BoomerChicks

Forgetful Moments or...CRS

RJ and I received an email this morning from his sister.  It contained this video.

We cracked up because this song is so close to home for the two of us.  I can't tell you how often we are looking for something or don't remember we should be somewhere.  In RJ's case his wallet, keys and glasses are on the top of his list. 

"Did you see my glasses?" he'll ask.

"No", I reply, "I don't wear them." 

"Well, you must have moved them.  They were laying right here." as he points to the coffee table. 

"Why am I responsible for your stuff?  I have enough to remember on my own without having to keep track of your life."

A stressful five minutes passes as we look for his glasses, complaining back and forth and playing the blame game. 

"They're hanging around your neck!" I cry out, after exhausting every possible place they could be.  RJ looks down and sure enough, there they are hanging from his neck on that stringy clip thing he bought so he would have them with him at all times. 

He puts them on, quite content now that he has found his eyes and moves on without saying a word.  I, on the other hand, have to put my two cents in.

"Yep, I took your glasses.  I hid them from you so you wouldn't find them.  Yep, that's what I did." 

I guess I am expecting some sort of apology or affirmation that he was the one who couldn't remember where he put his glasses!  After I complain that I was not the glass stealing culprit, his response goes something like this.  "Well, you are always moving stuff and putting things away so no one can find anything!"  It's the same scenario every time.  To add insult to injury, I have to then try and remember what I was doing before I was pulled away to look for his glasses!

It has been particularly challenging for the two of us now that we are on this "everything has its place" kick.  Yesterday, I found his screw driver in the laundry hamper. 

 "What the hell is this doing in with the laundry?" I asked him. 

 "I didn't put it there", he replied. 

"Of course you didn't!" I tell him.  "It just got up and jumped into the hamper by itself or may be it sprouted wings and crash landed in with the dirty clothes!  Put it where it belongs!"

For some reason everyone believes that it is the mama of the house that should know where everything is.  Now that I have been organinzing everything in clear plastic containers with labels on the front, I love it when someone asks me for something. 

"Where's the dog shampoo?" my son asks.  "In the clear plastic container marked DOG GROOMING SUPPLIES on the pet shelf", I sarcastically respond. 

"Stupid", he mutters under his breath.

"Huh, what?  I didn't hear you!" I laugh. 

It is daunting trying to remember not only your stuff, but everyone else's stuff.  As much as I write things down in my planner, I sometimes forget to look at that damn thing even as it stares at me from my desk.  I continue to have my own episodes of CSR which on occasion has resulted in near disaster.    

"Mom, the city is here to turn off the water", my daughter said the morning of my father's funeral.

"What! Why would they do that?" as I run down the stairs trying to put clothes on my half dressed body. 

"The water guy said you didn't pay the bill", she responds.  

"What bill?  Tell him he can't do this!"

I finally got outside and begged the orange vested city official to reconsider.  "We are having a reception here today after my father's funeral, I can't have no running water!" I tell him.  He hands me a paper and tells me to call so and so at the utility desk.  "She'll take a payment over the phone", he says.  "I'll wait while you get a confirmation number that the bill has been paid."

Thankfully, we had running water that day.  And, thankfully RJ's CSR has made it possible that he only remembered that incident for five minutes before it faded into the abyss of his brain.  It makes my life so much better that he can't throw it up in my face while we search for the umpteenth time for the glasses hanging around his neck!

Home Health Care Checklist

Since my Dad's homecoming from the hospital, I have had little time to do anything, let alone blog.  The experience of taking care of my Dad at home though has been rewarding, albeit, I will admit it is hard work.  More on that later, but I am happy to report that his condition seems to be improving. 

During these past nine days either I or my significant other have been running around from place to place, pharmacy to pharmacy, store to store to find the things that my Dad needs for his care.  We aren't alone, as we received a phone call from a friend today whose mother is now on home health care.  He told us that he was overwhelmed at how unprepared he was bringing his mother home explaining, "someone is always running out the door to pick something up that we had no idea we needed."  

For anyone considering home health care, below is a list of the things you will need prior to the patient coming home.  I have also included some helpful hints to get you started.  As I wrote in my previous post, there is little help or advice on how to provide a family member with quality home health care.  Be forewarned, don't depend on hospital staff or the case worker to help out!  I guarantee they will not provide you with a checklist like the one below. 

