Saturday, April 28, 2012

Friends in high places

It helps to have friends in high places.

Friday afternoon, I went with my daughter to visit my dad and as we were walking in, I held my breath, said a silent prayer that this visit would go well, and let my breath out again. As usual, I wasn't looking forward to it. It is painful to watch my dad in the condition he is now--lethargic, unable to walk on his own, and barely able to communicate. And he recently had yet another fall, leaving a nice bump on the back of his head. Thankfully, no concussion.

As we approached the main entry to the assisted living facility, there was an unusually large group of non-Alzheimer's residents sitting outside in rocking chairs. They all smiled as they saw my daughter and greeted her, reaching out to touch her. I wasn't in the mood to greet anyone as my thoughts were on my dad, but I made myself smile and greet them briefly as we walked by.

Once inside and signed in, outwardly I was smiling and greeting the employees and residents there, but inwardly the human part of me was screaming, because I didn't want to be there. I didn't want my dad to be there. I wanted him back in his cozy home, so I could sit with him in his living room, and have a normal conversation with him again.

We found him in the dining area again, in a new wheelchair this time, sitting at a table with another resident, a set of play tools set out before them. My dad was simply looking down at his hands, which were trembling. He seemed to recognize me this time, or at least gave the impression that he did. But his gaze kept going downward to his hands again, where it stayed for most of our visit. My daughter began playing with the tools, and I put my arm around my dad's shoulders and asked how he was feeling. He didn't understand the question the first couple of times, but then finally understood and replied with something resembling, "Pretty good."

Then I noticed he kept doing something with his hands in relation to the long sleeve shirt he was wearing, and figured out that he must have been warm and wanted to take the shirt off, so--seeing that he had another shirt on under that--I helped him take it off, which was quite the feat since he wasn't sure what to do with his arms. It was then that I realized that the shirt underneath that one was also long-sleeve, and a thick one at that. Under that, he also had an undershirt on. No wonder he was warm, even with his tendency to get cold easily. Outside, the temperature was in 80s, and the air conditioner was only doing so much to help.

Not long after that, he began trying to take off the second shirt, so I helped him take it off, which left him in just his undershirt, but then he was too cold, so he wanted to put the long-sleeve shirt back on. So I helped him get it back on, then it wasn't long before he was trying to take it off again. This time, he was trying to pull it over his head without unbuttoning it. After no success at trying to gently convince him not to take it off again, I figured a distraction was in order, so I gathered my daughter and we took my dad for a ride. This time, he had nice leg and foot rests, thanks to the new wheelchair.

One long wheelchair ride later (including a trip outside to the courtyard area), I went to look for someone to help me transfer him to an easy chair, and that was when I saw a friend. A friend who used to work for my dad many years ago, and who had worked as a sitter for my dad recently after he had just come out of the hospital. A friend who looked to be working as an employee there now. And indeed, she was! I was thrilled. I knew her to be a very detail-oriented type person who was good with the elderly, and had been good with my dad when she was his sitter. She would notice the little things that a resident might need. This was an answer to prayer.

My friend came to help me get my dad into the easy chair, but just as we were about to take him out of the wheelchair, the fire alarm went off. It was very loud. Both my daughter and I had to cover our ears. This was my chance to see if they would wait to evacuate the residents in that unit, or do it right away. A family member of another resident had told me during our last visit that they had waited to find out if it was just a drill first, and it had concerned me. Then I saw my friend jumping into action, coordinating with the other employees on shift in that unit, and everyone was evacuated immediately. So I had my answer. Either the woman the other day had her information wrong, or something had changed.

I was impressed with how quickly they managed to get all of those residents out. They only had a couple of glitches, which were quickly worked out. I wheeled my dad out myself, with my daughter by my side. They lined all the wheelchair residents up in a row along the sidewalk, and had the non-wheelchair residents sitting on benches or standing alongside them. Once they were all out, one of the employees did a roll call by visually checking to see if all the residents were there and checking them off with her pen.

Only one resident was combative, a woman, who kept trying to go back inside. An employee blocked her, body to body, linebacker style, saying a firm, "No!" It was the same employee who was doing the roll call. It was almost humorous to watch. Finally, after the persistent woman wouldn't give up and the employee was tired of playing linebacker, the employee took her firmly by the arm and took her for a walk down the sidewalk. Being a large woman can have its advantages.

When the fire drill was over, everyone was taken back in and things went back to normal. We left with my dad settled in comfortably in an easy chair. I will rest easier now in-between visits, knowing that my dad has a friend in his corner now who will have a personal interest in his care, and that when the fire alarm goes off, he--along with all the other residents in that unit--will be evacuated immediately.

Thursday, April 19, 2012

Tuesday's visit, and my concerns about elderly care

Tuesday afternoon, I went with my daughter to visit my dad at the assisted living home. When we arrived at about 1:00, he was sitting in the dining room area at a table alone, with a slice of Boston creme cake sitting on a plate in front of him. He was just sitting there, staring at the slice of cake. This was something I had not ever seen him do before. As much as my dad loves food, and especially sweets (and I say that in a very affectionate way because he is not overweight), it struck me that he was not immediately digging in. And I wondered: Why had none of the workers there noticed and tried to help him?

