Christmas at the Skilled Nursing Home

Muddy Creek on McMillan Drive

Celebrating Christmas with the family will change this year. We'll be sharing Christmas Eve with the ladies at the Skilled Nursing Home. It's over the river and through the woods to get to their facility.

For the past twenty-five years, we've invited the girls over to our house for the holidays. When they lived in Fort Worth, we'd drive over and pick them up and they would stay with Mom. Now, this isn't possible due to things that most people take for granted. For one, getting up the front stairs has become a major hurdle. The most important consideration for someone in a wheelchair is access. I never gave this a thought until I knew someone confined to a chair.

Also, access to a bathroom is one of the key things one must consider in these situations. I probably know the location of every bathroom in every store we used to frequent from Kroger to CVS Pharmacy to Home Depot and every medical office we ever visited.

We're lucky that the ladies live in a place with a caring staff and nurturing caregivers. Their Wellness Director, Latrice, is a happy and energetic lady who keeps them involved, even visiting their rooms to make sure they remember events. Despite the personal invitation and flyers distributed to remind them, Mom had forgotten about the Christmas party that was scheduled for this past Thursday night. When we arrived, she asked us why we came to visit so late. It was six pm. We said, "We're here for the party." She said, "What party?"

After a little persuasion, she and Louise trekked down to the cafe where we found a nice place to sit together. Louise went on a tour of the party table and she oooh'ed and aaah'ed and said she wasn't hungry but that everything looked so pretty.

We asked if there had been any Christmas music. John usually comes to play his guitar three times on one day each week. Mom didn't remember at first, then she told us he comes three times on Thursdays. We said, today is Thursday. "Oooooh, yes, he sang today."

John plays his guitar for the residents each Thursday.

They always enjoy his songs, stories and interaction with the group that gathers for his performances. He remembers each of them by name and plays their favorite song requests.

We consider ourselves very fortunate to have such an extended group of people looking after our loved ones. It's never ideal to live in a facility nor is it what they really want. Thankfully, Mom realizes that it is safer and better for them to have twenty-four hour staff to help them with their needs. She told me recently, "You children made the right decision to bring us here".

Even so, these things are difficult and have changed the face of the holidays for us all.

Handyman Special For Sale

Each time I unlock the door to her house, I'm struck with a sense of overwhelming sadness. Memories come flooding back even to that day years ago when we moved her from Fort Worth and carried her possessions inside.

The TV is off, the room is cold, mementos are scattered everywhere. These inanimate objects remind me of birthday celebrations, meals, new refrigerators, septic tank repair, skunks in the yard, trees planted, yards mowed, tornadoes, and days that will forever live in the past.

Children, grandchildren and great grandchildren have come and gone. So have two wiener dogs and a cat who shared this home with its two loving human parents.

Now the house lies vacant, silently waiting for me to empty it of all traces of the people who spent the last twenty years inside.

 

 Pictures on the walls, nick knacks on shelves, dishes in the cabinets, pans in the drawers, clothes in the closet, food in the cabinet, all wait for proper disposal.

My siblings have visited, taking with them any items to which they felt connected or which they presented as gifts over the years.

The vibes of these tangible items can be felt with eyes closed, holding these objects in hand, more clearly, sitting in a chair once occupied by the former residents.

Yet, nothing can replace those who resided here, two elderly women who wish they could still live in this small country home on half an acre, with its fenced yard and tiny storage shed; this handy-man special, double wide mobile home where their treasures on this earth remain and they do not.

Bike Ride on a Country Road

Last night as we settled into our post dinner stupor, our reverie was broken by the sound of an ambulance heading our way. Our custom of running to the window to check if it's headed to Grandma's hasn't changed, despite the fact that she no longer resides across the street.

"They're congregating at our corner!" I advised J who remained for the moment in front of the TV.

Seconds later, the ambulance was joined by a Lavon Police Department SUV which pulled across the end of our road blocking access to the corner where the ambulance stopped, lights flashing.Sirens screamed as a white Sheriff's car pulled to a stop behind the ambulance.

