Do You See What I See?

The vast majority of my mom's problems are physical, not mental. She does suffer from depression and anxiety, but not dementia in the way that Alzheimer's patients do. One of the things we associate with aging is declining vision. My mother's macular degeneration has advanced to the point where her distance vision is a nebulous thing, and seeing things up close is nearly impossible. Unfortunately, that includes her food. 

We have many eating aids, which I will discuss in another entry, but one very simple thing that helps is increasing contrast. Years ago my husband and I were gifted with Fiesta Ware dishes, four place setting that are white and four that are cobalt blue. My husband has always had an affinity for the white plates, saying that he like being able to see the food more clearly. As my mother's vision got worse, I realized that it was a big help to her if her food contrasted with the dish. So, when she eats something light in color, such as her favorite deviled egg or chicken, I use a dark blue plate. When the food is dark, like meatloaf or carrots, I use a white plate. It is a very simple thing, but it helps her greatly. If you are not lucky enough to have dishes that contrast, the dollar store or a flea market can be a treasure trove. And, the Fiesta factory has an outlet where you can buy individual pieces. 

Glassware can be another problem area. Some glasses and coffee mugs are heavier than a healthy strong person would notice. We have a collection of insulated plastic glasses, some with lids and a straw so that they can travel to the bedroom while she watches tv. Choose a mug or cup that is thinner, therefore lighter, and that has a larger handle rather than a very small loop. Small things, but ones that can make a big difference. 

What Goes in Must Come Out

I believe that whoever it was who invented adult disposable underwear deserves a Nobel Prize. Why? As the popular children's book says, "Everybody Poops." More about underwear later.

I mentioned that when she lived in her house, my mom had to use an adult potty chair because she could not navigate the stairs to the bathroom. Because of her heart condition, she takes diuretics in the morning. Her condition is fairly serious, so the dosage is somewhat high. Her routine has been to take her medications about 8:00 or 8:30 in the morning, then stay in bed, drowsing or watching tv and getting up to pee. Sometimes as many as ten times in a few hours.

The drug has its effects over about three hours, and my mom has always valued sleeping in, so this works out. When she moved in with us, I assumed that having a full bathroom on the first floor would eliminate the need for me to have to dump and clean the potty bucket every day. What I failed to take into account is that her room and the bathroom are at opposite ends of the house. There simply is no way with her current lack of mobility for her to make it there in time. So we are still using the potty.

The first thing I want to say about that is that the chemicals used to eliminate the odor really do work. We had experience with them from having a camping trailer and also from when we took care of my grandmother. My mom had a friend who stayed with her son and his family after a hospitalization, and they used a potty for a while. Her son or his wife would jump up and empty it every time she used it even in the middle of the night. Not necessary.

There are several versions and brands of this product on the market, some better or more convenient than others. I will often be talking about products by their brand names, mostly because sometimes it matters. In the late eighties, when my Granny was with us, the stuff we put in the potty was bright cobalt blue. It worked really well, but when the unthinkable happened (the potty got knocked over once), we had to deal with not only a messy situation, but the stain.

We have found that the best place to shop for this stuff is in the camping department of big box stores. Though I normall don't shop at Walmart for philosophical reasons, I have found them to be the best source of the stuff. We usually buy Coleman, but there are other brands. They come in a 16 oz. bottle, they are either clear or very pale green, they are about $5 a bottle and they work really well. They are sometimes hard to find during the off-season for camping, so we always stock up. They can also be bought online.

I empty the potty bucket carefully into the toilet and rinse by using the bathtub spout. Some hot water to rinse, add a squirt of Lysol (I keep it in my mom's bathroom in a small dish liquid bottle) swirl gently and pour it into the toilet and flush. I then put about an inch of water into the bucket. To that, I add about an ounce of the holding tank deodorant, as it is called. I don't measure it, I just pour a bit in. It is really miraculous how it works. The chemicals can't be good for the planet, but sometimes, as environmentally conscious as I am, all bets are off.

