I've posted before about in-law care-giving. Aged mother in law, lives in same town.
We are at the tail end of a visit from sister in law from several states away. Sister in law has been here for 3 weeks caring for her mother. A much welcome respite.
It had been discussed, prior to her arrival here on the scene, she would be talking it over with her mother, to try and get her mom to come up to her home, for a stay of maybe a few months.
This, in my opinion, is absolutely essential, as I am expecting twin grand-children, due in about 1 month (if they don't come sooner, as is the case a lot of times with multiples pregnancies). The expectant mother also lives locally here, and has a 4 year old daughter. I will be on that front, helping .. as much as is needed. And not on the front with mother in law and care-giving, and have made that as obvious and apparent as I know how to make it. It would be great if mother in law would agree to go to her daughter's home (several states away) for a period of a few months .. and allow me the latitude to put my energies where I want them to be, on my daughter who will have had a c-section .. and my grand-daughter (4 years old) and new twin babies.
Nothing doing. Mother in law has dug in her heels, and will not hear of it, going to stay with her daughter for any period of time.
What are her reasons?
In mother in law's defense ... her daughter ... I don't even know how to describe it. I will say that when her daughter comes here to visit, she all but breathes for her mother and if she could find a way to do that, she'd do that too. She is the most nervous nelly, never sit down - ever ... worry wart, do everything, all the time .. person that I've ever encountered.
A great example, as I was taking her to the airport yesterday for her departure, . I reached into the fridge to grab myself a bottled water and shut the fridge and turned to walk away, as I've done for all of my 50 plus years living on this earth .. and she said to me, "Oh make sure that fridge shut". WTH???? Like I don't know how to shut a fridge? That's just a small, very small slice of what she is ... how she is.
She is so very hyper-vigilant, seeing to every minute details down to it's finest most minuscule point, fine tooth comb, questioning every point along the way, "should we do thus and so, but maybe if we do thus and so, then such and such will happen, maybe we should do it thus and so .. but then so and so might happen, maybe we shouldn't do thus and so, but do "x" "y" and "z" instead, but if we don't do it that way then ..........", on and on and on and on it goes. And usually in hyper warp speed, as to every single friggin thing.
If her mother moans .. "what's wrong mother?, why did you moan, are you alright?".
Mother: "Yes, I'm fine, I was just sighing out loud".
Sister: "Why did you sigh? Are you hurting, are you sure you're alright, why are you sighing what's the matter?"
Mother: "For God's sake __________________, I was just sighing, .. calm down, I'm fine".
Sister: "Are you sure, .. because if something is wrong you need to tell me".
Mother: "Everything is fine, I'm fine".
Sister: "Are you sure, we did a lot yesterday, did we do too much, maybe we shouldn't of gone to two doctors in one day .. was that too much for you, are you too tired now, maybe we need to move those other doctor appointments so we won't have two in one day, is that too much for you, for one day .. is that why you were sighing .. what's wrong, are you sure you're alright".
Hopefully that kinda gives a little bit of a snapshot of what goes on when sister is in the ring directing things.
So in mother in law's defense.. I do get it, why she wouldn't be chomping at the bit to go to her daughter's home.
BUT ....
The only experience she has with her daughter, in the last years as mother in law has aged and been unable to go anywhere much, has been the daughter coming here, periodically, for periods of about 3 weeks at a stretch. When her daughter comes here, she moves heaven and earth for her mother and then some, and doesn't sit down, doesn't stop .. the WHOLE ENTIRE TIME.
Is there a possibility maybe (as I said to mother in law, when she expressed that isn't happening - talking to me - her going to her daughters .. ever) .. could it be possible that maybe if you would go to where she lives .. she'd be more busy managing her own life in that setting than your's and she would get out of your backside .. and not be as hyper-drive-vigilant as you experience in her, when she's here, could that be possible.
