Tag Archives: Assisted Living

Musings on Mom and Shredded Wheat

Posted on by
Reply

This evening I bought three boxes of bite size Post Shredded Whole Wheat and two curtain rods in Walmart and I feel sullied.

*

It was on my way home from visiting my mom in her assisted living in New Jersey – a two-hour trip one-way.  She was at the table napping in front of a magazine when I arrived, but one of the caretakers who likes to make me feel that my trip hasn’t been in vain, badgered her (but in a gentle way) until she lifted her head from her chin, opened her eyes, and together they sang a few bars of My Bonnie Lies over the Ocean and Cielto Lindo in Spanish.  My mom never knew Cielto Lindo or any Spanish when she was who she was.  I find it interesting that she has learned something new.  She said hi to me and gave me a smile, and went back to sleep.  

Mom and Me at the BeachWhen my mom isn’t too deep into her own thoughts or too sleepy, she recognizes me and that makes me feel good, but I would have been okay going home without connecting with her.  She’s 96 and she is tired.  I have no idea what goes on in her mind.  She has started to mumble when she is half-asleep.  She might mention her oldest grandchild by name, or my father, but there is usually no context to her mumblings, and I miss most of the words if they are words.

Often when I visit the house is full of chatter. Her housemates talk to themselves, one speaks on an imaginary phone she holds to her ear, some talk to baby dolls.   They are important conversations but only one-sided.  They have their own languages and sometimes they talk to me, expecting an answer.  I comprehend nothing except their desire to communicate.  I try to respond but feel very inadequate.  There is one man with the most beautiful smile and brightest eyes who speaks bubbly words of nothingness.  What was he like when he was whole, and what makes him so happy now?

Why should my mom wake up to smile at me?   I lowered my expectations a long time ago.  My visits are opportunities for me to see how she is, which means is her color good, has she slipped further into her illness, is she in pain, is she miserable, does she look comfortable and peaceful, does she need anything, and we hold hands.  If we talk, it is for a few minutes and then she drifts off.

When I left, I was already in my “why?” state of mind. 

*

My plan was to stop at the bank and Lowe’s and to pick up cereal.  Lowe’s had the paint but not the curtain rods. I don’t usually shop at Walmart.  It’s too big, too much a bully, too destructive, but it was on my way out of the big box complex, and it would have everything I still needed.  Just one stop on the way home instead of two stops in the other direction was a good idea.

The parking lot was very crowded.  I cringed looking for a space and once again entering the store.  Memories of my husband who would come home from errands excited by the tattooed ladies in the Walmart in Plymouth, New Hampshire made me smile.  I stood on tiptoes and stretched to reach the three boxes of shredded wheat that were on the top shelf — so far back and high that I had to coax the last two forward by knocking them down with the first.  Obviously PSWW is not a big seller.  The price was nice, but it made me even more uncomfortable with my lack of resolve.  It is so easy to slip into abetting the enemy.

PSWW is the only “just cereal” that I have found, even on health food shelves.  It has nothing added – no sugar, no honey, no nuts, salt, dried fruit, cinnamon, additives. The back of the box proudly shouts out that Post shredded wheat has “an ingredient list that is so good, we have nothing to hide.”  Why does this statement madden me instead of making me happy? I’ve  researched it and it seems to be true.  It’s not organic, but I want a “NO GMO INGREDIENTS” label, and no BHT, and more choices.

My body was quickly moving to rant mode, and eventually my thoughts caught up and settled on frankenfish; over-processed flour; chemical-laden apples ripening in boxcars; aspartame in milk; misuse of antibiotics; chicken breasts with no bodies, heads or feet lined up on shelves in a dark warehouse, hooked up to feeding tubes.  I just don’t understand an agricultural-industrial complex that arrogantly tries to convince consumers they have no right to know what they are putting into their bodies.  Individuals run agribusiness.  Their families eat food, drink water, and breathe air.  How can they  greedily produce foods that negatively effect their children’s bodies and their children’s environment?  How do they and the politicians who support them twist the reality which is that they are destroying the agricultural diversity and sustainability of our planet and the integrity of our food supply into the fantasy that they are graciously feeding the world?

My son, the one who works with food and public health, and I talk a lot about the world’s food supply.  He has convinced me that a new round of make-millions-while-crippling-life-as-we-know-it will belong to the medical-industrial complex.  They will discover ways to alter our bodies so that we can adapt to our unnatural diets, and of course we will pay with our health and our money to fix their “mistakes.”  Maybe we already are on this path; there certainly are enough pills and medical procedures that help us cope with our debilitated digestive systems and allergies and ballooning numbers of ill. 

One neighbor always tells me that we have choices.  We can shop at natural food stores, grow our own vegetables, buy at local farms, prepare from scratch. These choices are still very limited and they take research and energy, commitment and time.  They are luxuries not available to those who are struggling.  They are not concerns of the hungry.

There is more to life than shopping for food.  

____________________________________________________________________

Something new to think about:

http://www.businessweek.com/articles/2013-05-30/genetically-modified-wheat-isnt-supposed-to-exist-dot-so-what-is-it-doing-in-oregon

The Best Place for New Yorkers with Alzheimer’s — New Jersey?