I don't mean this to be graphic or overly-elemental, but I have been surprised by the number of people who have had difficulty dealing with this situation. As a friend once pointed out, "After a certain age, it becomes all about bodily functions." Sadly true.

Where the potty is located in the room has varied depending on my mother's condition, but right now it sits a few steps away from her bed. Coincidentally, it is where I sit to watch hockey games with her. I recommend putting it against a wall or a solidly placed piece of furniture to avoid it tipping in case of the using losing his or her balance.

The potty chairs can be adjusted for height, usually by a series of slots on the legs. They do break down completely, and we have even taken them apart to take on trips. I recommend taking pictures as you go to make sure you can put the chair back together.

Mom Needs Help

Mom needs help.

So often, that is how this conversation begins. Five years and one week ago, following knee replacement surgery, my mother moved in with me and my husband to recover. To be honest, we were hoping it would lead to her wanting to stay here, as taking care of our own household plus hers was wearing on us.

We didn't know that day that her already-sketchy health would practically implode, and that she would not only stay but need rather concentrated care for all of this time. Let me back up to tell that story first.

On November 3, 2011 we went to the cardiologist and the pulmonary specialist to have my mom cleared for a knee replacement she desperately needed. She has both Congestive Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD), so her ability to withstand anesthetic had to be confirmed. She had all the pre-op blood work done, the doctors agreed that sedation (twilight sleep) without a general anesthetic would be best and we went home happy that she would finally be more mobile. In recent years, we had had to move her bed to her first floor because of her difficulty making the stairs.

This move necessitated using an adult potty chair, since the only bathrooms are on the second floor and in the basement. That meant that each day when I came home from my teaching job, I would stop and empty the potty bucket and mom would get into my car and join me and my husband for dinner. Then, I would accompany her down the street (she could walk downhill more easily than uphill because of her breathing problems), and I would make sure she got safely into bed for the night with her night medications close by. But I digress.

On November 30, 2011 she had the knee replacement and all was well. After rehab that assured she could do a limited number of stairs, we picked her up on December 5 and she settled into the small room on our first floor that we had converted from our office to a bedroom for her. I had retired from teaching the previous spring and my husband was still teaching, so my routine was now full-time caring.

Two weeks later, when I came downstairs to give her morning medication and start my day, she was coughing. She said that she had been coughing all night and felt too week to sit up and have her breakfast with her pills. I called her PCP who advised taking her to the ER. I can't remember how we got her there, whether in our car or by ambulance, but she was admitted and found to have pneumonia. At one point, one of the cardiology associates said to me, "We can't figure out why, because she says there was no incident, but she seems to have lost about one-third of her heart function."

I didn't know when, but I knew there had to have been an incident. She was always one to downplay things like this. A stern look at her, and she caved. "One night I had really bad chest pains," she admitted. "Why didn't you tell me?" I practically yelled. "Well, I couldn't really talk or move." Okay, fair.

A bit of probing and she admitted that this had happened back in November, sometime between the pre-op testing and the surgery. She hadn't told us because she knew that they would not do the surgery, and she wanted the knee because walking had become so painful. So, an 85-year-old woman with multiple health problems and compromised mobility had had a heart attack, major surgery and pneumonia within one month. And in that order. Great.

Needless to say, her recovery was slow. Therapists and nurses came to the house. We struggled to figure out how to make all this work. And we were convinced that she would not last that winter.

Five years later, we have all taken a deep breath. She celebrated her 90th birthday this past July, and we have a routine that works for us. Most of the time. Her care is somewhat intense. She can't get dressed by herself, can't get even a drink for herself, but still manages to get through each day with as positive an outlook as she can manage.

We have learned enough about how to adapt our home and our routine to fill an encyclopedia. It is a problem-solving extravaganza that has been an eye-opener to our aging friends. And it has occurred to me that I should probably share some of the things I have learned so that they can help others.

I would stress, my mom does not have dementia. Her problems are most physical (she does suffer from depression and anxiety). Her big issues are mobility and dexterity. We have learned how to adapt our lives and our home to accommodate these problems. I am hoping we can help others solve similar problems.