When does variability become invariable?
The brain did a lot of dreaming but came up with nothing usefull over-night. Might be because just befor we turned it, the 98 year old took off on her own about thirty seconds after I left the room and, before we knew it, she had fallen in the hallway to the bathroom. The spouse was no more than six feet away, but she was quick as a flash.
So, what did I do? I yelled at her, berated her roundly, got admissions of wrong-doing and agreement that I should just leave her there. Then she asked for a pillow for her head and at that point the spouse and I agreed that she must be OK, got her on her feet and assisted her the rest of the way to the toilet. I have to admit that I was sorely tempted to administer a spanking. She tried to explain that that's just how 98 year olds are and I told her I wasn't buying--that she'd been a stubborn, self-centered, unco-operative person my entire life. And that's the truth.
********
Yesterday was, on the whole, unexceptional. The only ill effects of the fall the day before seemed to be a little soreness in the right leg, the claim that she could no longer walk even as she walked, and more frequent summons to do this or the other.
One of the things she was intent on was deboning the boiled chicken for the dog. Which she did for several hours, after commenting that the broth from the chicken served at lunch was really tasty and she could see why the dog likes chicken and rice. That cheerful mood dissipated as the afternoon progressed and by dinner time she was not interested in eating and went to bed somewhat earlier than usual. I affixed the Depends with duct tape (yes, that's become necessary again) and was awakened about eleven by the sound of crinkling plastic. By the time I got down to her room, she was resnapping her pj top and pretending to have done nothing, though the duct tape had been worked on. I told her to go to sleep and leave the Depends alone.
About 2:30 there were plaintif calls for help and I went down and helped her to the commode, after removing the Depends as she asked. I replaced it with a fresh one but didn't apply the tape, since it seemed unlikely that the bladder would leak much in the next four hours. Hardly had I got back into bed when there were more calls, followed by the request that I "hit her on her head" and the insistance that she was dying. I gave her some tea and some of her elyxir and told her to go back to sleep. Which she did.
By morning she had again removed the Depends and the bed was damp, but the sheets needed changing anyway. As I did that, I remonstrated with her that, as usual, she hadn't done what she was asked. She asked, "what?"
Although I explained about the Depends and not walking around without assistance and, in general, not doing what she is asked, I realized that it is hopeless--though it does make me feel better to express the frustration.
I should, however, be used to it by now. After all, I learned a long time ago, as a child, never to ask her for anything because the response was invariably, "no." Her justification then was that if children get what they want,they will be spoiled. Regardless of how modest the request. If one wanted anything at all, it was best to just wait and see if she thought of it herself. But, even presents were tricky because if one was insufficiently appreciate, the apparent generosity quickly turned to resentment. Indeed, resentment could make it's appearance on a regular basis--whenever someone failed to do what was expected, but, of course, never requested. The least painful strategy (emotionally) turned out to be not to want, not to ask, and not to get attached to anything one was given, because liking the gift more than the giver was also a cause for resentment and accusations.
Though one might think this is a terrible way to live, it obviously doesn't interfere with longevity. Indeed, longevity might be the curse of the selfish.
Well, dinner went off fairly well after a quiet afternoon. Half-way through the Omi suggested that we leave her here and take a train out west. Now that she's gone to bed she's afraid she'll die tonight. The sleep aid should kick in soon. She's like an over-tired child.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
'Twas another short night. About 2:30 in the AM, I heard the rustling of plastic and by the time I got downstairs she had walked over to the commode and sat down without removing the Depends. I'm not sure she's not sleep-walking when she gets out of bed in the middle of the night. It may be time to put up some sort of rail since she's really not steady on her feet.
After I got her back to bed and she drank some tea and some of her elixyr and she had a chance to tell me she's dying and thank me for everything, she went back to sleep, with the light on. The dark seems to be frightening, even with a night light.
Oh, yes, and I had to fix another hot water bottle for her chest. She says her heart hurts, but it sounds like gas. Don't know if the spinach, which she likes very much, is supposed to have that effect.
