Skywatch Friday –thunderboomers galore

 I have been watching the skies. We've had thunderstorm after thunderstorm. Having faced a drought last summer, it is glorious to have the rains.

I've been attending to a client with dementia. I feed him breakfast and dinner. Leaving his lunch out for noon. I've been there for 7 a.m., returning at 3 or 4:00, to check up on him. He managed his laundry, making it upstairs to the toilet, and watching the news.

Arriving in between a series of heavy storms in the afternoon, I found him in the kitchen, washing pretend dishes. Clearly thirsty, perhaps dehydrated. He was having some sort of episode. He was wearing only a shirt. This isn't the first time this has happened to me. Fortunately, as a 'professional caregiver' (according to Dr. Brian Goldman when he interviewed me for his radio show) I wasn't totally shocked. I've come across the same situation before, when a client who was abusing pain medications and drinking too much beer, met us in his living room wearing only a sweatshirt. Logically, he had soiled all of his pants, and didn't know how to use the washing machine. But that is another story of self-abuse!

With vascular dementia, the blood fails to circulate to the prefrontal cortex of the brain. The thinking part. The lower part of the brain stem, the reptilian brain at the back of your skull, manages to keep on functioning. You carry on breathing, blinking, and the other autonomic functions.

Your long-term memory can work, deeply buried in the brains memory banks. However, you may hallucinate. You may not be living in your immediate reality. My buddy had locked the screen door and wasn't letting me in. The lightning was cracking around me. It was beginning to rain heavily.

It took a half hour of persuasion for him to eventually arrive at the door and unlock the screen. What a relief! The lightning cracks were bad. The area had a total of 490 strikes, according to the radio.
He simply wasn't present. He responded to my talking to him, but clearly didn't know who I was, what I was doing, or what his next move would be. He shuffled closer to the door, but began to drink from the sugar bowl as if it was a cup of coffee. Standing two feet away from me, with the screen door between us, it was as if it was a whole different world he inhabited.

After I fed him, had him drink some fluids, he began to return. It was like he was in a fog.
He cannot process abstract concepts, such as what day it is. But his sense of humour returned, and we figured out that it was Wednesday. He was worried about his pills. The routine is to place
them in an egg cup, and he knows which ones he's supposed to take. With swollen feet, due to poor circulation, he needs to put his feet up three or four times a day. But he's too stubborn to do so!

You can get special socks, which keep the feet from swelling so much (my mother, with lymphedema, and wheelchair-bound father needed them), but his feet were too swollen for the pair he had. I let his son know. He attends an adult day away program on Tuesdays and Fridays, and I will drive him to that today. With his son returning tonight, we made it through the week.

Skywatch 7:2

I tell these stories not to shock you, but to educate. This is what many caregivers have to manage in their daily lives. The Ontario Government, in its infinite wisdom, keeps promoting programs to allow care recipients to stay in their homes, but that isn't right for all families. Not many can afford to stay home with failing loved ones.

What are your expectations of the healthcare system?

Middle class journalists writing about middle class folks facing healthcare issues.
It's not a happy mix. High expectations for some sort of 24/7 care.

Help falls far short for 'living widows' of dementia patients

-Dave Brown
 They are prisoners of love who work 24 hours a day without pay or benefits, and thousands live among us unable to plead their cases because they’re kept out of sight. 

 As with many of my clients, the middle class expect more for less. Sob stories of women acting as caregivers for husbands with dementia. Compared to many of my clients, who live in filth, who hoard, who cannot afford a meal out, who live on disability, I really have no sympathy for a journalist trying to garner 'awareness' for a topic such as this. Think of the family whose elementary-aged kids must stay at home on a bad day because Dad is having health issues, mom works for an hourly wage, and she is the only breadwinner. The cases are horrible if you are poor, working class, or living far away from family. The middle class don't want tax increases, they want big dividends from investments. They want outsourcing, and they have a sense of entitlement. They have no idea what it means to be poor and sick.

"What happens to the spouses of dementia patients is unfair, and unless we demand changes now, we’re next."

Life isn't 'fair'.

This particular woman is caring for her husband, but he does not know her anymore. Brown's column waxes eloquently about the issue. He claims that she is house bound ('enforced incarceration'), yet she has a paid support worker there for a couple of hours a day and she meets with 3 other women in similar circumstances. That's not 'enforced incarceration'.

Willard lives alone. His name in on a list for LTC.

