Tuesday, November 16, 2010

Influenza (flu) Vaccination - The Elderly are at Risk!

It is flu season and those at greatest risk of developing serious complications from this preventable disease is the elderly.  Read on and become better informed consumers of health care.

Influenza Facts


Influenza, commonly known as the flu, is a contagious viral infection spread predominately through coughing and sneezing. Common symptoms include high fever, chills, headache, muscle aches, sore throat, cough, and generalized fatigue.
Although it peaks in January and February, the disease is active from November to May.

Vaccinate to Prevent Serious Illness

The influenza virus changes from year to year-requiring annual vaccination to protect against the different strains. The vaccination is available in two different forms, the traditional injection, which contains an inactivated (killed) virus, or as an attenuated (live and weakened) virus that is sprayed into the nostrils. Both routes provide full protection against influenza.

According to the Centers of Disease Control (CDC), this year’s vaccine will protect against the following viral illnesses only:

• A/H1N1
• A/H3N2
• Influenza B

Those at Risk

Influenza is a highly contagious illness causing approximately 200,000 hospital admissions, and about 36,000 deaths per year. Pneumonia, a serious respiratory complication, accounts for over 90% of flu-related deaths. Moreover, children under the age of five, who contract the disease, are at risk of developing febrile seizures, a serious neurological condition. Annual vaccination is recommended for those individuals at greatest risk of developing serious flu-related medical complications:

• infants (six months of age and over),
• pregnant women,
the elderly,
• individuals with respiratory, cardiac, or kidney diseases,
• Individuals with compromised immunity,
• Health care and daycare providers, and
• Primary caregivers to those at high risk

Possible (Mild) Side Effects

Like any other medication, the influenza vaccination does have potential side effects. The most common side effects occur at the injection site, and include redness, pain and muscle soreness. Alternatively, some individuals experience systemic side effects that include red or itchy eyes, cough, fever, and body aches.

Treating Side Effects

Recommendations to help combat vaccination-related side effects include:

• Applying a cold and wet compress to the injection site,
• Increasing fluid intake,
• Taking acetaminophen or ibuprofen (as directed) to reduce pain and fever,
• Get plenty of (extra) rest

Many individuals feel a need to guard or protect the arm that received the vaccination. In fact, it is best to use the arm to help metabolize the medication and decrease the incidence of muscle ache and pain.

When to Contact your Doctor

Contact your doctor immediately should you experience any of the following symptoms:

• High fever
• Breathing difficulty or shortness of breath (call 911 if severe)
• Hoarseness or wheezing
• Rash or hives
• Dizziness
• Palpitations

Vaccine-Related (Serious) Complications

The influenza vaccine is prepared in chicken embryos, this type of vaccination is prohibitive to those with a chicken egg allergy. The Centers of Disease Control (CDC) has reported that, although rare, serious medical conditions have been associated with viral related vaccines, two of which are:

• Anaphylaxes or a life-threatening allergic reaction to the medicine.
• A serious neurological condition called Guillain-Barre Syndrome (GBS), characterized by fever, muscle weakness, and nerve damage.

Potential Impurities

Viral vaccines are manufactured with some impurities and may contain foreign proteins (DNA/RNA), other viral material, and of recent concern thiomersal, a mercury-containing preservative, found in multi-dose vials of the H1N1 flu vaccine. Advocates against vaccination argue that thiomersal can cause autism in young children. The amount of foreign DNA and RNA proteins contaminating these vaccines raise concerns that they may cause autoimmune-related conditions and cancer.

There are many who believe vaccinations in general are a bad idea. As the movement to decline vaccination increases so does many of those disease irradicated by vaccination. The debate to vaccinate (or not) is a heated one and ultimately each one of us must make an informed decision based on accurate information. Start by consulting your physician and visit the following websites for more information on the influenza vaccine:

http://www.flu.gov/
http://www.niaid.nih.gov/topics/flu/h1n1/Pages/Default.aspx
http://www.cdc.gov/h1n1flu/
http://www.cdc.gov/H1N1flu/vaccination/statelocal/centralized_distribution_qa.htm
https://www.vaccineshoppe.com/image.cfm?doc_id=11046&image_type=msds_sheet

Tuesday, August 17, 2010

Family Visits

I don't have a large family.  That being said, the family I do have is spread all over the country.  Last month we took my father to California to see his brother and his niece.  Earlier this month my niece came out to see her grandfather all the way from Connecticut.

My father wants so desperately to see his entire family before he dies. Yet I notice when he does have an opportunity to see a family member all he does is complain!  My poor niece was bombarded with trivial nonsense that was triggered when my father saw her!

My father has so many complex and convoluted issues that even he can't keep up with his own feelings.  Just the other day he said to me, "What is my eldest daughter's name?  However, ask him what his beef is with his eldest daughter, and he can't spit it out fast enough!  He remembers every dime he has given to people, and every fight or disagreement.  But ask him if he enjoyed the movie, he saw last night and he'll ask, "what movie?  We went to the movies last night?"

I love my family.  I know dad loves them as well.  Now if I can only get him to remember that the next time a family member visits.

Thursday, July 22, 2010

Me

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That's what you get when you have a 90-year-old move in with you!

Monday July 12, 2010
188 Days Since Accident
165 Days in Colorado

Where did all his energy come from?

Dad was up early today and when I came downstairs to make breakfast he sprang at me from his bedroom, slapped his hands together, and said, “So, what are the plans today?” I looked at him with one eye half-open and wondered who this man was standing in front of me and what did he do with my father. “Dad, remember that Joey and Jessica have (oral) surgery today to remove their wisdom teeth? We are not going to be doing anything for the next few days while I take care of them.”

Looking back I probably should have taken dad with me today. I really thought he would be bored and I did not want to have to worry about entertaining him when my children were going to need all of my attention. The kids and I left the house at 11:00am and did not get home until 4pm. It was a long day and the kids were starting to experience a lot of pain.
We walked into the house and my father greeted me at the door and said, “Where have you been all day? I was so worried; I have been locked up in this house like a prisoner.” “You just got home from a wonderful vacation and already you are complaining that you are in a prison?” I said. “I am going to get Grumpy for you to hold dad.” He laughed and walked over to the children and started making jokes but Jessica was in too much pain.
“Where is Larry?” I asked. “He has been outside mowing the lawn and fixing things, I wanted to help but he didn’t need me.” I have a lot of empathy for my dad, he wants to feel useful, but he is not handy. He only has one eye can barely see out of it. Larry works so hard and to be honest, when he has free time to work around the house, he does not want to spend time being slowed down by dad.

The fact is the next few days are going to be very busy for both Larry and I. Larry intentionally took an extra week of vacation from work to do some much need house maintenance. My time will be focused on carrying for the kids post surgical visits. I had no idea how the kids were going to handle having their wisdom teeth out.
Just then, I got this brilliant idea, I asked my father if he would fix a few articles of clothing for me. He was an excellent tailor in his day and unfortunately, he never shared that gift with any of his children. My sewing abilities included buttons and repairing small tears. I threaded several needles for dad and left him with a basket of repairs. I did not hear a beep out of him for about four hours! At the end of that time, he handed me a pile of repaired clothing! “You are amazing dad, thank you.” I said, while thinking to myself, what am I going to do to keep him busy for the next three days? Oh Larry….

Dad, a one-of-a-kind tailor!

Wednesday, July 21, 2010

California, here we come!

Saturday July 3, 2010
179 days since accident
155 days in Colorado


I did not sleep well last night and I never do the night before a trip. This morning however, I woke up with an energy I have not felt in a very long time. Things went very smoothly, the kids and dad got up and ate a quick breakfast. The car was packed last night so I just had to review my “morning of” list, give my plants a good watering, feed the dogs and Larry put them in the kennel (my ex husband watches the house and the dogs while we are away).

We found the off-site parking for the airport and there was the shuttle waiting for us! The first part of the trip today was going very well. By the time we got to security we still had a good two hours and it was a good thing too because the airport was very busy! Fortunately, with dad in a wheelchair we were brought to a special area that bypassed the traditional line through security. I could get used to this treatment!

Each child was given a responsibility before we left the house. Joey was first to go through security. He was in charge of the computers and other electronics. Jessica went next and was in charge of making sure that everyone took off their sneakers, jewelry, and emptied their pockets before entering security, and then she pulled things out of the trays, while Joey was putting the electronics and computers away. Alicia went last and was in charge of making sure that all our stuff made it through security. I went through the line first and made sure that all the toiletries and bags of medication were pulled out of the carry-on bag. I was planning to help Larry who was with dad, but before I could say anything security was padding down dad. They did not give Larry an opportunity to have dad walk through x-ray, which would have been so much easier! Now we were stuck waiting thirty minutes while they checked dad and the chair. All of that could have been circumvented if they let dad walk through x-ray and they checked the wheelchair!
 Dad at DIA holding "Grumpy," while waiting for our flight to LAX July 3, 2010

Finally to the gate! Just as we were getting settled at the gate dad announced that he had to go to the bathroom. I was hoping he could wait until we got on the plane because his bathroom visits take anywhere from a couple of minutes to 25 minutes. We pre-boarded the plane and took the second row across with the kids sitting on the right side of the plane, while we took dad with us on the left side. The flight to Los Angeles was uneventful. We landed a little early, got our luggage right away, and then went to the rental place for our minivan. I could not ask for an easier day!