The daughter is retired, lives several states away. Does come here, generally, every few months .. and stays for a period of about 3 weeks at a stretch. I wish I could make a list of everything the daughter did when here this last time, but it would take up the whole character allotment:
It's not gonna work to depend on her, to keep herself dehydrated. She won't/can't see to it . unless already hydrated as you see at present . and she is . doing better, more lucid... doesn't matter what's at the root of it, . Sjogren's is not curable . so it's not like they can give her a pill that answers to the Sjogren's . and then she instantly is rid of that as an affliction and thus .. then doesn't dehydrate . pointless to even go there on that issue .. the issue is . she dehydrates . .what are we doing about it.
I already know the doctor (supposedly) wrote it in the orders that staff are to push her to drink . and it's working .. so it's really kinda pointless .. it's working . at present.
I think my main points are, is this the right setting . considering her cognitive issues that are at present . a problem ...
What are you all noting as to that cognitive issue?
What are we doing, going forward, to assure that hydration is no longer at issue?
What are we doing to make sure there is proper supervision as to .. not leaving her with dried feces on her hands, and being impacted.
Seems like the too low of BP .. I haven't asked, but it must be better (just by the shear fact, she's better hydrated at present .. as she is now able to go to PT). So . that as any issue, has been remedied . as to hydrating her appropriately.
Seems like the falling . that has been answered to simply by the fact, . .she fell and broke her hip . and so now . even if her cognitively impaired function dictated she get up out of bed . her leg/hip . won't let her . .. so . that has been answered to at the moment.
It was somewhat interesting as reported to me by church lady who was there to visit MIL yesterday at what was the tail end of a PT session. She said the PT guy was talking to MIL about the importance of nutrition . protein . you need protein for your muscle strength .. and hydration . and it's importance and instances why/how. MIL listened. Then MIL said to the fellow: "I hear what you're saying to me, and I understand it, but it doesn't stick .. it doesn't stay in my brain".
BINGO . ya got that right!
Hopefully there will be a way for them to exclude her . and we can cover some ground without her there. But I don't look for that to be the case. Seems POSH's protocol .. is that she be there. Whatever ...
You also need to ask about what level of care they see her as needing, going forward. It's okay if they won't commit to telling you all right now, but SIL and DH need to be reminded that the THERAPISTS are going to be the ones who will make a recommendation about what level of care shes going to need after rehab. Her placement will not be based of unicorns and fairy dust. It will be based upon how far she can walk, if she has the ability to do ADLs and manage her nutrition and hysration.
I'd also check that her medical hx at the facility is accurate. Do THEY know she has Sjogrens, histoplasmosis, chf, and all the other stuff that she's been dxed with? Is she getting her eye drops?
I can't start the day without some coffee, Dorker! c[_] Did you know that you can drink black coffee (nothing added) before a fasting blood test? (That's assuming it's a normal fasting blood test to test blood sugar, etc..)
I know that .. on those two instances .. just a few nights back .. MIL was unable to answer her telephone . when SIL called .... and called, repeatedly. The phone, it turns out . had fallen to the floor . and MIL not able to retrieve it. Why MIL didn't think to call the nurse button to ask that someone retrieve it for her, unclear. Maybe that cognitive issue ..
But nonetheless.. SIL calling and calling, no answer. Finally SIL resorts to calling the nurse desk . since she can't get her mom to answer the phone. No answer . at the nurse desk .. for quite a long while in fact. When she did finally get someone . the answer had been they'd had two admits at one time . and so .. no one was around to answer.
Not sufficient in my book, but . it's not like it was an emergency .. (though it surely could've been).
But .. anyway . the 2nd night . had to do with the fact MIL had been left sitting in a chair .. and she did (so she says) call on the nurse button . wanting assistance out of the chair and into the bed. No one came . and no one came and no one came. And so finally MIL called SIL .. and asked if she'd call the nurse desk to ask if someone would come help her to get out of the chair and into the bed.
SIL then began calling the nurse desk . no answer, no answer, no answer . this went on for quite a while. Til SIL finally called the security desk (just up the hall from where MIL's room is) . asked if they'd go find a nurse .. the security person did so.
Next thing SIL knew, .. MIL called her, .. and someone had come and assisted her, she was in bed now. And so SIL talked to the nurse, the story given .. "one of our staff had to leave at 5 and we're short staffed".
