Month: February 2013

  • just call me miss near-miss

    I added another heap of … something … to my plate when I adopted a dog this past weekend.

    Sadly, it did not work out. I’m taking him back to the rescue organization, and trying not to feel like a monster/jerk/wimp.

    This was a very nice, very cute dog. Also, a smart dog with a dark side. And a dog with a whirling-dervish chaos-making ability that is very surprising in a canine that should be middle-aged.

    As the weekend progressed, even darker traits emerged, including snappy, lunge-y agression towards other dogs. And the stubbornness, oh, the stubbornness.

    The Elderly Relative’s reaction veered from outright fear to annoyance to a luke-warm acceptance and back again. Even though the dog is small, he was putting John at risk by jumping at him and doing everything in his power to get at his food.

    As I watched these minidramas unfold, grabbing at the dog’s collar and trying to steady and soothe John at the same time, I knew this was the wrong thing at the wrong time. It was a drumbeat in my head, this is wrong this is wrong. I made myself sick thinking my dark nighttime thoughts, feeling totally in over my head.

    You might have seen this coming. I sort of saw it coming, too. I thought that it would all work out somehow — maybe overwhelming and instant love for this new roommate would make me move heaven and earth to make it all work. Maybe I’d magically be able to figure out all the impossible logistics specific to this situation.

    But, no. Not only am I dealing with the questions/issues at hand, I’m queasily grappling with some bigger questions — am I cut out to be a dog owner? Or a pet owner at all? I watch the ease at which my boyfriend loves, accepts, and cares for animals — it’s effortless and beautiful. I adore dogs, but I feel the emotional investment I must make, the compromises, the work. I know that, given the right circumstance, that it would be worth it. But right now, I don’t have the juice to do it. Having an 86-year-old live-in pet (of sorts) can do that to a person.

    I know that I am a pure amateur that stepped into a varsity situation. I may try again when I’m living solo again, can come and go more easily, can really carve the time out to do it right. Perhaps I won’t. I don’t know. Right now, there’s a little creature snoring next to me for whom I have complicated but honest feelings for, who (I hope and pray to all that is good) will find a real home, very soon.

     

  • TCB

    Thank you for your comments, squeezes (virtual and otherwise), gifts (!!I got gifts!!), support, love, feedback.

    I escaped to San Francisco for a few days and felt like a PTSD-stricken refugee wobbling off a leaky boat. MM can attest to my extreme fragility. Fortunately, food, company, comedy shows, and rest have returned me to somewhat-among-the-living.

    I’ll go more into other stuff later (I am proud of that sentence and am leaving it in there), but first — just some crap I’m getting done, now that crises have passed and life is rolling forward again. Here come some BEFORE pics.

    Untitled

    It’s not like I have a brown thumb when it comes to gardening — it’s more like I have no thumbs at all. It took years of people saying “uh, whoa” when coming to the patio that I even saw the weeds, the bizarre overgrown pathway, the many dead plants, the ivy that’s creeping into the house. That chair cushion didn’t go missing in 2010 — it just got swallowed up by the.. uh.. plants.

    The best and most wondrous aspect of this snoozy story is that I hired a guy named Bill, a guy with the most profound Southern accent I have ever heard. I will do what I can not to pester him on Friday, but I will force him to say “barrel”, “July”, and other word that sound excellent through (I suspect) an Oklahoma-area filter.

    Six chairs needing repair

    I got 6 totally thrashed dining room chairs redone. “After” pics to come, once I overcome the shock of how much the re-doing cost! Yipes. But they are beautiful, so beautiful. Forgot to ask the chair guy if he encountered any manufacturing marks, but they sure look like Møller. The money will be recouped one way or another, even if it’s just payment of years of sitting my Danish ass upon these stylish seats.

    you stupid car

    You stupid car. You stupid, stupid car. I have spent instant-headaches amount of money on you, car. Enjoy your new transmission. Stupid.

    There will be no “After” pic of you, car.

  • healthcare, we have a problem. #4 (epilogue)

    Part one of this saga is here.

    Part two of this saga is here.

    Part three of this saga is here.