Across the street from the car, rental place was my favorite hamburger restaurant, In and Out; we ate an early lunch, and made it to the hotel by 1:30pm. Check-in was 4pm, but since I requested an early check-in, our room was ready for us. We had a small suite; dad took the sleeper sofa in the living room area. He had a nice huge television, and was close to the bathroom. In the bedroom were two queen-sized beds. The girls took the bed near the window, and we took the other bed near the door, and I requested a roll away bed for Joey.

Larry pulled out the bed for dad so he could rest and I unpacked our luggage and after a two-hour rest, we went out to check out the area, get a bite to eat, and pick up snacks, bottled water, and soda for the room. We had a refrigerator and microwave, which provided us the opportunity to make breakfast in the room every morning and have cold beverages and snacks for the evening. Feeding six people during vacation can be as costly as the airfare!

We were only twenty minutes from Newport Beach, but the parking situation was impossible. What made it even worse was the fact that we left dad’s wheelchair at the hotel, and the handicap placard from Larry’s car was still in his car back in Colorado! What rotten luck! Since dad was too tired to walk we had to forgo the beach for today. I was tired anyway and we still had to shop for groceries and find a place for dinner. Overall, it was a great first day.

Tuesday, June 29, 2010

I Have More Health Problems Than Dad Does!

Sunday June 27, 2010
173 days since accident
150 days in Colorado


The last week has been very hot, with the occasional afternoon rains, to cool things down. Unfortunately, the rain has done nothing to help with my MCTD flair-ups. Before my illness, I loved the summer because it meant fewer days with back pain (worst in the winter and early spring). However, the lupus-like condition doesn’t fair well in the heat, so I lose on both ends!

My father worries when I sleep a lot during the day, but sleep helps me feel better, and when I take a couple of naps I function better overall. I try not to tell my father too much about my health problems because I can see how much it scares him. However, the fact is, there are days when I just can’t get out of bed, period. I have learned a long time ago that it is best to listen to the signals from my body because when I ignore those signals, I always regret it later.

Besides, I have the greatest family in the world! I have been very fortunate to have two teenagers who just instinctively do whatever has to be done on the days that I am incapacitated. There have been more times, than not, when my husband comes home after working a long night shift, and rather than go to sleep, he would help me. I am a very fortunate woman and I never loss sight of this. Nevertheless, for dad, seeing me in pain can be difficult for him to handle. Ironic really, I am 50 years old, and on more prescription medication than dad is at almost 90!

So what do you do when the caregiver has more health problems than the elderly parent does? Nothing, as a family you must find ways to pull together and do your share to help. It doesn’t matter if my father was living with us or not. I still have my days when I can’t function as well as I would like too. Fortunately, I have figured out a system to circumvent the frequencies of my flair-ups. Still it is difficult for me, as a type-A personality I have always been able to multi-task and rarely ever put anything off for the next day.

I have had to discipline myself and accept the fact that it is ok not to finish everything in one day! I think this philosophy has also helped my father because he has many days when he is depressed because his mind is stronger than his body. My motto:

Don’t put off for tomorrow what you can do today

Has been replaced with:

There is always tomorrow…

Wednesday, June 23, 2010

Father's Day

Sunday, June 20, 2010
166 days since accident
143 days in Colorado


It has been decades since I spent a "Father's Day," with dad. Today, I experienced a mixture of excitement and sadness - the reality of which is that this may be the only one I get to share with him. In the past, I hated this celebratory day – I could never find a card that said what I really felt. I doubt Hallmark carried a line of Father’s Day cards for the man who got my mother pregnant.

So, I ordered a special cake, with layers of chocolate and white cake, nestled between custard, and covered with a white whipped cream frosting. I wrapped the matching tee shirt and baseball cap that read: Proud Grandparent of, and underneath was the name and caricature of each of his seven grandchildren. I boxed up the designer mug I made of a family-collage, and the inscription, "Grandpa Nathan's Coffee Cup." And the day went really well.

As I think about the events of the day, I come to the surprising realization that the gifts did not symbolize my parental relationship with dad, but the relationship he has with his grandchildren (my children).  Did anyone else catch the irony here? I don’t think I am punishing dad because I really am so happy that he is here and that I have the opportunity to celebrate this day with him.

The sad fact of the matter is this, my father was absent for my entire life. My mother died when I was barely eleven years old. I then spent the next seven years in foster care, and even though my foster parents were wonderful, I was constantly reminded of the fact that they were not my parents.

I really needed my father when I was a young woman venturing out on my own. I suffered needlessly, all those “firsts,” in life that I was either forced to go about on my own because my mother was dead or because my father was absent in my life. I can’t get that time back, but I also have this time with dad. I want to accept and love him for the man he is today, and not grieve what could have been.

Therefore, I took a few minutes to run downstairs to dad’s room and presented him with my father’s day card – the one that says how happy I am that he is in my life, and that I love him. Happy Father’s Day, Dad!

Saturday, June 19, 2010

Dad and Bingo - A First Time!

Tuesday,May 4, 2010
119 days since accident
96 days in Colorado


My father loves to play cards and especially if money is involved. As a child I remember long hot summer days when dad would take us to the park for hours at a time, not to play with us, but to play cards with his friends from the
old country.

Watching him now, he seems so frail at times, not the card shark he used to be, my children, usually let grandpa win. It really warms our hearts when his face lights up as each time he pulls the chips towards his pile. I haven't been able to find a place for dad to play cards but I did find Bingo.

A local fast food restaurant provides a monthly bingo game for members of the Senior Center. I personally dislike the game, I find it to be quite boring. But I thought it would be good for dad - Anything that would help him use his brain is going to be an asset to him. Bingo really is a great therapy game for the elderly as it stimualates the senses, exercises fine motor coordination, and is a nice social activity.

Dad started our slowly, he had difficulty with coordinating both hearing and seeing the numbers on his board. But after about 15 minutes I noticed he was moving through the process and keeping up. As a matter of fact, he won the first game.

It really turned out to be a pleasant morning and a good activity for dad. I only wish they had it weekly instead of monthly. Trying to find activities for dad has been a challenge because of the infrequency of them all. I am looking forward to summer break because the kids will be home from school and can help me find things for him to do.

Wednesday, June 16, 2010

The Medicinal Benefits of Vodka (According to Dad)

Tuesday June 15, 2010
161 days since accident
138 days in Colorado


I want to make one thing clear - I don't think anyone should come to the conclusion that my father is an alcoholic(and that includes me as well). Dad has been living with me now for almost five months and I have never seen him take a drink during the day. Instead of taking sleeping pills or valium like many of his cohorts, dad has a glass of vodka before bed. He is plagued by guilt and horrible images of the holocaust and when he takes his night time drink it provides him an opportunity to have a peaceful night's sleep.

At dad's age, logic might dictate that he stop drinking, but logic goes out the window when you see how strong and youthful my father is right now. I can’t remember the last time dad was sick with a cold or the flu, for example. George Burns lived to be 100 and he drank and smoked cigars.

So, the reason I am writing this is to share some of my father's interesting philosophies on the medicinal benefits of alcohol. As a side note, when I was a home health nurse I came across many from dad's generation, who also believed that alcohol served other purposes besides its obvious. And now, for your reading enjoyment I give you:

The Medicinal Benefits of Vodka

1. To cure a cold in the chest or head: take warm water and pour in some vodka.
2. To cure a sore in the mouth or toothache: rinse your mouth with vodka and swallow.
3. For a sore throat: Take some warm water, pour in some vodka, gargle with it, and swallow. Never ever waste the vodka, it will kill all the germs you can swallow it is ok.
4. For a cut, pour a little vodka on it, this you can’t drink so don’t worry it is only a little bit wasted.
5. If you can’t sleep at night: Drink some vodka and you will sleep through the whole night.
6. If you are depressed or sad: don’t take those crazy pills for depression just drink a glass of vodka and it will make you happy and help you forget the past.

Monday, June 14, 2010

If I Hear, "I Need Ex-Lax," One More Time!

Monday, June 14, 2010
160 days since accident
137 days in Colorado


Nurses have a responsibility to ask their patients' everyday, if they had a bowel movement. So it doesn't bother me to ask my dad the same question; and my father has no problem in describing with graphic detail the angst of his bowels!

"Why don't you give me Ex-Lax?" My father will yell to me from the bathroom! “I never had this problem in New York, it must be what you are feeding me,” he would say.

A visit to the gastroenterologist uncovered a perfectly functioning anal sphincter (muscle). “Your problem, Mr. Rosenberg, is that you are old, you need to drink lots of water, and increase your activity, walk thirty minutes a day.” The doctor would say. My father, always with a witty retort, responded, “Doctor, I may be old, but that doesn’t mean I have to be in pain all the time, why don’t you give me Ex-Lax?”