SIL on that issue . wants it out on the table, that isn't sufficing . while neither of the above were emergencies . they very well could've been . and short staffed .. or 2 admits at once . whatever . what do they intend to do to be more responsive.
I'm not sure I agree with wasting time on that .. but .. whatever.
Yes, I think I'd heard that about black coffee . but I was unsure, so I simply didn't have anything at all.
Yes, we're aware that w/Sjogrens .. the results can be dry mouth, dry skin .. etc etc. In the end, yes it should be noted .. in her chart as one of her ailments . but .. there is no cure for it .. and so .. wasting much time on .. "is that why she dehydrates so fast?". Who cares. She dehydrates . it needs to be solved. Period.
And no .. just in case it comes up in a search . I think I remember at one time, that Sjogrens can be associated with rheumatoid arthritis. She tested negative for that affliction.
Most medical errors can be traced to poor reporting or recording of medical history.
I've lost the train of this new stuff--this visit with the atty and SW and POSH are to accomplish..what exactly? How impaired MIL is? How bad this place is? Where she is going next? Getting a new POA signed? I kind of sped read a LOT and now I'm not in place as to what's going on.
I truly wouldn't get too sassy with the NH staff. They truly DO have other patients to care for, and I am SURE that MIL was hanging on every single nurse, aid and security guards last nerve by day 2. People are not perfect and they do, despite how caring they want to be---sometimes let personal feelings slip in there. YOU ALL complain about MIL and you know her and her many, many quirks. You can't expect a new person to suddenly be ready to jump in to care for someone who is obviously severely cog impaired as MIL is and not have a period of "getting used" to them. Having said that--they have dropped the ball quite a bit and I hope that is simply due to their not having an adequate dx of MIL.
OK. You guys have GOT to not go down that "it's the anesthesia" route with this meeting. She will or won't shake that off to a degree, but the FALL she had and the way she's acted since before she came home--she was NOT 'with it' by any means. And, sadly, despite rehab, she is going to fall again, and again.
DO NOT let SIL take everybody down that road. No doubt a degree of her decompensation is due to the lingering anesthesia--but she's not EVER coming back to even her cog abilities of a year ago. Even SHE realizes this.
Oh, man, is she going to HATE sitting in that room, everybody talking about her. She will remember this meeting.
If you get to read this before the meeting, Dorker, I wish you all the best. You will be the clearest head in the room. SIL is going to tank, DH will do his "deer in the headlights" and MIL is likely to have a complete meltdown. Keep your monkeys in place.
You can do this.
{{Hugs}}
As well - this is where Linda’s two little word gems come into play:
”REGARDLESS of whether or not Mil has Camel Dry In The Desert disease hydration is essential and a
protocol to ensure it is happening is paramount- NONETHELESS.
Anything to obscure the truth.
CHF, Diverticulitis, history of UTIs, and on and on, all of it. SIL seems to downplay things sometime.
The problem with not being to get thru to the facility, they have given an explanation. I might touch on that briefly. If the problem continues then certainly the problem needs to be revisited. But is that a battle that needs a lot of time devoted to it, probably not. MIL isn’t likely to be in posh for what? 1 week, 2, a month. If MIL was going to be there permanently I would take that problem to the facility administrator.
Priorities. Medical History. Hydration. Safety. MILs ability to follow staff instructions. Example: PT guy instructing her to eat more protein. MIL can be expected to remember she needs to eat more protein.
MIL “can’t” remember to eat more protein.
Unless there’s been a miracle as far as her memory goes.
*Granola Bar*
Quick medical history: Possible Dementia (I'd reiterate for emphasis), CHF!!, chronic bowel issues, TIAs, possible Sjogren's, unsteadiness on her feet, getting short of breath easily when performing simple tasks. Focus on the symptoms that she has shown and the problems that they have caused her even at home.
Then, focus on the level of care question. "We feel she needs a higher level of care than she is currently getting. How will this be addressed?"
**Can SW or Medicaid liaison expedite "Medicaid pending" status?
Goals should always be “smart”:
S - Specific
M - Measurable
A - Attainable
R - Realistic
T - Time bound
With a good goal or action plan, one should include each of these points - and with as much “detail” nailed down as possible.
