The Deed is Done

It is official.   My father is officially a Hospice patient.  His diagnosis is "adullt failure to thrive".  He has lost 4.5 lbs, more or less, in the last 30 days.  Not good.  He is refusing most meals, except for his 3 bottles of Ensure daily, and some fruit.  He seldom gets out of bed, although he can still walk with his walker.  We are assured that he is getting plenty of fluid, although they are not measuring fluid in/fluid out.

There are some real positives about Hospice care.  He gets another layer of nursing care, with a Hospice Nurse visiting at least twice weekly.

I asked what that additional layer would add to his care.  The answer?  "Another pair of eyes, eyes looking just at on patient, eyes looking specifically for his comfort, for small changes in condition or attitude, eyes trained to evaluate patients at this stage of life."  Oh, another pair of eyes looking from the same view that we do as a family, looking for signs that might be missed by a CNA who is dealing with 8-12 patients, each one with their own very important needs.  Eyes that are not tied by regulatory requirements to desks, patient charts, or medicine carts.

From my own perspective, it means dealing with RNs whose native language is English.  Don't get me wrong here.  My dad has been getting very good nursing care.  But the primary language of most who work at Oahu Care Facility is Filipino, Korean or Vietnamese.  There are communication gaps.  I wrote about some of them the other day.  In the US, men wear suspenders to hold up their pants.  In the UK, suspenders hold up hosery.  Braces hold up pants.   If I asked about braces from a UK perspective, the American thinks about teeth straightening.  When your first problem is translation, the more subtle differences get lost.  You don't always understand what the other speaker is asking or telling you.

It means having a nurse on call 24/7.   I've used that wonderful service in another lifetime -- another place, another patient.  I am incredibly thankful that there was someone to call whenever I needed them.

From the perspective of the checkbook, Hospice Care is well covered by my parents' insurance.  Ordinary long term care is not.  So we have suddenly dropped out of full private pay status into a much more budget friendly  insurance patient.

St. Francis Hospital, manager of this Hospice program, is a Catholic hospital.  They believe that spiritual and emotional health is important to physical health.  They offer both social workers and a chaplaincy program.  I've asked that a chaplain visit my dad -- not as a Catholic priest, but as a friend who comes to talk and visit, and who offers to pray with or for my dad at the end of the visit. He is not a church go-er, has not been for many years.  But he did  regularly watch Dr. Robert Schuller (TV's Hour of Power), and he did grow up as part of an active church family.  It's worth at least  one visit.

Give thanks for Hospice care in local communities where ever they may be.  Give thanks for those devoted folk who dedicate their lives and service to those whose lives are drawing to and end.

Don't forget to pray.

Decisions, Decisions

Ian and I are of one mind as to the care of our father.  That is a very good thing.

The morphine, even at low dose, is easing his pain, allowing him to sleep, and keeping his oxygen connection in in place.  That's good.  

A chest x-ray taken this morning shows that our dad has pneumonia.  His MD wants to try 3 doses of an antibiotic, to see what happens.  He also agrees that Hospice Care is appropriate, based on the type of treatment plan we are following.  

The order has been written, and the wheels are in motion.  Staff from Oahu Care will contact St. Francis Hospice tomorrow.  From there .... one day at a time.  

I wish him a fearless mind and a peaceful heart.  

Don't forget to pray.  

It was not a good day.

Yesterday when I went to visit my dad, he had to demonstrate that his nose was bleeding.  It wasn't free bleeding, like when you get smashed in the nose and require a small mountain of cold washcloths and some judicious pinching to staunch the blood flow.  Instead, he blew into a paper napkin a moist clot containing about 1/4 tsp of blood.

He complained of pain in his shoulders, more intense than it was earlier in the week.  He has been taking Tylenol to ease the pain.

He seemed apprehensive.

His charge nurse called just after 8 a.m.  He was awake most of the night, coughed a lot, and coughed up more blood.  His 0xygen level was running about 90%; he was placed first on a nebulizer, then on oxygen.  By breakfast, his oxygen level was up to 97%.

When Ian saw him early this afternoon, he seemed disconnected from reality.  Ian didn't think he was recognized.  He age only about two bites of lunch, and then only with assistance.

By 2:30 p.m. when I arrived, he was dozing, but woke when I put my hand on this shoulder, opened his eyes, and called me by name.  He dozed again, but when a little old lady from down the hall "came visiting", he thought she was my mother and greeted her warmly.

"Why, Mrs. Lind, I don't see nearly enough of you these days. Won't you sit down?  Bonnie, help your mother with a chair."

I did not correct him, and he was disappointed when a  nurse came to take the lady back to her own room.

He will continue to receive oxygen when staff can persuade him to keep a canula in place.  Better chance with that than a full mask.

He is receiving liquid morphine on demand, plus one or two drops on his tongue at bedtime.