You can and should ask the case manager for the names of recommended companies who provide respite care, although I asked for recommendations last week and I have still not received a call back.  Respite care allows you the opportunity to break away from time to time to keep appointments or run errands.  This service is not covered by insurance so be sure to get all the fees and charges up front before you employ any service. 

Definitely stay calm, keep your sense of humor and have patience.  As the days go by, you become less anxious and a routine begins to take shape, making life much easier for you and your loved one.

Here's what you will need for a bedridden patient.

At least two sets of hospital bed sheets.

At least two large quilted pads to use as pull sheets.

At least three pillows that can be rolled to provide body support for turning and to put between the legs to avoid any chance of bone on bone contact.  You can also buy body rolls/tubes at medical supply/pharmacy shops. 

One to two packages of disposable underpads or Chux.

One to two packages of Depends.

At least two hospital gowns (make sure if an IV is involved that the gown snaps at the shoulders).

A bib large enough to cover the patient's entire chest and abdomen.  A towel works okay as well. 

Thick bed booties with Velcro closures to prevent ankle ulcerations. 

Non-skid slipper socks for getting abled patients out of bed and into a wheelchair.

Three basins for bathing -- one for soapy water, one for rinsing and one for shaving. 

A urinal.  They sell these for both men and women.  This is important if the patient is catheterized as you need to measure output. 

No Rinse Shampoo (found at beauty supply stores).

At least three to four packages of disposable oral swabs.  The care of the mouth is extremely important, especially for patients with dysphagia, on oxygen and those who breathe through their mouths.

Mouth rinse.  (Crest Pro-Health (alcohol free) oral rinse works wonders).

Moisturizing soap or body wash.

Deodorant.  Be sure to check with the doctor to see if patient can use deodorant first.

Body lotion.  (Nature's Gate Pomegranate Sunflower Skin Defense, sold at Whole Foods works wonders on bed ridden patients).  Also check with doctor on using lotions as some hinder things such as heart monitors.

Quilted cotton rounds to use behind the ears (around the tubing of the oxygen cannula) and Q-Tips. 

Razor, shaving cream and blades.

Hair brush/comb.

Fingernail clippers and brush.

At least two boxes of latex, powder-free gloves.  You will use lots of these!

A laundry bag.

Lots and lots of pre-moistened wash cloths and wipes.  Those labeled "real fabric" and "oversized" work the best. 

Vaseline to use as a moisture barrier for any skin ulcerations or decubitus sores until the doctor writes a prescription for medication.  Do not use on the face or lips. 

Chapstick.

An Accu-Chek, depending on the patient's diagnosis.  Even if the patient is not diabetic, certain medications warrant blood sugar testing.  Ask your doctor if your family member will require testing. 

A hard plastic hazardous waste disposal with a tight fitting lid for needles and syringes. 

A supply of various batteries for any monitors or other equipment that the patient may require. 

Thick It or any other food thickener for patients requiring a pureed diet.  You can find various thickening products and foods online or you can buy the Thick It at Rite Aid. 

Protein powder and Ensure to make certain the patient is receiving enough nutrients. 

Stock up on bottled water, juices and applesauce. 

A high powered blender/food processor to puree foods.

Keep a box of straws on hand and use only when the patient is able to drink from a straw.

Lots of storage bins, boxes or baskets and label everything.  If you are not organized, it creates chaos, especially when home health care professionals or other family members are looking for items to care for the patient. 

Make yourself a daily schedule and post it.  Learn what medications should not be mixed or taken at the same time.  Learn which meds should be taken with or without food and plan accordingly.  Include turning times, oral care, meals, meds, bathing, nursing visits, hydration, catheter care, etc.  Document everything as you will be asked a lot of questions.  How much fluid did the patient take?  What was the urine output measurement?  How many teaspoons of food did the patient eat?  If the patient has to be taken to an emergency room and you have kept accurate daily schedules, you will provide the treating physician with valuable information.

Keep an accordion folder to store all paperwork, insurance papers, business cards, phone numbers, receipt of supplies, daily schedules, equipment manuals, anything important to the patient's care.