We were glued to the window, concerned, so J took a walk to the corner. The Nevada Fire Department vehicle that accompanies the paramedics arrived. Shortly afterward, their Number 2 engine arrived along with a Department of Public Safety marked car.

I ran upstairs to get a better view, but the scene was semi-blocked by the trees on the corner of our property. People were running about, gesturing wildly as officers looked on, taking notes with their eyes.

As J walked solemnly up the long driveway to our house, I could hear the unmistakable beat of a helicopter heading in our direction. The bright yellow Care-Flight helicopter circled above searching frantically for a place to land nearby.

In the past, they've landed on our front pasture, but this time, they chose another site down the road.

We found out that a woman riding a bicycle had been struck by a speeder who, according to a witness, had been doing about sixty miles per hour on our thirty-five mph street. Fortunately, someone in the car behind the woman stopped to render aid.

For about an hour, traffic in both directions and down our street was blocked off as the officers conducted their investigation while the noise of the chopper made its way across the cool blue sky.

We hope that her injuries were minor and that care and healing follow her Sunday night ride.



Three Dog Day at The Resort

It's always a good day when Ginger comes to work at the Skilled Nursing Home with her Dad. Up and down the hall you can hear calls of "Ginger...Come here, Ginger".

The residents enjoy kind kisses and a gentle sniffing before Ginger strides on past. She seems, like her Dad who's the Administrator, to have a purpose and destination to her step.

Eleven year old Ginger is a regular at the facility, showing up nearly every Monday through Friday.

"It sounds like home when she barks," one resident says.

The usual place where she can be found is in the doorway of Pop's office. There she naps and takes crackers and scraps from the residents who love seeing her and petting her.



Today was a bonus dog day with at least three other canine visitors.
This is little Cocoa who's another regular who comes to work with an employee at the home. She can be seen running quickly behind her master down the halls.

This is little Roxie who has a Mickey Mouse shaped emblem on her hind quarters.

A good time was had by all.



There Goes The Neighborhood

This Memorial Day Weekend will mark 24 years since we moved out here to the country.

Just thirty-five miles outside of Dallas, the quiet beauty of star-filled nights, breathtaking sunrises and colorful sunsets can't be matched in town.

This has been our daily dose of delight for all these years.

Soon, that sweet isolation and quiet peacefulness will be forever changed. 

Yesterday, the electric company broke ground on what has always been a horse pasture. Ten new houses are scheduled to be built across from our front yard.

I'm hopeful that the quality of the structures will enhance the value of our homes and yet, at the same time, sad with the intrusion into our revered space.

We knew it wouldn't be more than about ten years before the expanse of home owners into the Dallas Metroplex would uncover our little slice of Heaven out here in no where's land.

Send in the Cranes.

The Backroads of Texas

The long and winding road that leads to Mom's door is a beautiful drive that, unfortunately, floods when we get any rain. Lately that hasn't been too often so I take this scenic back road which cuts a few miles off my journey.

After yesterday's frog strangler  that doused us thoroughly as we carried in our groceries, I didn't expect to see the road open today. As luck would have it, the way was shining and freshly washed, ready for rubber neckers like me with a camera.



Greener on this side today

Sugar in the Morning

The good news is that Sugar, the seventeen-year old cat, survived the airplane trip from Dallas to his new home in South Carolina. He's now happily exploring and getting used to his new surroundings which include a beautiful sunny spot where he can soak up the rays.


Photo by Janet

The outside cat looking in is one of the original members of the household either Sullivan or Simon.
Sugar seems to have effectively turned his back on his peeping step brother and is down to the serious business of sunbathing.

A Roof Over My Head, La, la la...

His feline brothers are free to roam the woodsy back yard but Sugar was declawed so he can't go outdoors and face the native wildlife without protection. The other two cats are big squirrel hunters.



Birthday Celebration With New Friends and Old

The birthday girl, Louise, is celebrating her ninety-fourth birthday today surrounded by old friends, new friends and family.

After clearing away the lunch dishes, we brought out the homemade Italian Cream Cake and served a slice to whomever walked by and wanted a piece. It didn't take long for the cake to disappear, all but one large slice, saved for the birthday girl to enjoy later at her leisure.