Today the nurse practitioner, who will consult with the doctor tomorrow, suggested that he be placed in Hospice care.  They may or may not do the necessary diagnostic procedures to determine exactly what is going on in his chest.

At worst possible case, he has recurrent pneumonia.  Untreated recurrent pneumonia can lead to patient death in about 4 weeks.

I think my father is afraid of death.

Give thanks for the long, full life my father has lived.  Pray for a pain-free body and a peaceful heart.  Pray that he feels only love around him.

An Anniversary.

Thirty-three years ago, deer season was opening in Groveland.  It was one of those crisp, sunny autumn days that follow on the heels of the first cold snap of the season.  Our friends -- many from the San Francisco Bay area -- gathered in Groveland to support us as Ray and I were married.

We chose a spot we both loved -- under an ancient oak tree shading the front porch of the historic ranch house once owned by Edmund James, later Sol Ferretti, and finally Dunn and McLellan before it was sold to Boise-Cascade and incorporated into the Pine Mountain Lake subdivision.  The house and barn were moved from their original location along Big Creek to an elevation where they would sit on the lake shore of the last manmade recreational lake in California:  Pine Mountain Lake.

Kimo, then 7, sat on the deck snapping the lid of the ring box -- still containing the wedding rings.  I had visions of the rings dropping through the spaces between the decking and into the sand beneath -- and the need to crawl around under that deck to find these all-important symbols of our love.  I'm still wearing mine, so disaster was averted.

After a casual lunch and some wonderfully fruity punch created the night before by our favorite priest, we headed out through Yosemite National Park and Tioga Pass to Utah where I would meet Ray's family.

Give thanks for real love, the kind that strengthens over time, bringing out the best in each of you.  Give thanks for those precious memories.

Don't forget to pray!

Rainbows

It was raining lightly when I left for church this morning.  Against the cloudy sky this double rainbow stood out in glory.

It would have been a prettier image if I had been able to take the picture from our own street where there are trees, hedges and greenery.  Until the rainbow got lost in all those trees and hedges.

It would have been a prettier picture if I hadn't had to work around the gentlemen out for his Sunday morning walk, insisting on walking down the middle of the street into which I wanted to turn.

It would have been prettier if I had pulled just a little bit farther up the block on this street.    Or  realized that the lawn in front of this house is brown, not green.  And that there is almost no landscaping around the house.  Didn't we learn in a video class about paying attention to what else is in the view finder besides your subject?  Did I learn?  Guess not.

Enough excuses.  Give thanks for rainbows, where ever they happen to be.

Don't forget to pray!

Addiction

I admit it.  I am addicted.  To fabric.  Like most quilters, doll clothes makers, and even many dressmakers, I see a piece of fabric that I really like, and buy it.  Sometimes I buy complementary fabrics at the same time.  Sometimes I just know that the right companion pieces will come along.  Sometimes they do.  Sometimes the fabric sits in my stash for a very long time.

In one notable case, I bought a piece of fabric to make myself a dress.  After some time in my stash, Ray nagged me into making him a shirt.  He wore that shirt to death, but every time he put it on I mourned for the dress that I now  would never have ....

When the chance to win free fabric came up, I couldn't resist.  If you are inspired by color, pattern, design, fabric, take a jaunt to From Little Things and check out Sarah's new fabric give-away.  

Don't you love the names of her books?  Material Obessions and Material Obsessions Two.

I checked.  The books are available at Amazon.com.  But the covers on the American editions are B-O-R-I-N-G.   How come the Brits get the really fun photographs, as we get the boring stuff???  You can see the UK covers by scrolling down just a bit on the From Little Things link.

Have fun!  Don't forget to pray ....

The Neighborhood Mall

Kahala Mall is the neighborhood shopping area.  I was in high school when the mall was built.  My first "real" job was there, in the anchor department store.  Then it was Liberty House; today it is Macy's.

There has always been a grocery store.  For many years it was locally owned.
A couple of years ago, Whole Foods replaced Star Market.  

Cinnabon, near Whole Foods, is another of the mainland chains represented in Kahala Mall.  

There is no food court, but a number of fast food chains are represented:  Pizza Hut, Taco Bell, Panda Express, Arby's Roast Beef, Pretzelmaker ....  along with Starbucks, Jamba Juice, Godiva Chocolate ....  

Kahala Kids, and Reyn Spooner a little farther down the mall, are both locally owned.  They are two of the handfull of local shops not associated with national chains.

Today, the mall is enclosed,, air conditioned and carpeted.  Originally, all space between the shops was open air.  A mynah bird llived in a cage in the garden shop (which was in the wing which now features the Apple Store, Reyn Spooner, and Kahala Kids).  If you talked to him, he'd look at you quietly.  Eventually he'd mutter, "Birds can't talk."

