Observations, Learning, and Activities for the New "Over 21s"

Posts tagged ‘family’

Elder-Care

Elder-care is nothing like an eiderdown, or the care of an eiderdown.  One is about people; the other is about bed covers made of feathers.  No comparison.

How much do we know about elder care?  If you have an individual of advanced age living with you, how aware are you of certain common diseases of elder persons?  For example, do you know what the early signs are of diseases like congestive heart failure?  Do you know how to recognize the beginning signs of a stroke?   Are you watching your elderly home mate for signs of diseases of the elderly such as pneumonia?  Or of undernourishment? Or of sleep disorders that can lead to other problems?  Or do you assume that the elderly individual living in your home would tell you if he or she were ailing?

To be honest, although both my husband and I are over 65, we are still in reasonably good health.  However, we watch each other fairly closely for symptoms of health problems.  Right now, my only health concerns are cataracts which need to be removed, with the lenses replaced with appropriate lenses.  I also suffer from chronic back pain from spinal stenosis.  A few years ago, I was diagnosed with COPD, meaning that my breathing is not where it should be.  I have noticed muscle weakness in my hands, meaning I need to keep “special” appliances in the house to help me open jars, cans, and even bottle tops.  The latter is from surgery I had on my hand a few years ago that left my dominant hand weaker to perform the common tasks of twisting the caps off of bottles of water and mild, among other things.  And I can’t carry much one-handed any more.  Between arthritic spurs growing into and pressing on my spinal column, I tend to lose feeling in various pars of my body, causing little things like difficulty walking in a straight line, walking fully upright, carrying objects heavier than a few pounds, etc.  The degeneration of the disks in my spine help cause the spurs to temporarily slow down the response of my hands, arms, and legs.  But these are things I am aware of and am trying to do something about.

My husband suffers from problems of the urinary tract and–as one often hears on comedy shows–difficulty with urination.  I have noticed over the past few years that he is walking much slower than he used to.  He was never terribly coordinated, but now he has even more difficulty lifting or carrying items weighing over 20 pounds.  His energy level for physical activity has never been high, so it is difficult to tell just how much his overall movements have slowed.

These types of things are fairly normal among the elderly, and don’t necessarily suggest health problems.  Although I write about our own health concerns, I am also thinking about my mother’s recent death.  She had been living with my sister and brother-in-law for at least 15 years.  During the weeks–maybe months–before she died, she had started falling for no apparent reason.  She had worked in a hospital for 20 years, and was well aware of the symptoms of congestive heart failure.  I doubt that she ever told her daughter and son-in-law the symptoms, and maybe didn’t want to.  Before my father died of a heart-related condition about 20 years ago, I heard the difficulty in his breathing months before he died.  Because I lived 3000 miles away, I made it a point to take time off from work and fly out to see him, knowing it would probably be the last time I would see him alive, figuring the aneurism was letting him know to be prepared.  My mother knew why I flew out and was angry with me, in part because she was in denial about his condition, and in part because I supported his decision to decline a possible life-saving surgery–I didn’t encourage it, nor did I want him to die; I simply respected his decision and tried to get Mom to back off.  The problem with the potentially life-saving surgery was that (at that time) there was a huge risk that he would be left a paraplegic, a condition that he could not even begin to think about living with. He was a proud and active man. So when I heard in his breathing the signs of congestive heart failure, I needed to have closure with him.  I flew out to spend time with him–primarily him–to say goodbye in person before I could not say goodbye at all.

Although my mother did not appear to have problems with her breathing except for a cold that would not go away, and because she hid the falling from her family for quite some time, my sister did not get my mother in to see her doctor fast enough.  Instead of insisting on an immediate appointment after my mother fell and could not feel her legs to get up, they settled for an appointment the following week.  My mother was sent to the emergency room by her doctor immediately, and was diagnosed with congestive heart failure, pneumonia, and a few non-specific infections, one of which was from a skin condition that would not heal under my mother’s own home remedies.  Thus, within two weeks of admission to the hospital, my mother died in hospice care in a comfortable and painless state.  Her body gave up, but more importantly, her spirit gave up. Perhaps that is why she never mentioned the frequency of her falls to the family.