Try to find out ahead of time what prescriptions need to be filled.  Some doctors write prescriptions for liquid meds for patients with swallowing difficulties.  These meds are difficult to find outside of hospitals and need to be ordered.  This can take up to three days creating a problem when the patient needs to immediately start medications.  

Keep lots of disposable anti-bacterial Clorox wipes around to clean counters, bed rails, equipment, etc.  Patients are highly susceptible to infection so it is imperative to keep everything as sterile as possible.   

A back support/brace for yourself. 

The Homecoming

When children come into this world, we celebrate.  We throw baby showers for the new parents providing them with all the necessities for taking care of their new baby.  We provide help to the new mom and she can even enroll in parenting classes and "how to" courses.  Usually the most difficult decisions are what to name the little one and what paint colors to use to breathe life into the nursery.  There is much excitement and preparation as we welcome the new life into the world. 

It is a far different story when one's body begins to break down and we begin a different journey, end of life issues.

My father underwent surgery on November 4th for a shunt placement to alleviate the "water on his brain" -- medical term is hydrocephalus.  Although he is 82 years old, he was looking forward to this surgery because he was having a great deal of trouble walking, and had even experienced a couple of falls.  He wanted the ability to walk safely again in the worse way.  

While in the hospital, my Dad suffered a massive basal ganglia bleed and about a month later, two more bleeds in the frontal area of the brain.  He fought through aspiration pneumonia, dysphagia, ICU stays and at one point, hospice with a morphine drip.  His condition waxed and waned, a journey of highs and lows that kept my family on an emotional roller coaster. 

During this period of standing by a family member in a critical state, you also get to experience the drama of our health care system.  You get to witness first hand how cost has overtaken care, while trying to wade through hundreds of rules and regulations as you attempt to make sense of it all.  Everything, and I mean everything, is broken down by specialty and outsourcing.  There is no one central person you can talk to who coordinates this merry-go-round of health care either, that is your job.  At various times throughout my Dad's stay, I had to demand his chart in order to figure out what in the hell was going on.  I am convinced that the various doctors, therapists, technicians, case workers, and nurses who write in a patient's chart do not read each other's documentation. 

After 45 days in two different hospitals, the decision on where to "put" my Dad, based on the rules and regulations, was sprung on me quite unexpectedly.  While I had discussed options with various health professionals, it came as a surprise one day when I was told, "okay, he has to leave."  My options were a skilled nursing facility (the fancy term for a urine infested hell hole) or home discharge.  There was no doubt in my mind, I would take my Dad home. 

My father was delivered by ambulance on a Friday afternoon, December 19th to be exact.  He arrived wrapped in the fitted bed sheet that was on his hospital bed.  I ran out to meet the ambulance and found my Dad jabbering away.  He knew he was home although it was difficult to understand his exact words.  The only equipment and supplies that had arrived were a hospital bed, a wheelchair and the oxygen he required.  There were two nurses present; a home health care RN and a transport RN, along with two EMTs. 

The transport nurse was upset as she relayed to the home health nurse that the hospital gave her no history on my Dad.   She had a single piece of paper in her hand with three prescriptions written on it and said, "this is all they gave me."  She further reported that she had to request the chart and take her own notes to get the information she required on my Dad.  Both nurses were shocked to find that my Dad did not have a pick line in his arm, only two peripheral IV sites, one in each hand.  This apparently is a disaster for a patient who requires TPN.  I explained to the nurses that my father had indeed had a pick line in the hospital.  Since those lines last for up to a year, they were dumbfounded as to why it was removed.  Peripheral lines require a new "poke" every three days, not exactly fun when your hands are already raw, sore and swollen. 

Nevertheless we proceeded with the ritual of getting my Dad settled in.  The supply company arrived with syringes, a blood sugar testing kit, plastic tubing, alcohol wipes, gloves, insulin, saline, and TPN.  There was nothing else to care for my Dad.  I began to scramble for things that he needed like bed sheets, gowns, and later as time went on, I managed to scrounge up other essentials.  Of course, you don't know what you need until you need it!  Wouldn't it be great if there was such a thing as instruction courses for taking care of an elderly parent, or even such a thing as "geriatric" home health care showers.  But, there is nothing, not even a checklist, even when you ask for one.  Our health care system seems to think that family members all have medical degrees and we will know exactly what to do. 