A perfectly logical response, really - I smile to myself as I watch the doctor turn away from dad to write something down on a piece of paper. He turns to me and hands me the name of a medication that can be purchased OTC (over-the-counter). I recognize the medication as a preparation given to individuals who need to clean themselves out before a colonoscopy. “This will help your dad,” he says.

Why do doctors do that? I mean, dad is sitting right there, he could have looked at dad and handed him the note. I ended up turning to dad, and telling him what the doctor should have told him directly, anyway. I know dad is difficult to understand. I am so used to his Eastern European accent that I don’t give it another thought. Still, as health care professionals, we need to speak directly to the patient, even if, an interpreter is in the room.

Dad may forget things that he used to have on the tip of his tongue, and he may ask the same question more than I would like, but he is still a person, and for a man almost 90 years old, he still has it going on upstairs.

So I remind my fellow caregivers to treat your aging family with respect and dignity and permit them as much independence as is safe to allow. And if you hear, "I need Ex-Lax," one more time, just smile and do like I do, and give them a piece of dark chocolate,if their health permits it.

Wednesday, June 9, 2010

Cooking for Aging Taste Buds

Monday June 7 2010
153 days since accident
130 days in Colorado


Cooking for the elderly can be a challenge for a number of reasons, from poor appetite to decreasing numbers of taste buds. In dad’s case, I have the added problem of his lack of teeth. In the few short months since his arrival dad has lost a significant amount of muscle mass. Never having much of a weight problem, dad is all of a sudden finding himself very wrinkled, with sagging skin, and protruding bones. I supplement his meals with high calorie protein shakes but the real problem comes from his lack of appetite.

I have had to become very creative, while attempting to prepare nutritious foods for dad. I notice that he really enjoys the sweet stuff. Therefore, I experimented by putting a small amount of Splenda in several of his meals. To my pleasant surprise, dad not only enjoyed the meals he finished them.

Side Note > At approximately 40 – 50 years of age, we begin to experience a decrease in our taste buds, which is one of the reasons why the elderly lose their appetite. Food starts to taste very bland and unappetizing. The most important thing to remember when cooking for the elderly is to make sure that each meal contains a variety of nutritious foods.

For example, dad is not a vegetable lover so I have to juice most of his vegetables and mix in something sweet like apple juice. Fruits and vegetables provide an immediately energy source in the form of glucose which is critical for the brain. I can always tell when dad needs to eat something because he becomes weak and confused. I immediately give him one of the fruit/vegetable blends that I have prepared for him and within fifteen minutes, he is feeling better


I prepare, portion, and freeze most of dad's meals in advanced. This has become especially helpful when Larry and I have our weekly date night and the kids have to prepare grandpa’s dinner. Cooking for aging taste buds does not have to become a chore, just adding a small amount of sugar substitute and see if you can convert your poor eater into someone who enjoys food again!

Sunday, May 30, 2010

The Greatest Day of All

Saturday May 29, 2010
144 days since accident
121 days in Colorado


It was a beautiful day today - the sun was shining, the temperature was mild, about 75 degrees, and my husband decided to wash our cars and his motorcycles. Dad heard all the noise outside and decided to sit on the front porch and watch Larry work.

I really don't know how it happened because I was not outside, but my father ended up on the back of Larry's Harley. Yes, you heard that correctly - my almost-90-year-old father was on the back of a motorcycle cruising around the neighborhood.

At first, I was shocked and speechless. Did my husband go mad? What possessed him to take such a risk? And darn it, why didn't he get pictures and video of the experience?

Look, of course I was freaking out at first, dad can barely walk, and here he is on the back of a motorcycle? Bottom-line, I trust my husband. If he felt it was safe than I am fine with it. I want my dad to have as many new experiences as he can tolerate.

At nearly 90, dad has barely lived at all. I don't know if this is due to the guilt he has over surviving the Holocaust, while his family did not. I suspect guilt was partly to blame, but I also think dad never had anyone in his life to expose him to different experiences. It also didn’t help that my father was, and still is, one of the cheapest men on the planet!

Ok,I really shouldn't be so hard on him - Dad was poor growing up and equally poor when he came to the U.S. Making $75.00 per week, dad worked as a tailor, in a sweatshop on Manhattan's lower eastside; mom didn't work; she was a homemaker and mother of four girls.

Even when dad had extra money, he never used it on himself. I think he was always afraid that he would need the money for a rainy day. I, on the other hand, believe that life is something to experience and not observe. And that is exactly what I plan to have my father do - I want him to be an active participant, and not some old guy sitting on a park bench watching the world go by.

During the last four months we have tried to make dad as comfortable and happy as can be. So far, he has enjoyed the comfort of modern clothing*, proper fitting shoes, cotton socks, and soft bedding. Dad has experienced IMAX, a 3D movie, bowling, the Body World exhibit, Planetarium, dinner playhouse, concert, and countless culinary experiences.

I hope my father remains healthy long enough for my family to show him what it feels like to be part of a close, fun-loving, great family, who loves him. Everyone needs love, even dads who were not the greatest fathers in the world.

I am so grateful to have had this opportunity to get to know my father because now I can finally let go of all the pain, anger, and resentment of my childhood.




*recall in a much earlier post that dad used to hand wash all his clothing using a washboard! His clothing was about 40 years old and so thin that they actually fell apart in the washing machine, in my house.

Friday, May 28, 2010

Finding the Humor in Life

Friday May 28, 2010
143 days since accident
120 days in Colorado


Today the temperature hit 97.5 degrees! My father comes out of his bedroom wearing an undershirt, a long sleeve shirt over that, and then long pants with heavy knee-hi socks. I took one look at him, and like a mother sending her child back to her room to put something more appropriate on, I escorted him back to his closet to find something lighter to put on.

How should I put this? My father dresses as if he just got off the boat at Ellis Island back in 1949! When I was a child, I used to get so embarrassed when he would attend a school function. Remember the leisure suit of the 1970's? Well dad had one in lime green. He also wore bold striped pants with an equally loud (clash) shirt.

One of the first things I did when dad moved to Colorado was to take him clothing shopping. You should have seen him today! He had on a pair of dark green walking shorts a pleasant and smart looking green and blue print polo shirt and we finished it off with a pair of TEVA sandals (and no sox!)

My father looked like a younger man of 65 (remember he is nearing 90!). We drove the kids to the local family fun center for a day of laser tag, miniature golf, bumper cars, and the like and topped it off with ice-cream sundaes at Baskin & Robbins! All had a fun day!

After dinner, I figured dad would be exhausted, since he was up for the entire day. However, he wanted to watch a little television. Joey put on a movie for him and I went upstairs to finish some last minute paperwork. About fifteen minutes later, I hear dad calling my name. Joey, ran downstairs (he is faster than I am) to check on his grandfather.

A few minutes later Joey comes upstairs with a huge grin on his face. This conversation transpired between Joey(J) and his grandfather(GF):

J: Is everything ok, grandpa? Do you need something?
GF: There is a German picture on television!
J: Is that good or bad?
GF: I don't know.
J: (sitting on a chair watching the program for a few minutes) So what do you think grandpa?
GF: This is Ausweitz, where I was in the Holocaust. I thought your mother would like to come down and see this maybe we will see me there.
J: (confused for a moment and he then realized that his grandfather thinks that the movie is a documentary and that the people were real and not portrayed by actors). Grandpa, make sure you call mom or me, if you happen to see yourself or someone you remember from that time!
GF: Ok!

Oh the joys of being old and hmmm, confused?

Monday, May 17, 2010

Oral Surgery - Nothing to Smile About!

Friday May 14 2010
130 days since accident
107 days in Colorado


This morning I took dad to an oral surgeon to have his last two middle, lower teeth (canines) removed. The place operated like a well-oiled machine, with people coming and going every 20 minutes. Dad was no exception, even with one of the canines cracked near the gum line; he was done in less than 20 minutes. His bottom lip was quite swollen, the teeth were brittle, and the doctor had to take them out in pieces, leaving dad with a couple of stitches. There was no doubt in my mind that dad would, in a very short amount of time, feel indescribable pain. I filled the pain medicine (vicodin) prior to the visit so I would be prepared, and gave him one on the way home.

Once home I cleaned up dads’ face and replaced the blood-soaked gauze in his mouth. I gave him an ice pack to help reduce the swelling around his mouth, and put the television on until he fell asleep. Yesterday, I made butterscotch pudding, raspberry Jello, and two kinds of hearty soup. I also bought a variety of beverages and popsicles to keep him well hydrated.

I continued to give him a pain pill plus an anti-inflammatory pill throughout the rest of the day and into the evening.

My son was having a few friends over to celebrate his 16th birthday. Fortunately, it was a movie party, and away from the house. I left my husband home while I drove the boys to the theater and got them settled in with popcorn and then came back a couple of hours later to pick them up.

I was up for most of the night to check on dad and make sure he was resting comfortably. I knew I would be in for a long weekend.

Thursday, May 13, 2010

The Dentures Last Bite

Friday May 7 2010
122 days since accident
99 days in Colorado


It has been three months since dad received his dentures and I finally got up the nerve to request a refund. It was obvious to me that the dentist was not going to claim defeat, and my dad, although he constantly complained about the dentures while at home, would become indecisive while at the dentist office.

