Sustaining Elder Care – April 2024

2-day trips to Dallas have become the norm for me. I leave early from home, visit my dad immediately after I get to Dallas in the early afternoon and take care of any other business thereafter…then stay in a hotel overnight and drive home the next day. Now that the days are getting longer, perhaps I might visit him a second time in the morning before I head home although the assisted living group home is not ‘early.’ I probably would not want to arrive for a visit before 10 AM.

Dad still enjoys going out to eat and we are exploring more places nearby.

The warmer weather is great for walks. We have discovered that he does better with a four-wheeled walker than the two-wheeled one. The rough pavement makes it very hard to use the two-wheeled one. His balance is much improved holding onto the four-wheeled walker and he walks at a pace that is more like the way he walked prior to using a walker.

He has decided that 500 pieces puzzles are usually too hard…and he wants bigger pieces. I got 10 puzzles for $20 at the library’s used books (and puzzles) sale; knowing what they have is one of the benefits of volunteering for setup. Most of the puzzles I got have 300 pieces and I am hopefull my dad and others at the group home will enjoy putting them together. I picked ones with bright colors too – although that wasn’t a requirement from my dad.

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One of my sisters and her husband took my dad to her home to see the eclipse on the 8th. Unfortunately, he didn’t understand what was happening and kept asking where he was. It was a learning experience for our family – we will continue to enjoy taking him out to lunch occasionally but be very careful not to overwhelm him with more complex events away from his assisted living home.

I had thought I would be able to get down to one visit per month…but so far that hasn’t happened.

Previous Elder Care posts

Sustaining Elder Care – March 2024

A recap: My sisters and I started our journey ramping up elder care back in November. At first we thought we were being proactive in our conversation about ‘next steps’ with my parents’ doctor….but, less than a week later, my mother was critically ill and in the hospital. I spent the next 7 weeks in Texas. My mother managed to recover enough to come home before Thanksgiving even though she needed a lot of support at home. We hired caregivers to assist her at night through December and moved my parents to an assisted living group home just before the new year. As we worked to get them settled into the assisted living routine, we started a surge of effort to get their house cleared and on the market; the sale was finalized at the end of February. Both parents responded favorably to assisted living and decided they wanted to go out to eat occasionally rather than having special meals via take out as we had done for them at their house. In mid-February, they became sick with COVID…my dad first; he got Paxlovid and was recovering. My mother tested positive a few days later; her doctor adjusted her meds and she got Paxlovid; at first her case seemed even less symptomatic than my dad’s; the staff at the group home thought her breathing was wheezy one afternoon (even though my mother did not think she was having breathing problems) and sent her to the hospital via ambulance; she died 2 hours later.

The last few weeks have been busy ones. We reconfigured my dad’s living space from two rooms down to one and are in the process adjusting the assets my mom and dad accumulated to support his long-term care. As I write this, I realize that we have already settled into a ‘sustaining’ rather than ‘ramping up’ mind set. It isn’t that we won’t evolve what we do based on my dad’s needs…but we have a framework that will stay the same: the assisted living group home…daily visits from family….out to eat several times a month…walking in the neighborhood when the weather is good. Right now, he is still adjusting to not having mom around all the time; she was there for him for over 71 years. We are grateful to the staff of the assisted living for their increased attention. He still has times when he looks lonely…but he is talking more than he did when mom was around to talk for him.

Going forward, my trips to Texas will be quick ones – drive down and visit with dad in the afternoon before I head to my hotel, drive home the next day. Sometimes I will visit with dad in the morning before I drive back. I have done 2 of these trips so far in March. My sisters are there more frequently because they live closer than I do – one is there almost every day, another comes 2-3 times per week, another once or twice a week. Along with taking him out to eat, we put out his clothes for the next day, work on a puzzle with him, accompany him on a walk, help him find something that he lost (his wallet with his id and he glasses tend to go missing).

My sisters and I have had conversations about how much we have accomplished in the past few months – having to adjust very rapidly. We are not exactly relaxed at this point, but the stress level is dramatically lower!

