This past Monday morning, as I’m getting our cups of coffee, I hear the “click” of a pill hitting the floor. Did I miss seeing her drop one in her lap? I turn to find the dog nosing a yellow aspirin tablet and quickly move to pick it up. It’s damp. I guess the dog didn’t want it after all.
I put it on the table and start to get a replacement, but Mom waves me away.
“I don’t want that. It’s hard.”
The light bulb comes on. It’s not wet from the dog; it’s wet because she took it out of her mouth and threw it on the floor.
She had gotten up early, before our alarms, and had already been eating her breakfast cookie by the time I got her meds ready. She didn’t bother to finish chewing her cookie before taking her meds, I didn’t think about it, and the aspirin got cheeked with cookie bits, then mistaken for something hard in the cookie.
This morning, she’s up before our alarms again, and already tucking into her breakfast cookie. I move it out of her reach and tell her to finish what’s in her mouth before I put her meds down on the napkin.
“Okay, I’m finished.”
“You’re still chewing.”
She fishes a bothersome raisin out of her mouth and puts it on one of the four paper napkins spread out in front of her across the tablecloth. That’s one less for this morning’s paper napkin on the end table, I guess.
I lay her meds out on the cloth napkin. She takes all of them. The dogs start barking and I hurry to let them in, since it’s 6:15 am and many of our neighbors are retired.
The dogs run ahead of me, back into the kitchen.
“Are you going to give me my cookie back?”
I move the paper napkin holding the broken cookie back in front of her and take the three steps back to the kitchen counter. I pull her small coffee cup and my giant mug from the cabinet. I fill hers one-third full (the other one-third will be cream), hover the coffee pot above mine, just about to pour and…
Our current tablecloth is an impressionistic melange of harvest colors suggesting autumn leaves. As Mother is unable to count an impressionistic melange, she has taken to repeating counting rhymes from her childhood.
This morning, during coffee, counting along the fingers of each hand:
“One, two, three, four, five – I caught a hare alive. Six, seven, eight, nine, ten – I let him go again!” And then a big smile, pleased with herself for remembering, and also just happy to be alive and enjoying her morning coffee.
It made me smile, too. I am also happy to be alive and that we can enjoy our morning coffee together.
Shortly, I’ll be putting out the new Halloween tablecloth, and she will have something new to count at dinner.
Mom had her semi-annual (or is it quarterly, now?) check-up at the PACE center last week. The doctor discontinued two of her meds, lisinopril and atorvostatin, both of which were prescribed immediately after her heart attack a couple of years ago. He also changed her cetirizine from daily to PRN. It seems that the thing all three of these meds have in common is the possibility of causing drowsiness, fatigue and confusion.
For the past two years, I thought her heart attack had been the cause of her significant step-down in cognitive capacity. Given how very much she has perked up in the last 10 days, though, I realize that a lot of it was the post-heart-attack cocktail of meds that were prescribed in knee-jerk fashion, and that I was too distressed to objectively research and question.
She’s more alert, more energetic, and is walking better, with a bit better balance. And she’s got the whole household hopping! Welcome back, Mom!
We live in one of the areas of Florida most gently affected by Hurricane Irma, but were still left without power for the past five days. Between Mom’s day center closing in the days leading up to the hurricane, and it remaining closed until its power came back a couple of days before ours, Mom has been bored, sitting on the couch, being waited on because we didn’t want her trying to eat in our very dark dining room. We weren’t thinking about it at the time, but her inactivity for the past week was not the best thing.
When we told her Wednesday evening that she would be going back to the center on Thursday, she was happy, but then started worrying about how she’d get up in time while we were still without power and her alarm wouldn’t work. I told her to not worry, that I would wake her up. She woke me up at 1:30 am, calling me to her room to find out the time and if it was time to get up. I was grumpy and told her to go back to sleep. She wake me again around 6 am (half-an-hour before my alarm was set to go off), not calling out for me but asking imaginary people if they were paying with cash or charge. When I got to her room, she was sitting up, moving her hand along the slats of her headboard, and told me that she couldn’t get the card reader to work.