My family is not at fault for not taking my mother to see a doctor earlier. They simply didn’t know any better.  My mother was a relatively private person who mostly stayed in her room and took care of her ailments with home remedies.  Also, because of extremely busy schedules, the family did not notice that she was failing as quickly as they would if they saw her more frequently as part of the regular family gathering.  But the family has scattered all over the country, and only my busy sister and brother-in-law remain.  On top of all this, my mother had kept forgetting to charge her phone, so I had been unable to reach her for well over a month.  Maybe if I had heard her–maybe–I would have known she was ailing.

This is not the time or place to talk about a weird psychic connection I had with my mother, especially since I don’t really believe in them.  But I had been frantic to get in touch with my mother during that entire time because I felt that she wasn’t doing well.  My husband had just had emergency surgery, and I also wanted her to know that he had been hospitalized and, later, that he was recovering well.  As is my sister’s habit, she sent all calls from me to voicemail and never responded in any case.  It turned out that my brother-in-law got a new phone, so the calls to him on his old number were not getting through, either.  I stopped writing emails and IMs to my sister for the same reason I stopped calling her some time ago.  So it was not until a few days before she had her doctor’s appointment that I finally spoke to her on the phone.  All she told me about was the falling; she never mentioned the other problems, although she was unusually quiet.  For the first time in years, I was doing all the talking and she just said a few words.  When I spoke to my husband about her falls later that night, he immediately suspected congestive heart failure (he teaches medical school students), and we were anxious to find out more about her condition as the days progressed.  Not until a day or two after my mother’s hospitalization did I find out how ill she had actually become.

The problem was the lack of knowledge; the family could not understand the importance of the symptoms my mother was displaying (or, perhaps, hiding).  If an elderly parent, relative, or friend is living with you, make certain that you read up to learn about signs indicating the individual is getting ill.  Knowing the signs could improve the quality of life for the individual, and might extend or even save the person’s life.

A good place to learn about symptoms of diseases of the elderly and the signs that accompany the problems is webMD.com .  There is an entire section devoted to the elderly, with many easy to understand articles on symptomology, general health, exercise and diet, and almost any other health topic you can think of related to the elderly and elder care.  Our population of senior citizens–especially those living on their own–is growing rapidly.  Even if you only visit an elderly relative or friend once or twice a month, know the signs of common diseases of the elderly, including things like what malnutrition or dehydration looks like.  And of course things like pneumonia could look or sound quite different in an elderly person than in a younger one.  Learn what you can so you can be more of a help to an elderly relative living with you or alone.  The information you learn could save a life.

Maybe there actually is a relationship between the frailty of an elderly person (even if it is not apparent) and the delicate feathers of an eiderdown… .

Submitting from the great state of Texas,

#educ_dr

So Much Life Happening Right Now

Yes, life is happening all around me right now.  Some are good, some not so good.  Some…well, who knows.

Finally, after months of having to put it off again and again, I scheduled cataract surgery–got appointments set up and flight reservations made. All together, it takes about three weeks to get both eyes done from initial consultation and exam through actual procedure and follow-up, one eye at a time.

Not an hour after I get everything scheduled, I see an email message from my brother-in-law that my mother is in the hospital.  We must have been on the phone for the better part of an hour, talking about how she has been, what she says to me versus what she says to my sister and him.  You would think that because she lives with them, she would share more information with them.  But you have to know my mother.  She’s a real handful at the best of times.  At age 88, she is still kicking around and refusing help from anyone unless absolutely, positively necessary.  And she doesn’t like being “in the way.”  She has gone out of her way to avoid allowing herself to feel that she is home.  I can guarantee that this is not how she is treated; this is just the way she is.  So she also does not tell her family everything that she is feeling physically, either.  Easton Hospital

Until about a week ago, that is.

