Ramping up Elder Care – December 2024

My parent came home from the hospital the Wednesday before Thanksgiving...still requiring a lot of care at night which fell to me since I was staying in their house. Both me and my sister remained almost as sleep deprived as when we were alternating 24-hour stints at the hospital! We quickly realized that the strategy that had worked for the caring of our 90+ year old parents over the past few years was not going to work going forward…and the ‘new normal’ we had scrambled to established could not be sustained.

Even sleep deprived – I acknowledged there were magical moments and the joy of not being in the hospital anymore. I appreciated little things like the gentle glow of warm-colored night lights and the full moon shining through a skylight…and every bit of fractured sleep I could get.

Even sleep deprived – I acknowledged there were magical moments and the joy of not being in the hospital anymore. I appreciated little things like the gentle glow of warm-colored night lights and the full moon shining through a skylight…and every bit of fractured sleep I could get.

Before the hospitalization I had made appointments to interview companies that provide in-home caregivers and to visit an assisted living group home. We managed to keep those appointments and decided to contract for a caregiver at night for the month of December; that relieved our sleep deprivation and gave us a few weeks to decide on the ‘next step.’

Our experience with caregivers has been mostly positive but we quickly realized that there would be at least 3 people involved to cover the 7 days each week. So far 2 have not worked out: one that slept through most of the night and another that one parent disliked (strongly). We realized that the care givers rarely work with their peers (so no cross training or collaboration on unusual situations) and supervision was not apparent. The role of the company they work for seems to be primarily scheduling of services. And the services are expensive.

It has enables us to sleep through the night but the days have been fraught with home health appointmentss (nurse visits, physical therapy, occupational therapy, speech therapy, virtual doctor visits). There have been two medication changes – both with positive results. My sister and I have gotten very efficient at preparing thickened liquids and appropriately elevating the hospital bed to avoid aspiration of fluid in the lungs of our parent that was hospitalized. Other upheavals have piled on too: Carrollton’s replacement of a sewer line at the edge of the property, a plumbing problem that caused the only bathroom in the house with a door wide enough for a walker to get through to be unusable for about 24 hours, required fall yard maintenance, Thanksgiving celebration…and preparation for Christmas. There is always something that needs to be done that we can’t quite find time to do.

We researched assisted living options…at first thinking that they would be a back up plan but deciding that they should be the 1st choice based on our experience by early December and that the form that would probably be more suited for my parents would be a group home rather than a larger facility. We found one that had been created in a renovated house in their neighborhood for 6 people. We visited the facility and liked it. They had 1 opening at the time. Then they told us that there would be a second opening by the end of December (one of the residents being moved to a facility with a higher level of care) and that the largest room (the one that had been the master bedroom in the original house) was going to be available. We started the application process.

The initial discussion about assisted living and the specific place we were looking at seriously went as expected. One agreed to keep an open mind…the other had a visceral reaction and didn’t want to consider any other option than staying in the house they have lived in for 33 years. We scheduled a visit to the assisted living home…hoping that we could encourage both  parents to be in information gathering mode and ask a lot of questions.

The day of the tour arrived…one parent had already decided that assisted living was the way to go, the other was still thinking it was not. Neither asked questions on the tour but looked around eagerly. One was completely exhausted by the outing but confirmed their idea that moving was best. The other became convinced (and upset) that they were going to be losing the house they called home for 33 years and moving to the assisted living place.

We are proceeding with the process toward assisted living. There are many ways that it could fall apart…but as I write this post we are on track…planning to make the move in January.

Stay tuned for our continuing journey ramping up elder care….