Upon arrival, the receptionist immediately took dad to one of the patient rooms. I was surprised because I thought they would just hand dad his refund check and send us on our way. Instead, the dentist came in and asked dad what he wanted to do about the dentures. Dad looked up at the dentist and said, “I don’t know what I want myself.” Not very good at concealing my emotions, I must have shot my dad a dirty look because he sat up in the chair and said, “It is my mouth, you stay out of it!”

Maybe I was wrong to get so upset, but I confronted both the dentist and dad. I told the dentist that he should have instructed dad weeks ago, that he would not do any further adjustments until dad agreed to wear the dentures, as instructed, for a full week. I then turned to dad and said he should not agree to wear the dentures when he knows that he won’t (wear them).

Dad looked at the dentist and said he would promise to wear the dentures for a full week and wanted to give it one more chance. In agreement, the dentist wanted dad for a couple of hours to try a different approach to reducing the movement and placement of the appliances. I really didn’t have two hours to sit in the waiting room and asked if I could leave dad while I ran a couple of errands and picked up the kids at school.

I received a telephone call about two hours later – evidentially, the dentist tightened the bottom partial too much and when he pushed it down onto dad’s two remaining teeth, it hit a nerve or something and my dad cried out in horrific pain. He closed his mouth and refused to allow the dentist to do anything further. The dentist actually wanted me to come back and convince dad to open his mouth; when I arrived my dad was waiting for me and told me he was done with this dentist and the dentures. I signed the release papers, gathered up dad and his belongings, and high-tailed it out of there!

My father was furious not at himself, but at me for not standing up to the dentist, and refused to speak to me for the rest of the day. Two days later, he announced that his bottom tooth was cracked and he wanted me to call the dentist to pull the tooth! I must have called three or four dentists and each one was more expensive than the last. Embarrassed, I had no choice but to call the original dentist, the receptionist was very kind and explained that they would not be able to do the extraction because the teeth in question are canines. Generally, canines are the last to fall out and in dad’s case; they were anchored well into the bone requiring surgery to remove. Fortunately, they had a referral of an oral surgeon and gave me dad’s x-rays, and I was able to make an appointment for next Friday.

Monday, May 10, 2010

Video: Bowling Grandpa get a Spare!

In this video you will see my husband showing dad how to bowl (at 89, dad has never gone bowling. Dad throws the ball and knocks down 9 pins. I stopped video-taping assuming dad would get a gutter-ball - with everyone in amazement, dad actually makes the spare!

http://www.youtube.com/watch?v=8s_HkaER5Z4

Monday, May 3, 2010

Dad Takes a Fall!

Saturday May 1, 2010
116 days since accident
93 days in Colorado


Dad has wanted access to our backyard now for a couple of weeks. I was able to put him off with a variety of excuses, but ran out of them, now that the weather is so warm and beautiful. I want dad to enjoy the backyard, but have been hesitant for a number of reasons. Two of those reasons pertain to safety issues; the backless bench along the side of the deck and no banister leading down to the grass.
Just like a child, I know I can’t protect him from everything. But at least one can reason with a child, that is not the case with my father. In any event, I decided to give him a chance to prove me wrong and I took him out back and showed him around, pointing out the dangerous areas. Everything seemed fine, he sat outside and enjoyed the sun. I brought him some iced tea and a couple of cookies and went back into the house. Just moments later I ran outside to find the patio table on its’ side and dad laying flat on his back. He was conscious but not moving – here was my worst nightmare come true – that day severed his spinal cord and was paralyzed. Larry was already outside kneeling down next to dad. I covered my mouth to prevent my cries of fear, and began to move towards them. Dad looked up at us and asked, “what happened?” I had him remain still so I could assess the damage – to my surprise he was absolutely fine. The man has someone seriously watching over him!
So here is what happened – dad, tired of sitting, walked over to the patio table, misjudging the stability of it, he leaned against the table, and it flipped, sending him crashing to the floor (on his back). Larry and I helped him inside and I brought him a glass of water, dad looked at us both and said, “What are you making a big deal for, I am alright, you know how many times I fell in New York, maybe five times a day and I was fine.”
I couldn’t even think of a reply to such an utterly ridiculous response – and to keep myself from saying something that I knew I would immediately regret, I just quietly walked away. I could hear Larry trying to explain to dad that his constant falls is the major reason why he can no longer live by himself. Of course, dad became agitated and argumentative. He will never accept the fact that someone else has made the decision to take away his independence. A part of me certainly can’t blame him – I would not be happy if someone took that right away from me. On the other hand, I would try to come to terms with the decision and work to make the best of things. That is where dad and I differ, I am a realist, and try to be optimistic while dad is such a negative person. He can actually drain all the positive energy in a room; I am exhausted and fatigued after having one of our conversations about life. He has such a warped sense of the world, mistrusts everyone, and believes that life has no meaning. How can anyone have a meaningful and dynamic conversation with a person who believes only in his own reality?

Monday, April 26, 2010

Dad Goes Bowling!

Sunday April 25, 2010
110 days Since Accident
87 Days in Colorado


The family went bowling today to celebrate Jessica and Alicia's (belated) birthdays. I must have ran back into the house three times before we finally left for the Alley. First, I forgot dad's medicine, then I forgot to take my Flip recorder, and then I ran in a third time to grab the bottle of water and hard candy I left on the kitchen counter for dad. I really hate the fact that my memory is not as sharp as it used to be. Is this what 50 really looks like?

Finally settled in the car, we take off 30 minutes later than we originally planned. If we don't get to the Alley by 1:00pm we stand the chance of having to wait. Alicia has to be home by 4:00pm and we wanted to have a leisurely (not rushed) afternoon. Lately, it seems no matter how hard I try my time management skills seem to be in dire need of a tune-up! Today was certainly no exception. We were already ten miles south on the Interstate when I realized that I forgot to pick up the birthday cakes for the girls! I ordered one white cake with white frosting and another chocolate cake with chocolate frosting each with a girl's name on it. Oh, I feel just awful and I am sure I will feel even more awful when the bakery charges me for the cakes! You might wonder, why I don't make a to do list. Well, I actually do maintain a daily list of things to do, but I forgot it too!

We arrive at 1:35pm and we were informed that up until 20 minutes earlier there was no waiting. Frustrating! Larry, always the best at getting our time schedule back on track, suggests that we order a pizza,while we wait. Sounds like a good plan because I also didn't have an opportunity to eat anything and I was starving. As soon as we settled at a table with our large cheese pizza and pitcher of cola, no, sooner than our name is called for an available lane. Now we have to grab the tray of pizza, beverages, and plates, while at the same time manage to carry my bowling ball/shoes, Larry's gear, and hold onto dad. Larry takes the pizza and dad and goes down to our designated lane, while I take the kids for bowling shoes and to pay for the session. I had a coupon that saved us over $40.00 - just happened to find it in my glove compartment in the car and I have no clue when I put it in there, but was glad I did!

We were on a timer (two hours) and we had five minutes to find balls, load our names onto the computer, and get our shoes on. Geez, the other Alley we frequent had a much better system in place, when your party was ready to bowl you push the enter button and start, none of this five minute nonsense! Who can get ready that quickly when you have five people bowling? It took a couple of minutes just to get all the names into the computer!

Larry and I share the game, I have back problems and really have no business even bowling anymore, and Larry damaged his right thumb and he really should not have bowled either. We figured this was a good compromise, and it actually worked very well I was able to bowl with no back pain,(it helps having a custom-made 6 pound ball). Ok first up is Larry, he bowls very well, next is Joey, he has quite a wicked curve in front of a very powerful ball 16.2 MPH! Larry's best was 13+, Jessica 11, Alicia 9, and me between 8-12 mph. Dad is watching and enjoying a slice of pizza (don't ask me how he can do so well with two teeth in his mouth, yes, he is still refusing to wear the dentures).

We finish our first game and dad decides he wants to bowl. Jessica graciously gives up her turn so grandpa could bowl. She figured he couldn't do any worse than she was doing anyway (mostly gutter-balls with the occasional 2-4 pin hit). Larry finds a ball for dad and stands-by just in case dad has any trouble. The area around us goes quiet as people look over and notice my elderly father, who by the way is wearing a hard cervical collar, take tiny steps up to the lane and fling the ball. I pull from my purse the Flip recorder and tape the entire event. I figured he would get a gutter ball, but I am watching this ball, slowly but surely, slide down the middle, and like dominos, each pin, in succession falls down - STRIKE!

Dad jumps up and places his hands over his cheeks with utter shock and joy - the area begins to clap, and I proudly announce that dad,almost 90 years old, had never bowled before, and got a strike! Jessica's turn comes up again and she tells grandpa to go ahead and bowl on his strike. Once again, Larry helps dad to carry the ball to about 3 feet from the lane. Dad takes his little running steps and kind of drops/throws the ball. It slowly travels down the lane and with fairly good accuracy, dad knocks down 9 pins! The area goes wild - dad is ecstatic - I think to myself, that I have to get him in a senior league.

