Sunday, January 8, 2017

What's Next? Part 4

I should preface this post with a warning.  This is a Long we go.

The holidays have come and gone.  The Christmas tree is now stripped of its ornaments and is sitting forlornly waiting for transport to the backyard where it will become shelter for the wild birds.  We've been in a cold snap for the last few days; the temperatures have been struggling to rise above 5F in the daytime and plummeting to well below zero every night.

 The pictures in this post were taken almost a month ago when we had our first accumulative snowfall. Since these pictures, we've had warm weather and rain, and now last week's deep freeze.  Today we're expecting a high of 10F (if we're lucky) but tomorrow a possible 35F.  The thermometer is all over the place.  Just like my moods.
The holidays were very stressful.  Everything is stressful right now, but while Carl is taking my morning shift at Mom's for me this morning,  I decided to take the time to write.

Carl's mom's (I'll refer to her as MIL for mother-in-law) situation wasn't improving much after the wound care doctor expelled her from treatment due to non-compliance.  Try as we might, none of us can get her to wear a bandage on her leg or her compression stockings on a regular basis.  

Carl's dad (FIL) caught a bad cold the week before Christmas and started sleeping in his chair in their living room as it was the only place he could get some rest.  We stopped in on Christmas Eve and were both shocked by how sick he was.   MIL protested they were fine, after all MIL's leg is healing since the doctor told her she doesn't need to come back (no, that's not why) and FIL is a little tired (but he mostly wants to get out of housework).  Carl's side was scheduled to celebrate Christmas on New Year's Eve at Carl's niece's home which should have worked well, because by then, maybe FIL would be feeling better. 

We celebrated Christmas here on December 26 with our immediate family and Ann.  Mom was in fine form and played Sheepshead with us like a champ, at the end of the night, she needed help carrying her pennies home. 

On December 28, MIL had an appointment with a vascular surgeon to see if surgery would improve the circulation in her legs.  FIL opted to stay home from the appointment which is highly unusual.  He was not in good shape.  Both Carl and I urged him to let us take him to the doctor, but MIL insisted he was getting better and there's no need.  FIL was also adamant (and angry) at our insistence and since he's not suffering from dementia, we backed off.  Carl's sister and her husband and the grandchildren were all urging him to see a doctor, but the stubbornness won out.  No, he's not going.

Anyway, we loaded MIL and her walker into her car and into the doctor's office. MIL repeats herself continually, asking the same questions over and over.  I'm used to the drill since my mother often forgets things, too, but MIL is much worse.  And she's ten years younger than my mother.....this doesn't bode well.

The doctor looked at her chart, took a portable ultrasound unit to her feet, looked at her weeping leg ulcer (wrapped in Saran wrap, ugh) stood up, shrugged and said, "She does have some limited circulation but not enough to warrant surgery.  I want her to wear some prescription custom-fitted compression stockings to improve her leg swelling and keep the ulcer bandaged and sterile.  Hopefully, the leg will heal in a year or two.  But if it gets infected, well, that will be a problem."

MIL was sitting in her wheelchair, picking at her leg.  The doctor slapped her hand away and repeated the orders she's heard since this all started, but sadly, she disregards the advice at every turn.  He gave us a prescription for the stockings and we were on our way to the pharmacy.

MIL didn't want to go get the new compression socks, "Dad and I will go some other time.  Let's go home,  I don't need the socks anyway, he said my legs look good."

Carl said, "We're on our way to the pharmacy, let's go in and get them so you can get better."

"OH, I don't want to!  Just take me home, I'll have your dad take me later."

But we turned into the parking lot of the pharmacy and in we went. MIL's legs were measured and the appropriate size stocking was selected, the clerk helped me pick out bandages and wound cleansing medication for the ulcer and with her new stockings on her legs, we were on our way home.

We had to stop for gas for their car and while Carl was outside, MIL was rummaging around in her purse, trying to find money to pay the bill.  We'd both told her not to worry, we'd put it on our credit card, you can repay us when you get home.  But dementia has a strong hold on MIL and she was fretting all the way home.

"How much did the gas cost?  I can pay you.  OH, I don't have any money, shall I write you a check?  I can't find my checkbook!  I think I lost it!  How much did the gas cost?  I'll pay you.  I can't find my checkbook, and I don't have any money!  How much did the gas cost?"  

