Grandma is gone

My grandmother passed away early on Wednesday morning.

She was born in Italy, raised in Wisconsin and moved to Raleigh to be near my mother when my grandfather was ill. After 16 years in Raleigh, she moved to Atlanta this year. I am so sorry that she suffered at all. I am glad that she was not in the hospital for months and months. Even ten days was too long.

A memorial service is being held for her in Milwaukee on Monday. My grandfather held a position at St. Therese where the service will be held and both of my uncles were alter boys at that church.

I'm at a loss for words. I don't know what else to say.

The photo here was take in 2003. It's one of my favorite pictures of her.

Her obituary from the Milwaukee Journal Sentinel.

Grandma's hospitalization

I hesitated to write about this but thought that I should since I have written about Grandma quite a bit.

On Sunday night, my grandmother had a massive heart attack and stroke. The nursing home had her transported to the hospital immediately where they tried to perform a catheterisation on her heart. They were unable to perform the procedure and it is not clear to me if her condition deteriorated at that point or it was the calcium blockage or a combination of the two.

They found that Grandma has a calcium blockage and explained that her heart has been working hard for a long time to force blood through the aorta; however since the heart attack as weakened the heart muscle by 35 – 45% it is no longer able to provide the volume of blood required to overcome the blockage.

In addition, she is being treated for a lung infection which may have been caused by vomiting during her heart attack. Apparently this is very common.

There also appears to be some internal bleeding as her hemoglobin level has dropped to 8.

Today they were able to start removing the respirator which is progress. Yesterday, her resting heart rate climbed to 154 when they tried to remove the respirator and they had to heavily sedate her.

The neurologist determined that she had suffered a stroke in the right side of her brain which is impacting her ability to move her left extremities. They were unable to get her to move her left arm but they got some movement on her left foot. Of course, the major issue at this point is her heart.

My aunt if flying to Atlanta from Paris. She will arrive tonight.

Please keep my grandmother in your thoughts.

Grandma gets a move on

At the beginning of the month, my mother hosted a Family Meeting in which The Siblings all visited with Grandma to help determine where she will live once she is discharged from The Oaks where she has participated in a rehab program to help her recover from a broken hip. Nothing was determined at the meeting. The four siblings came up with a 2-2 tie. Two were in favor of independent living and two in favor of assisted living.

My parents kept on coming back to the two Sunrise Senior communities in Raleigh. My uncle in Atlanta offered that Grandma could move there. His mother-in-law is currently at Sunrise at Ivey Ridge near his home. After thinking about it for several days and getting input from The Oaks that assisted living is really where Grandma belongs, Grandma has decided to move to Atlanta. I think that her feeling is at least she will know someone there. Never mind the fact that the two grandmas have only met a very few times! Grandma has reservations for a studio unit which is similar to an Embassy Suites in terms of layout.

Since making the decision to relocate to Atlanta, Grandma has been kind of cranky. I'm sure that it's partly nerves. One example of said crankiness was on Mother's Day. The Oaks hosted a Mother's Tea and my mom joined Grandma there. There were flowers everywhere and all of the mothers got a corsage. Grandma like the corsage! Then they had some games like who has the most children, who has the most grandchildren and so on. Grandma had the third most grandchildren (seven) and she won a prize -- a gift basket of lotions from The Body Shop. She turned to my mother and grumbled, "What's and Old Lady going to to with these lotions?"

sigh

Grandma has lived in Raleigh for about sixteen years. Moving Day is Monday, May 19. It will be quite a change for all of us when she moves.

Wow.

What a change.

The Siblings: A family meeting

My mother essentially called a family meeting to discuss the Grandma situation. They are on the fence about assisted living versus independent living. My aunt -- Mom's sister -- came in from overseas and my two uncles planned trips here at the same time. They are all visiting Grandma today and they are going to try to reach a consensus as to where she should live.

The situation is that Grandma is high functioning for an assisted living place and maybe a little low functioning for an independent living setup. Assisted living is considerably more expensive and on good days she would be fine in an independent living situation. The main independent living facility that is under consideration provides three meals a day and weekly housekeeping.