********
December 2---
Another short night after five or six wake-ups. About 2:30 there were plaintif cries of help and I discovered the Omi sitting, almost all the way undressed, on the side of the bed, obviously wanting to use the commode.
She'd finally managed to remove the depends and shreds were strewn all around the bed. Urine production has really decreased, so the bed wasn't actually wet.
When I got her settled back in and told her to go to sleep, she said she had to go to school but didn't think she'd make it. Yesterday afternoon she was talking about building a room in Lengries, the town where her parents lived and died and which she never really liked (it's in the country and she's a city girl). She thought her parents would like it there and lots of people would come, but then decided it was probably too late. She just wants to be doing things, but thinking about Lengries did make her feel good (I'd suggested the day before that she think about something pleasant while she tried to go to sleep).
These middle of the night events still strike me as unreal--like there's another person. Her aspect is different, too. Her eyes tend to be wide open although she doesn't seem to see or recognize me and her speech is impersonal as well. Talking about going to school suggests that perhaps she's reverting to being a little girl.
Funny. When I showed nurse Judy the picture we had taken of the Omi sitting on the coffin-box, she said she wouldn't have recognized her as the person now sitting in the chair. And that was only last Saturday, when she had obviously pulled herself together, gotten dressed in street clothes and interacted with the family. It didn't surprise me since I've seen it before. The sociable person comes and goes.
******
Another somewhat short night. Found her at 9:30 on the commode from which she couldn't get up by herself. Sleep aide doesn't seem to keep her asleep. Then around one I was awakened by the noise of crinkling plastic and found her trying to get undressed under the covers. Put on duct tape, even though it probably won't work with the new kind of undergarment we picked up by mistake.
She woke at six and asserted that the dog needed to go out. The dog obviously didn't think so since she walked out into the kitchen, noticed it was still pitch dark, and climbed back into her chair. I gave the Omi some of her elixyr for her pain. About nine-thirty she was ready to get up but again collapsed as if near death in her easy chair. Gave her some more elixyr and by the time her hot cereal was done, she was able to eat and then read the paper.
Should note that both nurse Judy and I noticed a lot of gas rumbling around in her stomach. Quite a bit escaped yesterday, about the same time that the spouse reported feeling poorly. Our thinking now is that some frozen Pepperidge Farm layer cake may have been to blame. It's the only thing I didn't eat any of and it's something that Omi had quite a bit of until the spouse ate the last piece on Thursday night.
Anyway, today the Omi is feeling increasingly better. Did her nails this morning and then had a whole scrambled egg for lunch. Now she's reading the entertainment section of the paper which has a profile of Martha Graham.
Shared my suspicions with the younger son and he came back with the information that someone did tests on the ice put in drinks in fast food restaurants and 60% came back from the lab with evidence of contamination with e-coli. People don't wash their hands and the ice machines don't get cleaned properly. Yet another reason for not eating out.
*****
Some time in the afternoon, the Omi wanted to know if the lady across the street couldn't take her to bridge at the University. Had to explain that the lady across the street here doesn't play bridge--that she was thinking of her acquaintance in Georgia, over 1200 miles away, and that it was too far for anyone to come to play cards.
A trip to the commode was really tiring and caused heavy breathing and the realization (a first, really) that it was a silly idea to think about going to play bridge when she's feeling her age so much.
Dinner was uneventful, at the dining room table, and she even asked for pudding afterwards, in addition to finishing her gin and tonic. But then she was definitely ready for bed and had to sit and rest as soon as she got in her room.
The production of urine still seems to be decreased and bright orange in color. And, there's always the contriction in the chest when she's standing for even a couple of minutes. But, her mental outlook is better.
This morning, December 4th, she woke and wanted to get away from the ghosts in her room--wanted them to leave her alone, but was unable to describe them or identify them as other than that they were bothering her. I expect she was awakened from a dream. She hardly ever knows when she's been dreaming. Said she was tired and went back to bed after a trip to the commode. I gave her some elixyr in tea. (should look that word up and check the spelling)
Time to walk the dog. I've got to return to regular exercise.
