Friday, November 17, 2017

The Other Shoe(s) Dropped




As we all feared would happen with Carl's parents, another crisis occurred.  

Backing up the story and to recap; on October 31, Carl's mom had fallen at home and my FIL had called me to help.  We had all gone to the ER and voiced our concerns about their safety afterward, but she was sent home with a recommendation to simply stay hydrated. 
  
 At that visit, the ER did call a social worker to speak with us and she suggested we start making phone calls.  She listened to our worries with a slightly jaded, weary concern (they hear this stuff all the time) and eventually handed me a directory on aging and disability.  

My heart sank.  I was given one of those directories a year before by another social worker when my mom was ill, and to tell you the truth, it wasn't very helpful.  There are listings of all sorts of in-home caregivers, nursing homes, adult daycare facilities, but you are on your own with choosing what and who will work for you.  I had googled a few in-home care provider services last year and the reviews were downright scary.  For every good review, there were dozens more where the help stole from the elder, or didn't show up, or didn't perform the duties, or there was an endless rotation of new people coming and going.  Nothing about the reviews inspired me to think it would be a good fit for my mom at the time.  And, I was sure, nothing had changed from a year ago. 

We all attended MIL's follow-up visit with her doctor a few days later where once again, concerns about their safety were raised. The doctor was urging FIL to consider going into assisted living before anything terrible happened.  FIL was adamantly against his proposal.  He was able to care for both of them, he didn't need any help, and he could still drive.  The doctor did his best to stress the importance of doing something sooner than later, but it was all met with stony resistance.   At the end of the doctor's visit, we were all given a tour of the facility which didn't help; Carl's parents wanted to remain in their own home and could take care of themselves.  End of discussion.  We took them back to their house and then left for our respective homes, feeling depressed and worried. 
 
I was sad.  Of course, no one wants to leave the comfort of their home.  Though the assisted living place is very nice, I was trying to put myself in their shoes (or wheelchairs, that is) and wonder how I would adjust to the move myself.  The fact is, it would be the hardest transition of my life, hands down.  But if I had no other choice, what else could I do? I was able to care for my mother in her home and then, at the end, in ours, but Mom's condition wasn't as bad.  And there was no way one person could handle the needs of Carl's parents on their own.

The worst part of all of this is my FIL is nearly deaf.  The hearing aids he has are for the most part worthless and he never wanted to upgrade them.  As a consequence, the only way to talk to him is to basically, for lack of a better word, yell, which is very tiring.  

For one thing, I always feel I'm being disrespectful when I'm in his face (or rather, right up close to his good ear) hollering at the poor man.  He still has his wits about him, he knows what's going on, but he misses out on so much of the conversation around him.  And comically, often misunderstands what is said, resulting in nonsensical conversations.

"It's a nice day out, isn't it?" I'll say.

"No, there's no ice yet," he'll reply.

"Would you like to sit down?  Here's a chair for you," I'll say.

"No, I don't want a pear," he'll say.

So, after we were all told they could take care of themselves, we had no choice but to take them back home.   What could we do?  Carl's sister and her husband, the grandchildren, and everyone involved felt the same way; they are not safe home alone.  But we had to go with what Carl's dad decreed and pray nothing bad would happen. 

 We waited two days, and then Carl and I had gone over the Friday after the doctor appointment/nursing home tour to help his dad with some ironwork he had to finish for a client.  His dad wasn't very friendly at first; he was still upset with our meddling and insinuating he needed a nursing home, but eventually he simmered down.  Our son had done the welding over the course of the summer, but everything needed to be painted.  

FIL oversaw the entire process, telling us how to accomplish the task as he laboriously made his way across his gravel driveway with the help of two broomsticks as canes.  I had given my MIL a pair of outdoor walking poles which were adjustable and would have helped him more than the broomsticks, but sadly, he refused to use them.  

While Carl was busy with painting and I was idle, I asked FIL if there was anything he needed dug from the garden, such as bulbs, potatoes, etc.  After a comical interaction of guessing what I'd said (no, he didn't see any bugs in the garden) he brightened up and said, "Yes, I need to dig the sweet potatoes.  Do you want to help me?"

It is a testament to his amazing strength that he was determined to go with me to dig the potato crop.  I told him he could just point me in the direction and go to the house to rest, but he was not going to be deterred.  We slowly and painfully made our way to his garden where with the aid of a five gallon pail, he incrementally inched his way down to his knees and we commenced to digging sweet potatoes.  He has keen eyesight and could spot the tiniest fragment hidden in the wet soil.  After the sweet potatoes were dug, we moved on to the regular potatoes.  Carl joined us in mid-harvest and we finished up just before dark.  

