Saturday, April 27, 2013

The Wild-Goose Chase Search for Elder Care

Since January, our hospice staff has been faithful and professional, and I'm so grateful to them.

It has only recently dawned on me, however, how lonely the struggle (this word is not an overstatement) can be to find the right sources to fill gaps in my mother's care. As a former geriatric social worker, I wasn't prepared for the frustration this would bring up for me, now that such care is a personal issue.

Suggestions from friends. Calls placed. Calls unanswered. Calls placed again. Services promised, but never delivered. More unproductive referrals, which lead back to one's starting point.

The application for Medi-Cal has begun, and it's proving to be a long and complex process. Still, it's a necessary first step. There were some initial glitches. After putting in an internet application, I was told by an IHSS staffer that I shouldn't have done that, and was advised to cancel the application; a phone application to IHSS was sufficient to start the process. A follow-up from another IHSS worker contradicted this, and I was then told to reapply.

In the meantime, I'm being given facile advice to "just take out a reverse mortgage." How easy this seems when it's not your family home of almost 50 years on the line! Others advise caution before taking this step. In fact, AARP Magazine printed such an article just recently. I also get asked daily from various case workers and staff to "just try" hiring a private-pay caretaker, even when I express concern about cost concerns. Many people seem to be pushing their own agenda, or trying to quickly sell me their services, or those of "a friend who needs work." The need to carefully interview anyone, and present them as a trustworthy and consistent person in my mother's life seems also be lost on a lot of these people.

Acting on a suggestion by a family member, I called a referral service almost two months ago, seeking to get as unbiased information as possible about in-home care through In-Home Supportive Services versus placement in a skilled nursing facility. After just a few minutes of conversation, I was told my mother wasn't eligible for their services, but certainly "this other place can help you."

Fine. I called Agency #2, and had to follow up twice. After the second message, I got a return call, and gave clear details about my mother, our available resources, and the care options I was weighing. I was told that a mobile physician would be calling me back "soon" to arrange a home visit for assessment, and this in no way would conflict with the hospice service or physician we want to continue to have in place.

Two or three weeks later, I was contacted by Agency #2, and told them that no physician had ever contacted me. I'd given my cell phone number, because, gee whiz, I'm just stuck with being my own secretary. So, a follow-up was promised, and still, no doctor called. In the same conversation, Agency #2 gave me the name of Agency #3, and said they "would call me." Agency #2 was now saying Mom wasn't eligible for their help, which they might have said in our original conversation.

At another two week interval, and no word back from either Agency #2 or #3, let alone any mobile physician. I researched Agency #3's phone number online (they have sites both here in California as well as Nevada), and called. Again, I believe I clearly communicated the situation, and now I was being passed along to someone at a hospice, even though I told them we were totally satisfied with our current one.

This time I actually got a call within the day, but found myself talking to someone who said, "I was told you're not happy with your hospice, and want to change." Even though I again gave the details of my goals to meet my mother's needs, I felt I wasn't being heard. At that point, my patience ran out, and I told this particular individual, in no uncertain terms, that I felt shuffled around by the system. (Indeed, is there any kind of "system" in place here?) End of conversation.

I called Agency #1, bluntly voicing my disappointment in lurid detail. As I recall, I used the word "idiot" to describe the caller from Agency #3. Too bad it was only heard by an answering machine.

Back to Square One. Here ends my rant.

Wednesday, April 24, 2013

I should have been paying attention

Ergonomics. Body mechanics. Bend from the knees, especially when lifting. Spread feet to distribute the weight. Pivot with your feet, not your waist.

Boy, do I remember the yawn reaction when hospital employees--me included--would be required to sit through presentations on the above subjects. My coworkers and I (non-nursing staff) would often check out mentally, sit back, and pass notes (this was the pre-texting era). I will speak just for me; I thought the above advice had little or nothing to do with my life. And then my recent knee injury provided a reality check.

