Thursday, June 25, 2009
Mother's (and my) Progress
There have been many positive changes in Mother's quality of life issues - which have also been quality of life issues for me! I am mostly past the point of being embarrassed when having to address hygiene issues. I've made suggestions, gradual changes, and sometimes outright bullied her into taking these steps.
I didn't realize until just before our move here that she was NEVER brushing her teeth. She had gum surgery several years ago, and was always very conscientious about brushing and flossing, even taking a toothbrush and floss to work with her and using them after her lunch in the company break room. But her increasing dementia, and perhaps depression after my sister passed away, had given way to no attempts at regular hygiene at all. I finally told her that she HAD to brush her teeth at least once per day and (taking a page from the "dealing with small children" notebook re: offering options) asked her if she would prefer to brush her teeth in the morning or in the evening. She chose just before bed, and now she faithfully brushes her teeth every night, promptly at 9:30 p.m.
After her initial appointment with her new primary care physician, we were referred for an Activities of Daily Living (ADL) assessment, and ended up having several weeks of physical therapy, and a health tech aiding with showering. Mother's poor balance and increasing weakness were, for the most part, due to her amazing levels of inactivity. She was not moving around much, she was not getting any exercise; she just sat (or lay down) and watched TV all day. After a few weeks of 3x per week PT with increasing levels of exercise, and my gentle observation that if she became incapacitated, I would not be able to care for her, she has been walking around more and is generally in better shape. She did not continue the exercise regimen the PT set up for her, but neither did she return to her previous level of inactivity. As she is VERY interested in what the mailman brings us, I told her that I won't get the mail, so that she will at least make the walk to the street and back every day. I still can't get her to walk around the grocery store with me, though. She walks from the car to a bench at the front of the store, and waits there until I'm done, then walks with me back to the car.
She now sees a podiatrist every other month for footcare that she is no longer able to do for herself. She has new, comfy shoes purchased from SAS shoe outlet. We almost had a fight in the shoe store, as she was appalled at the cost ($80) and said she wasn't going to pay that for a pair of shoes. I told her they were good quality, leather shoes, and she WAS going to replace the old, wornout, ill-fitting shoes she had. I also told her that if she didn't buy them at this store, we would just have to go to another store - and another and another - until she found some new shoes that suited her. At that point, she must have realized that I was dead serious, and decided that buying what she thought were expensive shoes would be much easier in the long run. She is now quite pleased with them.
A health tech comes to the house on a weekly basis and assists with shower and shampoo. After the initial PT sessions, which included shower help, Mother realized that showering wasn't all that scary (the master bath has a large walk-in shower). But she was still resistant, and oh-my-goodness, I was quite reluctant, to me giving my mother a shower, and so it just wasn't happening as often as it needed to. I finally told her that I was arranging for weekly bathing visits by a nursing service, and it was going to cost $28 per visit, and as it was a health issue, it was no longer negotiable.
We have also moved through a series of steps to her wearing Depends (or actually, the Publix brand equivalent). I was worried that she would take offense at the suggestion, but her reaction was totally positive. She just seems to consider them to be a handy, helpful item. Thank goodness!!
For those of you who realize the import, I am also very happy to report that the Big White Purse is GONE! I had tried several times over the past two years to get her to go through it and replace it with another of her bags, but she was always extremely resistant. I guess we finally reached some tipping point of me really insisting and her getting tired of arguing. We cleaned out gasoline receipts that were over 10 years old, got rid of notes and phone numbers that she had no idea whom they were for, and got everything switched over to a nice beige purse (see photo above). And as with the shoes, after the painful act of change, she is now quite pleased with her new bag.
In addition to all these life improvements over the past nine months, Mother has recently started spending one day per week at a local senior program. But that will get a blog post all its own.