‘That’s your mother’

So, I seem to have taken a little break from the blog. I have seen Mom several times since I last posted, and there have been calls about a skin rash and a referral for speech therapy. And today, a care conference. I can’t really explain the lapse in posting. It just happens sometimes.

Mom has had at least two weeks of treatment for a pesky rash on her left arm. Today, it looked pretty good. There is still a pink patch on the inside of her elbow, but it’s fairly faint compared to how red and bumpy it was when I first learned of it. I got a worrisome call from the business manager when she checked into Mom’s insurance coverage in response to a referral for speech therapy. The online account indicated Mom’s Medicare coverage – which is managed through the Ohio Public Employees Retirement System – had terminated in December 2011. I knew this couldn’t be true, as I get regular statements about procedures and doctor visits that have been covered. A phone call cleared that up – thankfully a call the business manager made. I still get worked up about the financial elements of Mom’s care, possibly because of little mishaps like this that can strike unnecessary terror in my heart.

And then the speech therapist called to describe the evaluation she would do. Mom was referred because she had experienced a rapid weight loss. That can make nurses worry that residents aren’t eating well and could even have trouble swallowing. So this therapist evaluates the oral mechanics of eating to see if adjustments to the diet are needed. I asked the therapist to consider a peek at Mom’s teeth if she could get the chance. I worry that Mom’s mouth hurts because of tooth decay. Though no one has ever said she has tooth decay, I just assume it’s happening because her breath is just terrible, all the time. I learned today that the therapist asked for 20 sessions with Mom – she is waiting to see what Medicare will cover before beginning the therapy.

Today, during the care conference, the nursing representative reported that oral care is difficult for Mom. She screams when aides try to clean her teeth. She also screams when aides give her a shower – but they do complete that task twice a week. Unfortunately, more than one staffer is needed to shower her because she resists. The aide in the meeting today said Mom doesn’t hit or kick anymore, but she continues to try to get away. And she screams. Everyone knows about her scream because it is prolonged, for the duration of each shower. “That’s your mother,” the nursing rep said. I kind of didn’t like that. I’m sure my mother would prefer not to be so upset that she feels compelled to scream. No one is sure what it is that bothers her – the physical contact, the sensation of the water, the idea that she has lost control. Maybe all of it.

That was the only quasi-negative thing said. Generally, I think Mom is considered a pleasant resident to have at the center.

Mom weighs 188.8 pounds, up 8.8 pounds since March. Which is surprising, since she had some dramatic weight losses during this quarter. A year ago, she weighed 171 pounds. That was when she was a compulsive walker, and didn’t eat as much because her attention span was so short. She is eating well these days, between 75 and 100 percent of each meal. She uses her hands most of the time, but might pick up a utensil. She still gets ice cream for each meal and also high-calorie cereal at lunch and dinner. That might be discontinued since her weight is up now. For breakfast, Mom’s preference is cold cereal, no milk. She eats it with her fingers. I didn’t know they had determined that she had a preference like that.

Mom spends less time with her gentleman friends now. She is less clingy, they said, and Mr. R is less possessive, and one nurse recently said he frankly might just be forgetting that he and Mom used to be constant companions. Mr. Beard is much more easy-going. I have seen this myself. But Mom is alone a lot more often now, and she also finds companionship with women. The staff said she sometimes holds hands and takes walks with her roommate, which I am glad to hear – her roommate has had some adjustment difficulties but maybe her friendship with Mom is helping. Mom also tries to be comforting to others, patting people on the back. She watches activities more often than she participates. She still likes music and sometimes dances or claps her hands. She is playful. Recently, she tapped the activities director on the butt as a little joke.

Aides switch residents every six months, and that transition just occurred a few days ago. This aide, who has worked with Mom before, said she has observed one clear difference. Mom used to not necessarily be inclined to follow along when an aide coaxed her to go somewhere – the shower room, the bathroom, her bedroom, to a table for a meal. But now, she is more inclined to go along with what the aide wants. I would have expected just the opposite, mostly because Mom doesn’t seem to understand instruction. But I was glad to hear this – anything that’s easier for the aides is good news. She also said she had noticed that I had clipped Mom’s fingernails recently. I said I do that when I think of it and see that her nails are long. Well, Mom won’t stand for having an aide clip her nails. So interesting. Knowing that, I clipped them when I visited her after the meeting. She seemed concerned a time or two that I might hurt her, but she was mostly passive about it. Makes me wonder if I could get away with brushing her teeth. It’s definitely worth a try.

Mom has been happy and alert during my last few visits. Very pleasant, if not able to articulate much of anything. Oddly, today she began to count. “1, 2, 3 … 4, 5, 6, 7, 7, 7, 8. 9.” She stopped there. I asked her about her ABCs, but she didn’t join me when I began reciting those. I don’t know what prompted it. She wasn’t counting anything she could see. Just reciting the numbers, in proper order. One of those things that was available for retrieval at that moment, I guess.

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