If Grandma lived in an independent living facility and her health deteriorated even slightly, she would have to be put on a waiting list for an assisted living place and the she would have to move again. There are no good options in the area that allow people to transition from independent living to assisted living to a nursing home while remaining in the same community or complex. Since these moves are can be it traumatic -- especially for elderly people -- no one wants to make the mistake of placing Grandma where she will have to be moved within a few months.

Then there is the money side of things. At some point in the next few years Grandma will run out of money and The Siblings are discussing that as well.

Grandma's progress

Yesterday a friend of mine asked for a progress report on my grandmother. Here it is!

Grandma is still at The Oaks but she is off restriction -- no longer in contact isolation because the MRSA infection is gone. The infection was a bit of a setback for her because she needed to see the surgeon that fixed her hip so that she can be cleared to put weight on it. The surgeon couldn't see her while she had the MRSA infection. That means that her physical therapy had two set backs. While she was in isolation, she had PT but in her room so it was limited and now she has one week longer before she can put weight on it. They are guessing that she should be walking about two weeks after that. This means three more weeks at The Oaks.

Where she goes from there is anyone's guess. My mom is thinking that Grandma needs an assisted living place rather than an independent living place like Abbotswood. This brings up a whole mess of issues like the fact that assisted living costs a lot more. The siblings will probably need to discuss the situation because of the cost and so on.

Grandma is feeling a whole lot better now that she is off the strong antibiotics. They weighed her when she moved into The Oaks and again on Tuesday. She lost 20 pounds during the two weeks she was on those medications.

Grandma at The Oaks

Grandma was transferred to The Oaks on Friday. The move was supposed to occur at lunchtime but there was some kind of transportation problem and she didn't arrive until after dinner time.

Since just after her hip was put back together, she had complained of problems and she was tested for a yeast infection on Thursday. It's a two day culture and the results came in on Saturday -- methicillin resistant Staphylococcus aureus, also known as MRSA staph infection. She's on some very heavy duty antibiotics for this and she is in isolation for two weeks. The Oaks moved her roommate out. She is on what they call "contact isolation" now that the doctors at The Oaks have seen her. At this time, it seems that the infection was caught relatively early is confined to her bladder.

The Oaks is just under 15 minutes from my workplace and I stopped in for a brief lunchtime visit with her yesterday. She was very tired and the antibiotics are making her nauseous but her color is much much better. It's a really nice looking place. The Oaks is only two years old and the whole place is carpeted. They have Nautilus in the gym that she will be using for rehab. It has fountains, a courtyard, a Starbucks (or maybe they "proudly server Starbucks coffee") and all the TVs are LCD. Fancy.

My mother was relieved to hear that one of the symptoms of MRSA is confusion. Hopefully MRSA was the issue all along and that it is not mini-strokes that my mother was worried about.

I will try to bring Hannah to visit Grandma when we have a nice day. I need to confirm that I can bring a dog up to the porch or courtyard for a visit. Hannah used to do therapy at Dorthea Dix and I can get her paperwork updated if necessary.

Meanwhile, Mom and Dad have rented a storage unit for Grandma's stuff. Grandma was scheduled to move from her apartment to a retirement community today. At this point, it looks like she may be headed to assisted living instead but we won't know for a while yet.

Emma visits Grandma

Last night, Emma and I visited Grandma at Rex Rehab. Grandma isn't a huge dog fan. She grew up on a farm in Wisconsin and to her dogs are outdoor creatures, not family members. She does tell the story of one of the farm dogs that would scratch at the back door to be let in at night, and yes, their training went well and the dog slept inside. Why bring a dog to visit someone who isn't a dog person? I brought Emma for two reasons:

• Change of scenery from Grandma. It was an excused to bring her outside on a beautiful spring day. It was about 70 degrees out and I wheeled her out to the front porch area and then went to the car to get Emma who made herself available for petting.
  
  
• The Other Grandma has a dog visit her. My Uncle Phil's family brings a dog to visit his mother-in-law who is in a nursing home after having not one but two hip fractures within a few weeks (she broke her wrist too). This way my Grandmother can report the Phil and his family that yes, in fact, a dog has visited her as well. Grandma will like that.

