Look Behind The Curtain IN PROCESS

Let's take a look behind 

the "marketing" and "tour presentation" 

statements for many Long Term Care facilities. 

First area of "inspection" -- DINING.

Dining As It Appears:  

Walking in you'll see tables, often a TV, 

Maybe it's a combination "community room" 

used for visiting musical groups or for other uses. 

You're told how residents are "encouraged" 

to come to the dining room. 

How the staff has been trained in "

white glove individual service" 

and it's like dining in a nice restaurant. 

You're told.

If for some reason 

they can't get to the dining room 

or would prefer to "dine in their room", 

this is simply accomplished 

by the resident calling ahead 

and ordering what they'd like. 

Picture, if you will, 

someone with poor eyesight 

given a list with items on it 

about the size of this type. 

The list is in columns 

but isn't organized, just randomly posted. 

On any given day 

certain items 

"may not be available".

 

The resident, 

who has difficulty making decisions 

due to advancing Dementia, 

or just indecisiveness, 

now has to make another choice. 

Reading is challenging.

Listening is confusing.

So they ask for and receive

What "they always order".

Reality Dining:

This mulitpurpose room 

may be used several times a quarter 

for meetings and other events 

and closed to residents. 

Residents dine in the dining room

on their floor or in their room. 

This can be for one meal: 

breakfast, lunch or dinner 

OR it can be for an entire day.

Dining on the resident's living floor

is in a small area where residents

who cannot travel the distance 

or do not have the mental or physical abilities 

to sit with others due to either behaviour 

or limitations are regularly dining. 

No conversation possible.

Do not turn away. 

This will not change

It will be "your way" someday.

Dining begins and service ends at a set time. 

If you don't make it, you may have to settle 

for whatever might happen to be 

in the refrigerator on your floor 

and due to "cutbacks" that's possibly 

now limited to ice cream, 

bologna sandwiches,

maybe some low fat milk.

Some would say it's "service'

Others would say it's "control".

Life Lessons Learned

Some say you can adjust, make the best of a life challenge.                                   It's like falling into the "rabbit hole" of Alice in Wonderland.

You try your best, do what you can and often "go with the flow".

Here's what I wrote as we struggled just to move day to day:

Daughter and I are both trying to find full time jobs.

We're both working part time.

Can't afford to work on Commission basis.

Need consistent income to overcome and just pay bills.

With full time jobs, we would have some security.

We've found "gigs"--always waiting for the next one "to appear".

One day out of many. We needed desperately to be different.

We both had the day off. This was unusual. 

We had enough in our "budget" for the week to use the Gas                                             we had in the tank and replace it. 

Decided to "splurge" and take a chance,                                                                         to continue to survive, move forward.

We, separately and together, felt the need to feel close.                                           That meant traveling to Mom's gravesite.

To gain strength from being "near" as we did for years.

A journey of more than 100 miles round trip,                                                         providing some peace -- now that we've returned.

It's been difficult at my work lately. 

Challenges I'm not sure I want to continue to endure.

With no other opportunities, I keep believing in tomorrow.

Like many others, we move from day to day.

We know this time provides the basis                                                                           for our keeping a roof over our heads                                                                     and food on the table.

I know I can't walk away until I find another. 

This is the typical "world of work" and I am only one of many.

There's one "challenge" I face many do not -- 

Not so easy to find work "at my age".

Mom's life was her example to me                                                                                    of personal strength and caring beyond yourself. 

She taught me to believe in my "self'. 

I'd practiced that lesson many times over when she was around.

How Old Are You?

Usually sidestepping I decided this time to face the question and see the reaction.

She visibly jumped and immediately reached to put her arm around me even though I'd been walking on my own.

What's with this "age group"?

We were taught it's "not polite' and even "inconsiderate" to ask someone's age, race, educational or marital status.

Closest we've come is asking "Where'd you go to High School?" and that's after a conversation about where someone "grew up" starts.

