I've adopted....an 84 year old man....

As I write this, my 84 year old Dad is asleep on the futon in the living room which has become his bedroom. My 11 year old is at dance class.  My 9 year old is watching a movie, and my 7 year old is playing Star Wars on the Wii.  My husband is at work, and here I sit. I quit my full time job as a home health nurse back in June to spend more time with my parents as they seemed to be going down hill.  It was a good decision, and one I am thankful I was able to make. I don't know how I could have worked full time and taken care of them.

It was a bumpy night.  The kids slept fine, and my husband got a good night's sleep in our bedroom, but I slept on the couch next to Dad, and during the night, he had many hallucinations and frightening dreams that could only be soothed with a pain pill, a back scratch and a head rub.  With a house full of kids, it's a blessing that he can't hear very well, but it would be nice sometimes if he had more moments where he at least seemed to hear me.  I'll say things like, "I'm your daughter.  You're my Daddy.  Today is July 11, 2012."  He is good at pseudo listening, but I've learned that he really doesn't remember past a few minutes, but can remember being on maneuvers as an 82nd Airborne paratrooper back in the 1950's in North Carolina.  He talks about that a lot.

We've had quite a few bumpy nights with my Dad this summer.  My Mom passed away on June 28th.  She had become incapacitated over the last few months because she had a lung infection and decided to stop taking the antibiotics for it because she was convinced they wouldn't work.  We convinced her to finally go back into the hospital to get some pain relief.  She died two days later, but felt no pain as she passed.  My sister and I were with her.  I know she is happy now.  But Dad is still tormented, and his vascular dementia has progressed to the point where we really don't know how it will all end.  I know it is in in God's hands, and that gives me hope.  Without that, I would be depressed and on anti depressants myself.

Which brings me to why I decided to write this blog.  Dad had been on anti depressants for 15 years till one day, last October, he decided to stop taking his antidepressants cold turkey which everybody knows is a dumb idea.  He never really got back to a normal level of function after that decision. His brain chemistry had now been altered.  Now, the man who had been so wise, practical and logical with everything from money to dealing with people had now started to show the first signs of dementia which is a terrible disease.

I'm now living the results of his decision because what we have found out about Assisted Living Facilities (ALF), Skilled Nursing Facilities (SNF) and other elder care issues has been enlightening, and a friend of mine suggested I share that information.  I will have to preface it with this statement though:  I am only reporting my experience.  I have no ties to any company, and I don't even have any ill feeling towards any of these organizations.  I do believe that somehow the almighty dollar has created a problem for the elderly which should be eye opening and terrifying to everyone.

First of all, we discovered that there are places for people like my Dad.  Since right now, he is still semi ambulatory and is able to feed himself, he could go to a Skilled Care Assisted Living Facility or "SCALF" where for $3950/month, they would provide food, lodging and scheduled activities.  For an additional $450/month, they would even give him his medicines (which of course would have an additional fee for each medicine), but if he got a boo boo or needed some kind of nursing care, they would call home health.  I know that because I used to visit patients who lived there. Apparently, band aids would be extra...as would shaving or hair cuts, but they would give him a bath 2 days a week. How lovely. Other costs he might incur would be any kind of damages or things he broke which is of course understandable, but a few weeks ago, before they got his anti psychotic medication leveled out, he took a hammer to his bathroom door because he was convinced it needed to come off.   HOWEVER, the biggest eye opener to the Assisted Living Facility racket is this: If he should wander at night into someone else's room, we would be required to hire sitters (at $16.20/hr) to sit with him at night or we would have to sit with him or he would be asked to leave. This defeats the purpose of having him in a facility which could charge at least $4400/month.

