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:
She finally said, after my prompting her 3 x's .. 'yes, . well where is that button thing, push that for me".
It was right there, .. I handed it to her to do. She did so. But continued her struggle and did get into her wheelchair on her own, before staff showed up .. and was in route to the bathroom. Staff member showed up . helped her on into the bathroom and onto the toilet .. and told her, .. "now pull that cord when you're done and I'll come back and help you".
DH and I sitting in her room, curtain pulled so she'd have some privacy .. us on the other side of the curtain.
She eventually called out to me, "Dorker, can you come scoot my chair closer so I can use it to brace .. and get up off this toilet".
I responded "No, use the cord in there, like she instructed you to do".
She did that and in less than a minute a staff person was there to then help her up from the toilet .. and into the wheelchair to get back over to continue visiting with us in the room.
On that issue . that one also .. life's greatest mysteries. She doesn't use that call button to ask for help unless prompted repeatedly . she just struggles on her own to do it. If you ask SIL, the answer given is: "She says she just hates to bother them . they all treat her like she's a bother .. so she just struggles on her own" If you ask DH the answer given is: "She just refuses .. she says she's sick of their chit .. and that everyone of them wanna give her chit if she asks for help so she just says she's not gonna ask".
Of course the only way we'd know the true answer to whether they indeed treat her like chit for asking for help . is to have some kinda mike'd up nanny cam recording it, because what we witness when there on site, . no one gives her chit .. but they wouldn't . not with us there.
This specific complaint has been previously tabled with the DON of nursing there and the general answer is . "We don't tolerate anyone being unkind .. that's why they're here, to help you .. if you think you are being treated unfairly you need to get the name of who is mistreating you and let us know and we will address it".
But of course, that never occurs. Instead what occurs is that she ambulates on her own, refusing to use the call button (for which reason .. see above . who knows) .. and as she puts it "ya know I put my life at risk every time I do this" .. and doesn't call for help.
SIL wants to be on speaker phone. She has been working to try to get resolution to what can be a better set up as to the toilet. At present .. it only has what is a bedside DME over the toilet .. not as sturdy as SIL would like, as a set up. Has been trying to dial down on that issue, and gotten nowhere. At her home she had some apparatus . .and we'd gladly bring in there if they'd allow it to be utilized .. she had brace bars .. that were screwed on to the back of what is the toilet bowl .. and that was what was used at home. More sturdy. SIL wants to dial down on that issue some, to see what can be set up that is more sturdy.
Want an answer just out of curiosity .. why is PT ceasing? Is it because insurance has run it's payments out .. and if that's the case, when an it resume? Is it because of "lack of progress". What are the markers that determine resuming PT? She will now transition in the next couple of weeks to what they call restorative PT rather than being carted to the on site PT facility. Why?
I've told DH that's all I know that needs to be covered . but he wants me attending . feels like I ask intelligent questions and can follow up on questions answered that need further delving into.
I will go, because he requested it, .. but in truth .. I don't expect I'll be providing all that much input ... I don't even know who is who there on staff . I don't go there enough and am far enough removed from it all.
I'd bet the dementia/cognitive impairment is why MIL won't call for help. For whatever reason, she has it in her mind that they see her as a burden and/or will give her a hard time. I learned from my experience with mom that sometimes they tend to fixate on a specific idea or subject, often with no rhyme or reason, but somehow it makes sense to them. My mom was convinced that they had installed cameras in the bathroom and shower and that people were watching her.
Sounds like the conversation with grandson was interesting. I wonder what MIL said she feels is the problem between her and estranged son. Grandson playing peacemaker could go either way, not sure that's a great idea. If MIL's behavior toward estranged son was truly narcissistic in the past, grandson is an unwitting "flying monkey" as they say in perpetuating a reconciliation that may not be wanted, maybe for a very good reason. Hopefully not the case, but it could be a possibility.
I have said it til the cows come home to DH and to his sister and for whatever their reason(s) they never seem to find it necessary to get it tabled for discussion.
Ask me to be a part of the scene and I may go ahead and put it out there .. and see where it goes.
When is SIL scheduled to return to FL?
At any rate, it isn't worrying about bothering people, or stubbornness, that keeps her from wear the pendant or pressing the button. She just doesn't remember. It is all part of her dementia.