That was when she fell and couldn’t get up because, for the first time, she could not feel her legs.  She was near a wall in her room, so she was able to pull herself up into a sitting position until my brother-in-law got home.  When I spoke to her several days after this first happened, she told me she had been falling fairly regularly, but she was never hurt and she was always able to get up.  She also didn’t bother to share this information with the household.  As I said, she’s a handful.

Right now, she has congestive heart failure, pneumonia, and one or two infections that are being treated.  She is fairly strong, but she is in a semi-delirious state and keeps pulling out her IVs and pulling off her oxygen mask.  As I write this, she is being sedated, mostly to keep her from pulling life-sustaining equipment from herself, I think.

And while all this is going on–just after I made appointments for badly needed eye surgery–we are also trying to buy a house.  This is not an easy task at our age (66), and we need to dip into our retirement funds to make it work.  If we dip into them the wrong way, we will be left penniless into our old age, even though my husband is still working full time and doesn’t plan to actually retire until he is at least 70.  Basically, he wants to work as long as his employer is willing to keep him on.

So much is going on right now that can once again hamper something so important to me–arranging to be able to see enough at night to drive and maybe even read a physical book instead of using a reading device or a computer.  And I need to be able to drive at night, since my husband does not drive at all–doesn’t now, never did.

I wish I could be with my mother to provide some relief to my sister and brother-in-law, who are with her all the time.  But I’m no good to anyone without the ability to see at night.  And I am reasonably certain that my mother, despite this current setback, will be on her feet and being ornery again in no time.

And I wonder: will this be me in twenty years?  Probably not, but who knows?

So why am I worried that I may need to postpone my own needed surgery yet again?  Maybe it is because I’ve had to do it so many times before during the past three years…

No good dwelling on that too long.  What will happen will happen, regardless of my own needs and desires.  As always, I will roll like a shell in the ocean waves that surround the tiny island on which I currently live…

 

#educ_dr

On (My) Family

I’ve got a lot of years behind me, and I’ve made a lot of mistakes related to family. But what I’ve discovered is that I don’t particularly care for my family, especially for the way my children turned out. I don’t know what their memories of me are, as none of them have the guts to speak with me, even though I’ve never closed off any doors to them. They, on the other hand–and for reasons they have chosen to keep from me–have shut off any means of communication there can possibly be.

As a student of human nature, I observe and see both the deliberate misinterpretations and the meanness with which my adult children choose to withhold communication. Both are involved with significant others who are nice enough and smart enough in their own right, but who have severe limits in acceptance of differences. But then, the same is true of my children, so the matches are probably heaven-sanctioned. For a while, I was hurt by responses–or lack thereof–related to the only visit I have made to them in many, many years. My own frustration to being shunned upon my return home turned to anger and outright and open vehemence. Upon further reflection, I realized that I simply do not like either my children or their mates, mostly because my own children have chosen to ignore the concepts of both individual differences (specifically in the person who gave them life), of acceptance of the reality of aging, and the ability to weigh the many sides of an issue to determine future action/interaction. Clearly, I had been judged and sentenced without the luxury of speaking in my own defense.

As I have aged, I have suffered from a series of ailments which have left me in severe pain 24/7. Two months ago, I suffered a bout of extreme blood loss from a surprise attack of bleeding ulcers which ended up requiring the transfusion of 6 liters of blood. This can be a fatal attack if one is alone when such a bout occurs. Had my husband–from whom I was ready to seek a divorce–not been home at the time (the attack occurred at 2:00 a.m.), I would have died from the blood loss. He immediately called the community guard who called for an ambulance. Although I was floating in and out of consciousness during the 20-minute drive to the hospital, the intravenous delivery of fluids helped to stabilize me enough to get me to the hospital, where I received an immediate transfusion of blood and kept in the Intensive Care Unit for several days. For the first time in our marriage, and despite rare visits from him when I underwent 4 major surgeries (during one of which I actually died on the operating table and needed to be revived), he was at the hospital with me this time for hours at a time, trusting his fellow faculty at the local medical school to cover for him when he was with me. This was a major feat for my husband, who doesn’t drive, and who had to pay for taxi service each trip. All previous hospitalizations were no more than a city block from his office, and yet he rarely visited. If he did, he spent no more than 5 minutes with me because he had to catch the shuttle to the train station or bus depot. So his frequent and long visits during the bleeding ulcer recuperation was a huge surprise that changed the dynamic of our relationship forever.