Previous posts: November 2023, November 2023 update, December 2023, January 2024, February 2024, March 2024 (1)

Ramping up Elder Care – March 2024 (1)

A lot has happened in the last few weeks, so I am going to write 2 ‘ramping up elder care’ posts in March. In my mid-February post, I wrote “Are we through the bend…or is more to come before we settle into the new normal?” We were already getting accustomed to my parents’ house being sold…but we were also anxious with my dad testing positive for COVID. My mother tested positive a few days after he did….and died suddenly  few days later after being in the hospital for about 2 hours. So - the bend in my family’s collective life path is continuing into March.

My mother’s funeral was on the 1st. Dad was pleased with his appearance for the funeral; one of the assisted living staff helped him get into his suit (which he had not worn for a few years --- the last time was to a granddaughter’s wedding)…found another shirt so the neck would button and he could wear a tie! My sisters and I alternated being with him during the visitation and service. He seemed to enjoy my slide-by-slide narration of the pictures of Mother’s life from a young child to a few days before she died at 92. He also liked the limo. He did not like seeing Mother in the casket…thought it didn’t look like her even though he acknowledged that it was. He looked a few times then seemed to prefer watching the slideshow.

 My dad is grieving but very engaged with the reconfiguration of his living area at the assisted living group home. We started setting expectations a few days before the funeral so he would not be surprised when the furniture moves started to happen and it helped him internalize that mother was not coming back. The bed my mother has been using was one provided by the assisted living home and it was removed while we were at the funeral. We were all relieved that he didn’t seem traumatized that it was gone.   He is talking more than usual (he previously has always deferred to mother) ….and is more opinionated about how he would like things arranged. My sisters and I are spending more time with him, and the staff is very helpful. The staff has figured out that a small serving of ice cream is a great treat for him…and smooths out rough emotional times. So far – he seems to be surprising us with how well he is navigating his ‘new normal’ without his partner for over 71 years.

My dad’s reactions have been so positive that my sisters and I have already cleared away most of my mother’s belongings. It was a good time for us to talk to each other and him….noting some of the clothes she had worn for years…and others that were almost new…and trying out ideas for where furniture would be moved.

I don’t know for sure that we are at a new normal yet. We are with him more than usual…just to be sure he is OK. So far…he seems to be.

A few last pictures from my parents back yard the day before we closed on the 28th:

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One of the neighbors asked the new owner if he could cut the narcissus and daffodil flowers from the yard to bring to the funeral….and the new owner said yes!

One of the neighbors asked the new owner if he could cut the narcissus and daffodil flowers from the yard to bring to the funeral….and the new owner said yes!

Previous posts: November 2023, November 2023 update, December 2023, January 2024, February 2024

Ramping up Elder Care – February 2024

My parents have rediscovered the joy of going out to a restaurant for a meal. The weekday late lunchtime seems to work best (i.e. not crowded). It is quite a production: two elderly people with walkers…and two (or three) others with them. One of my sisters bought a small refrigerator for their room and they relish being able to put their leftovers there (and seem to prefer eating them for their next meal!). This is probably something I will try to do with them every time I visit. There are a lot of restaurants near the assisted living group home to experience.

Sometimes major bends in our life path are only recognized in retrospect; the events of January and February 2024 are a bend everyone in my family anticipated and acknowledges in real time. My sisters and I are acclimating to others providing the day to day care of our parents with their move to an assisted living home and the family has lost a long term hub for family events with the selling of their house.

• My parents moved to an assisted living group home at the end of 2023. They’ve settled into their new environment. My mother is improving; maybe it is simply a trend that started back in December, but it could also be the increased social interactions and her confidence that someone is always available to help. It is still challenging for my sisters and I to back away and not jump to assist them when we visit. The staff is helpful and patient with everyone! My dad is about the same although he was very disoriented at first; he is eating well.

• My sisters and I began to clean out my parents’ house soon after we moved them. They had lived in the house for over 30 years. There was a lot to go through. I made two short (less than a week) trips to Carrollton to help. During January we cleared most of the house by

  • Distributing furniture to family members or selling it or marking it for donation. I took two small tables, and my daughter took a larger octagon table for her office.

  • Donating clothes. There was very little that someone else in the family could wear. The closets in their assisted living rooms are filled to the brim with clothes that they wear.

  • Following the ‘bequeath’ list for decorative and kitchen items. I got 2 items from their 50th anniversary (one passed down from my maternal grandparents’ 50th), 1 from my parents’ 25th  anniversary, items that I remember from my childhood (a knife, fork and spoon of the silver plate my mother bought before she married; a orange cut glass bowl that I bought as a present to my Mother because it was her favorite color), 2 paintings my mother made (one of a dogwood blossom…and the pressed flower that I sent to her in 1984 from my Virginia house that she used as her model), the remnants of my maternal grandmother’s China….too many things to name although I am realizing that I should make a list for myself.