It was a long ride home.

We were back to the in-law's house by six pm and though FIL was on his feet, he still didn't look good.  I brought up the fact he should see a doctor and he cut me off in mid-sentence, he'll be fine!  He is also in need of new hearing aids, we now have to almost yell at him to be heard.  It's really pathetic.  The hearing aids he has are worthless, he might as well have a paper towel tube held up to his ear for all the good they do.  We've been trying to take him to another hearing aid place, but he won't hear of it.  (Ha, get it?)

After explaining to FIL what happened with MIL's appointment, we went home.  The grandchildren stopped in to see them the next day and Carl's sister called every day, too.  Everyone was concerned about FIL's cold.  Carl and I cross-country skied over on December thirtieth in the afternoon and I was losing patience in FIL's logic.  The cold was not getting any better.  MIL said he was sleeping a great deal but she kept waking him up because she thought he should get up and do something.

I took a seat on the couch near his chair and watched him sleep, his breathing was very shallow and fast and every now and then he'd be wracked with deep coughing fits.  He woke up and wasn't too surprised to see me sitting next to him, but went right back to sleep.

Carl's mom was talking to Carl in the other room and I heard her approaching in her walker.  She constantly complains about her sore feet, why can't she get a foot transplant?  All the women in the family suffer from sore feet.  The doctors won't help her.  All he does is sleep.  He wants to get out of housework.  She keeps waking him up because he can't sleep all day long.  He's not sick!  Why do you think he's sick?  My feet hurt.  I need a foot transplant. All the women in my family suffer from sore feet.  Doctors don't help her.  He sleeps all day.  She never wanted to live this long.  She has sore feet.  

Before we could stop her, MIL woke FIL up.  "Wake up!  You can't sleep all day, you won't sleep at night!"

I looked at my miserable FIL and hollered, "If you were my parent, I'd be hauling you into the doctor!"  (I only hollered because he cannot hear me.  And because he's stubborn.  And because I'm frustrated and worried.)

"I almost went in this morning," FIL said, "But MIL talked me out of it, she says I'll get better."

Ah, yes.  What happened to the Wisdom of the Elders?  Sadly stolen by the Dementia Demon, apparently.  

We hung around trying to talk some sense into him, but ended up skiing back home again because it was time for my mother's medication.  Thank God and our sons for the cameras at Mom's house, without the cameras, I'd be a wreck.  

 I told Carl we were going to let FIL stay home one more day and if he was no better, that's it, he's going in if we have to carry him to the car or call an ambulance.

As you may recall from my earlier rant, Carl's niece was planning a big Christmas/New Year's meal for the family the next day, New Year's Eve.  That morning we went over to see MIL and FIL after giving my mother her morning medication.  FIL was not any better and I put my foot down, he's going in whether he likes it or not.  I called Carl's sister and she and my BIL were coming to stay with MIL while we were gone.

Thankfully, FIL complied and started getting ready.  But if you've ever seen the old Carol Burnett show and Tim Conway portraying an old guy shuffling around, well, that's the fastest speed FIL was able to achieve.  He wanted to shave and then had to find the checkbook and then wanted to change his clothes again and then had to have us feed the cats and then the razor wouldn't work and then we needed to open a new razor but the clamshell packaging was being difficult but he didn't want help with it and where are his hearing aids and should he comb his hair and where is the checkbook again?

Just like the paragraph above, this is the way our life has been; one long-drawn out, slow-motion Stubborn Fest. 
Trying to run this circus is like herding cats.

While FIL was getting ready, MIL was cruising around in her walker going on about her sore feet and protesting that he's not sick, he's just tired, and do we know how old he is?  And oh, yes, her feet hurt.  But all the women in her family have bad feet.  She just needs a foot transplant. 

 Finally, after almost an hour of getting ready, we were able to get FIL in his car.  He has a handle on the ceiling of his car which we don't have.  Luckily he could help lift his upper body while Carl got his feet in the car.  BIL and SIL arrived just as we were leaving.  I called Carl's niece and told her we were sorry but we hoped to make it later for a visit.  She understood; she was happy we finally were getting FIL some help.

While FIL had been getting ready, I made a phone call to the Urgent Care clinic and asked if they could handle this situation or should we go to the emergency room?  They assured me they had all the facilities needed, so that was where I opted to go.  In hindsight, it was the wrong choice.