Clever, huh? Kinda cheesy but it does work.
MIL In attendance.
As to asking them, "what are your observations as to her cognitive issues and how they impact her well being here?".
I was told (which I do agree with for the most part) . that she has had some real struggles, .. the general anesthesia . .and it's after effects .. but that she also had some low hemoglobin and anemia . and dehydration . .all also contributors to being foggy . .as to thinking and those have been remedied at this point, and improvement is being seen in her thinking, somewhat.
MIL chimed in at that point, "Well I'm here to tell you I couldn't of told you whether it was day or night there for a long while".
Inquiring of them if this is the best setting for someone with so may other peripheral issues .. not just straight rehab
I was answered that it's not all that uncommon for folks her age to experience complications . outside of a broken hip surgery repair . and those are being addressed as they come up . but that then opened the door to her discharge/transition plan . talk of that . and so that was discussed at that point . that they are looking at a tentative discharge date of 4/15 .. and they wanted to know where did we wish to transition to . and we told them . and so it was mentioned that a referral will be forwarded . and some questions we asked as to continuing rehab services at the next setting ..
As to asking them about how we could come up with a workable plan as to hydration . since counting on her to do it, will not suffice, so many of her issues have been worsened by that mere fact, dehydrating, 2 x's now. The nurse . of the team that met w/us then went into explaining that it's part of her chart that all staff are to push fluids . when they encounter her .. but that there is no facility that is staffed to sit with her around the clock to push hydration or any other issue . but that via education . for her (yea okay sure) . and via the staff's push for same . that's about the answer they can give. Also urged that when any of us visit, don't ask her if she's thirsty . hand her the cup . and ask her to drink some .. each and every one of us that visit .
They report that she is in fact doing a better job at present of drinking and even asking for more . when the cup is empty . and that is my observation being there also ..
Asked what assurances will we have she won't fall . once she is again mobile enough to ambulate out of bed, which is coming. They said they can put padding . (not sure what that means .. they can lower her bed) but that too, education . she has to remember to call for help. At that MIL chimed in, "oh I'm not getting up .. I can't .. I learned my lesson and I learned it well". I then chimed in again, . "But you can't get up .. not now . but you will .. soon . soon you'll be able to do so . and you were cautioned before not to get up but did so .. I guess I'm looking here for some assurance there are measures to ensure her safety going forward and no more falls".
To that more of the same above, . padding .. ??... whatever that means . (I guess in case she falls getting out of the bed ..???..) .. and lowered bed. I remarked, actually she didn't fall .. in the bed, she fell in the bathroom . so .. ??.....
That was answered to, . "there are bed alarms . but the threshold to utilize those in rehab settings is a lot higher than it would be in a hospital setting ... so . utilization of a bed alarm . probably won't be a factor that can be put in place . but she is going to have to understand . that she cannot get up without assistance".
At that, MIL chiming in again, same thing. So really got nowhere on those answers.
PT reported they will be working with her some on transferring .. to wheelchair . as well as walking . and so forth ..
Transfer from bed to wheelchair (I dont' see that happening, she'd need more upper body strength to ever succeed at that, but . whatever).
The crux of the above comes down to ... if one cannot follow instruction (and it remains to be seen if she'll be able to, I doubt it) then .. fall is going to be a risk . as it has been for a long long time with her. That hasn't changed, it's gotten worse . and they can't fix it.
SIL brought up the fact they'd . MIL and herself, been unable on . two consecutive nights to get anyone at the nurse desk .. and that seemed to dismay the DON . that was at this meeting and she made note . telling us that nurses are instructed to carry the portable phone with them, if away from the desk, and that will be reiterated with staff ..
Reported about the dried feces on her hands . and the fact no one had checked on her and discovered this . why. The answer given . that should not have happened, there should be . the staff ratio there, . they are to be checking on patients every 2 to 3 hours . and so . if she did that damage in that window of time . that's how it wasn't discovered . that and .. it wouldn't be typical to check their hands for any specific reason . unless there as a hand injury or complaint . and so it's possible it got overlooked for that reason . but that was hung also on the dehydration . and impacted bowels as a result . and dehydration being better addressed at present, thus that shouldn't be an issue going forward.