In the LHIN next to us, Champlain (which includes Ottawa), Brown cites 13,600 patients with dementia, and he says that 94% are cared for at home and most by a woman. I find, in my local long-term care, many people with dementia. There is a men's group that meets in the TV room, with their wives who have dementia, and they have a grand time. Many cannot cope at home with a spouse who has dementia. Many are aphasic, and unable to communicate. We cannot give people the expectation that they should care for a loved one at home with dementia. Often, it is impossible. The disease trajectory is terrible and include anger, agitation, and incontinence.

If, in the Champlain LHIN were were able to pay for caregivers: personal support workers (PSW) at $12 and hour, the system would be bankrupt. The couple about whom he writes are both retired civil servants on indexed pensions. This couple married 'in sickness and in health'. Brown calls for volunteers and more donations. 

October book review club

I just finished House Rules. An amazing illumination of the life of a young man with Asperger's Disorder. Having taught a fair number of students with autism, the character development and the family dynamics hit home for me.

I love reading. Anything. Newspaper, magazines, blogs, book reviews.
But, for relaxation, and to try and escape my world prior to sleep, I love a good mystery novel. Picoult does an excellent job of integrating timely topics within her novels that feature a compelling story. Picoult spins a great tale.

Yes, yes. I know I've reviewed her books before, but the only other book I am reading, in preparation for a talk I am giving to a hospice group, relates to dying with dignity. This book was an interesting read. As always, there are twists and turns and the unexpected for the reader.

I've tried various authors, as my faithful followers know. I have come to the conclusion that I will never read Steven King again. Not since the death of my parents can I deal with the gruesomeness of his work.

My good family friend, who turned 78 last month, told me that she taught a young man who was pretty sick, gruesomely so. Clear as day she recalled horrible incidences in the life of this seriously ill young person, who went on to find a career in writing violent, gruesome, twisted mystery novels. Our friend has vascular dementia, and cannot recall anything on a short-term basis, but she tells wonderful stories about her childhood, her youth, her adult working life as an early childhood educator and teacher, all the same. She reminded me of my teaching days. You meet children you wonder about, and fear for their futures. What struck me about her story related to this novel. What struck me was that, unlike dementia patients, he knows what he doesn't know, and this seems fitting with the current amount of information available to family members.

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@Barrie Summy

Perth bloggers unite!

I was researching others in my near-by city who blog. These are the folks most active nearest to me...

I'd rather be blogging than out in freezing rain!

• Shabby Chic
• Sarah Herron Krissilas
• Cathy Breedyk Law
• PATRICK WHITE
• Matthew Barnabe
• Craig Mcintyre
• Spring Peach
• Friends of Murphys Point Park 
• Bastou

There are many more who started a blog and have abandonded it.

Many wonderful healthcare workers in Ontario

My friend, The Emergency Room Nurse (TERN), who writes a blog from an ER Charge Nurse point of view, is one of my favs. I depend upon her to pick out what is important in health care and draw it to my attention. She distills info, and I learn much, as well as finding common ground between my field (education) and hers, (healthcare), as I advocate for seniors in my community (you know poverty is the most influential aspect of ill-health).

TERN was writing about a fellow healthcare professional who is taking leave from writing.
She wrote:

Writing is hard work. It takes commitment. And there is no cure for it. I’m getting a little faster, but still, producing a longish piece, say in the range of 750 – 100 words, still consumes four or five hours — which is why you, dear readers, only see them maybe weekly.

Where the red squirrel played

It is demanding, time consuming, to write clearly, honestly and accurately about some issues.

I think this is exactly why I blog! Me and my generation are critical thinkers. We reflect, research, and comment on life, our profession, what seems right and wrong in society, in our neighbourhoods, communities, regions, provinces, nation and the world.

I am pleased to be able to stay at home, and bring my take on the world around me, to those who continue to read my blogs, respond, correct me and further reflect. A bad cold aside, I am resting with my laptop! No volunteering this week.

Retiree plays in the snow!

It counts, to put your opinion out there. Not on the 'comments' section of newspapers on-line, but in blog posts that add up to provide information for those looking for it.

My blogs have led to a number of contacts, interviews, and journalists seeking information (i.e., G8 Muskoka)and my insight, as a middle-aged professional. (Perhaps, at 53, I am nearer the old age than middle?) You know from your own discussions, that you are enlightening and illuminating the world around you.

It is only in discourse that we improve and learn. And while we research what we write about, we help improve the information on the web.