When we arrived at the clinic in Green Bay (about 15 miles from home) the receptionist told us there would be an hour wait; the waiting room was full of sick people; but if we wanted, we could go to the downtown location another six miles away.  Ok, we helped poor, weak FIL back into the car and went to the next clinic.  Luckily, we were taken in right away and FIL had a chest x-ray taken which came back as we suspected, with suspicion of pneumonia.  There was some lab work done in case congestive heart failure was the culprit, but we were sent to the pharmacy to pick up antibiotics and an inhaler.

After filling the prescriptions, we drove the half hour home and helped FIL back into the house, out of his outer garments and back into his chair to sleep. I no more than had the blanket tucked in around him when my phone rang.  The bloodwork came back suspicious for a heart issue, please bring him to the hospital ER.

Oh, was so hard to wake FIL and tell him it's time to go back to the hospital again, but we had no choice.  Back in the car, and now, weaker than ever, off to the emergency room.  By now it was 3PM and neither of us had eaten a thing all day.  We had been intending to feast on Carl's niece's excellent cooking, so in an effort to conserve calories, we'd skipped breakfast.  Bad idea.

We arrived at the ER by 3:30PM and a bunch of preliminary tests were run.  FIL's oxygen level was down to 88, so he was put on oxygen.  Then we sat and waited while FIL dozed on the gurney; thankfully he was able to rest more easily with oxygen.
 While we sat and waited I was able to update family back home.  The ER doctor came in finally and said FIL would have to be admitted to the hospital, it was indeed pneumonia and there were some other troubling numbers on the bloodwork they didn't like, too.  

FIL protested he could leave; he has a welding shop and a large tank of oxygen at home, he could figure out a way to hook it up for breathing, but not surprisingly, the doctor wasn't having it.  No, you are now our guest.

He was wheeled up to the ninth floor of the hospital and put into bed by 7PM.  Carl and I stayed until 8PM and then had to leave because it was time for Mom's meds again.  By the time we arrived back at the in-law's house to put FIL's car away and retrieve our own, it was almost 8:45PM. And we still hadn't eaten. (I know, poor us!)  Carl's sister and her husband had been sitting with MIL all day, and they were ready to go home.  We had to leave to take care of my mother so this left MIL home alone. 

Carl went to Mom's house while I went home to make supper.  We finally ate at 11PM.  We checked on MIL by phone and though she was confused about her husband's situation, she seemed to understand he was in the hospital for his own good and promised to go to bed.  

We were both exhausted; it had been such a long day.  My back issues are getting better provided I keep up with my stretching.  My hormone issues are not getting better, however and I'm feeling rather wretched.  Sleep is elusive and I often wake up with mini-panic attacks and a racing heart.  I know it's stress coupled with the removal of my hormone replacement treatment.  The timing really sucks.

The next day, New Year's Day, was spent with the usual giving Mom her meds, checking on MIL and then going to the hospital to visit FIL.  He wasn't doing much better but was seemingly more content to rest up and get well.  He didn't want MIL to come up to see him because he didn't want her to get sick, too.  The family all came up at various times which was very nice.  Thankfully, we are all pitching in to help with both in-law's care.  

I know I sound like a martyr, but I made it known I cannot handle all three elders at once.  I am the closest one in proximity and I also do not work outside the home, but this is too much for me.  Carl and I handle my mother as there is no one else to do it, and that's fine for now; we have a system in place.  But toss two more in the mix and it would be impossible.  And if our health fails, we cannot help anyone.  Caring for the elderly is an extremely stressful job.  

We were asked if FIL had an advanced care directive in place?  No.  Neither MIL or FIL have any health care power of attorney paperwork in place, either.  Oh, boy.  The staff urged FIL to fill one out, he was semi-against it.  He always said they should have gotten around to making one out but there was never any time since they led busy lives and he was still working in the ornamental railing business.  But now he wasn't interested in making one out because he was so sick.  
Two days later, FIL was not much improved and the doctor suggested possibly going to rehabilitation or at the very least, having in-home nursing/physical therapy come to the house. The caseworker called me at home and said she tried to reason with him but he asked her to leave.  He did not want any help, he just wanted to go home.  He didn't want to have nurses come to the house and he sure as hell wasn't going to rehab.  