We said our hellos and gave hugs, sitting down at the table with him. I then asked if he wanted some cake and picked up his fork and put it in his hand for him, pushing the plate closer to him. At that moment it was like a light bulb went on, and he began to eat, just like any normal person would. One of the workers there then offered my daughter a slice of the cake, which was nice, and she was all too happy to accept. Personally, I passed on the offer, since I had had a Coke with my lunch. Then I noticed that my dad didn't have anything to drink with his cake. This did not make me too happy, since I knew he had been sitting there for awhile with the cake, and as I looked around, none of the workers were making the slightest move in the direction of bringing him a cup of water. I was not angry, just a little perturbed, because it wasn't the first time it had happened.

I said, "He needs some water," to anyone who might hear it and got up and went to get a cup of water from the water cooler using one of the cafeteria type cups they normally have available there, but found none.

One of the workers noticed I was looking around and said, "Do you need something?"
"Yes, he needs some water, but there are no cups," I said as pleasantly as I could.

She was happy to oblige, maybe realizing at that point that they had forgotten to give him something to drink, and went to look for one. To my surprise, they had trouble finding one. Finally, they found a cup and brought it over and gave it to me so that I could fill it with water, but couldn't find a second one for my daughter, so they came up with a Styrofoam cup for her to use. I was surprised that they didn't have more cups available. Sufficient funds surely cannot be an issue. It is quite expensive for a resident to live there. 

I guess the thing that concerns me is that there seems to be a general lack of attentiveness to the residents there. The lack of a drink is just one of many things I've noticed during my many visits there. Other times it's been a resident in a wheelchair crying out for help repeatedly but being ignored (I think I mentioned that incident in a previous blog post), or any number of other things. Many of the residents, including my dad for much of the time now, cannot communicate their needs properly. They have to have someone looking out for them. To "assist" them in having their daily, even hourly, needs met.

Another example that has concerned me greatly is that when the alarm in a resident's room or one of the bathrooms goes off, it is ignored. Not once have I seen an employee pay attention to an alarm when it goes off, or if they do, it is only after several minutes.

The very first time I heard one of those alarms going off was when I was waiting to use the public restroom in the hallway near the main entrance. There was an office near there, and I could hear the beeping sound with a computerized voice repeating every few seconds, "Emergency, emergency. Bathroom One." There was no-one in that office at the time, so I went and found a worker and alerted her to it, thinking that an elderly person might need help. Her reaction really surprised me. She stared at me with a blank look and said matter-of-factly, something like, "Yes, we're aware of it. We can hear it on our walkie talkies. We'll take care of it." She didn't even thank me. Then she went right back to what she was doing and continued to ignore it.

I walked away scratching my head, and finally came to the conclusion that maybe they knew something I didn't. Maybe residents accidentally pulled the string all the time. But I couldn't help but wonder what would happen if there was ever a real emergency.

Then on Tuesday's visit, while we were in the activity room with my dad, there was an alarm going off again, and this time the computerized voice was giving the name of the resident and the room number. It went off several times, with pauses in-between. Then it went silent, so I assumed it was taken care of. But a couple of minutes later, it went off again. A family member of another resident there and I exchanged glances and were concerned that whoever was needing help wasn't getting helped. I was just about to get up and go tell someone when I finally heard one of the workers yell at the top of her lungs to another worker: "(Name of worker), can you go check on Mrs. (name of resident)! Her alarm is going off."

The family member and I looked at each other again and she looked thoughtful for a minute and then told me that the other day, one of the residents had pulled the fire alarm and they evacuated everyone. Then she said, "But they didn't evacuate the residents in this area." (Meaning the Alzheimer's/Dementia Unit.)

I wasn't sure I heard her correctly. "What? They didn't evacuate the residents here?"
"No," she said. "They wanted to wait to make sure it was a real fire first before evacuating these residents."

My first thought was that they considered these residents less important. But then I thought that maybe they were concerned because these residents tend to want to wander off or get confused and combative.

Yet, it still bothered me. They could very easily take them all out into the courtyard area that was fenced in with a high fence. At least that would be better than being inside the building if there was a real fire with smoke. They would need the extra time to get them all out.

I can't help but wonder if the elderly, especially those with Alzheimer's or Dementia, are being treated with the attention and respect they deserve. I am sure that in most cases, it is not intended. We all can get immune to things after awhile if we aren't careful... alarms going off all the time, the constant needs of needy people, etc. But we need to be careful. They are people, with real needs, and they need to be taken care of and paid attention to.

I also wonder: Do people tend to care less about the elderly in general?

If so, I hope to change that by bringing it to the attention of as many people as possible. And it also just reinforces my desire to make enough money to one day open up my own assisted living home and make sure the residents there are well-taken care of, and never, ever, ignored.