*************
Later--This being Sunday, the Omi preferred to have breakfast in bed, but didn't eat it all. She did tell me again how much she appreciated my looking after her and told me to take it easy now.
Just before lunch she was willing to finish her cereal and proclaimed it tasted good and then she announced that she was ready to get up and sit in her easy chair.
Getting upright is a problem. The color drains from her face and I suspect that the heart is having difficulty pumping the blood to her brain. The hearbeat seems to be consistently elevated. Her bladder is not being very productive and the stools are rather dark and accompanied by tissues that seem to disassociate themselves in water.
On the other hand, her mental acuity is somewhat better than usual. She's been responding to the spouse in context, making reference to the cake that made them both ill.
As an aside, the spouse continues to check on Majory Milne. Today, when he called, she couldn't remember whether she'd had lunch. Though she did know that she'd had breakfast. Then she suggested that she'd like some fish chowder from the Market. Five minutes later she called back to assert that she wanted the 'cup' not the 'bowl.' These old women are all the same. It's important for them to set conditions and give precise directions. Also, they prevaricate. The spouse caught Majory in a lie the other day. But, we've gotten really good at dealing with these quirks and to take them in stride.
It is interesting how persistent the impulse to give orders and to prevaricate is.
*********
December 6
It seems pretty obvious that a lot of energy gets expended during the night, trying to remove the Depends. Yesterday morning, she had obviously been successful, despite my getting up to reprimend her in the middle of the night. So, in the morning she awoke with the announcement that she'd been trying to do the laundry, but couldn't work the machine. Obviously a dream. But the bed was wet--not very since urine production continues to be reduced.
It was still a pretty active day. At one point she asked again if Dr. Nelson couldn't be gotten to find her a nurse. I think the intent is to replace me with someone who will be more amenable to doing her bidding, like when she had a house-keeper during her young woman-hood.
But most of this scheming occurs while she's lying down. As soon as she gets up, she's experiencing shortness of breath and chest pains. The heart continues to beat at an accelerated rate (making her feel warmer than she's ever felt in her life), but it seems to be having a harder time dealing with gravity.
Putting the duct tape on rather tightly had the result of making the Depends immune to removal. But, I was awakened at least four times with the sounds of the effort, which would subside after a few minutes. So, I didn't bother to get up and check.
The consequence of all this night-time activity seems to be tiredness today. She did get up about 9:30 for breakfast--not all eaten, like yesterday--and was ready to go back to bed about 11:00.
*******
December 7
A rather uneventful night ended with a demand to get up at 6:15. At that point, most of her clothing had already been removed, although she claimed to have just done it.
The trip to the commode was tiring and resulted almost immediately in shortness of breath and expressions of distress. She went back to bed and I gave her some of the elyxir in a bit of tea. About nine she woke and insisted she had to "get out of this place" which turned out to be an airplane on which she was the only passenger. (Yesterday she wanted to be rid of the ghosts that were bothering her).
After a while she realized that she was home and agreed to have breakfast. She ate the whole bowl of cereal, which I fed her in bed, and then went back to sleep. Nurse Fran came about 11:15 and ascertained that not much has changed. The blood pressure is a little higher and the pulse is elevated as before. The latter probably accounts for the fatigue and shortness of breath associated with getting vertical.
This afternoon, after having been up for lunch (just some tea and a jar of fruit) she went back to bed for a "nap" which lasted most of the afternoon. However, while she was sleeping she solved the problem of getting people whose legs don't work new legs. The particulars are impossible to explain (by her own admission) but she seems happy to have this "project." Even just taking a few sips of team has become strenuous and requires a rest.
Urine production continues to be minimal and dark orange in color, suggesting that the kidneys are failing.
