What??? How many times do we have to repeat things?

It must be awful not to hear.

My father lived in a silent world for a long time. His hearing was damaged at the place he worked. Years ago people didn't realize the necessity of ear plugs in a loud environment. Most people don't like to admit they can't hear. But we could tell he was just pretending to listen. I am sure he and my mother had a lot of arguments about this, but I wasn't there so I don't know for sure.

One day mom got him to go to an audiologist. His hearing was so poor that they could only use a device called a Miracle Ear. I am sure they have other ones now, but that was the best we could find at the time. Insurance usually DOES NOT PAY for these. Somehow he got a discount and only had to pay $4,000. They actually cost $6,000. We found out later that his hearing loss was about as bad as it could ever be. The technician said he personally never saw anyone with that degree of hearing loss getting a hearing aid.

Later on my husband's mom, Bernice, started to experience problems hearing. She stopped going to church because she said they were "whispering." She quit a group she was attending. We noticed we had to repeat our sentences, over and over.  Her younger sister got her a phone called Cap Tel, which is a device that prints out the words the caller is saying. Bernice was mad as a hornet that MaryAnn bought it for her. She refused to use it most of the time. I tried to reason  with her and say at least people could talk to her on the phone if she used it. She was very stubborn about this. I think she felt it made her "old" or needy.  It was very frustrating for us to try and communicate with her. I think that phone system could be a lifesaver for people. The doctor said many patients with hearing problems suffer from depression. We could tell she was withdrawn and not herself.

I actually took her to the audiologist, because we realized she could not hear when the doctors were talking to her. Unfortunately the  insurance she had would only pay for a cheap model. The servicing of the device was in another state, so she could not get it fixed locally if there was a problem. She sat there without understanding what was going on as I talked to the doctor.

She had already had a hearing aid and she was always fiddling around with it and she wore out the batteries in a few days.  She never wore it when she was in the house. The doctor explained her hearing was worse in one ear. So we said, let's see if we can try another kind (more expensive, insurance did not cover) that the  doctor said was very economical and worked well, in just the "bad" ear and see how she does. It worked right away, so we got both. Bernice had no idea what was going on. She just sat there and smiled. The doctor also said we could get a refund, minus a handling fee,
if she could not use them properly.

A couple of her kids pitched in and we said we would take care of the bills. It was so much better that she could hear. The doctor was wonderful and very honest. We asked her what she would do if this was her mother. She said Bernice's insurance was "worthless" and she would not use it. She spent a lot of time with us. I am so grateful for these wonderful people who try to help those who need it so badly. She also said if they did not work well for her, we could return them and get a refund minus a handling fee.

Unfortunately, even though they worked, she passed away unexpectedly within that month. The first thing I did was take those hearing aids back! That was a few thousand dollars. Bernice would have been happy that I did that. She was always worried about money. That's why she postponed getting help for herself for so long.

The moral of this story is: If you notice someone having hearing problems, get them help! Take them to the doctor. I learned so much about my mother in law by going with her to her appointments.  I almost cried when the doctor explained the link between hearing loss and depression. Sometimes we feel so helpless, but taking someone to the doctor is a small price to pay in the long term.

How did we find a Handyman and a Nurse combined?

Our dad was really a Mr. Fixit and a handy guy in every way. One day the garage door spring broke and they didn’t go anywhere because the garage door would not open. My husband offered to help and dad got really angry. He realized he could no longer fix some of the things around the home. Months later I remember calling a plumber because dad acted like he had no idea how to repair the leaking pipe. They were just not used to asking for any help or calling any repairmen. 

Dad also seemed like he was even shutting down more socially, mostly because he had a hearing problem and his sight wasn’t very good.  We began to realize he could not be left alone. If he were to fall, we had to have someone there with him. He also left a burner on the stove on high and walked away. Mom had to stay home most of the time.

We called a service that sent a “health care worker” to their home. Mom needed a chance to get out once in awhile. Most of us worked, so we thought this could be a good option and it could be scheduled. The minimum amount of time for someone to come to your home is 4 hours, at least when we checked. It also started at $20 an hour.  Mostly this overweight 18 year old girl sat on the couch and just talked. Mom treated her like a guest, and that wasn’t why she was there. She only came a few times. This was a bad idea. It also was a terrible mismatch for my father. We found out there are very few male nurses who work in this profession.  He needed someone to care for him and have a conversation.