FIL could barely get up, but refused assistance and eventually did end up on his feet again with the aid of the five gallon pail.  I handed him his broomsticks and we were on our way to his workshop.  His next request was for Carl to fix a saw that had stopped working.  It took Carl over an hour to figure out what was wrong with the tool, and after we hauled all the painted irons back into the garage for safekeeping, we headed home.  

I was looking out the window and sighed. "I don't know if we're doing the right thing.  He's getting weaker."

Carl said, "I know.  All we can do is hope.  He won't accept any more help."


That was on Friday night.  The weekend passed uneventfully, they were in contact with their daughter and granddaughter, no alarms were raised.  

Until Tuesday night.  

Carl had just left to go to his weekly slot-car racing engagement with Joel.  I was cooking beef stew meat in my pressure cooker on the stove and (once again) doing a walking video at the same time since I'd put off exercising in the morning.  The phone rang, and it was Carl's niece, "I just got here and both Grandma and Grandpa are on the floor!  There were no lights on in the house and I need help.  Can you come?"

After finding out they were still conscious, I said I would be right there. I immediately called Carl and Carl's sister and BIL and was scrambling to find jeans and a coat as I was wearing workout clothes.  Then I remembered I did not have a car here, since Carl took his car and the Oldsmobile was gone.  I'd have to walk up to Mom's a quarter-mile away to retrieve her Buick.   

After searching frantically for my purse (I rarely carry one and hate to do so) I finally located handbag and keys and headed out the door.  With Daylight Saving's Time in effect already, it was pitch black out with a brisk, damply cold west wind.  I called Ann as I was jog-walking on my way, and she joined me in my headlong dash in the dark, keeping me company while I weighed my options.

It seemed to take me forever to walk up there, but in reality, it was only five minutes or so.  I was still talking to Ann as I arrived at the garage, "Ok, ok, I've got the door open, ok, I'm getting in the car, and Oh NO! What?? I grabbed the wrong keys!"

Ann was on her lunch break and was just as devastated to hear this turn of events.  There was nothing for it but to head back the quarter-mile to our home, retrieve the right keys, and go back up the road to Mom's garage once more.  Ann was with me the whole time, so I made all these trips in less than a half hour.  Pretty impressive considering.

I arrived at the in-law's house and walked right in.  MIL was face-down on the ceramic tile bathroom floor.  The door was slightly ajar, and when I opened it to see how she was, I bumped her head.  

"What happened, are you in pain?" I asked.

"No, I'm ok. I'm just doing my exercises," she said.  "Sit-ups and push-ups, you know.  I'm ok, I'm ok."

I proceeded to the bedroom where my FIL was lying on his side with his granddaughter talking to him.  He knew me, but he couldn't get up.  They had both been down for over twenty-four hours.  A fall was the one thing we'd all worried about.  FIL's defense was always that he had his cellphone and if anything happened, he would be able to call for assistance.  Sadly, the phones were both in his bed, too far away for him to crawl to and too high off the floor even if he could have reached them.  

I wasted no time, marched to the kitchen, picked up the landline and dialed 911.  

"911, what is your emergency?"

I explained the situation calmly and was assured help was on the way.  I went back and checked on them both and informed them I called for an ambulance.  My FIL was upset, "You didn't do that!  I can get up!" but no matter.  Their granddaughter stayed by his side and I went outside to turn on porch lights.

  In a short time, a police officer arrived followed by first responders and then, an ambulance.   They assessed their conditions and determined because my MIL was showing worse signs of dementia and could not move that she was to be transported.  She kept insisting she had not fallen, but was merely exercising (after she'd gone snowmobiling that day.) The crew was understanding and assured her they could help her with her exercises in a more comfortable place. 

When the emergency crew assessed my FIL, however, they said since he was his own person, they couldn't transport him because he was refusing to go to the hospital.

I said, "I think he needs to go, don't you?  It's been over twenty-four hours."

"We cannot kidnap people.  If he doesn't want to go and is still competent, we have no choice," he said, brusquely.  

I was at my wit's end.

At that moment, the policeman came to our aid. "Well, if you can't take him in, can we at least see if he can get up while we're still here?"

All the while my FIL was protesting, "I can get up, I can get up!"

"Ok," the EMT said, "Here's your walker.  I want to see you get up now."

They gave him several minutes to try to stand, but it was pitifully obvious he could not.  The EMT made a phone call and a second ambulance was dispatched.  Finally we had them both on their way to the hospital.  

Carl and his sister and our BIL arrived just as they were all loaded up, so we all proceeded to the emergency room.  After examinations, they were both admitted to the hospital for a two day stay.  They were both extremely weak and dehydrated.  All of us stayed at the hospital until they were in their hospital rooms and then went our separate ways.  It was a relief to know they were safe at least.

