March 25, 2014–”I’ve been meaning to tell you…”

She seemed sharper mentally yesterday–knew immediately who I was and remembered William’s name with a little coaching. (“It’s the same name as one of your favorite relatives,” a clue I’ve used in exactly those words for close to four years now.)

It was too cold to go outside, so I took her from the dining room (again, an hour and a half before supper) back to her room so we could visit.  She still has a bit of a cough, and the swelling of her left hand is not completely gone, but overall she is much better.

There was something important on her mind, and she must have told me the same thing in different ways at least four times in 20 minutes.

“I’ve been meaning to tell you (“Mom”, “the nurse”).  I just haven’t had any energy lately.  I’m not sleepy, I just don’t feel like doing anything.”

Each time I explained that she had only been home from the hospital for a few days and it was quite normal for her to be tired.  She’d agree, we’d sing a few of her favorite songs, and then she’d begin the same thing again.

“I guess it’s too far for Mom to walk here.”

I said I thought she was right, and asked what she would like to say to her mother if she could.

“I’d tell her I love her.”  I told her I was certain her mother knew that very well.

She made a brief recording on WhatsApp for Layla and Ryan, her great-grandchildren, even though she hasn’t any idea who they are or how they are related to her.  Today Layla sent a verbal message back, but she was riding in the car with her mom, and the back ground noise is such that Mother would not be able to understand her.

It doesn’t matter on this end, because she won’t remember having sent the message in the first place.

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March 20, 2014–elevator not stopping

..at all the floors. I hadn’t seen her since she was in the hospital–my own minor physical anomalies. They did have the wheels of her chair locked when I found her in the dining room at her table–an hour and a half before supper.

She had a lap robe on her lap, so I wrapped it around her shoulders,  “hupped” the dogs into her lap, and we went outside in the sunshine–70 degree weather.

She wasn’t sure who I was, “oh yes, TINA,” after I told her I wasn’t Phyllis.  Last time I saw her at QO she had asked, “how long to I have to stay here?”  Not only doesn’t she know where she is, she had no memory of her transport to and from, nor her time in the hospital.

She had told me then that she had been visiting her cousins, Clarence and Fred Pincomb. Apparently the two shared time in the same business–one worked all day, the other all night.  She hadn’t seen Fred until “after church.”  Of course, both have been death for 50 years, and their businesses were totally separate, but that’s okay.  It pleased her to talk about them.

I told her her friend Al was going to visit her tomorrow. She said, “I can’t keep track of all these men that keep coming around.” Ba da BOOM!  Love it!  I hesitated to tell her he was the only one, and that he also visits others who are unable to get out and about.

I put her hearing aid into her ear, but it didn’t seem to matter much after the first minute or two.  I think she is shutting down that part of her brain.  The only thing she hears at QO is someone telling her what to do.  Conversation, such as it is, is rare for her.

I had a long conversation with one of the nurses at the hospital and aired some of my (many) grievances about “the best” nursing home available.  This woman is from Germany and had been a geriatric nurse before emigrating to the US.  Another time I’ll share what she told me.  It would be wonderful if the US would adopt even some of the things she told me were commonplace when she was a young nurse. Below:  Gram and her boys, Mozart and William Gram & her boys

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March 16, 2014–she being discharged!

I just got a call from the hospital.  She has responded so well to the antibiotics they are sending her back to the nursing home.  I added updates to the last post and will add to this one tomorrow afternoon after I get back from seeing her.

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March 14, 2014–emergency room again

Earlier this week she had pain and swelling in her left wrist–went round and round with Aetna re in-house x-rays.  Nothing broken, “arthritis.”

It’s 6 a.m. and she is on her way to the hospital.  Her temperature is 101 and she has rattling in her right lung.  They suspect heart failure, which causes swelling in the extremities.

Of course, she was diagnosed with congestive heart failure fifteen or more years ago, but this sounds serious.  I’ll go over there in a few minutes and update later.

_______________________

4 p.m.  They had her on IV antibiotics when I arrived.  She has fluid in both lungs, a urinary tract infection, her blood pressure was 180/113, and her poor left wrist swollen three times normal, angry red, and exquisitely painful.  Her right forearm and wrist were also alarmingly red, but not swollen.

I stayed with her until she was admitted five hours later.  She responded well to the antibiotics in that her blood pressure slowly dropped to 135/66, far less scary, and her right arm looked better.  The emergency room doctor though the left wrist swelling was gout, though he says that usually shows in the feet and ankles.  I’ll go back this evening and see what they have determined.

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This evening she hadn’t eaten much supper, but was comfortable and resting.  Her fever was still high.  She hadn’t seen a doctor since this morning.  I left word I want to know the doctor’s opinion of the swollen wrist and will go back tomorrow late afternoon.

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Saturday evening:  Her left wrist/hand are not as swollen–still hot and painful, but no longer look like one of those long balloons.  The doctor thinks “celluitis,” which in the elderly can happen from a bump, bruise, or cut.  The fact that she had two nasty bruises on her left elbow may have contributed.  The UTI was probably what tipped the scale, causing a systemic infection that showed up with fluid in her lungs and that awful swelling.

She is eating fairly well and doesn’t seem to be in too much discomfort, though her cough is still worrisome.  She’s right across the hall from a nurses’ substation, put there deliberately, I am sure.  I really like the people taking care of her today.  Someone from food service called me (at my request) and let me make up menus for her for several days.  I know what she likes, but if you ask her to choose, she really can’t.