Being disabled, however temporarily, can be a major disruption. Oh, sure, the parking placard will be a help, but it cost me trips to the doctor's office and the Auto Club. My colleagues are being more than gracious about giving me a more accessible spot in our office, but I recognize that's putting them out for a while. And I'm only beginning to problem-solve how I'm going to provide for my mom's care after my upcoming arthroscopic surgery (it's a real feat carrying handfuls of stuff to and from her room while hobbling on a cane!).

My knee injury, of course, was an accident, but I can't help but wonder if some awareness and increased care on my part couldn't have helped prevent it. All those lectures on workplace safety could certainly have relevance in the home, which is where my mishap occurred. Since so many of us women have been diagnosed with post-menopausal osteoporosis, this should cause us to slow down and be mindful of potential hazards--before we hit the floor. And there's that sneak called arthritis, slowly stealing away degrees of our mobility.

I pulled up the AARP website, and found the following article, "Preventing Falls at Home," by Alyne Ellis It's a great safety guide for us boomers, as well as our aging relatives.

There is much written about minimizing hazards to the elders we care for in-home, as well as material about how to keep ourselves sane as we care for them. Perhaps more should be written about how to avoid our own physical injuries, from a body mechanics standpoint. Caregiving--unpaid or not--is one of the most demanding jobs there is. And beyond that are the rest of our lives, which we deserve to experience unencumbered.

My personal safety hazards, I feel, are largely due to my temperament. I'm impatient and prone to rushing and "overbooking" my day, and may have been doing just that when I twisted my knee like a sourdough pretzel. And that is another subject for another day...

I have every intention of getting back to my full speed. Here's to that day:

Wednesday, April 17, 2013

Wednesday, April 10, 2013

My new friend, The Cane

Allow me to introduce you all to my newest companion. The first image is to thank my late grandma for having acquired The Cane after her fall in about 1980, after she fell and broke her hip while at a afternoon party at a friend's home. Over the years that followed, right up to her passing at age 94 in late 1996, she "progressed" to a walker, before becoming bed-bound. During one of my recent rounds of donations to various organizations, such as the Convalescent Aid Society, I very nearly gave this away. I'm so glad I didn't.

My latest misadventure began a week ago, while doing some very light housekeeping on my day off. I bent over to pick up some article of clothing that had fallen on the floor. As I straightened up and tried to move away from this spot, my knee cap and I seemed to go in opposite directions. Funny (?) thing is, I both heard and felt it. Pampering my insulted body part did no good; I was in more pain the next day. Off to my primary MD I went.

I've had x-rays, and my primary MD has now referred me to an orthopedic surgeon, as he says there's fluid on my knee. Mobic keeps the inflammation and pain bearable for short periods of time. Until my appointment rolls around 12 days from now (unless there's an earlier cancellation), I am left to consider some of the meanings of this turn of events.

First, I was embarrassed when one of my family members pointed out that I was using The Cane on the wrong side! An injured right knee calls for the cane to be on the left. Okay, one lesson learned.

In addition to an awareness of my body, I'm looking closer at my environment. Bless you, curb cuts; I never appreciated you before. Ditto stores that keep their checkout lanes moving, and offer assist out to the cars. Near-by parking spaces that are wide enough for me to ease in and out of my car seat are awfully nice, too. I don't yet know if I will be able to have a handicapped parking plaque; the fate of my knee will determine that.

As rough as it is on my pride, it's also interesting to experience the reactions of people around me, especially those who are younger and more mobile. Damn, I used to be one of those people! How quickly and suddenly that changed. As The Cane and I hobble along, I notice that many people are either kind and patient with my slow pace, or I will hear exasperated sighs as others swiftly circle around me to get past.

And, yes, I must admit I have often been in the latter group. Karma has given me a thump on the head.

I used to be amused when I'd observe "older folks" rock back and forth before getting off a chair, and listen to the grunts accompanying their movements. Well, now I'm acutely aware of how much I'm doing this. I have my own "pre-launch sequence": one...two...three...UP (UGHH!).