Before we leave, I ask at the front desk about a senior group, and to my surprise they have a (senior) league forming May 25. The cost is $10.00 per week, which includes coffee, dessert, and a free bowling ball with custom drilling! Not a bad deal at all. I am thrilled because I have been at my wits end trying to find a couple of activities for dad to enjoy and now I found one that will serve an additional purpose of increased activity (for him) as well. For a total of $30.00 we ended up bowling three games x four people (remember Larry and I shared the game), shoe rental, and a pitcher of soda. Now that is what I call a bargain!

Saturday, April 24, 2010

Taking Care of Dad - The Daughter Takes a Stand

Saturday April 24, 2010
109 days since accident
86 days in Colorado


Dad woke up in a cranky mood – he claims his heart is beating fast again, a little frustrated, I reminded him that he is having palpitations something the doctor told him he will get from time-to-time because of nerves (anxiety), but I was going to call an ambulance anyway to take him to the hospital. He looks at me and says, “I didn’t say I want to go to the hospital, what are you getting so upset for?” Before I could say anything Larry chimes in and says, “Nate, at your age you are going to have aches and pains, if we call an ambulance or take you to the emergency room every time you have some discomfort you are just going to spend hours being uncomfortable. You will be sent home with a bill (patient portion) from both the ambulance company and the emergency room. We should really save those times for when you really need to go to the hospital.

As a reader, you may think Larry and I are being insensitive to dad’s medical needs, but it is actually just the opposite. As a nurse I would call the ambulance in a heartbeat (no pun intended), but remember, I blogged about this last night, dad is a hypochondriac, for a man who keeps saying he wants to die; yet each time something hurts or he feels weak he panics and wants an ambulance. I have been in this situation with him more times than I can to admit.

Flashback Memory:
When my first child, Rachel was born back in 1987 dad started coming to visit once a year. When Rachel was five years old, we moved into a larger house. The guest rooms were in the (finished) basement. Dad had a beautiful large room, color television, his own bathroom with a Jacuzzi tub, and privacy. Anyway, before dad came out that year, I told him I was graduating from nursing school, so he could have an excuse not to come.

Side Note > Why do I say that? Because my dad never does well when he has to take the back seat, the visits had to be all about him – He didn’t do well at gatherings, he was very antisocial. It is sad, but oh so true. When I was a child, around seven or eight, I remember my parents going out on Saturday nights. They had a circle of friends from the old country, but after my mother died, the friends disappeared. Mom was the only reason they had so many friends, dad they merely tolerated.

Flash Forward Nursing School Graduation:
Nursing school was a tough gig for me. I didn’t have the greatest self-esteem and was sure that I would flunk out of school. Dad said I was not smart enough for medical school; I probably was not smart enough for nursing school either. Nevertheless, here I was, GRADUATION DAY! I made it – today I became someone special. Nothing was going to spoil this special day for me. Not even dad. Ok, well he was very capable of spoiling my day, he did it all the time, and each time I would say this is the last time.

I prayed the night before that dad would wake up in a good mood. He was cranky the day before, I was busy cleaning the house and preparing for the party, I didn’t spend much time with him. But he played with Rachel, took her to the park, I figured I didn’t need too. I was wrong – something was bugging him – I asked him what was wrong, and he said nothing. When he said nothing, it meant you better figure out what it is.

I woke up to a beautiful, slightly cool, and sunny day – perfect for an outdoor graduation! Dad was in a vile mood that day, I was so nervous that he was going to embarrass me at my graduation or the party, which was to follow later that day. No one really knew how to react to those mood swings of his. One minute he was fine, the next he was like a completely different person. If you tried to talk to him, he would snap and if you ignored him, he would snap. I knew at some point, that day a fight would happen. Right after the ceremony when the graduates were meeting up with families for picture taking, laughing, and congratulatory hugs my father decides to cop an attitude. I could tell he was stewing. Evidently, he was angry because I didn’t take any pictures with him. My friends all ran up to me to take pictures together, I figured we would take family pictures later, after all the pomp and circumstance. He didn’t get it.

So that meant I was going to pay for it – wait for it, wait for it…here it comes: My husband walked over to dad and said with a huge grin, “Nate aren’t you proud of Linda, I am so proud of her, look what she has accomplished!” My father looked at him and dropped the bomb, “Of course you are proud, you are just a truck driver!” There it was, the grin on my husband’s face turned into a frown, and I should have left it alone, but had to defend my husband – I immediately turned to my father and said, “Don’t you dare speak to my husband that way, you apologize to him right this minute! If it were not for him and his dedication to this family I would not have been able to attend nursing school!”

Well I just made it worse because now my father was going to be angry with me for sticking up for my husband. Dad just turned and walked away. Oh, I should cancel my graduation party – he is going to make me miserable – I just know it! That night about thirty people showed up to, help us celebrate my graduation. About ten minutes before the guests started to arrive my father announces that he is getting sick and has a fever. There it is, this is how it will begin – he is pulling out the “I am sick card,” which means you better drop what you are doing and take care of me.

I ran upstairs to get a thermometer and some Tylenol – his temperature was completely normal. His skin was cool to the touch and he looked fine. He had a little bit of a scratchy throat, but he gets that every time he comes to Colorado – he is not used to the dry air. I set up a humidifier in his room and brought him down a pitcher of water and some hard candies to help moisten his throat. My father refused to come up during the party, my husband brought him down some food, which he refused, we tried several times to coax him up stairs, each time he said he just wanted to be left alone. So we left him alone.

The next day my father had a fit! He began yelling at me, “What kind of daughter are you to leave your sick father downstairs in the basement like a dog, with no food, no medicine, nothing, while you are upstairs having a big party!” Well there you have it – his next victim was going to be me – I was going to be the daughter in the spotlight for the next six months – everyone would be told what a lousy daughter I am – he would ride that story and throw it in my face for years to come.

Flash Back About Two Weeks Ago:
Two weeks ago dad drank 12 oz of vodka and was so intoxicated that he didn’t understand English! He slurred his speech and I was afraid he was going to die that night. Well not on my watch – I was going to do whatever I needed to metabolize the alcohol – we walked, we drank coffee, we ate small bites of food, we talked, and he fought me the entire time to let him sleep. An hour later, he was becoming more lucid and was no longer slurring his speech. I was not happy, not one bit - My teenage children had to witness their 89-year-old grandfather falling over drunk! Once he sobered up, I let him (verbally) have it. What was he thinking? What kind of legacy did he want to leave for future generations of our family? What kind of role model was he to his grandchildren? Yada-yada-yada!

Dad had fire in his eyes – he was red faced angry! “Don’t you talk to me that way, I am your father and you will show me respect,” he said. “Respect? You get respect when you also give respect – you have no respect for me or this family!” I replied. For two days he would not speak to anyone, all he did was lie in his bed, come to the table for meals, and then return to his room immediately after he finished eating. Finally I could not take it anymore and told him things were not working out, he was obviously not happy living with us, and we were going to look into nursing home placement. At 50 years of age, I was finally going to take a stand – he was not going to ruin this family – make my kids nervous, and instigate fights between Larry and I.

I let out all the stops – No bullying, no sulking, no dirty looks, no abuse, what-so-ever was going to be tolerated in this home. All we have done over the last 86 days is bend over backwards to make him comfortable, include him in all of our family activities, and try to make him happy. And so, it began, I told him how I felt - “You don’t want to eat, don’t eat, you want to lie in bed all day, lay in bed, I don’t care anymore!” “We do not deserve this, I was the only one who came forward to help you and I have been doing my best to do just that, but you don’t appreciate it and I am done – I am especially tired of you accusing me, Larry, or the children of lying when we say something that you don’t want to hear.

Inner Conflict:
I went to bed that night feeling awful, like I failed. All I wanted to do was help my father, and all I ended up doing is making him angry with me. This is not how I pictured things to be. Maybe my sister was right, I should have just found a nursing home in Brooklyn – “No, I shook my head, he would have been alone with no one to visit him, take him out for dinner, and he would die a lonely and dejected man.” If he had to go into a nursing home, here would be better – I would visit and take him out frequently. Still, I felt like I failed – I wanted this to be perfect, I wanted my children to have a grandfather. However, if I back down then my father will win – the manipulation and abuse will get worse, because he will have control.

The next morning I awoke feeling like my body was used as a punching bag – I ached all over (I have fibromyalgia and stress is a trigger). I didn’t want to go downstairs and face my father. What would I say, worse, what would he say? As I walked down the stairs from my bedroom I overheard Larry and dad talking – it sounded civil, I stopped and tried to make out what was being said – Was I hearing it correctly? Dad was apologizing! “I know you have been good to me, and my daughter has been so good to me and she loves me. I am an old man and I get cranky sometimes, I don’t mean to give you any trouble, I am sorry and I promise not to give you anymore problems.”

I want to give him credit for coming forward as it had to be difficult for him to admit he was wrong, but the cynic in me only believes that he did this as a means of self-preservation. He knows he has a good thing here and doesn’t want to go to a nursing home. The pay-off for him was far greater than the sell-out.

