Parental Journal 99 from Planet Elderly: Mom Now Resides in a Skilled Nursing Community

The journey with dementia moves onward, and during the past couple of months Mom has fallen a few times.  Watching her gait over the summer, I could see that fall episodes would start in the near future. In September, she willingly agreed to try using a walker and said she felt more secure.  Trouble was, she didn’t remember to use it, so getting around started becoming rather precarious.

First Medical Adventure

I received a call saying she was shaking and having trouble communicating.  She was taken to the ER and it was determined she had an infection…maybe sepsis…but they weren’t sure. She was admitted and given two varieties of big gun antibiotics intravenously.

I stayed with her 12 to 14 hours each day but needed to be home to sleep. She was moved a few times to different rooms, and there was never anything other than a hardback chair for me to sit in.  Fortunately, the hospital could monitor her via video and using a sound alarm built into the bed.  It would go off any time she tried to get out of bed.  That gave me some peace of mind when I went home to sleep.

For Mom, she was just tired a lot, but her breathing was monitored as were her other vital signs.  She was put on oxygen because they suspected pneumonia.  The biggest challenge was going to the bathroom.  She needed assistance but didn’t think she did.  A few times assistance took a long time coming and she found her self in a puddle of urine and feces.  I had to advocate quite a bit.  When I told some physical therapists about the puddle, they were horrified something like that could happen in their hospital.  No shit.  I’m sure it happens often with the aged old who are hospitalized and cannot speak or advocate for themselves.

Mom had several tests done (Why not?  Medicare was paying for it, right?), and several rather fast-moving rides to those tests by young folks who had no idea she had dementia and would scare easily.  She didn’t scream or cry out, but her eyes got big.  She rated the food at this hospital as “lousy.” I would agree.  She didn’t eat much and lost some weight.

From the hospital she was sent to a rehab skilled nursing community to receive physical and occupational therapy.  She was not a happy camper, but after several days she was glad to be able to “go home” to her regular memory care assisted living community where she was welcomed with open arms.

mom and me shoes

(Chilling out during her first visit to the rehab center)

Second Medical Adventure

While roaming around without the walker one evening, Mom fell and was in a lot of pain.  I met her at the ER and it was determined that she broke her shoulder, a common kind of break for the aged old.

The ER doctor, who seemed in a rush because “I’m the only physician here,” he said, seemed attentive enough, but he wanted to send Mom “home” with some pain pills and a brace to keep her arm stable.  We were told it would take about 6 weeks to heal.  If it didn’t heal, there was an operation involving putting a rod in her arm, “but due to her age….”  I just nodded my head.

Because it was 3 a.m., they found a room for her to sleep in overnight and I was able to go home to sleep.

The next day the rehab community picked her up and brought her back for another visit and round of therapies.  She was in terrible pain.

She was at the rehab community only a couple of days.  As I watched how she was watched and assisted, and as I looked around the somewhat dark and dingy atmosphere due to the community being located in a basement area of a larger senior community, I just wanted something better for Mom.

Proactive Me

It’s my nature to look at problems and situations and try to plan options.  With two recent hospital adventures, it seemed clear to me that Mom was headed toward needing a skilled nursing facility as her permanent home.

I found it to be very stressful to have an incident lead to an ER visit, which led to time in the hospital, which then led to time at a rehab community, which maybe would lead to going back to her home community only to know that the same scenario would happen again and again.

I drove over to a new skilled nursing care center at Lenoir Woods, a Luther Senior Services community that has been in Columbia for several decades.  In recent years they have built new independent living apartments, torn down the old care center and built a new one with three skilled nursing facilities, and over time have stepped up their game to match their mission in helping elders live better lives as they progress through the aging process.  They are highly rated and have a good reputation locally.

My idea was to get Mom on the waiting list.  I just walked in and was able to speak  with the advisor who hadn’t yet started her busy day.  I told her about Mom’s background and what had been happening.  Turned out there was an opening, and Mom was moved in a few days later.

Third Medical Adventure

This one I missed because I did not hear my cell phone ring three nights ago at 11 p.m.

I did wake at 3:30 and saw that I had a voice message.  Checked that and was told to call.  When I did, I learned that at about 11 p.m. Mom was found lying on her back next to her bed and that she was bleeding at the back of her head.

They had her taken to the ER where she was examined, given two CT scans around midnight, had three staples put into the back of her head, and sent back to the care center.

“They didn’t find anything serious and sent her back.  She is fine now,” I was told.

