Monday, September 7, 2015

Adaptation

In case you hadn't noticed, I'm not sugar-coating any of these experiences. I think to gloss over the difficulty of having aging parents makes those who may yet to go through it feel worse about the reality of the feelings when their time comes to deal honestly with the experience.
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It's been about a month and a half since Mom was released from the nursing home. In that time, we've striven to find our new normal, to develop a sense of routine, a sense of rhythm to let all of our lives fall back into some semblance of predictability (or as much as one can have with elderly, unwell parents).


The first few weeks were intense, stressful and chaotic - Mom had a hard time adjusting to the new boundaries of her world, and came across as both demanding and unappreciative. Himself, my brother & I were all tired and stressed, worrying about getting everything just right and not missing some key component. Her first weekend home included yelling and tears on both her part and mine, but it helped us both see where the other was coming from and the path has been smoother since.

We seem to have resolved the caregiver issue, but not without challenges. Mom has opinions on everything from how soon after the dishwasher stops it should be unloaded, to how often laundry should be done. We are working with her to adjust her expectations in matters like this.

We often said that in the dynamic of my parents relationship, Dad was the body and Mom was the brains. Since Dad's stroke, it fell to Mom to ensure bills were paid, appointments made and kept, meals made and served while she relied on Dad to fetch and carry and bring. All that has changed. One of the hardest adaptations for Mom is how much frailer Dad became in the 4 months she was away. He is even more unsteady on his feet, had a spell of falling repeatedly, and we have had to tell both her and her caregivers that he cannot go to the basement and he cannot carry anything heavy or unwieldy.

Where Mom was once on top of everything, we see a significant degradation in her ability to process information, to remember things, to follow a complex conversation. She is easily overwhelmed with information. After a few very frustrating interactions, I have had to learn to provide her with information in small chunks, a definite change from the balls-to-the-wall, get-it-all-done-NOW mode I was in for the weeks leading up to her discharge. As someone who once planned the food services for a high school on a monthly basis, Mom is now challenged by planning for seven days of meals to make a grocery list. So we have a method for that, which includes a pre-printed list of the things she most commonly orders, with boxes to mark a quantity because she struggles to write. Once a week, we go over her list and talk about whether or not she has enough proteins for 7 dinners, and will she have leftovers or sandwiches for lunches.

I make charts, lists, reminders - anything to make it easier on her. To the grocery list I have now added a meal planner to help her think it through; she has a form to chart her blood glucose, and a chart to show what medications are taken when (although we fill her pill case weekly, she is reassured that she can grab this chart in an emergency).

In the meantime, as my brother puts it, "Dad has gotten what he wanted, for good or ill. Mom is home." She casts a large shadow, and almost immediately upon her return, Dad faded into it. He sits quietly most of the time, waiting for instructions or ways to help her. He gets upset if he's told he can't do things for her because they are risky to him - "I will take care of her! She's MY wife!" he insists. But helping move her, fetching and carrying for her (because she will still tell him to and he will still do it, no matter what we say) is hurting him. His back aches, and his hip, and the ankle that he broke which never healed right because he wouldn't wear the boot. When company comes, he's happy to see them but she dominates the conversations. He misplaced the opener for the garage door that goes to the ramp; she yelled at him. He lost his house keys; she called him names. It's heartbreaking no matter what - when she wasn't home, he pined for her, asked repeatedly to be taken to see her. Now that she's home, he is trying so hard for her and very often it's just not good enough.

In the meantime, we do the best we can for them. My brother stops during the week to take trash bins up or down from the curb. Except for this weekend, I go each Sunday to get the grocery list, fill the pill cases and check the grocery supply in fridge, freezer and pantry to ensure she isn't ordering things she already has. The guys have built the ramp, installed grab bars, removed doors and anything else that needs modifying. I schedule the handicapped bus for appointments, make sure the bills are paid, the groceries and personal care supplies ordered and interface with her doctors. 

This is our new normal - making the best life we can for them in their last years, the way they made the best life they could for us.

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