Why not a traditional nursing home you ask?  Well, we actually tried that.  The doctor told us that we could admit him to the hospital for 3 days, then Medicare would pay for 20 days of SNF and he could be admitted to a locked memory care unit.  After that, Medicare would pay for 80% and his secondary insurance would cover the other 20% for another 80 days. We (the family members who were actually taking an active role in his care) were very excited at the possibility of 8 hours of a non hallucinatory environment for sleep.  But this was a pipe dream.  The case manager at the hospital either didn't understand English or didn't care because he set us up with a SNF that had a bed for him, but as it turns out, there was no bed in their memory care unit, and to be honest, I think it's just as well.  He was discharged from the hospital on the 4th of July and taken by ambulance to the SNF, taken to a room (which was right by a door that said alarms would go off if opened, but I saw first hand that wasn't the case), handed a call button and told to "Call us if you need us."  At this point, my sister and I are both crying, exhausted and tired of having the hope ripped out from under us that we would actually find some place safe, affordable and helpful for Dad. I said, "I'll just take him home with me.  I can't leave him here." My sister had a good analogy to what it was like.  She said, "It would have been like leaving your 2 year old in an apartment building, handing him a phone and saying, 'Call me!'."  I later found out from a social worker friend of mine that SNF's are trying to get rid of memory care units because the assisted living facilities provide care for them.  The problem is, as it usually is with everything...money. They are all private pay.  Oh, and a small foot note to Long Term Care Insurance policies which he didn't have, but everyone needs to know about is this:  Check the fine print.  A lot of those long term policies have a clause that says the money can't be used in case of dementia or Alzheimer'.   Keep that in mind.

So here we are. My Dad has done well for the week I've had him here.  He hasn't been violent, and hasn't wanted to wander outside the house. We've even had some very sweet conversations where I actually think he remembered who I was.  We've hired a sitter company that will help when we need to go on vacation or just need a break. I guess we'll just take it one day at a time. Isn't that what everybody says?  "Just one day at a time"...like there's any choice other than that anyway.   But I do. I'm learning to "find the happy in the crappy" as I mentioned on a Facebook post one day.  As long as he doesn't get violent, or destructive, I'll let him stay here. I need to get his days and nights switched back to normal. My husband has been a jewel through all this.  He is supportive mature and even knew what to say to make me feel better. He said, "Well, we can still keep looking for something that would be good for him, but I figure that we should make his last time on Earth as comfortable as possible because he had a rough time during the first part of his life." He did have a hard childhood as a poor farmer's kid in Hardy, Arkansas in the 1930's, and he worked hard all his life to make sure his children had opportunities he didn't have. He was a good Daddy, and I want to be a good daughter...even if I am having to live as a sleep deprived Zombie.

To eat a plant or eat a bird...that is ONE of the questions.

Well, maybe not EXACTLY the question, but I certainly am scared to death after watching "Forks Over Knives" about eating dairy and meat that I am looking for recipes that may guide me in my seemingly never ending question of "What exactly DO Vegans eat?" Lettuce comes to mind.  That's a gimmie..Yes, apples, and I suppose all fruits.  Ok, so fruits and vegetables...Got it.  Now, we're getting into the fuzzy territory. I've always grown up with the idea that "a meat and two vegetables" was the standard operating procedure and basic way that most healthy people lived.  If you were feeling particularly hungry, you would throw in an apple cobbler for dessert.  (Can you tell I've eaten at Cracker Barrel one too many times?)  However, now, with the revelation that what I've been eating will kill me - or at the very least give me cancer or heart disease or both, I am really wanting to flip those genetic markers and make sure they don't get turned on.  Lots of my ancestors died of either one or both of the two biggies.

But how?  How with three children and a husband who believes that the high protein/low carb diet is what works best for weight loss, can I do this?  I've been thinking about it for a few months now - ever since I saw the eye opening horror film "Forks Over Knives."  You should watch it too.  I'm a skeptic when it comes to diet programs and anything vegetarian in general, but that has me convinced - dairy and meat will kill me....maybe even painfully in about 25 years if not sooner.