The goal is to get the house emptied and returned to the RM folks, at or about the time the property tax bill comes due, so as to transfer that hefty expense back to the RM folks and not have MIL incur same. That's the hope. One can pay it, and then be reimbursed the pro-rated difference .. if that's the option that's needed. In any event, .. to be truthful . her requirements per RM are that the home not be vacated by its resident for any given 12 month period of time.
She left her home, as we all know, about the end of August for a stint in IL with her daughter. That stint lasted thru January. The beginning of February she was finally able to return to her glorious home (not all that glorious in reality, but to her, it is). She was there all of about two weeks before falling ill with a UTI that left her unresponsive . and carted off by 911 personnel to the hospital.
She hasn't been back home since.
The RM folks don't have a nanny-cam installed to make sure there is actual residency there of the contract owner for the RM. They do send a monthly statement as to the RM and it's financials .. (the home is tapped out as to it's worth). That financial statement, along with all her other mail, gets forwarded here to our home. I guess were it returned to them, . via the fact no one resides there, they'd of long ago, questioned the fact no one is residing there.
So in any event, . she has been out of the home and remanded from that hospital stay to a rehab stint in POSH . and from there, . to Purgatory where she currently resides (semi-permanent) unless another placement is in the offing. But home, is not one of those options. So the home does have to be emptied of it's contents and then returned to the RM folks . and sooner rather than later.
Sounds as though the conversation SIL had with the powers that be, at the Purgatory the other day became a bit testy.
SIL calling there, displeased in large measure .. at their failure (continuously) to bathe her, .. and also .. the fact they'd carted her mom to a doc appt., to examine that hip .. injured in the most recent fall about a month or so ago, .. and in that transport provided by Purgatory .. they'd indeed gotten her to the xray portion of said appt., but departed before seeing the doc on site .. which was also part of the whole set up .. as to transport thereof.
SIL called Purgatory to express her displeasure on both points above.
On the bathing issue .. I don't know what to make of it. She was told by whoever she spoke with that seemed in no mood to take her crap .. basically .. "your mother gets her baths on her designated days .. could it be possible she forgets .. and tells you she didn't, when she did indeed".
SIL's response to that notion (and I have to agree with her, truthfully, MIL is definitely someone who suffers from some impairment, but she's not that far gone) .. MIL .. a shower/bathing is a huge ordeal. It's an enormous task .. she doesn't "forget" that someone did or didn't come bathe her. That much I agree with SIL on. So now, SIL feels as though they are "blaming" their short comings on her mom's memory and basically lying to cover their tracks.
In resolution to that issue, it was offered, there will now be a witness as to her bathing .. so that it's attested to it was done. SIL holds no confidence that these folks aren't lying and covering for one another, . and it can still be said .. "oh yes, she got a shower on "x" date .. and I see her that so and so was a witness". When in all truth, .. it's not a bit valid.
The other testy point .. was that SIL was drawing attention to the fact, they'd left there without MIL seeing the MD
MIL fell a month or so ago .. and she would've sworn she re-injured her hip.
Purgatory did what they do in such instances . she was put on a fall protocol and checked on more frequently for 24 hours . and they called in a mobile xray unit, which arrived the next day .. took xrays and the report was, no damage, no injury.
MIL was complaining she still felt as though she might've really hurt herself . that she was sore and limping . and she was worried it was really injured and how thorough was this whole mobile xray thing.
At that SIL whipped out her whirligigs and set them in motion .. and got an appt set up with the surgeon who fixed MIL's broken hip back in February/March when she fell and broke her hip.
It took this long for them to work her in for an appt, for xray and a visit to the MD. That was done the other day . Purgatory having sent an escort and transport for same. In that appt, the xray was seen to, . and then they exited, back to Purgatory. MIL stated that she even told her escort, .. "I believe I'm supposed to see the doctor too while we're here". The escort replied, . "no . you only have an appt for an xray" and off they went.
SIL taking exception to that, .. and raising her hackles with the staff person she spoke with.
Sounds like the staff person bristled back . that in the end, . they have the report, and there was no damage, as was shown by the original xray done . and ..it was truly a waste of resources to have gone that gamut, it was already known .. via the original xray there was no permanent damage.
SIL bristling back that she'd of liked that her mom see the physician and the physician visit with her and read the xray. The woman bristling back . the physician has read the report and sent it to them . they have it, they will provide a copy . there is no damage.
MO on the whole thing . more of SIL and her whirligigs .. and this time . .she has run up against someone who is pushing back (finally) and deeming it kinda a waste of time .. and I agree.
