Here We Go Again

Something went terribly wrong with the still-new aide this morning and I am again on my own with Mom. I want to explain what happened so you won't all think I'm a crazed caregiver, especially those of you who don't know me personally. I wrote much of this in a Facebook note because I didn’t want those friends, many of whom I only know through Facebook, to think there was something desperately wrong with me when I told them she was gone. I hope the same for you.

I want you all to know that I go to great lengths when I screen aides, as well as helping them learn the important things they need to know in order to safely care for Mom, even though many of those things they should already know since they all have experience in caring for the elderly, even to the point of working in nursing homes as this last one did. My, is that a frightening thought. I’m sure you understand just how frightening if you read my last post titled Just Plain Scary and saw the kinds of things I had to repeatedly remind her to do, things that were nothing more than basic safety precautions.

I know everyone has a learning curve and that some people catch on quicker than others. I've trained folks since I was in my early 20s, ten years of that when I had my own business, and believe in starting with the basics so they have a good foundation and then building from there. And I do believe in "training manuals" because I always had and have to refer back to them when I'm learning. So I've prepared three things for aides to read: a little about Mom and me plus an overview of her medical history; a list of their job responsibilities; and a list of things to remember. I ask them to read it all when they come for the meet and greet and watch their facial expressions as they do. I can often learn a lot by doing just that because what they're reading goes into great detail about how difficult Mom is to care for and how particular I am with her. That's fair to them and to me. When they're done, I ask if they read anything that concerned them, or frightened them, or made them wonder who the heck I thought I was. They always answer no. They leave the copies behind and if they're hired, I give them back to them their first day. I did that with this aide. She glanced at them and put them on the arm of the sofa. That's where they were when she left that day so I put them where she sat her purse so she'd see them first thing the next morning. They disappeared after that and I never saw them again. I doubt that she did either. So now I’d like to tell you what ended it all so quickly this morning in hopes you’ll understand that her reaction to what little I said, in a good-naturedly way, was over the top and uncalled for.

It's a rule here that they don't come in and start doing for Mom until we've had a chance to talk about how she did overnight and about any percautions we should take to get her started off on the right foot. Believe me, that’s very important. Roberta rarely did that. She just dived in.

Mom and I were up until 5AM this morning dealing with what I hope was the worst of the impaction. She has a repaired rectal prolapse so you have to empty her out slow and easy so as not to undo the miracle the surgeon performed. This time has taken longer than most. We were both worn out and it stood to reason she would be grumpy, so you use your head and do what needs to be done as you can. Simple logic.

I was in the bathroom when the aide got here and when I came out, she had the wrist BP monitor on Mom's arm. She was gripping Mom's wrist with her left hand and forcing her fingers apart with her right hand because Mom was making a fist. I should have nailed her right there because she was applying way too much pressure, but I didn't. I went over, and with a smile on my face, asked why she was trying so hard to undo Mom's grip. She said she couldn't get a good BP if she didn't. Like making her mad or hurting her was going to make her let anyone get a good BP. Good thinking. I could see how tightly she was holding Mom's wrist so I said, again good naturedly so I wouldn't make her mad, that gripping her wrist tightly would also cause a bad reading. She shot me a sideways glance that could have killed and said she WASN”T gripping too hard and she WASN’T hurting her and IF SHE SAID SHE WASN’T DOING IT, SHE WASN’T DOING IT! And the tone of voice she said it in was really, really bad. I was so stunned it took my breath for a second.

Now I don't know who she thought she was talking to but no one, and I mean no one, talks to me that way in my own home, not my family nor my friends. and especially not someone who has been shown every courtesy. I told her that what little I said in a good humored way in no way merited the response she had just delivered and that I thought we definitely had a problem. Her eyes got big as saucers, she stepped back and said we didn't, then went into the bathroom, I was sure to make a call to her agency to CYA, then got toilet paper, sat down, and started tearing and folding (we keep it done in advance), never looking up once. Mom was scared because all this was going on right next to her, so I calmed her down, pulled her up, took her BP, and called the agency. And yes, she had already called them. Good, I told them, because I was sending her home. And I did. No regrets.

I'd told the agency last week that I was afraid she was in over her head and getting frustrated because every time I had to remind her of something, all of which were things that I'd repeated day after day, she got a hateful look on her face, very sullen. Because she didn't talk much, I was never sure if it was her or me so I was minding my manners so as not to upset her until I could get to know her. It's obvious now that timid, smiling demeanor she let me see in the beginning was no more than a cover for a woman with a definate attitude. I've seen it time after time and when a simple thing like what I said this morning, which was way too nice considering what she was doing, sets someone off like that, well, there's going to be worse problems as time goes on. Been there, done that. So she's outta' here.