I want to know who kidnapped my father and put this pod-person in his place.

Closing Comments:
As for the Spring Festival – it was wonderful! I have been looking forward to the showcase of student talent. Dad had a huge grin on his face the entire time – even after each run to the bathroom because he had the r-u-n-s! We were out until 9:30pm as soon as we got home my dad took off his clothes to expose his pajamas and he was in bed within 30 seconds flat! Good night to you too dad!

Friday, April 23, 2010

Dad's Second Day in Colorado - January 30, 2010

January 30, 2010
25 days after the accident
Second day in Colorado


I am scared - plain and simple. My father looks so weak, so frail, even his once powerful voice is barely audible. Did I make a mistake bringing him out here to live with me? Am I crazy? What possessed me to bring him out here so soon? Maybe I should have insisted that dad stay in the nursing home for a few more weeks. Would he have survived there, though? I have so many questions - and no good answers. All I know is that I made the commitment and now I must follow through. What am I so afraid of? I have taken care of the elderly and sick people before. I was a very good medical/surgical nurse so this should be a piece of cake. But this is no ordinary patient in one of the several hospitals that I work in - this is my 89-year-old father, who was hit by a car, and seriously injured just a little over three weeks ago.

I just have to find my center - this is new, the entire family feels disjointed. If I could get dad in a routine, I think it would help all of us adjust. Right now all dad wants to do is sleep. I can't let him do that. Too much bed rest could lead to a pneumonia or clots in his legs. He did enough laying around in the nursing home. Now he needs to start rebuilding his strength.

I have already started a little bit of a routine with him. He tends to wake up about 8:00ish and wants breakfast at 8:30am. After breakfast, I help him to the recliner that Larry moved by the big window. Here he can get some sun, watch the people go by, or read the paper. This works for about 45 minutes though and then he gets antsy. Unfortunately, that takes me to about 9:45am. If I don't distract him with something then he immediately will crawl back into bed and lay there all day long.

So I move him from the chair to the kitchen table and pull out a deck of cards. My father used to play cards all the time when I was a kid he would go the Brighton beach every weekend and play cards with his friends in the park or under the Boardwalk. Playing cards is good for him as it helps to exercise his brain. We play for about 45 minutes, which takes me to 10:30am.

He goes back to bed and I let him take a nap until lunch (about 12:30). After lunch if the weather permits, we go out and run a couple of errands or go to a doctor's appointment and then pick up the kids on the way home.
Then I give him a cup of tea and a couple of cookies while he visits with the kids. I notice that dad really perks up when the kids are home from school. Sometimes they play cards with him, other times they talk about the school day.

We eat dinner at 5:30pm, which usually goes for about an hour sometimes two hours. This is our time to unwind from the day, talk and discuss current events or issues that the kids have on their minds. My father enjoys the banter. After dinner, my husband Larry helps dad to bathe and get ready for bed. I utilize that time to straighten up dad's room and bed.

7:30pm dad is comfortable in bed, I will put a movie on for him - he loves the TCM channel. About an hour into the movie, I find him fast asleep. I turn off the T.V. and check on him before I retire to my bedroom upstairs.

For the last couple of nights I have been waking up like every couple of hours - I check on dad and then go back to sleep. I hope this doesn't become habitual because I really am going to need my sleep if I am going to pull this caretaker role off.

Taking Care of Dad - To go, or not to go (to the hospital)

Friday April 23, 2010
108 days since accident,
85 days since dad moved to Colorado


It was a very cold and wet day in Northern Colorado; actually it has been raining heavily now for the last three days. Ah, we need the moisture − but for people who suffer from arthritic-like conditions, like my dad and me, this kind of weather, we could do without. Therefore, while I was taking more of my medication to deal with my symptoms dad was contemplating vodka to ease his. He actually has been much better about not demanding his "medicine." I think he realized that he better walk a straight line (no pun intended) with me after the incident two weeks ago when he abused his alcohol privileges*.

Dad is a hypochondriac, for as long as I can remember, he complained about one thing or another. However, if dad were distracted with liquor or a deck of cards, his symptoms would miraculously disappear. Therefore, you have to understand, even at the age of 89, when dad complains it usually is related to boredom or anxiety. That being said, today for the first time in 2 ½ months, dad started complaining of chest discomfort. The nurse in me had my cell phone in hand ready to dial 911, but the daughter in me, knowing dad’s history for the dramatic, held off making the call.

Flashback Moment:
As a young adult going to college out-of-state I felt an obligation to call my father once a week, to sort of check in, I guess. Those conversations were never pleasant, dad would usually say something to upset me and I would hang up feeling terrible. During many of those brief chats dad would casually, either mention that he had suffered chest pain and the ambulance came or he took himself to the doctor. Dad was notorious for being in the hospital over the holidays too – The guilt trips were awful – “if you only hadn’t moved to California (I went to college) or to Colorado (where I ended up after college), I wouldn’t be alone and so sick,” he would say.

He hated being alone, but every time one of his daughters would invite him for a visit he would end up causing problems. That daughter would be the topic of gossip for months and then another daughter would do something to trigger his angst and she would become the topic of gossip. I can recall plenty of Thanksgiving holidays when he would come to Colorado and leave the family in ruins. He always knew how and what buttons to push to cause trouble and then would sit back and judge everyone.

Flash Forward - Present Day:
Back to dad’s current complaint − Remember the story of the boy who cried wolf? I didn’t want this particular episode to be a wolf moment. So I retrieved my nurse-bag and checked dad out just to be on the safe side - his blood pressure, was a little elevated at 140/90, but within his normal range. His pulse was 74 and his heart rate was strong. When I asked him to describe the pain, he said it felt like an ache and he pointed to the center of his chest. The pain was mild (a 2 on a scale of 1-10), and it was localized, which meant it didn't move down his arm or up his neck, etc. I think to myself for a minute that dad suffers from occasional digestive upset – it could be the orange juice (OJ) I gave him this morning. I meant to buy low acid juice and forgot – I know that regular OJ does not agree with me and I get terrible heartburn.

Dad startled me out of my deep thought when he asked me, “Am I going to die?" I looked up at him and said, "Eventually dad, but I don't think it will be today." He began to cry, “Dad I was only kidding with you,” I said, while he motioned for me to bend closer to his face. As I moved closer to him he blurred out, "You are not going to let me down?"

I didn’t quite understand the question. “What do you mean let you down? Do you mean, send you to a nursing home?” I asked. He nodded “yes.” He is so afraid that he is a burden, and that we will get tired of the stress and responsibility, and decide to put him in a nursing home. He hugged me tightly and stroked my hair, crying, he said, "You are the only one who cared about me, you take such good care of me, and I love you very much."

He calmed down and then said to me, I kept calling for you I thought you were not at home. I pointed to his cell phone and asked why he didn’t call me. I explained that I was in the shower, had he called me I would have noticed the missed call. "I don't know how to use this fancy phone," he says in frustration. What to do, I thought. Then I remembered that I had bought two small dry eraser boards. I have one in his bedroom that I use as a daily reminder for the day of the week and the date. I figured the second one would come in handy to write the directions for placing a cell phone call. I had dad practice with me about 4-5 times, first he would place a call to me and then I would call him. The first time he spoke into the phone but forgot to open it. The second time he dialed the number correctly but forgot to press the send key. After another 2-3 attempts, he was successful.

After lunch dad felt better. His blood pressure came down as well, 130/82 and the chest discomfort went away. I think that laying flat is also problematic for him, especially if the problem is acid indigestion. So, I brought him another pillow and demonstrated how he should use them. I put on a movie for him and reminded him to call me if he needed anything. I went upstairs to my office to do some work. I checked on him an hour later and he was sleeping comfortably.

Closing Comments:
The question of when to call an ambulance or take a loved one to the hospital can be difficult to assess. As a nurse, I feel confident in my decision to forego calling an ambulance. It was an easy decision only because I know my father, his medical history, and the pain he complains of has been an on-going battle for a number of years. Nevertheless, would I suggest that you or anyone else reading this Blog withhold medical intervention? The answer is most definitely no - it is always best to err on the side of caution. If at any time you think a loved one might be having a heart attack or stroke for example, don’t even bother driving to the hospital, instead call 911 immediately and follow the directions of the 911 operator – you might just save a life in the process.


*(medicine = vodka)when he decided to drink himself into a drunken stupor (12 oz of straight vodka)and I told him I was looking into nursing home placement because I took on more than I could handle with him.

Wednesday, April 21, 2010

My Life as Primary Caregiver - The Horrors of Dentures

Thursday February 4, 2010
6 days since dad moved to Colorado


Today I took dad to the dentist to be fitted for dentures. It was decided that dad would get a full denture for the top and a partial for the bottom. His last four teeth (two on the top and two on the bottom) would be pulled this morning. Dad was excited about getting his teeth fixed. Since the accident, he has not been able to eat as his previous dental work was destroyed and his remaining teeth were damaged in the impact.

Dad did really well and tolerated the procedure without anything more than a local injection into his gums. After the procedure, the dentist placed the appliances into dad's mouth. I was actually surprised that this is done because the mouth is so tender and the pressure from the dentures, I would think would be incredibly painful.