Posted on by
Reply

Connecticut?

Many of the New York state regulations that apply to residences for people with memory issues have little to do with reality.  They prevent administrators from providing a continuum of practical, cost efficient, safe and sensitive care for Alzheimer sufferers.   My mom is 95 and has been in specialized memory care assisted living for the past 6 years, first in New Hampshire, now in New York.  Soon my mom may have to move, because she no longer will meet the requirements to live where she lives.  New Hampshire and some neighboring states don’t have these restrictions, but New Hampshire is too far away for me to move my mom back. Next stop:  a nursing home, back with family – or New Jersey?

One NY regulation states that no staff member, not even a nurse, may give a resident medication.  The resident has to be able to take that pill or liquid on his or her own.   My mother never could swallow a pill.  Her inability has nothing to do with Alzheimer’s.  However, it is necessary to circumvent the regulation so a staff member may crush her pill and serve it in applesauce or pudding. The rationale is to prevent giving medication to some one against their will.  This reasoning does not make any sense with those afflicted with Alzheimer’s and other dementias since they have lost the capability to make rational decisions.  Can’t take your medication?  Next stop:  a nursing home, back with family – or Connecticut?

On the flip side, an assisted living medication coordinator many not fill a PRN or “when needed” prescription written by a doctor.  The rationale here is that a person with Alzheimer’s or dementia does not know when a pain reliever or even a decongestant would be helpful.  Aides or nurses, especially if they have cared for a resident for several months, can see or hear when a resident is in pain or has a fever and needs medication, but the regulation prohibits their using their common sense.  Yes there will always be some staff members who may abuse the right to provide medication, but there are other ways of providing checks and balances to the process, rather than to outlaw it altogether.

Another regulation states that residents in these homes must be able to stand and ambulate on their own.  No gentle lifts or pushing of wheelchairs by staff are allowed.  If someone has become too weak to stand up without a helping hand, she’s out.  Next stop:  a nursing home, back with family — or New Jersey?

Still another regulation states that residents in these homes must be able to feed themselves.  Finger food is fine, but no help, not even from a volunteer.  Next stop:  a nursing home, back with family – or Connecticut?

A resident who is “uncooperative,” perhaps because she can’t sleep or does not want to eat or take a shower or take her meds can easily, unintentionally be pushed beyond her fragile line of self-control.  What happens when a resident is in pain or yelling in frustration or anger or confusion?  Often it depends upon who is on duty at the time.  If there is an aide present who has a solid relationship with the resident, the aide may be able to calm her.  If not, and there is no one who may take responsibility to assess the situation on-site, it is off to the emergency room, and most likely, off to the emergency room alone, secured to a gurney, with nothing more than paperwork stating that the patient is “uncooperative” and her behavior is not consistent with her norm.  How to avoid unnecessary traumas in the ER?   You must proceed to the Next stop:  a nursing home, back with family – or New Jersey?

The head of my mom’s “neighborhood” is a very compassionate, professional woman, and has gone out of her way even from home on her day off to time the ambulance pick-up so that I can meet my mom at the hospital.  She has warned me that if my mom is “uncooperative” or “combative” she could be sent to a psychiatric unit.

If there is no advocate for an Alzheimer’s patient in the ER, the doctor may have to admit her, start an IV, insert a catheter for a urine sample, take blood, order x-rays  and other tests to verify that there is nothing wrong.   The last time I was at the ER with my mom, the very wise and young head of the room wiggled through procedures and discovered my mom had a urinary tract infection, wrote a script for antibiotics and sent her back.  I was present and could assure him I was in total agreement with his approach; if not, he wouldn’t have been able to doctor as he did.

It gets worse at the hospital.  When it appears that the assisted living is not able to provide for the patient’s needs – why else would it send a cranky but otherwise healthy person to the ER room — the hospital must, according to state regulations, discharge the patient to a nursing home.  This almost happened to my mom on another occasion and for another reason.  I was there and I was able to get that wonderful head of my mom’s neighborhood to come to the hospital to offer her assessment of my mom’s condition and to vouch that the assisted living was capable of meeting her needs.  But what if I weren’t there?  Or think, what if you weren’t there for your mother?

I’ve looked at nursing homes in order to be prepared if my mom really did need to move.  Nursing homes provide skilled nursing.  Alzheimer’s and memory loss seniors do not need skilled nursing unless they have some other medical condition.  They need someone to help them transfer from their bed to their wheelchair or to eat or to toilet.   Nursing homes are also very expensive – from $5000 to $8000 more a month than what one pays for assisted living – which is already expensive.  Does it really cost another $5000 a month for someone to help a person into a wheel chair and wheel them down to the dining room?

I asked professionals at the nursing homes and in Alzheimer’s support organizations, how do people pay for this.  And the answer was:  “They don’t.”  Medicaid pays for it. “What if you don’t qualify for Medicaid?”  The answer:  “You will soon.”

Oh.

Something is out of whack here, and I’m not sure I want to try to figure it out.

Instead we will be going to Connecticut – or New Jersey.