I'm tired and frustrated. We will soon be flat broke. It will be all over and Mom will end up in a nursing home being cared for by aides like her or worse. Unfortunately, that's what nine-tenths of them are like anymore. Most of them are women who can't earn a living any other way and they're only in it for a paycheck, and that's the attitude that keeps resulting in Mom getting hurt. I've dealt with this plus more for so long now with aide after aide and that's cost me the time I needed to try to save our behinds. That's not fair. If I'm up front with them from the interview on, then they should be upfront with me. Don't take a job for only the money, especially this one. If they can't take constructive criticism, which I'm going to give time after time until I see they're doing what's necessary to keep Mother from harm, then I don't care. If they have an attitude that has probably shown itself on other jobs, I don't care. Those are their problems, not mine. They're treated well here, even coddled, in hopes of making them comfortable and getting through to them how important what they do is to both Mom and me. If they're not willing or able to give at least that, and to return the respect their given, the outcome is their problem.

The agency has been after me to split the hours here between two aides, thinking that since so many of them have a problem finding their way to work, I’d have a backup. Been there, done that, too. Two to train and I have to repeat and repeat and repeat. Two personalities to learn about and deal with. Two coming and going, which confuses and upsets Mom. Two to have to worry about not showing up. It's a nightmare. But this is what I told the agency later this morning after I’d thought it through: I’ll try two against my better judgement, but no more meet and greets. It obviously doesn't help and it's more of my time wasted. If they have someone, send them in, but one at a time. Tell them in advance that I'm fried, in a pinch for time and have none to waste. Tell them Mom's hard, I'm particular, and I'm tough. But I'm also fair, and patient if I see they're trying. Tell them that what I ask them to do and the way that I ask them to do it is the way it is. Period. Then, and just between the agency and me, they will have only three days. That's all I'll waste in sizing them up and seeing if they're sucking up every little thing I share with them that will help all of us, and then applying it. If I don't see that, they're gone. And I mean it this time. It's sad to have to reach this point and this frame of mind, isn't it? But I mean it. They’re costing us everything. So from now on, if they can't stand the heat, they can get out of the kitchen.

Till next time, whenever that will be,
Sharon

Just Plain Scary

I think I’d better write for a bit, at least until the adrenalin high I’ve been on all day subsides some or I’ll never get to sleep. Jay Leno just came on and I’d like to relax and listen to his monologue but I wouldn’t be able to stay in the chair long enough. I’m always glad to feel a little charged but this is ridiculous!

I haven’t posted since the 11th. It is now the 16th and I can honestly say there was only one day when I could have and that was Sunday, the 13th. It was my birthday and Mom had a problem we had been working on solving since the day before, so I decided to take the day to give her the attention she needed and deserved, and to give myself the gift of not thinking, even one time, that I should be posting, or I should be loading products on the aStore pages, or I should be cleaning out the fridge, or that I should…to heck with it. I shouldn’t do one darn thing that I didn’t want to do. So there. It was wonderful, but Monday followed Sunday and my day of bliss was soon erased from my mind. Back to reality. Well, at least I had that one day.

I’m going to write a tiny bit off what’s run helter skelter through my mind today, and the only way to do that is to just write the thoughts, many of which I said out loud and some that I kept to myself, and without trying to put them into paragraph form. There’s no way I could write cohesive paragraphs without losing the mental chaos, the confusion, the humor of it all. This may be hard for you to follow, but my mind is hard to follow sometime, so here goes, starting from shortly after the aide arrived:

