Salt and Predilection

The advertising phrase "When it rains, it pours" has been around almost 100 years, signifying Morton's Salt will not succumb to the elements of humid or damp weather. The words of the ad are, in turn, used more than the original proverb "It never rains, but it pours" to signify how troubles seem to occur in excess. If salt clumps in a shaker, a few grains of rice added to the non-Morton's salt can remedy the problem.  A few grains of salt, however, can perhaps remedy the excess of troubles.
Mom, who lives in a skilled care facility, called me the other day asking if I had any rice and could she have a couple of tablespoons. The salt had clumped up in the shaker at her usual table in the community dining room, and she thought she would add a few grains of rice to all the shakers. I told her I'd bring some rice, but after giving the issue thought, realized the simplest solution was to ask the staff for a different shaker.
On my next visit, I explained to Mom that bringing in rice from an outside source is not considered sanitary, would be a health code violation, and that all she needs to do is ask for a replacement.  She acknowledged I was probably right.
Rather than focus on her own needs and ask for help when she needs it, Mom prefers to fix everyone else's problems. While this seems altruistic, her contrived notions of healing the world, or at least all the problems - real or imagined - on her wing of the facility, leaves me with the task of negotiating with her. Even though she may understand my logic at the time, she later will comment on how I won't let her do what she wants.
In dealing with the salt issue, I found irony in how I often am dealing with multiple "Mom" issues, hence, when it rains it pours. Yet, if I take the troubles or Mom's antics with a grain of salt, I find them much easier to handle.
Even more intriguing are the salt related idioms that can apply to caregivers:
Rub salt in a wound - Often felt when the one in our care points out any deficits in the care we give.
Salt of the earth - The humble caregiver who needs to recognize his or her own value.

Writing ... again

Starting this blog was something I wanted to do for myself as well as to share insight with others. Unfortunately, when my mother discovered my blog, and I found myself defending my posts, I set my efforts on the proverbial back burner. 

Mom's situation has changed, and though she is still living, she is less likely to stumble on my musings. Too many times, I've said, "I need to write this down," and didn't.  So, armed with fodder and feeling somewhat autonomous, I am going to fluff up the pillows in my imaginary window and write.

The return

When I started this blog, I didn't tell my mother about it because I knew she'd think I was writing her life's story. I hoped that she'd not find it, and knew that there was nothing to be ashamed of if she did. Still, when she did discover it, I brushed it off nonchalantly while feeling like a teenager caught with porn under the mattress.
I took a hiatus, but feel drawn to writing about the issues surrounding the aging process, the fears and hopes I have, and the number of wonderful stories shared by various people I have worked with and friends I have known. So, I'm back - and Mom - if you read this, I love you!
Speaking of mom, I have mentioned before that I had high hopes for her retirement years, yet she has withstood so many setbacks. It seems that when she is just recuperating, she gets hit by another malady.
During the last quarter of 2009, she was able to get long overdue physical therapy to help her gain strength and balance for fall prevention. She diligently worked out three times a week with a therapist in the fitness room of her independent living center. Her sessions ended in January, but the benefit was remarkable. Mom felt the best she has felt in almost two years; her balance was better; she even has shoes that help her balance, are comfy, and attractive.
Then she was hit with a bout of bronchitis. A round with a Z-Pak helped, though the cough lingered. Mom complained about her breathing, but I never really made a connection. I attributed the problems to weather, overexertion, and other issues. Kudos to mom for taking the initiative to make an appointment with her lung specialist. Fortunately they had a cancellation and were able to see her quickly. During her visit, the doctor declared Mom had "extreme bronchitis" and took a chest x-ray. She was put on a stronger antibiotic and steroids. The next day, the doctor's office called and confirmed: mom has pneumonia.
I was kicking myself for not picking up on the symptoms sooner, but thanks to my sister for reassuring me that I did nothing wrong. Still, it's hard not to beat myself up for not being at mom's more. I think about things I could do to be more in tune. I envision writing everything down on a calendar so that I have a visual map of mom's complaints, medication changes, doctor's appointments, falls, dietary intake -perhaps even have her record her output and the dog's stats as well! While that is hardly realistic, I am plagued with "what ifs" and "should haves."
At the same time, I admire mom's perseverance. She feels like crap, but she keeps trying. She's a fighter; she has her own goals, things she wants to accomplish, and activities she enjoys. Today, my son and I went to mom's with pizza and the movie "G-Force." Mom wanted to see the flick when it was in the theatres, but we never could seem to find time to get there. I was determined she'd see it, so I rented it.
The movie and pizza were good - the time with mom was priceless.