I tried to reorient her, but never really succeeded. Somehow, in the night, the worry about getting up in time to go to the center had morphed into being worried about getting to her cashiering job on time, the job she retired from a decade ago.
Yesterday morning, for her first day back at the center, it took both me and my niece helping her to get her dressed and ready. After she was dressed, she moved to sit down on the couch and missed it completely, plopping down on the floor on her bottom. Although she didn’t fall any farther, didn’t hit her head or anything, Vickie said it seemed to jar her quite a bit. We helped her up and she seemed okay. “I didn’t hit my head, just my butt!”
I called the center to let them know that she had missed her bath the night before, due to our power still being out, and asked if they might work a bath into her schedule that day. I also mentioned her fall and her heightened confusion. The nursing staff called back later to get the details of her fall, and they mentioned that she was still talking about working at the grocery store “one town over” and were going to assess her for a possible UTI, which can cause extreme confusion in the elderly.
Last night at dinner (in the A/C, with the lights on – Hooray!), Mom was very animated and talkative, telling us all about all the people who came through the line at the grocery and her interactions with the customers and her store managers. We thought settling her down for a good night’s rest would make all the difference, but instead, over the next 3-4 hours, she would periodically call out the time on her alarm clock as the minutes changed over, thinking it was her cash register display, and talk to the customers she thought she was ringing up. She would quieten down for a few minutes, and we’d think she had fallen asleep when it would start up again.
When I got up this morning, Mom’s alarm didn’t go off. I went to check and it was unplugged–my niece’s solution since I guess Mom continued even after I went to bed. When I tried to get Mom up, she woke up just enough to tell me she was going to sleep some more and wasn’t going to get up to go anywhere, and said something about her customers. I guess she’s still unstuck in time. And so it goes.
After my call last week to Mom’s nurse/case manager, the doctor agreed to prescribe an antibiotic to treat Mom’s (strongly) suspected UTI without subjecting her to a quick cath procedure, which would have been no fun for all involved. Less than 24 hours later, she was less confused, more alert, more energetic and somehow able to hear a little better. She is nodding off less while sitting up watching TV, and she’s moving around more, getting herself up to go the bathroom, etc.
She got Vickie to call my brother, but got his voicemail. She got me to call again later, and had a nice conversation with him after I switched the phone over to the ear that she hears better with. (Now that I know her right ear works a little better than her left, I’ll have to watch for that when she makes a call.)
Of course, now that she is awake and alert, she is also more aware and interested in what’s going on around her. She realized that Vickie and I went to the grocery store without her. She wanted to know how much we spent at the grocery and was appalled by the total. Over the next couple of days, she asked both of us several times just what we bought at the grocery that cost so much. Vickie finally got her to understand that groceries are expensive, especially now that we’re feeding four people.
I’m glad she’s feeling better, and it is translating into less laundry for Vickie. But it also means that all her questions and requests are really keeping us hopping.
Every morning at 7:05 am (I have my phone alarm set so I don’t forget, either), I wake Mom from dozing on the couch so she can get dressed before her ride to the ADC arrives. Also every morning, I find her saved socks from the day before, show them to her, and tell her, “GET CLEAN SOCKS!” before I put them in her hamper.
Yesterday morning, she grabbed them as I did and wrestled with me a moment over the socks. She was playing by the end of our tussle, but I’m not sure she was playing at the beginning. Just before her ride arrived, I noticed that the tongue on her left shoe was partially shoved to the side, so I took the shoe off to find her sock only partway on, with half of it hanging off the end of her foot. When I pointed it out, she tried for a second or two to right it, but then gave up and said, “I can’t get it on.”