· She’s still sleeping soundly this morning and will be a little slow waking up.
· You’d better let her wake up on her own because if you don’t, she’ll be mad and
  agitated and that will set the tone for the day. Remember?
· Her stomach looks distended so she probably has gas. What do you say you pull her
  up and turn her on her side for a moment and give her a chance to pass it before you do her face and mouth care. Remember?  
· It’s 9:05 and the doctor’s office is open so I’m going to call them and see why no one's come to draw Mom’s blood that was ordered last Friday.
· Quincy (the cat), crying won’t help because you already had your breakfast!
· Why is that toilet still running?
· Did you take her vitals so we know what they are before I give her the BP med?
· Wow, that’s sounds a little high. That wrist monitor gives wacky readings if you don’t hold it directly across from her heart. Remember?
· When you change her, I’d like to look at the little red place on her bottom and then we’ll decide how to treat it. Okay? Whoa! You never lay her flat before putting the feeding pump on hold and clamping the tube. She could aspirate. Remember?
· Let’s see, I’ve washed the dishes, straightened up the kitchen, ate my toast and she’s still in the middle of the pants change. Mom’s getting a little too mad.
· Let’s put a dab of zinc oxide directly on the red spot, and then spread the barrier cream on her bottom. Don’t forget to not rub it completely in so it will protect her skin better. Remember?
· It might be a good idea to put the foot of her bed down now that you’ve got her pulled up, then straighten out her clothes. She can aspirate from the stomach up as well as the throat down. Remember?
· I’ll alcohol her table so I can use it to give her the Seroquel real quick. Okay?
· Man, I’ve got to get to started putting products on the aStore pages.
· Darn, I only have about one glass of Diet Coke left. Now I’ll have to run to the store.
· There’s another important part of pulling her up in bed. Once you do, you have to adjust her hips by gently pulling the pad to the right so her spine is nice and straight and she’s not lying crooked. If you leave her like that, she’ll start aching all over and then she’ll fuss. Remember?
· You want to make sure the bed pad is nice and straight under her because if it’s in wrinkles or rolls, it can cause pressure points that can lead to bed sores. Remember?
· No, Quincy. It’s too early for lunch.
· Her lips and mouth look dry. Maybe you should freshen her mouth and put a little Vaseline on her lips, don't you think?
· Dear, I can’t afford to donate to your cause because, in all honesty, I’m broke. Could you please take me off your call list?
· Are you sure it’s time to renew the dishwasher warranty? I’ll have to call you back.
· Did you remember to turn her and put a pillow behind her back?
· Now how the heck did I add a new category page to this aStore. Short memory.
· Good God! How many products does Amazon have for me to choose from in this category?! You gotta be kidding! Three thousand what?!
· Oops. It’s time to flush the feeding tube.
· No BM today and I know there’s more. Have to work in another dose of milk of magnesia. Bless her heart.
· If I look at one more nightgown choice I’m going to scream. But I’ve got to make headway on these pages!
· This water is running too slowly down this tube. Guess I’d better do 30ccs of Coke to clear it out.
· Why does she breathe from her stomach like that? I know I read that’s really the right way to breathe but it’s still scary to watch.
· This computer chair is killing me! I’ll be crippled. Let’s see, I’ll put a pillow in the seat and one behind my back. Now what can I use for a footrest? Maybe that would help.
· What the heck time is it? I haven’t heard back from the doctor’s office and she said she’d call me back shortly. The day’s almost gone and no call.
· Damn, it’s thundering and I don’t have any Coke!
· Quincy, is it really time to eat again or do you have a tapeworm?
· Oh, my God, another new category. I’m not even gonna look at how many products there are in this one.
· Hello. This is Sharon Clayton. Did you even find out when they’re coming to draw blood? Oh, you left them a message to call you and you haven’t heard back from them. And you forgot. Well, would you call them again and get back to me? Thanks.
· Good Lord, my legs are numb from sitting in this chair. I like to shop but somehow this isn’t the same. Amazon’s too big.
· Oops, time for afternoon Seroquel.
· It can be boring when she sleeps. There are lots of magazines that I’ve saved so help yourself.
· You’re okay, Mom. I’m sitting right here watching you so don’t be afraid.
· Hello. Oh, so what other service are you going to call and how soon can they come? Heck, she’s 90 and not eating anything by mouth and I’m worried. By the way, mobile r-ray was here Saturday morning and you would have had those results on Monday. Could you find the reports and read them to me? Yes, I do have their phone number. And you’ll call me back?
· Would you really run over to the store for me? Thanks for offering and that will get you a breath of fresh air, so good thinking. Would you get me a fried chicken breast as well? Thanks. I’ll listen for Mom while you’re gone.
· Hello? The chest x-ray is fine and the stomach report says she’s a little impacted. I figured that out already and we’re working on it. Okay, so if we need another x-ray, can we wait till day after tomorrow because she’s been going a lot until today and that will give me a chance to give her a little more milk of magnesia. I hope another day will do it and then maybe they won’t have to come back again a third time. Thanks.
· Hello? No, not chicken tenders. A fried chicken breast. You want me to tell the deli guy? Okay, put him on.
· How many more darn more categories do I have to go? Ohhhhhh.
· You just have a little tummy discomfort, Mom. Let me turn you up on your side and hold you there for a minute or two. You’re okay.
· Why is the pad up behind your back instead of under you fanny?
· I’m sorry, Quincy. I can’t stop and hold you now. I have to keep working on this aStore, so please quit pawing at my leg and looking at me like that. You’re making me feel guilty.
· Oops, time to flush the feeding tube.
· Is it time for you to leave? Did you remember to empty her wastebasket today? Did you take her vitals?
· Yea!! I’m done with that category! Get up and walk away from it for a minute. Oh, Lord, I’m hobbling here. Get the Advil.
· I’m eating my darn chicken before it’s time for the next round of meds and a pants change!
· Maybe I’ve made a bad choice for this new category. There are only 175 products. They must have them hidden somewhere else. 175. That’s impossible. This is Amazon.
· You’re okay, Mom. I’m right here.
· Gee, when did I last change the air conditioner filter? And what about this category made me think of a filter? Scary. If I go look, it’ll give me a chance to stand up and walk. Ohhhhhh. It’s been that long? No wonder I’m sneezing.
· There. Pants are changed, clothes are straight, hair’s smoothed back away from her face, oxygen tube’s in place, mouth's freshened and Vaseline’s on her lips, and her sheets are nice and straight just the way she likes them.
· Not yet, Quincy, not yet. But soon. You want a treat?
· Oh, my aching body.
· One good dose of milk of mag and another flush. Sleep tight, Mom. I love you…and I’m trying.

And that’s just the tip of the iceberg. Phew.
Come on, Quincy. It’s time.

Until our next time,
Sharon