Three generations shared life together for decades in one household. Daughter and granddaughter set aside their lives to care give for two family members at home. Life challenges of undiagnosed advancing Lewy Body Dementia and medical challenges of MRSA tore apart the family unit. Writing, reflecting and researching then and now to shine light into holes in our society's safety nets for the aging, care givers and families.
Sunday, December 29, 2024
High Cost of Dying
Thursday, December 19, 2024
LBD Changes The Brain
There's an underlying relationship of notes; the arrangement, the sequence and even the sounds themselves can be sequential and logical or varied and confusing.
Having Aphasia also makes carrying on a conversation with Mom both interesting and frustrating.
Ha Ha (not a laugh, a type of "membership" in a Haska)
She may use the same sound combinations in a sentence where they have another meaning and we're left guessing what new identity they've taken on.
Words were inserted into sentences as though they belong in a specific place and have a specific meaning. It's not random; it's as though the brain is simply substituting.
I often read about other LBD people who've been highly productive, intelligent and involved in life and wonder if having an active and capable brain helps to keep Lewy Body Dementia at bay causing the long roller coaster ride until it finally totally engulfs and destroys albeit often in the very last breaths of life.
The mobile phone we had for her became unusable.
Time passed and even if she was in the room and the room phone was allowed to ring many times, she didn't answer.
Watching and listening, hearing and more fully noticing various progressions or lessening of skillsets, I believe she was progressing in deterioration/loss of various processing skillsets
She'd often pick up the phone and didn't know which end to speak into and which end for her ear.
Mom never ceased to amaze me, though. I'd spend time with her, notice what I felt were changes, think they're now a fixed behavior and then on another visit, not necessarily the next, that change would not be evident.
This was one of the "masks" I've talked about with Lewy Body Dementia; off and on, sometimes fixed sometimes loose, never knowing who was really there.
Mom seemed to stare a lot more than she used to.
Yes, she had sight challenges and the hallucinations made that condition even more challenging.
We've all "drifted off" from time to time on a thought or concern This is how Lewy Body Dementia can affect in later stages and so we assigned this for years to LBD when maybe we were wrong, it could have been the "Meds".
Mom remembered certain actions needed to be taken but while in the process of doing the action would reverse her actions and undo what she'd done.
She usually remembered she's supposed to lock her wheelchair before attempting to transfer to her chair (she does this herself even though she should have assistance with the transfer).
She'll lock the brakes, move her hands and then believe she's not locked them and unlocks them. I'm sure others afflicted with LBD have similar reactions and that's why LBD can be so dangerous and so many falls.
Hindsight is always so much clearer. Advancements in the short time since I started writing this Blog, in the field of Neurology & Lewy Body Dementia, have moved light years ahead.
Today . . .
I'm really happy I somehow gathered the courage to "go public" with our challenges and share the problems and the possibilities we uncovered along the way.
I look even farther forward to the additional ways I can add to more individual walks along the paths we maneuvered so precariously.
Mom loved to read and she was a life long learner. I know she would be pleased to see what we've accomplished and how we're working to resolve problems that still exist and challenges we continue to witness and encounter.
Life is a process, it's full of surprises, Mom would say.
Thursday, December 12, 2024
Look Behind The Curtain
First area of "inspection" -- DINING.
Dining As It Appears: Walking in you'll see tables, often a TV, maybe it's a combination "community room" used for visiting musical groups or for other uses. You're told how residents are "encouraged" to come to the dining room. How the staff has been trained in "white glove individual service" and it's like dining in a nice restaurant.
You're told, if for some reason they can't get to the dining room or would prefer to "dine in their room", this is simply accomplished by the resident calling ahead and ordering what they'd like. And, of course, they can do that for the dining room, as well.
Picture if you will someone with poor eyesight given a list with items on it about the size of this type. The list is in columns but isn't organized, just randomly posted.
And on any given day certain items "may not be available" so the resident, who has difficulty making decisions due to advancing Dementia or just indecisive, now has to make another choice.
REALITY DINING: This mulitpurpose room may be used several times a quarter for meetings and other events and closed to residents. Residents must dine in their dining room on their floor or in their room. This can be for one meal: breakfast, lunch or dinner OR it can be for an entire day.