The hospital made the decision to send them to our local nursing home for rehab, the same nursing home they'd toured less than a week before under protest.  FIL was upset at first and said he wanted to go home, but the case worker was able to convince him of the need to go to get his strength back.  

So, as of last week Thursday, they have been in the rehabilitation center.  This is a huge change and an immense adjustment; but after a rough start, my FIL is now seemingly at peace with the decision as he knows he's too weak to go home alone.  I wouldn't say he's thrilled to be there, but he understands and is doing his best to adapt.  Carl's mom is more confused, as is to be expected, which is sad.  

We've gone up to see them every day and bring him things from home that he's requested, his mail, the newspaper, personal belongings, we check on the house, feed his feral cats, and return phone calls on the answering machine, and are trying to finish up loose-ends with his business.  Needless to say, nothing has gotten done around our place at all.  And Thanksgiving is next week?  Oh, dear.

And to add to the chaos, we've both come down with bad colds.  I heard FIL coughing a few days ago, too.  Almost everyone we know is not feeling well.   By the time we get home from the nursing home at night, we're too beat to do much of anything.  

Carl says we need to get into a rhythm with this; and he's right.  We can do it somehow.  We need a system, and we'll figure it out, it's just right now everything is topsy-turvy.  
As far as I got cleaning up the garden.

I was walking down the hallway at the nursing home the first night we had them there and a complete stranger to me was coming the opposite way. 

Our eyes met, and she smiled at me with tears in her eyes.  


"You look like you could use a hug," she said.

I said, "Gosh, does it show?" and we embraced as if we'd been lifelong friends.

She whispered in my ear, "Isn't this THE hardest thing?"

"Yes.  Yes, it is," I said through my tears.  

"Just remember, you're doing what's best for them," she said, and with one last squeeze of my hand, she was gone.



Angels do walk among us.















16 comments:

outlawgardener said...

I'm so sorry for your in-laws and for you having to go through this again so soon. You and your family are in my thoughts and prayers! This is, indeed, "The hardest thing." Sending you strength and hugs.

Karen said...

Thank you, Peter. :-)

FlowerLady Lorraine said...

Oh dearest ((((Karen)))) ~ This is such sad news to hear, especially at this time of year. I am so glad though that your inlaws are in a place being cared for. Bless their hearts.

Oh my, your gift of an unexpected kindness with a hug was just beautiful.

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

Sue said...

It is indeed the hardest thing to have to go through. Your in my thoughts, Karen.

Ellie's friend from canada said...

I am rather misty-eyed at this. My mother was profoundly deaf but of sound mind. She was in the hospital and she was given the mental assessment tests by a psychiatrist. Neither of her hearing aids was in and the psychiatrist judged her to have dementia. I wrote a note to the chart saying she wasn't demented but profoundly deaf and she didn't hear in the lower ranges but could hear my voice and that I'd like to be there when she was retested. Rather, than have me come when he retested her, he proceeded. This time he used a voice amplifier box which amplified his voice. Obviously he was either demented himself or at least not too swift because he didn't think that a low male voice amplified was still out of her hearing range. So for the next two years she was treated as if she had dementia. The nursing home lost 1 hearing aid, the hospital the other. Out of desperation, I went to the hearing aid clinic and asked if they had any loaners we might borrow. They had previously told us that they couldn't do anything more for her. In the meantime, technology had developed. When I was standing at their counter, one of the audiologists reviewed her chart and said that she had just returned from a medical/ audiology convention and had learned of hearing aids that had been developed for profoundly deaf children. And so, I spent more than $5,000 for a new pair of hearing aids. What a difference. My first priority if it were my father in law would be to get some hearing aids for profoundly deaf children. And get him back in the land of the hearing. They are made by Phonak Naida. When my mother was back on the same unit at the hospital two years later, one of the same nurses exclaimed "but she is not demented!" and I replied "she never was, she was profoundly deaf". The problem is that my mother, like your f-i-l would answer to what she thought the question was. Such answers sound demented to regular people. Such answers are dangerous. In a nursing home, half the time the hearing aids aren't put in, or are not put in properly or aren't turned on or don't have the batteries in or need new batteries. Then the deaf person doesn't know how loudly they are speaking so it sounds as if they're yelling, i.e., demented.
So if you can, contact an audiologist about the Phonak hearing aids. I would lend you my mother's but they would have to be electronically reprogrammed for your father in law and new ear pieces molded and I don't know if an audiologist would do that. (I'd have to find them, too). Still, your father in law would be a lot easier to deal with if he were back in the hearing world. And it would be safer for him, too. You could also have a little white board and an erasable felt pen so you could write questions down when you know he hasn't heard you correctly. Although the answers to misinterpreted questions can be amusing, it is dangerous if people think the person is demented not deaf.