*****
Did I mention that the Omi never got out of bed yesterday except to use the commode? Although she ate all her breakfast hot cereal, she had virtually no lunch and only pudding for dinner (potato crowns with sauce didn't go down). Since I was going out to my once a month meeting, I didn't argue.
When I got back, she was still awake and wanting to know if I had fun. I changed the Depends and tucked her in for the night and at 3:30 she called to have the diaper removed so she could use the commode. Getting up was strenuous and she returned to bed convinced that this was the end. I didn't think the signs were right and persuaded her to take some of her elixyr and try to go back to sleep. That worked until about 4:30 when she needed more reassurance. About 7:30 she was ready for another dose of her elixyr, along with some tea and then announced that she wanted a sleeping pill so she could sleep. I gave her one Nytol. That lasted until about 11:00 when she was awakened by the slamming door (the spouse went out) and informed me that she couldn't play three games at once. No doubt she'd been dreaming. Since it was about time, I administered another dose of the elixyr after she refused to eat but a few spoonfulls of the cereal I had fixed. Then she went back to sleep.
*****
December 9
A good night without interruptions. When the Omi awoke, she took her juice but found it hard to drink. Later she said that she was losing water (peeing) and I told her that was OK because getting up is really a strain.
Mid-morning she only ate about a third of her cereal. Eating, too, is a strain.
About a half-hour ago she called out "when are they coming to take the body" and I found her sitting on the side of the bed. I explained, again, that they don't collect live bodies and that she was still breathing and talking and moving around. Then she said that she had to pee and observed that "doesn't count as dead" either. I had to laugh.
Then she decided that she's recovering a little every day and that she's going to get people new legs and her grandson would have to help. We need to call him. I suppose he's got special standing because he made the box.
Somehow she keeps vacillating between wanting to be dead and fearing that she's dying. Lesson--the issue is really complex and I wouldn't want to be in a position to make a decision to assist someone who's not comatose.
About three this afternoon, she was suddenly sitting up on the side of the bed, ready to go to dinner. After I explained it was a bit early, she agreed to sit in her easy chair and have some tea. Went to sleep before it cooled in the cup. Woke her to take a few sips and then she announced she needed to use the commode. That took a lot out of her and she just wanted to get back to bed.
Of course, as long as the plumbing is working, it's unlikely that the end is near. I guess. She's still on this roller-coaster where one minute she's dying and the next she's on the road to recovery. I'm thinking that she has to reach a point where she actually accepts that she's going to die and then does. There's a difference between accepting and willing.
****
At 1:30 AM the Omi demanded to have her Depends diaper removed. I did, and replaced it with another. At 6:00 AM I was summoned to be told that she needs to find "geduld" for herself. Geduld, of course, means patience. And nobody can disagree with that assessment, but it's really beyond my capabilities to help her do that. I gave her some juice and another dose of elyxir and she went back to sleep.
When she awoke about 9:30 she declared herself ready for breakfast, but only ate half. By the time that was consumed, it was well past ten, so I gave her some more of the elyxir and she's been sleeping since. Even the slamming of the back door does not seem to wake her.
Oh, yes, she also said that her continued existence is boring. When I suggested that since not many people live to 98 and she's not done it before, so it ought not to be boring, she didn't object. I'm thinking she's achieving some sort of peace, but I could be wrong. We'll just have to see.
******
Sundays are never good. The Omi called out about 3:30 AM. I think she was repeating her address--perhaps even in her sleep. I put on the light, changed the Depends and gave her a warm cloth for her forehead. She complained of headache.
About 4:30 there was another alert. Gave her some medecine and suggested she go back to sleep. She announced that she was probably going to die because now she'd decided she didn't want to. Told her it doesn't work that way but she didn't look like she was going to die today anyway. Then at six she seemed wide awake and asked for a nail-file to do her nails and was ready to eat breakfast--only half, it turned out. She said she didn't want anymore because it wouldn't help her die.
