Friday, November 27, 2009

Thoughts on Thanksgiving With Both Parents in the Pokey

Thanksgiving greetings from my elderly triage center in Northern California.

I had to take a break from blogging to attend to the latest Crisis of the Elderly Parents: Mom fell at 6:30 Tuesday morning and is now in the hospital.

Naturally it is never as simple as that. She called me after she fell and I rushed over and called 911. They took her to the ER and X-Rayed her and said she hadn't broken anything and sent her home. I got her some strong pain pills and put her on the couch and gave her something to eat and a pain pill, with strict instructions to stay put. Then I went up the hill to visit Dad who has pancreatic cancer and lost five pounds last week in nursing care.

When I checked back in with Mom, she was in the fetal position, calling out in pain. How could this be, I asked myself? She's always dramatic when she is ill, so I wasn't sure what to think. Her doctor prescribed some even stronger pain pills and said if they didn't work she would have to go to the hospital. On Wednesday morning, since she was still in the fetal position and crying out, I called 911 again and took her to the hospital. After all day in the ER (Such fun! And I could have been defrosting the turkey!) they decided to admit her. She spent Thanksgiving Day on morphine in the hospital.

She didn't like visiting Dad in nursing care anyway.

"I hope you aren't planning to let her live by herself anymore," the physician said to me on the telephone yesterday. Oh sure, I said to myself. My mother always does exactly as we tell her. Instead of saying this I said to him, "Oh, you are so right. My family wouldn't think of allowing that."

We'd like Mom to go from the hospital to the bed next to Dad in the nursing home. Not that Mom will go there. But we continue to dream of the triumph of hope over experience.

Entrance to skilled nursing center and location of parent #1.

Meanwhile, back at the nursing home, my father has had a good week. He's been eating well, sleeping well and has gradually adjusted to his new living arrangements and the regular routine we've established.

I arrive at 7:40 a.m. to help him with his breakfast. I enter the dining room behind his chair and scratch his back, and, without turning his head he says, "That's Robin."

Yesterday he said, "I was hoping you would come. And I said to myself if she doesn't come, I'm going to cut her off."

This morning, I kissed him on the cheek and he said, "That's worth a million dollars. Bet you'd like to have it now, too." He hasn't yet heard we're spending his fortune on his care, but oh well. I told him it was raining outside and he smiled and said, "I have a plan." What's that, I asked? "I'm going to let it rain," he said.

He may have dementia, total hearing loss, terminal cancer, chronic lymphocytic leukemia, can't walk or feed himself, but he hasn't lost his personality nor the quirky way he looks at the world.

Speaking of which, last night at the hospital Mom tried to get out of bed on her own and fell again, then pulled out both of her catheters, which in the case of the Foley catheter was quite a difficult task because it involved both her bladder and a balloon.

A rainy day outside Silicon Valley's newest hospital: location of parent #2.

"I can't understand why she would behave like this," my sister said to me after speaking with the nurse this morning. "She's being so naughty."

"Why should she stop now, just because she is sick," I asked. People don't really change much, no matter their situation. Mom has always had a very strong personality and does not take direction from anyone, especially doctors. She has been very unhappy with Dad in nursing care. She wouldn't agree to move out of the house, but she obviously hated living there alone. She's had one ailment after another in the month he's been gone that has kept her from visiting him. Something is clearly hurting in her--whether it is mind, body, or both we don't yet know.

So on Thanksgiving Day, as I shuttled between the two of them, I realized I had a lot to be thankful for. I moved back to California just in time. Just in time to be here when they both fell apart and actually needed me, for the first time in their lives. And though I missed my friends the Seymours and their annual Thanksgiving feast, full of the fascinating and witty characters at their table, I knew I was lucky. Both my parents were safe and having their own kind of fun. Mom, playing Camille and having an audience at Silicon Valley's Newest Hospital (which looks like NY's Four Seasons Hotel inside) and Dad cracking jokes at the world, and imagining his daughter loves him only for his money, which, by the way, the thrifty Scotsman had always planned on taking with him. And which, in a way, is exactly what he is doing.

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Tuesday, November 17, 2009

Moment of Clarity Following a Granddaughter Visit

Dad and his granddaughter, Dana, November 2009. That is something very close to a smile on my father's face.