When everyone had left, I stood by my Dad and thought to myself, "this is the scariest thing I have ever done in my life."  As anxious and nervous as I was though, I knew it was the right thing to do. 

Back in the "Olden Days"

A little girl, I'd guess around five years old, asked me today in the grocery store what it was like in the olden days?  I cracked up!  I remember asking my elders that question a few years back.  8 -)

 Here's the best way I can explain what it was like in the olden days! 

More Waste in our Health Care System

Another day, another trip to the doctor's office with my Dad.  This time he saw a cardiologist to get a "medical clearance" for his surgery that was supposed to have taken place yesterday. 

As noted in my previous post, Speaking of Jobs..., it was a real merry-go-round trying to figure out who was to give my Dad his "medical clearance" for surgery.  Today, while he was at the cardiologist's office, he was told to take his shirt off so they could do an EKG.  I mentioned that he just had one as part of his pre-op evaluation.  The nurse indicated that she would call the hospital and have them fax over a copy.

A few minutes later the nurse returned.  The hospital has no record of my Dad!  (I should note that my Dad has had three admissions to this hospital since 2003).  They have someone else by his name, but the birthdates don't match, and there is absolutely no record of an EKG!  He had blood work, x-rays and an EKG less than a week ago!  Poof, he's gone!  I couldn't believe what I was hearing.  So up on the table Dad went to undergo yet another EKG. 

I will be very curious to see how many EKGs are billed to my Dad's insurance.  They may have lost the records, but I seriously doubt if they lost the billing information.  And, does this mean another pre-op evaluation?  Sheesh!

How's Norma?

I received an email just a short while ago from my cousin with this little (true) story.

A sweet grandmother telephoned St. Joseph's Hospital.  She timidly asked, "Is it possible to speak to someone who can tell me how a patient is doing?"

The operator said, "I'll be glad to help, dear.  What's the name and room number?"  The grandmother in her weak tremulous voice said, "Norma Findlay, Room 302."

The operator replied, "Let me place you on hold while I check with her nurse."  After a few minutes the operator returned to the phone and said, "Oh, I have good news, her nurse just told me that Norma is doing very well.  Her blood pressure is fine; her blood work just came back as normal and her physician, Dr. Cohen, has scheduled her to be discharged on Tuesday."

The grandmother said, "Thank you.  That's wonderful!  I was so worried!  God bless you for the good news."

The operator replied, "You're more than welcome.  Is Norma your daughter?"

The grandmother said, "No, I'm Norma Findlay in 302.  No one tells me shit."

My cousin added a comment: "OMG, I don't know whether to LMAO or start crying.  What a pathetic display of our health care system."

Given the day I have had (see Speaking of Jobs... below), I certainly relate.  I know she can as well, as my aunt, her mom, is currently hospitalized and facing the challenges of the health care system.  My family has a few words for our health care system -- hote vrit!  (You will only understand that if you are of Croatian ancestry and can pronounce it phonetically.  I have no idea how to spell it).

Speaking of Jobs...

My father is having brain surgery which is scheduled for tomorrow, October 28th.  I have to have him at the hospital at 6:00 a.m. 

The surgery was scheduled by his neurosurgeon who informed me that I need to get a medical clearance from his primary care physician.  He wrote this on an envelope with his office fax number and told me to have the primary care physician fax it over to him.  This was last Wednesday. 

Upon calling the primary care physician, I was told that the neurosurgeon had to request this.  I called the neurosurgeon's office back and told the staff member who answered the phone.  Actually she told me before I could finish blurtting out the other doctor's instructions.  After I hung up, I thought, if the neurosurgeon's office knew this already why did they ask me to get involved. 

Knowing how things "slip through the cracks", I have been following up with both doctors' offices to ensure that this clearance is complete.  It is now the day before the surgery and still the proper clearance has not been completed and faxed over to the neurosurgeon.  I have spent the better part of my day making phone calls trying to get this done. 

The last phone call I made, the primary care physician's office stated that they just received the request from the neurosurgeon today.  Really?  I was then told that the medical clearance has to come from a cardiologist.  Well that doesn't help matters since the cardiologist my father last saw is on a road trip in Ohio! 