This was probably my last visit to Grandma at this facility. She is not progressing the way the staff had hoped and the social worker at Rex Rehab told my mother that Grandma is "on the fence" between needing assisted living or a nursing home.

My parents did a ton of research in a short period of time and selected a facility that will help her with rehab to get out of the wheelchair. Nursing homes do rehab but to keep from getting worse, not rehab to improve. Grandma is scheduled to move to The Oaks at Carolina, near the NC Farmer's Market, on Friday. My parents felt that this would give Grandma one more shot at getting to Abbotswood, the independent living retirement community that she had planning on moving into in April. With the broken hip and the need for 24 hour care, though, that move is on hold.

Grandma should be at The Oaks for at least a month.

Grandma's Easter weekend

This weekend we gave Grandma an Easter basket and took a few pictures when we saw her.

Grandma update, still in rehab

DH and I went and saw Grandma last night. She is still in the rehab facility recovering from her broken hip. She's had more bad days than good recently but we did manage to get her to smile a bit.

Grandma had complaints about the food -- cucumbers, pasta with asparagus, broccoli soup. She giggled when I pointed out the green theme and the fact that it was St. Patrick's Day.

She repeatedly said that one of the workers there was "flirting" with her. He brought in her evening snack of apple juice, graham crackers with peanut butter. Clearly flirting!

Of course she had nothing good to say about my aunt. My poor aunt can't do anything right. "She was going to call me every day but she didn't call..." We pointed out the time change but I doubt that it helped my aunt's case.

Grandma in rehab

No, not that kind of rehab! She was transferred from the hospital to a rehab center while she recovers from her broken hip. She's at Rex Rehabilitation and Nursing Care Center of Apex, which is pretty close to my house.

Since her fall last Friday, her health has been really up and down. On Saturday, she was super cranky and not making sense. My mom said that maybe she had a mini-stroke. On Sunday and Monday, though, Grandma is in a really good mood. Then Tuesday, not so good. She had a lot of visitors on Monday so maybe she was tired? Mom went over all of the medications with the nurses in the hospital and everything seemed to be in order, however, Grandma has a history of not taking her medications. Maybe there are some side effects that we weren't seeing earlier?

On Tuesday afternoon, Grandma was transferred to the nursing home for rehabilitation. They didn't have any beds in the rehab wing so she's in the nursing wing for a few days. Last night Mom was very worried and mentioned mini-strokes again and said that Grandma's speech was slurred which is new. We are hoping that once she is moved to the considerably livelier rehab wing, she will feel more herself.

Grandma's fall and her plans to move

The plan was for Grandma to move on April 1. We thought the problem was her plans to go to Atlanta for the week of Easter but it turns out that is not the issue at all.

On Friday Grandma fell. She was able to get to a phone to call my parents but my parents quickly determined that they could not move her and called 911. She was transported to a local hospital where they found that she broke her hip. The good news is that after rescheduling her surgery twice, they were able to get her in on Friday and she was admitted to the hospital where she will stay until Tuesday. Then she will be discharged to a nursing home for rehab. We are expecting her to be in rehab for a week or two.

While she was in the Emergency Room waiting for the surgery, they gave her several morphine injections. At one point, after her surgery was rescheduled for a second time, she turned to my mom and asked, "Do you think we should cancel?" Mom explained that canceling was probably not an option!

Later on, one of the nurses came in and another nurse commented to the first nurse, "Oh your pregnant!"

Grandma replied, "But I'm 88!"

When I saw Grandma today, she was in a good mood. Apparently that was not the case yesterday.

At this point, her move to to Abbotswood retirement home is still on. Instead of moving from her apartment to the retirement home, though, she will be moving from the nursing home. That means that my mom and dad are going to end up going through 16 years of stuff that she has accumulated since moving to Raleigh from Milwaukee. Since her apartment is more than twice the size of her rooms in the retirement home, this is be no small task. The apartment is packed to overflowing and that makes it even more difficult.

Grandma picks a new place

Grandma put down a deposit to be on the waiting list for a place at Abbotswood. She and Mom toured Abbotswood and Independence Village and went back to Abbotswood again a second time to see a room that had a patio or balcony.

