Saturday, March 31, 2012

The long good-bye - part I

"It's as if someone has taken everything sweet, kind and good from my mom and left an angry stranger," a friend told me last month. "She's become impossible to please!"

I knew what she meant, remembering countless friends who saw their mother or father change, like mine is changing. It doesn't happen to everyone lucky enough to live into their eighties and nineties, but it happens.

I visited Mom at her assisted living facility last week, and everything I said was the wrong thing to say, everything I did was the wrong thing to do, anything I asked about was the wrong thing to ask.

She accused me of lying about career accomplishments. When I offered to show her my awards, she thought I wanted to show her my warts and responded with disgust.

"Not warts, awards I've earned!" I said.

"You think I'm such a fool, I don't know that anyone can get awards for themselves at any old award store, and type up certificates? Or else if you got something, must be everybody got the same thing!"

Then the visit turned into a typical visit for the past year, like this:

She scolds me for wasting money she thinks I don't have, not helping her like I should and for offering to help when everyone knows she is very independent and needs no help, especially not mine because I have always been useless, even as a small child.

Once we could talk about anything, but now almost every attempt to start a conversation ends when she raises her hand as if policing traffic and if it's ignored, she shouts, "Shut up! Shut up! I will not listen to this!"

Forbidden: small talk, questions about how relatives are doing, asking about her health or telling her about mine, anything about politicians, news or the past, unless she has a statement to make, and then response or questions are forbidden.

If I don't call and tell my sister I'm in town, she's worried we are feuding and to avoid each other, we won't attend her funeral together but if I call my sister, she's vexed about having to go pick her up or getting her dropped off, because my sister cannot drive.

Mother always has an errand to run or a place to go, and when we arrive she mutters, "You are so thoughtless, not like your brother who drops me off at the mall or grocery store and parks my car himself. It hurts me to walk!"

"You could let me go to the store for you, or let me drive," I say, envying my husband whose idea of visiting Mom is to drop me off at her facility and scoot up the road to the Soaring Eagle Casino for the day.

"I can't let you drive because when you were 16, you backed out of the driveway into the neighbor's parked car, which proves you are a terrible driver."

She asks my sister to navigate, to tell her whether a bicyclist is approaching from the right or if a car or truck is about to enter the space she is trying to back into. Except my sister has had strokes, and gives answers like, "Well, I can't read this guy's mind but it LOOKS like he might speed up when he sees you backing out and if you don't stop, you MIGHT nail him!" as Mother is already backing up, so she slams the brakes when a horn honks or someone screams, and then she screams at my sister for being stupid.

The visit ends with her telling us how she will be dead soon, and hopefully the afterlife has more to offer, and then tells us her latest desires about her funeral arrangements, obituary notice and will. All visits have ended with what my siblings and I call "the death talk," even after pleasant visits in the past.

In better days, I thought she spoke of such things to remind me that our lives are temporary, happy times are fleeting, we must appreciate the quiet pleasures like pulling weeds together, playing with water colors, singing hymns or driving past places where we lived or loved.

In the good days, she never said she hoped the afterlife had more to offer.

She probably knew it couldn't.

Thursday, March 29, 2012

Managing Multiple Medications Safely

One of the most difficult things about taking care of others has been keeping track of medications they can and should not take.

Ten years ago, my husband, daughter and grandson took one medication a day but now it's closer to thirty regular prescriptions between them, and more drugs taken temporarily or for a specific problem.

Here are mistakes a caregiver might try to anticipate and avoid:

1. When a patient is hospitalized, they are often given a month's supply of medication before they leave the hospital and then a week later some prescriptions are changed again, with strength increased, decreased, medication eliminated or changed to a different generic brand. It may be hard for someone who is ill or disoriented to understand that a new medication replaces an old one. If the medication is for high blood pressure or high blood sugar, taking too much medication can be dangerous.
     Advice: Dispose of medication that is replaced or discontinued.

2. Hide pain medications or any medication for anxiety or depression, because visitors using the bathroom may look in a medicine cabinet and be tempted to partake.

3. Don't store gel capsules in a bathroom that gets steamy from the shower.

4. Patients do not usually advise a drugstore that a prescription has been discontinued even though more refills are available or the prescription has been replaced with a different strength or brand name. Someone taking more than 6 or 7 prescriptions with different expiration dates can then easily pick up one that has been replaced, and take too much. It's best to avoid "automatic refills" of prescriptions unless taking the same thing, same amount over a long period of time.