Then Dad did not want to bathe. He had always been very particular about his appearance, but this did not seem to faze him. We tried to get a nurse over to bathe him, but he refused to cooperate. He was still able to perform most tasks like getting dressed and eating.

Having a health care provider come to your home around the clock actually costs more than a nursing home. We knew dad was at the point of needing assistance, but mom wanted him home. Dad used to say, “They are going to take me out of this house in a box.” He wanted nothing to do with any place that was not his home.

Even though they lived in a ranch, the living room had 1 step down. Dad needed grab bars. My brother had an in-law, Ted, who was extremely handy, and he was a nurse. We hired Ted to make the repairs in the home that were needed. If Dad needed any help, Ted was there. He was out of work, so it was the perfect match. He installed bars in the shower and  fixed the broken tiles. It was a great solution to the problem at the time. He fixed the toilet height  and made everything handicapped accessible. 

This combination of handy man and nurse was a match made in heaven. Dad liked having a guy around.  Too bad it did not last for too long. Ted left town and we were in a position to find help again. 

This in-between stage is painful. The person who needs help never seems to know it. My mother didn’t really want anyone in the house. At least when someone was there she could go to the store. She really needed to get out of the house. Caregiving is one of the most stressful jobs in the world, even if it is for someone  you love.

AFTER THE PSYCHIATRIC WARD 

After this traumatic experience,  we figured out a way to dispense the pills without mom having to check on Harry. A company has a pill dispenser that connects to the phone line. You fill it up 2 weeks at a time. It actually tells you in a computer voice, “It’s time to take your pills.” It’s like the Life Alert System. I was in charge of filling up the dispenser. If he didn’t take his pills after a few hours I would get a telephone call from the provider of the machine at my home. This way someone other than my mother knew that the pills were not taken. It was  $75 a month for this service. I have to admit it was really efficient to have the people call. If he was not at home the pill machine kept talking every 15 minutes, “It’s time to take your pills.”

I later found out that you can go to Walgreen’s and buy a large pill dispenser with a 31 day calendar, with a small container which holds a day’s worth of pills. This was $50, and this is what we later used when my mother needed a pill dispenser. The negative side of this is that someone needs to check and make sure the pills are being taken. There is no accountability like the phone call.

Elderly folks take a lot of medication and possibly vitamin supplements. It’s a good idea to make sure this is a foolproof system. It is way too easy to overdose.

Since Dad was with Mom we weren’t considering a nursing home or assisted living, at least not yet. We still did not realize completely what was going on. 

Legal Documents

As  I said before, my brother is a financial planner. My parents were very private about their money. We all knew they needed some legal documents, but you never knew how dad would be. We had to assign powers of attorney (POA) for financial and medical reasons. If you do not have a POA and something happens to your parents, you are out of luck. No one will talk to you. You need one for medical authorization and one for legal and financial decisions. We also created a family trust. 

I can remember holding my breath as the attorney presented the paperwork to my dad. Only Dan and I were there. When Dad signed it I couldn’t believe it. He just gave his power away. We wondered if he understood what he was doing. Mom signed it as well.

Whew! That was a feeling of relief. At least now we had some authority to help them out when and if they needed it. Unfortunately, I found out later I needed much more to handle their affairs.

Dad’s in the Backyard Underneath the Tractor

I got a call from Dan, “Dad’s underneath the tractor and mom called 911. Where are you?” I was almost home so I scrambled over to their house as fast as I could. Dan got to see the paramedics cutting my dad’s clothes off. I got there just as the ambulance was leaving his home. This was the adrenaline rush I hated. We got all worked up because he was doing something stupid.

Apparently, after being in the house all winter, Dad decided to mow the lawn. They had 2 acres and he enjoyed being outside. It was a nice spring day, but the ground was still wet in the rear of their property. He got stuck and decided to do what he always did in this case. He got out and tried to push it out of the mud. He passed out. Mom looked outside just in time to see him fall. She screamed and called 911, then us. 

We did this 911 thing 4 or 5 times over the course of many months. Every time it happened, we thought he was going to die. It was such a horrible feeling.

