At The Hospital With Mom

This happened in March 2008. Mom spent 9 days in the hospital and 6 weeks in a skilled nursing facility before returning home. She is doing fine, now, but it was touch and go for a while.

Tuesday night after dinner, I took my mother to the bathroom. I helped her pull her pants down and get seated on the toilet. After toileting, she could not wipe.

“My arms aren’t long enough,” she said.

I cleaned her and pulled up her pants. I guided her to the sink to wash her hands. I turned on the water for her. She put her hands under the water and just stood there letting it run over her fingertips.

“Pick up the soap,” I said.

She picked it up and held it under the warm stream of water.

“Pull it out from under the water.”

She pulled her hands and the soap out of the running water.

“Rub your hands with the soap.”

She began to make lather.

“Put the soap down. Wash your palms. Wash the backs of your hands. Wash your fingertips.” I gave her instructions one at a time. It was all she could process.

Afterwards, she grasped her walker and hung on to it as she shuffled into the hallway that leads to the living room. After a few steps, she stopped.

“Lift your foot, Mom,” I instructed.

She couldn’t move. I reached down and tugged on the pant leg of the foot I wanted her to lift.

She couldn’t do it. She started to slump to the floor. I thrust my hands under her armpits and held her 197 pound body. Shaking with increased adrenaline, I called my husband to help.

Freddy ran into the hallway. He held her from the front and I held her from the back. I tried to get her to respond to my shouted commands to stand. She slumped and pinned my hand to the walker.

“Freddy!” I yelped. “She’s pinned me to the walker!”

He pulled her away from my hand. She started sliding out of my grasp. I placed my knee between her legs and she sat on it as she collapsed to her knees.

“Bob! Bring us a chair!” Freddy yelled to my father.

My father brought a wooden chair into the hallway. Freddy placed it behind me. I worked my way behind the chair while holding onto my mother. I pulled while Freddy lifted and we dragged her unresponsive body into the chair.

“Mom!” I yelled. She opened her eyes, looked at me and closed them again.

“Mom! I’m going to take your blood sugar.” I turned to my husband and barked, “Freddy, get her insulin and kit, please!”

He ran to the kitchen and got her insulin out of the butter compartment in the refrigerator door. He ran back to me.

“Where’s her kit?” he asked.

“It’s…it’s …it’s…” I couldn’t articulate. “I’ll get it. Make sure she doesn’t fall.” He nodded.

I ran into the living room and grabbed her kit from the top of the medicine console. “I really need you to know where these things are!” I complained, loudly.

“I know!” said Freddy.

I ran back to the hallway and opened the kit. I inserted a test strip into her meter. I tore open an alcohol pad and rubbed it on her fingertip. I pricked her fingertip and squeezed until a small globule of blood appeared. I touched the test strip to it and watched the meter count down. 5, 4, 3, 2, 1…457. I slid her needle from the kit and loaded it with 27 units of insulin. I cleaned her arm with the alcohol pad and gave her the insulin injection.

My father said, “I think she should go to the hospital. Insurance will pay for it.”

“I think you’re right, Dad.” I said. I looked at my husband. “Freddy, will you call for an ambulance?”

“Okay,” he said. He went into the living room and began looking for the ambulance phone number in the phone book. After a few minutes, he came back into the hallway. “Should I call 911?” he asked.

“Watch her. I’ll do it.” I said.

I found two ambulance numbers in the yellow pages. I called one and a recording said it was the fire department. I hung up and called the other number. A recording told me that I had the ambulance and gave me choices to push on the touch tone phone.

“Agent!” I said, not wanting to navigate the robo-system.

“I’m sorry. I didn’t hear….” I hung up and dialed 911.

When the 911 operator came on I gave my name, address and requested an ambulance for my mother.

“Is she conscious?” she asked.

“Yes.” My voice trembled.

“Is she breathing okay?”

“Yes.”

I wanted to cry, but knew I had to keep it together so I could give information to the operator. She asked what had happened to my mother and I told her. She assured me the ambulance was on the way. I hung up and went to wait in the hallway with my mother.

