The Fall Isn’t Pretty

Author’s note:  This post was written at the end of 2013.

Pearl went to the doctor today. Yesterday was rough. We found her on the floor in the living room after breakfast. She wasn’t hurt, but she had slid off of her chair. She was sitting on the floor waiting for help to arrive, didn’t even call out for us. She may only weigh 80 pounds, but it was a struggle to get her seated again. She didn’t have enough strength to help herself.

I realized then that although Pearl hadn’t been complaining of any distress she had been acting differently:

 1. Reduced appetite

 2. Confusion

3. Weakness

4. Unsteadiness or loss of balance

5. Change in her mental status

I noticed also that her feet and face were swollen, and her urine had a stronger odor.

 At dinner she had finished less than half of her meal then started for her room, and Bam! She hit the floor again. Ron was closer but couldn’t get to her before she hit her head. Not hurt, she said, but she seemed confused as to how she had fallen.

If an elderly person in your care changes overnight as she did, it is easy to think that your loved one is seriously ill. When I worked as a medical assistant, the children of elderly patients would bring them in for an evaluation for nursing home care. The most prominent symptom was usually mental status changes. These changes can be pretty drastic. To us health care workers, the patient was not the sweet smiling person we usually saw in the office. It was easy to see why families were frightened.

We would test their urine and in almost all cases, the patient was found to have a UTI, that’s a urinary tract infection- what we know as bladder infection. However, other types of infection can cause similar symptoms.

Infection can have profound effects on the elderly. I hope that this writing is useful to relieve your concerns when you encounter symptoms such as these in your loved one. Take them to their physician,  see if the problem can be easily remedied.

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Nothing Like A Good Fire

Pearl has lived with us since she was 93. She is 99 now. Go ahead, ask her how old she is, she will say 60.  At 62, I am now older than she is. Does this mean I can now be the boss of her?

She was still living alone before she came to us, and for years she stayed by herself while we worked all day. We made sure she had meals and snacks at hand, but she did fine on her own for a few years. She was with us to see to her meals and laundry and make sure she was well.

Now there is no longer any chance that we can leave her alone for any period of time. Even to work in the yard. We explain what we are doing even if only one of us is leaving. While doing yard work we try to coax her out to watch. She may come out but not for very long, it is just as easy to watch us from the window. That requires us to continuously come inside to check on her.

The last time we left her she said, ”But what will I eat?” That should have been a red flag to us. We answered, ”You just ate dinner. It will be time for bed soon. Go on when you are ready, and we will talk to you in a couple of hours.”

 I guess she had gotten the idea that we weren’t coming back, because when we returned home she was in the kitchen, repeatedly pushing the start button on the microwave and saying, ”I can’t get the light to turn off!” I checked the readout on the microwave and it showed 43 minutes cook time left before it blew out.

The “light” was a flame burning inside the closed microwave. We couldn’t get close to it as she would not move and continued to push the button. My husband started yelling over her “It’s on fire!” while I bodily lifted her and moved her out of the way to extinguish the flames. We asked what she was thinking and she answered, “I wanted a piece of toast.” There was no toast or any other food item inside of the microwave, not even ashes, there was only melted plastic from the ring. We told her she broke it and she promised that she would replace it.

After that we got help to keep her during the day. She was dropped off and picked up each day with a family member, and there she received excellent care.  After about another year Ron retired, then a few months later I joined him in retirement, so we were no longer leaving her at all.

Grandma did pay to replace the microwave the next day. She still remembered her accident, and repeatedly said that she was going to replace the broken one. We were concerned that she would try to borrow the car to do just that while we were asleep, she was so determined, so we took her right away. Got one with a locking control panel.

We can laugh about it now but we thank the Lord that it was only a small contained flame. It could have been a tragedy. Needless to say, we never attempted leaving her after that, if she can’t go out, we don’t go out. Also, even though she has never driven in her life, just to be safe we keep the car keys in our room. She may decide to go out for toast.

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Field Trips Are Fun for All

Ron has an aunt of 84 who lives in a nursing home. He takes care of a lot of her business, and she relies on him to take her places. She has other family but for some reason we are her taxi service. Actually, the reason is that she doesn’t have to pay us as much for gas as the other relative.

We try to have her bundle her errands as it’s about a 30 minute drive to her place. She will call asking for something, like a calendar. Later in the week she may request that her bring her some paperwork from the past, or a new notebook or something. Next, she needs stamps, and maybe the same day she will ask to return something she had purchased at a dollar store during the previous outing. 

 We can’t leave Grandma home alone so it is all four of us, Ron, Grandma (Pearl), Auntie and I. When we take Grandma out, we use a wheelchair. She is quite capable of walking, but she is slow and tires easily and wheels are safer.

Auntie wants her own wheelchair. She cries foul each time she sees her 99 year old sister seated in hers. ” I had a wheelchair in my room at the nursing home, but they took it away”, she complains. Our car seats 5 and only one wheelchair fits in the trunk, so you see the problem.