They always released him after a time of observation or overnight. He was just getting too weak to be doing this type of physical labor. It’s hard to see a man decline when he was so strong. He would work for hours on end outside. He loved his yard and he enjoyed working, no matter how hard it was or unbearably hot.

Is a Medical Power of Attorney a good idea?

A Medical Power of Attorney (also known as a Health Care Power of Attorney) gives someone you trust the legal authority to act on your behalf regarding health care decisions if you ever become incapacitated or unable to communicate. 

Why is this important? If your parents (or spouse) has an accident or for some reason is incapacitated, they may not be able to discuss their medical care options. I am including as much practical information as I can to help the reader. Many people don't realize there is a P.O.A. specifically for health care.

When my father was in the hospital psychiatric ward, they asked us if any of us had a health care P. O. A. At that time we did not, so they gave us forms at the hospital to fill out.

This is my first piece of advice: Get health care powers of attorney for your parents in the event one is needed. Otherwise, the staff at the hospital will not follow any directions you give them.

Do Not Resuscitate (DNR) I went to the ohiobar.org for this information for the explanation. We did have this for my dad.

What does DNR mean? 

DNR stands for “Do Not Resuscitate.” A person who does not wish to have cardiopulmonary resuscitation (CPR) performed, for example, may make this wish known through a DNR order. A DNR order also addresses the various methods used to revive people whose hearts have stopped functioning or who have stopped breathing. Examples of these treatments include chest compressions, electric heart shock, artificial breathing tubes and special drugs. 

When completed by a doctor (or certified nurse practitioner or clinical nurse specialist, as appropriate), these standardized DNR orders allow patients to choose the extent of the treatment they wish to receive at the end of life. A patient with a DNR Comfort Care-Arrest Order will receive all the appropriate medical treatment, including resuscitation, until the patient has a cardiac arrest (heart has stopped beating) or pulmonary arrest (breathing has stopped), at which point comfort care will be provided. By requesting a DNR Comfort Care Order (DNR-CC), a patient chooses other measures such as drugs to correct abnormal heart rhythms. With this order, comfort care or other requested treatment is provided at a point before the heart or breathing stops. Comfort care (also called symptom management or palliative care) involves keeping the patient comfortable with pain medication and providing palliative (supportive medical) care. A DNR-CC does not mean “do not treat.” Your doctor can explain the differences in DNR orders. 

At the time of this printing, Ohio has two trigger points for the DNR protocol (the DNR Comfort Care and DNR Comfort Care-Arrest), but DNR protocol changes are being considered. Consult your health care professional for details.

**I suggest you speak to your doctor(s) about these. Usually the patient  or the spouse is consulted when this paperwork is being completed. It was difficult for my mother to choose the DNR for dad. Luckily, we never had to use it.***

Does everyone want CPR? 
Although in some cases it does save lives, CPR (cardiopulmonary resuscitation) frequently is not successful or does not benefit those who receive it, especially elderly people or those with serious medical conditions. Even if revived, the person can be left with painful injuries, or in a debilitated state, or with brain damage resulting from oxygen deprivation. Resuscitation can involve such things as drugs, forcefully pressing on the chest, giving electric shocks to restart the heart or placing a tube down the nose or throat to provide artificial breathing. People with terminal illnesses or other serious health conditions may prefer not to be resuscitated when the end nears. For more information about the pros and cons of CPR and whether it is right for you, talk with your doctor, your family and, perhaps, your religious leader. 

If you want to read more, go to www.ohiobar.org.  Your state should have information online about this. Also, you can always ask a doctor.

The Way to keep Dad from Overdosing

I saved many of my emails. My first Grandchild, Elle, was born the week this all happened. This was when Dad was in the psychiatric ward at Lutheran Hospital.

Hi,

In the middle of all this chaos, this little Angel was born. Now let's get to the real business, which is Dad.

Today is Sunday the 18th of October. I visited Dad at Lutheran Hospital. He was in good spirits and we watched the Browns on the TV in the big room. He is without a doubt one of the most lucid people there, at least today.

His doctor started him on an antidepressant today. That should  help. He has not bathed or washed his hair. He needs to. The nurse gave him a spongebath. His eye is inflamed from his rubbing it so he got some hydrocorticone to stop the itching. He thinks he is coming home tomorrow.