We "birthed" this Gen and their offspring?                                                                   They seem to think today is where we've lived consistently.

It takes them time and often it requires a mixed age group for these "Gen Xers," who are actually close on our heels but don't realize it because they're so busy going through life stages they can't see where they are and where they're going.

Death walks in and reasoning walks out the door. 

I liked her, I still do, but it amazes me the questions 50 somethings ask directly.

No preparation.  Didn't know her name or relationship.                                                     A person obviously related; the Memorial Service was very small.

What happened to "polite conversation"?

Manners seem to have moved aside to instant gratification.                  

Where are the "manners"; not asking "personal questions" we taught?          

She seems bright and capable but this "direct question" of someone I just met is far too personal -- would she ask a contemporary what size Bra she wore on first meeting?

I know! She's amazed "people my age" aren't bent over, shuffling and having trouble processing simple sentences.

I like you but you really need to "get out" more and mix with all generations and not just see "growing older" as "getting senile".

Death isn't confined to age groups or "getting older'.

We are all, however, facing that "final curtain" and do not know when it will be drawn across our life. Even for Gen X the day grows closer.

Beginning of The End

In these words, I find the strength needed to share

Knowing you, who read, have a reason.                                                                         Need unfilled, often critical in timing and purpose.

A journey concerned, caring and confused, maybe alone.                               Medical error; no one admits

A few come to visit, some express concern.                                                                 Advice is their "contribution". Misinformation abounds.

Time and funds limited.                                                                                               Sons married living hundreds of miles away.                                                               Daughter trying to stay in college.

No cell phones or computers that could send pictures.                                 Believing each day would bring healing, life would change.

Lied to by the Hospital and the Doctors.                                                                     "All he has to do is gain a little more weight."

They knew what was happening to my husband.                                               They changed his dressing on the incision.

Record keeping often typed.                                                                                       Easy to "adjust" to "cover errors & omissions

The Dr writing them made the error.                                                                       Never set a foot near my husband on that fateful night.                                       Gave the direction on the phone to "lance" .

Infection or inability or both created a deep incision

HE was a SHE in the ER; short staffed, definitely.

SHE was unable to help my husband

         took out a phone and made a call

         followed orders given uncertain of how to proceed

        did as she was told

HE  was not in the ER

       was somewhere he didn't want to leave

       did not ask the right questions

       caused the beginning of the end

       did not appear all the time we were in the ER

       wrote the report, signed it stating HE did the cutting.

Sight unseen, she followed his direction              

He never saw the patient

He never ensured a Dr made the incision

How harmful his "advice" would prove to be

His failure to ensure competency led to my husband's death

It was 2009, personal computers were rare but hospitals had systems. 

No Dr attending. 

"She" made a call. 

Received directions to"lance" 

She did exactly as she was told.

Beginning of the end.

LBD Social Signs

"Hindsight is better than foresight" is never more true than for caregiver's, family, friends of loved ones with Dementia.

Current studies cite the appearance of specific behaviours as being the "keys" to diagnosing Dementia.

Many forms cannot be specifically cited or identified until there's a post mortem examination of the brain.

It doesn't matter if someone has Alzheimer's, Lewy Body, Frontal Temporal or others, they have Dementia.

We need to recognize Dementia as the next big life challenge.

It's fatal, physically and emotionally draining.

It's destructive and stops life as we know it,

General articles and reports often become focused on the decline of mental processing citing bodily functions including standing, walking, incontinence as type or stage of the disease.

Are these really effective measures of Dementia's progression? 

Are we simply focusing on those areas we consider "more important" and use to determine the "level" of the progression and level of caregiving?

When are we going to recognize Dementia, especially Lewy Body Dementia, doesn't appear like Cancer often does with a lump you can feel or Heart Disease with a stroke? 

Lewy Body Dementia often masquarades.  As I wrote in the blog entry: Masks: Ever Changing Faces of Lewy Body Dementia , LBD is not always visible. 

