Medical Marijuana

FAMILY MEETING WITH DOCTOR AND SOCIAL WORKER AT HOSPITAL THIS AFTERNOON

DOCTOR: According to the records I have, [mom] refuses to take her medication and refuses to eat. She wouldn’t talk to me at all this morning.

MY FAMILY (practically all at once): What?????? She’s not taking her medications? She’s not eating? Why hasn’t anyone told us? We had no idea!

DOCTOR: [Turns to mom]. If you want to get better you have to eat, take your medications and take in liquids. Why aren’t you taking your medications and eating?

MOM: Incoherent answer, looks very confused.

A HALF HOUR AFTER THE MEETING, BROTHER: By the way, I checked at the nurses station, to see if they had a log they kept of medication. Evidently, mom HAS been taking her medication. Her ROOMMATE is the one who isn’t. Mom was just grumpy this morning when they woke her up (mom’s been grumpy in the morning for as long as I’ve known her, and that’s a long time by now)

ME, READY TO KILL: And didn’t that nurse come in yesterday to say that mom had eaten her lunch? In fact, she told us – in excruciating detail – exactly what parts of the meal she ate and how much of each item on her plate. Yesterday she asked for ice cream and today said she wanted a banana, now that I think about it.

BROTHER: I think they gave the doctor the wrong chart.

After an afternoon meeting that went along those lines, I downed a little extra help myself. Not anything illegal, just potent and not available without a prescription. Good thing I made a stink at the meeting about the apparent lack of coordination and communication between hospitals, primary care physicians and departments. It makes no sense at all to me, and I made that concern quite clear.

Gaaaaah.

 

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.

Hazan-O-Rama

Marcella Hazan’s Classic Italian Cookbook

This is where two of my three tomato sauces came from. They’re safely stowed in the big freezer downstairs, awaiting my return from Buffalo (I’m leaving this evening for a week or so).

The kitchen’s been a busy place this week, at least up until Saturday, when we took our last stay-cation of the summer and went up to Portsmouth, New Hampshire for a day of sightseeing. More on that later. I’ll look forward to this a bit later this year, when the leaves are falling and the evenings are chilly:

Tomato Sauce I – Hearty

Days of Wine and Chocolates

We are, at last, on our way home. We’re doing it slowly, with a three-day stop-over in the Finger Lakes of New York State. This is a wine-growing region with big tourist appeal. The wines are better than they used to be and some are downright respectable. Cheese-makers have recently begun to take advantage of the many dairy farms out here, with some luscious results. There are also a few micro-brewers and at least one place that produces hard ciders from apples it grows on its own property. New York is an apple-growing state (as is Massachusetts). We picked up a bottle of cider, a bottle of wine and two packs of raw milk cheddar, one Colby and one with garlic. Yum!

My mother is stable for now and I can leave her without either feeling guilty or terrified. She has close to 24-hour care and Medicaid is going to be kicking in at some point in the near future. I’ll probably be back in August to check in on  her and see if she’s in any better shape. Right now she’s still in considerable pain following her accident in May. She’s due for a minimally invasive medical procedure on her spine in mid-July. Everybody in the family is crossing their fingers and hoping it will be effective.

And, if anyone’s interested, my mom suffered a compression fracture at t12. That means she has fragile bones and osteoporosis and, when she fell in May, fractured a vertebrae in her lower spine. Recovery is slow and painful. I’m crossing my fingers and hoping for the best.

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.