His doctor talks too low for him to hear. The nurse told her to speak up. I gave him a picture of his first great-grandaughter and he said, "How about that!"

Tomorrow Dan and I go to the Eldercare attorney to learn about VA benefits, etc.

Sandy

1. 
   

   From Brenda:

   Just so you know, there is another medicine dispenser we could consider from Med smart. It costs $489.95 incl s+h. It has 60 compartments for meds and you turn the unit over to dispense the meds after it alarms to tell you it is time to take them.. It just does'nt seem as secure to me, but you may want to google it to see what you think. Believe it or not, right now I am more worried about mom. She has her insurance bills all screwed up because dad made changes between companies and she says she'll ask dad when he goes home.(That sounds like a good idea if dad knew which way is up.) So I'm going to mom's to try to sort things out. AAAAAAAAGGGGHHHH! Brenda

   ReplyDelete
2. 
   Sandy SteppenbackerOctober 22, 2009 at 1:09 PM

   To: Cyn, Brenda and Dan:
   I ordered a med dispenser which is $75 a month. It should arrive within a week. It is connected to the phone line and I will be alerted if he doesn't take his pills.
   
   I went over insurance with mom and we have it straight. Yesterday dad saw another psychitrist and after we left he went to the opthamologist. He created quite a scene. He also was yelling and swearing at people and calling all those in the ward "Idiots!"
   
   They have upped his anti-psychotic medicine 3 times so far. They are afraid to let him go home. They will not let him out Friday. The EARLIEST will be Monday. The social worker told me mom should rest and so should all of us. He was cursing the entire family today. Social worker said he "was going to be a handful" when he goes home. Brenda said there is a lady on the floor that exposes herself to him. I personally think Dad should kiss the ground mom walks on when he gets home.
   We are still keeping the 1:30 appt. with the nursing home on Saturday at Mom's. The RN or social worker will be able to talk with us all about what kind of care Harry should receive at home.
   Daniel-we need to get his financials in order or they will just flush their money down the toilet. I don't know if Dad can stay at home very long in his present state. Those medicines will have to actually change his personality. (Wouldn't THAT be nice?)
   
   Love you all! Dan-I know you are on overload. I love you. Call me if you ever want to. Otherwise I will see you Saturday. I am bringing a pie. Mom's BD is Sunday.
   
   She cried today and said she should hav just let Harry die. Poor Brenda. She was at her house then. I was telling them he wasn't going home yet.
   Love you all!

   
   

Was it Stubbornness or a Suicide Attempt?

Blog Entry 2

I realized that it isn't going to flow in a blog if I copy the chapters in the book, so I skipped my introduction and Chapter one.

This is part of chapter 2, just showing you how the craziness progresses....

Was it stubbornness or a Suicide Attempt?

One day, we all got a call. It was mom.

“Harry and I were arguing. I told him he did not take his medicine.  We went round and round with this. He got mad at me and said, “Ok then.  Here you go.” He took a whole week’s worth of pills and swallowed them down with some water.”

“How much?”

“A whole week’s worth. He picked up the pill 

dispenser and took every one of them. I don’t know what to do and he won’t go to the hospital.”

Brenda, Dan and I all raced over to their home.

My father completely denied taking the pills. The pill container was empty, though.

Dad kept arguing that my mother was making it up. He was nasty.”You think you know everything. I told you I didn’t take them.”

Finally, my brother looked him in the eye. “Dad, I need to know if you took those pills.

Did you?”

Then my Father admitted that he took ALL the pills.  We checked with the hospital and they said he needed to come in - NOW.

Dan said, “Dad, we have to take you to the hospital. Where are your shoes?”

Dan picked up the pair of tennis shoes and he shoved and shoved to cram dad’s feet into the shoes. He said, “Dad, these are really tight.” He was frantic and we did not know if his life was in danger or not.

Dad had a hard time walking, but Dan got him in the car and we all went to the hospital.

We later found out that he had shoved my MOTHER’S  shoes on dad’s feet. That’s why it was so hard to put them on. Tennis shoes all look alike.