Define Caregiver

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Anyone with an ounce of humility often scoffs when called a caregiver. "I am only doing what I am supposed to do," or "I love my (parent, child, spouse), so of course I'm going to do what I can" are the typical responses. So how does one know if he or she is a caregiver?
Definitions vary, but the common thread is, if you are caring for someone in some way, that aids in their well-being, you are a caregiver. Assistance may come from near or far, may be done in your home or the loved one's home, may be provided 24/7 or only on occasion.
Care usually involves helping a person with tasks that are typically done independently. Tasks can range from checking in by phone, running errands or shopping to cooking, cleaning, handling documents and bills, or aiding in day-to-day physical care needs. The amount of time and tasks done related to caregiving are as varied as each individual.
Caregivers vary in age depending on who they help. A child may actually take on the responsibility of seeing that a parent with mental illness, alcoholism or drug addiction receives necessary care. A parent may have to care for needs of a physically challenged child. An adult may check in on a neighbor regularly by carrying mail or a newspaper to the door. Others may care for an aging parent by ensuring the environment is safe and that the parent is cared for in his or her own home or some level of facility care.
Regardless of your caregiving status, take pride in knowing that you are not just doing what you are supposed to do. Accepting the title of "caregiver" doesn't mean you do something because you have to; you do it because you love the other person.

Martyrdom

In caring for the people we love, caregivers will fall into self-destructive behaviors. We exhaust ourselves from stress, worry and overexertion, or we feel guilty for being angry, tired, and not doing a "better job." In between the excessive anxiety, we sandwich in work, children, grandchildren, maintaining our homes, or stress because we aren't able to coordinate all these things. We don't eat right, we don't sleep well, we don't go to the doctor when we should because we already spend time there with our loved ones. The guilt and pressure are unending, yet we drag them around like we are loaded jackasses.

I certainly do not claim to have the magic answers, but there are a few things that I try to remember, making the burden a bit lighter.

1) Take care of thyself FIRST. If the caregiver gets sick, the house of cards falls. Eat right to keep up your energy, nutrients, and avoid headaches! Rest or your body WILL wear out. Get medical attention when needed. An ounce of prevention is truly worth a pound of cure.

2) Breathe! When we stress, our breathing becomes shallow, our muscles tense up, we get headaches, and our thinking clouds. Five minutes on the deck, backyard, or in a favorite corner can be an oasis when the soul needs rest. Take a deep breath in through the nose, exhale slowly out the mouth.

3) While breathing, stretch a minute. Stand or sit up straight, lift your shoulders towards your ears, relax; lift again. Now, roll your shoulders in a circle, rotate forward a few times, then backward. Make a fist and then stretch out your fingers. Repeat several times. Look straight ahead and bring your chin to your chest - feel the stretch down your neck and spine. Bring your head up, tilt your right ear towards the right shoulder, then the left ear to the left shoulder. All movements should be slow and painless.

4) Take responsibility for your own feelings. This may be hard to believe, but it is true: No one "makes" you feel like you do. Reactions are learned and we can unlearn them. Do not allow your loved one to manipulate your own behavior. By taking a step back, and viewing a situation objectively, we are less likely to lose our tempers or become upset. When a child throws a tantrum, the parent can get angry, or be matter-of-fact. Generally, by the parent being in control, the child calms down. The same is true for those we care for. (I did NOT say treat them like children - the issue is about the caregiver's behavior!).