Asking of them, . what is it they see as her placement going forward . and the answer given . that will depend on Rehabbing and how far she can progress . they are working at present . on mobility . as well as .. clothing herself . (clothing herself is a "maximum help needed" at present) .. toileting .. she needs "medium help" .. hygiene with toileting . medium help needed at present . and so . they are working on those things via PT/OT . and she is presently able to walk, (with walker) 20 feet .. and so the goals thus far . are mobility and ADL's . and it will depend on her progression . it's too soon at this point to determine what will be the ultimate recommendation as to placement.
On her cognitive function . that they answer to .. there is improvement (they're right, there is . but there was room for improvement, a lot of it) .. and that too, we will monitor . in the coming weeks as to how much that improves to whatever her new baseline will be. More dialogue that sometimes the normal . prior seen baseline returns . and sometimes it never does . and so .. we will have to see.
All in all, I guess it was an "okay" meeting. No real assurances . but I also .. there aren't gonna be any ..
As we were told at one point, .. "if you'd like to hire someone to sit with her, 24 hours a day .. that's always an option and they can monitor hydration and/or help her to get up and down . if needed, but short of that .. we aren't staffed to provide that kinda help .. no place is".
I agree with that.
She might fall again .. yep. But that's been an ever present danger with her for the last umpteen years . and she has fallen time and time and time again . but this time . she got seriously hurt. She hasn't before. But . no assurances she wont' fall again . nobody can give that assurance. Short of hiring someone to be at her elbow 24/7.
Hydration . not even any real assurances there .. other than "education" as they want to hang it on . .someone cognitively impaired . that they don't . seem to want to acknowledge how impaired . until we get further down the road from surgery to see what level of impairment is there. But they did address it in the aspect the staff are now checking that more frequently and pushing that issue . and she is more hydrated at present, and as such . .not as weak . and not as out of it mentally.
I guess .. pretty much .. I didn't feel like a widget this time . I felt heard . not all the answers I'd of
Not all the answers I'd of liked to hear . but I think .. if what I'm wanting to hear is that they will make sure she doesn't fall . not gonna hear that .. if I'm wanting to hear . yes we will stay with her around the clock and hand her a water cup to drink . I"m not gonna hear that, anywhere.
Seemed like the engine is trying to crank towards discharge to Purgatory at this point. In fact, we'd been told previously .. once a referral is made for Purgatory and a bed available . one needs to jump on it, even if they would rather stay at POSH . one needs to go for it, . because waiting . a bed may not be available at Purgatory .. when one is ready to go ..
And this place, POSH . does not take Medicaid Pending .. Purgatory does.
That just about sums it up .
Is Purgatory an AL, NH or both?
I don't remember the specifics on the Purgatory you and SIL want for MIL. Is it also a rehab? SNF? If it's a rehab and a bed opens up, consider moving MIL there immediately and she can finish out her rehab there, then stay as a Purgatorian (ok, I just made up that word!). And once she becomes familiar with Purgatory, perhaps the best plan will to have her transition to becoming a long term Medicaid resident there.
This is what we did with my mother. When an opening came available at the SNF we wanted her to end up in, we moved her there and she finished her rehab there. She then stayed in the same room and transitioned to a long-term resident. (And then she moved to a single in the same hall.)
I think you have a good handle on the fact that MIL will probably never be as good physically as she was before her fall. My mother was discharged from rehab still needing someone there when she got up to walk with a walker. She still needed assistance in the bathroom and transferring. And prior to her hospitalization and subsequent rehab, she did ALL ADLs without assistance (well, she did need some assistance showering but refused it, so she only showered once a week).
Is SIL aware of this? Because MIL will probably not be kept in rehab until she was exactly as she was before her hospitalization. If SIL appeals the discharge, she could get a few more days for MIL. She already did get more days by virtue of the broken hip and dehydration stalling her progress.
I am just cautioning you not to have too high expectations. There's been a lot of complaining about what POSH did and didn't do, and I agree that there are things that they were very lax about. But they are not staffed to provide the kind of assistance that MIL got used to when she had SIL. Unless SIL wants to stay with MIL all day, that is just the way that it is.