Back to the visit with my dad, he is now having to use a wheelchair exclusively, and has been for some time. Funny, that particular wheelchair doesn't have the big wheels on the sides, only a set of four smaller ones, so he can't wheel himself around, and no foot rests, either. Apparently, it was the only wheelchair available at the time and my step mom has a better one ordered.

The recent change in his medication seems to have solved the issue with him wanting to use the restroom anywhere and everywhere and he seems much calmer; however, he is also much more sluggish and slow now, and doesn't make much eye contact at all. Getting him in and out of the wheelchair is quite the task, too, as he will say he's ready to get up, but then doesn't seem to understand how to bend his legs to do so, and won't try to get up until after several prompts. I guess it's either a choice between high agitation and inappropriate behavior, and a calmer demeanor and sluggishness.

My daughter wanted to wheel him around herself, but I had to insist on having her "help" me instead. We took him for a ride outside and visited there for awhile, and my daughter once again gave him flowers, which he smiled at and said, "Thank you." After a few minutes, he managed to say that he needed to go to the bathroom, so we took him after getting a worker to help, and after that took him for a ride around the facility. When I passed by the exit door, I can't tell you how tempting it was to just wheel him right out of there and to my van, but instead, I reluctantly turned and went into the activity room/resting area, figuring he might be ready for a nap.

First, I took him to a wing back chair and asked if he wanted to sit in it, to which he responded, "Yes. That would be good." (I am amazed by how well he can respond at times.) However, instead of getting out of the wheelchair, he just kept putting his feet up in the wing back chair. Finally, I moved him from there and took him over to an easy chair and after getting him in it, discovered that it had a broken foot rest, so a worker helped me get him back out of that one and into one with a working foot rest, which was no easy task.

I got him nice and settled in the easy chair with his feet up, and that's when my step mom came in for a visit. It was so good to see her, as we had not seen her for a couple of weeks. She checked his feet, which--I discovered--had been swollen, causing his toes to rub up against his sandals. She had brought antiseptic spray and sprayed his toes, which he winced at and complained, in his own way, that it bothered him. I can see why, too, as he had broken skin there, so she blew on them to cool the sting, then applied band-aids and put his socks and sandals back on.

When it was time for my daughter and I to leave, I leaned down to make eye contact with my dad to tell him we had to go, and he protested and said, "Noooo." I laughed and hugged him and said, "I know, I know. We'll be back, though."

He didn't hug us in response, but that was okay, I figured it was the medication and that he was probably hugging us back on the inside.

Tuesday, April 10, 2012

A singing child can do wonders

Yesterday I took my daughter to school, thinking it was the day to return from Spring Break, and felt like a big doofus when I discovered that it was a Teacher Planning day. At least I felt better that there were also other parents there trying to drop off their kids. Apparently we completely overlooked the extra line at the bottom of the class newsletter: "April 9th - VPK Holiday."

So I decided to just take her with me when I went to see my dad, not knowing what I would find with the newest developments in his behavior. I prayed silently on the way there that the visit would go well.

And it did.

A nurse had dropped in to change some bandages on some of the residents, including my dad, who had some skin tears on his arm. She and I got to talking about Easter, and I found out she was also a minister. I took her aside for a moment and asked her to pray for something specific for my dad and explained his history as the son of a Baptist preacher. She then prompted my daughter to sing songs to my dad, the first of which was "Jesus Loves Me," which the nurse and I sang along with her, and at one point we switched from singing, "Jesus loves me," to "Yes, Jesus loves you," directed to my dad. Prior to that, he was only looking down and not making eye contact with us at all, even when the nurse urged him to say Hello to us. As we began to sing, he slowly looked up at my daughter, who was standing directly in front of him, and his face lit up and he even began to smile a little.

What a relief to see my dad go from looking forlorn and hopeless, to happy and hopeful again. My daughter and the nurse then sang a couple more songs, and for the rest of our visit with him, he was much more responsive and lively. Then we guided him to the dining area, where I took out the Resee's chocolate Easter egg I had bought for him, as well as two other Resee's eggs so that my daughter and I could eat one with him. He didn't say a word, but his facial expression said it all as he enjoyed eating it and gave us a little smile.

It was so good to see him, and I was very thankful for such a nice visit.

Sunday, April 1, 2012

No visit this past week and not-so-pleasant update from step mom.

I haven't been able to visit my dad this past week due to my daughter being sick with Walking Pneumonia (which she is now just about over), but received an update from my step mom of two incidents, one where he reacted to one of the workers there and wound up knocking her down, another where he was relieving himself anywhere and everywhere BUT the bathroom, so finally they had a meeting to try and figure out what to do and decided he would need overalls with the front zipper sewn shut so that when they saw him looking like he needed to go, they could have enough time to get him to the bathroom.

It was hard to hear about both incidents, as they are so far from anything my dad would ever do in his right mind, and I feel so badly for the worker who got hit and knocked down. Once again, though, I lift this up to the Good Lord and put it in His hands, and continue to pray.

This week my daughter is off from school for Spring Break, so I will try to go and visit one day later in the week to allow for ample time to make sure that I have not contracted my daughter's pneumonia.