Archive for October, 2009|Monthly archive page

Mellow Mom

I seem to be on a two-visits-per-week plan at the moment. And that’s just fine. I am actually considering skipping a visit this weekend and then visiting Mom Monday around lunchtime. And then my sister is visiting later in the week and we will spend much of the day Thursday with Mom. This is nice for me, to be developing a routine, and it seems to be working for Mom, who was as calm today as I have seen her in months.

I arrived around 11:30 a.m. and found Mom sitting in a chair that was part of a big circle in the program area. The activities calendar said there had been a Halloween bash at 10:30, so I assumed this had just ended. Music was playing rather loudly, and most people were still sitting in the circle. One staff member was dressed as a princess. Another was a hippie. I learned later that the kids from the daycare had come over in their costumes to mingle with the residents. I’m sure it was adorable. Mom had no memory of it. I noticed Mom had on her light blue Crocs today instead of her pink ones, and I pointed it out to her. She also had on blue socks. She didn’t recall that she had a pink pair of shoes. I told her it is nice to change things up every now and then.

I sat next to Mom for a little while. She didn’t make any significant show of emotion upon seeing me. Though she eventually says, at some point while I’m visiting her, that she likes having me around. Or that I am her best person. Today she said she’s lucky to have me. I said I’m lucky to have her. And she said, “Well, thank you.” I suggested taking a walk around the place but she said she had to pee first. So I took her to her bathroom. And I looked into her room, just to see how everything looked, and there was a male resident, who I didn’t really recognize, sleeping in her bed. I looked in her closet to see if I could find the pink Crocs. I didn’t see them there, or anywhere else in the room. I decided not to be worried about it, especially since she has the blue pair to wear. Mom did a good job with her hygiene this time, and her diaper looked good. I was pleased with that. And then we took a little walk down the hall, through the lobby and to the other side of the building. I looked into her old room, where her former roommate was sleeping as her husband talked with an aide, from hospice, I assume. I heard him say he had been associated with General Eisenhower.

We went back to the program area and sat at a table to wait for lunch to arrive. Mom said at one point, “I need a … container.” And she held her hands in front of her. “A purse?” I said. Somehow, I knew that’s what she meant. And she said yes. I happened to have noticed her purse under her bed when I had been in her room before. I told her I’d get it and come right back. When I went to her room, the napper was gone, but he had left behind a giant pee spot. I got Mom’s purse and brought it back to her. She pulled out a little white stuffed dog toy and said, “This is my pal.” She put him in the middle of the table. I went over to Penny, the nurse, and told her about the strange napper’s pee. I asked her if I should tell an aide, or if I should just know it will eventually be seen and leave it be. She said she’d let an aide know. “And then your mom will leave a puddle in the same spot later,” she said. Possibly true. Probable. She wasn’t giving me a hard time. Just sort of telling it like it is around the place. Lots of pee, everywhere and all the time.

At the table next to us, a woman gently rubbed the feet of a male resident who I assumed was her husband. She looked kind of young to have a husband with Alzheimer’s, but I have seen people of a range of ages at this facility. Later I saw her stroking his face. He put his hand out to her, and she kissed his palm. I don’t think he ever spoke a word. But she talked to him for quite awhile. That can be how it is for quite a few family members who have a loved one with Alzheimer’s – talking, but not being spoken to.

Mom said, from time to time, “I’m trying to think of something to say.” I urged her not to worry about that. She wasn’t fretful, though. Just interested in trying to converse. I took that as a cue, and I just started telling her little stories. I had seen a video on Facebook earlier in the day of a beagle that can play dead. I demonstrated that to her, and she laughed. I asked her about the kids and the Halloween party. She didn’t remember it, so then I told her a little bit about what I had heard. She asked how my family is. I said fine. And I told her she is a big part of my family. That puffed her up a little bit.

Eventually, lunch arrived. An aide handed me Mom’s tray, knowing now who I am. Today was fried fish day. Mom doesn’t like fish. They gave her meatballs instead. I am always glad when I see that the kitchen reads the questionnaires about what residents do and don’t like to eat. I got the tray belonging to the woman sitting at Mom’s table. I poured her milk and buttered her bread, just as I had done for Mom. I enjoy helping a little bit. And paying attention to other residents. I kind of assume other family members might do the same for Mom. It’s just that kind of place.