    So, yeah. With breathtaking speed, a grenade in the form of pneumonia was thrown into the lives of John and me, and it changed everything.

    My family got down to business. A sister, a brother, a cousin, a sis-in-law and I Skyped for two hours a couple days after the health-grenade was lobbed. We picked my sister-in-law’s brain completely (who is a nurse and hospital administrator); we brainstormed and we strategized. We made some hard decisions, we got on the same page. They continue to be a sounding board, and are willing to take on whatever tasks they can handle remotely. It’s not like they weren’t available before, but there’s nothing like a crisis like this to make a family sink or swim. And swim we did.

    I articulated and fulfilled my needs. Up to now, I had been slowly adjusting my availability to John as his care needs increased, even though it was impacting my work and personal life. With John’s health crisis, I could really see that I could not handle what I thought I was handling. I made use of a caregiver resource agency; I not only was empowered to identify and ask for what I needed, but I also was given info and resources that got me on the right path. Still not quite there, but getting there.

    I became even more cynical and skeptical about health care here. Not much to add to that, if you’ve been reading along.

    Elder care advocacy is needed. Many people treat seniors like shit. Many other people accept and allow a culture that treat seniors like shit. I am going to help change that. I encourage you to to help, too. Before you know it, idiots will be screaming in our wrinkled faces. Should that be the title of my new book?

    I cleaned house. I have three particularly difficult relationships that I needed to deal with:

    • The doctor. He has a horrible, loud, fake-jovial bedside manner. Years ago, he dismissed my concern’s about John’s dementia, neither recommending a neurologist nor medication. Recently, he misdiagnosed John’s illness and then he prescribed codeine, which led to John’s psychotic episode. My sister A found an MD who comes highly recommended, has much experience with geriatric care, and will officially be John’s new primary care physician next month.
    • The caregivers. I sort of tolerated the caregiving agency and caregiver that we had been using for the past two years, even though John nor I really liked them all that much. With John’s illness I spent a lot of time dealing with the caregiver and agency and really saw how completely unacceptable they were. I’m not going to go into details (it’s complicated), but I made a tough but necessary transition to a new agency who have many staff experienced with working with clients with memory issues. And they’re cheaper than the old agency.
    • The friend. He’s an old pal of John’s who handles John’s finances. He’s a very good and concerned friend, but he’s also a cheap, opinionated boor. We’ve wrangled a lot about John. His tight control of John’s limited resources was one of the factors that kept me from asking for enough care and services for John. That is, until the recent events pushed me past my limit. I made it clear that I need to be free to take care of John effectively and safely, and that means getting help whenever I need it. I think it took this crisis to finally make this friend realize that I’m not lazy nor indifferent nor stupid about John’s money or wellbeing. I now have significantly more outside support; it’s still not enough, but we’re getting there.

    I am resolute yet fearful. I have been told by many people (including you) that John’s lucky to have me. He has no blood family, he never visualized or planned his future needs as a senior (except for the finances, which are barely okay). After my mom died in 2003, he just kind of lived in this fog of denial, hoping we wouldn’t make him move from the house we own, existing in this tiny, lonely orbit, until dementia descended. Even then, in the early stages, he just didn’t or couldn’t face the future.

    Which of course makes me think about my own future. I don’t want to, nor can’t, live in a denial bubble like that. I don’t want to be 86, let alone 86 with dementia. But what will be my options if I do become needy? Financially, I have nothing for the future. Personally, I have no kids, my siblings are much older — who’s going to step in for me? Who’s going to be my Becky? These are my dark, late-night thoughts. But, as the Boyf says, I have no crystal ball, I don’t know how everything’s going to turn out, so why worry? Oh, but I do. I do.

    I’m no saint. I know that people like to say things like “you’re a saint” or “you’re so selfless” to me, which is very nice and I’m taking the comments in the spirit intended, but it’s not accurate. I moved in here because it was a mutually beneficial arrangement, that John was (and is) a pretty mild and agreeable person, and at the time, the caregiving was easy. I am not a natural caregiver, and I have been bad at it and fed up with it more times than I can count over the years. Then, when this health crisis came down, I got in over my head fast and had to deal because I had no choice. If I left, he would die, so I stayed.

