Posts Tagged With: home health care

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.

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Homecoming Week

It’s Friday morning, and Dad came home on Monday.  It’s been a week for homecoming, for adjusting, and for many discoveries.  A long week, but one worth it all.

From last week until Monday I worked to get the house cleaned, organized, and ready for Dad.  My friend Patty came from Moss Bluff a couple of times, and the two of us managed to get a lot done.  By Easter weekend, when I needed to see Dad, I was working still, and exhausted.  Kay came in on Saturday, and I just stayed in my bed and slept.  No visit to Lake Charles.

By Monday morning, things were ready.  By 11, Dad’s hospital bed had been delivered and set up and I put fresh new linens on it, with a blue comforter.  The bed is in what was the living room and is now his bedroom.  I angled it with the head toward the kitchen and the feet toward the front of the house so that he could see the television and look out the front door if he wanted.  I drove to Crowley, signed the discharge papers, loaded his clothes in the truck, then wheeled Dad (holding more stuff on his lap) to the truck and left.  A few minutes down the road, I pulled in at the dialysis clinic and reversed the procedure, getting the wheelchair out of the truck bed, unfolded, and getting Dad out of the truck into the chair.  I sat with him in the waiting room until the dialysis tech came to get him, and talked with her briefly.  Then it was off to run errands.  Medicine first, then a couple of other stops, and then back to Egan.

I unloaded a few things, leaving the rest until later.  I set up Dad’s medicines in his pill box and put some clothes away.  Most were dirty, though, and I left those near the laundry room for later.  Back to Crowley, a quick stop for celery and other things, and then to dialysis.  By the time I picked Dad up and got him home, I was truly tired.  Getting him out of the truck and into the house wasn’t too hard, but learning to get his wheelchair up the ramp and in the house was a bit tricky.  He was really tired, so I put him to bed.  While he slept, I made shrimp etouffee and cooked rice.

He ate some etouffee, enjoyed it, and then after taking his medicine, slept.  I tried to sleep, but gave up — he was restless, I was anxious, and didn’t really sleep steadily. At 3:30 a.m. I looked for him and he wasn’t in bed; he’d managed to get out of bed and into the kitchen– without a walker!  I have no idea how long he’d been there, but his skinny legs were pretty shaky, and I managed to get him back to bed.  He was confused, thought it was suppertime, and had been ready to get something to cook.

Needless to say, I did not sleep any more that night.  Luckily, the recliners in the room are very comfortable.  My iPad kept me company as I watched and worried.

Tuesday morning was a busy one.  Physical therapy came to evaluate and assess his condition; a physical therapist will come twice a week to work with Dad.  While the PT was still there, the home health nurse came to evaluate and assess Dad as well.  Dad was pretty alert by this time, which was good to see.  He interacted with the PT and nurse and held conversations.

He slept; we had visitors on and off that afternoon.  Tuesday night was better — I gave Dad his bedtime meds a bit later, to assure that he slept through the night.  Or I hoped so.  I slept, on and off.

Wednesday morning was pretty uneventful.  I cooked breakfast again; he ate.  He always wants his coffee, though I notice he doesn’t drink as much as he used to do.  Still, it’s something he wants. The home health aide came to help Dad shower. By 11:30, I’d delivered him to dialysis again and headed back to Egan.  My friend Patty had come again to help; she was catching up on Dad’s laundry while I took him to Crowley.  I came back and we worked some more.  Charles came over and visited some; I love friends who bring chocolate cake with them!  That was a perfect snack.

Errands, errands:  this time to Jennings, to find a bed alarm (the home health nurse had told me I could get one at the medical supply pharmacy there), a new shower bench (adjustable, because the one in the shower is too low).  I then headed through Egan to Crowley, stopping for another couple of errands.

Dad had been clear all morning.Wednesday afternoon, though, when I picked Dad up at dialysis, the tech told me he’d become a bit disoriented.  He still was so — and stayed that way through yesterday.  Every day at dialysis seems to tax him a bit harder.  He slept on Wednesday night and wouldn’t eat supper, though he did take his medicine.

Yesterday, I puttered around the plants on the front porch.  Carmichael’s delivered the portable oxygen concentrator that’s been in repair for nearly two months.  Physical therapy and home health came again.  Billie sat with Dad so that I could take Dad’s tax information to his CPA in Iota.  I quickly picked up mail and came home.  After Billie left, I warmed up some lunch and he ate, slowly; he finished his small bowl of etouffee.  Later in the afternoon, he wanted cake, and ate the whole piece. That was good.  He was still a bit confused, though less.  His back has been giving him a good bit of pain, and the pain meds help.  He does sleep a lot, though.  But I have to pay attention: last night while I was working on my taxes on the computer here in the office, I heard him — he’d gotten out of bed and was using the walker to head to the back bathroom, which has always been his.  Only when his walker wouldn’t fit in did he believe that he had to use the front bathroom.  By the time he’d turned around and gotten back to the living room, he was too tired to do anything but go back to bed.

Even confused, he manages to do things that surprise me.  Yesterday he kept talking about cooking peas.  He was dreaming, I kept telling him.  I wasn’t cooking peas, and neither was he.  He kept insisting, though.  It was about 5 when I finally noticed a plastic container out on the kitchen counter.  You guessed it — frozen peas. Just when he got them out, I have no idea.  But believe me, I’m learning that he manages to do things whether he should or no.