People with LBD, in the beginning stages, seem to be capable of adjusting their minds, are "socially conscious", even far into progression of the disease.

They may laugh about "what they've just said", mix and match information that seems to go together to the "untrained" and "unfamiliar with the subject" ear and eye. 

Another observation I've had with Mom is how vacillating Lewy Body Dementia really is; behaviors were so unpredictable. 

It amazed me how caregivers at Mom's facility and especially the floor nurse, an LPN, believed we could affect her behavior or we could change it or Mom could choose to change it.

Unfortunately, these are all false beliefs about a real, medical condition that like Diabetes, Heart Disease or Cancer, cannot be controlled or adjusted through "willpower" or "determination".

The other night at a presentation, the message was conveyed by a gentleman about his wife and how she could somehow, if she just tried, control or affect actions like sitting up in her chair. 

It was HIS wants and needs for her to be who she's always been, not who she was becoming.

After a long period of time and a good day, when for some reason her brain neural pathways had shifted, changed or somehow let a message "slip through", my Mom might make that movement or give that response.

We, too, desperately wanted Mom to be the person we knew, we lived with, to be there, to have the ability to "return" to the person we felt comfortable around and with.

Like a trained animal, we reward the Advanced Dementia patient who shows us they "can" do something, hear something correctly, respond correctly, with a smile, words of encouragement and even with statements like "I knew you could do it if you tried hard enough".  

How grateful I am now realizing that with enough advancement of the Dementia this level of self satisfaction on the part of the visitor, the family member, may not truly register with the person struggling with Dementia.

Then, there is the other belief, and one popular today, about "the right medicine" controlling and eliminating "the disease".

You see, we're far more accepting of something we "catch" changing someone's life than we are when there is a "loss" of what is perceived to be the "self' of the individual which many believe should be able to be "personally controlled".

It may be more like eradicating Cancer. 

Controlled to some degree, possibly, perhaps, but the ability to eradicate may be more challenging or accomplished with some form of discovery that shifts development and progression.

We may find the causes of some Dementias and be able to change behaviors (smoking) or where you live (not close to where chemicals have been dumped) and therefore not get a specific Dementia (Cancer).

Unless someone determines there is one specific cause for Cancer -- possibly a genetic tendency or even lack of certain configurations/compositions -- Dementia, like Cancer, in my opinion, will be with us for many years to come.

Dementia may be seen as being prevalent in the very elderly but each passing day we're discovering, as we grow from an infant to a toddler, through adolescence and into adulthood, the vast frontier of the brain and how it is the center of the individual human universe remains an ongoing challenge.

Just recently, some have started  classifying other brain diseases, Muscular Dystrophy and Parkinson's for example, into the area of Dementias. They affect the brain and that is where Dementia works so the theory is they're related  or even one and the same.

Let's have a movement within society to be as health wary about Dementia as we are about Cancer and heart disease that affect human relationships and lifestyles.

Let's open the discussion, bring into the light, show the world we see, hear and most of all support those who are challenged with and from Dementia including the individuals and their care givers whether family or other.

YOU have the power to facilitate a change. 

Start a conversation. Volunteer to visit LTC's.

YOU hold the future in your hands.

It's your future or at least the future of someone you love.

Line of Descent

Life is life and death is death.                                                                                             Until the time when East meets West.

Extend your arms, reach out your hands,                                                                           Close your eyes & take a stand.

There they are, each one you knew,                                                                             Now gone as others and so will you.   

Parents left, then brothers, too.                                                                                       Sisters lingered as though they knew                                                                         When they walked on, so would you.

A line was formed and except for War                                                                         Each one came "home" to lay beside                                                                                 A wife, a child, in their own space.

You came and went leaving flowers for all,                                                           Knowing the day would come                                                                                     When you answered the call.

We wait for you to come and stay                                                                                   While now you turn and walk away.                                                                                   We too had hopes and plans like you.  

