Tuesday, September 25, 2012

Whose problem?

I thought I learned about taking responsbility for my own actions from my mother. 

"Don't come whining to me about ---" she used to say, filling in the blank with the latest crisis in my teen life.  "You got yourself into this.  It's not my job to get you out of it." She wasn't being mean, just practical.  Encouraging independence, responsibility.

Another time, watching our neighbor care for several granddaughters of questionable legitimacy:  "Don't run off and get married, then bring your children home for me to raise.  They are your children, you raise them."  I was still in high school, not even contemplating marriage much less children. 

My favorite mental health counselor often admonished, "Assign the problem where it belongs."  Usually it was a reminder.  Sometimes she added,  "If you can fix it, do.  If you can't fix it, it is not your problem." 

So it is a little startling to hear my  mother, in an apparently rational state, say things suggesting that all her problems are caused by someone else.  Once upon a time, all her ills came from my father.   Now it is her doctors.   "I was fine until they changed my medicine."  That's partially true -- but the new med is also deflecting a whole range of more sinister conditions lying quietly, waiting to pounce.   The new med is also keeping her pain-free. 

Nor does her attitude address the things she can do to mitigate the negative impact of the new medication. Actions she chooses not to take. 

Change seldom comes easily.  Change is especially not easy when you are out of practice.  Or after 98+ years of living. 

Acceptance of difficult circumstances is even harder, especially when the ultimate difficulty involves your own mortality. 

What choice will make a difference in your life? 
Don't forget to pray....

Sunday, September 23, 2012

The Slide

Yesterday I was bragging that my mom was still mentally sharp, reading, researching, doing her own accounting.  

Yesterday was a difficult day.  It was especially difficult for my brother, who has not had a lot of direct care-taking opportunities in his life, particularly end of life care-taking.  See his post of yesterday, 22 Sep, at ilind.net.

Yesterday, our mother slept from 9 a.m. to 7 p.m., then thought she was waking up at the start of a new day.  Yesterday morning she could still sit up in bed unassisted.  Yesterday morning she was in pain, but reasonable stable on her feet behind that walker.  On Friday she could easily put the battery in her hearing aid.  On Friday she could reliably open and read her mail.  On Friday she  was taking meals at table.  On Friday she was directing how life should be in this household -- we need to be on a schedule, you (meaning me) need to go off and do things for yourself, I will eat this but not that ... 

Today is different.  Today she cannot sit up in bed without assistance.  Today  she is unsteady, even behind her walker.  Today she looks at but does not read the morning paper.  Today she eats what is put in front of her, takes her pills as directed.  Today I am not confident she is reliably reporting what she is feeling. 

Jackie, our mother's lead Hospice Nurse, called this morning, obviously having gotten a report from the on-call weekend nurse.  Jackie suggests that that "tingly feeling" on the side of the head may be something real and physical -- or not.   She says what we are seeing is also consistent with coming off certain medications.  She says monitor and report.  She suggests we have absorbent bed pads and diapers on hand -- just in case -- when the prunes and other laxitive products kick in.  She is ordering a bedside commode, which will be delivered tomorrow. This may pass, she says.  It may also be another step in the path toward that inevitable door. 

I love you. 
Thank you.
Forgive me.
I forgive you. 

Don't forget to pray....

Wednesday, September 19, 2012

One more time ....

My mom was admitted to a Hospice program this weekend.  Third hospice patient I've been directly involved with, third hospice provider.  Our experience in Tuolumne County was brief but heaven-sent, and allowed Ray to die at home.  My dad was in a nursing home when enrolled in hospice care, and it was a very different experience. That hospice program seemed to chug along on its own steam, doing what it does every day without making any accommodation for our specific situation or desires.  Except for who paid the bill, there was no discernible difference in day-to-day existence. 

We have yet another Hospice provider for my mother.  She is at home.  We're still adjusting, have already had a medication issue, but it got resolved and  I get a response when I call their office.  We've met Toni, the Weekend On-Call RN; Alicia, who did a qualifying assessment; and Jomel, who made the first contact with a potential patient.  All have been young and polite.  None have been local.  Jackie, the Case Manager RN, is also young, but she is local.  Thinks on her feet.  We don't ask "ordinary" questions.

It's not that anyone expects my mom to die in the next month, or in the next few months.  It took some talking to get people to realize that her "on paper" condition is very different from her real-life condition.  On paper, she is healthy, better than 99% of people her age.  She can toilet herself, feed herself, walk unassisted in her 4-wheel walker -- by doesn't go anywhere without that walker. When she squeezes your hand, her grip is still firm.   But none of the normal measures of health and fitness consider her long naps -- morning, afternoon, and early to bed,  18 hours or more of sleep each day.  They do not address her decreasing food intake and gradual weight loss.  I jokingly say "Conversation would be nice!", but it's true.  Often communication is in one word commands, waves of the hand, or just pointing with a grunt.  Now I learn these behaviors are indications of withdrawing into oneself, and a typical end of life behavior.  It was those cumulative behaviors that  tipped the scale to qualilfy her for hospice. 