The family was thrown into turmoil; now what?  He can't come home to MIL because she can't care for him.  FIL was threatening to call a taxi and check himself out of the hospital.  The caseworker said since he didn't have any paperwork signed 'he is his own person and capable of making his own decisions' so sadly, all they can do is 'send him home to fail'.  

 FIL's granddaughters, Carl's nieces, have been very helpful, so overnight FIL had gotten into his head that the 'girls' were going to take care of him and MIL and he wouldn't need any more help.  The caseworker called me and told me of the situation and I said, yes, the 'girls' are very good to their grandparents, but they have young children and full-time jobs, so no, they are not capable of doing everything.

Then on Tuesday afternoon, FIL called me from the hospital.  I could barely understand him, but he wanted me to call the family together (except for MIL) and meet at the hospital.  Lab work had shown elevated calcium levels which prompted a bone marrow biopsy and he was scared. Understandably.

In the meantime, the nurse called me and told me we should try one more time to talk some sense into him because the caseworker wasn't able to speak with him anymore due to his stubbornness.  The staff gave us the POA paperwork to fill out and I stood by the head of his bed and read/yelled the form to him.  I felt like such a cruel jerk hollering out the contents of the paperwork to him, but what else could we do?   

Sadly, he became angry and refused to speak to us, simply shutting his eyes to block us from his sight.  Of course the fact everyone has to yell to be heard makes it sound even worse; it was an awful time.  He finally started talking again, but simply changed the subject.  Ugh.

   The caseworker said they would try another counselor the next day; and luckily, the chaplain had some luck getting through.  FIL signed the POA for health care, hallelujah!  Of course, he can still make his own decisions, but at least we have some paperwork in order.  Luckily the chaplain and nurse were able to convince him to allow in-home nursing visits for a few weeks, but that was the extent of the care he would accept.  And let us not discuss an Assisted Living Facility!

I was at Mom's on Wednesday when the hospital called me; FIL was being discharged today, when are you coming to get him? 

 Oh, boy, now what? 

 I called Carl's sister and her husband, and we met at MIL's house and rode together into the hospital one more time.  After much grumpiness on FIL's part, he had reluctantly agreed to Meals on Wheels (which hasn't started yet, but now they've already called to cancel but which BIL reinstated, sound like fun??) we had him in the car.

The doctor said FIL needs a 4-wheeled walker.  FIL said no, he doesn't want one.  BIL and I drove to the home medical equipment store and bought him one.  The doctor also said he'd need a chair for the shower.  FIL said no, he'd take his walker (he didn't have one at the time) in the shower with him.  So BIL and I also bought a shower chair for him, too.  This was met with all sorts of protests, but no matter, we have to be thick-skinned again and let the chips fall where they may.

Finally, we had FIL back home.  Despite missing him all the days he was gone, now that he was home MIL met us at the door and wanted to know why we brought him back home.  Because, remember after all, her feet hurt and she can't take care of him.  Somewhere along the line, she thought he'd had a heart attack instead of pneumonia, and all manner of silliness ensued.  
On Thursday, the home health care nurse showed up for her first visit. I arrived at 7:45AM to run interference if need be, but luckily she was not sent packing.  I thought the visit went well.  At 9:30 AM I left my in-law's and went to Mom's for her morning meds.  Carl had been taking the holiday med visits for me while he was home on vacation, so once again, I dropped the ball on Mom's situation. 

While we were visiting, I noticed she was favoring her foot, wincing.  After questioning her, she admitted she'd fallen in her driveway on the ice going to get her mail.  Of course, the mail thing has been a no-no for her for the past few winters, especially when it is icy, but while the cat is away, the mice will play.  I asked to see her foot...
 Oh, dear!  I immediately called the doctor's office and her set up for an 11AM appointment.  I then went directly to the post office and tried to have her mail delivered to my house but forgot my power of attorney papers at home, so back I went to retrieve Mom and the POA. We were early for her appointment, so I ran into the post office and straightened out the mail forwarding issue.  Now, if she remembers, which she probably won't, all of Mom's mail will be sent to me.