Dining on the resident's living floor is in a small area where the residents who cannot travel the distance or do not have the mental or physical abilities to sit with others due to either behaviour or limitations are regularly dining. No conversation possible.
Sights and sounds that to the more capable person are not just distracting, they're disturbing; you get to see what it's like, how you'll be, where you're headed. That's demoralizing and can cause the "moods" to be constantly down that are regularly measured as mandated by Federal and State Rules and Regulations in LTC Facilities.
Dining begins and service ends at a set time. If you don't make it, you may have to settle for whatever might happen to be in the refrigerator on the floor and due to "cutbacks" that's possibly now limited to ice cream, bologna sandwiches and maybe some low fat milk.
Why wouldn't you make it to dining on time? Multiple reasons.
Your roommate is in the bathroom and you need to wait until she/he finishes because there are no other bathrooms set up to accommodate your need to have a bar to transfer and enough space for your wheelchair to be moved behind you safely.
You can roll yourself in your wheelchair but you can't get out of your bed or chair without assistance and staff shortages mean you wait a minimum of half an hour or longer for help that should have taken just a few minutes.
Or many other challenges faced every day by residents trying to adjust and adhere to schedules while they cope with limitations and deterioration.
Table Service isn't just one to one, it's one at a time and each person is asked what they want but no "written orders" are taken so the server heads back to "adjust" the order and wait to have it ladled out. She/he then walks slowly over to the person and delivers it and moves on.
Fast food we may not want it to be but faster service would be easier on the residents who often wait over an hour before their turn to be served.
Assistance with anything in the dining room? The lady who broke her back has to ask repeatedly for her dish ring so it won't move while she works to feed herself. IF she wants assistance, she must be fed at the dining area on her residential floor, no accommodation in this dining room.
Guess it doesn't "look good" to those who might be visiting. Besides, they only have so many "allocated" feeders so they'd have to pay an additional cost. You can always provide it yourself, of course, anything that you'd "like" to have, and pay independently.
REALITY IN-ROOM DINING: Served from what's been brought to the upstairs dining room you may be served first or last. It's just like downstairs: one person scoops out for one resident at a time. Snails move faster. Then, one staff member takes one dish to one person either in their room or in the upstairs dining area.
Now, all this time, upstairs and down, residents are really lucky if that particular meal someone is kind enough to ask them if they'd like something to drink. They often wait from the time the arrive or are brought into a dining area for service to begin and for their "turn" to finally come to get some form of drink or food -- and seldom are they given within a short period of time of one another.
Room trays are assembled from a "ticket" that's been put together and sometimes the food is "preassembled" and usually very cold and very "tough". It's usually been sitting (goodness knows for how long and where) since someone assembled it downstairs to go up with the carts. It often arrives as long as thirty minutes after everyone's been assembled in the dining area by staff members.
Many of those who "dine" upstairs on the floor where they live have been started to be assembled at least an hour before dinner's officially scheduled. Some have been sitting in the area almost all day long. Maybe they've been checked on and maybe not; maybe they've been changed, maybe not. Who keeps track?
DINING ON SPECIAL OCCASIONS. The facility posts an "Invitation" for friends and family to "join the festivities" and lists a menu with a set cost per person. This Invitation is limited to being posted in one of the two elevators so if you happen not to get that elevator, you don't know about this "opportunity".
Added staff appears for service. There's even someone acting as maitre'de to escort "families" to their seats. Tables are set up specifically for "reservations". It's not at all like everyday but visitors see and believe it is.
Missing are tables or areas for "singles" or "groups" of residents who don't have someone joining them for this "special meal" They're expected to "eat upstairs" -- either in their room or with the people who need supervision and assistance.
Happy Holiday!
As mentioned about this past Christmas dining, name tent tags on the tables was a nice choice as were the tablecloths but adding "and family" and not having tent tags for residents who wanted to eat in the dining room but did not have a "place at a table" was upsetting.
