Well, today Karma said, "Girl, you think you have it all figured out, huh? Well, check this out!" (Because Karma is a sassy African American woman, as we all know.)
It was a rough day, and my BFF (who happens to be a therapist) Shrinky Dink is asleep, as all sane people in my time zone should be. So I'm gonna write a therapeutic "good enough" blog post--complete with the gritty details of my everyday life. Thereby contradicting myself.
I submit that contradicting myself is okay for exactly two reasons.
1. I am a woman.
2. I am bipolar.
And both conditions have changeability as a symptom.
Anyhoo, here is what happened today:
My grandma's hospice nurse told me that it isn't safe for her to live alone anymore.
Perhaps I shouldn't have been surprised by this. My grandma was diagnosed with lung cancer last October. She has COPD, still smokes, and has no intention thankyouverymuch of stopping. She also has congestive heart failure and has had at least 3 heart attacks. And she's had several mini-strokes, and now has vascular dementia because of the damage caused by them. Considering all this, it's amazing she's still as feisty (and vertical!) as she is.
As her caregiver, I've been doing everything I can to keep her living independently in her own apartment. It's what she wants. It's what I promised her I'd do. She's had hospice care twice before, but "graduated" out of it by not deteriorating quickly enough for Medicare's rules. Things have changed for her over the past month.
My grandparents are on the far right.
Today was the initial evaluation for her 3rd stint on hospice. I was told she will qualify, but because of her worsening dementia, I need to find her another place to live. She needs to be somewhere where people will check on her frequently, will help her to the dining room, and will assist her with hygiene. The hospice nurse said she thinks she's beyond the level of assisted living, but that I might be able to find an assisted living place that offers the amount of care she needs.
As a gerontology student in college, I worked and volunteered in nursing homes. There are good ones out there, but in my opinion, they are the exception rather than the rule. I always told my grandparents that they wouldn't have to go to a nursing home.
But I didn't consider that dementia could be a part of the picture.
Dementia changes things. It's worsening. And I know it's not something I can handle on my own. With dementia, there are safety concerns, self-neglect, personality changes. Sometimes when I call my grandma to remind her to take the medicines I arranged for her, she tells me she already took them. I ask her to double-check, and she says she does. The next day I visit her and the medicine is still there. Increasingly, she hasn't been answering the phone--even though she's pretty much stopped leaving her apartment. The other night I went to check on her when I couldn't reach her by phone, and I found her holding her bloody elbow. She'd fallen. Yesterday I called her to remind her about medicines and she told me she was sitting on the floor. She never sits on the floor. It's too hard for her to get back up. I don't know if she fell again. She's been weak lately, so I took her to the doctor Wednesday. On Sunday she asked me when we were going to the doctor about her weak legs. I reminded her that we'd gone on Wednesday, and that afterward we'd gone to the hospital for x-rays. She didn't remember any of it.
You might be thinking that the solution is to move her in with us. We did that once before. She lived with us for a year after my grandpa died. It was an incredibly stressful year. She was miserable. We were miserable. She does better in her own space.
My grandma has always been feisty, but dementia has added a little meanness to the mix. She yelled at me yesterday for cleaning her cat's litter box, even though she hasn't cleaned it once since she adopted the cat. (My mom and I have been taking turns.) Sometimes she's mean to my son too. She's called him a weakling and she gets mad when we ask her not to smoke while we're visiting her because it triggers Nature Boy's asthma. I once left him with her while I ran to get her something from the store. She lit a cigarette and started smoking. Nature Boy said, "Hey Meemaw, will you please not smoke while I'm here? I have asthma." She yelled at him, "Get your ass outside then!"
Even though I tell him it's the dementia, it still affects him. He's never known the sweet, nurturing grandma that I grew up with. Because he's homeschooled, he has to go with me when I take care of her. If she moved back in with us, he'd be around her 24/7. He'd be affected by the things she'd say and do. And by how stressed out I'd be. And who would be with her when my son and I go to our homeschool activities, to the library, or to medical appointments? Nature Boy has already experienced losing his great-grandpa to cancer in our home. What would be the impact of having to go through that again?
So I'm going to try to find my grandma an assisted living facility. She will fight the move. I just pray I can find one that meets her needs. I love her. And the thought of her in a nursing home, possibly confused and afraid, breaks my heart.