure of that!" Older patients are such doctor followers. They seem to really respond to the "The doctor said" trick a LOT. I even use it with my reluctant walker. "Your doctor said you should walk every day...." and off we go.


As we watch the older generation deteriorate into a daily pill organizer, we sometimes start to think about our own future. Will be take a "pill for every ill", or will we stay healthy and vibrant for as long as possible?


If you're concerned about your health, and want to secure a healthier future, please consider feeding every cell in your body what it is craving, while clearing out the junk. I'm here to help! Watch the short video here, and see if this is something you'd like to know more about.

Tuesday, February 25, 2014

Walking With Don

He likes to act like it's a chore, and a drudgery, to take those walks. His eyes say otherwise. He pulls on his baseball cap, and does his best to get into his jacket without help. I step in at the moment he begins to exhibit frustration.







We go the same route each day. With Dementia it's not so much about variety - it's about safety and familiarity. Some of what I do isn't due to training, but due to watching the results in my treasured charges. Don responds well when we start our walks by observing their yard. This helps me know where he is that day. Is he in the present, knowing he has lived in this house for 50 years, or is he confused and thinking this isn't his house? Knowing that helps me help him. I ask open ended questions. I assume nothing.



We walk to the left, down the hill. The road curves to the left at the bottom of the hill, about 3 houses down. We generally walk 2-3 blocks. Sometimes we encounter neighbors along the way, and Don always calls out to them, cheerfully. Today Rick was working in his yard, pulling up dead plants. Don began speaking to him, but Dementia had the upper hand today, and much of what he said was disconnected and made little sense. The neighbor ignored this, and made a great effort to understand.


 Jim came out of his house to shake both our hands and have a conversation. He encouraged Don and told him "You're doing great". He didn't seem shaken when Don described "felling the trees" and bruising his hips. Don gestured around at the tall pines when he said this. I don't know if Jim had a clue as to what Don was telling him. It's been on Don's mind, lately, that he once fell under a tree and I helped him up. This happened in August.

Often, on our walks, Don is reminded of a story. He launches into it with great excitement. "Do you know where he was born?" he asks me, regarding the owner of one of the homes. Of course I don't, and shake my head. "Well, there are three."
"Three?"
"Next to each other. Three.... um..... next to each other."
"Countries?"
"YES!"
"They're near Russia. But I don't know."
"Ok - like Estonia?"
"Yes, that's one of the three."



Our conversations go like this much of the time. I search my memory banks to fill in his memory blanks. I just made that phrase up. It's clever, right?


Today I was really put to the test. He had LOTS of stories, all with huge blanks. I told his wife it was like reading a book with some words blacked out or pages missing. But he enjoys telling the stories, so much, that he just powers through.




When we started to approach the house, he was visibly tired. I helped him up the front steps, and he said "Thank you for taking me out there." I smiled. He paused, then said "And - thank you for bringing me back. That was even more important." We laughed.






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Friday, February 21, 2014

"I have to go to bed"

It wasn't our normal day. It was raining far too hard for Don and I to engage in our favorite activities together; working in the yard and taking a walk through the neighborhood.

He looks forward to Tuesdays and Fridays, when I come to care for their home, and for them. Lately I've been bringing "treats" for lunch. It's true that the visits from his children bring joy, but my visits are regular and predictable. The activities have become both predictable and necessary to his emotional health.


When he saw it was just pouring relentlessly, I could see the understanding in his eyes, that this day would be different. He was worried about being "in my way", so he retreated quietly to the office and silently watched Ella work on taxes.


He used to do these things. As I said before, he's well aware of his new limitations, and it's a deep, grieving process. Imagine watching all you loved to do slipping away. You keep hearing "You can't do that" and "No - don't do that".

I met him in the hall on one of my trips  back and forth. He looked so dejected. His head was low, and he said "I have to go to bed." I waited. He pointed to his head. "It's because my.... this. It's broken."

It's broken.


 I just patted his arm. "I know, you feel that way. Go rest, if you feel like resting."


It reminded me of a song I heard when I was in training as a Caregiver for clients with Dementia and Alzheimer's. You can watch it on YouTube here. The song is called 'I'm Not Me Anymore'. It sums it up. Do I cry when I watch this? Oh, no, not me! *cough*












An hour later the sun was shining brightly and the sky had turned to blue. I rushed to their office and asked Ella if she could check to see if Don was actually sleeping. "I would like to take him out. I think he's depressed." I said.  She decided, asleep or NOT, I was right, and she'd wake  him up for the walk.


A confused-looking but happy man emerged from the bedroom and slowly made his way up the hall.