 We took her to the store to exchange a pair of shoes. She complained that her back hurt and she needed a wheelchair. There were none to be had so she asked for a pill for pain. As we had none to offer we went to the med aisle, where she picked up the largest package on the shelf saying that she would hide them in her room. We knew that wouldn’t be allowed so we encouraged her to purchase the smallest bottle. That started a confrontation.

She began to yell that no one was going to deprive her of her right to keep medicine. She yelled at Ron, who told her to stop. Next she yelled at me, and I said “Never talk to me like that again. Do you understand?” She reeled it back. I wonder if nobody ever tells her she can’t behave like that. Maybe she remembered who was driving. I can’t say.

At the checkout, she didn’t want to buy water in a bottle to take the pill, saying she would get it free from the drinking fountain. Where was it?  At the back of the store. She next began telling the folks in line how much her back hurt and how the nursing home never gives her any medications before she goes out. The ladies in line behind her bought her a bottle of water. “What a nice gesture!” no one was as surprised as she. ” Those ladies do not even know me!”

At this point we had not even begun the real shopping. She took one tab, and instantly began to feel good enough to hike around the store to check out purses and such. She bought shoes and a jacket to return at a later date. It will be fun.

As we approached the exit, she remembered that she wanted a hairnet. Back in we all paraded to find her one more item. It took some time to decide between the black or the brown ones (not that it matters, but she has gray hair). Back through the checkout for the third time and finally we could leave for real.

By the time we delivered Auntie back home we had been gone for almost four hours, and gone shopping three times all in one store. We arrived back home and went straight to our rooms exhausted.

Also yes, we informed the nursing home that she was harboring a 500 count bottle of pain killer, probably under her mattress.

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A Good Story Is Always Enjoyable

Pearl doesn’t talk much, just to answer questions or tell us what she is doing but this week this is what she told us:

“The lady that works here said: ‘You know what will cause you to have the runs? Those oat squares. They’ll do it every time’. ” I heard her myself, she was standing right at the top of the stairs.”

No lady works here but if one did, she would have made good sense. I wouldn’t dare give Pearl a bowl of oat squares. There was no one here.  An empty box of squares had been on the table for a moment, though while Pearl was eating lunch. I’m guessing she had that entire conversation in her mind.

A couple of years ago Ron told me that when a social worker was checking up on her, Pearl told the lady that someone pulled her hair. Just came out and yanked it with no provocation. We were puzzled about that, as we are usually the only ones around here and we always treat her gently. At that time she was still combing her own hair. I met with her social worker over the phone a few times and in person for a long interview. It was then that she told me that I was no longer being investigated.

Here’s how that conversation went:

Me:  Investigated? What for? Why?

Investigator:  For the hair pulling incident Pearl told us about.

Me:  What about it?

Investigator:  You know, her saying that you pulled her hair.

Me:  What?! She said that I pulled her hair? I didn’t pull her hair!

Investigator:   Oh, we are sure of that after our investigation and interviewing you both. Pearl has an active imagination and cannot distinguish between reality and her thoughts.

A part of the dementia process, we were told.

Later we learned from Ron’s sister that years before, Pearl had had a screaming fight with her (Pearl’s) mother in law, and she pulled her mother in law’s hair. Ron’s sister had witnessed the whole thing.

Had Pearl been thinking of that moment from her own past? I don’t know. I only know that the idea of anything causing any pain to that frail lady causes me pain,  just like a mother feels with her baby.

A few weeks ago Pearl was ready to go home. “I wish I hadn’t sold my car, I would drive home and go to bed.” She has never driven a car in her life and has never owned one.  We told her that she was at home and her bed was upstairs and she could go to sleep at any time. She said, “I know it”, then stayed up for another hour talking about her car.

You gotta laugh

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The Stuff You’ve Seen

Think about it. Those who are in their 80’s and 90’s have lived through an incredible world of change. Many of our elderly predate WW I. That’s so with Pearl.

Born in 1914. She grew up on a farm, as did many more kids than do today. She called the sink “the zinc” when I first met her. In her youth they were made from zinc, it’s how they got their name. Her home had no electricity or indoor plumbing just like her neighbors’ homes.