MIL has been carted to PT 3 x's a week . since this latest fall .. and if she were truly re-injured that would've been picked up on in PT sessions and they'd of found her not able to work PT.
Waste of time/resources.
I agree with the staff person.
I have to wonder if they have caller ID at Purgatory and fight over who has to take the next call from SIL. Who draws the short straw.
But yet later, when SIL happened to talk with MIL .. that same evening, . only hours later .. and ask her mom (since it was a Saturday, designated day for showering) .. "did they come bathe you".
The answer given was: "No, . no one came".
Now where is the disconnect?
DD didn't stay there and witness a shower ensuing . she only reported that a CNA showed up to shower her, .. as they were leaving.
Where did it fall through the cracks? Did the CNA vaporize upon DD and company's exit from MIL's room?
Did she ask and MIl declined . yet when SIL asked her mere hours later on the phone .. rather than report, .. "yea they came, but I was too tired, I sent them away", .. no .. not what was reported by MIL. It was "no, no one ever came".
I guess the CNA that DD saw .. I guess she vaporized into thin air.
MIL is at the point where EVERYTHING needs to be verified before a family member acts on it. Reading this story from the beginning, it is clear that she showtimes to some extent and the rest is propped by habit and relationship. She seems more “with it” because there is a pattern to family communication that masks a lot of this AND she falls back on a lot of generic talk (these people are mean, don’t know what they are doing, etc.)
I remember that point well with my ILs, and I am still in it with my brother. No fun at all. But, if I were DH and SIL, I would be taking almost everything MiL says with a grain of salt unless I have VERY good reason to think otherwise. They can still look out for her, but they need to remember that they now need to protect her from herself, probably more than protecting her from the perceived issues with others. I am not saying ignore real problems, but the first step to resolution is verifying the true source of any given problem.
The longer Mil can keep SiL’s attention focused on the deficits of others, the longer the attention stays off of her issues... not that the thought process is that conscious with dementia. It is similar to a child who tries lies about someone else to keep from being found out. Subconscious self-preservation.
Ambushing for an eval during that meeting is probably going to be the greatest gift you could give to any of these folks.
Anyway, taking MIL complaints with a grain of salt is a good idea. Verify before taking it up with the facility and learn the art of just agreeing with MIL complaints, being solicitous without plans to *fix* things. SIL strikes me as the sort who has never learned to pick her battles or to look at the big picture. Or to understand that not everything is black or white; there is a mixture of truths, from all sides.
This is what we struggle to do with my mother. Yes, the facility doesn't do everything it's supposed to do. Understaffing is the unstated reality and *necessity* - for if these places actually had enough staff, no one could afford them.
I would like to recommend actually installing a camera. We did so with my mother, and it's a good thing, too, because we know from what we see there that Mom is up and about a lot at night even though she says she sleeps all night. She thinks she has a normal life in terms of doing stuff in the day according to schedule and sleeping at night. But she does not.
With the camera, we have spotted falls when she would have been unable to reach the call button she wasn't wearing; we summoned staff by phone to go help her. We have seen that falls happen when the walker is nowhere near. (She says she always uses the walker. No.) One time regarding a shower, she complained of meanness. Yet we saw no meanness. My sister watches some stuff live, which is how we know.
The camera recommendation will be hard to do now that SIL has been waging war with the powers-that-be there. We put in the camera without asking so we could monitor Mom not so that we could mount complaints or document them. Once some of the failings of the facility became important, the powers-that-be learned we have cameras. They know, though, that our purpose wasn't to rat them out but to watch out for Mom.
I'm sure the facility doesn't like the camera, but there has been no push for us to remove it.
My FIL had a TIA last week. My MIL only sorta-kinda acknowledged that his short-term memory is significantly affected.
At first, my local SIL pulled me aside to ask me to apprise my slightly disabled DH about FIL's deterioration. (Yes! Of course!) At the time, we were in my IL's home, but in various rooms, working on their relocation to Independent Living.
But then ... at one point we were all in the garage at the same time. My SIL then spoke to all of us - including MIL - about what she had seen with FIL. Ambush!
And it worked (at least for now).
This week, I have a few errands to run with and for parents-in-law. My MIL has taken pains (which, I'm sure, truly hurt) to remind me that FIL's short-term memory is worse, and that he needs me to go in with him to his hearing-aid appointment (which was my original evil plan).