Previous posts: November 2023, November 2023 update

Holiday Decorations

This December is going to be a unique one for me…away from home….focused on other priorities…somewhat stressed by the situation. I am savoring the decorations two of my sisters arranged at my parents’ house:

The wreath on the door…

The reindeer and poinsettias on the mantle…

The big wreath on the wall…

These are all decorations that have been used in previous years…associated with pleasant memories of past Decembers, prompting us to prepare for celebrating an anniversary, a birthday, and Christmas that are all part of our family celebrations in December. The month has always be an emotional high…and this year there is the overlay of realizing that it is probably the last one for my parents in this house.

New in 2023

It’s December already…time to think back on 2023 about what was different about the year. This is a way to acknowledge the ‘new normal’ during the year before I start thinking about the tweaks I want to make intentionally in 2024.

  • I honed my diet slightly.

  • Making a slurry of 1 tablespoon of chia seeds every morning to drink as I swallow my daily vitamin/supplements reduced the dryness of my skin. The change got off to a rocky start; the package listed 2 tablespoons as the serving size and I got nose bleeds two days in a row (and I hadn’t had a nosebleed otherwise since I was a child!) after a week of that serving daily. With a little research, I discovered that 2 tablespoons is way too much Omega-3 oil to get every day!

  • I have recently started added a teaspoon of spirulina to my chia seed slurry on some mornings…continuing my preference to get nutrition from my diet rather than pills. It is a different mix of nutrients that my usual diet…makes up for maybe not getting enough leafy greens every day. The powder is a very pretty color too (I am thinking about swirling it on top of vanilla ice cream next St. Patrick’s day!).

  • Hemp oil is great on popcorn….replacing butter. This is my strategy for making my favorite light meal even healthier! The oil has both Omega-3 and Omega-6 oil. So far I haven’t overdosed on Omega-3 again (no nosebleeds) but I might skip some chia seed on some days. The only downside of hemp oil from my perspective is that I must remember to keep in in the refrigerator.

I signed up late in the season with a Community Supported Agriculture farm in Springfield. It was a learning experience and continued my journey of finding fresher veggies that are available in the grocery store although I probably won’t continue (farm too far from my house to pick up my share, delivery fees, spoiled by the CSA in Maryland). The veggie that both my daughter and I enjoyed the most from the CSA was arugula….far better tasting and more durable in the refrigerator than can be purchased in the grocery store. I am considering setting up tables with growing trays and grow lights in my basement to grow my own crop!

I started listening to more music this year…finding artists on YouTube then using Apple Music. My favorites at the end of the year:

  • Brooklyn Duo

  • The Boys of County Nashville (Celtic Tribute to Metallica)

  • Low Strung

A lot more time in Carrollton, Texas. Just before the COVID-19 pandemic, I had started going to Carrollton more frequently to help my parents. The pandemic interrupted that plan until we were vaccinated. By the beginning of 2023 I had established a rhythm of being in Carrollton a week out of every month. That pattern changed in November 2023 when the hospitalization of one of my parents caused my sisters and I to recognized that they needed someone with them all the time. This December is going to be a huge transition time for them and for us. The end of 2023 is a first in another dimension for me: the longest time I have been away from my home since I traveled with Up With People in my junior year of high school.

2023 was my first full year living in Missouri. So much to explore! In 2023, we made first visits (and some seconds) to places close to Springfield and around St. Louis. And there is a lot more of the state to see!

Gardens Aglow Vicariously

I am in Carrollton, Texas this December working with my sisters as we increase the daily assistance for my parents. It is going to be a very different December this year. The yearly tradition (started last year…our first December after moving to the Springfield MO area) of walking through the Springfield Botanical Gardens Gardens Aglow display will be a vicarious one for me this year. My husband and daughter did the walk last week and sent pictures.

It was a drizzly night so they both just used their phones rather than more expensive cameras. There were not many people walking the garden (probably because it was wet) so the pictures don’t have as many silhouettes of people as we had last year. The pictures put me in a holiday mood….even while I accept – even savor - that I am where I need to be, doing what I need to do here in Carrollton this December.

