Cloud hidden, whereabouts unknown

Grandma on the picket line, fighting for workers’ rights. I’m so proud of the work she did and forever grateful for helping me my whole life.

Well I’m taking some time with my quiet friend
Well I’m takin’ some time on my own.
Well I’m makin’ some plans for my getaway
There’ll be blue skies shining up above
When I’m cloud hidden
Cloud hidden
Whereabouts unknown

— Alan Watts Blues

Late on the night of January 8th, Grandma’s tenacious grip on life finally let go — not with a sudden fall or illness, but peacefully in her sleep, which was how I always hoped she’d go.

I started this blog to offer a slightly different perspective on caregiving, but it turned into much more than that. My daughters learned about their family. Other caregivers thanked me for making them laugh. And I found an outlet for the confusion, frustration and flat-out bewilderment that comes with taking care of an elderly person. Even one you dearly love.

When Grandma died, she was a mere shadow of her former self. I would much rather remember her as the sassy labor leader who stood up for what’s right and knew how to hobnob with politicians to get what she wanted. Millions of full-time employees have people like my Grandma to thank for their time off, their health care and retirement benefits — even their weekends. Because unions didn’t just help their members; they improved working conditions for everyone by promoting the audacious view that people shouldn’t literally be worked to death. But I digress.

I can’t end this blog without thanking Brookdale Hospice for the excellent care they took of Grandma. As her dementia progressed and her contact with the outside world grew rare, the aides, nurses, social workers and chaplains who visited Margaret and listened to her stories were the highlight of her day. They helped me make informed choices and offered suggestions when I started looking for residential care. In the end it wasn’t necessary to move Grandma to an assisted living facility, but just having people to talk to about it made the journey less overwhelming for me.

Sometime during the final days of Grandma’s life — when I was checking on her through the night, changing her, and administering pain meds — it dawned on me that it was almost the tenth anniversary of my Grandpa’s death. I literally picked up where he left off, which means I cared for Grandma in some capacity for 10 years. That’s 20 percent of my life. I try to remember that when I feel guilty for the times I was short with her or even outright mean. One of my friends commented on social media that I’d been a loving granddaughter. I admitted that wasn’t always true, but I can say Grandma had everything she needed and wanted during the twilight of her life. Just before she died I bent down one day and kissed her head and told her I loved her. “You’re a nice lady,” she said. Wherever she is now, I hope she knows I did my best.

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In the year 2025

In the year 2525
If man is still alive
If woman can survive
They may thrive

What does the future hold for the avalanche of baby boomers careening toward old age? The cognitively intact may find it downright rosy. But the majority will probably have a chronic condition or two. Researchers seem to be divided over which way trends are headed.

There’s no evidence yet that it’s a worldwide phenomenon, but England and Wales have seen dementia rates decrease over the last two decades. It turns out healthier, better educated people stay sharp longer. But it’s too soon for Americans to breathe a sigh of relief. Definitive research hasn’t been done here yet. And while boomers are better educated than their parents, the U.S. is still the second fattest country in the western hemisphere. Not an enviable position considering the myriad health risks of obesity.

Obesity factors into heart disease, high blood pressure and diabetes, and they’re all on the rise. So even if dementia rates level off temporarily, it could be the calm before the storm. Eight out of ten nursing home residents today suffer from at least one chronic condition, and that’s not counting all the other aches and pains associated with aging. Grandma often wishes old age on me so I “see how it feels.” If my 88 is anything like hers, I assure her I want no part of it.

So how does all of this affect me, Al Franken? Realizing healthier living today helps your brain later on is both empowering and terrifying. I thought I was pretty healthy when I saw the doctor last fall for some weird ankle swelling. It turns out I have a host of problems I wasn’t even aware of. I’m taking meds now and fighting the obesity factor, but will that be enough to keep me wise as I grow old?

What do you think? Are the odds for dodging dementia improving? Or is poor health the price we’ll pay for modern medicine granting us a few more pharmaceutical-fueled years? I’d like to believe in the former, but I’m holding my kids to their word that if I go too far downhill they’ll take me for a nice walk on a river bluff and push me in. Just in case.

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When pms and pre-dementia collide

If it’s a day or two before my period and I’m running late and I already have a million things to do including pay bills for Grandma but she can’t hear me when I ask for her checkbook so the third time I yell “Where’s your CHECKBOOK?” and she tells me not to yell at her then spends the next 15 minutes trying to figure out where she hid it, I’m pretty sure I look like this.

Several days every month I’m noticeably more aggressive, angry and anxious — in other words I’m PMSing.

Meanwhile Grandma grows more fearful, disoriented and suspicious by the day. She’s never been diagnosed with dementia on any of her frequent doctor visits, but you only have to have a conversation with her to see the telltale signs. Some days are better than others, but when her bad days and mine collide, it’s like poking a bear with a stick: No good can come of it.