A trip to the commode mid-morning was, as usual, stressful. When she's lying down she forgets that standing up causes shortness of breath. Her sense of self-awareness continues to be poor. That makes it hard to know what's actually wrong or bothering her. The blood-blister on her heel is slowly healing. So that process seems unaffected--as are the eliminatory processes, albeit somewhat diminished.
******
A few hours sitting up in her easy chair, most of them spent sleeping, made her feel not well and she spent the rest of the day in bed. She managed to finish her hot cereal for lunch and then a jar of baby fruit. For supper I fixed a scrambled egg, but she only ate half and a few sips of tea.
Everything was quiet until about 9:30 when there were suddenly shouts for help. She needed to get back into her bed, although that's where she was. About midnight there was another episode of needing to get back into bed. I expect she was dreaming and woke up confused. (In the afternoon, she started to separate the sheet from her comforter because she didn't want the neighbors to take it). Thereafter there were periodic comments, mostly in German, that didn't make much sense but about three o'clock she insisted she needed help to "get out of here." I asked where was she wanting to go and she said "to the street. Maybe the gentlemen can help us." I said, "no, we're not going anywhere," gave her some medicine, held her hand, put a warm cloth on her forehead, and waited for her to go back to sleep. It was a very fitfull process. The hands and eyes would suddenly wander, not really seeing and purposeless.
I'm thinking that all my life I've done things that I wouldn't recommend to others. This "do it yourself" habit is really not for everyone.
Now it's 4:30 and she's back to her critical mode--the service in this place is not good, the patients are kept waiting too long. She'll tell the doctor when he comes. What I'm wondering is if I will actually miss the demands and complaints and that grating voice when they are gone. All my life I have heard that unmodulated voice and calculated from afar whether it was saying anything worth attending. Lots of people found it fascinating, but not for very long. Wonder if they felt relief when it was gone.
Noon--The Omi has spent most of the morning talking gibberish off and on. The medicine seems to have calmed her somewhat but she refuses food and even water. At the moment, she's staring at the ceiling talking about her brother who was killed in France in 1940; claims he brought a slip of paper telling her he was shot at 11:00AM. Wants to know if they are going to collect his dish.
At one point she said she saw her daughter on the ceiling as well. Now that's a bit disconcerting. Said she was trying to feed the dead.
While her color was a bit off this morning, sort of yellowish, some red has returned to her cheeks. The breathing is normal and the voice is strong.
Suddenly, she got up, sat on the edge of the bed and wanted to go to her easy chair. That wasn't easy. She's not able to stand on her own. But, she can sit and cross her legs and announce they were supposed to come get her at 12:00 o'clock.
Three-thirty--apparently sleeping soundly. The chattering and broken sleep has stopped. Perhaps, come nightfall, it will start up again.
********
Despite my checking on her every half hour, she managed to surreptitiously, under the covers, take off her pj's and her depends and then pee in the bed. She didn't have any difficulty whimpering that she was sorry.
After I had everything changed and got her back into bed, I made it clear, once again that people who are dying do not get undressed in secret. Then I asked if she wanted some pudding and she consented to eat. So, it was all a ruse, again. She's playing crazy in hopes that will get her moved to another venue where she can be in charge. No matter how often I explain that's not going to work, she tries again. She's really totally resistant to being directed in her behavior. It's amazing that one can survive that way for such a long time.
Since her afternoon exertions seemed to have worn her out, I left on the light and the door to her room open, so I would be alerted by the spouses "correction" of those conditions upon his return. And so it was. About 11:30, I got up and went downstairs to do a quick check and give a dose of medicine, if she was awake.
The spouse did alert me that he thought she was getting undressed under the covers. Not "getting," it turned out. She had managed to wiggle out of her pj's AND the duct-taped Depends and was in the process of removing the top. I remonstrated and put everything back on and gave her the medicine and a drink of water and then listened as she coughed off and on for a half hour.