Next stop was Mom's doctor's office.  Her foot was x-rayed and they couldn't see any broken bones, thank goodness, but she's still having some issues with her feet, so I am taking her to see a podiatrist on Wednesday.  Mom wasn't happy about any of this, but I told her we have to stay on top of these things so they don't get worse.  I hugged her and told her I appreciated the fact she doesn't fight me as much as she could.  This job is hard enough without temper tantrums thrown in.  

We'll find out how Monday's appointment for FIL goes; the blood test results will be back in and we'll know more.  I've been very lucky it hasn't snowed much lately; I'll have to take care of snow plowing at Mom's, our house, my in-law's house and my late brother-in-law's house, too.  That's a lot of snow removal. 

We had a rather quiet Saturday and Sunday so far, I shouldn't talk too loud, the day isn't over.  There have been numerous visits to the in-law's house from grandchildren and everyone is communicating which is great.  

 This is a cautionary tale for Carl and I, too.  A wake up call.  Life is short and getting shorter.  We've got some of our plans in order but there are many more we need to make.  Don't wait until everything hits the fan before taking appropriate measures.  

Review your wills, power of attorney paperwork, and estate planning.  

And how does that old joke go?  'Treat your children well, they are the ones who will be picking out your nursing home.'  








FlowerLady Lorraine said...

Oh dear Karen ~ My heart aches for all of you. Do take care of yourself as much as you can as you continually care for others.

You are in my thoughts and prayers ~ Love & hugs ~ FlowerLady

Tomato Thymes said...

I am sorry that you are going through this, but have been through it relative to Dementia which the doctors all told us was essentially a terminal disease. No one speaks of it like that. The book by Paula Span--When the Time Comes was a great resource for us. Plus contacting our Counsel on Aging too was a help.Just some suggestions.
We scanned all the POA documents onto our phones . The originals were not always needed but since our phones are always with us, the documents were too.

Wish you the best in your journey.

Peter/Outlaw said...

What a difficult time for you and Carl. I'm so sorry. Are you sure your name isn't Job? Good advice as well! Thinking of you all and sending healing prayers your way!

Sue said...

It is truly a sad and difficult time for you, Karen.
I thought I had it rough caring for my mom for a year and a half. I couldn't imagine mustering up the strength to face day after day of tending THREE elderly relatives.
I hope you get some help..........and soon!
I'm worried about you.

Rosemary said...

Hi Karen
So sorry to hear of this difficult time you are having.Age is not kind to us.
Looking after 3 elders is challenging to say the least. Especially when they are not compliant.
Sounds like you are doing the very best for them all.
What an amazing age your Mom has gotten to and still living on her own I know you are right there but still amazing.
Sad what dementia does to a person my Mother is in a nursing home with dementia for the last 2 and a half years. Starting to lose knowing who I and my sister are.
One blessing is she is not difficult ,she is in her 90th year.
Thankfully she made my sister and I POAs so when the time came decisions tho hard were somewhat easier to make and enact.
I have done the same re POA for my daughters. Harsh reality of life it is.
Hope you will take care of yourself and Carl in this hard time.
Get all the help you can...

Alison said...

Oh Karen. What an ordeal your holiday season was, when it should have been joyous and relaxing. Please remember to take good care of yourself too. I hope you manage to get some good quality sleep. I know how elusive that can be.

Peonies & Magnolias said...

Oh my goodness Karen. Y'all do have your hands full don't you. My heart goes out to you and Carl. Take care of yourselves!!!

Junebug said...

Wow, not a lot I can say to help but I hope you know I am thinking of you! Hang in there dear one!

Pam's English Garden said...

So sorry, Karen. You and your family are in my prayers and thoughts. P. x

Pamela Gordon said...

Oh dear Karen. What you are going through with aging parents is a nightmare. I'm so sorry about all this. We've been through it years ago so I know some of the issues you speak of. I pray things will settle for you soon. Sadly, dementia takes away all reason so it is impossible to talk to the patient and get them to cooperate. God bless you and Carl as you take care of your parents. Pam

Tomato Thymes said...

Thanks for your comment on my blog. Also one other thought. Sounds like your in laws and mom need plenty of attention. If you have not done so already, the appropriate family member should consult with professional advisors about not only healthcare power of attorney forms but business power of attorney forms. They are 2 different documents and we had those in place in advance before my MIL's dementia became very bad. It was essential down the road because we needed those documents. Best to you.