"Look what happened while you were sleeping!" I said. He decided it was because he took a nap that the sun came out.

He got ready as quickly as he could, and off we went on our walk. It was precious. As we were leaving, Ella asked "Do you want your cane?" and he replied, gesturing toward me, "She's my cane."

I'll tell you about our walk tomorrow. Meanwhile, consider that your family member with Dementia may be very aware that they're "broken". Find a routine in which they find joy, and faithfully keep that routine. It can be in short bursts of time - 20 minutes here and there. You won't say "remember" about any of this. You'll just do it again and again. Their hearts will remember, even if their minds forget. Think of it this way: you leave an impression on their heart that will be felt forever. That gentle impression warms when you re-appear. They may not know why seeing you makes them happy, but their heart will always remember. Dementia and Alzheimer's affects the brain. Love affects the heart.



Lyrics to the song:
I’m breaking // I can feel it inside // Something’s taking // over my mind // Causing page after page // of memories to fade // Into nothing
I’m losing // more of me everyday // It’s confusing // I feel lost and betrayed // As places and things // faces and names // Fade into nothing
I’m not me anymore // Not who I used to be, anymore // There’s a thief running loose in my head // A thief who won’t rest till I’m dead // Stealing my mind one cell at a time // Till I’m nothing
I hate this // I can’t run, I can’t fight // I can’t take this // I feel buried alive // I don’t know who I am // Just a shell of some man // Left with nothing
I’m not me anymore // Not who I used to be, anymore // There’s a thief running loose in my head // A thief who won’t rest till I’m dead // Stealing my mind one cell at a time // Till I’m nothing // Just nothing // Nothing

Tuesday, February 18, 2014

"An item"

Dementia has a lot of stages, and a lot of manifestations. So far, with Don, it's been very low key and predictable.

Friday I arrived to find Ella a little bit rattled. Seems Don was insisting on going out into the yard and working all alone, which is so unsafe for him. He also had taken a great risk and stepped over a kiddie gate blocking the stairs on the back deck. She had begged him to wait for me to arrive to go into the yard, but he countered it with "Don't tell me what to do!" And so that phase begins.


After I arrived he confided in me that he had sneaked out. I reminded him that I enjoy working with him in the yard, and that I'm there to help keep him safe. We went out and worked hard, and as always he chatted happily while we were out there.

Then we were done. Well, the clean up was done, but he wasn't "done" being in the yard. I followed him to the shed. He turned and looked directly at me with a look I had not seen before.
"Don't you have some work to do inside?" he asked. I smiled.
"I always have work I can do."
"I'll be out here for two hours."
"Um..... "
"Okay, I'll be out here for ten minutes, then."
"OK. But I will be watching you from inside."

Reluctantly, I went back into the house to do a few  household chores, checking on him every few minutes. I could see his gray head through the shed window. He was walking back and forth, aimlessly. Take the gloves off. Put them back on. Pick up a tool. Put it back.

In about half an hour I came out there as if nothing had happened and asked if he was ready to take a walk. He was very ready, and was back to his normal happy demeanor. I just think he needed to have his way for once. The thing is, that won't be safe at all for much longer. That's unfortunate.


We took a wonderful walk around the neighborhood, talking with anyone who happened to be around. It's like the air lights up his brain. When we got back, I suggested that we take a drive and check out where I used to live, and some of the new construction in the area. He was very happy about this, because he loves my truck.


We drove and drove and drove, and he directed me where to turn with flawless accuracy. It was amazing, and so much fun. Almost 100% of what he said was lucid and perfect. We saw where I used to live, and he admired my old neighborhood.

His daughter had arrived just as we were leaving for the drive, but he was unconcerned and didn't seem anxious to get back home. When we did get back home, he was exceptionally happy. The daughter had brought Valentine's Day cupcakes and invited me to have one. Suddenly, Don started out the back door into the garage. "Where ya goin', Dad?" his daughter called out.
"Just out here...." he said in his lilting voice.
They looked at me. I said "I think he's going to the freezer."
Sure enough, that's where he was. His daughter asked him what he was getting out there.
"Oh, just an item." he said casually.

He returned with a precious little plastic dish of frozen applesauce. Applesauce he had made. It was for me.


Maybe you understand this gesture. Maybe you'll have to think about it. He made that applesauce during his last "okay" weeks. He will never make applesauce again. He wanted to give me something. He wanted to give me something back.

An item.


It's very, very special to me.






How do you get through long days of caring for someone with Dementia? How do you take care of YOU? I take good care of me. Here's how.