The steep downward spiral began on August 23.  The day before her doctor told her that her white cell count was up a little bit and asked if she had a cold or the flu.  "No." she said.  Then she came home and thought about it.  "No wonder I haven't been feeling very good," she said.  "My white cell count is up."  She could have added, "and my kidneys are no longer working at their best."

All the books on death and dying say that sometimes you have to give a person permission to die.  Or in my mom's case, to feel sick.  To let go, stop struggling to put on a strong front.  It wasn't her imagination any more.  She wasn't sick enough for medical intervention by her doctor (who refused to give her an antibiotic), but she is not completely well, either.  Now she is allowing the rest of us to know she feels less than perfect, allowing herself to sleep as much as is needed, allowing  herself to take enough  pain medication (and it's powerful stuff, beyond Tylenol and Aleve and aspirin) to stay relatively pain free. 

So we watch.  We wait.  We keep her comfortable.  We strive for sanity in the midst of chaos.  We love her.  Unconditionally. 

Don't forget to pray ....
* * * * *

Tuesday, September 4, 2012

Manu o Ku, Hawaii's "Bird of Peace"

It was a new bird in the mango tree last week.  A pair, actually.  At first I thought it was a pigeon, but the wing span (the bird book says 24") was too wide, the wing shape wrong.  And the color!  This fellow clean, white, with black beak, large black eyes, and dark feet  A beautiful, unique bird.  Here he is, more or less as I first saw him.

The bird book says he is a Fairy Tern (Gygis Alba), a native in Hawai'i and not to be confused with the Australian Fairy Tern.   To avoid confusion, he is better known as White Tern.  Or by his Hawaiian name, Manu o Ku.  He is a listed as threatened species, but his numbers are increasing.  He's migratory, arriving in April and leaving again in September.  Some breeding pairs like Hawaii so much that they remain here year round.

He is described as friendly and curious, not afraid of people.  Nope, not afraid; I thought one was going to land on my head the other day!  A fish-eating sea bird, but raises its young on a tree branch -- sans nest.  Raises only one chick at a time, but may have three nesting cycles in a season.

More looking.  The Fairy Tern may be threatened, but is considered a common bird in the major parks around Oahu and in the unpopulated islands and atolls of the northern end of the Hawaiian chain.  He is also the official bird of the City of Honolulu.

Give thanks for those things -- like the birds -- that add beauty to our lives!
Don't forget to pray ....
* * * * *

Sunday, September 2, 2012

Hidden Stories

One of the things you learn quickly as a genealogist is that if you cannot deal with the skeletons in your family closet, this is NOT the hobby for you.  Every family has skeletons hidden away somewhere.  My personal view is that they contribute to who we ultimately become.  Sometimes they drag us down.  Sometimes they lift us us up -- either because they are so positive, or because they are so negative that we are driven to overcome them.

I invite you to stop in at ilind.net to read my brother's post for today, 2 Sep 2012.  I had showed him a photo of the remnants of the Fergushill Rows (Kilwinning, Scotland) earlier this week.  The photo caught his attention.

Our paternal grandmother,  Jeanie Montgomery,
lived in the Fergushill Rows until she was about 12.  There was not a whole lot lower one could go on the social scale and still survive as a family.  Her life at Fergushill represented the very bottom of the economic pit into which our line of Montgomeries and Greigs slid.  Earlier generations had better times.  Our great-grandfather began the climb out after following his own father into the coal mines.  His children and grandchildren  kept climbing.  The climb takes determination -- and education -- and more determination.

The photo above was taken during the family's years at Fergushill.

Our grandmother lacked the education, but she made up for it in determination.  She would leave those muddy streets, open sewers, and 6x9' lodgings behind.  She would be all the things she dreamed a gracious lady would be.  She never shared the stories.  I heard them from her brother Tom's children, pieced them together from literature in Scotland and online about life in the Ayrshire mining camps, and from visiting the  museum at Eglington Park, Kilwinning.

Grandma is probably appalled that I'd consider sharing her stories.  But her experiences and attitudes are just as formative  as those of the English landed gentry in Devon, the farmers and livestock men in West Calder and Dumfiresshire (Scotland), the pioneers who spent 200 years settling the American frontier from Virginia and North Carolina all the way to California, and the pioneering seamen who followed a legend and a star -- and later, regular migration paths -- across the Pacific Ocean in open canoes to eventually settle in Hawai'i.

Share your stories.
Don't forget to pray ...
* * * * *