Sunday visit

I went to see Mom on Sunday morning, about 45 minutes before lunch. She was sitting at the same table she had been at on Thursday, with two other women. I sat down next to her and asked how she was doing, and she said, “OK, but the pee is coming soon.” I said if she had to pee, we ought to go use the bathroom in her room. She got up and walked with me, and she said, “I feel so much better when you’re here. Let me hug you.” So we stopped to hug. It might have been the tightest hug I have ever given her.

When we got to the bathroom, she hiked up her shirt to start pulling down her pants, and aimed her butt at the trash can in the corner. “Over here,” I said, pointing to the toilet. “Oh. They’re similar,” she said. She was laughing. I said, “I guess…they are both…receptacles.” We laughed some more. I checked her closet, and found that one of the packages of underwear I had brought in had been opened – a good sign. I could hear Mom fussing in the bathroom. It turned out the extender seat – a raised plastic seat that’s put in place of a regular toilet seat so the user doesn’t have to lower him- or herself so far – was wedged up against the new roll of toilet paper, and Mom couldn’t get any of the paper off of the roll. I reached in and worked the roll around several times to pull off some paper for her. But it wasn’t enough. She had realized she had to poop, too. She was very dramatic about completing her bowel movement, grunting and leaning backwards. I told her not to rush. To just sit and let things happen naturally. And I turned the wedged roll around and around to get her plenty of paper. It was sort of a funny scene. She finished, and I flushed the toilet for her, but it didn’t completely empty. I tried again, and the water level rose dangerously high. I urged Mom to wash her hands. And I watched the toilet. It didn’t overflow. But I just left it. I figured if an overflow was in the toilet’s future, that didn’t have to be my problem.

Mom and I sat on the chairs in the little lounge area near her room to chat. She said she didn’t have any clothes but those that she was wearing – pink pants, a pink striped T-shirt and her Navajo-patterned heavy fleece jacket. And pink crocs with no socks. (I wonder if the staff members don’t know she has an entire drawer full of socks. She never has them on these days.) I told her she has a closet and a dresser full of clothes, and that staff will help her pick them out, and that they wash her clothes every day. She seemed impressed by that. As we were sitting there, I noticed a male resident across the program area from us. He came out of his room with jeans on, but no shirt. I didn’t see him for a little while, and the next time he was in my line of vision, he was wearing nothing but his adult diaper, which was sagging quite a bit. “You have to have clothes on,” said a nurse, who was following him around. She put a hospital-style gown on him. I didn’t see him anymore after that.

Mom and I took a little walk down the hall to the lobby. Mom didn’t seem to recall that she used to nap in the couches in the lobby. There were some families visiting there. And then another male resident, who had followed us down the hall, began to talk to us. I had no idea what he was saying. But I said, “We’re all going back down the hall to have lunch pretty soon.” I’m pretty sure he said he had already had lunch. He kept talking, and we walked down the hall together, and Mom and I stopped to sit on a rocking bench in a little alcove. This man sat across from us on a couch, and he kept talking. And I would nod, and say OK. And remind him that it was almost lunch time. This is a man I typically see keeping very quiet, sitting at the same table as us and not saying a word. I wished I could give him the proper response. I just tried to give him positive feedback of some kind. I hope he wasn’t as frustrated as I was.

I returned Mom to her table and we sat and waited for lunch. Another woman at the table got her tray first and started to eat. I kept looking at the cart to see if I could find Mom’s tray – it has her name on it – but I figured it was behind other trays and I didn’t want to go rearranging all the trays so I just stood around and waited. I went back to her table and the woman at the table had slid her tray over in front of Mom, as if to share with Mom. It was so sweet. She doesn’t talk much, except to say hello. I told her she was being generous but that Mom would get her food soon. The other woman at the table had to be roused from her nap to start eating. An aide finally handed Mom’s tray to me and I put it in front of her. I went to get her a napkin/bib thing that everyone wears and when I came back, I could see she didn’t know how to cut her ham. So I cut it up for her and told her how good it looked. And I pointed out her pumpkin pie – a past favorite of hers. “I have a piece of pie and so does she,” Mom said about the woman who had shared with her. “I’m not sure how that’s going to work out.” I told Mom everyone gets pie so it should be just fine. She likes sweets, so I imagine the pie was the most important thing on her plate. And then I told her it was time to go and I kissed her goodbye.

