Home and the Re-Entry Phase

I’m back home, after a relatively fast and uneventful drive home. I’m slowly – slowly – getting back to normal. My first impulse yesterday morning was to clean my front hallway. I practically took it apart piece by piece. I somehow needed to get this clean and organized. I figured it was my way of riding my grief in a constructive way. But, about halfway through I suddenly realized what I was doing: cleaning my hallway in some weird effort to bring my mother back. She was very clean and it suddenly made sense why I was deep-scrubbing the entry way and hall. That would have been her entrance to my house.

I broke down after I realized that and ended up losing it for quite a while. Thank God my husband was at the hardware store so he didn’t have to see me yowling all over the place. Things being what they are, though, I expect those experiences to return until they’ve worked their way out of my system.

It does feel good to be back, though. Familiar surroundings and tasks have been very stabilizing. I’m also going to have a massage later this afternoon. I managed to pull a muscle with all that deep-dive cleaning and would like to get that smoothed out, along with the rest of my body which, at this point, could really use it.

Coming Up For Air

I’m starting to regain my equilibrium after my mother’s wake and funeral. Everything was, thankfully, short. This is the first day after all that and I’ve pulled out the computer to start answering emails and otherwise getting back on track.

This will take a while. Being near my mother’s usual haunts is especially difficult, but I seem to be holding up.

Many of you have sent your condolences and I want to say thank you. It’s made a tremendous difference. I’m going to take things as they come. NaNoWriMo might have to wait another year, along with some other things I’ve been planning to do. The important thing is that I’m getting back to myself and am moving on from here.

My dad seems much more at peace than when my mother was alive. She was in very poor health and he carried the tremendous burden of her care. There were 24-hour aides and then a skilled nursing facility, but he still bore a tremendously heavy burden. I was worried about him, but he’s been far more resilient than I was expecting. My entire family has been, actually. I am grateful for that.

A Passing

My mother passed away last night. She was 89 years old and in poor health for many years. She was in a skilled nursing facility and had recently contracted pneumonia. I am told that she died peacefully, in her sleep.

I’m saddened but also relieved. In some ways I lost my mother some time ago, as her mental and physical health declined. She was no longer the same person. My own expression of grief occurred a few months ago, following a message from my sister. At that point my mother had again fallen and was in the Emergency Room. My sister was of the opinion that she would not be coming home. I remember sitting at my desk in front of my computer and writing this in my personal journal. I cried for her then and said goodbye. I let her go in my heart, wrenching as that was. I remembered that time when speaking with my brother this morning about what had happened. I relived it in my mind’s eye.

Will I cry again? Probably. But the wrenching, goodbye grief may have already passed. I’m waiting to hear back from my sister with updated funeral arrangements. After that my husband and I will prepare for our trip back to pay our final respects and lay my mother to rest.

I was very close to my mother and knew that she had limited time. I made a decision over a year ago to spend as much time and share as much joy as she needed. I cared for her in Buffalo for seven weeks, then regularly went back and forth to visit her for shorter periods of time. I spent one Thanksgiving in Buffalo General Hospital when she was there. I also saw her at home and had the time to take her out and about. She and I savored walks and gardens together (she was in a wheelchair). We laughed. We had meals together. We opened presents on Christmas, Father’s Day and her birthday. I feel content with that. I did what I felt I needed to do.

So, farewell Helen Rydzynski. If you have an afterlife, may it be filled with the joy you gave us. I’m sad to see you go, but relieved that your suffering and illnesses are finally at an end.

Helen Z. Rydzynski July 28, 1924 - November 2, 2013
Helen Z. Rydzynski
July 28, 1924 – November 2, 2013

Taking A Breather

I’m in Buffalo, NY this week with my parents and siblings. My mom’s gone through yet another round of hospitalizations and is due to be released soon…we hope. At her age, if you name it, she’s got it: blood pressure spikes, frail bones and a tendency to faint and fall (see frail bones, above). Add mild dementia/elder depression to the mix and you’ve got a very vulnerable individual. Her medication is all over the map. Each hospital department and rehab/nursing facility has its own medical staff that can override previous medical and drug regimens. You’d think a person’s primary care physician would have the final say in this, but no. No wonder my mother’s confused!