SO, the question begs to be answered.. Barring any accidental death, do I really want to live beyond 25 years?  And, maybe, would I like being 69 if I didn't have one of the big diseases?  I've seen enough patients to say that I don't think I wanna live past 80 if I have a debilitating disease...or any disease for that matter.  Like everyone else, I would like to just be cognitively super savvy, physically fit and independent well into my 90's....or beyond...However, I draw the line (like I'm the one really in charge of the "timeline" of my life) at outliving my children or grandchildren.  I'm not a vampire wanna be thank you. I think maybe not.  I think sometimes that the bottom line and even bigger questions are "Is there food out there that I can enjoy that won't kill me? AND, Would my instant gratification for what tastes good really be satisfied by granola and tofu?"  See, even the thought of that makes me throw up a little in my mouth. That's my big (we'll call it health insurance) search which I might blog about from time to time because it helps me sort out what I think I need and want.

So, now I'll go drink a bottle of water and take a walk.  I'm sure water and walking are safe. Maybe I'll have some oatmeal when I get back.  Can't have cereal cause I can't have milk if I'm a vegan.  Oh, and by the way, I consider anyone who attaches any kind of religious belief to their food is an idiot. Yes, I did just have to throw that in. Peace to you...even if you do have a weird religion. And, yes anything other than Christianity is weird and wrong.  I know, we'll sort it all out when we die, but do you really want to be wrong if I'm right about this and you wind up in hell?  If you don't know that by now, I feel sorry for you. I'm not gonna erase that last paragraph either because it is Easter weekend and "If we deny Him,  He will deny us." So, sorry if you're offended, but I'm feeling like I don't do enough witnessing lately anyway and I really believe that Jesus will be coming back soon...which makes me ask yet another question..."If He comes back before I get old and might start seeing some of these diseases, shouldn't I go ahead and indulge in that steak if I want to?  Oh, so many questions on such an empty stomach.

You learn something new every day.

I like being a nurse.  I don't like the paperwork involved, but I like the people. Oh, and I'm also not really a big fan of looking at strangers rashes or getting asked medical advice when they find out I'm a nurse.  I'm not a doctor.  A lot of people get those two things confused...including nurses.   I like the people because they provide the best stories to tell.  Some of them I can even write about without getting thrown in the pokey because I've infringed on someone's privacy rights.  I always change the names, the circumstances and the place.  But, even with doing that, the stories are true and are just too odd to have been made up.

Take, for instance, the story of Mr. Clean.  I'll just call him that because of what the poor guy did - at the advice of a nurse no less- (but not me thank you).  He had a foot fungus that would itch the chigger right off of a boy scout. A nurse friend of his suggested that he soak his foot in bleach every night. She told him to mix a half a CAP (with an "a") of bleach with a gallon of water.  He did this for five years which obviously didn't cure the itchy foot.  However, one fateful night, his wife (who normally mixed up the solution) was out of town and Mr. Clean decided he could do it himself.  Unfortunately, he put a whole CUP (with a "u") of bleach in one gallon of water and then dried his foot, put his sock on and then later that night when he was going to bed and took off his socks,  he took the skin from the top part of his foot with it.   Off he goes to the ER, (which by the way I'm sure would be a great place to get even more "You did what?" stories, but I don't work in the ER.  I work in home health.  I'm a whole different kinda nurse.  Currently, we're taking care of the foot and it's starting to look better.  Now comes the infection prevention measures. Fortunately, he's diabetic and has diabetic neuropathy and can't feel his feet too well.  It's the small blessings in life that make it doable I guess.

So what have we learned from this post students?  Don't soak your feet in bleach.  In our next episode, we'll tackle the concept of "If you're an Octogenarian, don't think you can start walking down an extremely steep driveway without avalanching to the bottom and breaking something."  Benefit from the stupidity of others people.  That's the real survival of the fittest.

His name was Coos Coos...