5) Don't be a martyr. There's a saying, "Get off the cross, someone else needs the wood." No one expects a caregiver to be a robot or to be perfect. Life is still happening and you have every right to be a part of it. Everything does not have to be done perfectly; if you are anal about how things are done, admit it, and get out of the way when others try to help! I have learned to close my eyes and be thankful that I have help. I have even said, "It's my problem, not yours, so I will leave you alone - call me if you need me."

6) Ask for help; share the load! If a friend says, "tell me what I can do," take him or her up on the offer. Can the friend stay for an hour while you pamper yourself with a bubble bath? Maybe she will do your laundry or cook a meal - even just having someone help fold towels one day makes the burden lighter. If they haven't offered to help in a while - ask anyway!

7) Even far away family members can help. My sister lives 700 miles away and said, "If I can ever do anything ..." I've held her to it, and she has come through! When mom was selling her home, I was overwhelmed with other issues like taking her to various medical appointments, tying up lose ends at the house, and filing my father's will with the local courthouse. My sister has worked for attorneys and real estate agents, so when questions arose about negotiating the best offer, I called Deborah and said, "Handle this!" She made the calls, gathered information, and clarified points that mom had misunderstood from the real estate agent. Together, the three of us were able to make sound decisions in selling mom's home, and the stress was off of me. My sister was pleased that I included her, and actually needed her. Deborah also makes an extra effort to call mom regularly, and, thankfully, backs me up when mom complains about my being bossy!

8) Don't lose yourself in the process. We get so overwhelmed at times that we become machines. We will never have regrets if we don't vacuum the floor or leave a few dishes in the sink. We will regret the times we didn't sit and have a good laugh with our loved ones, or didn't take time to share stories, read, or see a good movie together.

9) AARP has great resources for caregivers. Spend some time at their website.

10) Take time for you! It is possible if you follow a few of the steps above. By taking time for you, you will feel better and can be a better caretaker for yourself and the one you love.

Snow Storm Elicits Flurry of Thoughts

Mom called this afternoon to be sure I arrived home safely from work. Snow had begun to blanket the east coast and roads in our hometown were being closed. She then began to relay her upheavals because of the weather.

In her retirement community, there is a community dining room that offers lunch and dinner. Normally she drives the short distance there, either in her car or on a golf cart. Just recently, the facility started offering shuttle service for the cottage residents. In order to send the staff home before getting snowed in, the dining room served a buffet today and everyone was asked to come during the lunch service time. Mom took the shuttle over to the main building and a friend wondered why Mom didn't drive. Mom said, "If I drove and had an accident in this weather, my family would kill me!" The friend said, "Oh, I'm sure if you had an accident, your family would just be happy that you were alright. They wouldn't be concerned about a wreck in this weather." Mom replied, "You don't know my family!" Mom knows us too well.

As our conversation continued, Mom began to lament some of the items lost in downsizing to her smaller home. "You know, I don't have any candles or matches," she complained. I reminded her that I bought her flameless candles - she is on oxygen and is not supposed to have an open flame nearby. "But if the power goes out in this storm, I will need candles and matches!" I decided to give into the argument, rather than have an aneurysm over a non-issue. "I am sure that if such an emergency occurred, you could call security and one of those guys would bring you a match." Mom replied: "Oh, that's okay, I already got some matches." One of her neighbors apparently produced the incendiary devices. Now, I wonder, what would she burn?

She also was concerned about the lack of heat if there were a widespread power outage.

"MOM - that's why you are living on the retirement campus!" I said. "If the power goes out, they will make sure you are taken care of. You will not go without heat, food, or light!"

I am not sure of the exact procedure, but I assured her they would, at the very least, take her to the main building. She agreed, and then worried about her cockatiel. "I can take Missy (the dog) with me to the other building, but I can't take Mickey." Her rendition of the storm began to resemble scenes from "The Day after Tomorrow." I suggested she cover the cage to keep the damn bird warm and he'd be fine for 24 hours alone. We live in the south - snow doesn't survive well here. Al Gore has not declared a national emergency, and while I am concerned about global warming, I don't think we've reached the Apocalypse - yet.

She then began discussing Missy's reaction to the snow, and how, when the dog squatted to pee, she bounced back up because the snow was freezing her butt.