Grandma has a bird feeder on the patio of her current apartment and she wanted to be able to have one in the retirement home as well. Mom was concerned that the door to the patio would take up more floor space than Grandma really wanted to give up so they toured a place with the patio to see what it was like. Apparently, she liked the patio unit a lot! Her first choice as first floor patio unit. Her lease is up May 1 and we are hoping to have her into her new place by mid-April.

The entry into this new stage of her life has been a long process. It's good to see her make this decision and brave of her to do it on her own.

Tying up loose ends

Celebrations: Birthday, Christmas, Dog Day Afternoon

Back in November, I wrote about my angst over the holidays, my birthday and my brother visiting from out of town. I selected Option 2 and went out to eat for my birthday. We had a nice time and I'd do that again.

We had or usual Christmas Eve gathering at my parents' house, with Darling Brother there and had Dog Christmas at my house on the 27th. DH and I had a pleasant enough time on Christmas Eve. The food and wine were both great. Grandma was scheduled to go to Atlanta for holiday but changed her plans at the last minute. DB was there, having arrived in town on earlier in the day.

DB had very little to say on Christmas Eve and acted as though we were interrupting his football watching. I was pleasantly surprised that he gave gifts. I do hope that he liked what we gave him but I may never find out.

Grandma sent a thank you note saying thanks for the gift. The cookies were good. I'm guessing that means that the digital photo frame was not a hit! Actually, I think that she'll like that more once she is in her new place.

That brings us to Dog Christmas. We've never brought Hannah or Emma to my parents' for Christmas Eve and since my folks have come over to my house for my birthday on the 25th, the dogs have given gifts (it started with bark...) and received gifts. Since we moved my birthday celebration and I still wanted to have people over, we called it Dog Christmas. My mom made some beautiful quilts for the dogs this year!

DB was invited as well and he was told that it was optional. He came and then was rude to the dogs! Shoving them aside and prompting me to call him on it, saying, "Don't shove them! They live here!" DB just made a face. I don't think that he said a complete sentence to anyone the entire "visit" and he had nothing to eat or drink. His body language indicated that he didn't want to be there and he made rude faces and gestures. Why on earth did he come? The only good thing that came out of that I was not the only one to notice this.

Grandma

As you may have guessed from Grandma's change of plans this holiday, she has not been feeling well. After her 911 call, emergency room visit and appointment with a surgeon, it was determined that she should be taking Metamucil. She eats whatever despite the fact that her diet hasn't been working for her. She continues to take her medicine in some random way, not as it was prescribed.

Christmas week, she said to my mom that she was ready to look at assisted living places first discussed back in June. Mom decided to strike while the iron was hot and they took a tour of Abbotswood. The tour went well and Grandma asked to see a second place, Independence Village. I'm not sure if she is on the waiting list for Abbotswood or not. She started talking about placing furniture in the apartment there...

That about ties up the loose ends from 2007.

Goals

I'm working on my goals for 2008. I'm making good progress on them but I may need to modify a few

• core, I saw the YogaFit stuff and was inspired
  working on core but haven't gotten the DVD and probably won't
• try mountain biking and hopefully get a bike (and use it!); got a mtb, using it
• English century; still looking, in fact, I'd love some suggestions for this. It may be that I work on climbing more -- enter the 3 Mountain Madness 75 and figure if I can climb Pilot...
  
• climb better. I feel that I was not a very good climber this year; working on it
• gain some speed; working on it
• stay healthy; working on it
• Tour de Cure in June, MS150 in September; entered TdC (MS150 registration isn't open yet)
  

Digital Grandma

On a brighter note, I've been putting together some photos for Grandma's Christmas gift. We're giving her a digital photo frame and I've been gathering some pictures to put on a memory card for her. We've noticed that she likes pictures of herself so a lot of them are of her!

Grandma's Saga continues...

When last I wrote, Grandma had eaten two servings of lasagna and feeling fine after a somewhat miraculous recovery.