An ambulance and a fire truck pulled up in front of the house. Four paramedics came in. They worked together to check and record my mother’s vital signs, blood sugar and medications used. Her blood sugar had gone up to 488.

My husband pushed her wheelchair into the hallway. I helped to lift her out of the chair and into her wheelchair. The paramedics pushed her through the house and out the back door where they loaded her onto a gurney.

“Call my brothers and sister!” I yelled to my husband.

“Okay,” he answered and went back into the house to get their emergency numbers from the list posted on the wall, next to the calendar.

The paramedics rolled the gurney down the side of the house, to the street and loaded my mother into the ambulance. I climbed into the back and strapped myself into a seat next to her, wanting to be close in case she felt lost.

The paramedic inserted an IV line into my mother’s arm. “Ready,” he said to the driver. He grabbed the radio mike and keyed it to tell the hospital that it was 8:30 p.m. and our ETA was in six minutes.

ER staff rolled her into room 24 as soon as we got there. They checked her blood sugar. The meter couldn’t record it. It was over 500. A nurse took blood for the lab to test. They started a five hour cycle of checking her blood and giving fast acting insulin to bring it down.

My youngest brother and his wife walked into room 24. They waited with me through the testing process, a CT scan and the PCU admission in the fourth hour after her arrival. Sharing the burden felt less terrifying.

We went home after 1:00 a.m. I showered and went to bed, waking every few hours. In the morning, I fixed a heat and serve meal, then went to the hospital with Freddy.

My youngest brother’s wife was waiting at the hospital entrance. “She’s been crying this morning,” she said. “She doesn’t know where she is or why she’s there. We should stay with her in shifts, so she won’t be scared.” I agreed.

We went straight to my mother’s room. She lay in bed looking at the wall in front of her. She looked scared.

“I thought you left me in a nursing home,” she said with a sorrowful look in her eyes.

“I would never do that.” I told her, remembering the promise I made to her 41 years ago when she worked at a convalescent home. I felt sorry that I had gone home the night before.

I stayed with her taking a break in the early evening to eat and go back to the house to pack for an overnight stay. My youngest brother and his family stayed with her while I was gone. During the night, nurses woke her every two hours to take her blood sugar and give her insulin. They changed her disposable diaper and cleaned her thoroughly each time.

She ate breakfast in bed. Afterwards she asked for the bedpan. The nurses got it for her and put her on it. When she finished, they’d take it. A few minutes later, she would ask for it again. This happened three times. When the doctor came to see her, I asked for her to be catheterized. When they put the catheter in, she filled the bag with 800 ccs of urine. Something had impeded her natural flow, making her feel the need to urinate frequently.

They took her blood sugar and got her up for lunch. She sat in a chair next to the bed and began to eat. A nurse came in and gave her a shot of insulin. She continued to eat. After a few bites, her hands began to shake. I covered her legs, in case she was cold. She ate a little more of her food. She grabbed hold of her water cup by putting two fingers inside and her thumb on the outside. She pulled it to her breast and held it trembling. I took it and held it to her lips. She drank and drank and drank. She picked up her fork, put it in her chicken soup and raised it, dripping to her lips. She couldn’t get it to her mouth. I picked up a spoon and asked her if she wanted help. She nodded and I put a spoonful of soup in her mouth. After a few bites, her head lolled back and her eyes closed.

I pushed the nurses call button. Nurses came in and took her blood pressure. It was 77/51. They got her into bed and took it again. It was 161/90. They took her blood to test for an infection and then put her on antibiotics. They told me the test results would take a few days to culture. They took her to get another CT scan. The results were no different than last night’s scan. There was no neurological damage other than the Alzheimer’s disease. They took a urine sample for testing. Each time they came in they asked her questions.

“What’s your name?”

“Rosella.”

“What’s your last name?”

“Harris.”

“Who’s the president?”

“Nixon.”