About 2:30 I was summoned, wished a good morning, and told she'd just figured something out about a city's population. I responded that it was really too early to be up and that I needed to go back to sleep and she should too. By 4:00 she'd obviously tired of trying that and started talking (loudly) again. I went down to see what was up and she told me that she'd "behaved" (all clothes still on) but that she needed to use the commode. So, I helped her up and, as is now not unusual, she experienced some distress in her chest (didn't happen yesterday while I was changing the sheets). By the time she got back in bed she was moaning that she was dying and I gave her a dose of medicine, held her hand while she calmed down, and then left her to go back to sleep. Which is where we are at now.
*******
The rest of yesterday was largely unexceptional. She ate half her cereal at breakfast (juice with medicine at about seven) and the rest about lunch time. In addition, she had a jar of baby fruit and towards dinner time asked what there was to eat and I made her a scrambled egg, of which she ate half. Also had a bit of chocolate pudding, and quite a bit of water. Indeed, she announced that after hating it her whole life, she now prefers the water to anything else. (Well, we'll see how long that lasts).
While we were doing lunch, I noticed that the Depends had been half undone again and she tried to give me some story about how when she was on the stage, she had to get dressed and un-dressed all the time. See, when it's in the wrong, the brain is still agile.
Anyway, I prepared her for the night with a Nytol and a dose of the elixyr and a suggestion that she try to sleep more than a couple of yours. She said she'd try three. I suggested eight would be better. Sure enough, at 11:30 she started yakking (it was incomprehensible, even the intonational pattern sounded like Swedish, or something). That went on for about an hour. Then she called my name and I went down and she told me something about a most expensive ring and playing golf--i.e. more nonsense, but in German and English.
So, I gave her a drink and a dose of medicine and told her to go back to sleep. She asked what she would do without me and then, for about another hour, as I lay in my bed, she went on about how "the good child wasn't letting her sleep" and that " it was time to sleep." I think she finally did because I know I did, until she woke me calling my name at 4:00.
Again we had a conversation about what she should do--go to sleep. And I put a warm cloth on her forehead and closed the door, hoping for the best. She did say "Ich seh schwartz" meaning she doubted that she could sleep and her wide open eyes (I could see the whites) would tend to back her up.
But, as of now, all is silent. It's the mid-night hours that seem most bothersome.
*******
I'm finding it hard to do a running commentary during the day. After the night-time agitation, the Omi slept until about nine and I was just fixing her breakfast cereal when the hospice nurse arrived to do a quick assessment.
The vital signs remains essentially unchanged, but the Omi shifted from being attentive to looking comatose in the nurses presence. When nurse Fran had left, it didn't take much to rouse her to eat at least half of her hot cereal. Then she asked if the doctor was a real doctor and I had to explain about the nurse being a real nurse, but I don't think it registered.
Anyway, she went back to sleep, more or less and didn't rouse until after noon, when she did have a jar of fruit. Ate the rest of the cereal later, when she announced she was hungry.
I had suggested during the night that she try counting sheep to go back to sleep and she did a couple of times during the day. It took a while for it to register that what was coming over the monitor was counting. She was asleep during supper time and we enjoyed a broiled chicken in peace, along with a visit from the first son who'd come with birthday greetings and a new router to set up the wireless system in the house.
When the Omi woke up, she was glad for a little visit but didn't know what to make of her grandson's query about how she was doing. Wanted to know why he asked and was it because she looked so bad. Everything is always about her and now that she's hard of hearing its even more so.
Tried to get her to eat the rest of the pudding, but she didn't want much. The elixyr and the Nyton went down with a lot of water and then she went to sleep rather easily. About 11:30 she was back to counting--usually a few numbers in the 90s and then she'd end with "Enough, finito, genug." That went on, off and on, for a couple of hours and it wasn't until nearly 2:00 that she called my name and said she was hungry. So, I went down and fed her the rest of the pudding and gave her another dose of the elixyr, hoping that would put her back to sleep. I guess it did and I got to sleep until almost five.