• The house went on the market on February 1st and we accepted a full-price offer on the 2nd. Closing was requested for 2/28. February became a sprint to clear out the two sheds on the property and donate the furniture that no one in the family wanted. I made a very focused trip to help.

  • Salvation Army came with a truck to get furniture and boxes of books. It was tricky since the city had the street in front of the house torn up (infrastructure update project). The truck managed the pickup from the alley.

  • Tools were mostly distributed to the sister that wanted them. Some were tools from my paternal grandfather.  My daughter got a telescoping tree trimmer (she has the bigger trees…but I can borrow it when I need it).

  • The trash and recycle bins were full for every pickup and some items were put at the curb in front of a neighbor’s house for bulk pickup.

  • Some odds and ends were taken to be repurposed. I got some white vertical blinds (not attached to anything…just loose pieces of blind) which I plan to cover with Zentangle patterns and hang (not sure where yet). There were three small pieces of Masonite that I got for another Zentangle project. Some pieces of wood were taken by my sisters for art projects and specific repairs at their house.

  • One sister is having the king headboard (purchased in 1963…beautiful wood) made into a display case. She also took the antique meat grinder that we found in one of the sheds.

  • Another sister is taking most of the yard equipment to distribute to her family’s houses so that it will be easier for her to do yard maintenance.

Are we through the bend….or is more to come before we settle into a new normal? As I write this my dad has tested positive for COVID-19. The symptoms were mild and initially attributed to some new eye drops. He was tested after one of my sisters that visits frequently tested positive. He is getting Paxlovid. This is the first experience with COVID for him and my mother; they are both vaccinated. Hopefully this will be a minor blip and we’ll achieve a new normal in March.

Previous posts: November 2023, November 2023 update, December 2023, January 2024

My Parents’ House

Once the decision was made in mid-December with my parents to move to an assisted living group home, I found myself examining the house that that had called home for more than 30 years – the last home they would own…the only one that didn’t still have a mortgage when they moved. The contents documented the whole of their lives.

The creation of the garden room not long after they moved into the house was a project that added more than space to the house.

The space was lined with house plants (some that had grown quite large) and had great light. The jigsaw puzzle table was there…a rocker and glide…and a transport chair that was easily maneuvered into a sunny spot to observe birds outside at the feeder or read the paper. The glide, puzzle table, and transport chair were moved to the assisted living group home.

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The large plant in the foreground of the picture with the transport chair is one that grew up into the skylight of the garden room over the decades. My sister had brought it home from her work when an office closed. It bloomed in December (something it had done rarely over the years)…to the joy of my parents and the whole family. My sister has now managed to move it (in a U-Haul truck) to her house about an hour away; we were all relieved that it survived the trek intact.

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A clay pot that another sister made was in the corner of my parents bedroom holding a collection of peacock feathers and dried seed pod/flowers….a suncatcher. My mother selected it as something to move with her – perhaps because of the memories of each item and the vase itself. Peacock feathers are special in my family because my maternal grandparents kept peacocks in their later years.

Back in the garden room a small poinsettia purchased recently sat on the windowsill. The second image is my favorite artsy image of December 2023! The pot was small enough for the windowsill at the assisted living group home so it moved with my parents.

We are now in the phase of sifted though everything in the house….taking a little more to my parents, distributing items to family members and my parents’ friends, donating some items….recycling and trash are the last resort. There are ups and downs to the work. It is giving us time to internalize the pivot point in my parents’ lives (and our own).

Ramping up Elder Care – January 2024

A lot has happened since I wrote the December chapter of ‘Ramping up Elder Care.’ The assisted living group home we initially found ended up not having space…so we looked at several others and settled on one that was probably better than the one we found in their neighborhood in every way but the location. When we took our parents to see their new home the day before the move, one was optimistic…the other one was silent but attentive.

The focused activity was intense to get them moved just before the end of 2023. Our strategy to have a night time caregiver in their home during December and then move them to assisted living worked….but it was more challenging that we anticipated.