Catching up

I went to visit Mom, finally, today for the first time in nine days. The last time I had seen her was on Oct. 13, when my Aunt Nancy and Uncle Gary drove over from Springfield for a visit. I met them at the center. Nancy brought Mom chocolate chip cookies from one of the best bakeries in Springfield. We found Mom in the program area and sat with her for a short while on the couches and chairs near her room. Mom had a cookie. She seemed to think she recognized Gary. We tried to chat a little. Gary and I talked about Ohio State football. I showed Nancy some pictures. When Mom’s lunch arrived, we sat with her briefly and then decided to leave so she wouldn’t be distracted. I felt like she seemed just a little bit stressed about the visit, like she wished she had been prepared for it or something. I have often felt she wants to perform for people other than me – like she would try just a little harder to be as present as possible, as chatty as she could be. It makes me sad that she feels any stress like that, but it’s also an interesting phenomenon, that she can make some sort of extra effort for people she doesn’t see very often.

I then went to Texas for a professional meeting. And I saw some close friends during that trip who also live in Austin. I felt a little bit of dread in advance of the trip – about being away from Mom and, even more, from Patrick, about the fatigue associated with travel, about the demand for social activity that goes along with such professional meetings. But it all went smoothly and was quite enjoyable. It was definitely good to have a few nights out with friends I rarely see – my senior year college roommates, in fact. My friend Steve and his wife have a child I hadn’t met. My friend Cam is living in the perfect city for him – all live music all the time. We enjoyed each others’ company.

And the meeting was so interesting, and there were so many people there, that I was able to just listen to workshop presentations and lectures for the most part, and keep the social activity – at least with strangers – to a minimum. I didn’t see a whole lot of my co-workers who also were there, and I didn’t get to catch up as much as I would have liked to with the friends I have made in this association. I was disappointed to feel the way I did. Often, I can be quite chatty, can really get into talking up a stranger with whom I clearly have some common ground, and I certainly enjoy talking to people I know a little bit or a lot. But I was just in a different place on this trip. Preferred to be a little more withdrawn for whatever reason. I wasn’t depressed. I wasn’t fixated on Mom. I wasn’t having a bad time. I was just avoiding the crowd to a certain extent. Isolation was OK with me. I wonder if I over-isolated, however, and missed out on some social activity that might have given me a boost.

The meeting featured a “meet the scientist” lunch, during which all kinds of experts hosted a table for science writers who wanted to hear about their research. I listened to a molecular genetics professor from UT Southwestern Medical Center in Dallas talk about his Alzheimer’s research. He studies a gene associated with the disease, ApoE. When he started his work, his interest was hardening of the arteries (atherosclerosis). Over time, he has shifted his focus to Alzheimer’s. The gene has roles in both diseases. I listened intently and understood what he said for the most part, and recall that he has traced just about the entire pathway defining this gene’s function. But that gets him only so far in terms of, say, being able to guide drug developers in how to interfere with that pathway, or enhance it, or whatever is needed to slow progress of Alzheimer’s, or prevent it, or treat it. One thing that sticks out to me is that he described a pivotal moment when his graduate student called him at home on a Sunday afternoon to describe disturbing mouse behavior. The student wanted to put the sick mouse out of its misery. But this professor realized that the mouse behavior was an indication that the genetic modifications made to the mouse were quite meaningful. He raced to the lab on a Sunday evening to check it out. This was in 1998, he said. Eleven years from that epiphany, there are still no solid answers for clinical application in this one small component of Alzheimer’s research taking place in this country. It is disheartening. At the same time, I was charmed by this man and his dogged pursuit. He is actually quite distinguished in the field. It is just such a complicated disease.

Today, I carted a box of disposable underwear into the Alz center – the ones that had been sitting in my cubicle for a long time. I walked right by Mom as I took the box to her room. She didn’t notice me. She was sitting at a table with two other women. I put the box on the floor in her closet, and I hope the place uses the darn things. The staff members have seemed to ignore the Depends I left in Mom’s little toiletry cabinet. I’m sure they are supplying their own, but before the Medicaid application was approved, I was supposed to supply them. I suppose I will be billed for the underwear the facility supplied between Aug. 28 and now, or whenever they receive official word that the Medicaid has kicked in. I know Mom is cared for. I just don’t know why they’re not using the stuff I have provided for Mom’s bathing, grooming and dressing.