"Who’s that lady over there?” The nurse pointed to me.

“It’s my Mama!”

My eyes welled with tears. Whenever I’ve faced trouble in childhood and in adulthood, I’ve always wanted my mom. In better years, she was there to support me and help me get through life’s problems, big or small.

I want my Mom, now, but it’s painfully clear I can’t have her. I’m her Mama, now.

Just Another Day In The Life Of Inspector Caretaker: Not the Danny Elfman, Oingo Boingo Kind

It’s a good thing I examined the toilet seat before depositing my delicate derriere there at 6:00 this morning. I have gotten in the habit of standing to the side of the commode each visit and tilting my head to the left, letting the light reflect off the seat, just so, to reveal its state of cleanliness. You have to be careful when you live in a house with two males and a mother with Alzheimer’s disease.

As I tilted my head, I saw the telltale skin particles left by my mother. “Hmmmm,” I thought. “She used the bathroom this morning instead of the bedside potty.”

As I popped open the can of bleach wipes, wiped down the toilet seat and the front of the toilet bowl, dried it with toilet paper, and sat down to do my morning business, I wondered if she got there on her own volition or if my father helped her. She needs help with mobility. I help her to lift herself into a standing position. I make sure she positions her body inside her walker, instead of pushing it like a shopping cart. But every once in a while, she believes she is mobile and in those moments of fantasy, she is.

Just yesterday, when I went out in the back yard to water the garden, we had one of those occurrences of fantastical mobility. Apparently, as soon as I closed the back door, my father fell asleep on the couch. My mother, who had been talking about cookies for the past two nights, was possessed by an insane cookie craving. This was not a good thing. My mother is diabetic. In the throes of cookie madness, she pushed herself up and out of her green velour rocker. Leaving her walker as an afterthought, she tottered out to the kitchen and found my father’s chocolate chip cookies. She unzipped the one gallon bag, took two cookies and moved out of sight to the far side of the kitchen to eat one. Then, forgetting to be sneaky, she staggered the length of the kitchen and back into the living room. My father sensed someone was in the room, woke up and saw her moving towards her chair with that tightrope walk of hers, clutching a cookie in her garden gloved hand.

I wondered about the trail of cookie crumbs throughout the kitchen, until my father confessed her indiscretion. “I couldn’t take it from her,” he told me. “She worked so hard for it.”

Anyway, I digress.

As I sat there, perched on the commode, I surveyed the scene of usage, taking stock of what I needed to clean with another bleach wipe. I spotted more skin cells and smudges on the shower seat. I finished my business and pulled out another bleach wipe. I wiped the sink counter, the faucets, light switches and doorknob. I turned to the shower seat and sanitized the smudged area. I hung a fresh towel on the hook next to the sink.

Now, call me Monk, but this is absolutely necessary. My poor diabetic mother is susceptible to the nastiest of yeast infections. She is required to take antibiotics for at least a year. Ladies, you all know what antibiotics do to your flora and fauna. Add diabetes to the formula and it’s a recipe for disaster. When you factor in the Alzheimer’s you have a woman in a full blown yeast trauma, who forgets that she has it, so she scratches it when it itches. Yeast itches all the time, so the end result is not just red skin, it’s a blood bath.

I considered the restraints available to discourage her from harming herself. I thought about those little collars designed to keep dogs from disturbing their ears to put on her hands, but I knew she would obsess on them and the questions would go on forever.

“What are these?”

“They’re dog collars.”

“Why are they on my wrists?”

“To keep you from scratching.”

“Why am I scratching?”

“You have a yeast infection.”

“How did I get that?”

I opted for cotton garden gloves. They breathe, they’re comfortable and they soften the result of scratching.

Again, I digress.

I finished wiping down the surfaces in the bathroom and bent down to pull my T-shirt, undies and towel from under the shower seat, where I stored them the night before, after my shower. I noticed a pair of wet, disposable underwear stuffed into the towel. I deposited them into the bathroom trash, pulled up the rug in front of the toilet and grabbed another bleach wipe. I scrubbed the floor in front of the toilet and under the shower seat. I picked up all the soiled clothing and walked it out to the hamper in the laundry room. Then I washed thoroughly in the kitchen sink as I talked with my father.