• The nightly caregivers were not consistent; we had over 5 people that handled the overnight shift during the month. Almost all of them slept for part of the night. One was very talkative. One was not very helpful. One got sick and had to leave early.

• We opted to have two rooms for them in the assisted living group home – one for sleeping and the other for a private living room. It seems to be working well – better than having one larger room. There are 6 other people living in the assisted living group home.

• Our parents had a lot of clothes that had accumulated over the years. Some no longer fit but one of them insisted that most were moved to assisted living.

• There were a lot of toiletries. We opted to not take any that had dust on them! It was a harder than expected job to pack up what they would need.

• My dad had to transition from a safety razor to an electric….which he hated.

• My mother only began to stabilize on her meds toward the end of the month. For a few days we thought we might have to continue to give her two of her medications rather than transitioning those medications to the assisted living facility staff but it stabilized just before the big move. Physically, she made progress with the help of an excellent occupational therapist and the suggestion from a physical therapist to try massage boots for the edema in her feet and lower legs (OK’d by her vascular surgeon)

• We celebrated their 71st wedding anniversary with special visits from family members and great food for the whole week before the move. It was joyous…but also stressful to get the visits scheduled at good times for everyone and to eat all the excellent leftovers!

• One sister handled financies, another handled medical transition, another focused on evaluating what would need to be done with the contents of the house and sheds; I focused on my parents’ needs since I was in the house with them those last few weeks. Everyone helped pack up what needed to go on moving day….and it was still chaotic and stressful.

• In retrospect…moving on the Friday before a holiday weekend was not the best decision because the staffing at the assisted living was reduced over the weekend and they had no time to learn to supply thickened liquids required by one of our parents (so we ended up supplying them for the weekend).

And now, as I write this, I am home in Missouri….monitoring via the cameras we’ve installed in their rooms at the assisted living but otherwise trying not to interfere as they get acclimated to their new surroundings.

The next stage is getting their house ready to sell. I’ll be back in Carrollton in mid-January for that project; hopefully I’ll be rested and ready to work by then! And my parents will be adjusted to the big move from their home to the assisted living group home.

Previous posts: November 2023, November 2023 update, December 2023

Ten Little Celebrations – December 2023

December has been one of the most unusual (and stressful) of my life. Along with all the upheaval – there were still little celebrations to notice and savor.

Completion of a construction project. Big machinery digging in the street/sidewalk, the alleyway, and backyard of my parents house. The city was replacing an old sewer pipe. It was interesting to watch…although there were a few anxious moments too. We all celebrated when they finished within the 3 days they’d estimated for the project!

A warm day to mow the leaves. The leaves didn’t really begin to fall in Carrollton TX until December. We celebrated a warm day to mow them into the yard.

Crystalized ginger, big peppermint sticks. I savored special foods from the past that I haven’t eaten as much in recent years. I bought the crystalized ginger and a sister provided 6 of the big barber pole peppermint sticks. I started the celebration of my birthday early!

Red velvet cake. When I was growing up, my usual birthday cake was red velvet cake – made by my mother. This year one of sisters and her husband discovered a diner that had an excellent version of the cake – and bought me two pieces – which I enjoyed 2 days in a row prior to the actual birthday!

A break. My other sister came to make lunch for my parents and I took a break away from my parents’ house. I went to a small café for brunch and they had a special: birthday pancakes! I opted to get that special (another early birthday celebration) and thoroughly enjoyed it. Then I walked (and took pictures of birds) around Josey Ranch.

December celebrations. My birthday is just one of the normal December celebrations in my family. There is also my parents’ anniversary (their 71st) and Christmas! It’s always a hectic month…full of family visits.

Good sleep. I usually sleep well but it has not been as consistent this month….so I celebrated a particularly good night!

Fall foliage of crape myrtles. I’d never noticed crape mytles in the fall before. At my parents the conditions must have been just right for them to turn from green and hold their leaves this year. I celebrated how great they looked with the leaves and seed pods.  

Finding assisted living. Change is hard. We had moments of discovery and panic…celebrated finding an assisted living group home for my parents and then realizing that the details required another burst of energy. As I write this we are all celebrating how much we have accomplished with our combined efforts.

Daughter arriving. My daughter came for my birthday and the anniversary. She took me out for Ethiopian food to celebrate my birthday!

December 2023….what a cresendo for the year!

Ramping up Elder Care – December

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