When I walked up to Mom’s table, she opened her mouth and said, “What a surprise.” I hugged her and sat down at the table with her. I said hello to the ladies sitting there. They didn’t really respond, though one woman nodded at me. I told her I had been away for a little while and that I hadn’t seen her in a week. And that it felt like a long time to me. Patrick had told me that on Sunday, an old friend of Mom’s from Cleveland called to say he was in town and he wanted to visit Mom. He got directions to the new place from Patrick and, as far as we know, it worked out OK. I asked Mom if she remembered seeing Ed. She had no recollection of a visit from him, or from Nancy and Gary the week before, or, for that matter, the last time I had been there. I could tell her hair had been washed. She wasn’t wearing glasses, and I asked about that. “I lost them,” she said. I had seen them on the table in her room so I got them, cleaned them and put them on her face. We’ll see how long that lasts. I trimmed her nails and painted them pink.

A local performer came to sing and I sat in a big circle with the residents and listened to her for awhile. Mom said to me, while sitting next to me, “You look like a doll.” “I do?” I said. “Yes. You look good,” she said. “And so do you,” I said. The woman sang “My Blue Heaven” and Mom knew some of the words. Mom said repeatedly that she was a good singer. I said, “She’s going to be here for awhile to sing for all of you.” “Well, happy birthday,” Mom said. It was just an expression of satisfaction on her part. “Merry Christmas,” I responded.

The funny thing was, today was my birthday. Mom hasn’t known about my birthday for about four years now.

Messy stress

So, Mom is content in her new facility, the former nursing home owes us some money and the Medicaid application is approved. So why do I still feel a little edgy? I guess these things can have lasting effects. I have wanted to convey complete peace and serenity now that Mom isn’t pooping in trash cans, trying to escape or otherwise expressing her displeasure about her surroundings. I am now convinced she is going to be fine. But I haven’t yet felt quite fine. My therapist says maybe this is a period of let-down, that in some way I am having a physical reaction to having had to be on standby for the next crisis for several weeks. But shouldn’t that be over by now? Plus, why let the Medicaid application be so stressful? That was just a matter of waiting things out.

Perhaps the Medicaid wait was stressful because I received bills for more than $15,000 from two nursing homes and one pharmacy during that wait. They are addressed to me as the “responsible party.” No matter that Medicaid was going to cover virtually every cent of those bills once the application got approved. Seeing figures like that on a bill can make one a little jumpy. I have also carted around a large envelope of documentation about Mom’s finances since June 22, adding to it as I compiled things I didn’t know I needed to compile. This is what that pile of papers looked like Friday, on the floor of my cubicle, after I had gone rifling through the files while talking to the case worker on the phone:

Bank statements, IRA statements, POA copies, retirement and Social Security information, tax returns, you name it.

Bank statements, IRA statements, POA copies, retirement and Social Security information, tax returns, you name it.

And though I am very lucky in terms of my employment, where I am surrounded by coworkers who are friends, my schedule can be flexible and the steady stream of work arrives at a usually friendly pace, I have several stories piling up in advance of a science meeting that will take place at the same time I am traveling for my own professional meeting at the end of this week. And I had to finish up two other timely stories as well. That, coupled with the insanity of last week, when I went a little berserk dealing with Mom’s former nursing home, caused me to not be very attentive to the details of keeping my desk organized. This is how it looked when I left on Friday:

The mess to the right of my computer...

The mess to the right of my computer...

...and the mess to the left of my computer. I\'ve never been known as the world\'s tidiest person, but I find this level of mess sort of embarrassing.

...and the mess to the left of my computer. I've never been known as the world's tidiest person, but I find this level of mess sort of embarrassing.

Finally, the approval of the application means Mom’s disposable underwear will now be provided by the facility in which she lives and the cost will be covered by Medicaid. But because I didn’t know when the application would be approved, I had ordered her latest supply from Amazon.com. This box is also on the floor of my cubicle:

Four packages of 14 pairs each of adult size XL underwear - if only I had thought of Amazon.com a year ago.