BUT ...
Sounds like Purgatory's availability .. it's a "quad" room. I don't think SIL nor myself realized this, in the setting of the meeting .. that it's a "quad" room, meaning 4 beds.
Somehow, maybe it was after the meeting and in talking with SW Jessica that fact became more illuminated and SIL and myself both questioning .. "wait, a 4 bed? ... wait .. hmmm .. no ... we DON'T have to transfer her right this minute .. can we wait until a semi private comes available (2 bed)".
SW Jessica a look of .. oh I don't know . .don't know her all that well .. maybe .. somewhat annoyed .. maybe quizzical herself . .not sure.
Her response: "I can talk to them and find out .. what you don't want to do is run the risk of waiting . until .. it's time for her to depart POSH and there are no beds at Purgatory at all".
SIL feels strongly .. dug in, entrenched .. not budging .. etc etc. It's gonna be enough of an adjustment for her mom period . all of this .. huge/enormous . and even having to go from a private room (what she's in at POSH) to a semi private .. go put her in a quad with 4 other beds/residents .. might as well get the mental ward ready . that's where she'll end up.
I kinda agree with SIL .. do we "have to do that".
We were aware that Purgatory has 4 bed rooms .. saw it .. been there .. questioned even .. Medicaid Betty about it, as she's the one who suggested we go have a look there at Purgatory. Betty had assured, when hearing our concerns that she won't be put in a quad .. Betty had assured that no . we don't have to do that. So now, here we are hearing from SW Jessica that a bed is available at this moment .. but it's a quad .. and .. maybe not even aware ... in the setting of the meeting at least . not until later that the bed they have available is in a quad . and some pushback on that . and somewhat from SW Jessica .. a "not sure" . maybe even a tad bit of annoyance from her, not sure (just can't read her, don't know her well).
SIL did reach out to Medicaid Betty last night .. and Medicaid Betty said, "No . let's wait til a semi private is available". SIL said she then asked Betty if she'd get with SW Jessica and let her know, we're holding off until a semi private becomes available and Medicaid Betty didn't respond (this was all via text, Medicaid Betty's preference as to being contacted).
Oh and btw, .. a paralegal came yesterday and numerous signatures obtained from MIL .. POA being one of them. New Medical Directive of some sort, Living Will, . so on and so on.
Purgatory is a SNF and yes, has rehab facilities on site. It's said that for one to qualify for Medicaid funding one has to have been in a SNF for 90 days .. and that POSH . her presence there, is the clock ticking on that 90 day requirement.
Why can't she just stay at POSH .. to clock out her 90 day requirement. Because POSH does not accept Medicaid Pending . which is what she will be at a point along in all of this. Purgatory does.
What is Purgatory like. It is what I'd define more as a nursing home, in my limited exposure to these settings . than does POSH.
In fact (another look of perhaps . quizzical .. perhaps a slight annoyance .. from SW Jessica when the following was said by SIL to SW Jessica as to Purgatory)
SIL: "Oh . well when we go to transfer her there . can we get it arranged that she come in through the front door. Ya know, when we went there, they have two different entrances . and we couldn't find any parking by that front entrance, so we went to the back entrance . and if they bring mother in thru that one . it will be B-A-D .. a lot of the slumpers all clustered there .. by the tv . and the nurse desk .. a LOT .. (she's right) .. vs .. the front door where .. we did see the
1. Don't get hustled into taking a bad option.
2. Based on my boarding school experience, seeing as you've got to share your living and sleeping quarters with other people anyway you can be better off with three other people, kind of spreading the social load as it were, than you are in more cramped space with one other person. Four is quite a nice number.
Where we did see the setting of it all, touring .. can they set it up that she be brought in via that front door, do you know.
Not sure . .. wish I knew SW Jessica better .. maybe the look on her face, was nothing more than .. I don't know, that's a good question maybe you can direct that to administrators there .. maybe that's all her look on her face was portraying . but it also that same look of . maybe perhaps slight annoyance.