My sister's middle daughter is moving to Monterey to marry a naval aviator attending the Naval Postgraduate School there. It gave her a chance to stop by and visit her grandfather. She hasn't seen him since he entered the skilled nursing center.

He really brightened up when he saw her and the two of them kidded about the Navy (in which she served) versus the Army (my father's branch.)

She has been very close to her grandfather over the years. When she was about five years old, she and her older sister, Devon, and her mother (my sister) and her father visited the grandparents in Los Altos from their home in Colorado. When it was time for the family to return home, my father asked Devon, who was eight, if she wanted to stay for a while longer, without her parents, and Devon said she sure would. Dana, younger and shyer, hung back, holding onto her mother's leg, and it was decided she was too young to stay. So Devon stayed behind and spent about four days being pampered by her doting grandfather.

The story goes, that when Devon returned to Colorado, she regaled her sister with tales of the fun she had had, and poor Dana burst into tears. Every year after that, until they were in college, the girls spent a week or so sans parents with their grandparents, swimming in the nearby pool, barbecuing hamburger dinners, flying kites and generally having fun with the grandfather they called Pa.

I took this picture of Dana with Dad when we were all in Spokane, Washington several decades ago for my grandmother's funeral. These rites, both happy and sad, bring families together.

My father, who has never been really sure of himself with grown-ups, has always loved children, and thus, he has a special bond with his granddaughters.

Now, one of them is planning a wedding for December, and we're not sure when we will also be planning a funeral.

So it isn't any wonder that Dana got tears in her eyes when she departed from her visit with her grandfather. She said she would be coming back soon, but I saw my father watch her as she walked away.

Later that day, after I had sat and helped him eat his dinner, I wheeled him in his chair back to his room.

"Robin," he said. "I'm a mess. I'm really sick."

I nodded my head that I knew.

"I mean not sick to my stomach sick, but really sick."

I nodded my head again. This is the first time my father has said this to me. Until that moment, every time I had asked him how he was feeling he said, "I'm fine."

But, even though his mind isn't clear these days he does have moments of clarity like this one. I knew he was thinking about Dana and my sister and me and he was letting me know he was going to be leaving us.

I have accepted this, because that is all you can do. But when I kissed him goodnight I wondered, as I often do these days, if I would see him again.

And now, I know that he wonders too.

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Monday, November 9, 2009

To See Ourselves As Others See Us

We may get old, but inside our heads we must not always see clearly that we are.

The other morning I went to the nursing home early to help feed my Dad his breakfast. He can't walk anymore and he can't feed himself and after he has been showered and dressed, the nurses wheel him into the dining-room-for-the-distressed, where he must then wait for his meal and the help he needs to eat it.

After I arrived, my father's roommate was wheeled to a spot just across the table from him. Bernie is my father's approximate age and spends most of his time in dialysis. When he was placed at the breakfast table he promptly fell asleep.

My Dad raised his ancient, shaking finger and pointed at poor Bernie, snoring away, and then Dad rolled his eyes. "Look at that old guy," he said.

As opposed to you? The young guy here? I had to smile, because my Dad was also smiling.

On that particular morning, my father told me we were in Al's Barbershop and Al must be giving away breakfast to his customers while they waited.

"I'm sick of this," he told me. "All I wanted was a haircut." Still, the breakfast appeared to be free so my father, always both a thrifty and hungry person, partook heartily.

One morning he asked me if we were eating a "full English breakfast." I didn't know what to say, so I just nodded that we were. "But, have you told them we are one-hundred-percent Yankee?"

He's from Alabama and he only claims to be a Yankee if he finds himself on foreign soil. Like London. Or New York City.

When the nice young lady who serves the meals in the dining-room-for-the-distressed appeared with a warm hand towel for my father at the end of his meal, he winked at me.

"He knows how to buck for a tip," said Dad, getting his genders mixed up as he frequently does these days.

Yesterday I took my mother to the nursing home to see Dad and he was so excited to see her that they sat for a while holding hands near the nurse's station at the end of the hallway.

Mom and Dad together at Dad's skilled nursing center.

One older lady, whom I've described previously as Mrs. Anglo, sat nearby, dozing in her wheelchair.

My mother nodded her head toward Mrs. Anglo.