Four packages of 14 pairs each of adult size XL underwear - if only I had thought of Amazon.com a year ago.

I am kind of irritable these days, sadly. I also have had heartburn every day for a week – something I have never experienced before. And fairly regular headaches. So please pardon me while I feel a little sorry for myself even though things are generally going my way. Sometimes, the rest of the body has to catch up with what the mind already knows, I guess.

APPROVED

Mom’s Medicaid application is approved. At least verbally. I should get a letter in the mail soon. I’m so glad I can stop carting around a huge envelope of documentation with me wherever I go. I was doing that just in case the case worker or a nursing home might call with a question or a demand for more documentation.

I spent about a half hour on the phone with my Medicaid case worker before we settled this. I haven’t heard boo from her for almost two months but today she called me urgently to talk about the case. It’s a good thing we talked. She was convinced I hadn’t successfully reduced Mom’s bank account to under $1,500 for August and was going to approve for only Sept. 1 and later. Meaning Mom’s 20 nights of nursing home care in August would be private pay. There is something called Act 52 for these kinds of application problems that allows for gradual payment of bills not considered eligible. But I couldn’t see why she said Mom had too much money when I could see her balance at the end of August was about $1,080. She said we were at $1,510, and asked me several times if I might have a bill from August for $10 in purchases for Mom that I had forgotten about.

She and I both had our computers going, I was flipping through my paper files, and we finally figured out that she was counting an old retirement account of $400 or so against Mom’s August bank balance because she had forgotten to notice that it had been cleared. In early August. So she fixed that on her computer, and with a few keystrokes said approval moved up to Aug. 1. “Now I can approve that bad boy,” she said. These case workers are so overloaded. Even though I was in a panic about the approval date, I tried to stay calm and just ask her if we could take another look to be sure. I’m so glad I did that. She was actually quite nice. She called me “Hon.”

I think I might have a few drinks tonight to celebrate. Good news for a Friday afternoon.

Resolved

I was giving Mom’s former nursing home 24 hours to respond to the e-mail in which I questioned their handling of Mom’s assisted living credit. And then I was going to call the county long-term care ombudsman and file a complaint. Lo and behold, I returned to the office this afternoon from an appointment, and there was an e-mail from the business office coordinator. I was almost afraid to open it. I was braced for a fight, had been talking about this issue at my appointment, had had heartburn all day, and was just generally full of resentment about the whole thing.

The first words were: I want to apologize… Good start. …as I did not review the amounts before I emailed you. Well, that was dumb, don’t you think?? She provided a detailed breakdown of Mom’s deposits, her additional credit from assisted living (meaning I overpaid them for the month of August, stupid me, but I was being cautious), the cost of the carpet replacement (NOT $1,600), and the fact that there is MORE THAN SIX-HUNDRED DOLLARS remaining as a credit that can be applied to Mom’s nursing home bill (which could be for a whole month, or just half a month, I have no idea, because I don’t know all the rules). If it’s only half a month, Mom will get a little something back after all is said and done. Assuming Medicaid is approved.

Please know that the Facility would never claim a credit amount ‘because it’s there’ as that would be a violation of the Resident Admission Agreement. I guess she had to say this for the record. Maybe my sarcasm didn’t come through.

To her credit, she was polite. Just gave a straight response to my cranky questions. Began with an apology. Provided the correct information. If only she had done that the first time.

I wrote back that I accepted these terms and authorized application of that credit to Mom’s nursing home account. Because Noah the administrator was still being copied, I took the opportunity to say that had anyone told me between yesterday and Aug. 12 (or Aug. 14, I guess, when we officially vacated the assisted living apartment) that the carpet was damaged, and that we would be responsible for paying for its replacement, that could have prevented my intense reaction to her message. I still don’t like it, but it would have made sense, and been courteous, and been appropriate, to inform me of this at the time the decision was made to replace the carpet and bill my mom for the cost.

Still no word from Noah, who I believe is ultimately responsible for this entire mess. And really, whatever, I don’t care. The biggest problem with this now is that I was all worked up with rage and then had no place to put that energy when I got this e-mail. So I cried a very little bit. And now I have a splitting headache. But in the long run, it is a good thing that this particular problem is put to rest.