However, the dentist assures me that this is the best way as the dentures will help keep the swelling and bleeding down and make it that much easier to tolerate the new anatomy in the mouth. Who am I to argue? I don't agree, but hopefully the dentist will be right about it. I have dad sleep with a soft mask (the kind you see dentists wear) so that it would catch any drainage from his mouth.

Friday February 5, 2010

Dad wakes up in horrible pain. I am so glad I had dad where the soft mask because it was full of blood and other drainage, which would have been all over the pillow if it had not been contained, by the mask. The gums were terribly red and sore. I gave dad some ibuprofen to help with the swelling and then had him rinse his mouth with an antiseptic rinse I purchased before hand for this occasion. I feel so badly for dad, I had my wisdom teeth pulled 30 years ago and to this day I still remember the pain I had - it last a good ten days. I worry about dad getting dehydrated, so I keep him on a high liquid diet for now.

Monday February 8, 2010
4 days since denture procedure


Dad is in a lot of pain and discomfort from the dentures. We stop in today and the dentist makes some adjustments. He assures me that this is normal and to come back as often as necessary for adjustments.

Monday February 15, 2010
11 days since denture procedure


Dad is not tolerating the dentures at all. He tells me the bridge is fine but the upper denture is hurting him. What is frustrating to me is he complains to me about it and then when we go into the dentist he acts as if the pain is minor. I think this dentist is a saint for putting up with dad. I wonder how many of his other clients are coming in this frequently.

Monday February 22, 2010
18 days since denture procedure


The dentist continues to advice dad to wear the dentures all day to get used to them. But my father will not listen. He tells the dentist that the adjustment feels very good. We go home, he eats lunch and then complains the appliance hurts and he takes them out. Now he is talking about having the remaining two teeth pulled because he doesn't want the dentures anymore! Larry and I convince him that it really is in his best interest to keep the dentures so he can enjoy food and not just live on soup and soft foods.

Monday March 1, 2010
25 days since denture procedure


The dentist is able to see what is hurting dad; evidently, there is some bone that is exposed where a dead tooth was pulled. He does something to the area and then adjusts the dentures and guess what? My dad finally has a big smile on his face. The dentures don't hurt. To be sure I give him a couple of crackers to eat - I should have done this weeks ago. I want to make sure that the dentures feel fine when he is eating something. So far so good, he says. So now we have good fitting and comfortable top denture and no complaints about the bottoms (they seem to fit fine since the first day).

Monday March 15, 2010
39 days since denture procedure


Over the last few days dad started complaining that the bottom bridge now does not fit well. Perhaps the pain of the upper denture was masking the bottom bridge pain. I don't know, but now we have to deal with the bridge. Oh this poor dentist, I feel so sorry for him. He has been nothing but kind, but I wonder how long that will last?
The dentist makes significant changes to the bridge so it fits more comfortably and I am worried that it is going to be too loose. Sure enough at dinner dad is complaining that food is getting under the bridge and pushing it up. He is very frustrated and says that the dentist "killed my teeth."

Monday March 22, 2010
46 days after denture procedure


The dentist always greets us with a smile and kind word. I don't see a wedding band on his finger - surprising, he should be married - the guy would make a great husband! So patient, considerate, and kind. On the other hand, maybe he was married and took all of his work frustration out at home? Hmmm, I wonder, the guy is just too perfect.
He spends a long time with dad today, and brings in his technician to see what can be done with the bottom bridge. Dad leaves and still complains. The dentist asks him to please wear it all day for the next couple of weeks too much adjusting may break the bridge. I knew dad would not listen. He ate lunch. Complained that the top denture keeps falling down and the bridge keeps coming up. He takes them both out right at the lunch table. How gross, good thing my kids and Larry were not around to see this little display.

Monday April 5, 2010
53 days after denture procedure


Dad refuses to wear the dentures - he says he can eat without them. Just pull the bottom two teeth and his gums are strong enough to eat anything. To prove it he eats an apple that he cuts into quarters. I was surprised to see him eat it with no problem. However, 30 minutes later he tells me that his gums are hurting him. I reminded him that he is expecting his gums to do the job of real teeth and they are going to hurt. He still does not want the dentures.

I wait a week to see if dad still feels this strongly about the dentures. He is so indecisive, one day he wants them, and the next day he doesn't, the next day he wants me to make the decision. No wonder he never did anything with his life, he can't make up his mind!

Monday April 12 2010
60 days after denture procedure


Well, dad still does not want the dentures. The dentist told me about a month ago that if the dentures don't work out he would give us our money back He will keep trying to make it perfect if we give him the chance. I call the office, so apologetic; the receptionist was very kind and said that I should bring back in the dentures and she would give me a check. I didn't even ask if it were for the full amount because I was so embarrassed and just wanted to get off the phone.

Monday April 19 2010
67 days after denture procedure


I am supposed to bring in the dentures today. I dread going back to the dentist. First, I don't know if I am going to get the full amount back. Could he decide to charge us for each week of adjustments? I mention to dad that today I will bring the dentures back to the dentist. He says, "Maybe I should give them another chance?" My mouth dropped open and I just stared at him in exasperation. Fortunately, Larry and the kids were a witness to this because my dad will deny ever saying it (he has very selective memory). I call the dentist and thank goodness, I got the voicemail. I left a message, and asked for their patience and understanding with my almost 90 year old dad. He wants to try again. I would like to know if I could bring him in later this week for another adjustment. No response back yet.

Here is a word of caution to all of you out there considering dentures. Take it seriously and make sure you are willing to make the commitment to them. Dentures are not like real teeth; they serve a purpose, but do not take the place of real teeth. You have to get used to them, plain and simple. Although I still have all of my teeth and can't speak for denture-wear, I can say that I had to wear a full set of braces for 18 months between the ages of 45-47. I hated them. Food would be stuck in the braces, the wires would poke me in the gums, and I would get sores from pressure points. However, I got used to them. Now at the age of 50 I have the most gorgeous set of teeth! I don't even remember all the discomfort.

Taking Care of Dad - Dental and Medical Appointments

Monday – February 1, 2010
28 days after the accident


6am: I have a friend who takes my kids to school on Monday and Tuesday morning, which is such a relief because I don’t want to leave my father alone until I know what his abilities are. I watch the kids leave at 6:30am and check on my father. He is still sleeping so I take the opportunity to get a little more sleep myself.

9am: My father is quietly lying in bed. I call his name gently and he looks up at me. “Good morning Dad,” I announce. “Come on, let’s have some breakfast.” I am happy to see that he is moving a little better today and he is less confused from the day before. I pour him a glass of fresh apple juice, which he gulps down. I suspect he only nutritious meal of the day was lunch at the senior center. My goal right now is to help him regain his strength.
For breakfast: I gave him the fruit and oatmeal warm breakfast cereal and a fruit salad with ½ banana and 2 strawberries cut up small; ½ cup of decaf coffee and 1 small chocolate macaroon.

Dad is extremely constipated, the nursing home sent him out here with two huge bags of strong oral medications. Just three days before I picked him up in New York he was rushed to the hospital because he passed out while having a bowel movement. He doesn't need medicines he needs activity, plenty of water, and proper nutrition.

My second goal for dad is to clear up his constipation and get his bowels working properly. I increase his water and make sure he eats plenty of ripe fruit. I am also going to put him on some supplements and probiotics to help the process along.

10:30 am: We have an appointment to fit dad for dentures. The consult goes well, tomorrow dad will return to have four teeth removed and his temporary dentures fitted. He will eat much better now that he has teeth. Evidently, the bridge he had in New York was destroyed when he was hit by the car.

12:00 noon: I take dad to lunch at this new sandwich shop right down the street. We can smell the fresh bread as we walk into the shop and my mouth began to salivate, I forgot to have breakfast and did not realize how hungry I was.
I ordered an 8” vegetarian sub for dad and I to share, it had lettuce, tomato, alfalfa sprouts, avocado and Swiss cheese. Delicious! My father actually does pretty well without teeth, still I had the sub cut into four sections and had them slice the tomatoes and lettuce very thin and small.

1:00pm Stop at Walgreens to fill the prescription for the antibiotic that dad will take after he has his teeth pulled. It is very important for individuals with heart conditions to take antibiotics after having any kind of oral work done to prevent infection. While I was in the pharmacy, I picked up another cervical collar for my dad so I could wash the one he was wearing. Also bought him a comb, latex gloves to change the gauze pads he will have in his mouth tomorrow, razor and shaving cream so he can shave tonight, and some fruit popsicles in anticipation of him wanting something cool in his mouth after surgery.

2:15pm Pulled into the garage and helped dad into his room. I hung up his coat while he took off his sneakers and socks. We went into the kitchen and I poured him a glass of water. We chatted for a few minutes and when the kids came home from school they visited with him while enjoying their afternoon snack. My son helped dad over to the recliner and elevated his legs. He pulled out a deck of cards and began showing him some new card tricks. I took the opportunity to throw a load of my own clothes into the washing machine, and sat down to pay some household bills and make a couple of phone calls to set up doctor and eye appointment for my father next week.