5. Keep receipts of medications taken and note if and what side effects occur, because it's often difficult to get records a few years later from the drugstore, especially if it has gone out of business.

6. An insurance provider may imply that a mail order drug company be used instead of a drugstore, and even pressure the client to use the services. Mail order prescription companies automatically fill any prescriptions sent to them by a doctor and mail the medicine to the patient, whether the patient wants it, already has a three month supply, or had a bad reaction to the drug. Refusing delivery is not an option. But maybe refusing to use a mail order service is an option even though it's not what the insurance provider "prefers."     

Saturday, March 24, 2012

Hunger Games the movie versus book

The movie: heroine nearly shoots a deer but misses, heroine yells when small sister is chosen to join other children in a fight to the death for the amusement of the rich audience. Heroine grimaces, frowns and frets a lot, while dressed in spectacular clothes. The games begin: almost all children die off camera except for a few boys who fight hand to hand combat, their movements blurred and choppy concealing detail until the camera looks away and then pans to someone lying face down in the grass as the other limps away. A few corpses are shown, a cannon announces each death, hero declares love for heroine, appears to betray her, saves her, then is saved by her twice. Game over. The end.

The book: heroine shoots deer, rabbits, squirrel, wild dogs to feed the sister and mother she loves and help the people of the village, with the help of a boy she loves. On-screen hunting  might shock people more than the graphic violence of children being killed, but except for shooting a bird in flight which she fails to collect, no animals were harmed in the making of this film, even for pretend. The graphic violence described in detail in the book was softened or moved out of sight in the film. I was glad for that.

The movie does not capture emotions, complexities, conflicts and feelings and without that, the movie is just another action flick in which the hero and heroine have narrow escapes from sudden death as minor characters get devoured or blown to pieces.



Wednesday, March 21, 2012

Nook Tips

Before we developed the same eye disorders, my sister read a book or two each week and I read two or three books in addition to daily newspapers and weekly magazines, from the time we were kids until we both developed the same eye problems, cataracts and Fuchs dystrophy.

Surgery restored my vision for driving and using a computer, but I couldn't easily read books or magazines without my eyes crossing.

Thanks you e-readers, my sister and I can read again.

Tips I learned at a seminar held at Barnes and Noble:

1. A Kindle only handles books downloaded from, and Nooks take books from Barnes and Noble. If my sister and I both bought the same kind of e-reader, we could share many books.
2. Books stored on an e-reader do not effect the speed of downloads or internet use  and each e-reader can hold thousands of books.
3. A charge holds for about ten hours if the internet connection is turned off when not in use. This also protects the e-reader from hackers and viruses. When setting the book aside, turn the book off using the button in back of Nook Basic or on the top left side of Color Nook.
6. Inside the store using the Barnes and Noble website, it is possible to browse and read any single e-book for an hour.
7. To access a list of free e-books to choose free books, on the home page choose "buy" and then select the desired topic and enter 00.00 as the price.

What is the appeal of The Hunger Games?

My grandson and I began to read "The Hunger Games" together, but it was too disturbing to me.

What disgusted me fascinated him, the idea of an America in the future where time has led the rich to crave combustible celebrities, extraordinary fashion and televised drama at the expense of the poor whose labors, resources and even children are given as "tribute" to atone for an uprising 75 years before.

In the story, children chosen in a yearly lottery to be given training and weapons, then set into a huge arena to fight, maim, kill each other until only one remains standing for the entertainment of the rich and to win food for the victor's district.

The children are forced to kill each other while followed by cameras depicting the drama and carnage until only one survives, although most of the children die by The Capital's nightmarish booby-traps.

The author wants to shock people into recognizing the nature of war itself; how innocent children suffer, how for soldiers the wounds never heal, how inequality and cruelty eventually lead to insurrection, but I wonder whether children raised on Hannah Montana can grasp such lofty themes.

I expect the movie to focus on beauty, fashion, teen romance and carnage, unable to convey the narrator's anger, commitment, conflict between wanting to love and hate, wanting to fight or run which made it possible for me to skim the violence to get the story.

