Posts Tagged ‘HANC’

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!

Forced to Follow my Dream

Since becoming my mother’s Housekeeper, Activities Director, Nutritionist and Companion (HANC), I face new challenges daily. In some ways, on some days, it’s as if I am responsible for an 85-year-old toddler. Without family intervention, her meals would be meager and lonely, her health declining rapidly.

man on motorcycle

Prior to moving, my sister, Jane, or my brother, Joe, cooked for her, but they weren’t able to be on hand daily to ensure she ate what was prepared. That’s my job, now.

Without my support system, I might have burned out quickly. By far, my biggest supporters are my brothers and sisters. Each in his or her way has provided invaluable assistance. Some have taken us out to dinner.

family phot

Others have brought food or even tea parties to us. Some have helped with yard work. All have given words of gratitude and encouragement.

tea party

Jane offered to give my husband and me one weekend off each month.

I had no idea how important that would be, but Jane knew.

What a gift!

Gift with a bow

When we first moved in, I needed some time to unpack and assimilate.

boxes

We all needed to adjust to the new lifestyle. We were here three months before our first weekend away, which meant it was all the more important – but what a fiasco! We’d started planning a trip to a local resort town, but something didn’t feel right, so we decided my husband would follow his instincts and use “the force” to direct us on our spontaneous adventure.  My well-intentioned sister didn’t realize that my night-schedule husband wouldn’t wake at dawn, as hers would have. I knew this, so I promised her I’d call when we were leaving, but she came early. It all worked out well, but it seemed as if we were being rushed that day.

traffic jam

We drove an hour to North Charleston, where he surprised me by taking me to the Fire Museum, a wonderful visual tribute to firefighters all over the world.fire museum

That evening, we enjoyed a sumptuous meal and sat outside our less-than-ideal hotel/motel room watching a feral cat colony. The next day, we drove to historic downtown Charleston and the Battery where we started making plans for a future trip.

customs house

A short drive to the Isle of Palms, where we toured the island and I took photos, took us past the Windjammer Beach Club and we modified our plans. My husband then drove us to Sullivan’s Island. He  stopped so I could take some photos of the historical monument that described an early battle during the Revolutionary War.

monument plaque

Then we saw him.

A young man was rising out of the water, a hose attached to a jet ski. He rode on a stream of water, hovering the inlet. It was the highlight of our day.

jetski rocket

I have wanted to travel, for as far back as I can remember.

Wait. That’s not accurate or truthful.

Bernie

My first memory is of my sister Bernadette “Bernie” and me making cucumber pies. I was five and she was almost four. We lived in the largest house I can remember for my family of ten, although at that time, the “babies” had not yet been born.

The house was situated on a corner at the intersection of two major thoroughfares. Long before interstate travel sped by on freeways created for the purpose, travelers used these small-town highways.

On one hot summer morning, our house roused to the sound of a collision and we knew a large truck had been involved. This one had been filled with cucumbers. Housewives and older children rushed to the intersection to help clean up the debris so traffic could resume as soon as possible. My mother pickled what she could and those too bruised or broken became playthings for Bernie and me for a day. We made the best-smelling mud pies in town.

reading

When I wasn’t making mud and cucumber pies, I was reading. I don’t recall a time in my life without books. Once I started school, I read even more. That’s when thoughts of travel first entered my mind. I longed to visit exotic places I’d read about and for many decades, I believed travel meant passports, airfare and foreign countries.

I’m reconsidering my perception.

passport

To be certain, I do own a passport. It’s in almost pristine condition, though it will soon be time to renew it. I have traveled outside of the United States, but barely.

cruise ships

Although I enjoyed it thoroughly, traveling on a cruise ship is an extremely limited sort of travel.

Hawaii hello

My husband and I have dreamed together of being able to spin a globe to stop it with a finger on “Where shall we go next?” knowing our dream is tied to our budget. Outside of a few cruises and some outings while visiting family, our travel has been limited – in location and ambiance.

As another month approaches, we are faced with a dilemma.

sign

  • Where should we go?
  • What will we do when we get there?
  • What kind of restaurants will we find?
  • Do we want to visit the typical tourist venues or go off that path?
  • How can we avoid another iffy hotel, when the online rating system is flawed?
  • Can we really afford to spend the night away each month?
  • Can we afford not to stay overnight?
  • How much can we, with our current jobs, afford to disconnect?