By this morning when I got up at 6:45, I’d been awake for awhile.  Dad was awake too, and I started breakfast while I gave him his meds.  In between, I finally started writing this blog again.  It’s 7:45 now.  In the last hour, he has gotten out of bed and used the walker to go to the bathroom by himself. He’s eaten part of his sausage and most of his biscuit and jelly.   He’s resting again now, after taking a pain pill.  I told him I’d let him sleep for a while.  I need to shave him and help him change clothes before I take him to dialysis.  While he’s there, I will run errands.  I also need to put the bed alarm on the bed — it’s a pad that fits under the sheet, wired to an alarm.  When Dad is off the pad completely, the alarm sounds.  I’m sure it will startle both of us if it goes off.  But I don’t want any more 3 a.m. surprise visits to the kitchen.  Nor do I want to find any more containers of frozen peas (or whatever) on the counter and wonder when he got those out of the freezer. I’ll unload the groceries and the shower bench.  I probably ought to load the extra garbage bags and boxes and take them to the dump as well.  By 3:30, I’ll be at the clinic waiting for Dad, and wondering what to expect.  Will he be confused again?

Homecoming Week in high school and college is usually about football games and parades and celebrations.  It’s been Homecoming Week here, just without the football game or parade.  Celebrations?  They’ve gone on all week, every day.  I celebrate that he’s home and asks questions about the house occasionally.  I celebrate when he wants to look outside and I coax him to sit on the front porch bench for a few minutes.  I celebrate when friends drop by and he engages in conversations.

Those celebrations are important — he’s home.  He knows it and is comfortable.  He’s glad to see friends.  Even with the confusion and the weakness, Dad knows he’s home again, and I think he’s relaxed more.  He smiles more than I saw him smile while he was in Southwind.  Sometimes, I think, he wasn’t sure he was going to come home.  Now he’s secure in his home of nearly 46 years.

It’s been a week of adjustments — for both of us.  By today, I know the schedule to expect from home health:  Tuesdays and Thursdays, physical therapy; Wednesdays, aide to bathe Dad; twice a week, home health nurse.  I’ve figured out that my free time to run errands will be on Mondays, Wednesdays and Fridays while Dad is at dialysis.  If I need to make an appointment for me in Lake Charles, it needs to be on Tuesday and Thursday morning, when Billie can sit with Dad; I need to be back by 1 because she works at the library in Crowley on Tuesdays and Thursdays from 2 p.m. to 5 p.m.   Friday afternoons by the time I get Dad back from dialysis, Kay will be here, and I can have until Sunday afternoon to head to Lake Charles to my house.  I know I’ll have a week to 10 days in June; I’m trying to figure out how to have a longer break — I want to go to Greece to a friend’s niece’s wedding, and to see my apartment in Athens, and to hang out with friends there.  That’s my goal, anyway.

I can tell that every day I will start Dad’s breakfast by 7 — a biscuit, one patty of sausage, and some coffee.  He doesn’t want an egg right now.  I’ll cook.  We eat supper together every night, which is good for both of us.

He sleeps.  While he does that, I do laundry.  I watch television.  I wash dishes and I cook.  I check on him frequently, sometimes talking with him if he’s awake.  Reassuring him if he’s confused.  Today he told me about a trip to town, seeing someone he used to work with.  I guess his dreams take him places he can’t go anymore. I don’t fuss at this; I just accept it and nod and talk.  Frequently, he tries to get out of bed because we “have to go . . .” somewhere; I reassure him that no, we don’t, that he’s at home and we don’t have to go anywhere yet, that he can go back to sleep.  Keeping calm is easy, I find, and if I’m calm, it sets the tone for him.

Now I also I putter around the front porch plants.  They’re all looking healthy and green.  The agapanthus are beautiful and blue; I have some other smaller blue flowers as well.  My friend Carolyn gave me some lovely yellow flowers in a blue pot.  I have two kinds of ivy in hanging baskets.  I’ve planted a lot of herbs.  I have a hibiscus tree in a big pot.  The windchime reminds me often just to close my eyes and listen, to sit and enjoy the moments.  The hummingbird feeder and bird feeder haven’t gotten any action yet, but I’m hopeful — and they’re cute, anyway.  The yellow bench with the blue and tan floral cushion is comfortable and inviting.  It’s lovely to have the small space so handy, so available — and so welcoming to all.

As the week winds up, I now find time to write as well — finally.  It’s as though I’ve been racing for days to get ready to get Dad home, and then to get Dad settled and to figure out what’s going on.  Now, I think I have a handle on the general scheme of things.  I’ve still got chores to do and appointments to set up; I need to set up a follow-up visit with Dad’s primary physician.  Today while he’s in dialysis I’ve got to buy groceries and some cleaning supplies.

Charles reminded me yesterday that I need to spend time here in the office space, too.  I’ll need my own space, he says, and he’s right.  So I’ll start working on clearing up the boxes that are still stacked here.  I’ll figure out where my own craft supplies really are so that next week I can begin working on jewelry again.

In the meantime, I have discovered that when I go to Lake Charles, I have to crate my three cats and set them on the front porch there while I flea-bomb the house.  Yes, that house now has fleas.  Oh well, at least I can bring the laptop and iPad and some cold drinks and sit on the porch there in my rocker.  I don’t have any plants in pots on that porch, but I do have lovely roses that are in bloom.

Two porches to enjoy — and my pets.  Dogs here in Egan, cats in Lake Charles.  Friends in both places.  Dad at home, comfortable and feeling secure.  Kay to relieve me on weekends.

And time to enjoy, to write, to read, to create.

Who needs a parade?  I’ve got porches!

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