I finally asked to speak with the office manager for the primary care physician's office.  Over the years I have come to know her well.  I reminded her that she knows my Dad and she knows what kind of reaction he is going to have to all of this, not to mention my reaction.  Since when have I been hired to become the coordinator in this endeavor?  Please, put me on the payroll if that is the case. 

The office manager said she would call me back in fifteen minutes.  At this point it looks like my Dad will have to postpone his surgery which isn't going to go over very well, given that his anxiety level is already a 10!

True to her word, I received a call back from the office manager who said that my Dad definitely has to be cleared by the cardiologist and she has made an appointment to see his partner on Wednesday at 10:00 a.m.  So it looks like it is a definite, no surgery tomorrow.  Now for the hard part...explaining this to my Dad!

Don't you just love managed care? 

We Think We Never Change!

Have you ever been quilty of looking at others your own age and thinking, "surely I can't look that old?"  Of course you have.  We all have an ego!  Well, you'll love this one as told by a woman named Alice Smith!  (Surely a fictitious name!).

My name is Alice Smith and I was sitting in the waiting room for my first appointment with a new dentist when I noticed his DDS diploma on the wall which bore his name.

Suddenly, I remembered a tall, handsome, dark-haired boy, with the same name, had been in my high school class some 30-odd years ago.

Could he be the same guy that I had a secret crush on, way back then?  Upon seeing him, however, I quickly discarded any such thought.

This balding, gray-haired man with the deeply lined face was way too old to have been my classmate.  After he examined my teeth, I asked him if he had attended Fairview HIgh School.

"Yes, yes I did.  I'm a Bulldog," he gleamed with pride.

"When did you graduate?" I asked.

He answered, "in 1975.  Why do you ask?"

"You were in my class!", I exclaimed.

He looked at me closely.  Then that ugly, old, bald, wrinkled, fat ass, gray-haired, decrepit, son-of-a-bitch asked, "what did you teach?"

The Ice Cream Man

My neighborhood still has the friendly ice cream man.  He cruises our street at least twice a day.  It must be a profitable demographic for him.  Well today he got a new customer, my Dad.

It's a beautiful day today and my 82-year-old father is sitting out on the porch, the three dogs content and happy, laying next to his chair.  Suddenly I hear, "Daughter, do you want an ice cream?"  I chuckle as I hear the music from the ice cream truck in the background and say, "no, do you want one?"  By the time I get out on the porch to see if my Dad wants me to get him an ice cream, the truck has circled the cul-de-sac and is one house past mine.  I yell, "stop" which he so politely does. 

I ask my Dad what he wants and he answers "butterscotch".  In the meantime Dad is yelling to RJ, "hey, do you want an ice cream?"  He's not really in the mood for ice cream either and declines.  I insist that RJ accompany me to the truck.  Upon crossing the street, we come face-to-face with a giant picture menu of ice cream goodies plastered to the side of the truck.  No butterscotch, in fact the vendor had never heard of butterscotch.  I step out from the truck and yell to my Dad that there is no butterscotch.  He is slowly walking across the street, cane in hand, to see for himself.  He's grumbling. 

Once in front of the menu, my Dad can only see one choice, a Bomb pop, and begins to grumble again that there is only one kind.  I remind him that all the pictures on the side of the truck are choices he can make.  While he is looking, he insists that we get one too.  Okay, RJ chooses a Chocolate Taco and I pick the Sundae Crunch.  Pops is still perusing the menu.  Finally he zeros in on a Mississippi Mudd ice cream sandwhich.  I knew my Dad wouldn't like it because it has nuts in it.  I tell him. 

My Dad points to the picture, looks up at the vendor and says, "does this one have nuts?" 

"Yes, it does", says the vendor.

"I don't want that", my Dad replies.  "I've got two of them I can't use now." 

We cringe, but seriously we can't help but laugh, as our faces turn beet red.  Fortunately the ice cream man doesn't seem to understand my father's reference.  He finally settles on the Giant Ice Cream Sandwhich.  The man says, "that will be $4.50", which my Dad can't hear and cupping his hand to his ear, he is saying, "huh?"  RJ hands the man the exact amount, grabs the ice cream and peels out.  I tell my Dad that RJ has paid, let's go. 