    At some point I’ll be proud of what I did and am doing but I am still in the thick of it, or at least trying to stay one half-step ahead. There’s just too damn much to do.

    Blessing-counting time:

    • Coast Caregiver Resource Center — serves adults with cognitive disorders by helping those who care for them. I am so grateful to the Center’s Carolyn K, who keep me and my family, informed, supported and sane.
    • My brother Peter, his wife Pat, my sister Annie and cousin Sally — these are the family members that stepped up to listen, mediative, problem-solve and care. We worked together very well. This is a very, very lucky thing.
    • The friends that stepped up. I have to say, it wasn’t too many. But there’s a few who have come over and made me dinner, took me out for a drink, called me once or twice. I don’t have the personal support system here as I did in SF, that’s a fact. So, thanks to those of you who rallied ’round. I extend this thanks to my online friends too.
    • My boyfriend and his mom. She has been pinch-hitting like a champion since December, coming over to sit with John when I’ve been stuck without care, often being asked at the last minute. He’s been my escort and sweetie and makes me feel normal and lets me have fun even things are (oh I have to say it: literally) shitty.
    • My health, my flexible and forgiving boss, beer, movies, my iPad, roof over my head, love. The end.
  • health care, we have a problem. #3

    Part one of this saga is here.

    Part two of this saga is here.

    This (all-true) story is bumming me out, so I’m going to power through all the rest of the details in this post. I’ll get to an epilogue in a couple days.

    So there I was, finally let in to see my terrified and very, very sick stepfather in a room in the ER. In the previous three hours, he had had blood drawn, some tests done and was hooked up to antibiotics and fluids. He was diagnosed with pneumonia and dehydration.

    We spent five more hours there. It was maddening. I ran home to get a coat and phone charger then came back and waited and waited with John, amidst a cacophony of beeping machines, screams of injured Friday night drunks, and bewildered questions from the poor old man.

    Deafening alarms would periodically go off from one his machines, and were ignored unless I tried to catch the eye of someone — anyone — wandering around outside our curtained room. Every single member of the staff did everything s/he could to avoid and ignore anyone who wan’t a fellow staff member. I felt invisible and like I was going absolutely insane.

    Even though I didn’t see him until the end of the night, the attending physician sounded like a standout asshole among a whole lot of assholes. He was the person that needed to see us, to assess the situation, interpret the lab results and give the okay to the next step. Every time I’d ask a nurse when we could talk to the doctor, I’d get a hushed “oh, he doesn’t like to be pestered too much.”

    At one point of the night, he ordered a urine sample. A nurse and aide marched into our room, ordered me out, and proceeded to bark at John, demanding that he PEE! NOW! into a bottle. He was crying and pleading as each one of them got in his face. The nurse shouted at John: “Mr. ________, we are going to have to put a needle in your penis if you do not cooperate, do you want that?”

    That’s when I burst in and got them the fuck out of there. After calming John down and treating him like a human, I tried to get him to pee, to no avail.

    [I found out afterwards that something they were testing for — bacteria in the blood, something that John turned out to have, causes a side effect: inability to urinate.]

    But we didn’t know he had bacteria in the blood. In fact, at 1:30am, the doctor declared that John was fit enough to go home, even though

    • he obviously wasn’t;
    • I made it clear I had no way to get him from my car to the house (let alone take care of him);
    • they did not get back all the lab results, including the one for bacteria in the blood (which causes sepsis).

    After his IV needle was pulled out too roughly (and John’s blood spraying everywhere), after my tearful pleas that that was NO WAY I could get him home and take care of him, after the both of us being dismissed and ignored and mistreated, I had to bring John home, all by myself.

    This is the point I get these questions: “Why didn’t they admit him to the hospital? Why didn’t you demand they admit him?”

    To this I answer: don’t you think I would’ve if I could’ve? Put on my shoes and see what you would have been able to accomplish. I had no one to talk to about my options. There were no advocates; I have never been in this situation before. Everyone conspired to make it seem like I had absolutely no choice but to get him home, that night, on my own steam.