“Did Mom go to the bathroom this morning?”

“Yeah, she wanted to go to the bathroom instead of the bedside potty. She’s wearing underwear.”

“Her underwear?”

“Yeah,” he answered. “She started pulling open drawers when I got her back to her room. I asked her what she was looking for and she said ‘underwear’. I asked her if she wanted a diaper or underwear and she said, ‘underwear.’”

“Oh. Okay. I’ve got to get her out of those. They’re bad for a yeast infection.”

My mother takes the bulk of her medication at 6:00 in the morning. This gives it time to get into her system before she gets up at 9:00. I grabbed her insulin from the refrigerator, her blood sugar kit from the medicine cart and emptied her 20 plus pills into a cup.

I went into her room and got her up to put her disposable underwear on. While sitting on the side of the bed, I gave her the cup with morning pills and another with juice. She took them in four swallows, asking me if I’d collected the medicine from all our neighbors. She lay down and I took her blood sugar. It was 120. Not bad, considering the cookie madness of the day before. I gave her an insulin shot, told her to go back to sleep and started out the bedroom door to put the cup, the kit, the insulin, and the underwear in their respective places.

She stopped me with her question, ““Why am I wearing gloves?”

“To keep you from scratching.”

“Why am I scratching?”

“You have a yeast infection.”

“How did I get that?”

“Diabetes and antibiotics, Mom. They’re a bad combination.”

It’s the beginning of just another day, except this morning, after a little sleuthing, it took a bit longer to get through the routine.

A Rough Start: What Next? Maybe I Shouldn't Tempt The Fates By Asking!

“GOD DAMN IT! Don’t ask me again! That’s the FIFTH time you’ve asked me and I don’t want to talk about it anymore!”

I hear my father shouting at my mother as I walk carefully down the worn steps leading away from my upstairs bedroom.

“Oh no! It’s only 7:51 a.m. and she’s up?” I think.

The first five weeks after I moved home to care for my parents, I had to wake my mother from a sound sleep every morning at 9:00 a.m. The time change occurred last Saturday and I thought she would transition well to it, sleeping an extra hour each morning. But this past week, she has woke up earlier and earlier each day. I can’t seem to get up before her, even when I set my clock.

“I just want to know why I can’t have ANY COFFEE!” my mother snaps back at my father. She is diabetic and has not had her fasting blood sugar test yet. My father is denying her coffee until I get up and test her.

I step on the carpeted floor of the hallway, walk quickly down its two bedroom length and turn the corner into the living room.

My mother is leaning forward on her green velour lounge rocker, with a frustrated look on her face. She was diagnosed with Alzheimer’s three years ago and cannot form new memories easily. Lately, she seems to fixate on one question or comment and repeat it throughout the day.

She is dressed in the black pull-on pants and printed blouse that I laid out in the bathroom last night. I discovered that if I leave a pair of protective underwear on the shower seat, in front of the toilet, she will put them on if she wakes in the middle of the night and finds herself wet. I applied that idea to her clothing and started putting the next day’s clothes in the bathroom closet at night. She has found them on the mornings she gets up early and has dressed herself.

My father is leaned back on the new, tan couch. He is visibly upset and angry. Earlier this year, after his second bout of chemo for lung cancer was finished, he began to hallucinate. The doctors did tests and told my father that the cancer had spread to his brain stem. The hallucinations have been brought under control with Thorazine, even as the inoperable cancer grows. Last Friday, he began to hallucinate again. I have added another Thorazine to his bedtime dose and the increased dosage has made the little girls in white, who poke needles in his eyes, disappear.

I stand in between the green rocker and the tan couch. “DAD, YOU CAN WAKE ME UP WHEN SHE GETS UP.” I shout. My father is hearing impaired.