I made some coffee, listened to NPR news for a while, and had a nap.  I woke up and got myself ready to go check in on her, not sure what to expect but having visions of her pain and misery from previous medical adventures.

When I arrived, a man was leading a program for the crowd gathered in the living room area and there was Mom, seated in a recliner, wide awake, participating with a smile, and when she saw me, she said, “Oh, hi!  How you doin’?”  No word about pain, about being tired; no memory of her latest adventure.

Eventually I did say, “I heard you were at the ER last night.”  She looked at me as if she didn’t believe me.  “Yeah, I’m told you fell and had three staples put in the back of your head.”  Her eyes shifted left to right.  “I hope they were nice to you.”

“Oh, yes.  Theyt were nice.  They were very nice.”  And then she started feeling the back of her head to check on the staples.

And Here We Are:  Observations as of Thanksgiving Weekend 2018

*Mom has been eating less these past few months.  We had a fabulous Thanksgiving meal yesterday at her community, but she only nibbled at it.  I cleaned my plate and ate a few bites of hers.

*She weighs 109 now.   When I moved her to Missouri she weighed about 103 and her doctor wanted her to gain some weight.  While at her first community, she ate well and peaked at 134 or so.  That was a bit much a bit fast, but then she started eating less this past spring.

*In addition to lessening food intake, her taste buds seem to be changing and she doesn’t recognize food very well.  She was unsure about whether she liked the homemade rolls served at every meal.  A couple of weeks ago, that was a favorite item.

*She feeds herself, but has difficulty reading and selecting from the small lunch menu that offers two main items and a variety of vegetables and sides.  If left to herself, she may only select “mashed potatoes and gravy.”  They are yummy…and made with real potatoes.  She never says no to the dessert cart when it stops by her table.  She rarely finishes dessert, but she enjoys a few bites.

*She has difficulty remembering to use the walker and how to use it.  She struggles with it, often trying to carry it or use it backwards.  At least she is still getting around, although she put staff in a panic the other day when they found her walking without the walker.  She cannot learn new things and that is sad to observe.

*She is having more difficulty expressing herself.  She will point and start a sentence but cannot find words to state her question or concern.  She is aware of this difficulty and it frustrates her.

*She responds quickly and happily to anyone who walks by and says, “Hi, Pearl!”

*Swallowing pills is more of a challenge.

*She has her own wheelchair now for any time she wants to use it and for the future.  When I told her we were buying one, she said, “Good.  And then you can use it, too.”  Yep.

*At lunch she sits with three other folks who are quite verbal; not everyone there has dementia.  I enjoy sitting with them and chatting away.  We have a lot of laughs and Mom enjoys it.

*Mom’s short-term memory is kaput. She tries to cover up with “oh yeah,” but it seems clear that she cannot retain what recently happened or what was recently said.

*After Thanksgiving dinner yesterday, she started to sundown.  She kept asking what I was going to do and what she is supposed to do.  She could not remember that she has a room there, so we walked to the room and I showed her several of her things…side table, recliner, favorite knickknack, bathroom.  After returning to the loveseat in the living room, she asked again.  She had no memory of our walk down to her room.  We went again.  “I need to know what I’m supposed to be doing,” she said over and over.  We went back to her room and she decided it would be okay to sit in the recliner and watch The Hallmark Channel.  She remembered that channel.

Mom ER visit nov 2017 cracked rib

(one of her ER visits)

Each day when I am with her, I try to take in her presence…make her smile…share some laughs.  If she is agitated or in pain, I just sit with her and let her talk…acknowledge her difficulties.  And I am sad.  Going through this long grieving process is difficult, but for now, we can still talk to each other and have some golden moments.  I am grateful for her lucid times and I am grateful we are still creating memories.

 

About jjmummert

Just another voice in the wilderness from someone who's lived on this planet for over 70 years and faces permanent residency on Planet Elderly. Update: As of March 2, 2017, I turned 70. I'm now an official resident of Planet Elderly. Dad passed away September 22, 2016. In late March 2017 I was able to move Mom closer to me where she resided at a memory care assisted living community until being downsized to a skilled nursing senior community in October 2018 in Columbia, Missouri. I view the Parental Journal entries as part therapy, part family history, sort of a case study of our family's journey with dementia. It's quite an adventure. Recommended readings for others who have loved ones who live with some form of dementia: The 36-Hour Day; the website: https://www.agingcare.com/ ; https://www.alz.org/
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