Just prior to this attack, we had decided to seek help for our 24-year marriage instead of just ending it outright, either formally or informally. The sudden realization that I almost died on him made him realize that he was actually afraid to lose me, despite all our differences. The effort that he made to visit me frequently–often more than once a day–touched me in a way that I haven’t been touched by anything he did in many years. Thus, we are making great efforts to try to change the way we interact as well as our expectations of each other. We are both taking the continuation of this marriage very seriously. To me, I now know that he actually cares.

Meanwhile, although I posted on Facebook from the hospital, neither my two children nor my sister made any effort to wish me well, or to at least check to see how I was doing. My mother uses no electronic devices, but lives with my sister, and I know would have made an effort to call me if my sister had mentioned my illness to her. Thus, my sister either did not see any of my posts, leading me to believe that I had been blocked from her news feed, or simply didn’t care enough to mention it to my mother. That I had been blocked from my children’s feeds was obvious even before I was hospitalized, although it is not clear to me why my son chose to block me. But then, he ignored any communication I tried to initiate with him since my return home from my visit with him as well, whether via post, email, or direct telephone contact attempt. Upon the recommendation of my psychiatrist–whom I had been seeing since before the visits to my children and sister because I was trying to make sense of my relationship with my husband–suggested I write a letter to my son, who, as far as I knew at the time, was not shunning me. Since there has been no response of any kind, I guess I received my answer about my place in his life. In addition, I wrote to my 86-year-old mother letting her know what my situation had been and simply giving myself a sense of closure, in the event I would have no further direct contact with her. My husband is not good at thinking about letting family members know about any important events, so there was no expectation from me that he would contact family to let them know what was happening with me–although it is clear that none of them would have cared anyway (except my mother).

Since my illness, I have come to realize that family is not everything–at least, not blood relations or in-laws. The people I now feel closest to are people who are not related by blood or marriage (except my sister-in-law and her family). These are friends, whose friendships I cultivate when I can; with each of these individuals, I have had more individual contact than with my biological family as a whole. For the first time in my life I have come to understand the meaning of the concept that family does not need to comprise ancestral kinship. Family is those people with whom one can be oneself, even when one is cantankerous  or when one makes unthinking remarks. I am finding I have Family all over the US and on this small island of St. Martin/Sint Maarten to whom I feel closer than with my biological family. This Family allows for my idiosyncrasies and passions and opinions without believing that I am being “dramatic” or self-indulgent. This Family understands when I take different positions–usually in a single 5-minute interval–because they know I am continuing to attempt to make sense of my world. In other words, they think the same way I think, even if we disagree at a given moment or on a particular point. I like to explore and weigh my thoughts out loud and through practice,and my Family is OK with that. My Family has no problem with being honest with me–often brutally–knowing that I will weigh all their comments and reactions, and apologize when needed or argue my case better when I disagree. These are the people I love and respect beyond measure, and they come from all walks of like–cultural, religious, professional, etc.

Thus, my initial hurt at the shunning by my purportedly Christian family was very quickly replaced by a sadness over the loss of their love and/or caring. For years I have known that I love my sister-in-law more than my sister, and have developed a respect for my niece(in-law) for her courteousness, including the simple written or spoken “thank you” for even the smallest gifts. Not one of my grandchildren has ever sent us a thank you note, and only two have thanked me when a gift or courtesy was delivered in person during my recent visit–but even they have never made an effort to provide the small courtesy of a thank you without physical presence. But then, neither have my children or my sister. What a family I come from and what children I have raised! It is almost embarrassing to be related to them at all.