“Ahhhh!” He growls and waves his hand at me, as if to wave me away. The irritation he feels is mirrored in his expression. He reaches for the remote and mutes the booming surround sound system, fed by the TV. “Whaaat?” he drawls.

“IT’S OKAY IF YOU OPEN THE UPSTAIRS DOOR AND CALL ME WHEN SHE WAKES UP. I WAKE UP REALLY EASY. I’LL GET UP AND HELP.” I tell him.

“You’re up late writing your book. You need your sleep,” he says. “Besides, you always wake up before 8:00.”

“DAAAD! WHEN I WORKED IN SAN DIEGO, I GOT 3 HOURS OF SLEEP A NIGHT, MOST NIGHTS, AND I FUNCTIONED FINE. I’LL BE OKAY AND IF I’M NOT, I’LL TAKE A NAP WHEN MOM TAKES HERS.”

He shrugs his shoulders. I’ll set my clock earlier for tomorrow, because I know he won’t wake me up.

I turn to my mother. “Mom, Let’s get you up to the table and I’ll take your blood sugar. Then you can have your coffee.”

My mother scoots to the edge of her green rocker. She leans forward and pushes herself up from the worn arms of the chair. She balances her weight, hands gripping the chair arms and gets her feet underneath her. She grabs her cane, holds out her free arm for me to hold and walks, supported to the table. She sits in a table chair and waits for me to set up her testing kit and insulin.

I sit next to her. I give her an alcohol swab to clean a finger. After she wipes her finger with the swab, I hand her the Ulti-Lance® Automatic Adjustable Lancing Device to prick it. She positions it on her finger, pushes the trigger and says, “Ouch!”

I load an Eclipse test strip into her GlucoLab™ meter and as she squeezes blood from her finger, I apply the test strip. The capillary action of the test strip pulls the blood from her fingertip.

“Five, four, three, two, ONE!” I count down with the meter. “Oh no! Your blood sugar is 229!”

“Is that good?” my mother asks. Four years ago, she tested daily and maintained a diet that kept her blood sugar between 90 and 130. That’s the goal we are now trying to make.

“It’s too high, Mom.” I tell her. I show my father.

“229?” he asks. “What’s she been doing?”

“I THINK I SHOULD HAVE GIVEN HER A HALF OF AN ORANGE LAST NIGHT, INSTEAD OF A WHOLE ONE.” I say.

“Okay.” He walks back to the couch, shaking his head. Last week she tested 130 and 131 on two consecutive days.

I insert the BD Ultra-Fine® II insulin syringe into the Lantus®, turn the bottle upside down and withdraw 10 units of insulin.

“Where do you want it?” I ask.

She slides up her left sleeve. I wipe her upper arm with another alcohol swab. I insert the syringe. It resists, then goes in. I wince and quickly plunge the insulin into her arm. I pull out the syringe and rub the injection site with the alcohol swab.

“How’s that? I ask.

“Pretty good,” answers my mother. Apparently she didn’t feel the resistance.

“I’m setting up a new needle for tomorrow.” I tell her. I toss the old needle into the sharps container on the end table we use for the medicines.

“Now, I’ll get you coffee.” I tell her.

“Finally!” she says.

I notice her feet are bare when I set her black coffee on the table in front of her. I walk to her bedroom, get a pair of socks and hand them to my father. He has developed a ritual of putting her socks on her each morning. She insists she can’t bend down to put them on, but every once in a while I see her do it. Not today, though.

“Oh! Your feet are bare,” says my father. He hobbles to the table, bends down and puts her socks on. “I get to gaze upon your lovely, painted toes.”

“You’re a keeper!” she says and gives him a smile. This is why he puts her socks on each morning. He likes to hear that specific compliment.