QUALITY OF FOOD. Prepared ahead most food is cold to lukewarm. Sometimes "water bath" serving containers are used, sometimes not. Everything is prepared alike; few seasonings and very little salt. But they're heavy on the sugar in the sweets!
Variety is limited. One choice of entree per meal. One set "menu" per meal. You can try to substitute but if it's "forgotten", too bad. And, you have to make sure you call at least two hours before the scheduled time which means you need to call by 5:30 AM for breakfast; kitchen staff isn't around to "take your order" the evening before; the person who does that is gone for the day before service begins.
COVERS TO PROTECT CLOTHING. Need a covering for your clothing because your arthritic hands have difficulty balancing the regular fork and spoon? Even though you use one every meal, no one thinks to put it at "your place". Every day your name is put at a certain place and although you've eaten there forever, no one thinks to provide this benefit for your arrival.
Covers have a nice pocket in the front to catch dropped food but they have a snap in the back even someone with capable hands and good eyes has difficulty closing. I tried. It took several attempts. Ladies with any hair length are greatly inconvenienced because they can't hold up their hair while trying to manipulate and place those small snap and closure in just the right configuration.
DISHES AND UTENSILS.If you want to use "special utensils", there has to be a "special order" for those. So, you struggle to balance food in a small bowled spoon with a very narrow handle you can barely hold onto. Grasping a slender handle on the fork they place in front of you is difficult but it's even more frustrating because you constantly drop food as you try, unsuccessfully, to balance it from the plate to your mouth.
Glasses! Who in the world provides glasses filled to the top with liquid and expects a Senior to be able to ensure it gets to their lips and down their throat without spilling half the contents? And a glass so small it's barely capable of holding 3 or 4 good sized swallows.
STRAWS. Ask for one and it's like you're asking for something that hasn't been invented yet. Do they have "special cups" similar to "tippy cups". YES. What does it take to get one? Waiting half your meal and asking half a dozen times or more.
Again, there is no consideration, no "remembering" what a "dining guest" likes/needs. That would be REAL service along with getting food that isn't dried out and cold, of course.
A PLACE FOR EVERYONE AND EVERYONE IN THEIR PLACE. Yes, you can ask to sit with "someone" or in a "group" of people. But if that group isn't hospitable, you're soon looking for another place to sit. If you don't "ask", you're "assigned" and that means it's really difficult and sometimes impossible to get staff to move you or for you to move to another location.So, tables are set with "name signs" and you sit there every meal with the same people, hospitable or not.
It's not dining with whom you want and choices made each meal to dine with this person or that one.
TV IS ON WHETHER YOU WANT IT OR NOT. Conversation? Depends on where you're seated. Close to the TV and you can barely hear yourself think but since some residents want it on, it's on. Sometimes I think it's more for the staff, especially in the "floor dining areas" so they can watch their "favorite programs" while serving the evening meal and feeding residents who take a longer time to eat.
AND TO THINK. THIS IS "DINING". THIS IS A "PLEASUREABLE EXPERIENCE" and as such is a "highlight" of your tour of the facility.
For many it's one of the few times they're social. Some days there are no activities. No events. And they don't have the strength in their aging bodies to make it up and down, up and down, up and down, more than three times in any one day.
ASSISTANCE? At times. But because the facility is almost always short staffed, it's everyone for themselves and so many start down to the lower level dining room far in advance just to ensure they get there on time.
Of course, those who have "challenges" in weak bladders truly have a choice -- stay on the floor and eat with those who provide no chance for conversation or socialization or take a chance they'll have an accident because there are no restrooms past their room that can accommodate their needs for entry and exit.
MOM never wanted to go into a "facility". She made me promise I wouldn't send her until she had no idea where she was going or where she was.
Well, Julia, the woman who came into our life and used Undue Influence on Mom helping her to "disconnect" from our family didn't have to "honor your mother" as I felt obliged..
Julia saw Mom's declining ability to reason as a trained Registered Nurse AND as someone who specialized in providing care giving for men and women with Dementia. She knew Mom's mental capabilities had diminished far beyond what we realized or saw.
Julia succeeded in getting Mom and the State of Missouri Department of Health and Senior Services to "consider" and to "believe just enough" to put into action several steps that took Mom from the home and family she loved out to experience the raw, rough and hardship world of living permanently in Long Term Care.