We think we have a solution.lottery

Scaling down our global travels dream (until we win the lottery), we’re going to put names of cities and towns in a hat or a box or a basket or maybe just stack them like playing cards.

hat and cane

Each month, we’ll draw out the name of that month’s destination for our weekend away.

There are no rules, but we do have some guidelines.

  • No location should be more than a three to four-hour’s drive from home. This will ensure we can enjoy our destination as well as the journey to get there.
  • We’ll spend a little extra for nicer accommodations, even if we have to skimp on our main meal out.
  • Some months, we will pack a picnic basket, depending on our final destination.
  • Each location should have some draw: a museum, an aquarium, a historical monument, a botanical garden or some other special amusement.
  • We reserve the right to change our minds.

wine

Now, my task is to locate cities and towns that fit our criteria, set up the cards with options for entertainment and search out accommodations.

historic inn

If you have any suggestions for exciting destinations or locations within a few hours from the Charleston/Columbia South Carolina or the Savannah Georgia areas, I’d love to know about them. Please, leave me a comment with your suggestions.

The Little House in the Country

City HallI was thrilled when I first moved from my lifelong hometown, with a population of 5,360 – according to the latest U.S. Census Bureau – to Atlanta, with well more than 900 times that.

City scape view

At the time, I needed to be absorbed into the city’s anonymity, to feel the pulse of cultural diversity. Several years later, I downsized the city but upgraded my lifestyle.

House in the suburbs

We moved from a small two-bedroom apartment on a fourth-floor walk-up into a three-bedroom house with a two-car garage. About one-fifth the size of Atlanta, this city was still fourteen times larger than where I returned to report for HANC duties. As a HANC I am my mother’s Housekeeper, Activities director, Nutritionist and Caregiver.

Chef

Much of what I’ve done has been typical for a homemaker or a HANC. Cooking, cleaning, stimulating conversation; memory work; driving to appointments, refilling prescriptions, answering the telephone and coordinating with family and friends who want to visit; these are all things that for more than a decade, I have resolutely eschewed.

Why am I now thinking of sewing myself an apron?

World Book encyclopedias

I have fought to be atypical in all my endeavors. I never thought I was superior, yet I felt somehow different from others. One sister has called me the family dictionary for ages. A friend told me my knowledge is encyclopedic. A co-worker nicknamed me the breathing style guide. An employer thought I had moved to South Carolina from Chicago or Manhattan, because of my demeanor and lack of strong southern dialect. No wonder I sought to escape my small town.

            Yet, here I am.

Award

Thomas Wolfe wrote,

You can’t go back home to your family, back home to your childhood … back home to a young man’s dreams of glory and of fame … back home to places in the country, back home to the old forms and systems of things which once seemed everlasting but which are changing all the time – back home to the escapes of Time and Memory.”

    Yet, here I am.

I left my little house in the country for one of the largest cities in the U.S.A.

NAMPA AWARD   The whole enchilada

 

 

 

 

 

 

Filtered by my environment, I’ve lived my dreams of writing and editing.I am pleased that I seem to have achieved some level of glory and fame. I have no desire to escape time or memory. In fact, my mother’s fading memory is one of the things I hope to help her preserve. As Alzheimer’s begins to scar the surface of her recollections, I went back home, to my family, but not to my childhood.

place setting

I miss the culinary delights that are typically found in large cities, the hidden spots frequented on rare and special occasions. I do miss my friends, the bonds forged while working on our individual novels and short stories or as we groused about deadlines or unmet expectations. I miss my infrequent lunch and after-hours buddies.

Photo outing

I will have to find new photography field trippers and cultural outlets. Now, instead of one or two grandmothers, I am surrounded by them within my own family and it feels different. Good, but different.

house in the woods

I did not return to the Little House in the Country  as a child, seeking anything but peace of mind. For myself, primarily, as I ached every time I had to leave my mother, knowing her health declined daily. For my mother, secondarily, because in order for me to have peace of mind, I needed to provide her with a level of care and companionship that might ultimately improve her condition somewhat.

children in summer

I did not consider that I would provide peace of mind to my large family, but I have. Each one has conveyed in his or her own way how grateful they are to know that our mother is no longer alone.