"Every time I see her, she looks thinner," she said. This from my mother, now so thin you can practically see the light through her body.

The good news is that in both my parents, the will to live on is extremely strong. And the feeling of youthfulness prevails, in spite of all evidence to the contrary.

On Saturday my father was complaining about doing his physical therapy and we couldn't seem to talk him out of his bad mood. Then I wrote on a piece of paper for him:

"Are you through with life?"

He read it. And then without looking at me, he hung his head. Was it disgust that I would ask? Was it shame that I thought he felt that way? I don't know.

He looked up and me and smiled. And then he shook his fist at me.

And then he did his PT.

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Tuesday, November 3, 2009

Nursing Home Characters

My father is in a gorgeous facility, up above Los Altos Hills, that includes villas for independent living, apartments for those needing assistance, and the skilled nursing center where he is now installed. I have to admit that there are times, lately, when the place reminds me of the Noel Coward play Waiting in the Wings, which I saw in a revival on Broadway a few years ago, starring Lauren Bacall and Rosemary Harris.

That play is about a nursing home for actresses in which stars fade but old rivalries never die.

Or, to put it another way, Coward points out that people are just as petty and dysfunctional when they are old and sick as they are when they are young and healthy. Only more so.

The place where my father in ensconced proudly announces on its gate that it is a "Smoke Free Facility." And it makes me laugh when I see that, because almost every day I see this cadaverous old man sitting in his car in the parking lot, smoking away, his car door open and his head ducked down beneath the door. In spite of what he imagines, he is not invisible.

There is the old woman I'll call Mrs. Anglo, down the hall from my father, who has only recently taken to speaking in Spanish, with a very bad accent. It seems she learned Spanish as a child from a maid, didn't speak it at all during the next eight decades and now, seeing the international cast staffing all the jobs at the nursing home, has suddenly begun speaking to all of them in Spanish. Fortunately, some members of the staff can usually understand her.

She has another odd habit I forgot to mention to my sister the first night she came to dinner with my Dad and me at the nursing home. About mid-asparagus, my sister got a funny look on her face and I turned and saw Mrs. Anglo shaking her finger at my sister. She never said anything, not even in Spanish.

"I forgot to tell you about that," I said. "She scolds people."

There is another woman who always goes to the dining room alone. I suspect no one will sit with her. Every five minutes or so she calls out, "Help!" and then sits quietly for another four minutes and fifty-nine seconds until out pops "Help!" again. One night she did it a lot more than usual and they had to call a security guard.

My father's doctors have told us that his time is very limited, but the amazing thing about him is that he looks robust, says he has no pain, and is eating everything that isn't nailed down.

Today, however, when the physical therapists tried to get him to stand, he told them he just didn't want to. He was clearly able to do it. He said he felt we didn't understand how sick he was. Believe me, we understand. I've been up there for hours every single day, understanding.

"We know," I said. "We just want to see if you can get going a little. It will be good for you." But he just kept complaining and we finally took him back to his room.

It has been a contest, for the past couple of weeks, between my father and my mother as to which one of them is the most ill. Even last year, when my father was in the hospital with a broken vertebrae, my mother came down with pneumonia. I'm not saying she intended it, but there you are.

This last month, now that my father is in nursing care and getting tons of attention, my mother has had various illnesses that have kept her from visiting. She had nearly fatal stomach flu for a while and now her back is giving her nearly terminal pain. I hate to make fun of it, but the coincidence is worth noting.

Sometimes I can't decide which of them is the more spoiled.

Which brings me, I suppose, to the famous five stages of grief, first delineated by Elizabeth Kubler-Ross. To wit: denial, anger, bargaining, depression, acceptance.

I think we can fairly say I'm in the anger stage, and usually that brings me to try to see the funny side of things, in order to dissipate my anger. Which reminds of me of a line Lauren Bacall says in Waiting in the Wings: "I'm just bristling with olive branches."

Its hard to be a good daughter-caregiver when you're bristling. With anything. And that is part of the process, too, I guess. Like the old guy smoking in the parking lot, we bring all our baggage with us to aging and dying and caregiving and sometimes, carrying it around is a very heavy load.

Makes me understand, completely, why that lady cries "help" every five minutes. I only wonder she pauses so long between cries.

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