Last week the planets aligned for just such a clash. It started when Grandma asked me for the same groceries three days in a row because she kept forgetting I’d already bought them. At one point I threw approximately 40 rolls of toilet paper on the ground in front of her to prove she wasn’t on her “last few.” By the time I’d stacked them all back on the shelf I was royally pissed.

A few hours later, the tension ratcheted up another notch when her doctor’s office scolded me via voice mail — first because they had to leave voice mails then three more times for her Warfarin levels being wrong. I decided she wasn’t capable of following the complicated prescription regimen by herself anymore, and I confiscated her multi-bottle stash of pills.

I feel I need to preface what happened next. For the past year or so Grandma has made appointments she didn’t need, hung up on Life Alert courtesy calls because she forgot she had the service, called 911 when she was cold and accused a service company of talking to her impersonator. I deal with the repercussions every time. So when I think it’s necessary, I listen to her phone calls. Sometimes it’s the only way I really know what’s going on.

To make a long story short, when Grandma called her friend the next day and — almost whispering — told her she urgently needed to see her, I knew the current battle of wills had reached critical mass. I’d refused to buy her groceries, blocked her calls and stolen her medicine, and she was getting the hell out of here. I called her friend back and told her everything that had transpired then asked for her advice. She offered to come down and smooth Grandma’s ruffled feathers, and I thanked her. I told her not to be surprised if Grandma had her bags packed when she showed up.

With Eileen’s help, the next day we managed to temporarily allay Grandma’s fears (although she did confront me in front of Eileen for stealing her entire box of oatmeal cookies). Mercifully, my hormones slid back to threat level yellow and the drama died down.

Grandma’s Warfarin levels were acceptable this week, so I know I did the right thing. This morning she zoomed upstairs on her stairlift to find out why she hadn’t had her eyedrops by 9:30, but by this afternoon she’d thanked me for the neatly organized insurance statements, doctor’s appointments and paid bills I handed over to her this morning when she asked. As I said, some days are better than others. Tomorrow she may accuse me of stealing her checkbook again, but I’ll have my hormones under control and we’ll work it out.

Until the next clash.

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Committed to memory

Don’t it always seem to go
that you don’t know what you got til it’s gone.

Every day, Grandma and I review the basics: today’s date, whether it’s 9 am or pm, why she takes Warfarin. I remind her other people in the house like “the kid” and “somebody” have names. Most days she gives me grocery lists of things she already has.

Sometimes Grandma knows her memory is failing her. On those days I wish I could jump in a time machine and take her back a decade or so to stave off her memory loss. Each time I play guess-which-common-household-item Grandma’s trying to describe, I wish I’d known lifestyle choices play such a big role in how well we remember things. Now that I’m aware, I’m incorporating as many as I can into my own routine:

Lay off the liquor
Grandma’s never been a big drinker, so I doubt this is her problem. This one’s going to be tough to adhere to, but the memory loss research I’ve been doing gives me new motivation to reduce my wine intake.

Flex that hippocampus
Exercise stimulates the growth of new brain cells in the hippocampus, your brain’s memory gatekeeper. So while your goal may be outward beauty, every trip to the gym also boosts your brain’s short-term, long-term and spatial memory.

Eat your bloody broccoli
After almost five decades of resistance, I give up. I’m assimilating with the pro-broccoli borg. For those of us who hate it, there’s a cruel irony in how gross broccoli tastes and how good it is for you. Luckily, a lot of other foods are memory boosters too.

Last night we dined on deviled eggs, parmesan edamame sauted in olive oil, more olive oil on the salad, black bean and sweet potato burritos and lemon blueberry trifle for dessert — a delicious family dinner that included six memory friendly foods. I now keep a picture of the memory-boosting shopping list on my phone — in case I forget what’s on it.

Minimize your meds
This is a tough one. Your doctor prescribes medication to improve your health, but the medication she prescribes may carry with it side effects that negatively affect your health. I’m not a doctor, and I’d never advise Grandma to go off her meds. But I see a direct correlation between her Warfarin usage and her confusion level, which isn’t surprising given that decreased blood flow to the brain contributes to age-related memory loss.

There are loads of brain exercises you can do to keep your memory sharp. Unfortunately, a lot of them require good eyesight, dexterity or a valid driver’s license, none of which Grandma possesses. The doctor’s already told her she’ll be taking Warfarin the rest of her life. As for mobility and diet — she’s made conscious, stubborn choices to be sedentary and eat crap, and they’re coming back to haunt her. It’s cliche, but if she’d known she was going to live this long, she’d have taken better care of herself.

At this point the best I can do for her is fill in gaps in her ever-shrinking memory. And try like hell to preserve my own.

Image credit: happyroman / 123RF Stock Photo and stillfx / 123RF Stock Photo