Dustin might never be told that his other grandmother survived bombs, German soldiers grabbing anything of value, Russian soldiers grabbing peasant girls, the loss of her home and homeland, the hunger in a decimated nation, the pain of exile.

Or how my husband's mother, Dustin's great grandmother, witnessed soldiers on horseback killing her mother and other women and children of her Russian neighborhood while she hid in a tree.

My dad had it easy compared to my son-in-law's and husband's mothers, on a hospital ship at the Invasion of Okinawa, less than 500 miles away when the atom bombs fell upon Japan.

My grandson is 75% Russian and 25% early American colonist, but if he ever thinks war is entertainment, or even if he believes this movie is, I might tell him.

It's not.

Sunday, March 18, 2012

How we lost $17,000 on St. Patrick's Day

About a month ago, I read a newspaper headline to the effect that nearly every home has an antique, art, heirloom jewelry or SOMETHING worth more than the owner would expect.

I read past the headline, certain we have nothing of value at my home or in the home I bought for my daughter, who lives across the street because she in unable to take care of herself and son alone.

Yesterday without asking, my daughter sold a resin sculpture I bought in 1994 from an art gallery in Rochester Hills for $800, to a neighbor for $300.

It is called "Yesterday's News With Magic," a limited edition sculpture by Michael Garmin.

She turned her heart to art after a string of romances ended badly and she sought something safer to love than men for a few years.

The sculpture depicted a man resembling her latest ex-boyfriend slumped against the wall of an old bar, reading a rumpled newspaper.

An optical illusion created the perception of a changing panorama behind the window of a cheap hotel.    

The size was three feet tall by two feet wide and in the mid-90's, mostly sold to bars and nightclubs.

The last time I checked the artist's website, about four years ago, it sold for $3,000 in mint condition.

Now the piece sells for $17,800.

I was angry with her but when I went to her house to tell her the mistake, I saw her without make up for the first time in months, her cheeks blistered and a sick yellow to gray complexion, so instead of scolding I just asked why.

She feels loved, she said, and didn't want to remember the past.

"It was Saint Patrick's Day," she added, "and the man who bought it is Irish, fixes my furnace for free and his wife invited me to their home for a party where everyone drank green beer, which made all of us a bit impulsive.It needed restoration I couldn't afford and if I move in with you and Dad, or died, you will throw it away."

She looked at my scowl as I stared at the tremors in her hands.

"You always said it was depressing," she concluded.

She was right.

So was the newspaper reporter who wrote that homes hold treasures unrecognized by their owners.

But the greatest treasure in a home is always its inhabitants.

Sometimes it takes a tornado or a health crisis to recognize that.



Wednesday, March 14, 2012

Life Signs

I retired a year ago, after my husband went into a medical crisis. Jerry spent time in intensive care at Crittenton Hospital, where the nurses were wonderful and probably saved his life. Diabetes, heart and artery disease, small strokes, sepsis and sudden kidney failure had all taken a toll on him and working full time with a disabled daughter and dangerously ill husband was taking a toll on me.
The first week of official retirement, my ten year old grandson came to spend winter break with his mom, grandpa and me.
Dustin played happily all week while my husband recovered in his recliner and our daughter rested or slept on our couch because her furnace was out again and she sleeps most of the time.
Suddenly boy's chin clunked to his chest as he replicated a skateboard jump with twist off a 12 inch high jogging trampoline.
"I'm okay," Dustin said, but his face turned white as a hard boiled egg. Chills shook his body. He couldn't turn his head or lift his chin.
I put him to bed but became alarmed a few hours later when he said he couldn't raise or turn his head.
His dad took him to Beaumont Hospital, where X-rays showed two dislocated vertebrae, C2 and C3. The doctor said, "Any sudden movement could sever his spinal cord."
His dad feared losing his job if he missed work that night, so I arrived in time to ride the ambulance that transported Dustin from Troy to Royal Oak, where he was admitted to intensive care.
The ambulance driver said sometimes little boys have conditions that look very serious, but they recover very quickly. It reassured me, but then I went numb with panic when we were met at the Emergency Room by a team of pediatricians and specialists, plus a Chaplin who offered me "grief counseling."
Dustin looked small in a blue cervical collar big enough to be a flotation device. He hardly spoke, except to ask for help drinking or sitting, and how soon before he could skateboard again and when his parents could come. The hospital said the insurance would only pay for 48 hours care, so Dustin was being sent home when he should have stayed in the hospital.
He slept most of the ten days until the collar came off, until the danger of paralysis passed.
He recovered.
Not me.
Thumps, cries, screams, any threat to his head or neck made me panic.
Cries and screams were usually reactions to the Lions game on t.v., a missing remote control device, or Dustin's $19,000 bill from the hospital which, due to disputes between medical and homeowner's insurance, hospital billing and two divorced parents, I feared having to pay,
Today when Dustin screamed, everyone ran. We found him bent over the bathroom sink, crying, "A scar! On my chin! I can't go to school!"
"It's a scratch," I said.
He put his face up to the mirror. "It looks like a tattoo! I zipped my skin when I zipped my hoodie. Cool!"
Trying to prevent another crisis created contagious panic.
 I'll try to remember thumps, cries and screams are signs of life.
And remember to embrace life instead of bracing myself against the bumps and detours on its rocky, awesome road