For the pair of ladies who've recently moved into the Rehabilitation and Skilled Nursing Facility, they've both put on a few pounds, made a host of new friends, attended church services, been serenaded by musicians, played Bingo and Wheel of Fortune and generally lived a more active lifestyle over the past few weeks than the previous few years.

Of course, there's still a general longing and tearful wish for "home" and the beloved family cat who can't join them at "the resort". Life has turned into a double-edged balance between pain and pleasure, matching safety against independence. To these precious ladies who would in any case, rather be in their own home, the services they have available have become more than just nice to have. They have physical therapists to help keep their mental and physical bodies in tune and a caring staff of dieticians, doctors, physician assistants and others to ensure their well being. They are in the care of around-the-clock nursing staff, technicians who assist during middle-of the night emergencies, along with the fail safe assurance of back-up generators for power loss like in the country home from which they moved.

Though all this is true, I deeply feel the loss of their proximity - my heart aches with each lonely entry I make into my Mother's former household seeking some missing item to deliver to their shared room.

Their world has grown larger in activities and yet, at the same time it's grown smaller in real estate. It is an adjustment for us all, but none feel it more clearly than Auntie, who has left behind her boy, Sugar, the cat.


A Month Plus at Skilled Nursing

Things go on as they must in the Skilled Nursing Facilities around the country. From the horror stories I'm hearing at the lunch table with Louise and other residents here, we're lucky to be at this one. (What?) Yes, lucky, lucky, lucky.

Some of the other places don't measure up to basic standards from what we're hearing. One place nearby has a World Class Chef but the nurse call bells go unanswered. We don't have that issue here. Staff is responsive and they have addressed my concerns. Things are definitely improving.

Two nights ago, Louise got a roommate. The semi-private room has a fabric curtain that serves as a divider between two adjustable beds. There are 2 TVs, separate phones, dressers and closets for each resident. They share a bathroom. Today the room temp was set to 76 and it was blistering hot in there. The new patient in the room is recovering from pneumonia after a fall where she broke four ribs. She moaned through the night following her arrival, making a fitful night's sleep for both residents.

It took a few days, but Louise was able to remember Amy's name and they started sitting together for meals in the dining room. It's kind of like the lunchroom at school, where you have to know where the regulars sit and not take their place. When Mom and I visit now, we have a certain place where we all sit together.

Another of Louise's friends, Betty, has started coming to the table early and helps to find Louise's meal ticket in the bin. She even helps her read and circle the menu choices. The residents can pick between 2 main entrees, veggies, bread, dessert and beverages. The iced tea is surprisingly great!


 

The Food Service in the Dining Room:
When guests visit, they can share a meal with residents if they wish. They can even order specialty items like hamburgers or a sandwich. It's good food; not gourmet dishes, just comfort food cooked soft for the target audience of Seniors and recovering patients. Just don't let them write "soft grind" on the ticket unless you want your chicken pulverized.

BTW, don't plan to be in a rush.

A Trip by Ambulance

She crawled down the hallway to get to the living room

That dreaded call from across the street came in around nine on Saturday night. Mom relayed right away that Louise fell in her room and couldn't get up. She crawled into the living room and called out to my mother, who couldn't hear her from the other end of the house.

Louise couldn't get back into her wheelchair, yet, refused to go to the hospital insisting that she was fine. In her bedroom, I asked her to demonstrate that she could transfer from the bed to the wheelchair and back. She was able to do that, so I went home. I live across the street.

By Sunday morning, Louise was too sore to get out of bed. I dialed 911 and she was taken by ambulance to the hospital where she was admitted. She had a painful injury to her left ankle that had fusion surgery in 2007, and her left knee was bruised. They found she also had a urinary tract infection. After she arrived in the emergency room, a bruise appeared on her chin following the line of the cervical collar that had been placed on her during the ride.