    Which I did, with great peril and many, many tears.

    The next morning, after making sure John was not dead, I called my sister A and told her I was about a second away from getting in my car and leaving forever. Thankfully, she talked me down, and thankfully, a couple people came over to help out.

    As I was lying in a dark room, trying to compose myself while people were there to watch John, the neighbor came by.

    Here, he said. It was a piece of paper; written on it was “Bob” and a phone number.

    They called my house for John, he said. Don’t know why.

    I called the number. It was the hospital where John had been. Since I only had the name “Bob,” it took me forever to find the right Bob. Turned out he worked in the lab.

    “Mr. ___________ needs to come in immediately. He probably has sepsis. It’s urgent.”

    Click.

    Thanks, Bob.

    [Why the hell did the hospital call my neighbor? They did not call my cell nor our house number, both of which I made sure were on the forms. I deduced that they called the “in case of emergency” number from John’s ID wallet. Seriously.]

    Fortunately I had others to get John to the ER this time. They spent about 4 hours there, getting chest x-rays and other tests, administering antibiotics and watching John’s blood oxygen levels fluctuate alarmingly.

    At least, I thought, they’d admit him to the hospital to get the care he desperately needs. Sepsis is extremely serious.

    In the meantime I spoke to John’s caregiver agency. I really needed guidance or at least a collaborative approach to figure out the care for John. Instead, I got this weird, slightly impatient “well, what do you want? 24-hour care? We can do that, but it’s super expensive!”

    I was a wreck. I knew John was going to need medical monitoring and major care (including dealing with his total incontinence and help with lifting him) after he got back from his hospital stay.

    At least, I thought as I tried to catch up on sleep, I have a couple days to arrange it.

    That was the moment that John was brought back.

    The hospital did not admit him, again. Apparently the threat of sepsis had passed, sorta?

    I had to kick into gear and try to cobble together care for John. Somehow I managed, even though I was alone with him for large stretches of time (including overnight). Not pretty. Not easy.

    It was two nights into it that I decided to give him a bit of codeine cough syrup (that his doctor prescribed) to help his horrible, wracking cough. He was very ill.

    So, try Googling “dementia” and “codeine”.

    Possible side effects can include paranoia, psychosis, and death.

    Of course, I only Googled this after the fact, a two-hour middle-of-the-night ordeal.

    John had a complete and total meltdown, literally screaming “they’re after me! they’re after me!” and trying to run, to fight me — he was absolutely gone. I thought he would die right there. I managed to get him into bed but he was inconsolable. It took a couple hours before he could calm down and I could see him again.

    At this point of the story, I often get “are you going to sue your doctor or the hospital?” The answer is no, so leave it alone. I’ve related this story to many medical personnel and the most common reaction is a shrug, like “what are you gonna do, doctor’s aren’t going to know everything, hospitals don’t like to admit people.”

    My after-the-crisis to-do list was growing (steps 1 and 2: fire the doctor and caregiving agency). The week continued in a haze. I had a phone meeting with the family members that care about John, and they were very kind and helpful (and regretful that they did not live closer).

    My sister-in-law, who’s a nurse, was the first and only person to mention to me that home nursing aide care is available and covered by Medicare, if one’s primary care physician ordered it. So I got him to order it, but it came laughably after the fact; the first nursing visit only happened last week.

    So it went. I experienced a week or so of sleeping in short bursts, cleaning pee and puke and poop, marching like a zombie through a haze of fear, frustration, and feeling overwhelmed at all times. Trying to work at my job, trying to achieve my personal best at not changing out of pyjamas, trying to feel like there was hope.

    And John? He was and is a champ. His dementia mercifully erased the traumatic memories of the horrible stuff he went through, he has maintained a (relatively) cheerful demeanor, and is healing faster than probably you or I could from his illness.

    We’re both on the other side now. I’m feeling relieved that the crisis passed, but there have been many hard lessons learned and decisions made, and so so so many phone calls.

    More later. The wrapup.

    Go to Part 4

  • health care, we have a problem. #2

    Part one of this saga is here.