My mom suffered a compression fracture of a vertebrae in her lower back in early May of this year.  She can’t really tolerate narcotics or other strong pain medication (see mild dementia, above) and they can’t correct the condition surgically (messed up back due to osteoporosis and scoliosis). So, she’s wearing a back brace – which helps, from what I can see.

I just want the woman home, with her family. I want her off of the drug-regimen-of-the-week club, so her brain can recover from the crap they’re pumping into it at different levels from week to week. Let her live the rest of her days in peace. Let her look at some flowers, see pictures of us as kids (she loves that), laugh and smile around the dinner table at home. Then, when she’s ready, let her go.

How Difficult Can it Be?

When I was a kid, an aspirin company used to run a series of commercials about headaches. The company, Excedrin, did little vignettes it called “Excedrin Headache Number #. Then you’d hear something – a stressful conversation, a dinner plate crashing to the floor or some other headache-inducing event.

I’ve got a new one – “Excedrin headache number 1,000,000,000: the health care aide.”

My mother has aides to help her throughout the day. Some aides are excellent. They take the initiative, they care about their charges, they report issues as they come up. Other aides don’t.

As you can probably tell, this is a blog post about the aides that don’t. Actually, there’s just one aide. She started a few weeks ago. It was immediately apparent that this person was dull-witted (okay, enough beating around the bush – she was fuckin’ stupid), but we assumed she was doing at least the care portion of the job, such as sponge-bathing my mom on those days when she couldn’t take a shower and showering her on those days when my mom was up to the task.

This is where super-aide comes in, a woman who’s been working with my mom since December. Smart, engaging, takes the initiative and loves my family. My mom’s been in more-than-usual pain the last few days, so super-aide gave her a sponge bath since she was on-duty at that time.

That’s when we found out that the other aide was doing no such thing. How difficult can a sponge bath be? You take a washcloth with warm water, you soap up the person, you wash, then wipe her down and dry her off. My mother then mentioned that bad-aide’s idea of a sponge bath was to wash her face with a cold cloth. Good-aide (who is very close to my mother and really cares about her) hit the ceiling. Not only is the bad aide not doing anything else (no washing, no dishes, no engaging company), she’s not cleaning my mom, either. What the f*** is she getting paid for, I wonder?

So, as you can probably tell, the good-aide is not the only one who’s pissed. Bad aide won’t take the slightest initiative and talks about herself constantly. Self-absorbed chatter is no stranger to my family, but at least we don’t talk about relatives dying, which is all the other aide talked about until I stopped her. But, then she’d start up again.

I was planning on having a chat with bad-aide about doing work around the house when she wasn’t directly caring for my mother. Her job description includes laundry and dishes as needed, like after a meal. My father was doing that. You have to realize, my dad always does dishes and laundry but the aide should be taking that work off of his 91-year-old shoulders.

So, dumb as a post, takes no initiative and does a shit job of personal care. She’s outta here!

Normal, Kinda-Sorta

It’s beautiful outside – warm, but not too hot and very sunny. I indulged myself and went for a longish walk while the morning and early afternoon health care aide kept an eye on my mother. My parents live in Kenmore, NY, a suburb of Buffalo. It’s a neat and clean little town with charming gardens and nice places to walk. I really miss walking, especially in Boston. Kenmore will do, at least in its nicer parts.

I walked up a side street until I came to a very pretty little corner with a municipal building and garden out front. There was even a little gazebo, surrounded by early summer flowers. I was surprised to see so few pedestrians on such a wonderful day. Back home there would be people everywhere on the street: mothers with strollers, joggers just off of the bike path, and folks walking bikes across the street with toddlers in baby seats on the back. Lots of Spandex, since we’re so close to the Minuteman Bike Path. Sigh. I’m getting lonely for home.

But, the stroll was nice. I stopped at a restaurant for a late breakfast and took my time getting back. I need to do more of that.

Mom on Porch

The weather was nice enough so that my mother could get herself outside and onto the front porch, with the help of an absolutely wonderful aide. we’ll do the same tomorrow.  When I got back both my mom, dad and the aide were sitting outside enjoying the view and the weather.

Delaware Avenue in Kenmore, NY

See what I mean about the lack of people on the street? Beautiful day, sunny and warm,, not too hot and nary a soul in sight. I saw a few folks walking here and there but, for the most part, the streets were completely empty. Still, it was beautiful.

