Monday, June 17, 2013

Ice Age

I realized the other day, that my heart is encased in ice. On reflection, that isn't really that surprising, but at the time that the realization came, I really hadn't thought about it overmuch. I hadn't needed to.

heart on ice photo: heart 28 ice_heart_by_chmstudio4.jpgNow that Mummy is being cared for by professionals though, I must find a life. That's not nearly as easy as it sounds. It means that, for good or ill, I now have to allow my emotions to be engaged in other ways than just worry (about Mummy; about money; about what next; about when I'll get to go back out into the world). For that to happen, I've got to bring the emotions, the heart, out of the deep freeze where apparently they (and it) have been stored for some months now.

Unfortunately, there are no road maps for this part of the journey either. Just as there were no road maps for managing the finances; managing the emotions; managing the decaying relationships in the active caregiving phase of this journey, there are now no instructions for how to get back into the world.

I don't have anything to offer by way of advice having only just embarked upon this phase of the journey myself. I'm just making things up off the top of my pointy head. All I've got so far is this: I have to take my time. Thawing is typically a slow process and to try to rush it, to force myself to be ready for new emotional journeys before I actually am ready, is to put myself in a place I have no business being.

I miss my mother. I expect to hear her sniffle upstairs or to come down the steps any minute. I am alone much of the time and yes, somewhat lonely and therein lies the danger. I am that much more likely (on account of the loss) to leap into something inappropriate and unhealthy (or at least unhelpful) because of my state. Leaping when ill-prepared is a recipe for disaster and I'm not just talking about love relationships either. Business relationships, new friendships, any kind of 'relationship' right now has to be scrutinized very carefully. One's ability to clinically assess is compromised, I believe, when one is or has been under a protracted period of stress. Heaven knows, I don't feel well prepared to make any hard decisions. The hardest decision I've been able to make in the last few weeks was a car buying decision and I did that with help!

ice melts for love_edited + caption by Petschm 2013 photo heart_lovemeltsice_fromJanjaansalbum.jpgSo now, I must learn to trust myself and my decision-making abilities again.

I remember years ago after having emergency surgery, I found that for months afterward, every twinge my body gave me was cause for me to call the doctor. I eventually had to explain to him that I simply couldn't trust my body, and had to rely on him to tell me that I was OK. Who does one call in situations such as mine? There's no doctor of the self-confidence. I suppose there's counseling, but I'm not entirely sure that that's what's needed here. I have a feeling what is needed is time. Healing cannot be rushed.

Somebody really needs to write a manual to go along with this journey. Tramping this ground alone and without any kind of guide or aid is dangerous business.

Friday, June 14, 2013

The Warehouse

I've been away from writing for a little while because Mummy was in a rehab facility. I've been wanting to write about it, but couldn't. Now that she's moved out, I can. I didn't like the place at all. To be truthful, I hated it. It's a warehouse.

At the risk, of having someone sue me for maligning their facility, I won't offer any descriptors of the place that might expose its identity, but let me be very clear: I hate it.

What's wrong with it? Here's the short list:
There were 32 or 33 dementia patients in a single space. There were maybe 5 or 6 staff working per shift. If you do the math, that's five patients or so per staff member. Patients have vastly differing needs: some need to be fed while others can feed themselves; some need bathrooming assistance, others are more independent; some patients are mobile, others are not; some have 'behaviors', others do not. Given the range of abilities and challenges, having only six staff per shift means that patients' personal care needs are being met in the most perfunctory way.

One of the things that Mummy got while she was at home, was time outdoors. This facility hasn't even got a garden into which the patients can be taken for fresh air. Mummy is also now in a wheelchair, so the whole question of going outdoors is no longer entirely in her hands. Moreover, AD patients are typically kept in locked units, so going out is controlled by others but in a situation where there are five or six GNAs (geriatric nursing assistants) to 32 patients, you can be sure there will be no time outdoors. Fresh air? She gets that when I go to see her. Not good enough.

Of all the things that offended my sensibilities, it was the cavalierness (is that even a word? Yes it is, I just looked it up) of the treatment that most offended me. There seemed to be no sense that these patients were still (oh the horror!) people, in need of mental and physical activity that would allow them to retain what remains of their minds. It's all well and good to say that it's hard to do, I know it is, I've tried to do it. The mere fact of its being difficult however, is not reason enough not to try. One Wednesday, I went to visit only to find my mother, along with the other patients, parked along the walls, gazing at nothing. The television was on, but some vapid thing was playing. The TV was clearly for the entertainment of the staff not of the patients. The GNAs and CNAs (certified nursing assistants) didn't seem to be overly troubled by the emotional, social or psychological needs of the persons in their care. Surely, we can do better than this? I have to believe that there is better out there somewhere.

What troubled me especially, was the idea that for this the federal government spends thousands and thousands of dollars each day. Mummy's daily rate was $237. That is in excess of $7,000 a month. For some, that is paid for by a combination of Medicare/Medicaid dollars and Social Security. For some, like Mummy, it's 100% self-pay. But friends, if I'm paying - either out of pocket or through federal government assistance - oughtn't I get some value for my money? Surely, at that rate, that is not too much to ask? Surely? I know, I'm given to asking hard questions but surely some value for my money should not be an impossible request.,1331016599,4/stock-photo-pallet-of-red-brick-96836191.jpg
I strenuously object to the notion that older people, especially sick older people, should be treated like a pallet of bricks or a load of wood awaiting transport to the nearest construction site. "Just park it over there!" That is NOT good enough. My mother has taught too many people; engaged too many minds - mine included; contributed too much to human society, to be treated thus. It's not good enough for me and I'm pretty sure, even if others' parents haven't done great and marvelous things for others, they did great and marvelous things for their families. It's not good enough for them either. This is not good enough. I don't know that I have the capacity or indeed the energy, to follow up and complain to whomever needs to be complained to, but this is simply not good enough. It is an obscenity, made all the more obscene because these people have all paid for this care upfront through their income taxes. They are people and should be respected until they take their last breath, no matter how hard that is to do.

Anyway, it matters not. Between the time I first started writing this entry more than a week ago, and now, Mummy has been moved. We're somewhere else. Somewhere, where, upon arrival, she was greeted with warm smiles and a "Welcome Home!"

Now that, is what I'm talking about!!