Sometimes she forgets to bring clean socks with her from the bedroom, and asks me to get them for her. This morning, I noticed that she had fallen asleep without putting on her shoes, usually a sign that she has forgotten her socks. Before waking her, I got a pair from her drawer, but she already had a pair–she had just fallen asleep. I woke her up to put her shoes and socks on, took the extra pair back to her room, and got back to the living room to find her trying to put a shoe on her bare foot. I took the shoe, set it to one side, and handed her the socks, saying, “PUT YOUR SOCKS ON FIRST!”
She smiled and shook her head at her own forgetfulness, and started putting her socks on. I guess I set her shoe aside to the wrong side, because when I checked back, she had her socks and shoes on, but on the wrong feet, and couldn’t figure out why they wouldn’t close properly.
Increased confusion can sometimes indicate a UTI (urinary tract infection) is brewing. Guess I’ll be making a call to her doctor in a few minutes.
I stayed up too late reading last night. I had hoped lie down again for a few minutes after getting Mother settled with her meds and coffee. Instead, after letting the dogs out, I hear her muffled voice calling my name. I open her bedroom door to find her sitting on the floor beside her bed, her walker just out of reach, a package of briefs balanced across the attached basket.
“MOM! WHAT HAPPENED?”
“I was getting my Depends out of the closet and fell down. I didn’t hit my head, but I hit my butt! Can you help me up?”
I bend her knees up a little bit, hoping she might be able to get her feet under herself a little easier, but her knees don’t bend that much and she was no help to me trying to pull her up by holding under her one arm I could reach. I’d need help.
I wake Vickie. Thank goodness she’s back. If this had happened with Mom last week, all I could have done was call 911 for the firemen to come pick her up.
With one of us on each side, we’re able to pull her upright, and while I’m trying to get her balanced on her feet, I realize she’s shifting her weight in order to sit down on the bed. I move aside and she plops on the edge of the bed to rest a moment after her ordeal. I take the package of briefs into the bathroom and refill the drawer. Vickie stands beside her a moment, and then heads back to her room to try to get some more sleep.
Mom positions her walker, stands up, and moves toward the bathroom. I go back to the kitchen to get her meds and coffee ready, and add two items to today’s mental to-do list: call her nurse at PACE to let him know about her fall, and swap out the remaining briefs packages on the closet floor with all the Bingo prizes on her dresser.
My alarm goes off at 6:30 am. I don’t hear Mom’s alarm going off – this means she woke up early, turned it off, and is already up. Not always a good thing.
I go outside with the dogs because the new fence our neighbor is putting up is not quite finished. The mosquitoes are happy to see me. The dogs do their doggie business and we all come back in. Gracie bounces back and forth between her kennel and the fireplace, willing me to walk faster so she can have her breakfast. Sophie stays safely back so as not to get bounced on.
Mom is already sitting at the dining table, getting fresh paper napkins to crumble her oatmeal cookie on. I go to Mom’s bathroom to check to see if her sink is wet, which tells me she’s washed her hands, which in turn tells me that she changed her Depends before coming to the table, unlike Tuesday when she was up before me and I had to refuse to give her her coffee until she went back to pee and change her Depends. The sink is wet this morning – all is well.
I get Mom a new glass of water and her meds. I stand beside her to make sure she takes one pill at a time, as she is less likely to drop them on the floor than when she tries to shove three or four pills in together. If I’m watching, it’s one pill at a time. If I turn away, I find pills on the floor later. At least the dogs don’t eat them.
I pour our cups of coffee, give Mom hers, and walk mine to my desk (really my sewing machine case, closed, with a desk pad on top – it actually works quite well).
Sophie barks to let me know she’s finished eating, so I step back outside with the dogs for additional doggie business. Gracie takes care of hers right away. Sophie stares at me, wondering why I’m standing out there. I wait a couple more minutes, wave away a couple more mosquitoes, then call the dogs in. Gracie runs through the door, but Sophie realizes her window is closing and heads for the far corner of the yard. I wait just inside the slightly open door, hoping I’m successfully hiding from the mosquitoes. Sophie disappears around the corner where the fence is unfinished. I go look for her and I think interrupt her looking for good sand to eat. She finally comes inside with me.