Although my husband thinks I may be a little premature, I have decided to change my will so that, in the event my death precedes his, not a single token will be endowed to any member of my biological family. None of them deserve it. None of them would consider the intrinsic value of a bauble for the non-financial value I have placed on it. None of them would understand in the slightest why I have put any value on such a trifle. None of them are the type of people I consider worthy of inheriting an iota from a clearly eccentric relative. Not any more, anyway. My Family, on the other hand, will appreciate even the smallest token of what I have to give–mostly because they know and understand me so well. To them, my eccentricities are lovable–or at least tolerable–characteristics. They love me for who and what I am and are willing to accept my flaws as well as my charms. That is why to me they are Family as well as friends. The best part is that they understand my lack of phone usage, which I wrote about in a previous post. (sigh)

Here is the important part: I am more than the sum of my parts. I am stronger than my biological family take me for. I may not have achieved all that I set out to do; I may not have been whatever mythical person my biological family thought I should be; I may have not become the person aimed to be when I was much younger. But I like most of the elements that comprise me, and I continue to try to improve those things I do not like about myself. I am a better person today than I was yesterday, and I will be a better person tomorrow than I am today. I love people for who they are, not for what they are or what they have or what they can do for me. Those people who have hurt me in the past are no less deserving of love than the people who have helped me in the past. There is little enough love in the world, and I will continue to love my family because they are my family, even though they have shunned me as effectively as a fundamentalist religious clan blots out the existence of an excommunicate. However, I will no longer make any effort to communicate with family who clearly wishes to not communicate with me. They are in the past, and there is nothing more that I can do to open lines of communication–especially since I am not the one who closed them.

And I am surprisingly quite comfortable with that.

Patterns

In one form or another, I have been an observer all my life. It started during infancy and early childhood in my birth country of France. But that was only the beginning…

France

I was born in 1950 in a small town in France. My parents, Displaced Persons from World War II ravaged Belarus, were “undisplaced” in northern France, in a town that needed more workers for its coal and steel industries. My father came from a family of comfortable farming, while my mother’s German-ancestry family originated in Russia where her family owned a flourishing grain mill. The story of how she ended up in Minsk is much like the Proletariat takeover of the house in which Dr. Zhivago grew up in the movie. Her family ended up in Minsk because they had relatives there. However, the relatives had already left–either through escape or through evacuation because of their German heritage–and my mother’s family was stuck there for a while. Minsk turned out to be a major battleground between Russian and Nazi forces, and male family members who had not already been conscripted by the Communists back in Russia were conscripted or arrested by either the Russian forces or by the Nazis. My father’s family fared a little better initially because my grandfather was shrewd enough to negotiate with those who would take his landholdings by demonstrating how he could run the newly expropriated farm. Although my father’s family lost all personal possessions, they were allowed to move into a small home on the property from which my grandfather could serve as overseer of the new cooperative. However, during the “negotiations,” my grandmother was badly beaten for trying to save her chickens (primarily laying hens) and died shortly thereafter.

Somehow, when the Nazis were defeated through the joint efforts of US and Russian forces, my parents ended up in a camp for Displaced Persons, where they met. Neither of my parents talked much about their experiences in this camp, although they managed to become part of a theatrical and choral group that met in the evenings after work, where they met each other and eventually fell in love. I am not certain, but it seems to me that the camp was in Germany, because they talked about how their German marriage certificate was not valid in France and they had to marry all over again.

