Joined: Thu Apr 21, 2011 9:07 pm
On patience and wise counsel: no special care just yet
I haven't posted for a few months, as Fall is my busiest teaching quarter, and the geriatric whack-a-mole adventures continued in between. More than once, it looked like my mother would be in the dementia care unit before the holidays or at most shortly after. But she is still with my dad, for now, despite one misadventure which sent her there briefly, and thanks to some wise and timely advice from a colleague and friend.
The misadventure began, as they usually do, on a weekend. The usual morning nursing aide was out, and a new one came by their assisted living apartment to help my parents get ready to go to breakfast. She found blood all over my mother's pillow and bed, and my dad yelling at her. They called me to say my dad was exhausted and needed a break, and whisked my mother off to the dementia care unit. I figured out at this point that my mother had had a nosebleed when she woke up - not as bad as the one two weeks before at my house, but enough to scare my dad. He tried to get her to stop poking a paper towel up her nose and making it worse, but she couldn't hear him (I discovered her hearing aids were in the wrong ears.) My mother was very distressed about being moved and told me that all the staff there were very kind but were just waiting to put her "in the can". ??? - she explained that after you die, they cremate you and put the remains in a little can. Like dog food. It took two days to get her sprung from what she viewed as a kind of imprisonment - seems they had to decide whether they needed to file an elder abuse report - the head nurse was out until Monday, of course. After three meetings, with and without my dad, I finally got everyone convinced that yes, she had nosebleeds frequently; yes, the doctor would order discontinuing the one baby aspirin per day; and yes, their care plan needed some tweaks. Ever since then, alas, she has felt that she did something bad to get parked in the dementia care unit, and has apologized to us many times a day. "I'm sorry, I'm sorry, I'm sorry!" Poor lambkin. Of course my dad was horrified at the idea that he was suspected of elder abuse - at least that got cleared up eventually.
My dad is 96, too, though, and the stress of caregiving is wearing on him. It's clear the handwriting is on the wall. But I didn't want to force the issue and insist that she be moved, though I feared it was nearly inevitable. I would have asked the senior nursing staff for some advice - they are actually quite sensible, and did clear up the "elder abuse" issue in short order. But my dad, a retired accounting professor, is deeply suspicious of the senior management at the retirement community and believes they mandate increased care to improve their bottom line (it's a nonprofit but they still have to balance the budget.) He's very angry over many of their day-to-day decisions that he feels are unfair to the working staff. Still a crusader against injustice, my dad...
So I asked a colleague, a very experienced senior social worker who specializes in dementia care and research, if she would meet with him and help us think about the challenges. She is a wise woman, kind and thoughtful and sensitive. She was awesome! She spent an hour and a half with him, and he was comfortable enough to be very frank with her. He came back laughing. And her insights and advice were really helpful to all of us. I will note a few, as they may be helpful to others:
1. My dad is not ready to let my mom go; he would be lonely and would feel guilty, and he knows she would go downhill. So it's worth extra effort to give him the time he needs to make peace with this.
2. He is very angry at the management, but much of this is displaced anger from his frustration with my mom and perhaps even with me. It's much healthier for him to be angry at the management, not my mom, but it's useful to understand the roots.
3. He is just barely managing, and any glitch in the routine really upsets him. In particular, glitches around the bus coming to take my mom to respite day care one day a week, or around meals, are most upsetting, so the efforts to fix should focus on those parts of his routine.
She had many very practical small suggestions, too. And he is inclined to listen much more to someone outside the retirement system and outside the family, so she offered to come back in a month or 6 weeks and see how it's going.
So I am deeply grateful to have a colleague so wise and generous! And I'm trying to cultivate my own patience...
Laurel - mother (96) diagnosed April, 2011, with LBD
Joined: Fri Jan 15, 2010 9:33 pm
Re: On patience and wise counsel: no special care just yet
Lucky you Laurel, to have such a friend. This must take a big burden off you, at least temporarily. Lynn
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.