I wanted to say to SIL . and maybe should've .. "what difference does it make SIL . she never leaves her room anyway .. not wanting to mix and mingle with "those people" .. doesn't matter, . she was carted into POSH this time, if she's to be believed, via some entrance that took her by any number of slumpers . so she says .. and she lived to tell about it .. whatever".
I didn't weigh in.
She's right .. there are a lot of "slumpers" there. In fact, .. maybe cruel of me . but after we'd left touring there I cited to SIL one particular elderly man . had been laid out .. all sprawled out . in a recliner in the hallway .. legs going this way and that way .. and his head slumped back .. stretched out, mouth gaped open . asleep .. I asked of SIL .. "do you suppose they check the pulse of those who are laid out . that one guy in the recliner .. MY GOD . was he dead? Do they know do they check that?".
He looked dead.
There were many conglomerated around what is the tv area .. in the area where we entered Purgatory .. and they were all slumpers .. all of them.
Of course, we didn't see the other residents that maybe are not .. maybe they were in their rooms or in an activity room . we don't know.
SIL is right (but I'm of the school of thought .. all of this is gonna be a steep steep adjustment for MIL .. every single shred of it .. but one that cannot be sugar coated .. it just is what is is .. ) .. SIL is right though . this is gonna be a huge adjustment .. her going from what is her home ... and only she and her doggie .. and then .. occasionally .. whoever was summoned .. via myself, DH . or SIL when in town . to service her needs there. To a setting where she now shares a room . with some other soul . and God knows . will it be a soul that never shuts up . .ambles on talking for hours non stop .. will it be someone who suffers from emphysema .. and is hacking up a lung 24/7 .. will it be someone who never talks .. at all .. we don't know.
Sharing a room with someone is going to be a huge adjustment and one that can't be helped .. so let's get on with it, .. is my kinda take on it.
I did ask . when we were there at Purgatory visiting .. do they try to . .as best they can pair up like room mates . as in ... MIL can talk .. she isn't so out of it that she can't communicate .. do they try to pair up a roomie that will also talk, listen .. someone not so sick they can't talk. The answer given .. they do their best . and when/if they see there is a problem . and it does happen . they will work to try to find a more suitable setting ..
Annoying how SIL gets lost in the weeds on things ...
We've covered this ground before .. but I guess she forgets . or maybe some how mistakenly thinks it germane . I do not.
Yesterday we were talking of how weakened MIL had become .. mostly this was in the context of present setting .. hemoglobin too low, too low of BP .. dehydrated, etc etc.
SIL then jumps back to prior stay at POSH for what was the stay to recoop from the UTI/Diverticulitis .. (I find it supremely annoying . I just do .. it's not germane to what is being talked about . why even go there).
SIL: "Yea and you know when she was here before, . they had her on this zero sodium diet . .. and she wasn't eating .. she just didn't like any of it . why did they do that .. that made her even weaker, she wasn't eating, she was loosing all this weight".
Me and POSH SW . and nurse, in unioson: "CHF .. low sodium diet, to control CHF".
This ground had been covered at the time MIL was weathering this .. why do you have her on a zero sodium diet. CHF was the answer. Every time .. maybe not the answer you want . but that was the answer. Every time.
Why are we going back there to that issue.. It's been answered. And now answered again.
True .. I don't get it that they did that . and now they do not .. I don't know why/how . somehow that first stay at POSH . they deemed her to need a zero sodium diet . this stay at POSH that is not a factor . I don't have any clarity on that . but nonetheless .. she is no longer on a zero sodium diet and she "is" in fact eating better .. (still eats like a bird, but that's an improvement over what was the case when it was zero sodium).
I find it really annoying to have to circle back to bring her up to speed at times.
Her questioning the other day as we struggle with dehydration issues . "why aren't they doing the Pedialyte things .. those have loads of minerals and stuff, why aren't they doing that".
Me: "SIL they also have loads of sodium too, remember we've been cautioned against those for that reason".
SIL: "Oh yea you're right".
She gets lost in the damn weeds .. so often . on so much of it . and having to bring her back to circle on it all. Sheesh. I find it annoying.
SIL has suggested several times .. and I keep bringing her back to center.
SIL: With the dehydration thing .. it's almost like we need an alarm or something .. that sounds like every 10 mins . reminding her to drink drink drink.