Garden in Front of Municipal Building

This was one of the gardens I saw in front of the municipal building, which was built in the 1930s. It’s a lovely building, although I couldn’t really get a clear shot of it with my camera.

Gazebo

The gazebo, and the garden surrounding it, was lovely. Once my mom is sufficiently recovered, I plan to take here here for a little stroll. That might mean me pushing her around in a wheelchair, but I don’t mind. We have a good time together, mom and me.

Snapdragon

There was a lovely snapdragon planted among the other flowers. I loved the color, so I took a picture. I just couldn’t resist!

I stopped for a late breakfast. The food was tolerable, but not great. Yes, I’m a food snob! However, I have been getting more greens into my parents’ diet since that’s how I eat. I’ve been chopping up salads and serving them, along with vegetable side dishes to go with the ever-present meat and potatoes.

I eventually wandered back to my parents’ home, passing some very pretty little gardens on my way back. I was particularly impressed with this tall rose bush:

Rose Bush

In the all-in-all, not a bad walk. I hope to get the same in tomorrow. Baby steps, but it did feel a bit more “normal.”

 

This is No Way to Run A Health Care System

My back is aching again, after a long afternoon and evening of being my mom’s primary caretaker. I’m a little too old for this, I think. I can’t keep up with the physical demands of a personal care aid with medication-dispensing responsibilities thrown in for good measure. I’ve figured out how to put on a blood pressure cuff, so a machine can read my mother’s blood pressure and heart rate. I dispense medication which, thank God, I don’t have to sort out every week into a set of pill containers. I apply and remove pain and nitro patches and change wound dressings. I’m a pro with disposable rubber gloves and I don’t even want to say what I need them for.

My mother’s taking at least 10 different medications, especially for her blood pressure which is quite high in the morning, although it tapers off when the meds kick in. Without them she’d probably have a stroke. She also has bouts of senile dementia when she’s institutionalized (hospital or nursing home), although that clears up rather quickly once she’s home. Put her in a nursing home and you may as well just bury her. So, we’re trying to keep her home.

My sister has spent the last six months jumping through hoops to qualify my parents for Medicaid. This is the US government health insurance program designed for the poor. Unfortunately, longer life spans means that many elders – my parents for example – end up spending down their savings paying for health care and basic living expenses. Thus, my mother at 86 and my father at 91 basically have no more money for long-term elder care.

My brother and sister (and now me) have racked up some hefty bills, which we’re hoping the Medicaid program will reimburse. Once the massive amounts of of paperwork have been hauled off and filed, we should be able to start with round-the-clock assistance that won’t come out of my back or my pocket.

I’m absolutely appalled at what Medicaid puts you though to qualify for assistance. Some people end up having to wait for up to a year and even then make endless rounds of phone calls to various agencies and private contractors just to keep things moving along.

Then there’s the stuff that each person is allowed to do. A health care aide can’t handle medication of any kind (prescription or over-the-counter). They can’t even put protein powder into a beverage or item to eat. An aide can help a person ambulate, move from a sitting to a standing to a laying position. That person can also wash and dress a person. My mother needs that, plus four rounds of pills a day, in addition to other meds she takes separately. She needs her blood pressure taken 2 – 3 times a day. She has three or four different types of eye drops, since she recently underwent corneal transplants to correct her vision. Oh, and the aide can talk to the person, to keep them mentally active.

Oh, but here’s the best one: an aide cannot assist a person if they have fallen to the floor, or have been laid onto the floor by that aide. My mother has suffered a number of falls in the last few months. She gets dizzy and faints then…CRASH! It’s off to the hospital, the nursing home and a pile of misery, for us and especially for her.

It’s difficult for me to see my mother in pain. She’s recovering from a vertebrae fracture in her lower back and is in constant discomfort. It’s improving, but it’s pretty sore most of the time now. In-home physical and occupational therapy, which we do receive via private insurance (I think…) leave her weak and exhausted. It’s important to her recovery, though.

So, here’s a question: how do other countries deal with long-term elder care? What about you, Australian readers? Any Brits out there? Canadians? Folks from Europe? Great Britain? I’m very curious to know what other countries besides the US do to make sure their senior citizens live long and healthy lives without bankrupting themselves and/or their children.