Some were done and some remain                                                                                 Others we took into this grave.                                                                                           It's up to you to carry on.                                                                        

To Move Is To Live

They sit in wheelchairs waiting. Some given privileges of chairs.

Forbidden to walk because they might fall. Too few caregivers.

Sometimes a smile from a passer by. Sometimes a glance of curiosity.

Dogs and cats greeted better than older human beings in facilities.

If life could only be like a story on a streaming service. . .

Where each of us who have abilities and choices change places . . . 

With family members in "Institutions". Would we then see?

Those who did not have or somehow lost the ways and means . . . 

Go through the doors of government subsidized Elder Care

Interesting they use the name "Elder" 

A title in many Communities given out of respect and honor

Are you so sure it's "as promised"? 

Have you really gone behind those "closed doors".

Do you see what you want to see because you need it to be?

I understand. I walked that walk. Everyday I had to work.

So hard to know we could not take Mom home.

She lived with us for over forty years into her 100th year.

We didn't want her "institutionalized".

We were finally able to move her but no money for private care.

Both of us had to work to survive.

We tried another facility and then another and another. 

LTC with government support was worse than kennels for animals.

Tears come to my eyes even today knowing what was done to us by the Church Lady is being done by others in a high tech world.

Predators are all around us as we move towards 2025

I found another attacking one of my Cousins.  

They are a devious group of humans, focused on self gain.

             

Do not go blindly, open your eyes wide.                                                                         When it's your time you'll see far too clearly.                                     

Society won't support you.  Your value is gone.                                 

Values are for what can be achieved and how fast.

Ability and possibility.

A commodity worth only what the market values.

Aging isn't what they tell you it is

When you're young and anxious to grow older.

When you arrive, it's not the destination you thought

No turning back, you can't even run away.

You'll stand up tall, hoping to look strong

Or bend over with the weight.

 

Looking into a darkness

Seeking to find the light

Making do, moving on, waiting for someone, anyone

And you, young one, see this as best for ME.

You who complain on ships about the food 

Waiting too long for anything, not enough space

Change places with me and see for yourself

Closed doors change points of view

Signed in, locked up, waiting for the light

A few privileged have it better, or so I'm told

I travel to meetings, conventions and find

What's practiced that's humane is few and far between

I will keep looking and writing seeing words are the way

To ensure those growing older will see better days.

Gaining Peace of Mind

This Blog has travelled to many parts of the world.

Many speak different languages but all with a "common interest" -- CareGiving For A Loved One.

I've varied  writings about the time spent with Mom, the challenges of her unrecognized Dementia, the problems we encountered and were unable to resolve.

Knowing the challenge of unrecognized Dementia, of verbal abuse and manipulative control of the weakest among us who often were some of the most strong -- 

Taking advantage, getting "high" on manipulation and control of the weakest, wrecking havoc through  tearing families apart.

Julia appeared to "have it all" -- a beautiful home, active in the Community and in Church, volunteering to bring to those least able to attend an offering, a Communion, seeming to care when actually looking for their weaknesses to prey upon.

Learning shared brings peace of mind.

Reaching out I hope others will share their experiences.

Gimme

What’s with this surging need?                                                                                 Demands the old hand over, recede.

I can stand or lean any way I choose.

At my age, not much to lose.

I sit and type and wonder why

The words come flying out of “the sky”.

Have they been hiding all along

If so I’ll use them as My Song.

Am I poised to live and learn

Will I continue to actively earn?

So many questions, far less time

Will I burn or will I shine?

Does it matter any way 

If I choose to have my say?

Like bursts of light.

Words join as if in flight.

 

Like Geese in the air

They join and create.

They fly away

To live another day.

Winter is harsh

It hides their food.

We humans see.

We’re not fools.

Each finds their own tools.

To survive and to wait. 

Knowing there is an expiration date.

While we can, we do.

When we can’t, we won’t.

Today I have the choice.

Today I raise my voice.

Megaphones can screech

Across the electronic page

Telling me I’m worthless

Just because of “age.