As if there wasn't enough for mom to be concerned with on a normal day, the snow has brought it's own blizzard of mental diversions. I, in the meantime, should step out on the back deck and "chill."

Behavior Modification

Raising children is exhausting because a parent constantly monitors kids' behaviors in an effort to keep them safe and healthy. One can never be completely braced for the transition that occurs when she turns monitoring away from her children, towards an aging parent. The similarities are remarkable, yet there is still the revere that is held towards elders.

When my own children were growing up, I remember learning that, when given choices, kids feel more autonomous. Instead of issuing a direct order, "Eat your vegetables," offer alternatives, "Would you rather eat all of the carrots, or eat half the carrots and half the peas?" I tried, but it got tiresome. Eventually, I resorted to telling the kids, "Okay, you have a choice: Clean your room OR I'll beat your ass ,and you still have to clean your room." My children grew to understand, if not appreciate, my warped sense of humor.

Years later, my mother was having her own battles with her father. He was always a strong-willed man with a commanding presence, and mom never broke loose from his control. Even as a woman over the age of 70, she constantly sought approval from him, and was hurt by his lack of appreciation for her extraordinary efforts. Yet, she never gave up.

After he fell and broke a hip, he moved into my parents' home. He recouperated well for a 96-year-old man, and was able to walk and climb stairs. A year later, he fell out of bed in the middle of the night, and injured his other hip. Mom called for an ambulance; the technicians were able to get my grandfather back in bed, but he refused to go to the hospital. The next day, mom called me at work. She was concerned because he had a huge bruise on his lower back, he couldn't move without pain, and he certainly couldn't get out of bed. I said, "Well, he might not like it, but call the ambulance anyway!" Mom was fearful that her father would be mad at her. She was just as scared as he was stubborn.

I left work, drove to mom's, and went straight up to see my grandfather. "Hey there," I said. "I hear you have fallen and you can't get up!" He laughed, "Yeah, well, I'll be alright." I sat on the bed next to him and held his hand. "Papa, that's the problem - we don't think you'll be alright if you stay here." I began to outline the impending doom. "If you lay in this bed, you will not get better. Your joints will stiffen up. You have a terrible bruise, the size of a dinner plate, that could cause a clot to go to your lungs or heart. When you don't move, your lungs do not work as well. They will fill up with fluid; it will get infected; you will then have pneumonia, and at your age you WILL die." My grandfather cut his eyes at me, but managed a skeptical smile. I explained that we could not take him to the doctor to be checked because he could not walk down the stairs, and we certainly couldn't carry him. Even if we did manage to get him to the car, he couldn't sit. The only option was to call an ambulance. "Papa, laying here and dying is not an option," I said. "Mom doesn't want you to be mad at her, so I have come to negotiate." He laughed. I went in for the bottom line offer: "We are going to call an ambulance. Period. You can like it, or not, but it would be nice if you'd cooperate and agree to us calling them."

"Well," he said, "If you put it like that ... yeah, I guess you may as well call them."

I felt like I had been through NATO negotiations.

When the ambulance arrived, they had to call for back-up from the local fire department. The stretcher couldn't be negotiated around the steps and carrying my grandfather with a bedsheet was going to take extra hands. My personal thrill came when four muscle-bound men walked through the front door - Greensboro's finest I fondly dubbed Mr. January, Mr. February, Mr. March, and Mr. April ... but I digress. My point is, to reduce the chances of impending insanity, I look for a silver lining whenever possible. Mom, dad, and I stood in the foyer while these young bucks strode up the stairs. I didn't hesitate. "Wow, Mom," I said, "Who knew that when we got up this morning, we'd have this great eye candy to consume today!" The men blushed, and mom laughed. She earned it.

My grandfather passed away almost two years ago, and now I find myself in similar situations with mom. No longer am I the mediator; instead, I am in the authority of reason. Mom thinks I am a dictator. More on our adventures later ...

(Photo: My grandfather holding my granddaughter - his great-great-granddaughter, September 2007. He was 98; she was a few weeks old)