Short Version: GOOOOOOOO, TEAM AMBUSH!
I would like to believe Purgatory is a moderately decent NH and MIL is getting a shower half the time she is offered one. I hope she is not declining all showers.
For everyone’s sake I hope Purgatory is keeping a log of when showers are offered, declined and completed.
I hope the testy person SIL encountered on the phone is present during the Care Meeting. I hope that person is the DON. I hope you introduce yourself as Martha (Dorker) not to be confused with Mary (SIL). Surely, you guys can get to the bottom of the shower issue. It certainly appears the issue is MILs inability to provide accurate information and SILs inability o accept that MIL can not provide accurate information.
This whole conversation provides a perfect path to discuss with the DON MILs Cognitive Decline and how to best get everyone on the same page...most importantly SIL.
I can completely sympathize with the testy person on the other end of the phone having to deal with SIL on a daily basis.
I am on Team Ambush, too!
And you also reminded me of one other thing... once we learned to agree and be solicitous without trying to fix things, life became MUCH better for all. We had slowly spiraled into the “what” (constant action to fix everything), not seeing the bigger picture of “why” there were so many more problems to fix in the first place.
Once we did, it was like someone turned the lights on. A hard place to get to. But, I am surprised that SIL got there and then regressed so much. It is almost as though she has forgotten all of the decline she herself witnessed. Talk about out of sight, out of mind, lol. Usually that happens when someone hasn’t been exposed to the dementia of the loved one. But she has. I think DH needs to ask her whether she has forgotten about the significant cognitive impairment that MIL has.
Anyway, good luck at the appointment. You might want to be a broken record. Anything in the meeting that even tangentially looks attached to dementia issues, say to DON, “Is it reasonable to think that this may be resolved with a cognitive eval?” Over and over.
It also means you have to come up with less material, lol;)
Hopefully, the meeting will go well... we are all rooting for you all!
Both SIL and DH KNOW mom is batty and will not do 'well' on this battery of tests, but they seem incapable of getting one ordered and followed through with. AND A good long talk with a ability evaluator who can guide them and give them the knowledge they desperately need to talk to and 'manipulate' SIL.
Is it b/c the are afraid of what a evaluation might say? I wouldn't be shocked if it said she thought she was a cat. She doesn't think nor act appropriately to her 'age', no shock, but they need to know what she CAN respond to, what she CAN Do, what she WILL do. AND methods to work around the lying about the falls, the baths, etc. It does NOT look good for Purgatory to have it's clients complaining of meanness from the nurses, the lack of general hygiene and just, a poor place for others to choose for their LO.
She needs her baths 3xs a week---check her scalp. She could have weeks and weeks of "dandruff" built up there and THAT smells funky and old. It itches--I used to do my clients feet for her, nail salons wouldn't take her. We'd soak her feet for about an hour and the old dry crumbly, crusty skin would just peel off in hunks. It was gross, at first, but she got so she loved her weekly pedicure. (Nowadays she'd be a star on You Tube)
Do they have jetted walk in tubs in her NH? That's looks kind of lovely. I can see her fear of falling in a shower. But I am sure they out a lot of towels down and make it as "non-slip' friendly as possible.
And SIL has pushed back her return to Sept? Is anyone surprised? This whole soap opera has moved at a glacial pace for more than 2 years.
I missed this (in fact, missed Dorker's most recent set of posts entirely).
"Perhaps September." I'm sure that SIL is enjoying her life in her home without the difficulties of MIL being local. Of course, she is still burning up the phone lines and making herself a staff favorite (NOT!) of Purgatory.
But, really, how much better YOUR life is now, Dorker, now that you are the periphery of all things MIL.
I guess chemo is still on for your father this week, or do you not know that yet, as he has to get bloodwork first the day before? How good it is to know that there is an alternative mode of safe transportation to and from chemo (his caregiver) other than you, yes?
I know SIL does genuinely intend to come back and help wrap up the house, but I LOVE the idea of "perhaps September at some point" as a purported time frame for doing things you don't really want to do! I'm going to start using it too! For example:
When will I start organizing my receipts for 2019 taxes? Oh, perhaps September at some point.
When will I complete various spring cleaning tasks, arrange for the extra trash pick-up of clutter in the basement, see about this or that needed but not urgent home or yard project? I would guess perhaps September at some point.