Then why, tell me please,

Do you want to incur

More candles each year

To blow out in a blur?

You can’t wait to age 

You see it as a “perk”

Let me tell you, my “friend” 

That’s acting like a “jerk”

Value what you have

Embrace where you are

Soon you’ll hear the shouts

Causing you to doubt

Others have been born

They demand a place

Wanting to take yours

It’s going to be your fate.

It’s a life story

Filled with doubt and worry

Stand up, speak out

It’s never too late

Spread love

Not hate

Strange how survival is seen as distress

It causes concerns and such a mess!

From what we achieved

And refuse to “secede”.

Money, Money, Money

To have and to hold, til death do us part . . .   

Planning and celebration followed by change and fears

I think therefore I am, only as long as I can 

My everyday life and living.

The road we walk, from here to there                                                                       

Winds, climbs, turns and drops

In control, at the helm, able to steer, able to halt. 

Decisions I make point to the direction I take.

Would it were so easy as years flying by

So many aims for pie in the sky.

We're told we can make it if we just try.                           

Decades added swiftly now.                                                                                                     

Time stands to fall around One and All.

I stopped expecting he would change

Like my Dad, he focuses on self.

Hurting those who gave and loved so long

Can't change a cat's stripes, the saying goes.

Ah, well, perhaps one of his five

Will someday see what's made them blind.

False, misleading, self centered lives

How sad the parent's focus, how sad their plans.

Can't change what he refuses to see. 

The harm they do isn't to "me".

It's self inflicted and self imposed

Some day he will lighten the load.

Until that time I see and I know . . . 

What waits ahead is pre-chosen

He can't serve two masters

Freedom did not change or end with me.

Sad he's not able to say:

"Let's stop this unneeded separation . . .

My behavior was wrong, I made many mistakes . . . 

I jumped to conclusions and put my "self" above all. . . 

That self centered focus is what causes a fall. . . 

Someday, my son, we'll meet again

You will be able to speak freely, will see far clearer

It could be sooner, if you so choose

We all have a very large amount to lose

Even farther as the road lengthens

As generations come and go.

It's your choice, as always, 

We do not sit and wait

Our lives filled with giving, not hate.

 Sad you've not seen the light 

The darkness called and you went.

Perhaps you'll wake up someday and see

You left the best behind when you hit the tree.

Get A Real Life!

Written Jan 23, 2017.

Husband, five, and Mom, three years, have passed. 

Seems like yesterday. 

I've moved forward -- my way.

My Husband. 

My Mother. 

Start to live again, I'm told. 

You "deserve" a life.

My life has been. . .Continues to be. . . Service to others.

Do we tell someone who's lost a loved one to Cancer to stop speaking out? 

How about saying to someone who has MS there's no longer need to walk for MS, talk about the "disease" or any other?

It's over now, get on with your own life.
You can't do anything different. 

What happened, happened.

I am

The voice of those overwhelmed

The hands of those trying to balance life

The voice of those who have passed, 

If I am silent, 

Their passing would be in vain 

Others could suffer the same mistreatment. 

Relationships and families tearing apart.

Tomorrow's capabilities through today's revelations.

If only I had known ...

If only someone would have... 

I raise my voice

Listen, Reach Out, Walk alongside

My Journey Continues

People seem to not want to talk about Dementia. 

They're willing to talk about Alzheimer's, the Association for the disease has made this one part of Dementia more "palatable" and more "acceptable" because the name doesn't detail as directly the fact the disease is MENTAL.

MENTAL CHALLENGES ARE STILL VERY FORBIDDEN AREAS OF DISCUSSION.

My husband also had mental processing challenges due to the administration of several drugs.  

DEMENTIA LIKE BEHAVIOURS AREN'T LIMITED TO AN AGE.

Down's Syndrome. Multiple Sclerosis. Concussion. Brain Damage due to accident or birth related affect lives, Medications

Mental Health is often thought of as either being a grave illness, a birth defect or an accident of life. 