    When we last left the story, I barely got my stepdad John to the brusque and ham-handed doctor, who declared John had the flu. Before I allowed anyone to leave us, I demanded a flu shot for myself, which I got.

    John was too weak to get out of the wheelchair and into my car by himself. Perhaps miffed that his illness had made him incontinent, the office staff offered no help. This was the first time I had to bear most of his weight and dangerously collapse him into my car. Once home, the same thing — I had to half-carry him out of the car, then cajole him, one tottering step at a time, to walk into the house. I fully expected him to fall and sustain an injury and wondered (not for the first time and not for the last) how I got to this position — without help, without guidance, and with putting us both in danger.

    A short time later the caregiver arrived. Since I started living with John, I have been making do with a caregiver visit only 6 hours a week (2 hours a day on Monday, Thursday and Friday). I also hire an aide on evenings and weekends, as needed. This has not been even close to enough help for me, but I’ve allowed myself to be intimidated by a variety of reasons not to demand more caregiving. This has been enormously risky, as I’ve allowed John to be alone for too-long periods of time, and have allowed my own personal and professional life to suffer. Don’t forget, I have a full time job in addition to the caregiving, which I provide for free in exchange for living rent-free (in a house I co-own, but that’s a whole other story).

    The caregiver (who I’ll talk about more later) was as alarmed as I at John’s state of health, which was deteriorating before our eyes. I’ve never seen anything as fast as that — within minutes he became glassy and unresponsive, and too weak to move at all.

    I called 911.

    I have to say, actually picking up the phone and dialing those numbers is not an easy thing. My inner voice practically chanted “don’t overreact! you can handle it without all the drama!”

    I’m so glad I didn’t listen to that voice, even though it was incredibly hard to see John strapped to a stretcher, shouted at, poked, prodded, and then slid into the ambulance.

    They told me there wasn’t room for me and to come to the hospital in my own car. Fortunately I remembered to ask what hospital he was going to. “What do I do when I get there? Who do I speak to?” I shouted after them, but was drowned out in the noise of sirens.

    Once I arrived, I was told to wait in the emergency room until they called me. It was there I beheld a standing-room-only sea of incredibly sick humans, most of them certainly with the flu. Babies, pregnant women, kids, adults, elders. Entire families, all hacking and heaving. A pile of available flu face masks, and not a soul wearing one.

    I sat there for three hours, trying not to breathe and using the last of my cell phone’s charge to try to find someone — anyone — that could come be with me. Except for the aide, who was out of town, every single person I tried to contact was sick with a cold or flu.

    When I couldn’t stand it any longer, I went up to the desk person.

    Me: Hello, I’ve been waiting for three hours for word of my stepfather John _______.

    Desk person: Three hours!?! That’s too long, the doctor should’ve talked to you by now. What’s the name again?

    Me: John _______.

    Desk person (going down a stapled list of names): Nope, he’s not here.

    Me: That’s not true. He came by ambulance here. Three hours ago.

    Desk person (making sounds on a walkie-talkie): No, no one by that name is here. Ma’am, you’re going to have to call the other hospitals in the county.

    Me (the first of many tears making its way out of me): The emergency crew very clearly said this hospital…

    Desk person: Ma’am, I’m going to have to ask you to clear the way for other …

    Nurse at a computer (overhearing the conversation): John _______? He’s here. Go on in. You could’ve asked to go in hours ago.

    And that experience was a walk in a sunshiney park compared to the next five hours!

    Two things I’m glad I did:

    • Calling 911
    • Remembering to bring all the important documents for John: ID, insurance card, Advance Health Care Directive and Power of Attorney documents. The directive is a set of written instructions that a person gives that specify what actions should be taken for their health if they are no longer able to make decisions due to illness or incapacity. Power of Attorney is a written authorization to represent or act on another’s behalf in private affairs, business, or some other legal matter. Big shout out to John’s friends and relatives who put all those documents in order years ago and to all of us who keep track of them in an easily-accessible place. Seriously, if shit went down a little differently, and if he didn’t have all that stuff with him, this nightmare voyage would have been so very much worse.

    Go to part three.