Week 2, Day 3: In the Moment

Dad’s been home now just over a week.  Every day has reinforced my sense of being more in the moment that I usually manage.  Just being in the moment has been a goal of mine since college, when I read the works of Ram Dass, especially Be Here Now.  It’s not something I ever conquered — that need to control my time, to plan my future, to spend so much time in the yet-to-come that I completely (or nearly so) ignored the beauties of the now.

That is one benefit of living with Dad now.  I can spend some time thinking ahead, but not much, really.  And I don’t assume that my plans will come to be.  No, the plans I make now are really more like possible scenarios.  Yes, that’s it — I think about possible scenarios.  But I don’t count on them.  That is only frustrating.  And disappointing.

Now I spend each day in and of itself.  I awaken to the alarm clock, get up and cook breakfast for Dad.  I give him his medicine.  I put laundry on.  I wash dishes.  I spend time with him.  I watch television.  I read.  I putter around the house and porch.  There is no particular order to these things — they just sort of happen as they are needed.

On a beautiful cool morning like today, I spend time on the front porch with my iPad, reading The New York Times and CNN online.

It’s Wednesday, which means that the home health aide comes to help bathe Dad, and today that’s wonderful.  Today has been a turning point, one bound to come, as certainly as what happened on Sunday was bound to happen.

On Sunday I was sleeping in my bed in Lake Charles, and about 8 the phone buzzed with a text from Kay.  Dad had fallen in the bathroom and she’d managed to get him up, in the wheelchair, and into bed.  What to do now, call 911?  No, I told her — call Home Health.  She did, and they said a nurse would be there in an hour.  Within 15 minutes, I’d dressed and packed and was on the road.  I was back in Egan before the nurse arrived.

After determining that the on-call doctor (who was rude and chewed the home health nurse out for calling him, adding that he’d “kill” his wife for giving out his number) would’t help by authorizing the mobile x-ray unit to visit us, the nurse arranged for an ambulance to take Dad to the ER in Crowley.  I rode with him and Kay followed in her Rav 4.  After x-rays and an exam by the ER doctor, Dad was released — luckily, no fractures, no breaks at all.  The trick:  now we couldn’t get him home by ambulance.  Kay and I managed to transport him in the Rav, and at home I got the wheelchair and we got him back to bed.

He hasn’t been able to put weight on the left leg since then.  He’s been in pain, with frequent leg and muscle and back cramps.  He cannot sit up for more than a minute or two.  He cannot use the walker at all now.

Which led to yet another dilemma:  how to transport Dad to dialysis.  On Monday morning, I talked to his primary-care physician’s office, and learned that I needed to talk to Acadian Ambulance on my own.  I did that, and within 15 minutes had arranged for transportation to dialysis.  That day I followed the ambulance to dialysis, went in with Dad, and talked to the nurse and staff about what had happened.
Then I had lunch and went home, falling into bed for a nap.  I got up, put on some laundry, and watched television while I waited for Dad’s return.  That was uneventful, and I signed all the paperwork.  The phone call later from the administrator who’d ridden with Dad was a surprise — certainly, the call was necessary since he was telling me that Dad had been evaluated and approved for such transportation (Medicare requirements), but it was also partly personal, since the administrator wanted to tell me what a treat it had been to have Dad in the ambulance.  He’d enjoyed visiting with Dad, and asked if he really had played baseball; I told him yes, that Dad had in fact played ball at the University of Texas for a short while.  Dad had reminded him of his own grandfather, and he just wanted to let me know how much he had enjoyed the trip with Dad.  Such surprises are joyful for me, because I know Dad is wonderful not just as a father but as a human being, but with such comments I have the pleasure of knowing that others appreciate him.  Even as weak as Dad is, as in pain as he is, he makes conversation warmly and with interest.

How quickly such turns can occur — on Saturday, Dad had been alert and feeling good.  He watched baseball on TV most of the day, visiting with Kay and our friend Billie.  He ate a good supper of spaghetti that Kay had made.  He had a day better than most days had been.

Yet on Sunday morning, in the bathroom after Kay had helped him get there, his legs simply buckled and he fell.  Even with nothing broken, Dad has now become less mobile, less able to assist me (or anyone) in turning or getting up or getting dressed.

He was in such pain that he wouldn’t let me change his clothes, even though I tried.  He let Billie and me help him to the bedside toilet yesterday only because I refused to let him get to the actual bathroom.  It was, in fact, a difficult task for the two of us to get him out of bed and on the bedside toilet.  He was frustrated after all of the effort, too, because nothing happened.

