Posts Tagged ‘Alzheimers’

I am not a Nurse!

Uniforms and hats

I’ve worn some interesting hats over the years, but of all the hats I’ve worn, a nurse’s cap was never one.

             Ask my brothers and sisters and they will tell you that I am not a nurse. I’m the family erudite. As a child, I played school, not hospital. I pretended to be a teacher, not a nurse or a doctor.

            So, why did I volunteer to become a caregiver? Why am I my mother’s HANC?

Woman on scooter

She needed help with Housekeeping, because her limited mobility prevents her from doing all but basic cleaning and home maintenance. This same handicap, brought on by the fall that broke her hip and precipitated an entire shoulder replacement, controls the amount of Activities in which she can participate.

good food

Her dependency on a walker and her failing memory restrict her ability to prepare Nutritious meals. Although she has lived alone for nearly three decades, it was clear her limitations were preventing her from many social interactions; she needed Companionship.

            She needed a HANC, not a nurse.

woman on phone

Every day requires I employ my Housekeeping and Nutritionist skills, but the need for me to be her sole Companion changes if friends or family call or come to visit.

book

Her willingness to engage in activities other than watching television, crocheting or working word puzzles  is contingent on her energy levels. If her overall health declines, she needs a nurse, not a Companion or Activity director.

She’s had a few bouts of illness. Only one, so far, resulted in hospitalization. That’s when I realized I am not a nurse.

tray of medical items

Nurses run on schedules and panicked calls from patients. My shifts run twenty-four, not eight or even just sixteen hours. Some nurses taught me how to control her pain by adjusting her body and supporting it with pillows. Other nurses taught me the strength in a gentle touch and the power of a calm demeanor. Some taught me they care more for a patient prior to receiving discharge orders than they do for those eager to go home.

pain meds

One nurse displayed a preference for medication rather than providing attentive nursing care.

Unfortunately, I learned my mother respects a nurse’s authority more than her daughter’s opinion. Still, no matter how caring, compassionate and qualified a nurse can be, family is always better.

family photo

Even a family as goofy as mine!

Hit the wall, but don’t let it hit back

It’s not uncommon for a HANC to hit an emotional wall at some point. Keeping a tidy house, directing activities, planning nutritious meals and providing fulltime companionship will take its toll. Wall with flowers

Doing all this while maintaining a career and relationships can add to the stress level of even the most well-balanced person, but to attempt the feat while caring for a beloved pet that becomes ill, relocating your entire household and “coming home” after nearly a decade-and-a-half away can prove exhausting.

wall corner pin and tan

If you don’t rest and take care of yourself, your body will give out in any number of ways and you will be forced to take a break. Be mindful of your physical, emotional and mental state unless you want to suffer the consequences of fatigue, colds, headaches or other maladies.

small bricks

  • No move ever goes exactly as planned or expected, even when you have options for contingencies. Unexpected problems will emerge, such as the old air handler that fails to perform during unseasonably hot weather or the elevated utility bill resulting from the faulty appliance. Cars break down, oven doors fall off, pests invade, rain seems never-ending; yet you are the one who must hold things together for everyone else.
  • Expecting the unexpected can help HANCs cope with computers that fail or cell phones that break. Accepting Murphy’s Law makes it easier to cope and respond appropriately when things go wrong. Then the family has a sense of calm cohesiveness.
  • Problems arise when HANCs expect too much from themselves and are less forgiving of their own mistakes than they are of others. With so many responsibilities, it can be difficult to remember to take time for yourself, time to play, relax, to do nothing. Don’t be too stubborn to listen to the advice you give others.
  • Realize that the housekeeping aspect of your new job does not require miraculous transformation of a marginally kept house into a magazine cover shot. Take care of the necessary daily chores and reserve some of the deeper cleaning for another time, after you have settled in fully.
  • Perhaps the most important part of being a HANC is the activities director portion, but this does not mean you must plan every waking moment of each day. Some days, it means making no plans at all, but being open to what the day brings. If the weather changes, be prepared to change your plans accordingly. Sometimes, an activities director needs only to provide simple conversation and gentle reminders about recent events. Too many changes and too much commotion can be overly stimulating and frightening. A good HANC knows where to draw the line between keeping busy and being a busybody.
  • Learn as quickly as possible how much activity the person in your care can handle at a given time and don’t push beyond that limit. A walk outdoors might be all you can handle one day, but the next day, a drive or shopping trip could provide interaction or the chance to meet old friends. Don’t rush and don’t put your desire to fill the needs of being a HANC before his or her need to do whatever is important at that moment.
  • If the person in your care has memory issues, don’t let your personal frustration drive you to impatience. Allow time and encourage memories by urging conversations with friends and relatives. Give hints and recollection prompts and know that the other person is more annoyed than you at the declining memory.