Next since I am giving all of this unsolicited advice, I would ask their doctors to test them for nutritional deficiencies.
If they have been dehydrated, are they also eating poorly? I mention this because recently I had a folate deficiency. You would not think I would have had one but in the elderly it is not uncommon. I would ask the doctor to test them, especially your mother-in-law, for folate deficiency. 50% of elderly patients with dementia have folate deficiencies. When I had mine, I could not think, I couldn't remember anything, and I was increasingly weaker. Our bodies only store about 2 weeks of folate in our bodies. If they weren't feeling well or didn't eat leafy green vegetables or calf's liver or other food high in folate, they would spiral downwards really quickly. I am not saying dementia doesn't exist but it co-exists with folate deficiencies which mimic the symptoms of dementia.

I send you thoughts, prayers, and blessings.
Ann

Beth @ PlantPostings said...

Oh, Karen, you've been through so much! Aging is so depressing, especially when people reach the point where they can't be self-sufficient. I'm so sorry. I know it's hard to find time for it, but self-care is essential and is NOT a selfish thing. I hope you can find little ways to treat yourself to little joys and rests here and there. My thoughts and prayers are with you.

Karen said...

Rainey, thank you. I know, the hug was so unexpected, what a blessing. Just as you are a blessing to me. :-)

Karen said...

Sue, thank you, we will keep on praying for the best outcome.

Karen said...

Ann, I tried to take my father-in-law to a highly recommended audiologist, but he was always against going. He felt the hearing aids he had were 'good enough'. Yes, it is very sad that he cannot hear, I suspect his terminal cancer diagnosis was a huge deciding factor in his decision, too. Sadly, he is getting weaker though he's doing his best with physical therapy, but the disease is progressing. I'm so sorry that your mother had to go through the stigma of being labeled as a dementia patient. Thank goodness for you advocating for her! I will try to do my best for him, too.

Carl's parents have always been diet and health food conscious, but I'm sure it was possible things have started to decline the last few weeks. I will discuss these concerns with the staff, too. Thank you, Ann!

Karen said...

Beth, thank you for your kind words, I will indeed look for ways to find some joy.

Ellie's friend from canada said...

Karen,

I didn't know about your FIL's terminal cancer diagnosis. That's sad. I wouldn't have made my comments about hearing aids had I realized. I can understand he didn't want to spend the money. These recently-developed hearing aids for profoundly deaf children (used in a senior) are wonderful. I will never forget when she and I were sitting out in the care home's garden when I saw the most puzzling look cross her face. She was wearing her new hearing aids. I asked what she was thinking and she said, "Well, Ann, I never missed hearing magpies, you know!". She had heard the magpie sitting in the tree behind us. Another day, I dropped something on the floor next to her and said very quietly "oh damn!" and she looked at me and said "don't swear!". From then on, I had to mind my p's and q's! I am sorry to hear of your problems. I do think it might be an idea to have a little white board so if you know he's not hearing you, you could write the comment or the question. Unfortunately, my mother was legally blind so I couldn't use one with her.

In spite of her being labelled (for two years) as demented, we had a wonderful time. She and I always found something to laugh about and to find joy in. That was what I noticed in the long-term-care facility –– that no-one laughed (except us). Beth's comments above about self-care are so true. You've been through a lot. You need to take care of yourself and steal time for your own delights and joys. I used to steal away with a friend who drove to the mountains (about 48 minutes away) early in the morning for a change of pace and then see my mother and my brother (who was in a hospital at the other end of town) in the afternoon. It was amazing what a 4 hour escape did to my spirits!

Karen said...

Ann, I think the white board is a very good idea, it would truly help to be able to write things down so he doesn't feel he's guessing when answering questions. Your relationship with your mother sounds so much like the one I had with mine, what a blessing you were to your mom and she to you! Your respite trips with your friend sound wonderful. I've given up exercising on a regular basis since all of this has happened, and know I would feel better if I got back into it, so I will make it a priority once again, even if I can only fit in thirty minutes here and there. Thank you for your kind words!

Pamela Gordon said...

OH Karen, I'm so sorry to read this news and all you're going through with your in-laws right now. I hope they will realize they need care and will stay where they are. What a shame. If I could I'd give you a big hug! Take care of yourself. Pam

Carol said...

My Prayers go out to you ♥ It is the hardest thing to do even when you know it's the right thing to do. Take care of yourself too. It's so easy to get wrapped up in their needs that you neglect yourself and that is not good for any of you♥

Karen said...

Pam, thank you so much, 'virtual hugs' are great, too!

Karen said...

Carol, thank you! I'm getting back into exercising on a daily basis which is great for stress-relief and also, for my burgeoning waistline. :-)