Pain pills help him for a time, but not long, and not enough.  By last night, I knew that I’d be calling Dad’s doctor this morning to request something more — a muscle relaxer, something, maybe stronger pain medicine.  But I knew that having him lie there and moan and yelp with pain just because he lifted his left leg (or tried to) just wasn’t acceptable.

Yet he was hungry enough to request chicken-fried steak for supper — and I had some ready to put in the oven (thanks, Walmart, for frozen chicken-fried steak patties).  With green beans and mashed potatoes and peppered milk gravy, that chicken-fried steak satisfied Dad and I was happy to see him eat almost all of his supper.  I joined him in the meal, enjoying mine too.  I cleared off the bedside table, cleaned the dishes, and sat with him for a while.  He warned me that he might have to go to the bathroom in the night — and would probably just “go right here, in the bed.”  I told him that was fine, not to worry.  Yet he was, because that was so unpleasant for him.  Dignity often goes out the door with illness, with debilitating pain.  He was embarrassed for saying this to me. I tried to reassure him that it would be okay.

By 8:30 last night, he was in more pain, so I gave him another pill as well as his night sleeping pill.  I tucked him in, kissed him goodnight, locked the door, and went to my room.  I crawled into bed, read a while, and was out by 9 pm.  I slept until 8 a.m. this morning, knowing I could.

Yet by then, Dad was awake.  I fussed because he didn’t call me earlier. Sure enough, he had indeed had to simply go to the bathroom — in his own underwear.

I quickly fed him breakfast and knew that the home health aide was coming, so I didn’t start moving him around yet.  The less of that done, the better.  She arrived, and I told her what had happened.

She cleaned him up and then bathed him and dressed him in clean clothes.  Before she left, she gave me some good tips for taking care of similar problems.  I had put out diapers, but Dad refused them.  Instead, she suggested that I look for adult pull-ups — much more like underwear, and thus more dignified while still helping me out.

Another new surprise twist in caring for Dad — and I just have to learn to deal with it.  The aide only comes once a week, and both Dad and I will have to work together now in dealing with similar incidents.  It’s an invasion of his privacy and a reduction of his dignity, I know, for his daughter to change his underwear and clean him up like a baby.  Yet there’s no one else to do it.  I’m not sure how I feel about it — I used to clean Mother up, certainly, but we were the same gender.  This is different.  I’ll make it happen, despite my own embarrassment, and Dad’s.  I’ll try to make light of it.  I want to allow him his dignity as much as possible.

And yet another unpleasant surprise came today when I called to arrange ambulance transportation to Dad’s follow-up visit to his cardiologist tomorrow (test results from the recent nuclear stress test came back with abnormal results).  Medicare and supplement insurance do not pay for ambulance transportation to a doctor’s visit!  Even a reduced-rate cost would be just over $500.  I am now waiting for a return call from the cardiologist’s nurse to see whether I can leave Dad at home and come in for a consultation without Dad.  The ambulance is tentatively scheduled in the meantime.

Unless the muscle spasms disappear, and unless Dad regains the ability to sit without such pain and use the wheelchair, I don’t know whether I can actually manage to get him into a wheelchair, into the truck, and to the office and back home again.

Not that I wouldn’t willingly use the ambulance for such an office visit, but at that cost, I know I need to be judicious in using it.

All of this makes me wonder just how our elderly manage without family.  I know that nursing homes and assisted living facilities are choices for many. They are, however, expensive, more than mere Social Security payments can cover.  Moreover, I know that for Dad, this would truly be awful — he endured the two months or so at Southwind because it was necessary, but he always knew he was coming home.

Now that he is home, I know that he’s secure in a known environment.  I’m there 24/7 during the week.  He has friends drop in for visits.  He doesn’t have a roommate who is less than thoughtful in so many ways.

He has privacy.  He has his own home around him.  He knows he is loved and cared for by his daughters, that friends are there to help.

So much happens in such short periods of time.

I take my life day by day — I hope for weekends in Lake Charles, I hope for a week in Greece this June, but those will be gifts for me, treats.

Certainly I live my life a day at a time.  More properly, perhaps, I live it hour by hour, even minute by minute.

Even a minute brings such profound changes.  One minute, Dad was able to help us get him up and dress him and he could sit in a wheelchair.  One minute more and he’s on the floor of the front bathroom because his legs have given out.

From Friday to Monday, he went from transportation via wheelchair and truck — with me — to transportation via gurney and ambulance.

It’s only Wednesday.  It’s his tenth day back at home.

Living in the moment isn’t a theory any more for me; it’s reality.  I only have the moments, and I cherish them.