In the interest of fairness, I should report that after she got her pudding, she observed that she was being "spoiled." But then, when I told her to go back to sleep because it was only 2:00 in the morning, she immediately came back that she hadn't told me to get up at 2:00. I will give her the benefit of the doubt and suggest that she didn't remember calling. Short term memory seems to be about gone.
Soon after I came down I heard her counting again, went in and told her the time and suggested she go back to sleep and she wanted the light to stay on. Then, about a half hour ago she called to have the Depends removed. That usually means she wants to use the commode and, after I moved it close to the bed, she did, successfully.
(If you don't want to know the particulars of a person's defecation habits, skip next paragraphs)
Ever since the Omi has been more or less bed-bound, bowel movements have been a bit of a problem. We've tried various softeners and eating more roughage and I finally settled on having her drink prune juice every morning. That's how I've avoided having to resort to an enema which is what became necessary the first time she spent much time in bed with pneumonia.
Once the system seemed to be working pretty well (I kept track on movements on a calendar), there was a pattern of many trips to the bathroom (each a little success) on one day and then none for two days or so. When there was a major success it was followed by a lengthy wash and the few times when she forgot to flush, I noticed that the use of paper was really minimal.
I mention this because since she's having to use the commode for all excretory functions, I find that I have to prepare bundles of paper for her to use, each of which needs to be inspected and each of which I have to prompt her to deposit in the commode bucket.
At first I thought she'd just forgotten how to clean herself, but now I'm thinking that it was a firm habit to resist having bowel movements until she was in a situation where she could have a wash afterwards. In other words, we're looking at a life-time of willed constipation so the evacuation of the bowels could be handled appropriately, in her own bathroom. And whenever it got too bad, she'd just give herself an enema. (I always wondered why she had a douche bag in her cabinet, since there was obviously never any opportunity for its usual use after intercourse).
I wonder how common this pattern, if it is a pattern, is in other cultures. I know the French are accustomed to using a bidet, but I didn't think it was used for routinely washing after moving the bowels. Also, when I think back to the apparent confusion about what to do with used toilet paper on the part of recent immigrants to New York city from places like Puerto Rico and Cuba (throwing it in the toilet was obviously not their custom and employers didn't think to provide waste receptacles), it occurs to me that the problem was in adjusting the eliminatory routine to the requirements of a time-conscious work-place--a problem which employers weren't prepared to give any thought to at all, especially since they all had their own wash-rooms. Funny that designation for a space where less and less washing actually occurs. Even nurses have taken to using anti-bacterial sprays instead of soap and water. Not a good thing, in my opinion.
End of morning report.
Mid-day report for December 15
I didn't replace the Depends after the successful trip to the commode, but half an hour later she insisted that it be taken off. Obviously not remembering what happened a short time ago. About an hour later, I went to make a correction--too late. Had to change the sheets but was fortunate that this time the laundry-man hadn't already left.
Breakfast was still being refused but after a while there was a lot of moaning and groaning and I decided she was probably hungry. The hot cereal (most of an eight ounce bowl) was consumed as by a snapping turtle--couldn't wait for the next spoonful.
Afterwards she took a nap and was awakened by the ringing of the phone. Must have been dreaming since she was sure there were tubes in her arm that needed to be removed. Also, she claimed not to know who I was. Didn't recognize her dog either because it didn't respond to her calling its name. Wanted to know my name and to go home. (this is a recurrent problem--been going on since 2002 on St Simons) Fed her a whole container of organic chocolate pudding for lunch and then she went back to sleep.
Meanwhile Julian had a visit with Majorie Milne who's having trouble swallowing and doesn't recognize how often she ends up choking and coughing. He visits with her every day now, but she's going to have to have more constant attention soon. People wanting to be on their own on their own terms are a problem.
********
December 16
Lots of chatter last night for hours, but it wasn't until 1:30 that she called me to tell me something about heads and boxes. I gave her some elixyr and a drink of water and told her to go to sleep. That seems to have worked until about 3:30 when I awakened to the sound of ripping--the Depends was being attacked. I got up and remonstrated and things were quiet until 5:30 when she demanded that the diaper be removed. I complied, but insisted on putting on a fresh and tried to explain about her not feeling the wetness even though she could see where the bladder had leaked. Trying to explain about osmosis is useless.