Monday, March 12, 2012

Mom versus the wheelchair

For two years, Mother refused to use a walker or wheelchair, but she could barely walk. She wore an alert button to summon help when she fell, but that didn't stop her from getting concussions and injuring her knee.
"Give me one good excuse why you won't get a wheelchair." I said.
"People will think I'm old," the eighty three year old said.
"I'll get you a helmet with a sweatshirt that says "Test Driver," I said.
"People will feel sorry for me," she said. 
"No they won't. They'll get mad you're blocking their way with the chair."
"I don't want people to get mad at me," she said.
"Too late. Each time you fall and get hurt, you block hallways and grocery aisles until the ambulance arrives."
"I heard someone got electrocuted in an electric wheel chair," she said.
"I heard anacondas dwell in the plumbing of Rochester Hills," I said, "but I still go barefoot in the bathroom. In the dark." 
"But you screamed like an idiot when you stepped on my sponge roller the other night. Take no chance, have no fear, that's my motto," Mom said.  
The phone rang.
My younger sister, calling from California.
Mom turned on the speaker phone. She said she had good news.
"Oh!" Mother said, "did the doctors find out what's wrong with your knees so you can go back to work?"
"No! I can shop, cook, clean, my knees stopped hurting, I've stopped falling, and I don't need surgery. All because I bought a wheelchair," my sister said.
"But you're so young!" Mother said.
"I looked older hobbling and falling down every day," Sis said.
Mother finally went to an orthopedic specialist to see what she needed.


Saturday, March 10, 2012

Caregiver Survival

Being somewhat ambulatory in a household where everyone else is less than somewhat, I've found the following  choices to be especially helpful.
First, faith.
Faith in God.
Faith in a better future, even if the future is as close as tomorrow and the "better" is as small as a cup of hot chocolate on a cold afternoon, an entertaining television show, laughter following a night of tending to someone in pain or a day of taking reluctant people to doctor appointments and blood tests.
Faith that what I do for incapacitated or young relatives matters, even though mostly it's cooking, cleaning, driving, reassuring and making sure medications are properly taken, appointments are kept, reckless behavior is quashed, each chore is completed in time for the next chore.

Second, brief flights of freedom.
Hobbies that make me forget everything for awhile; for me, reading, art and creative writing.
Meeting a friend for lunch, because after people in my house are fed, they hardly notice my absence until dinner but in the evening they all want to tell me something or need help with forms or homework, and they fear the dark and my disappearance into it forever if I leave.
Sometimes a nap or a long, hot shower in the middle of the day constitutes escape and rejuvenation.

 Third, the Caregiver's Golden Rule: Remember to do unto one's self as one has given and done for others.

Fourth, faith.