Mental Health management to most medical practitioners means use of drugs to alter or control.

I seek to find other ways to see, understand and find ways to caregive for and with loved ones.

Visiting our friend in Mom's previous "home", her Long Term Care, I overheard a woman who was leaving the facility talking about her husband.

She said how "good" he was when she arrived. 

Then, she said, he ate and his "behaviour" became difficult. 

She said "THEY" were going to have to do something.

Give him something to change the way he was.

DRUGS. GIVE HIM MORE DRUGS. 

Alter his behaviour to reflect what "she" felt comfortable with. 

He was expressing feeling, need or concern. 

It was not in a way "she" found acceptable. 

A wife like many medical professionals. 

Seeing what's on the surface not looking for the cause.
The husband could have a reaction to meds he's being given.
The husband could have unfulfilled needs.

He might have had a bladder or bowel release and was uncomfortable but his declining mind could only interpret it through anger, hostility or negative action.

TODAY'S COMMON REACTION TO CHILDREN AND THE ELDERLY IS to drug them. It's not new, practiced for decades.

Make them docile. End the behaviour through the simple swallowing of a compound that may be an underlying cause of the behaviour.

Delaying, not resolving, never recognizing it's not control the person is displaying, it's the inability to affect possibly physically and/or mentally.

How many drugs have we found once thought to cure or solve a problem cause severe reactions, complications  worse than the problem, or even DEATH.

Remember Thalidomide?  Look it up. Use the Internet to learn from respected, non partisan sources to grow knowledge and find ways to support positive actions.

We don't consider "aging" to move from being an infant through to an adult, but it is.

We don't consider "aging" as a negative and something to want to turn away from or fear until we start to listen to the voices chanting the mantra of AGEISM.

Listen carefully to what is said around you, to the voices crying out and the whispers that surround -- see the change, the rotation, the movement from those who "have been" to those who "are becoming".

Watch and listen closely. 

Open your eyes, your mind and your heart.
Look beneath, beyond and read between the lines. 

We do not age as one.

We age as a society.

We grow older with one another -- if we are wise, that is.

Women Of Great Strengths

Strong Women  

Every day I see them. 

Do you see them?

The Caregivers, Workers, Leaders, Women With Purpose

Some stand out while others move mountains unnoticed.

Gladys Burrill ran a Marathon, at Age 92

Burrill earned the Guinness Book of World Records as the oldest female to complete a marathon. 

At age 92, she finished the race, which took place in Honolulu

in nine hours, 53 minutes 16 seconds.

 

Diana Nyad Swam from Cuba to Florida at age of 64

In 2013, on her fifth attempt at age 64, Diana Nyad 

was the first person confirmed to swim from Cuba to Florida without the aid of a shark cage. 

The journey was 110 miles long and took her 53 hours straight.*

 

My Mother’s Mother birthed 11 children with all six boys serving their Country during WWII and grandsons volunteering for Korea and Vietnam. 

She chopped down a tree in her yard with a trunk that was 8 to 10 inches wide at the age of 87 because none of her six sons could find time. 

My Mom, walked miles for school and for Church. 

She was a caregiver for her siblings and did work at home until joining her older sister at the age of 13 doing housework for those "more fortunate in life" to send money home for the "younger ones" and then taking in the youngest girl and giving her a High School education.

In her early forties, to prepare to leave an abusive husband, my father, she studied Chemistry and Human Anatomy to pass tests to become a Beautician, now called a "Stylist'.

In her mid fifties, she fell and broke her wrist, had to close her beloved business and joined our family with one son, a few months old; our family would grow to another son and daughter.

From the time she was 65 into her 90’s, we encouraged her and she traveled the world, walked the Great Wall of China, was in Germany a week before the Wall Came Down, in Tien Mien Square two weeks before the demonstrations. 

In her mid 80's, she took our pre-teen daughter on a Nile River Cruise visiting the Pyramids and walking significant distances to share her love of other cultures and places. 