Me: "And she'd be annoyed by what is that damn noise . why is that thing sounding off .. somebody needs to shut that off .. and the water cup sits not touched, she wouldn't relate the two SIL .. her memory".
SIL: "Yea you're probably right .. wonder if we could find one that would sound every 10 mins with "drink water, drink water, drink water" ..
SIGH . who knows.
MIL saying yesterday in the setting of the meeting, her words: "Ya know, my biggest problem here is that I still think I can do everything myself and I want to . I don't want to bother them with every little thing . so I want to do it myself . without asking for help . .and bugging them".
This in the context of her having to ask for help with toileting .. and her stressing that she just wants to get up and go toilet on her own (fortunately she cannot at the moment, but that will change .. when she becomes more mobile).
Them then stressing to her, . ."We'd rather that you ask us to come help you to toilet . so we don't have to A) clean you up when you didn't ask . and/or .. B) pick you up off the floor . injured . from having tried to do so yourself on your own.
Just . all in all .. I don't know . I think all along I've had a clearer picture of what the setting is for MIL .. and her capabilities or lack thereof . and potential for recovery .. or lack thereof .. I don't know that SIL does even still .. maybe some of it yesterday brought it more to the forefront in her mind . maybe not . who can say.
I try so hard to walk a tight rope of being sensitive to his hurt in all this . and he does hurt thru it all .. it hurts him for his mom ...
I don't know why .. I am over here on this island of reality 101 .. and he's over there on this other island of "wish/hope/flying monkies and fairy dust".
Maybe that's because I've been there . .in the trenches . far more than he ever was . maybe that's it .. and final. I really don't know.
But he does "hurt" watching all of this proceed. I try very very hard to be sensitive to that and make the appropriate sympathizing sounds . etc.
But this morning .. I just couldn't help it ....
He sat listening to what was being said, asking questions about Purgatory .. and that setting (he was not with SIL and myself touring it) .. and I answered appropriately as to the Purgatory site. He asked if there are slumpers there, indeed . .many ..
This then brought a tear . a moment of a tear or two on his part, and choked him up . just for a moment. His next words:
"this all just breaks my heart for her, .. she n-e-v-e-r wanted to live long enough to have to be put in a place like that .. I think of all the times I sat out there visiting with her and her saying to me, *now don't ya'll put me in a place like that".
Him with a bit of choked up emotions at the moment.
My response: (Not loud and angry but matter of fact). "How dare her to have done that to you .. how dare her! That is UNFAIR ............. I would N-E-V-E-R .. ever say that to my kids .. never! How dare her. What did she think . I mean . people can become frickin bed ridden damnit .. who did she think would haul her ass out of the bed and wipe her ass . c'mon!".
DH I think sensing my annoyance, responded: "Well I was aware .. even all along as she'd say those kinds of things . that one can never tell what the future holds . and I never patted her on the hand and said there there mommy .. no .. you mustn't worry .. we'll take care of you . I knew better .. in fact, I'd always tell her, when she'd say those kinds of things . that one doesn't know what the future holds . .we'll just have to see".
Maybe after yesterday and the meeting and the pent up frustrations of the last few weeks .. it just hit me broadside.
I'm aware those conversations have gone on thru the years .. very very aware . that was not a newsflash .. but .. just . hearing it this morning as we now inch closer to Purgatory as her next stop in this journey .. and it's troubling emotional state brought about in DH .. and it just hit me wrong.
How dare her to have put any of you in that position.
DH then: "Her problem is that she's spent her entire life denying that she'd grow old .. ".
Me: "And you and your sister both fed it .. the delusion .. both of you. As her therapist asked her the other day .. what did you think would happen MIL as you age, and her answer .. I don't know I guess I just always thought I'd die peacefully in my sleep .. and the therapist responding . don't we all, .. but we don't all get to choose that, so we have to accept the reality that "IS" rather than what we wish it would be".
At that .. that was pretty much the end of it.
I don't know who is more annoying at times .. DH with his poor poor pitiful mom . or SIL with getting lost in the weeds of it all and having to go find her and pull her out of the weeds again.