Actual correspondence

Well, I went off the deep end today. After I received the phone call mentioned in the previous post, I e-mailed the business manager in response (I couldn’t stomach talking on the phone). In that note, I told her I would not call the Medicaid case worker’s supervisor because I considered it an aggressive move that I wasn’t comfortable making. I also mentioned that I had asked another staffer to use Mom’s assisted living credit to pay for her patient liability – essentially, all of her monthly income (state retirement and Social Security) minus $40 that Medicaid allows people to keep for “incidentals.” I told her I had never heard if that had been done. And that after that liability was covered, the facility still owed Mom $655 from the credit. When the business manager responded to my e-mail with a polite thank you, she also said she’d check on Mom’s credit and what happened with that.

About an hour later, I got this e-mail:

Emily,

Unfortunately we are unable to apply the credit amount from Bonnie’s Assisted Living account to her Care Center account. Damages to the carpeting in her apartment exceeded normal wear and tear; therefore the credit on the account will be applied to the cost of replacing the carpet.

Please let me know if you have any questions.

Thank you

D. K.
Business Office Coordinator

Noah the administrator was copied on this note to me. So I replied to all, glad that he was copied, my cheeks burning red hot:

Dear D.,
I do have questions. Is it really going to cost $1,664 to carpet two rooms and a closet in an institutional apartment? And why am I finding this out now, more than four weeks after I was sent a statement indicating Mom had a $1,664.00 credit (I have it right here with me), including return of her security deposit AND her pet deposit? And since she put down $1,250 in deposits, is it really appropriate of your facility to claim the remaining $414 of that credit? Aren’t deposits intended to cover such “above wear and tear” damage? Are you just claiming the rest because it’s there?

She moved out on Aug. 12 from that apartment, and from Whetstone on Aug. 28. To be told on this date, Oct. 5, about an outstanding charge for damaged carpet strikes me as completely unacceptable. I am really curious about record-keeping there. I also got a voice mail from B in accounts receivable that I owed for Mom’s SEPTEMBER patient liability, when she moved out on Aug. 28.

At any rate, I don’t expect you to change your mind. But I will say that being given this information on this date makes it impossible for me to pay Mom’s August patient liability immediately or in a lump sum, as I have spent her money down as required by the Medicaid process. I was acting on the expectation that the credit statement I received from your facility was authentic and that it actually indicated that [your facility] owed my mother money after her liability for 15 days in the care center (before I was told she would have to leave) was covered by that credit.

I am afraid I might be taking out on you, D, frustration that I have felt with the way I (and more important, my mother) have been treated by [your facility] since Mom became a Medicaid applicant. She spent $80,000, her life savings, over 22 months [in assisted living] and had a fantastic experience there. I can’t say the same about the experience with the facility since Aug. 12. Perhaps that is unfair of me, to link Medicaid with how things have gone since Mom left [assisted living], but it is hard not to jump to that conclusion.

Emily

A girl can only take so much.

How to ruin my day

The administrative types at Mom’s previous facility sure do have a knack for pissing me off. I suppose it could just be me, since I am the common denominator and there are at least three people there who can set me off. But I have a hunch they just have a talent for making me angry because all of my interactions with them now revolve around money. As in, they want their Medicaid money for the 15 days Mom slept at and was “cared for” at their nursing facility. The business manager just called to ask if I have talked to my case worker’s supervisor at Medicaid to see if that can speed the process along. Well, I have not made that call. I feel no need to hurry the process along – not on their behalf, anyhow, though it would be nice for me to have it finished up – and I really don’t care to anger my case worker by going over her head.

Meanwhile, the business manager at the Alz center, where Mom has been since Aug. 28, takes a far different approach when she talks to me. She gives me guidance, tells me how things will work. Of course, she wants the money, too. The facilities have staff to pay and bills to pay. But she said she didn’t think a call to the supervisor was particularly crucial. She didn’t think it would necessarily be harmful, but she didn’t push me to do it. I kind of think – these business managers know the case workers and supervisors better than I do. Why don’t they just make the call if it is something that might move things along? Also, the Alz center business manager told me that the previous facility told them Mom had already been approved for Medicaid when they were doing whatever communication goes on between facilities during a transfer. So they lied, too. Was that to hustle Mom out of there? Would the Alz center otherwise not have accepted her? I really don’t know. But the whole thing just makes me crazy.