Louise is a non typical 93 year old female who lives at home with her 88 year old sister. She dresses herself, prepares daily noon meals of sandwiches and washes dishes by pulling herself up to stand at the sink. She routinely maintains her own personal hygiene, showering and shampooing unassisted, performs toilet transfers, makes her own bed and takes care of her cat.

Feb. 11, Tuesday 4 pm - Patient was transported by ambulance from Lake Point Medical Center to a Skilled Nursing Facility arriving around 5 pm. Assigned to room 505 B.

Upon arrival at GH, patient was evaluated by Gladys and Rose, Nurse Techs who removed her street clothes and put her in a hospital gown for the initial assessment of her condition. Personal clothing (including nightgown) was available at the time of arrival provided by Niece who accompanied the ambulance. Clothing was placed in patient's dresser and closet. Dinner was provided. Patient fed herself and had a good appetite completing most of the meal. Bedside commode was positioned next to bed. Staff was briefed on patient's personal history prior to injury.

Feb. 12, Wednesday 10:30 am - Upon my arrival, Patient was found in bed still dressed in a hospital gown. After a discussion with the Nursing Supervisor, patient was helped to the bedside commode where she was seated with the door to the room left open in full view of hall traffic. Upon direct questioning as to the course of treatment and reason for remaining in bed, patient was seen by Occupational Therapy representative, Sara, who immediately responded by assisting in getting the patient dressed in street clothes and taking Patient to the Exercise room for evaluation. :)

Feb. 13, Thursday 11:45 am - Patient was located in the dining room following Occupational Therapy where her relatives (Niece, Sister and Friend) joined her for lunch of soup, Chicken Tetrazzini and pineapple cake. Patient's appetite was good and she fed herself without assistance. Visitors remained until 2 pm. :)
4:30 pm Niece received a frantic call from the nursing staff at the request of patient who was agitated to the point of tears asking that I return to GH. She was already in bed and had been dressed in a diaper (not pull-ups) and was extremely distressed by this action of the staff as she is able to use the toilet if assisted in making the transfer. :(

Feb. 14, Friday 10:00 am - Valentine's Day. Patient was located in the Occupational Therapy area with electrodes attached to her left ankle. She had refused her breakfast, yet when offered, drank a large glass of milk fetched from the kitchen. Kitchen staff was very accommodating even offering a banana. Patient had been showered and her hair had been shampooed. :)
3:00 pm Family members returned to find patient in distress, searching the closet for additional "pull-up" underwear. Staff informed family that patient was not to put on disposable underwear unassisted. (Grabbed them out of my hand and put them back in the drawer.) Patient was extremely tired and tearful, having difficulty in expressing her concerns. Visitors departed approximately 4:30 pm with patient stating she would eat the evening meal in her room.


Feb. 15, Saturday 11:45 am - Patient was located in the "Small Dining Room" seated at a table with patients who lack the skills to feed themselves or communicate verbally. Patient was in tears and visibly shaken by this development. Her hair was in disarray and uncombed. I moved her to the "Large Dining Room" where the patient fed herself unassisted after recovering her composure. She explained that someone had "fed her dinner" the previous evening in her room. Patient stated that the staff did not make eye contact during the meal, instead concentrated on a device held in the staff member's lap while distractedly shoveling food into the patient's mouth. Later, she rang and asked that the room lights be turned off along with the TV. Lights were turned off and TV was left blaring all night. :(

Following lunch, I asked a tech to assist in helping patient to the bathroom where staff member continued a conversation on her cell phone during the transfer from wheel chair to the commode. Patient was dropped from 6 inches above toilet where she landed on the seat and was left in my care. Tech did not return to assist patient back to wheel chair. I assisted with the transfer back to her wheel chair and in performing personal hygiene needs: hair combing, teeth brushing and washing of dentures not done earlier in the morning. :(
4:45 pm Patient was assisted in reaching the phone after 6 rings. She was tearful and tired and said, "Sometimes I don't even want to go on."
7:00 pm Patient answered the phone and seemed somewhat calmer, had been showered and was dressed for and comfortably in bed.