Walk in the Carrollton Neighborhood

Getting out for a walk in the neighborhood was a treat during the routine of being with my parent in the hospital for 24 hours and then catching up on everything else (including sleep) for 24 hours…repeating. Even though I was exhausted, being outdoors in the crisp air was exhilarating; as always, I had my camera in hand to document what I noticed.

I didn’t get away from the house before I noticed the mini-mums in the front flowerbed and the oak leaves on the ground but held upright by the groundcover.

There was a flowerbed near the sidewalk a few blocks away that was full of ceramic yard art tucked into the plantings. The frog was my favorite.

I noticed that the city of Carrollton (Texas) has marked the drains along the street…indicating that the drains go straight to waterways (i.e. not treatment for contaminates).

There was a confused pear tree along the way – blooming in late November rather than waiting until the spring!

Refreshed and feeling less stressed…I returned to my parents’ house for a nap.

Ramping up Elder Care – November 2023 (update)

My sisters and I thought we had time to learn about various options at a comfortable pace and then ramp up support for our parents in a targeted way over the next few months. We ordered two cameras to install in their home and made appointments to meet with two service providers for the next time I was in Carrollton – but that plan changed quickly when one of my parents entered the hospital.

I went to Carrollton early - entering 24-hour rotations with one of my sisters to support my parent in the hospital. My other two sisters and my daughter handled things at my parents’ house (it is traumatic for two elderly people married over 70 years to be separated for even short periods).

We learned a lot during the hospitalization about changes we need to make to avoid aspiration of liquid into the lungs (i.e. thickening of ALL liquids to honey consistency is now required). Previously some liquids had been thickened to a lesser amount (nectar) but water was unthickened….and now even that will have to be thickened. But – the reward is no coughing while (and after) eating or drinking!!!!

Small anomalies can make big impacts…low potassium and dehydration were two that our parent experienced. And the associated weakness/dizziness curtailed almost all physical activity for a little over 24 hours which required some slow increase of activity on the following days to get back to ‘normal’…and maybe that was a ‘new normal’ that was a little reduced from the prior normal.

Two cameras were installed and we used them along with virtual meetings to help our parents talk to each between physical visits. We decided a third camera would be worthwhile, so it was ordered.

We quickly established a contingency sleeping arrangement in case the hospitalized parent required more support at night immediately after coming home from the hospital.  The room includes a twin bed with plenty of room for a caregiver to move around….and for extra equipment. We are anticipating that ambulation will need to be monitored/supported (i.e. a belt around our parent … a caregiver with a hand on it) during their recuperation until we are sure the fall risk is minimal.

As I write this, our parent is still in the hospital but due to go home within 24 hours. We hope we have ramped up our support plan sufficiently.

Stay tuned for the next installment of Ramping up Elder Care!

Previous posts: November 2023

Ramping up Elder Care – November 2023

My sisters and I realized earlier this month that we need to ramp up the support provided to my parents and the needs were quickly going to exceed what the 4 of us could provide. We had tweaked the situation over the past few years in significant ways: they no long drove themselves, their doctor/labs were mostly done in their home, one of us was with them every day providing at least one meal and their refrigerator/pantry was kept well stocked, there was always a pile of jigsaw puzzles, my dad carried a smartphone on his rambling walks so we could locate him (fortunately he never got lost), they both wore fall necklaces, and we set up a voice activated system for reminders/calls for help. They might not need someone with them 24/7…but we are seeing that it might not be that long before they do.

And so – a new adventure begins…

Our first action was to contact their doctor for a virtual meeting about ‘improving support to our parents.’ The doctor also brought a social worker to the meeting. We documented our observations…why we thought more was needed. It was a very productive meeting with some things we could do immediately (like adding some cameras to the home) and a list of services available in the community.

We started with the idea that we wanted to keep them in their own home with support from private care providers to supplement what we do but quickly realized that we should explore assisted living (particularly small, home-like facilities) as well.

Stay tuned for what we learn over the next month!