We started a Multi-Gen family lasting over forty years.

 

Genetics, the right food and keeping active physically and mentally along with the financial means and interest can take us far beyond what we think we can do.

If they can, I can, You Can -- with a little physical and mental "luck of the genetic draw", focus and determination.

 

*https://www.careline.co.uk/success-top-10-late-bloomers/

Beginning The End

I saw it happening. Didn't want to believe it. 

Shared with family. Can face when not facing Mom.  

Her passage into the final stage of Lewy Body Dementia--like other stages -- slow at first, highlighted by major changes, not always visible, often seeming to reverse. 

We're not certain how far into this stage she's travelled.

As we see the "new stage" we wonder when it began. 

I think we're seeing it when we're really into it because the changes are more noticeable and seem to be more prevalent.

How far along are we on this journey with Mom?  

Are we really slipping into the final final stages?  

SNC Nurse Manager called and said she thought Mom was ready for Hospice. 

I haven't cried for a long time.

Not  since my husband's death have I really sat down, tears flowing without any ability to stop them. 

I started to cry, I was at work, 

I hid the tears until I could be alone.

We were unable to visit for two days. 

When we arrived, Mom was slumped over.

She was  almost falling out of her wheelchair. 

I'd seen other residents this way. 

She couldn't communicate. 

Just two days had passed.

Mom wasn't communicating as much; she was talking before. She was eating or could be encouraged to eat.

She held and was able to finish, both pieces of an egg salad sandwich.

Now she looks as though she's lost at least twenty pounds.

Why didn't I see this extensive weight loss? 

Was it because her clothes are the size they are?

 

Some blame goes to the Nurse Manager.

She said Mom was holding at the same weight as always.

Just a few weeks ago.

Truth or fiction. We relied on whatever we were told.

Could Mom have lost that much weight without our seeing it happen? 

Yes, we'd both been busy.

I now had a full time job.

My daughter had a very busy part time job.

We weren't stopping by every day. 

She was eating we were told

She ate well even when we weren't there to feed her.

False, misleading, deceptive; not reality.

Meant to "pacify" members of "the family".

They "could" feed her?  It was obvious they were short staffed.

If loved ones weren't there, a "resident" was often "on their own.

Mom and others could be seen using their fingers.

Not able to use a fork or spoon.

From potatoes and gravy to veggies like corn or peas -- driven by the need to eat.

Tears come to my eyes even years later when I'm re-reading and feel so guilty, like I abandoned my Mom, even if I was working two jobs, trying to survive, desperately believing we would be together, the three women in the family -- again. 

Hospice. It's such a final step. No matter what they tell you about people going "off" Hospice.

At Mom's age, this is most probably not going to happen. 

I don't like the limitations. 

If we accept Hospice we can't take her or send her to the hospital for an infection.

Mom and so many others have had UTI's.

I see UTI's as not something that has to be a part of growing older and incontinence. Am I being realistic?

If those who are responsible for her care checked her more frequently and didn't let her sit in her excrement or urine, I don't think UTI's would be so frequent.

I see how short staffed they are; I hear the men and women beg for someone to take care of their needs. 

I hear an LPN tell someone to "be quiet" and "I'll get to you".

Twenty minutes later she's still distributing medications and no one has helped the person who called out.

If Mom's Caregivers at the SNC watched her as closely as we did, they'd see the changes, catch the eye and other infections. 

Most of all, they'd monitor her illnesses/infections as a medical facility, which in Missouri a Skilled Nursing Center is, alert the Dr in charge the medication did not work.

We can't not try to help her. 

Mom's wishes have always been to seek medical help for infections. 

We'll make the decision and take her to the hospital -- even though she'd just been about ten days ago.

I'm walking the road with Mom and I'm not that far behind where she's travelled even though Mom had me later in life. 

I'm afraid for her. I'm afraid for me. I'm afraid for you.