Here are some of the things she saw at their beginnings:

  • The phonograph, records, and radio

  • Talking pictures

  • Women get the vote

  • The Great Depression

  • Prohibition and it’s subsequent repeal

  • The development of vaccines which have almost wiped out many dangerous diseases

  • Silk stockings and later pantyhose, followed by no hose at all

  • Women began wearing slacks

  • Women began wearing bras

  • Much later, women burned their bras

  • From hay wagons to the Model T, to automobiles in every driveway

  • Permanent waves (Someone asked what those were, we know them as perms. They were big in the 80’s – no pun intended)

  • WW II, Korea, Vietnam, wars and rumors of wars

  • Commercial airline flight

  • Rock and Roll

  • The fabulous fifties and the influx of labor saving devices for the home

  • The Pill

  • Hair dye

  • Man walks on the moon

  • Michael Jackson moonwalks

Enter, with microwaves, the electronic age:

  • TV, then color TV

  • VCR, Laser disc, DVD

  • Home computers, Bluetooth and WiFi

  • Film that develops in 60 seconds, in 10 seconds

  • Digital cameras

Pearl had one of the first caller ID boxes. If she saw the light flash she cleared it and started calling all the relatives to see who called. She thought it would be very good if someone invented a box that would show who called instead of just having a flashing light. We tried to tell her…

We’ve gone from market baskets, to cloth market bags, to paper, to paper or plastic, to cloth market bags. And I’m just scratching the surface here.

But think about it, it is no wonder that sometimes our seniors are a little confused. When I worked in retail we used scanners to ring up groceries and a machine popped their change out at them. Everything was done speedily, and sometimes it would cause anxiety and mistrust in the elderly customers. I would try to see things from their viewpoint, and always remember to give them a little extra human interaction.

So. When you see a senior citizen using a cell phone, texting, or on Facebook, send a little love their way. They’ve really accomplished something! They’ve made the quantum leap into the 21st century

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But What Should I Wear?

It is the dead of winter. Being the frugal household that we are, the heat is set in the 69 to 72 range and you will find us in layers, sporting sweaters and hoodies. I am in my bare feet. I know. It’s a sickness.

Grandma is but a tiny thing of approximately 85 pounds coming from a house set to 80 degrees throughout the year. Anyone visiting her then would have found her quite comfortable in short sleeves. She does not get the layering concept. It’s foreign to her. Maybe it’s a laundry thing, I don’t know.

My husband and I both agree that she will have clean clothes every day. He bathes her two to three times a week and each morning I choose an outfit for her and lay out all she needs after I make her bed.

We have a very organized system going. Ron’s job is to make the coffee. Priorities must be observed.

All of Pearl’s clothes are in her closet. I have hung them so that the entire outfit is on one hanger, eliminating the hunt for the right combination. This also makes packing quick when she has a sleepover at her granddaughter’s.

I have also color coded the hangers. Fall and winter items are on black hangers and spring summer clothes are on white. I simply move the current season’s hangers to the center of the bar. (All of my closets look awesome thanks to the advice of my daughter in law and my youngest son’s girlfriend.) Everything else she needs is in her dresser.

We still have her dress herself and we will continue to do so as long as she is able. It requires supervision to ensure that she does it right and we may have to help with knots or fasteners. But each morning is a victory.

As to the layers – she gets them on because we tell her she needs to. After breakfast she goes into the living room and removes the sweater, jacket or whatever, like she just came in for a visit, and she sits in her chair and says she’s chilly.

Oh well, that’s why they invented the snuggle blanket. Hers says MU. Go Tigers!

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Odyssey In Elder Care: A Caregiver’s Journey

The year is 2007. I am at work at a doctor’s office where I am a medical assistant. My husband Ron, a forklift driver, is called by his mother who tells him that she has fallen down the basement stairs and can’t get back up. She tells him to hurry.  Ron calls me and then 911, and we all arrive at her house at about the same time.

My mother in law’s name is Pearl. At the time of the above incident she was 93 years old. Widowed since 1999, she was still able to live on her own. She took care of her own housework, cooking and laundry. She had never driven a car, so my husband or another family member served as chauffeurs. We all helped with the heavy work. Ron visited her almost daily after work.

The paramedics found her on her bed with a heating pad on her back.  She had managed to crawl upstairs and implement her standard treatment for aches and pains. The EMT’s told her that that action had probably done more damage and increased her healing time, but her answer was that she was hurt and a heating pad helps.

X-rays and MRI revealed three fractures, one in her neck and the others in the mid area of her spine, along with bruising and a strained shoulder. She was in the hospital for a few days and then went to rehab. She stayed with us for a time till she insisted that we return her home.

She did not do well at home after her accident. She would call to have assistance opening boxes of food. She couldn’t operate the coffeepot, She began to lose weight on her diet of crackers and bread. It was time to have help. She moved in with us, where she has remained for most of the last 6 years. We are the full-time caregivers, with occasional breaks from Ron’s sister and his niece.

The decision was made quickly. She relies greatly on her son, he lives closest to her home and she had seen him almost daily since her husband passed away. Our concerns were that she would fail rapidly in a nursing home environment. When she is not happy she will stop eating. We also wanted our grandchildren to know her and remember her as part of their lives.

Almost 7 years later, at the age of 99, here she still resides. This blog is about that time and how we have all changed. I write because at times I feel trapped in these circumstances, and it is a form of escape for me. And at times it is a release for tension or anger.

Anyone who cares for another adult is likely to encounter some of the same experiences. You may find answers here or you may just like seeing that you are not alone in this. In this blog I will share the everyday odyssey in elder care.

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