I tend to act quickly to situations. I try to be prepared enough that I don’t overreact, but at times, I don’t work out all the scenarios. I had not considered how my transition to HANC-dom would impact others in the family. I just knew I had no option but to go home.

House in the country

My parents built The Little House in the Country and we moved into it when I was in the sixth grade. I was over-dramatic when I thought I would never see my best friends again. I thought I hated the new house and who could blame me?

two missing

I have four brothers and three sisters. The house had four tiny bedrooms. Now, it has two! The day we moved in, the house was “dried-in,” which means it had a sub-floor, four exterior walls, a roof and studs for interior walls. The electricity had been turned on and the plumbing was installed. There were no walls or doors inside the house. We had no privacy so my mother stapled sheets to the studs around the bathroom. Little by little, cardboard walls were also then stapled to the other rooms. As time and money allowed, sheet-rock was installed.

Worden parents

My mother told me she had moved frequently once she married my father and when they moved into the newly-built, but unfinished house, she told him,

“This is the last time I am moving. If you want to live somewhere else, you will have to do it without me. I am not leaving this house until I am dead.”

            She has “made do” with whatever she could and has improved The Little House in the Country as much as she has been able.

flowers

Now, it’s my turn. The city girl has come home to her roots and I rejoice when I find grubs or red wrigglers in my compost bin! A recent trip to buy a simple piece of hardware turned into a field trip for me, when I started setting potted plants and hanging baskets into the shopping cart. My urban-bred husband shook his head and waited.

outdoor flowers

I spent hours arranging and repotting dahlias and mums near the mailbox and I fretted over which soil to use for the rosemary and pepper.

rural house

I traded in my small country home for an equally small apartment in a thriving metropolis that was later traded for a spacious home in the suburbs and I pursued my career as city editor. Returning to my roots, I have swapped all I held dear for what is most precious to me. With that, came The Little House in the Country.

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Labels? Who needs Labels?

     Not long after we moved in, I woke at 5 a.m. to the sounds of gagging and rushed to my mother’s bedside.clock        When I spoke with my local sisters, I was told that she has been doing this for years. About every three or four months, she becomes intensely nauseated and must be monitored for dehydration.

Jane, my oldest sister, said, “The doctor can’t find any reason for this. He said, if she insists, he will put a scope down her throat and see if he can find anything. I got scoped and they found I have a hiatal hernia, but there is nothing they can do about that.”

We agreed it would be worse for our 85-year-old mother if we forced a scope down her throat and they found something but there was nothing they could do for it.

Elderly woman

         It’s bad enough to be a parent and have to sit by while your child is suffering, but when the one who wiped your nose is ill, the feelings shift to a different level.

     Not long ago I called her for relationship advice. I’ve always sought her advice on things related to parenting, cooking, sewing and so many other topics.  If I  called her when I felt ill, she always had homespun advice.

     Scrape an apple for diarrhea, eat a spoon full of sugar for hiccups.

An apple a day

Drink a cold glass of water with baking soda for digestive disorders.

cold water

Give the other person space.

I need my space

She was always right, too. So, when she called my name in distress and looked to me for help, I traded in my HANC hat for a nurse’s and became the caregiver.

What is the proper first-aid to administer to your mother when she is throwing up?

First Aid Station

When my children were sick, I kissed their foreheads and wrists to check for a fever. I rubbed their backs to ease congestion and relax them.  Today, I held the pink, plastic hospital pan under Momma’s chin and waited. I had a cool, wet washcloth ready and stroked her cheek when she thought she’d finished, but I wanted to do so much more.

While she napped fretfully, I emailed my brothers and sisters a quick update.

cup of trea or coffee

My brother, Joe, who lives next door, came over for coffee at 8, but before he could finish his first cup, I had to return to Momma’s room for another round.

over the counter medications

I couldn’t go back to sleep and I dared not make much noise, so I wondered what I might find in her large medicine cabinet of ingredients with names I cannot pronounce that might bring her relief, should she vomit a third time and I wondered why she was sick.