     I like dogs.  Really, I do.  We always had dogs growing up, and I even have a dog now.  I have found that I tend to favor larger dogs which don't qualify as "nippy, ankle bitters".  As a home health nurse, part of my job is to go into the homes of strangers and provide whatever nursing care that's ordered.  Most of the time, people who have ankle biters, usually have enough sense to put the dog in another room or outside or shove it in a drawer when someone visits them. This was not the case today.  His name was "Coos Coos"..yes, just like the ricey/noodlelish food. He was a tiny, white, long haired Chiwawa, and he hated everyone except his owner.  He was solid white except for a light brown patch of hair that surrounded his little white butt...Yes, it looked a lot like poop. I was not impressed with Coos Coos, nor he with me.  But I was there to take his owner's vital signs and discuss her medications and quite possibly, he would get kicked or I would get bitten before the visit was over.
     I don't know why....I have a theory for another blog - but most of the patients I see would qualify as active participants in the show "Hoarder's Buried Alive". This particular house was no different. There were boxes lining the doorway and little paths through the maze of clutter as I found my way to a level spot on a box where I could put my bag. The difference between this hoarder's house and all the other houses I've been in was the fact that most of the time, I've been barricaded away from the pets or they've been too scared to attack me.  Not this time. We went through the usual niceities and after I washed my hands, cleared a chair, scurried away a roach and sat down, Coos Coos settled down a bit.  I talked to his owner for a few minutes then it was time to take her blood pressure.  Standing wasn't something Coos Coos wanted to see me do, but something I desperately needed to do for fear of more roaches. He would be content to stare at me as if his beedy little brown eyes were keeping me paralyzed in my chair. However, I had no intention of staying in this lady's house any longer than required.  As I took out my blood pressure cuff and approached his owner, he danced around in circles and lunged at me if I ever turned my back.  It was the first backward and blind blood pressure cuff placement I'd ever completed.  He must have thought we were playing "Red Light/Green Light" because each time I turned my back on him, he gained a little ground.
     His owner, we'll call her Ms. B. (though that's no where near her real name) said, "Don't turn your back on him or he'll get cha!"
     "Do you think he'd be happier in a different room so I can do your assessment?" I hinted...
    "Oh, no, he'll be ok...Just don't take your eyes off of him," she said.
     "Ms. B, that's kinda hard to do since I have to read the blood pressure cuff dial," I said.
     "Well, you'll be ok.  It'll upset him more if I lock him up," she said.
     With my irritation meter reaching hypertension levels, I quickly finished up my half blind assessment and headed toward the door.
     "I think you'll probably have to walk backwards so he won't try to bite you," said Ms. B.
     This was not easy in the least bit. Not only did I have to maintain eye contact with the doglet, I also had to maneuver backwards toward the door and try not to knock over any boxes into the tiny little path carved out to the door.   How do people live this way?  Why do people live this way?  Do they just become blind to the junk?  Mental illness runs rampant. I just know it does.
     Anyway, as Coos Coos escorted me to the door, his anxiety level started growing because his high pitched bark started getting louder. Just as I was almost to the door, Coos Coos grabbed my pant leg and was shaking his little head trying to tear my pants leg off.
     "Coos Coos!  Stop that!" Ms. B yelled which was the end of her involvement or control of killer Coos. 
     Thankfully, just then Ms. B's phone rang and she went to the other room to answer it.  I was almost to the door, and then my foot just accidentally - and with no ill feeling or premeditation of any nature on my behalf - kicked Coos Coos clear across the room.  I think he landed on a roach.  But don't feel sorry for the Coos. That little foot fling bought me just enough time to slip out the door and close it...Just as I closed it, I heard Coos Coos hit the door with his nose..followed by a deep, throaty growl that I've only heard on nature shows documenting the mating habits of wildebeests...or so I've imagined.  Needless to say, so I must say it, I am kinda dreading the next visit to that patient's house.  Maybe I should bring it a snack...maybe it won't contain rat poisoning....maybe it will.....: )