I called to report my concerns to the nurse on duty (Beth) who was compassionate and understanding and listened to my account about lack of respect and dignity being demonstrated by the recent developments. Monday I will make a report to the Facility Administrator. There is a distinct difference in the weekday staff and the weekend staff who operate with little administrative supervision.

Community Attendant Program To The Rescue, Eldercare Blessings

I'm reminded of Pearl S. Buck's story, The Good Earth, in that I've been afraid to praise the benefits of the Department of Aging and Disability or DADS, as they're known, for fear of jinxing the program. At long last, following a lot of hoop-jumping, the ladies in my care are getting the help they need to remain living independently at home. Being homebound, according to their Medicare Advantage plan's definition, is that leaving  home is a major effort. That definitely describes the ladies across the street, who at 88 and 93, still maintain their own daily activities but neither own a  car nor drive. Thankfully.

With that independence comes other disadvantages like trying to cook meals, which has become a dangerous activity to someone in a wheelchair who is legally blind from macular degeneration. And to her younger sister, it is a matter of concentration, along with sense of smell and hearing, which seems to be lagging at times. Recently, a grease fire in the kitchen nearly sent the pair to well, we'll just say they were both fortunate that in a moment of clarity the flaming pan was moved to the nearby sink without harm. It was a real eye-opener for me.

Truly, I'm in denial about my Mother, who for the last twenty or so years, has remained so vibrantly active and able, not retiring until she turned eighty. Now as her skills diminish, I'm grateful that they have qualified for Home Health Services Care. With the two ladies living together, their combined allotted hours gives them a Community Attendant who comes five days a week, eight hours per day.

The real difficulty has been the inconsistency of schedule for the attendant since the middle of November when the program started. First, we had the Thanksgiving holiday, then a flat tire, then Christmas, then New Year's, then the stomach flu (out for 8 days) for which we remain grateful was not shared with the patients, then several days of ice and road conditions making travel too dangerous to come. If things ever settle down, it will be a lot better for the ladies who are fond of a predictable routine at their house.

The strange part is the element of coincidence (?) in the attendant's name. It has been strangely validating to be assigned a wonderful and enthusiastic twenty-one year old named Joe. Yes, a lady named Joe. I thought I was the only one with a name spelled like a boy. Other than my fictional character in The Pub novel I'm writing. Hmm. Strange. She's blonde and sweet, a young mother who takes pains in being creative with the meals she prepares for my Mother and Aunt. And what a major relief it is to have her help.

Good rice. It is good rice.

Signs in the Neighborhood

Driving past this feed store reminded me of the old place that used to be at the four way stop sign in Murphy Texas. No longer in business, their bait sandwiches have gone the way of the buggy whip.



Bait Sandwiches? Stop in at our deli.

Murphy's Bait and Tackle was demolished and replaced with a strip center containing a Lowe's, a Chick-Fil-a and a Chipotle restaurant mixed in with other stores.

I circled back through Lucas after finishing an errand that took me down this crooked and woodsy back road in the first place. Stopping just long enough to capture a photo of their sign, I figured it's only a matter of time before places like this one disappear completely.

Christmas Decorations

Putting away the boxes of Christmas decorations made me want to purge my rampant collection of holiday decor. A couple of trips to the trunk of the car and once again, my boxes fit neatly into the cupboard beneath the stairs. I knew exactly where I was headed with the donations.

Of course, it was somewhere that I would likely bring home more stuff than I dropped off.

The trip held no exception to the truth about giving; it makes more room for treasure. This vintage punch bowl was discovered at The Samaritan Inn in McKinney Texas.

Oh yes, one more item to find room for in the overflowing cupboard. The old pressed glass pattern brought back days of Christmas in the sixties and was simply irresistible. We traditionally served red punch poured into dainty little glass cups with handles way too small for anyone's fingers. The recipe was prepared with ginger ale, Hawaiian punch and pineapple juice cooled with ice cubes of frozen fruit juice. My sister was in charge of ladling at our house, hard at work at here at her duty post.

Perhaps when the right festive occasion comes along and punch is required, I might find a use for this set of elegant glassware. I can imagine filling it with a colorful holiday beverage. Forget the paper cups, I enjoy using real dishes.