BE EVER VIGILANT, FAMILIES. Be ever vigilant Seniors. It may eventually be necessary as Mom and I always talked about but going before "your real time" is going where there are too few rules and regulations and too little enforcement to successfully ensure the safety and well being of one of our most precious gifts, long life.
Tuesday, December 3, 2024
Life Lessons Learned
Some say you can adjust, make the best of a life challenge. It's like falling into the "rabbit hole" of Alice in Wonderland.
You try your best, do what you can and often "go with the flow".
Here's what I wrote as we struggled just to move day to day:
It's been difficult at my work lately.
Mom's life was her example to me of personal strength and caring beyond yourself.
Sunday, November 17, 2024
A Higher Calling
You came into this world needing to be fed, changed, given care, concern and consideration by those around you.
Then you became less dependent and more defiant.
Generations of women lived as subservient first to fathers, then to husbands.
Sunday, November 3, 2024
How Old Are You?
Usually sidestepping I decided this time to face the question and see the reaction.
She visibly jumped and immediately reached to put her arm around me even though I'd been walking on my own.
What's with this "age group"?
We were taught it's "not polite' and even "inconsiderate" to ask someone's age, race, educational or marital status.
Closest we've come is asking "Where'd you go to High School?" and that's after a conversation about where someone "grew up" starts.
We "birthed" this Gen and their offspring? They seem to think today is where we've lived consistently.
It takes them time and often it requires a mixed age group for these "Gen Xers," who are actually close on our heels but don't realize it because they're so busy going through life stages they can't see where they are and where they're going.
Death walks in and reasoning walks out the door.
I liked her, I still do, but it amazes me the questions 50 somethings ask directly.
No preparation. Didn't know her name or relationship. A person obviously related; the Memorial Service was very small.
What happened to "polite conversation"?
Manners seem to have moved aside to instant gratification.
Where are the "manners"; not asking "personal questions" we taught?
She seems bright and capable but this "direct question" of someone I just met is far too personal -- would she ask a contemporary what size Bra she wore on first meeting?
I know! She's amazed "people my age" aren't bent over, shuffling and having trouble processing simple sentences.
I like you but you really need to "get out" more and mix with all generations and not just see "growing older" as "getting senile".
Death isn't confined to age groups or "getting older'.
We are all, however, facing that "final curtain" and do not know when it will be drawn across our life. Even for Gen X the day grows closer.
Thursday, October 31, 2024
Beginning of The End
A journey concerned, caring and confused, maybe alone. Medical error; no one admits
A few come to visit, some express concern. Advice is their "contribution". Misinformation abounds.
Time and funds limited. Sons married living hundreds of miles away. Daughter trying to stay in college.
No cell phones or computers that could send pictures. Believing each day would bring healing, life would change.
Lied to by the Hospital and the Doctors. "All he has to do is gain a little more weight."
They knew what was happening to my husband. They changed his dressing on the incision.
Record keeping often typed. Easy to "adjust" to "cover errors & omissions
The Dr writing them made the error. Never set a foot near my husband on that fateful night. Gave the direction on the phone to "lance" .
Infection or inability or both created a deep incision
HE was a SHE in the ER; short staffed, definitely.
SHE was unable to help my husband
took out a phone and made a call
followed orders given uncertain of how to proceed
did as she was told
HE was not in the ER
was somewhere he didn't want to leave
did not ask the right questions
caused the beginning of the end
did not appear all the time we were in the ER
wrote the report, signed it stating HE did the cutting.
Sight unseen, she followed his direction
He never saw the patient
He never ensured a Dr made the incision
How harmful his "advice" would prove to be
His failure to ensure competency led to my husband's death
It was 2009, personal computers were rare but hospitals had systems.
No Dr attending.
"She" made a call.
Received directions to"lance"
She did exactly as she was told.
Beginning of the end.
Tuesday, October 29, 2024
LBD Social Signs
It doesn't matter if someone has Alzheimer's, Lewy Body, Frontal Temporal or others, they have Dementia.