Tuesday morning, however, she called 911 because The Pain was so bad. It was so bad that she did not call Mom, who is less than one mile away. Grandma was taken to the emergency room where a CT Scan revealed nothing new. Additional tests were preformed and she was referred to a surgeon after tests revealed an "abnormal bowel gas pattern" in her abdomen. She was went home with a stronger dose of the pain pills that she is taking intermittently. Tuesday afternoon, she called Mom to let her know about the eventful morning. Yesterday, Grandma was feeling fine and was in a good mood.

Grandma sees the surgeon next Tuesday.

I am wondering why she did this end run on Mom? Is she acting out or really in sick? I'd hate to think that she was really really sick and we not taking her seriously. It all reminds me a bit of The Boy Who Cried Wolf.

The whole situation makes me feel bad. I hate that my grandmother isn't feeling well -- whether it's a physical or emotional problem. I hate that my mother is having to deal with the fallout. I hate that the medical community sometimes confuses quantity of life with quality of life.

Grandma's episodic health issues

My 87-year-old grandmother's health-related episodes have a definitely pattern. The week before Thanksgiving, my mother said that she had until about a week after Thanksgiving before my grandmother's illnesses flared up. I don't know if it's nerves or attention getting or what.

My mother's prediction was off, but not by much. The Saturday after Thanksgiving, Grandma let Mom know that "the pain" was getting worse. I don't doubt that her pain is real but Grandma always refers to it as The Pain, sometimes causing DH to make Lost in Space references.

Mom: Are you taking your pain pills?

Grandma: Yes.

Mom: Are you taking them every six hours?

Grandma: I take them every morning.

Grandma wanted to go to the doctor. When asked what the doctor could do for her, Grandma indicated that pain pills was what she needed. When it was pointed out that she had pain pills, my grandmother said that she really needed some antibiotics. Grandma called for an appointment.

The situation got worse before seeing her general practitioner. The following weekend, she said that she might need to go to the emergency room. She was still not taking her medications as directed. Mom talked to her again about following the directions and said, "If you're not better in a few hours, I'll take you." Mom did some errands and came back to a blinking answering machine light and a message from Grandma saying that she was well enough to come over to my parents for Sunday dinner. Apparently about an hour after talking to Mom the pain suddenly went away. Smart money says that she finally had taken the pain medication. That evening, Grandma packed away two generous servings of lasagna. Her stomach must not have been bothering too much.

My parents had to be bad guys and explain that no one wants for her to be in pain and that she either had to take the medication prescribed in the dosage prescribed or she would have to go to a nursing home where they could help her out with this. Mom has mentioned to me that Grandma's episodes are starting sooner -- the Saturday after Thanksgiving instead of the week after Thanksgiving -- and lasting longer. This is not good.

This has been an ongoing process and I've mentioned it before. We all want for it to be her decision to go to an assisted living facility on her terms. She really does need to take her medications though, especially since they seem to help. One concern that we have is that she is not putting it all together anymore.

I don't mean to belittle her problems. Grandma does have some medical issues, namely atypical tuberculous, along with a pulmonary specialist to go with it, and a small B-cell lymphoma that her oncologist is keeping an eye on. The symptoms that she complains about, though, are things that have been bothering her for twenty or thirty years. In other words, not new. It's difficult for us to know if The Pain is worse now or not. Again, I wonder if she is subconsciously going through this for attention.

Assisted Living...

(imported from FB)

5:40pm Tuesday, Jun 26

I had lunch with my mom today she gave me the update on grandma, among other things.

Apparently my grandmother is going into an assisted living facility. She thought that she had Alzheimer's Disease but we think that it may be more of a generalized forgetfulness than that. She has left the door open several times, left the gas burner on stove, gets out of cars and walks away as if the door will close itself.

The icing on the cake was probably her drier. She called my mom last week and said that her drier was broken. She had washed and dried one load and when she put the second one in, it malfunctioned. She called the repairman. My mother offered to go over and take a look and my grandmother said that she had it under control, the appointment had been made and so on. Well, the repairman came a week latter. As you can probably guess, she had not turned it on.

After that, she started to say that she had Alzheimer's. She has made some indications that she would like to move to one of the two assisted living facilities in her neighborhood. This is good news in a way. A year ago, after she broke her foot and refused to do the rehabilitation exercises that they wanted her to do, she was wailing,"You're just going to put me in a home."