And I have been thinking that we have passed the three-month point since I applied for Medicaid. I would like that to be resolved, with approval, of course, so I have one less thing to worry about. I sent a new bank statement from Mom’s account to the case worker at the end of September. I sent her a note a few weeks ago asking if she needs anything else from me. She doesn’t respond to me. The last time I talked to her, in late August, she said she was working on May cases. And the business managers tell me that’s how it is: the case workers work in chronological order. My application date is June 22. I would guess that she should be working on June cases by now, but what the hell do I really know?

Two short visits

I am trying to develop a routine for visits with Mom. This week, I went to see her before lunch on Tuesday and Thursday. I am allowing for about 45 minutes to spend with her so I can get a decent feel for how she’s doing. Yesterday, I concluded that she is doing great.

On Tuesday, I could see her clothing situation had improved. She had on black pants, a striped T-shirt and a red fleece jacket. It had just gotten cool outside, so having fleece on made sense. Her hair still didn’t look recently washed, but it looked better. I’m wondering if, even if she gets into the shower, she protests about her hair and face getting wet. I’ve heard some aides in the past say that about her. I painted her nails at a table in the program area while two other residents sat and watched us. I also clipped her nails – they seem to grow very rapidly. She likes the manicure so I will probably make it a weekly thing. Then she said she would like to have some pink stuff on her cheeks. So I took her to her room, where I have hidden a small makeup bag in her sock drawer. I put on some powder and blush, and had her put on her lipstick because she does it better than I can. I combed her hair. And then she was feeling pretty in pink, I think. I left when her lunch arrived. She was a little confused, sitting, then standing, then sitting again, while I tried to say goodbye. I eventually convinced her to just sit still and start eating.

On Thursday, I found Mom in the lobby, on the couch, but sitting upright. I sat with her and she was telling me about how the little kids from the daycare had just been visiting. She described a somewhat chaotic scene, but I didn’t really know how much truth there was to that. She loves little kids, but she seemed to be overwhelmed by them on this particular day. She brought up the kids several times during my visit. She was wearing blue pants and a red corduroy shirt, so I assume now that someone is helping her dress. I ran into her guardian angel and just asked her if she could look into why the disposable underwear I brought for Mom hadn’t been used. She also told me I needed to take away the laundry basket in Mom’s closet to be sure that the facility will take over the laundry. Where do they keep it? I thought, but didn’t say out loud. And then she said they pick up dirty clothes from each resident’s room every morning and run them through the wash every day. Wow. That’s one way to stay on top of it, I guess. And, perhaps with the amount of incontinence in this population, it’s best to not let these particular dirty clothes sit around for long. So I took the basket home, and while emptying it into the washer, discovered two pairs of Mom’s roommate’s pants among Mom’s belongings. So that’s where the strange clothes came from.

For the rest of the visit, Mom and I took a little walk around the facility, stopped to sit for awhile, and then took another walk. We went over to the skilled side, where she used to have a room, and an aide said hello to Mom and told her how much she missed Mom. And she said she wanted to brush Mom’s hair. Whoops – I guess I should have done that, but I hadn’t bothered. I didn’t take it as a reflection on me. I could see she just had affection for Mom. And of course, I am glad to see that anytime, anyplace. We returned to the program area to wait for lunch, and we sat at a table with two women I recognize but hadn’t spent much time talking to. One is a very talkative woman who seems pretty with it. Another is a fairly new arrival who cries a lot. And the talkative one was talking sternly to the sad one about how lunch would be arriving soon. And the sad one cried. A nurse came over and asked the talkative woman to try to be more comforting. But the talkative woman and even my mom said this woman cries all the time. Still, it’s hard to see her cry. She said she was hot and wanted to take off her sweater, and I helped her with that. She said she was hungry, and a volunteer came over and comforted her and then went and got her tray as soon as the first group of trays came out of the kitchen. She felt a little better when she got her food.

I got Mom’s tray for her – something I have never bothered to do. I poured her little carton of milk into a glass, and removed the warmer, and put her napkin on her lap, and put the knife and fork on her plate, and put her soup in front of the tray so she could eat it first. All the steps I have seen the aides do. This time, she was not confused. I kissed her goodbye while she was eating, and she returned to her soup without another thought about me.