My sister, Bernie, suggested Benadryl might ease Momma’s upset stomach. “It can’t hurt her.”

doctor prescribed medications

      I wasn’t certain, so I checked her shelves that are stocked with over-the-counter and prescription medications as well as with herbal and folk remedies. I found one Jane had marked with a sharpie: Nausea. I was relieved to see it could be taken sublingually.

memory patvch

Along with her Exelon patch for “mild to moderate Alzheimer’s disease” and her daily and nightly prescriptions for various other age-related issues are two other prescription bottles. One is an antibiotic she must take prior to certain dental procedures and the other is the prescription for nausea. When I moved in, with Jane’s approval, I discarded the prescriptions she no longer takes, since they had all expired.

Nearly an hour after her second episode, and moments before I found the prescription, she vomited a third time. After she calmed from that, she placed the small pill under her tongue where it dissolved and was absorbed into her bloodstream and again, she napped. Another hour later, she woke up, still queasy, but stronger and thirsty.

label

My friend, Turner, suggested her problem could be a side effect of her blood thinner. She’s such a smart woman!

 I discovered some interesting things about the rat poison doctors have prescribed for my mother.

warning label

Warfarin side effects that require immediate medical attention are:

  • Severe bleeding (This is why we have to guard against injuries and bruising, which could disguise internal bleeding.)
  • Black stool or bleeding from the rectum
  • Skin conditions such as hives, a rash or itching (This is a problem she’s had once since I moved in with her. Now, when I see unexplained whelps and rashes, I will know it’s not a spider bite or allergic reaction, but a side effect to her medicine.)
  •  Swelling of the face, throat, mouth, legs, feet or hands (only once, her left knee was swollen)
  •  Bruising that comes about without an injury you remember (We tend to recall every time she bumps herself and we always watch for easy bruising to follow.)
  • Chest pain or pressure (This occurred today, with the vomiting.)
  • Nausea or vomiting (This seems to be under control, but she is still very weak.)
  • Fever or flu-like symptoms (Once, before today, I thought she had a fever, but the thermometer did not indicate an elevated body temperature.)
  • Joint or muscle aches (She constantly complains of pain in her knee and other areas, so she takes an OTC pain pill.)
  • Diarrhea
  • Difficulty moving (Some days are much worse than others)
  • Numbness or tingling in any part of your body (she has recently complained that her hands are falling asleep.)
  • Painful erection lasting four hours or longer (at least I don’t have to worry about this one!)

Although rare, warfarin can also cause skin tissue death (necrosis) and gangrene requiring amputation. This complication most often happens three to eight days after you start taking warfarin. If you notice any sores, changes in skin color or temperature, or severe pain on your skin, notify your doctor immediately.

Less serious warfarin side effects to tell your doctor about:

  • Fatigue (Some days, she complains that she is just feeling lazy. I wonder. . .)
  • Gas (I thought this was just my cooking.)
  • Feeling cold (She complains of feeling cold, even on the hottest days and did not want us to buy a new air conditioner because she liked the heat.)
  • Pale skin (This is something we can blame on our family tree.)
  • Changes in the way foods taste (Ah, so, now things are beginning to make sense. She was prescribed to take Warfarin; a side effect of Warfarin is that food tastes differently and sometimes it doesn’t appeal at all, therefore, her “appetite” is considered down and voila! another prescription is written for an appetite stimulant…oh, the western medicine plot thickens.)
  • Hair loss (Only her hairdresser knows for sure.)

check these symptoms

     I have since checked all her medications to see what other side effects might present problems. Maybe I can keep my HANC hat on longer and avoid the nurse/caregiver hat in the future.

     Twelve hours after the first sound of discomfort, Momma was weak, but no longer vomiting. She didn’t have much to eat or drink, but I kept offering ginger ale and water.

     We may not like reading the warning labels, but they can certainly help understand why those in our care suddenly start displaying strange symptoms.

 

     Labels! We DO need those stinking warning labels!

Boy hugs space man

 

 

 

     I’ve noticed a tendency toward stomach upsets when she worries – especially about finances. Her life has been turned around since we moved in. Although she appreciates our help, she can’t deny we’ve changed things in her world and in her routines. The changes, while good, can still be stressful and stress causes all sorts of dis-ease.

 

     Maybe she needs to hug a space man or maybe she needs a little space, of her own. It can’t be easy to suddenly have the noise and activity of a family after so many years of solitude.

 

 

 

 

 

 

 

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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