I remembered that a new practice opened up just minutes from the house and there was a good eye-doctor in the shopping center where I go for groceries. I was pleased to get those appointments out of the way. Dad still has his secondary insurance from New York but I am going to have to find other insurance because they will not cover him after 30 days (his type of insurance is only good in New York).

4:00pm Dad goes into his bedroom to watch the news and rest while I begin making dinner. I thought a nice pork roast would be nice. I had marinated it with ginger and pear juice, placed a few slits into the meat, and placed it a hot oven for a couple of hours. I made a couple of vegetable dishes, long grain rice, and then headed upstairs to visit with the kids before dinner.

6:15pm My husband gets dad and the kids set the table while I pull out the pork roast and slice it – oh it smelled so good, I couldn’t wait to sit down with a glass of white and enjoy my family’s company over a nice dinner.

Dinner has always been an important ritual in our home; we eat as a family every night, with little exception. It is our time to relax and share each other’s day. My father enjoys this part of the day very much because he was so lonely living by himself, the chatter and laughing puts a very big smile on his face. Warms my heart to see him so joyful and engaged. He has been depressed and fearful ever since the rehab staff told him he can't live alone anymore. I am going to see if I can set up some counseling sessions for him to help him during this difficult transition.
Friday – January 29, 2010
25 days after the accident

1 day in Colorado

10am: My father wakes up in good spirits, he slept very well. I am not surprised considering how late we got in last night. My children are off to school and my husband is sleeping (he works the night shift). So I make a light breakfast for my father, since I am not sure what kind of foods he likes, I give him a fresh fruit platter, cut small since he has only 4 teeth, two top canines and two bottom. He enjoys the fresh blueberries, strawberries, and bananas. Next, I give him 3 oz of yogurt and a cup of decaffeinated black coffee with a shortbread cookie.
11am: I set him up on the reclining chair by the front bay window so he can relax, get some sun, and read the morning paper, while I clean up the kitchen. He is close enough for me to see and talk too.
12 noon: He is tired, I help him back to bed and put on the television for him, and he watches a movie and falls back to sleep about 2pm.
2-4pm: I take this opportunity to empty his two suitcases and wash all of his clothes. Because he used a washboard to clean his clothes, most of them were so embedded with dirt and grime and so worn thin that they fell apart in the washing machine! One of his coats just shredded in the washing machine, I was shocked at the condition of these clothes.
4pm: My husband arrives home with the kids. It was a nice reunion for everyone, my father’s eyes lit up when he saw the kids and my husband. Fortunately, my husband and father get along very well. This would be especially difficult if that relaxation was not intact. The kids entertain my father while I begin getting an early dinner on the table for everyone.
5:15pm: We sit down to homemade meatballs and spaghetti. I know my father cannot eat this; I made him a bowl of homemade squash soup. I don’t want to push the food, let him eat slowly and regain his strength. Besides, I don’t know what kinds of foods he can tolerate, squash is easy on the digestive system and he enjoyed it.
6:30pm: My husband spends some time talking to my father while the kids and I clean the kitchen. I overhear my father say, “Are you sure I am not a burden to you?” My husband tells my father, “Nate you are part of the family, and never a burden, we are happy to help you, and glad you are here.” My father cries, he is depressed and scared, still confused, he asks my husband three times if he is a burden. Each time my husband reassures him that everything is fine and will be fine.
7:30pm: We all watch a little television in my father’s room, he starts to fall asleep at 8:45pm so we kiss him goodnight and turn off the television.

Taking Care of Dad - My Journey as a Primary Caregiver

Tuesday January 5, 2010

while crossing the street on the way home from his daily 1 mile walk, dad is hit by a car. The young driver is speeding up to make the light and does not see dad in the crosswalk. Dad is admitted to the hospital in critical condition. He has a C-2 fracture of his cervical spine, a scalp hematoma, bruised left tibia bone, and various cuts, scrapes, and bruises. I will not be contacted until Friday!

Flashback:

I have been trying to get a hold of dad since Sunday. We speak several times during the week. Dad lives in Brooklyn, New York and I live in Northern Colorado. I worry about him living alone. He refuses to go into a retirement home and is not ready to move to Colorado to live with my family and me.

Wednesday January 6, 2010

I get a call from John, dad's super (he keeps an eye on dad for me) he has not seen dad in two days, but the television in his apartment has been on continuously. I mentioned that I too have not been able to get in touch with him. He does not have a key to the apartment,as the tenants are the only ones with keys.

Thursday January 7 2010

I contact Benny, one of my childhood best friends, who lives in Brooklyn to go check on dad. Benny and I have been talking me sending him a copy of dad's apartment key. I wish I had done so two months ago when we first spoke about it. It is now about 10pm EST, and we have no choice but to contact the police. The police want to breakdown the door, but I get a weird feeling in the pit of my stomach. I ask the police to wait another day so I can check the local hospitals.

Friday, January 8, 2010
3 days after the accident


The hospital contacts me to inform me of dad's accident. His injuries are serious but by some miracle, he is not paralyzed the neck fracture does not touch the spinal cord. He is going to be transferred this weekend to a rehabilitation facility (a nursing home) for several weeks. Dad is too confused to speak to me. The social worker at the hospital suggests that I wait until he is settled in at the nursing home.

Monday January 11, 2010
6 days after the accident


I have called the hospital all weekend to check on dad. He finally is transferred to the nursing home about 7pm.

Tuesday January 12, 2010

Finally I get to speak to someone - the social worker informs me that dad is in bad shape and although it looks like he is going to make it, a miracle really, he will not be able to go back to independent living. As both his medical and financial power of attorney, I am going to have to decide about placement for him.

I finally get to speak to dad. He is very confused, keeps repeating himself, I find that I continually have to reorient him to what happened, where he is, who I am, etc. Come to find out that the hematoma is in that part of the brain where memory is stored. Dad may never regain his memory or be able to retrieve any. I am so scared for him.

Wednesday January 13 - 20, 2010
9th day after the accident and more

During the next week, I check in on dad three times per day, speaking to the social worker, doctor, and nursing staff daily as well. Each time I speak to dad, he sounds scared and confused. Tells me that they won't let him out of bed, he must wait for someone to walk with him to meals or they bring the tray to him in bed when they are short staff to walk with him. He is crying all the time, begging me to get him out of the nursing home.

The doctor and social confirm, what I already suspect, that dad can no longer live independently. I must decide now about placement. I ask dad what he wants to do - nursing home or come to live with me. He wants neither - and continues to hold onto hopes of going home.

Later that day,I receive a phone call from a(home health)social worker, who has been following dad for months. She was worried about dad because he missed their last two appointments. I filled her in on his situation and she generously offered to speak to dad to help him during this transition.

In the meantime, I have to start making plans to go to New York and put dad's affairs in order. I will have no help in closing his apartment, rerouting his mail, closing his bank accounts, terminating the utility bills, contacting his doctors, getting current prescriptions, etc. How the heck am I going to do this without any help? A major concern is also brewing in my own household. I have no one to take my two kids,Joey 15 and Jessica 14 to school or stay with them while my husband works(the night-shift).

I struggle with so much right now. I know dad never wanted to go into a nursing home. He won't even try to see the positive in this situation - that at 89 he managed to live independently all this time, and the accident did not leave him paralyzed. Nope, I suspect he is going to fight me all the way.

My other concern is a serious one - will dad get the proper care in a nursing home? He has a broken neck and must wear a hard collar for the rest of his life. He is too old to risk surgery. As it is, the staff is struggling with dad now; he keeps breaking his collar, during his attempts to remove it. He is on his fifth collar and the doctor has asked me to convince him to leave the collar in place. So already, I am worried sick that before I even get out there dad is going to sever his spinal cord.

Wednesday January 20, 2010
16 days after the accident

The consensus, after speaking to the doctor, social worker, and the home health social worker, is to bring dad to Colorado to live with us, at least while he is recuperating. After that we will see. I just can't think that far ahead.

I immediately make all the arrangements to fly into New York on January 25 (overnight flight,)and return home with dad on January 28(late evening). Yes, that is right, I have only a little over 3 days to close dad's apartment and take care of all his financial and other related things.

There are several problems, first is my health. I have severe lower back problems and a condition called Mixed Connective Tissue Disease. I would not be able to handle two layovers each way. Frankly, I don't know if I am going to be able to handle one flight. Although I am in remission, I have residual problems from the illness.

Larry wants to come with me but he has to stay behind to take care of the kids. Well his boss will only give him the 25th to 28th off, which is the other reason why my trip has to be so short. We decide that I will take one of the kids with me to help me. Jessica is eager to go and I think it would be good for her and me as well to have this time together.

I just made the reservations online and paid for the tickets. the cheapest tickets I could find put us on non-refundable, non-change tickets. So the plans are made - there is no looking back now...

At the age of 89, my dad has lived independently and alone, since the death of my mother back in 1970. No longer able to go back home my husband and I made the decision to bring dad home with us to Colorado to live with our family. It is going to be a difficult journey for all of us. My dad came to this country in 1949 and has lived in Brooklyn, New York for the last 40 years.