I go into the bathroom to change into clothes. I see her used protective underwear lying on the floor under the shower seat at the same time I step into a wet spot on the carpet in front of the sink. I sigh and pick up the underwear. It has soaked through the carpet in front of the toilet and left droplets of urine on the floor tile. I throw the underwear into the waste basket, pull the liner out and tie it closed. I pull the extra liner from the bottom of the trash can, shake it and line the can with it. I pick up the rugs and pile them outside the bathroom door, along with my mother’s nightgown. I take a Clorox wipe and clean the floor. I reach into the closet for clean carpets and place them on the cold tile in front of the toilet and sink. I wash my hands, change from my nightgown and pick up the trash bag and dirty clothes, as I leave the bathroom. I drop the clothes into the laundry basket on the back porch and throw the trash into the trash can on the patio outside. I wash my hands, again, take the clothes out of the dryer, transfer last nights wash into the dryer and then fill up washing machine with a new load. I start the machines. I wash my hands a third time.

I throw defrosted ribs into my computerized Crockpot for tonight’s dinner. I cook a breakfast of ham, eggs and toast. I serve my mother at the table and my father on the couch. I set my place next to my mother. We eat silently, while the TV blares and when we’re done, I collect the dishes to soak in the sink.

My mother gets up, walks to her green rocker and sits down. “Will you bring me coffee?” she asks me. I rewarm her coffee and bring it to her.

There is a knock on the door. Our Maltese, Roxie, growls and begins to yip shrilly. I answer the door, while shushing the dog.

“I’m from Pacific Power. I’m here to collect on an overdue bill,” a woman says.

“I paid them!” my father hands her a bill for September marked paid. It’s now November.

“Sir, you’ll have to look in your checkbook,” she says, looking a little unsettled.

I follow her gaze and notice he has blood under his nose. It looks like the toothbrush moustache that Hitler wore. I make a mental note to tell him after the Pacific Power lady leaves. He steps back into the house.

“He has brain stem cancer.” I tell the lady, to explain the September bill. “How much is the bill? Do you take credit cards?”

“Oh. I’m sorry,” she answers. “$180.88 is due. You’d have to call it in over the phone if you use your card. I can take a check.”

“Even if it’s a California check?” I ask. Some companies don’t want to take out-of-state checks.

“Don’t matter to me,” she says.

I write out a check. I ask if the company will credit the double pay to his account when they get the check he sent. She assures me they will.

When I go back inside, I see that my father has laid out all the bills on the table. He is searching for the power bill.

“IT’S TAKEN CARE OF, DAD,” I tell him.

“There!” he says, pointing at an entry in his checkbook. Instead of writing Pacific Power, he had written the monetary amount on the payee line, when he recorded the transaction in his checkbook.

“OKAY.” I said. “NEXT MONTH IS ALREADY PAID FOR.”

He starts trying to figure out what bills he has paid and what bills he owes. The piles of bills are too overwhelming and he says, “I’ll do this later. The checkbook’s a mess.”

“YOU CAN TAKE IT TO YOUR BANK AND THEY WILL BALANCE IT FOR YOU.” I tell him.

“Ahhhh.” He shakes his head, “I don’t want them to see how I messed it up.”

“YOU KNOW, THEY’VE PROBABLY SEEN WORSE.”

He shrugs, gathers the bills into piles and shuffles off to the couch.

“I don’t know what’s wrong with me. I think I’ll go to bed,” says my mother.

“No, Mom. You just ate. You’re blood sugar is up. Drink some water. It’ll make you feel better. You have to wait until after lunch to take a nap.”

She looks at me as if trying to figure out an argument to rebuke my statements, and then she takes a drink of water from the bottle on the end table. “I can’t take a nap?” she asks.

“No. If you sleep now, you’ll stay in bed all day, and then be up all night. It’s not fair to the rest of us.” I tell her.

“You can stay up to entertain me.” She grins, widely. Her eyes are devoid of cunning. They look as innocent as a two-year old’s eyes.

I smile and shake my head. She continues to grin at her joke. I know the focus of the questions of the day. They’ll be about napping.

I hit the ground running this morning, when I wanted a slow start. It’s calm now, but I can’t help but think, “What’s next?”

Maybe I shouldn’t tempt the fates by asking.