When will I finally get the sugar and gluten totally out of my diet? Most definitely I believe perhaps September at some point.
And so on. . .
Result of the care plan meeting.
An assessment/screening will be ordered as to cognitive issues. HOORAY .. but .. been there, seen it done .. and deficits were noted, .. and orders for further testing were ignored .... at SIL's hand.
As to the showers and that great mystery. She will have a witness (so they say) when she showers .. and it will be noted. SIL is to be called, if MIL declines a shower. This because the great divide here, the gap in the whole story. MIL reports "No, no one ever came" as to designated shower days (and no, she can't remember whether today is Tuesday or Sunday .. she doesn't know .. so expectation she'd speak up on her designated days Saturdays and Wednesdays, .. all for naught to expect that from her). So there will be a witness to attest to the fact she was showered .. so they say. There will be a phone call to SIL if she declines a shower.
They say she had a shower, .. ask her and the answer is: "No, no one ever came".
So hopefully some of the above can begin to dial down on that issue.
The toilet .. at present only has what is a DME bedside commode apparatus placed over what is the actual toilet .. to raises it's height ... and that is sufficient as far as the height .. but it's not sturdy enough .. so they report they will defer to PT . .to see what can be provided as to a more sturdy apparatus as to toileting.
As to the call button .. and her refusal to use it .. or .. .whether she just forgets . they say they have her on a 2 hour rotation .. as to checking on her, .. as to any needs .. I'm not sure that's accurate .. but I'm not around there enough to speak to the contrary on it. They say that cognitive assessment might answer to some of that piece as to whether she is just forgetting to utilize the call button or if it's as she reports it .. "I just feel as though they treat me as if I'm a bother, and so I don't want to bother them, and I do it on my own". Who knows where the truth lies. But their solution is that she can .. if she will .. and I spoke up that is too much for her to remember (which then dials it back to the cognitive piece) .. she can't remember to .. write down the name of any offender she feels was less than friendly to her, and/or maybe treated her as if she's a bother .. that was their recommendation . that and .. if she can't do that .. can she call for the DON to report it .. that so and so was in her room when asked to assist .. and was less than kind.
My response to the above was that either of those options aren't going to be viable in her case .. she won't remember to do that ... she will just continue to do on her own . .rather than ask for help.
The result .. "let's get that cognitive piece looked at, and try to dial down on whether this is a memory issue or whether it is a matter that she feels she is being treated as if she's a bother".
Asked why is PT ending. Is it because of "lack of progress" or is it because insurance has run it's course. PT personnel weren't present and the question will be sent out for answering to from those folks.
All in all, I suppose we'll see .. as things progress forward .. whether any of the above proves helpful in the end.
Suits me fine .. it's hotter than 40 h377's here ... and October isn't a whole lot better, not in FL . but it's usually better than August/September. It is miserable, every day with a humiture around 108 or thereabout .. daily. It's miserable.
Yes, MIL's home has A/C .. but a lot of hauling stuff out of there .. will be coming and going from inside and out . and I'd prefer to do all this in maybe February when the high for the day might be in the 60's . .if given my druthers.
SIL's issue .. her husband .. he had a dental implant that fell out. Had to go get it re-inserted .. and that one fell out .. and so .. I guess there is now evidence the tooth next to that one is being damaged . .and so he will have to have a bridge and crown . and .. he's diabetic and has supposed to have been on a 3 month rotation for teeth cleaning . and because they have spent the last several years back and forth from FL .. .that hasn't happened .. and so there is evidence now of the beginnings of periodontal disease, so a referral for that to be looked into, so .. September sounds like it's going to have some dental work for her husband . needing to be seen to on their end. Thus . the move now to "may be October before we can get there".
That and her daughter is to go on her honeymoon September 18th . and be gone for two weeks . and her daughter's dog (1 of the 2 dogs she owns) .. has some seizure disorder, and some other heart something and is aging .. and the daughter wants .. if possible . for her mom to be in town .. should the dog take a turn for the worse and the dog sitter not saddled with what could become a dying dog ..
So for those reasons .. SIL now reports "it may be October before we can get back down there".
Fine by me.
Didn't you say that MIL didn't realize her grandson until 2 hours into the 3-hour visit with him? That screams of cognitive impairment to me...it took her 2 hours to connect the dots?
So, are you on chemo taxi duty for your father this Friday?