As we are walking back across the street, my Dad is asking, "how much did this cost?"  I tell him and he begins to grumble about it being too much money and they didn't even have butterscotch. 

All three of us sit on the porch to eat our ice cream.  As I am eating mine, my Dad hollers, "how come you got nuts on yours?"  I tell him that it is a cake crumb coating.  This seems to intrigue him because he hears "tape" instead of "cake" and says, "oh my God, how can you eat that?"  We go into a five minute session of tape vs. cake until I finally spell it...C-A-K-E.  "Oh, oh, I thought you said tape!" 

Now remember my Dad ordered the GIANT ice cream sandwhich, and as he is munching away at it, he says, "damn, this is a honker, it has no end."  I am quite frankly surprised that he can eat any of it.  He had a big pancake and fruit breakfast, a meat loaf sandwhich for lunch with a slice of peach pie and after finishing this "honker" ice cream, he asked, "what's for dinner?"

The Pesky Chin Hair

I never imagined that one day I would do battle with a hair.  That's right, a hair!  This particular hair is not on the top of my head either.  It is an annoying little stubble that grows on the right side of my chin.

I first encountered the chin hair phenomenon about eight years ago.  While participating in a routine meeting at work, I caught the glimpse of one of my coworker's profiles.  Lo and behond, she had this twisty little "thing" hanging off of her chin.  (It was long enough that it hung in a three spiral formation).  I told her she had a thread hanging off of her face.  It's a good thing we were friends because she snapped back that it wasn't a thread but a hair!  I was intrigued.

Thinking that I would be doing her a favor, I reached into my desk drawer, grabbed my scissors and snipped it.  Of course, we all started to laugh and we proceeded to have a lengthy conversation about the perils of menopause and aging.  We made ourselves feel better by comparing the female chin hairs to the male's pesky nose hairs, or worse yet, those hairs that grow out of their ears.

Well paybacks are a bitch.

My own little chin hair surfaced about five years ago.  I never really took notice of it until one day I was scratching my chin, and there it was.  It was long and soft, and I guess if I can be thankful for anything, it was at least blonde.  Upon further inspection though I was mortified that despite its blondeness, certain profile views revealed it in all of its glory.  In the sunlight it was especially visible and hung off of my face like a windsock blowing in a summer breeze!

I was not in a particularly good place either upon this discovery.  I too was at work.  Panic set in.  Dear God, what should I do?  How long had it been there?  Not wanting to be seen like this, I recalled the scenario several years earlier with my coworker friend.  I grabbed my scissors out of my desk drawer and snipped it as short as I could without doing myself bodily harm.

Since that day, I have tried everything imaginable to make my pesky little chin hair die.  Waxing, shaving, plucking and applying hair removal products have not been successful.  Although I am determined to rid myself of this creature, I have managed to name the hair.  Appropriately I refer to it as Harriet.  This was a mistake as Harriet now thinks she is my new BGF.  She doesn't like to be away from me for more than 24 hours.  I'll whack her and the next day she is gingerly peeping out from beneath my outer dermis layer with a happy little, "hello, I'm back."

Now I have done battle with pesky little annoyances in the past.  The infamous teenage "zit" that appears just under your nose prior to an important big event.  A hot wash cloth combined with some acne cream and victory was mine.  If it left a little mark, it could easily be concealed with a little foundation.  But the hair, the hair is a menace.  Have you ever tried to cover a hair with foundation?  At first you achieve a nice smooth "lay down" result but then it suddenly springs up like a flag pole on the 4th of July.

I asked around for advice.  Of course, I only sought out trusted friends, particularly those that I thought might be experiencing this menopausal phenomenon as well.  "Do you have chin hairs?", I would ask.  "Did you make them go away?"  Some have been lucky...their Harriet disappeared after the second or third pluck.

I have tried to sweet talk Harriet.  I have suggested that she relocate, like to the top of my head where she would have lots of friends.  But, Harriet is a loner, a clingy friend who does not want to share me.  I suppose for that I should be grateful and pray that Harriet won't someday change her mind.  Pray that she won't decide to eventually throw a party, making me the next bearded lady in the circus.