The hospital attendants said they would “keep him under observation”, and apparently they don’t pump people’s stomachs anymore. So we watched as Dad’s pulse slowly went down. No one seemed overly concerned. I went home to make dinner and was coming back.  Brenda and Mom went to the cafeteria, since they  were waiting. They had heard Dad be uncooperative with the medical staff before they left. Dad was not happy being there. Dan was alone with my dad.  No one was watching his vital signs but Dan. There was a monitor on him. Dan watched as Dad’s pulse went down. The nurses said they were watching from the main reception area, but Dan started to get nervous. His heart began to race. He was getting upset. He was watching the number of beats per minute go down.  He was concerned , but he thought surely the staff was watching this. Then Dad’s pulse went down,  down to 10… 9…8… 7……BEEP!!! BEEP! BEEP!

Dan started yelling. Dad was coding. The doctor rushed in  with the paddles to revive him, knocking Dan over in the process. Dan was traumatized beyond belief. 

Dan said they hit dad with the paddles once. Then they hit him again. Dad sat up, looked at my brother and said, “Don’t think you know what the f***is going on.” He then fell backwards and they hit him two more times. His pulse came back.

They made Dan leave the room. Dan was shaken and ready to kill someone. I have always wondered WHY they let Dad’s heartbeat go down to the very bottom. To this day my brother is still traumatized over this.

When we all returned we realized we had completely missed all the drama. They kept him overnight for observation. It was like being on a roller coaster. We were all numb. Then they decided they had to hospitalize him.

The Psych Ward

When a person overdoses, doctors have to take the situation seriously. They put my dad in another hospital with the psychiatric patients. He was there for about a month. One thing we totally missed happened then. Dad had not been diagnosed with any memory issues up until this point.

In the hospital he told my mom he had waited for lunch one day and the ward was completely quiet and dark. No one else was looking for their meal. It was 12 on the clock. WHY were they not feeding him?

It was 12 a.m. He thought it was lunch time. Getting the times messed up is something an Alzheimer’s patient might do. We did not recognize this very telling sign that there was more going on there.  

Funny things happened to dad there. He looked at us and whispered, “These people are crazy.  Why am I here?” We told him it was because he took at the pills at once. A lady in the ward allegedly got into bed with him. He was pretty upset about that.

We told him to cooperate with the doctors and he would get out of there soon.  (We kids were amused because we thought he should have been there a long time ago.) When they asked him, “Why did you take the pills?”, he answered, “Because I wanted to kill myself.” He thought he was being funny. Brenda finally coached him and told him, “Dad, if you ever want to get out of here, stop saying that.” He was there for about a month, leading the sing-alongs at the end. Dad had a very odd sense of humor, to say the least.

Do you have aging parents and are they starting to worry you?

                              

You will have many conversations like this title if you have aging parents. I am writing a book to help people with through this trying time. Right now I only have my mother still living. My husband and I have buried 2 dads and 1 mom already. That experience, plus the fact that I practiced real estate for 37 years, makes me an expert on moving people.


 Old people never want to leave their homes. My dad used to say. "They're going to take me out of here in a box." But the reality is that poor health, a fall or broken bones, dementia or Alzheimers will put a monkey wrench in their best made plans. I'll bet most people never think about their parents getting old and feeble, unable to take care of themselves. I am hoping to alert anyone 50 years or older to make some plans or at least have conversations about assisted living, finances, insurance policies, bank accounts, wills, etc. These are only a few subjects that I am going to touch on. We started most of these much too late, but thankfully we got some things done right. 


 I am the oldest of 4 children. We are reasonably intelligent, but we have a pretty typical family that doesn't always see eye to eye on important subjects. Our parents really did not talk about their finances with us. We knew their home was paid off, but we didn't know exactly where their money was or how much they had. We knew they had a will, because my brother is a financial planner and he made sure they did that. They never wanted to talk about death or funerals. They seemed to get agitated if we ever started talking about the future in those terms. I wish I could turn back the clock and educate them and my siblings on all the critical details that we were missing. I also think the interactions between us as siblings were difficult but often hilarious. We have 4 type A personalities, and that  was a recipe for some tough but funny conversations. 

I  will tell my story and show some emails that we sent back and forth. I also am going to explain how we had to learn about probate, trusts, Medicaid, VA benefits, hospice, funerals, different types of senior living communities, dementia, Alzheimers, banking, insurance policies, powers of attorney, fiduciaries, CCRM and more. Hopefully  someone reading the book will have most of their questions answered and laugh a little as well.

This blog will represent different chapters of the book.