In France, they lived in a community of Polish immigrants. The effect on me was that my first language was Polish, as that was the language of the community. So, when I started pre-school at two and a half years of age, I was an outsider looking in on other kids whose native language was French. To participate, I had to learn French. To become part of the group, I had to learn to communicate; so I learned to speak French. Now, science has taught us many things–one of which is that children pick up the languages used around them. In general, the first language children learn to speak and respond to is the language of the home. However, if this is different from the language of the community in which the child lives, the most likely language in which the child learns to respond is the language of the community. When a child begins to attend school, the language one speaks is the language of the school, which usually. Or responds to the language of the community. In my case, at a very young age, I was simultaneously moving through three languages simultaneously, probably learning none to any great degree of fluency, and having to contend with a fourth language–German–when we trekked to Germany to visit my grandmother, aunt, and uncle. Talk about potential confusion! Yet I managed, according to my parents. And then, at age four, we immigrated to the USA–where yet a new language needed to be learned–English.

USA

It didn’t take long for me to end up in what was called a nursery school back then. Again, I had a new language and a new group of children to adapt to. Again, I found myself in the role of observer. By age 4, language skills are pretty well developed, so I had to start at a higher level of “beginning English” than where I started with “beginning French.” Although I observed and observed, it was not until a WWII veteran who worked as school custodian began to help me that I made any real progress. For whatever reason, he took an interest in helping a young child learn English. He was a natural teacher, and led me through naming objects and putting together words and phrases so I could communicate with the other children. Because of his help, I was able to catch up enough with English so that I could attend kindergarten from mid-year (January) in my neighboring school a year after my arrival in the US. Interestingly, not even the kindergarten teacher realized–until the first parent-teacher conference–that I was not from an English-speaking home. In fact, my teacher–Miss Oxenford–so quickly forgot that I did not start the school year with my classmates that she inadvertently provided me with my first sense of “differentness” when we were working on a circus unit.

Each child had been given a circus animal to color. At home, I was not limited to the box of 8 Crayola crayons that is characteristic of what kids got in schools back then; my mother insisted on as wide a pallet of colors as she could provide, and always purchased for me the 32 or 64 color box. I, even then too much of a realist apparently, knew that elephants were gray. I had a personal experience with an elephant just before we sailed for the US, when an elephant at the Paris zoo and a monkey in the same area became involved with a bow that my mother had affixed in my hair. The monkey stole it from my head; the elephant stole it from the monkey and actually returned it to me! Thus, I knew that elephants were gray, and–from my Crayola collection at home–knew there was such a thing as a gray crayon. However, there was no gray in the 8-color box. When I asked the teacher if she had a gray crayon, she turned to the class and asked how she had taught them to make gray. The response was that you use the black crayon very lightly. She had forgotten that I had only joined the class a short time ago, and I remember her blushing when she saw my own embarrassment. The good part of this exchange, however, was that she had established my sense of belonging in the class.

The importance here is that I used the observation skills I had been using for almost 3 years to blend in to a great degree, and to do so in a relatively short period of time. However, I should also add that the embarrassment that I felt forced me to observe even more carefully so that I could avoid future episodes of “standing out.”

These observation skills, due partly to self-preservation and partly to a need to communicate and belong, continued to be useful to me as I grew older. That’s not to say that I always applied the observations good behaviors and shunned the less socially acceptable ones; it’s just that I became an expert on observing and assimilating those observations as I grew older.

The difficulty with being an observer, however, is that it can interfere with genuine and sustained social interaction. And I can look back and see how many times I interacted or responded in a less than socially “proper” way. For example, although I learned to observe behaviors, I cannot say that I ever developed a fashion sense, or that I ever fully understood how I interacted with other children. Because of my parents’ background and their jobs, the social skills that were reinforced were not necessarily those of American children. Because my parents’ ethnic community was more scattered than the communities of other ethnic groups, that led to fewer interactions with local children than were perhaps helpful to my overall social development as a child growing up in America. Home and “community” expectations were simply at odds sometimes with American expectations. So I grew up functioning with one foot in two different communities, without adequately filling either set of expectations–this despite my observation skills…

 

Li’l Ole Lady Ellie