I move toward me desk and see my to-do list from yesterday and remember Mom’s laundry. I go to the laundry room, pull her clothes from the washer to put in the dryer with her pants that I forgot about yesterday and which are now all wrinkled. That’s okay – the wrinkles will come out with the addition of the other wet clothes. I hope I don’t forget them again today. I put the towels from the Bath Lady visit last night into the washer, along with the spider I surprised as I gathered them up.
I go back to the living room to pull the two pairs of socks from under her little pillow. “You can put these in your hamper yourself, you know.” She says, “Okay”, but it’s not the ‘I understand and will do what you ask’ Okay. It’s the ‘If I say Okay maybe she’ll go on and let me watch my TV’ Okay. I take the socks and put them in hamper.
I ask Mom to trim her fingernails (another item on my to-do list). She says, “Not now,” which is what she always says. It usually take two or three requests before she does it.
I finally move back to my desk, sit down for morning journaling, and have my first sip of coffee. As I’m writing, the phone starts singing a calypso song to remind me that it is now 7:05 and I need to tell Mom to get dressed, as she has, as near always, fallen asleep sitting up on the couch. I move to the couch, touch her arm, and say “Time to get dressed!” She gathers up several napkins and tissues to stash under her pillow, but I take them to throw them away. She puts the nail trimmers back in the little glass dish on the end table. I move them back to the arm of the couch and remind her she needs to trim her nails. “I don’t want to do it now!”
She leans back against the couch cushion, and I have to say, again, “Time to get dressed!” because she’s forgotten in our exchange with the napkins and nail clippers.
I come back to my desk, have my second sip of coffee, and resume journaling. I absentmindedly scratch at a mosquito bite on my leg. A few minutes later, I notice Mom come out of her bedroom, move toward the couch, then turn around and head back to the bedroom. For socks. She remembered that I had just cleared out her cache. She returns to the couch, and I hear her whistling, wheezing breaths as she works to get her socks and shoes on. I know if I offer to help, she will forever relinquish the task to me, and that will be one less thing she does for herself. One less thing she does at all.
The dogs start barking as the Wheelchair Transport car rounds the corner and approaches our house. Over their noise, Mom yells, “Kay! Kay! My ride is here.” I walk into the living room to check her shoes. Today, unlike most mornings, she has succeeded in getting both shoes on properly. Hooray! I take the pop-clip from the glass dish she has returned the nail clippers to, and clip her hair back out of her eyes. She keeps refusing a trip to the salon, even though a couple of weeks ago she asked Vickie to trim her hair with the kitchen shears. Vickie politely refused, reminding her grandmother that she is a nurse, and hasn’t been a hairdresser for almost 30 years. Mom still doesn’t understand why Vickie won’t just whack her hair off with those scissors in the kitchen drawer.
I corral the dogs into the studio and open the front door. “Will you be home at regular time?” she asks. I nod. “Tell Steve hello for me. Have a good day and I’ll see y’all tonight!”
She steps out the door, and I watch as she approaches the edge of the porch, heaves her walker up into the air and then down the one step. I want her to continue to have the strength to do things like this. I worry about her toppling over. Today she is fine. I wave to the transport driver and close the door behind her.
I finish up my journaling by writing out three affirmations, five times each. This morning’s affirmations are:
I envision my life as I want it to be.
All is well, and even better things are coming.
I attract positive people and great opportunities.
Sometimes I find myself repeating them in my head later in the day, which I guess is the whole point.
The dryer buzzes. Back to the laundry room. I dump all the clothes from the dryer into the ‘Clean Clothes Only’ basket and take it into Mom’s room to put everything away: 8 shirts, 8 pairs of pants, 2 nightgowns, 2 housecoats – and 2-1/2 pairs of socks.