wall and pipes and sky

Can you tell Fran about what we did yesterday?” might be too generic. Try, instead, “Will you tell Fran what you thought about the farmers’ market?”

Don’t quibble over details, but help with dates and time management.

“Remember, we went to see Sally after you had your haircut. Yesterday was the day we went to the museum.”

reflection of wall

The activities you engage in are to help deter boredom and keep the mind of your loved one stimulated, not for your own entertainment. This can be difficult to remember at times. It can be harder to implement when you are also trying to maintain a healthy balance. If you feel you are close to hitting an emotional wall or at your physical limit, take a moment to collect yourself. A few minutes alone in the shower or a short walk outside might be all you need. Put some space between you and whatever is frustrating you. If your loved one is too demanding, make a promise to yourself to take a break as soon the current crisis has passed.  Keep your promise.

sunset wall

  • By providing a healthy diet for the person in your care, you are also ensuring your own nutritional needs are met. Just be certain your specific dietary needs don’t clash with medical needs. Don’t force anyone to adhere to your menu preferences. Introduce new foods gradually. Make suggestions, not requirements. Don’t preach about snacking, but make healthy choices readily available and be sure to set a good example with how you eat. Keep a water bottle handy, especially when leaving home. Don’t forget to drink water, yourself.
  • Companionship could well be the second most important facet in any HANCs position or life. By growing in communion with the one in your care, you may not add years to a life, but you will certainly add life to those years.

road walls

Knowing your job as a HANC means you understand the obligations, but does not lessen the responsibility to take care of yourself.

fence wall post

Enjoy the journey and stay off that wall.

Two Weeks as a HANC

When we visit our parents as adults, we want to believe everything is under control, as it was when we were children.

     We may see or smell things we’d rather not, but to keep the fantasy alive, we tend to ignore them.Gransmomma and siblings

   Usually, we make a point to clean something or do some yard maintenance on our visits, but mostly we visit, because our parents want to spend TIME with us, not watch us work.Clock in town square 

     Once we are back home again, we can pat ourselves on our backs for whatever we did. We might tut-tut to our spouses or siblings and think about what must be done “one day,” but we don’t want to believe our parents are anything less than super-humans. We want to remember them as strong and independent, virile and always capable.

Matt's guns

 Those of us with large families hope someone else will inevitably step up and take charge.

      For me, living more than 300 miles away, I had no option but to allow my sisters and brothers who lived closer to do just that. Each did what could be done  around schedules and personal requirements. Each filled a special role.

     My role was to visit as often as my job allowed and do what I could during the few days I was “home.”

     Over the years, our mother’s physical capabilities have declined and her memory lapses have worried us more and more. We have talked one-on-one with each other, but never as a collective family about her increasing need for more companionship, better nutrition, help with housework or more diversions to help her focus mentally.

variety of produce

     Once, my sister’s husband was driving Momma’s car, with Momma on the front passenger’s seat when Momma became startled by what she thought was an oncoming car.

      Momma decided for herself that she would no longer drive.