General articles and reports often become focused on the decline of mental processing citing bodily functions including standing, walking, incontinence as type or stage of the disease.
Are these really effective measures of Dementia's progression?
When are we going to recognize Dementia, especially Lewy Body Dementia, doesn't appear like Cancer often does with a lump you can feel or Heart Disease with a stroke?
Lewy Body Dementia often masquarades. As I wrote in the blog entry: Masks: Ever Changing Faces of Lewy Body Dementia , LBD is not always visible.
Another observation I've had with Mom is how vacillating Lewy Body Dementia really is; behaviors were so unpredictable.
The other night at a presentation, the message was conveyed by a gentleman about his wife and how she could somehow, if she just tried, control or affect actions like sitting up in her chair.
Like a trained animal, we reward the Advanced Dementia patient who shows us they "can" do something, hear something correctly, respond correctly, with a smile, words of encouragement and even with statements like "I knew you could do it if you tried hard enough".
How grateful I am now realizing that with enough advancement of the Dementia this level of self satisfaction on the part of the visitor, the family member, may not truly register with the person struggling with Dementia.
It may be more like eradicating Cancer.
Let's have a movement within society to be as health wary about Dementia as we are about Cancer and heart disease that affect human relationships and lifestyles.
Saturday, October 26, 2024
Line of Descent
Life is life and death is death. Until the time when East meets West.
Extend your arms, reach out your hands, Close your eyes & take a stand.
There they are, each one you knew, Now gone as others and so will you.
Parents left, then brothers, too. Sisters lingered as though they knew When they walked on, so would you.
A line was formed and except for War Each one came "home" to lay beside A wife, a child, in their own space.
You came and went leaving flowers for all, Knowing the day would come When you answered the call.
We wait for you to come and stay While now you turn and walk away. We too had hopes and plans like you.
Some were done and some remain Others we took into this grave. It's up to you to carry on.
Monday, October 21, 2024
To Move Is To Live
Tuesday, October 15, 2024
Stop Pushing Me!
Close the door and the windows, please. I’m tired of insects who buzz around Looking for somewhere to feed.
Do, Watch, Contribute More.
If you don’t, you’ll close The Door.
Everyone’s waiting just for you
They can’t go another day
Without knowing ‘What’s New”
The pressure is strong
The days not so long
I juggle and leap
Getting very little sleep
If, When, How, Why
Everyone reaching for the Blue Sky
The Door That Will Open
Time that never stops
Life forever changed
When You’re “On The Top”
Remember those dolls?
I see at a glance
Their arms pulled to stretch
As we make them dance
Who’s pulling your strings
Who’s igniting your fire
What twists and turns
Until you feel your life burn
The Treadmill
Becomes a racetrack
We construct and design
Always seeing faster
Is at the head of the line
One at a time
Place a foot on the side
Deep breath, look around
Hear that familiar sound?
The person you want to be
Stands tall in your shoes
Run too fast
You’ll usually lose.
Slow down, sit and stay
Look around, take time to play.
Your inner child needs to rest
You’ve passed Life’s Greatest Test.
It's your race, not theirs
To walk or to run
To stand or to sit
In shadow or Sun.
When you measure you miss
The subtleness
Of This. . .
Today followed yesterday
Tomorrow will too
It's your life you're living
You choose while you're giving.
Friday, October 11, 2024
Broken Family
Sunday, October 6, 2024
Gaining Peace of Mind
This Blog has travelled to many parts of the world.
Many speak different languages but all with a "common interest" -- CareGiving For A Loved One.
I've varied writings about the time spent with Mom, the challenges of her unrecognized Dementia, the problems we encountered and were unable to resolve.
Knowing the challenge of unrecognized Dementia, of verbal abuse and manipulative control of the weakest among us who often were some of the most strong --
Taking advantage, getting "high" on manipulation and control of the weakest, wrecking havoc through tearing families apart.
Julia appeared to "have it all" -- a beautiful home, active in the Community and in Church, volunteering to bring to those least able to attend an offering, a Communion, seeming to care when actually looking for their weaknesses to prey upon.
Learning shared brings peace of mind.
Reaching out I hope others will share their experiences.