He reports that it did a world of wonders for him to have forgone that session. His appetite, which had been nil mostly, .. increased ... his weakness/malaise . improved, .. etc. He is looking forward to getting back on track, .. aware that injecting that poison into his system .. will likely bring about more of the same, but a necessary evil.
SIL was on conference call for this care plan meeting and it was suggested she be evalauted for cognitive impairment, via screening and she agreed to same... so thus far, no push back. MIL was evaluated previously, in hospital .. inpatient for a UTI .. a couple of years back .. and deficiencies were noted, and order for further testing, which SIL then negated, . hanging it all (at that time) .. on the whole "she had a UTI .. that is known to cause confusion and disorientation, they shouldn't be testing/screening folks inpatient . their world upended, . stressed, don't feel good .. and then count it with any validity", and there went any further looking into that issue. Even though I vehemently, having been on the front line of it all, sans her absence here . .disagreed. The nuero doc had even noted that she was found to have active microbleeds in her brain .. which can set in motion vascular dementia (nothing can be done about microbleeds) .. I fought SIL's notion vehemently . got nowhere.
That was at a time when the sole goal/purpose was to keep MIL in her home . where she's happy .. and she will manage. Nobody wanted to peek behind the curtain of what that reality actually is and how it plays out.
I'm here to tell ya .. yes indeed the UTI caused further confusion and disorientation at that time, for certain .. I agree. BUT .................... absent that UTI things were not firing on all cylinders any way, and thus my stance "get it looked at, what's the frickin harm". But no go. I guess .. maybe underlying that, . maybe it would've been seen just how compromised her mental capacity really is and it would've been deemed unsafe that she live alone .. her most ardent desire at that point in time .. and SIL's .. as her mouthpiece, arms/legs/brain ... also .. and so for SIL to have to go through with that testing and learn that she has no biz living alone .. can't manage on her own (as I said from every rooftop I could find with a megaphone) ... would've meant having to forge those waters earlier than what did indeed happen in the end .. her not being able to live alone any longer.
So now .. she lives in a nursing home .. and you see that cognitive impairment .. staff suspects it .. and so they suggest getting it looked at via screening.
HOOORAY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
I have zero doubt deficits will be found. Nor does SIL for that matter. To quote her: "Oh her memory has gotten worse since that hip surgery back in March .. it's worse .. it wasn't good before that, .. but that made it even worse".
To quote my response to her: "SIL if you remember, I've been on this train since that UTI hospitalization a couple of years back and the nuero doc having found deficiencies at that point in a screening .. but you felt they shouldn't of been looking at that point .. with her inpatient in a hospital .. and upended and stressed and not feeling good .. you felt the results of that screening shouldn't of been counted with any validity .. she's had memory issues for quite a long while, this isn't new".
SIL: "I think I just wasn't read to see it at that point, but you're right".
So I don't think she will discount anything in the realm of taking a look at the cognitive piece on it all, .. now whether she is on board for further testing when
Whether she'll be on board for further testing when/if deficiencies are noted and further testing ordered .. remains to be seen. And I'm not even sure it would be all that beneficial at this point . to dial down to that degree .. But I'm kinda ignorant on the topic and how it would benefit her further to have it zero'd in on ..
Yes, deficiencies exist .. woefully exist .. yes. But dialing down on it all, .. will bring about what?
I don't think she's so far gone that she needs a memory care unit ... even I don't think she's that compromised.
I guess we wait and see.
Interesting in talking with her yesterday after that meeting .. as we kinda debriefed what all was said ..
Her talking of the whole shower debacle ... as we hone in on and try to get to the bottom of a resolution on that issue.
And her words: "Ya know, I don't like it that they want to hang everything on her memory .. and that she DID have a bath, she just doesn't remember it .. I really really do not buy that, . .for her a bath is a huge ordeal .. it's enormous .. she doesn't forget within a couple of hours that she was indeed bathed .. and for them to .. I hate to call them liars .. but for them to say that she WAS bathed, . and I just talked to her and she said *no nobody ever came* .. no .. I don't buy it"
Me: "Well we'll see .. they are now going to enact that a witness be a part of the bathing/showering routine . so as to vouch for the fact she was bathed . and they said they'd notify you anytime she is offered and declines a shower, .. so .. that's a start .. at least to a working resolution .. let's see how it plays out".