On the whole, she's pretty lucid this morning. Wanting to know what the elixyr is for and would she die if she didn't take it. The answer, of course, is "no." She'd just be even more uncomfortable and hurting.
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Well, it's been pretty much non-stop talk this morning. She's had half her cereal and promises to get some sleep, but is still talking. The explanation she gave was that she's changed her mind about dying and now wants to live longer and talking lets her know she's alive. Doesn't make much sense and she herself concluded that she's crazy. Have to agree, but less so now than at other times.
December 17--Saturday
The rest of Friday was uneventful in the sense that there was no change from the level of confusion. She ate the usual quantity of food and woke from naps obviously confused about what she was into--cooking up a chicken for the dog or making a pot of rice, all while she lay sleeping.
No Nytol at bed-time. It wasn't wanted and it obviously did do any good anyway. Almost like clock-work she started talking about 10:30 and that went on for an hour until she decided she needed water. I delivered that and told her to go back to sleep. Then, after midnight, the script changed and the topic was either getting her to a hospital to die, or out of the hospital to be home with her daughter. I managed to ignore the rambling until about three when she again called my name. I don't even remember what she wanted, just that I gave her some elixyr, a warm cloth on her forehead and a new hot water bottle which she cradled to her stomach. After that there was mostly silence, punctuated by moaning and groaning, which actually ring false.
The desire to live seems to have been short-lived.
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December 18
The first half of the day yesterday continued very voluble. After being told I should sing because it was Christmas, an orange was requested, for the same reason. Since it's not Christmas yet, neither was delivered. Besides, I don't sing. I mid-morning sponge-bath went well and was appreciated.
After lunch (the rest of breakfast and some fruit), silence descended. Then, about four I noticed some scrabbling under the blankets and surmised that the Depends was to be changed. Indeed, she'd moved her bowels and never made a peep. So, that was a new experience!
I don't if she was cowed by the experience of having to be cleaned up, but, although she agreed to a scrambled egg for supper, she hardly ate any and went to sleep. I had to rouse her for her elixyr and decided to give her an alprazolam, in hopes that it would calm her enough to prolong her sleep.
That seems to have worked. There wasn't any talking and no groaning either until about 4:00 AM when she started clearing her throat rather emphatically. After a while she called for assistance and when I went in she wished me a cheerful good morning, in German, inquired after my health and assured me that hers could be worse. Then she was thirsty and found again that the water tastes good.
Still later she requested a typewriter, so she could express herself more quickly and explained that she's trying not to be too stupid since she's got a really smart daughter. The language of this morning is almost entirely German and the stock phrases are those of polite company. It's strange. It's almost as if there's another person there.
Uncertain about what she was to do next, perhaps eat something, I brought out a container of prune puree (Gerber's) and that went down lickety-split. When it was done she asked if she should sleep now to regain some strength. Who could disagree. Now all is quiet again. It's all of 5:30 in the morning.
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The Omi slept through almost until noon and asked for a hot water bottle before I came back from the store. She didn't however signal that another bowel movement had taken place. So, that appears to be a new constant now.
I fixed her daily bowl of cream of wheat (eight ounces of mil, big pat of butter) for lunch and she ate it all. A little later she finished off the chocolate pudding and then had a little doze. Supper was a modest amound of curry sauce and rice which was too hot at first and then not to her liking. She cleaned her palate with some more pudding--just a little bit.
I think I'll try the alprazolam again. It did seem to lessen her distress.
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Monday morning---talking has been going on for about four hours. It's 6:30 now. Just shook her hand good-bye. She says she's going to die now. Doesn't look like it to me, but who am I to say?
I think I'll start a new post.
Posted by Hannah at December 18, 2005 05:30 AM