Pain sure has a way of siphoning off one's focus, and impacting one's mood. When the pill wears off, I turn into a proverbial crabby old lady. And last Friday, I got my first parking ticket in a long time, because I parked on the "wrong side" of the street, getting in the way of the street sweepers...on a street I've frequently parked on for the past three years. AGHH!!

Every two months, I look forward to my AARP Magazine, with its wealth of articles geared to our generation. Last night, I was suddenly aware of how drawn I am to articles about managing arthritis, and foods to foster longevity. I remember when I was 50, and began getting my issues. At that time, I'd give this magazine a quick skim, and pass it along. I wasn't ready to acknowledge that the articles were written for me, and that not considering their advice might actually hasten what I've been avoiding...aging.

There...I admitted it. Aging isn't something I've wanted to face. But then, facing it doesn't have to mean surrender. No, siree. Once I get my knee treated, I want to resume the battle for a long, vibrant life, with a projected cut off of 102 years. As I get toward that "expiration date," I might just decide to renegotiate the terms.

I finally have to give up my illusions of invincibility. It would also be useful to get my head out of...wherever it's been. Somehow, things are going to work out, so long as I can settle for being a human being of 58. In the meantime, The Cane will be good company.


Lifelines, or ties that really bind?

Up to a year or so ago, my clock radio, always tuned to KUSC for soothing background music, was enough, whether for working in my home office, or for unwinding to sleep. But now, I'm slowly adjusting to what is now called the "new normal." The above gadgets are my constant companions, even at bedtime.

In the middle is my cellphone, with me at the office, the grocery store, on date nights. What do you think? Should I just get it implanted somewhere in my body? My ever-present fear of misplacing it would be eliminated, so I wouldn't be a modern castaway in a sea of humanity. It's my conduit to my gentleman friend, my mom, my son, my clients, the whole damned world. Right now, I'm doing this post while waiting for a teleconference that was supposed to have happened almost an hour ago, and I'm putting other activities on hold till it gets going. For someone with a full-plate approach to life scheduled to the nanosecond, being "on hold" like this, by the person who requested the call, is irritating and disrespectful.

On the left is what we call the "house phone," which is a backup for when the hospice staff forgets my cell number.

At the right-position is the walkie-talkie, half of the set I gave Mom last Mother's Day (see my 5-12-12 post). When I presented Mom with this gadget, she scoffed, "Yeah, I can really see myself using this!" Now, it's our connection across a hallway-maze that bisects our barely-1,400-square-foot house. She is mostly bed-bound these days, and I spend much of my home-time in my back office, as if we inhabit separate countries.

The idea of room-to-room shouting repels me, but sometimes the walkie-talkie is intrusive. Are any of you old movie buffs? If so, you may have caught scenes where some 1930's business hustler has a desk full of candlestick phones, and at any given time, has one up to each ear simultaneously. That's me.

It seldom fails...I'm in the middle of a business-related call, and the walkie-talkie suddenly comes alive with a "Hey, Val? Val? Val?" I briefly excuse the "professional me," and give a brief "I'm on the phone, Mom," to which she says, "Okay. I was just checking to see if you were still here." Then, back to the other receiver to tend to business. Literally two minutes later, the walkie-talkie produces another hail.

On my one day off, I've taken to carting all three of these receivers with me -- to the kitchen, out in the front or back yards -- and it's an interesting juggling feat when I'm trying to clean or do pruning. Recently, I thought of finding a small-sized tool belt to wear as part of my day-off garb. It stinks, believe me, to have one my three gadgets ringing on a faraway counter, across a wet, freshly-mopped kitchen floor, or perched on one of the garden statues. My recent knee injury has complicated these scenarios, but that's a topic for another posting.

Sometimes I have the fantasy, inspired by some movie scenes, of just heaving one of these devices -- across the room, out my car window, or into the trash. Nah, it'll never really happen. I just savor the precious times when there's quiet.

Let me think on this matter further. In the meantime, I'd love to hear from any readers as to their similar experiences or suggestions.

Have a good day.