I was chatting with the charge nurse, who is a dog lover.  I said something about how much Mother would enjoy it if I could smuggle the dogs in tomorrow when I come. She said, “If I don’t see it, it didn’t happen.  I just won’t see you come in, okay?”

How nice!  she’ll love it.

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February 25, 2015–waiting for the school wagon

It was a lovely afternoon yesterday, so right after my class I went home, got the dogs, and drove out to see her.  What a crazy winter its been!  Everything shut down two weeks ago because of ice and snow, but the last couple of days have been in the 70s.

She was in her wheelchair at her table in the dining room, even though it was an hour and a half before supper.  She looked nice.  Her hair was freshly washed and brushed, and the lavender throw she had in her lap matched her shirt.  I just wrapped it around her shoulders and wheeled her out into the sunshine.

As usual, the dogs seemed to love sitting in her lap for the ride.  I found a bench where I could sit and position her so the sun would hit her face without being in her eyes.

She was very quiet, responding appropriately to my comments but not offering any of her own.  We talked about the weather, and I asked if she remembered any really cold winters.

“Of course!  Walking to Fry’s Corners when it was so cold your legs could hardly move.”

“Wow.  That sounds pretty bad.  Why did you have to walk to Fry’s Corners?”  (where ever that was…)

“To catch the school wagon.”

“Oh?  tell me about it.”

It was the most I’ve heard her talk in several weeks.  The school wagon was pulled by two horses and could seat 8 or 9 kids “if they were little” on the benches on either side.  Between the benches was a little wood stove that everyone had to be very careful not to touch or tip over.  It didn’t really help, though, because every time the back door opened and someone climbed in, all the warm air leaked out.  If it was very cold, the driver sat inside.

“But how could he drive the horses?”

It seems there were slots for the reins and he spoke to them through a “voice box.”  “That’s what I called it,” she said.  Unfortunately, I could not get her to describe what it looked like or how it operated.

I asked if she had hurt herself when she fell yesterday.  She said she felt okay.  The staff had called me.  She had finished eating supper and was trying to climb on the table, thinking it was her bed.

I had a long talk with the social worker a few days ago.  He says she in almost completely incontinent.  The singing she used to do has been replaced by loud talking.  They say “talking out of her head,” but I think both are just so she can hear a voice, any voice.  She so desperately wants someone to talk with her, to engage with her.  Most of what she gets is someone telling her what to do and how to do it.

I missed a care planning meeting two weeks ago.  No one told me about it.  It was on a listed posted on an office door I have no reason to look at, and on the bulletin board by her bed.  The stuff on that bulletin board (schedules, menus) hasn’t changed since she’s been there and I am not programed to put on my reading glasses and go exploring for things I might need to know.  Ticked me off.

Maybe they’ll let me reschedule.  It was during the ice storm.

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February 10, 2014–further changes

Although her chest is clear and she seems to have recovered completely from the bronchitis, she seems much weaker.  I tried to help her to the bathroom yesterday and she had trouble walking and keeping her balance even with me hugging her arm close next to me.

She no longer moves her head to look around her.  Even with light/dark vision, she used to be able to distinguish objects enough to avoid them.  Now she doesn’t even try.

I could not get her to stand up straight.  It was like last time when she was walking her feet forward under the sink.  I was patiently waiting,  trying to let her manipulate her own clothing, and she just couldn’t do it.

When she was finished and I was trying to help her back into her wheelchair, she could not turn to find it, kept trying to sit too soon and pushing the chair away, even though the wheels were locked.  I had to ease her to the floor and get two CNA’s to help lift her into the chair.  I’m not strong enough to do it.

So this is a new change.  I can never take her “out” again, and think the time for off-site doctors’ appointments is over.  I simply can’t handle her weight and lack of coordination.

I called Mary yesterday to ask if she wanted to continue to visit, what with all the changes and challenges and she told me honestly that it has gotten to be too much.  I understand.

Her decline is progressing.

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February 4, 2014–she’s fine!

Last Wednesday, after three nights in the hospital, she was discharged.  The diagnosis was bronchitis, not pneumonia.  The kept her on a bronchial dilator and antibiotics for a week following, and they worked.

I did have to have the nursing home remove incorrect notes from her medical chart. They had her down as having COPD and some allergies, all of which are not true.

The hospital is very close to home, so I visited her daily.  Wednesday, when she was discharged, she was telling me a long, involved, very detailed story about how her step father had drowned while trying to save his two sons, who also drowned.  It “was in this morning’s paper, page 2, right hand column.”  She had told the same story to her nurse.

None of it is true–not the story, and since she has been blind for several years, certainly not a newspaper article.  But it was very real to her, indicative of her worsening dementia.

I went out to QO today to supervise her haircut in their beauty parlor.  My goodness, she still has the most beautiful hair.  No one else in the family inherited it, much to our chagrin.  I had the dogs with me and she was happy to have them in her lap, but had little to say and seemed to have more trouble hearing.  No hearing aid because they won’t be responsible for keeping it out of the laundry.  It lives in my glove compartment and I forgot to take it in with me.

She sounded good–lungs clear, no wheezing or coughing.  But her mental acuity has slipped again.

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