      She didn’t suffer the indignation of having her driver’s license taken from her, but she told me she misses not being able to trust herself behind the wheel of a car. She still loves to “take a drive,” and told me after her recent trip for bloodwork, “This is fun. I don’t care if it is just to the doctor’s office and back. I like to get out of the house.”

Oak tree lined dirt road

      Now, that we are living here, I can take her for a drive any day of the week. We don’t even need a destination.

 I hope to do more of this kind of driving once we are unpacked…at least, maybe after I have finished cleaning the kitchen. Goals are good.

redundant swiffer

     I try to clean, organize and unpack a little each day and I hope we aren’t confounding her, though sometimes, I think we must. There have been some incidents that make me know we need to be here and I am tempted to take over, but she loves her independence and I must remember she handled all her daily-living activities long before we moved in. She is proud to load or empty the dishwasher, but I do all the meal preparation – sometimes with her nearby. She still is able to do laundry, and I am pleased to allow her that chore. Today, she patched a pair of my shorts that had ripped. I would have probably worn them, ripped and all, until I could no longer do so. She enjoys doing needlework and I may end up in patches, but each one is lovingly stitched.

 quilted

     She is headstrong, but reasonable.

    Some changes make her wonder, “Why, after all these years, do I need to do that?”

As long as we explain what we are doing and why we must do it a certain way, she accepts the changes with grace. She just needs to know why.

 

     For many years, she has lived in a house with almost no insulation in the walls or attic, which makes her air conditioner work harder than it needs to. It also makes the house extremely hot during the summer. She’s on blood-thinning medication, which means she is relatively comfortable in a house that is warmer than 80 degrees. What she doesn’t seem to understand is that at 84 degrees or even 90, as it was one day, her thinking is impaired. She was very grouchy during the hottest days. She didn’t want us to purchase a window air conditioner, but when I told her we needed to, so I could cook and clean, she accepted it. We paid for it, but she’s not always certain she didn’t buy it.

    

     We can’t easily open most of the windows to allow a cross breeze and the roof has no venting for the heat. I noticed her mood improved when we were able to cool the house to anything below 78. She has started wearing a knitted shawl in the early mornings so I can do my household chores in more comfort. We compromised without even discussing the problem.

      At times, she smiles when I do something my father used to do or that she once did, but can no longer do. Nostalgia can be good.

     She has been writing her memories in a variety of notebooks and they are random. She knows there is no “book order” to them, but I hope to share them, soon.

Journal pages blank

     She retells stories, not remembering that she may have told the same story, almost verbatim, a day ago – an hour ago – five minutes ago. We do our best to listen and react as if it is new. Sometimes, she stops herself or asks us to stop her if she is repeating.

     Sometimes, she simply forgets things. “I never” and “I know I didn’t” precede many declarations. Whenever I remind her, respectfully and gently, in detail, she usually says, “Oh, yes. Thank you for reminding me.” It must pain her to know that her memory is slipping away from her. She often says, “I pray all my children can live long lives, but I do hope you can be healthy and not like me.”

      The worst for me is when she and my husband each want my attention at the same time and neither knows the other is also speaking to me. Some days, I just want to cry. Some days, I do.

 mom and son

 

     This is but one day in our new life adventure. There are many challenges and many rewards. When I moved out of this town nearly 15 years ago, my mother managed a hotel and was one of the most amazing people I knew, physically, emotionally, intellectually and there were few women whom I felt compared to her. I still feel that way about her.

I wanted to live an adventurous life in a city and for three years, I did just that. Then, we moved to a smaller city and my life became that of a suburbanite career woman. I immersed myself in my job and was content to visit my family whenever I could, but I also contented myself to vacation in more exotic venues as often as money permitted.

       Now, I have returned home to a more bucolic life and it’s good.

 

torch

     As I listened to a whippoorwill while standing between two tiki torches that kept the mosquitoes at bay  I thought about today’s achievements in addition to my editing and writing. It is good. It is very good, indeed.

 

 

 

 

 

 

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