Bob V

I found, as a teacher, that few had the guts to listen to me, or my peers. My supervisors (i.e., principals/managers) were more concerned with appearing brilliant to first their supervisors, and then management, and then the public. Once I hit bottom and became clinically depressed: caring for failing parents, moving far from friends and family, leaving the best classroom (Gr. 8s), staff (Sir Win) and principal (Dave Hogg) in OCDSB ever, leaving a fabulous city in which to raise kids (Nepean), to live by a lake in Muskoka, I ended up finding peace by writing my book. Not on education, as I originally thought, but on being a caregiver for my mom with cancer, dad with a brain tumour and the ensuing dementia. Now, much more centered, I can volunteer and help others.

Our granddaughters

Some of us are unafraid to call a turkey a turkey. Workplace bullying, Full Day K, for example
I tend to reserve trite, flippant, fun info for my Facebook friends, and the more serious issues I channel into Health, Education, General Rants on my 3 main blogs.

I play with images, and memes, and generally keep reading, researching and writing.

Happy santas

Forgiveness vs. guilt

What with all the press that the Silver Tsunami is being given, and my friends who have bemoaned their lack of motivation, I wanted to create this post. Much has been written about preventing dementia. I think, just like teaching your child to read by age 3, entrepreneurs are simply catching the bandwagon. We know how to be healthy. At this point, it is better to identify dementia early, and begin to treat it and prepare yourself for middle and old age.

It is important to

• exercise properly,
  
• eat well, and in moderation, mostly veggies and whole grains
• high fibre, low salt, low fat
  
• drink lots of water & hydrate,
  
• drink alcohol in moderation - one glass of red per day is recommended
• watch your weight, blood pressure, stress levels
• participate in healthy things for the big 3: mind, body, spirit.

That said, you really need to forgive yourself. The first week of July was always my week to do the things that needed doing. After being mom/teacher/mentor/volunteer/committee member for 10 months, there were things needing doing.
Then, the second week I forgave myself.

You need to depressurize, not give yourself more deadlines, must-dos, and guilt. Go for an afternoon walk. Read, write, play, dream think. That, too, is meditation. Each day is your new chance to make lifestyle changes. Set goals and meet them and rejig your goals when it is right for you. I remember going to the gym and seeing the spandex-clad size 4 cuties, with the young men ogling them. That just didn't work for me!

I have had a tough two weeks, conflicts with guests, issues with the house (can you spell money pit?), and the joy (but pressure) of playing grandma. I find writing and reading on the computer is really cheap therapy! It opens up a whole new world and helps me realize who I am as a person - not as my role: mother, wife, grandmother, volunteer.

I loved taking yoga classes. I cannot, now, but do stretch when I can, now that I know the poses. I have a video, which helps remind me.

But where do you start?
It starts with one step at a time. Manageable goals.
When I wanted to get back to working out I began by laying out a 1 km stretch of road. I walked, crawled or ran as far as I could. Eventually, when you plug in a short distance, and you build that time into your day, you can increase it.

Here is a place for excellent resources.
I worked for CHAP, as a coordinator of volunteers. They have some great resources on their page. There are some places where you can go for support, and they will send you a nagging e-mail as you wish. Do that, if it is right for you. Mostly, it is in finding a kindred spirit and sticking to a plan. The best of luck!

Seniors Driving

With an increased life span, and many people with health issues we must be more vigilant in monitoring health issues in seniors. Current buzz revolves around keeping senors off the road.

The Star seems concerned about this issue with two articles!

Physicians, health care providers, family members and insurers are responsible for reporting seniors who are unable to drive. Despite the magic age of 80, we must be aware and take responsibility at the earliest signs of dementia. Families have a responsibility to monitor their aging family members to protect society. If a family member has shown dementia-related factors, then adult children must monitor these issues.

CBC this morning featured a clip that stated that "100,000 drivers over the age of 65 will be on the roads in 2028." I was quite surprised. How certain are they that these folks will have dementia? I hope to sail through my 60s in good health. Such ageism in this day and age...

We can prevent, identify and ameliorate dementia symptoms, but they must be recognized and faced up front by family and neighbours. Most are in denial in my experience. When accessing services caregivers and family members might be at their wit’s end.

In Ontario the CCAC oversees patients released from hospital, but their mandate does not cover frail or ailing seniors at risk in the community. Very few resources exist. Some seniors can find resources through non-profit agencies (see my links), but these agencies rely on donations, rather than tax dollars, and care is finite and difficult to arrange. Aging at home funding agencies and programs have been slow to develop, despite a long-standing client bases in those who are disabled and in supportive living and day programs.