Tuesday, March 6, 2012

Update on Daughter's Health

Jennifer says she is feeling emotionally better about feeling physically bad.
She is happy her doctor never called with her test results from the cat scan on her pancreas, assuming this means there were no irregularities.
She prefers to assume everything is all right, and it probably is, as far as something physicians can easily detect.
Meanwhile, she continues to lose weight and a size ten boy's t-shirt and basketball shorts fit her better than her own jeans and sweaters.
Her hands shake uncontrollably, and her eyelids flutter.
Her pain, feeling cold and exhausted means that her son's usual view of his mom is her face above a blanket.
While arguing with her, my husband received bad news from his doctor, and advice he has yet to take.
I decided I had better take care of myself, which care givers often forget to do.
My swollen knee was x-rayed, I was given anti inflammatory medication and I had an allergy shot at the highest dose yet.
By nightfall my face was so swelled, I could not see to fix supper.
My family tucked blankets around me and worried I might die.
Their fears were annoying and I must be equally annoying when I worry about them.
So I will try in future not to do that.
Their attempts to be comforting were comforting.
So I will try in the future to be more so.

Saturday, March 3, 2012

Losing a job but finding work, part 3

After months of fearing homelessness and hoping for miracles, Mary and her husband decided to use some of their retirement savings to buy a home in Indiana, where relatives lived.
Paying cash gave them an advantage over other bidders.
Their new home is on ten acres instead of four, it cost $100,000 instead of $350,000 like their previous home, and it is bigger than the home they lost.
They are surrounded by forest yet only four miles from a major city, and Mary says it feels more like home than any where they ever lived, perhaps because it is completely paid for and "No one can take it away from us!"
Her husband's health improved despite the emotional stress of waiting for foreclosure, and the physical stress of moving their belongings by themselves, 370 miles, one truck load after another using their pick-up.
Mary drove to Michigan twice a month to work for a week at the retail store, and sometimes she drove by the home she once loved.
"It was so sad. We had asked the bank to let us refinance, but they would not allow that, and after we left, each time I drove by I saw more and more deterioration and signs of people breaking in. A year after we left, it still wasn't for sale and I noticed someone had ripped the boards off so I peeked inside the windows. The basement was flooded, and it looked like someone stole even the kitchen sink."
The store where she worked closed permanently, and she was eligible for unemployment benefits again.
A few months later, her husband's 99 weeks of unemployment ended but a month later he turned 62 and filed for Social Security.
Mary started a new job this month, working full time doing work she once performed in Bloomfield Hills for $15 more an hour than she earns now, but she is grateful.
"Our boys are happily married, successful, working in careers they love," she said, "But I tell them to recognize the difference between what they want and what they really need. "The landscaping, home improvements, vacations, cars, all that STUFF we bought sort of enslaved us, and it was the money we saved that saved us. Now we have freedom to relax, enjoy life, help our parents and visit friends and relatives. Life is good."

Thursday, March 1, 2012

Losing a job but finding work, part 2

After the shock and humiliation of being fired passed, Mary found benefits.
Unemployment benefits paid 2/3 of her salary.
Arthritis symptoms and migraine headaches disappeared.
Blizzards she did not have to commute through made her happy to be inside in her lovely home.
After posting her resume and completing applications online a hundred times with no result, she took part time employment at a high-end fashion store, a job she always wanted, at 1/4 her former hourly pay.
"I loved helping women find flattering styles and hoped my degree would lead to a higher position," she said of a promotion that never came.
On holidays she drove to Florida, Georgia, and Indiana to visit relatives, becoming active in their lives now that she worked part-time.
Her husband purchased more flower bulbs, saplings, gardening gadgets and tools, making their four acres of land a show place for the gardening business he hoped to start if the unthinkable happened, and he lost his job of 37 years.
He was "let go" a year after Mary, at the age of 60.
"Before we were down-sized out of our jobs, we believed our good judgment and hard work would bring rewards in the form of higher pay," Mary said. "Not unemployment compensation or Social Security from early  retirement." 
She continued: "We couldn't make our $3,500 a month house payment, so we just waited for the mortgage foreclosure, tried to find jobs, and we grieved."
They considered starting a business in doggy daycare or flower and plant sales, discovering costs, regulations and zoning issues they never expected.
They started a business breeding golden retrievers. As a result they own four dogs they purchased to breed, plus the last litter, born a few days after learning two of the sold dogs suffered a potential birth defect. so none of their twelve animals could be sold or bred.
Their credit union let them live in the home for a year without paying on the mortgage, then offered a deed in lieu in return for the property.
"A deed in lieu frees you from your obligation to the mortgage holder, but it ruins your credit and bars you from another mortgage for seven years," Mary said.
Stay tuned for part three later this week