This bust of Jack Lord, who in his lifetime lived in the neighborhood and was a frequent shopper at this mall.  Someone regularly gives him a fresh flower lei.

It's definitely not Groveland.  There's lots more stuff here, but none of the personalization or personality of shopping in Groveland.  Here, there are lines for everything.  You don't routinely stop in the parking lot to visit with a friend, find a shop owner who will go out of his or her way to find you a specialty product not  normally carried, or catch up on local news from friends who also happen to be shop owners.   I miss the community of living in a small town.

Give thanks for friendships.
Don't forget to pray.

A Milestone

A week or so ago my mother found an advertisement that caught her fancy.  "This is what I should have."  she announced.  Never mind that I've been trying for the better part of 2 years to get her to even look at one of these.

Today she went shopping.

The new walker has 4 wheels, 2 hand brakes, a basket AND a (probably the most important feature) a seat!   Makes shopping a whole lot easier.

She plans to use it in her gardening, too.

Give thanks for timely advertising.

Don't forget to pray.

Comfort Zones and Second Languages

Last Sunday I joined several of my Daughters of Hawaii sisters, along with members of the Hawaiian Royal Societies, at a service at St. Andrew's Episcopal Cathedral honoring the birthday of our last reigning monarch, Queen Lili'uokalani.  It should have been a very familiar service.  It wasn't.

It wasn't the service that was different, but the language.  It was mostly in Hawaiian, from the lovely solo chanting of the processional right through to the closing hymn.  One of the two lessons was read in English, as were the prayers of consecration.  The sermon was preached in English. Announcements?  English.  Everything else was in Hawaiian. We were a part of the regularly scheduled Hawaiian language Mass offered weekly at St. Andrew's.

Hawaiian is a beautiful, melodious language, but I am not a Hawaiian speaker.  I can read the words, but have to work at everything new.  I can grasp the meaning of what I am reading if I am familiar with the English version of the text, but in most cases I am reading words with no understanding of what they mean.  In my struggle with the language, I lost the experience of worship. I was out of my comfort zone.   I left feeling frustrated instead of nourished.

Suddenly it dawns on me that this is the same experience shared by immigrants to the US.  The language is different, and therefore strange.  If I recognize every third or fourth word, do I really understand what is being said?  How can I learn this new language if no one in my daily life uses or understands it?  How can I build a vocabulary in meaningful context?  Is there someone patient enough to help me through this barrier?

What happens when I travel?   Even English-speakers from different parts of the world give different meanings to common words.  Nappies or diapers?  Suspenders or braces?  Fanny?  Accepted slang, or rude and crude?  Note that Americans wear fanny packs, while in the UK they wear bum bags.

Walk through the market, or explore a cookbook.  What in the world is a Swede? (a rutabaga, not necessarily a citizen of Sweden.)  Caster sugar? (sold in the US as baker's sugar)  Treacle? (Molasses, but I am not sure if it differentiates between dark and light varieties) Sultana? (golden raisins, usually made from Thompson Seedless grapes).  In Hawaii we have gulches and streams.  In California we are likely to call them canyons and creeks -- often pronounced cricks.  Farther east, they become valleys and rivers.

As we remember that today is the anniversary of that terrible day in September 2001, let us celebrate our humanity, give thanks for the diversity that gives us breadth and strength, work to get beyond our differences such as language or accent or even where we worship.  Celebrate the lives of those who were lost that day, American or not.  Celebrate the courage of those who responded to help in whatever way they could.

Happy birthday, Eleanor!

Don't forget to pray....

If Can, Can ...

Armed with a brand new pocket-sized camera, Panasonic's FH20 (on sale at Costco for a couple of more days at the best price I've seen nationally), I wandered Kahala Mall.  This t-shirt, hanging in the doorway of one of my favorite boutiques, caught my eye.  I am likely to go back and purchase it as a Christmas gift for my mom.  It says a lot about how one thinks and feels at 96.

If you can do it, do it.  If you can't, you can't.  Don't fret about it.  Worrying over something you cannot do doesn't do you -- or anyone else -- any good.



The sentiment was particularly apropos yesterday.  After appointments and errands taking up a large hunk of my day, I    found this scene behind the 40' or so of front hedge.











And these at the front
door.



If can, can.  My mother had watered and pruned out the front hedge.  Whenever possible she worked from her garden chair.

Then she ran out of energy.

Filling the green waste can was now my task.  It's a big can, but her morning activity filled it about 2/3 full.

Mother's version, after her nap.  Smiling sheepishly.
"You picked up my trimmings.  I was waiting for you to get home and move the [wheeled] garbage can over so I could fill it up."

And then the afterthought:  "Thank you."

If no can, no can.
That's why I am here.   To pick up at least some of the No Longer Can part of her life.