Care conference 3

By all staff accounts, Mom is doing quite well. I think many staff members like her. I think they like all the residents, perhaps even love them, in fact. They are so affectionate and attentive to the residents. Mom is just pretty fun these days – friendly, social, agreeable most of the time. Not generally a source of any problems. It is so nice to hear this about her.

I met with four staff members for this latest quarterly care conference – the heads of social work, dietary and activities, as well as a nursing representative who is also Mom’s “guardian angel” under a program ensuring all residents have one staff member specifically looking after their every need.

Mom is steadily gaining weight. She has gained 5.9 pounds in the last three months. And that is just fine. She walks around a fair bit, so she does get exercise and is still very mobile. I think it’s typical for patients to eventually lose weight as they lose interest in, or familiarity with, food. Her health is otherwise good so her weight is really not an issue. She doesn’t always eat 100 percent of her meals, either. She usually does engage in any snacking that is available, like ice cream socials and things like that.

Mom continues to participate regularly in activities and seems to like them all – bingo, arts, games, etc. The activities director said she sometimes observes that Mom will experience brief periods of unhappiness that manifests in a variety of ways – sulking, grumpiness – but which always passes fairly quickly. It is much more common for Mom to just be content, dancing, smiling and socializing.

I now have clarity on the meds situation. One antidepressant was completely discontinued: Wellbutrin. Mom still takes a small dose of an antipsychotic each day, and I wouldn’t be surprised if she’s eventually completely weaned from that. The Trazodone she takes for sleep has been reduced from 150 mg to 50 mg each night. That’s terrific, I think. She still takes Zoloft, which she has been taking for years and years. With these changes, her mood has stayed stable and, it seems to me, has possibly even improved. It’s interesting. I have always been in favor of antidepressants of any kind to ensure that Mom wouldn’t feel sad or scared. With the reductions in these meds, she is certainly not scared, and doesn’t really appear to be sad, either.

The dietary director did note that Mom recently took her shirt off and was walking bare-chested along a hallway. The director asked Mom what was wrong and she said she was hot. So it wasn’t a behavioral thing – just a comfort thing. The director took Mom to her room and got her a lighter shirt. Mom was able to put it on herself. The aides report that Mom’s participation in dressing herself tends to vary from day to day, but she still apparently can handle the shirts. I was starting to help her dress this time a year ago, I think. Interesting that she can do some dressing herself this much later. This was also a reminder that I need to switch out Mom’s clothing – get her cold-weather gear out of her closet and load her up with T-shirts and lighter pants. This reminds me that I also need to make sure her Crocs are returned to her room. Both pairs were missing the last time I visited. I know they’re in the Alz center somewhere, and I assume staffers know exactly where they belong.

Mom is among the residents experiencing a scabies rash at the Alz center. I didn’t realize how common this is until I read a little bit about it. I recall her pointing to a spotty rash on one of her fingers about two weeks ago. I told her it looked like she might be having a little allergic reaction to something. It must have been scabies. And I wonder, given what I read, if this is why Mom recently suddenly pulled down her pants while she and I were taking a walk – if she might have been feeling itchy but didn’t know how to describe it. At any rate, the staff members have treated all of the affected residents. They think I probably am not likely to get it since my skin contact with Mom is never really prolonged, and I typically wash my hands after being with her. I’ll know better in several weeks – it takes that long for the rash to develop.

Meanwhile, Mom is still caught up in her romantic relationship. I visited her after the care conference, and found her asleep on a couch with Mr. R sitting in an adjacent chair. Another of his girlfriends was asleep in the chair next to him. Mom woke up when I approached her, and stood up to hug me. No tears this time. She was a little groggy. We took a walk to the lobby, sat down for a brief time and then returned to the program area. I was short on time so I didn’t wait until lunch began. I told her I needed to return to work, and encouraged her to sit with Mr. R. She seemed a little confused, like she wanted to come with me. But then I more firmly sat her down on the couch and kissed her goodbye. I walked a few steps toward the door and turned back to see what she was doing, and the two of them were in a deep embrace. Now I know another way to distract her when I leave.

5 comments so far

  1. Jennifer on

    I am still working my way through your blog. About a year ago we thought we would have to put my 90 year old Mom in a nursing home (things looked very bleak). My oldest brother started researching the various nursing homes where my Mom’s friends had gone. To say the four of us were completely clueless is a HUGE understatement. I’ll be honest we didn’t even know the difference between Medicare and Medicaid and that was the tip of the iceberg.

    My oldest brother also had the brilliant idea of putting an ad on Craigslist for in home help. He then turned over the 135 applicants to my brother Jeff and I. We pulled out a few “choice” applications and set up shop at a Panara Bread Company for the interview process. Keep in mind that three of four siblings thought the Craigslist idea was the dumbest thing ever. While it provided some entertainment and a huge waste of time three of four were correct. You do not advertise on Craigslist for elder care.

    Early this morning I got a call from a long time good friend. She was sleep deprived and clearly crying. She too has a 90 year old mother she is caring for. In addition to this she has a 66 year old sister with Dementia/Alzheimer’s (I’m not sure of the difference). The 90 year old Mom and the older sister were living together until the sister became worse then the mother.

    My point in all of this rambling is that I cannot thank you enough for your blog. With the information you have provided (and the bumbling around our family has done) I was actually able to give her some knowledgeable information about what she needed to do. I’m pretty sure that her sister has limited resources. I told her that from your photos that even though your Mom is on Medicaid the facility still looked quite nice. She found this very comforting.

    Your blog is informative yet personal. It’s much easier to read then a textbook (I struggle if it gets to complicated) but you have given some great information. I think you should publish this as a book!!!

  2. jeff on

    I also think it would be a great book, both as a history and as a document of this type of health care crisis in our country. We are so lucky with how things turned out at the Columbus ALz Center, all because of Emily’s commitment to our mother’s care.

  3. momsbrain on

    Jennifer: I hoped that by just writing what I do and observe, it might be helpful to someone else. I certainly do not know all the answers, but I can describe how it turned out for one family. Our support group leader frequently notes that every Alzheimer’s case is different. Your friend certainly has an unbelievable challenge, and I feel for her. I hope she can get the help she needs without too much of a struggle. I will say that in my mom’s experience, being on Medicaid in a nursing home does not mean she just sits and drools all day. I hear so many people worry that that is what will happen. It is not that way at Mom’s facility, and that gives me hope that there is good care at many other facilities, especially those that specialize in dementia care.

    Jeff: We are lucky indeed, I think. And thank you!

  4. Elizabeth on

    I also think the blog posts would make a terrific book; I’ve thought that many times upon reading these actually. And I’m very glad to hear that Bonnie is happy and doing well – healthy and with an exciting new man in her life.

  5. momsbrain on

    Hi, Elizabeth! I have thought this couldn’t possibly be a book, but then I heard that baseball pitcher Curt Shilling and his wife wrote a book about having a child with Asperger’s syndrome – as one family’s experience. I guess this is similar to that… but for now it is just a blog.

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