SIL: "I just don't get it .. I mean the other day on Wednesday her designated shower day .. I called HER . and I called staff . to remind both of them .. because she had a doc appt the next day I wanted her bathed .. and so .. I called and reminded both of them .. and was assured it would get done. Talked to her that night and no "nobody ever came". I said to her at the time, "mother you know you can ask for a shower". She said, "I don't know what day it is .. I can't remember that". I told her .. "I reminded you .. I called you and reminded you". ... she said to me, "I guess I just forgot" .. I mean .. I don't know what else to do ... she said when I reminded her .. "yes .. I so badly need a shower, my head/scalp feels like it's crawling with filth . I need my hair washed . .and Wednesday came and went . and no shower .. ".
Me: "She doesn't connect the dots . gee . my scalp feels nasty .. I need to bathe .. and then act on it SIL .. by pushing that button .. cognitive impairment".
SIL: "I know .. .and then the whole thing . .she complains that she does take a shower, and it gets her hair all wet . sometimes after she's had her hair done .. and I tell her .. use your shower cap that I bought you . but she says she doesn't know where it is ... and .. she asks where is the shampoo that's her's .. that they want to use their shampoo and she can't find her shampoo"
Me: "no and they aren't going to let her keep a bottle of her own personal shampoo in the shower, . because then they have to deal with stuff that comes up missing and disgruntled residents . so she has her personal care items in the top drawer of her dresser .. and so .. she can't remember to look there for it?!?!?!".
SIL: "yea and she complains that she can't get to her clothing because they hang everything up . they don't fold anything .. every thing goes on a hanger in her closet .. and she's in a wheelchair so she can't get to it hanging in the closet".
Me: "SIL the buzzer, . to call for help . that's what it's for .. they say they have her on a rotation to check on her every 2 hours (I kinda don't believe that, but am not there enough myself to argue that point) .. so . one of those check-ins every 2 hours .. might be a splendid time for her to ask one of them to grab something of her clothing from the closet.".
SIL: "I know . but she isn't able to remember to do that .. I tell her to use her grabber thing that I got her, to fish something out of the closet to wear .. I guess that's how she does it, she can't stand up and look thru what's hanging there, but she can't remember when someone comes to check on her . to ask them .. "hey would you look in my closet and get me something to change into... h377 she's supposed to be asking for help to change clothes .. and not doing it on her own . but she doesn't remember to even do that. Either that or .. as she would have us believe ... they are unkind and treat her as if she's a bother, so she doesn't bother them".
Me: "I don't buy that, not entirely .... I never will. I'm sure there are some that aren't as friendly and chatty .. I'm sure, that's life ... but they aren't all mean and unkind . no way .. "
SIL: "Oh I agree .. I think it's her perception sometimes more than anything else".
On a good note .. I was aware some of this was going on. The Recreation Director was a part of the meeting and reports that MIL travels out in her wheelchair daily . and into the commons area .. and .. goes from person to person there, trying to chat up various slumpers (that's what you find in the commons area .. the slumpers) . and that she goes there daily . spending a couple of hours . and will go from one to the next to the next, . .attempting to chat up those that are capable of doing so .. and the recreation director said the following: "that is so sweet of her, . I wish I had 10 more like her to do that .. it's helpful . .".
I chimed in: "and it's helpful to her, to gain some perspective .. as to the fact some are far worse off than she is . and so make use of what you do have, which is . in her case, . the ability to hold a conversation with someone".
Very interesting to me to note that the other day Chatty Cathy's bday had been upon them. One of the other residents there, . one that seems a little more with it, . had somehow donned a taxi . and gone to the store to get a bday cake . and balloons and so forth to have a little party to honor Chatty Cathy's bday . and I don't even know how it came to be .. that MIL and this other person planning the party ... somehow connected paths . and so .. MIL had offered to help fund this . and so it became issue # priority A1 . that DH bring her some cash to give to this person to help fund this little bday bash .. and DH did do so, but it was a reminder after reminder from her, to DH . in phone calls, "don't forget I need you to get me some cash so I can help pay for the bday party for Chatty Cathy".
DH did do so.
But interesting to me, that this person who seemingly can't remember her g'son (that one I kinda get . she hasn't seen him in years) .. this person who can't connect the dots on what she feels in her scalp as filth and needs to be washed .. and so get a shower, ask for one .. this person who can't seemingly connect the dots as to the buzzer, and asking for help .. she sure didn't forget .. at all . that she owes this other resident some $ .. to help fund the bday party. That one she didn't forget, at all.