Okay, Re-Farmer. Take a deep breath, and relax a bit!

What.

A.

Day.

Well. Morning, really. It’s only mid-afternoon, as I start this!

I had a 9am appointment with the guy that runs homecare for my mother’s town, and area. After feeding the outside cats, including giving Gouda his personal bowl of lysine supplemented cat soup, I had to leave it to my daughters to do the morning rounds. Instead, I went through a copy of one of the assessment forms the homecare guy had given me a copy of, after his last visit with my mother.

To recap: my mother wants to go into a nursing home. A very specific nursing home. Back in July, we went to her doctor about it, and she started the ball rolling. What we didn’t know at the time was this was something that gets decided by the home care department, not the doctor. The doctor does have to approve it and fill out some paperwork, but normally, people who need it tend to go from a hospital, after some sort of incident, into long term care without ever going back home in between. My mother is not at that stage. After he did a panel with her, assessing her physical needs, it was clear she was not that far gone… yet. He recommended supportive living.

There is only one supportive living place my mother would be willing to live in, and after looking into it, today was to start the process of application to get her in.

Which would put her on a year long waiting list.

There was, however, that behavioural assessment form.

When I first started going through it, after he gave it do me, I’d read a question and think, oh, no, she doesn’t do that. Then I’d read the examples and realize, wait… yes. She does that. Has done it for years. It’s getting worse as she gets older. Yes, this is a problem we are dealing with.

The thing is, we’ve been dealing with a lot of these for so long, we don’t even think about it anymore. I had to see it written down as questions, with examples, to realize just how far she was deteriorating in this category.

I had talked to him on the phone about this a little bit, but today we had to go through all the other assessment forms he needs to go through, as well.

We were at it for two hours.

I am so glad he was able to fit me in this week! He’s going to be away all next week, the last week of the month is the busiest time for me, and I had only one day available – and that would be the week I would expect the exterminators to try and visit my mother’s unit to confirm the bed bugs are gone. If she doesn’t let them in for a third time, she will get evicted. I’m hoping to be there that day to prevent that.

Long story as short as I can make it:

When it comes to her physical needs, her recent diagnoses have actually been helpful for her, in that she actually wants to go into a personal care home (aka: long term care aka: nursing home). He updated the file on her medical changes.

With some things, it’s hard to say. As my mother is living independently, I’m not there to see if, for example, she can or can’t wash herself properly. All I can say is, she refuses to shower, and does not have a bath tub, so all she sponge bathes herself every night. Is she doing a good job? I can’t say. I can say, she refuses to use the commode her was able to requisition for her, even when I found that her bucket fits perfectly in it, making it easy for her to empty it herself. What is she doing instead? I’m not sure.

With other things, I can see she has made adjustments to work around her mobility issues. Can she dress herself? Yes, because she only wears clothing she can put on herself. No buttons. No zippers. No ties or snaps. Can she feed herself? Yes, but she has trouble eating, because she refuses to have her dentures fixed to account for a tooth that was removed – a tooth that her one of her dentures was held by. Her being able to find work arounds or just put up with things puts her on the line between categories.

We did talk about having home care come to her place to prepare meals, and to make sure she takes her medications on time and properly. They can do bulk meal preparation for her either once every two weeks, or once a week, or someone can come by once a day for a meal prep.

If it was once a day, it would be something very quick – I think they’re only allowed 15 minutes. So it would be something like making a sandwich and heating up a bowl of soup. Everything would have to be ready in advance so that a meal just needed to be assembled quickly.

If it was weekly or bi-weekly, someone would come in for 2 hours or something like that. They’d do all the cooking, divide it up into individual portions, and set those in the freezer (except those that would be used right away).

We decided it would be best to try my mother with every two weeks, then adjust as seems appropriate. As the person who does my mother’s grocery shopping, I would have to talk to the home care person about meal plans and what they would need.

We also talked about my mother’s medications, and how she’s not taking them as she should be. Someone would be coming to her place three times a day to make sure she takes them. They can only do that with medications that are in bubble packs. They’re not allowed to touch anything from a bottle. That includes the new eye vitamins my mother is now on.

Then we got to going through the behavioural assessment.

As we went through the questions, I had to give examples and, in come cases, explanations. This included telling him about what’s going on with our vandal, and her habit of reaching out to him and poking the bear, in spite of our efforts to protect her from him.

I’ll have to get back to that one, later, as we have some new crazy going on from there!

As we went through the different questions and he struggled to take notes that would make sense, there were a few times when he had to just sit back and talk about some of the things. Even things that happened to her when she was still living in Poland, and the atrocities she witnessed and survived. He even made note that she would likely need what they call “spiritual care” that is available, typically for combat veterans and former prisoners of war.

I gave other examples of some of my mother’s behaviour, including something she did during a road trip with my brother and his wife a few years ago, and some more recent examples while driving with me. I also told him about what she did to stab my brother in the back, which she still doesn’t recognize as being at all a problem. After a while of this, he stopped and sat back, hesitating.

“I don’t want to sound rude,” he started, pausing to try and find the words.

“It’s like a movie,” he finally said. A movie where all this crazy, insane stuff keeps happening to people, that’s so over the top. I basically said, “yeah; and when they see the movie, people would find it unbelievable and unrealistic, because people don’t behave that way, right?”

Yup.

Even with all this, though, my mother is a very unusual case. He’s not even sure she qualifies for supportive living, because a lot of her needs are beyond what they offer, but she doesn’t qualify for assisted living at all. Her behavioral assessment, however, may actually be what puts her in personal care – which is what she wants. She’s just on the edge.

In the end, he’s going to have to have a consultation with the person he deals with that makes the final decision. He does know, my mother needs help, and we can’t give it to her. Regular home care can’t give it to her, either.

On the plus side, since all this started because my mother went to the doctor to try and get into a nursing home back in July, she already has the doctor’s form on file that is recent enough, along with the chest X-rays they require. She’s also supposed to get a brain scan, but we’re still waiting on a call for that. She’s already been visited by the geriatric care person, and the occupational therapist. They will need a copy of my brother’s PoA paperwork, which I have and can get to them soon. As PoA, he’s first contact for next of kin, while I’m second contact, as I’m physically closest to her.

He printed out what he needed, and then he had to deal with something quickly before going to my mother’s. I called my mother to let her know we were going to be coming over, only to find she had been still in bed! She had time to get dressed, at least, but when I got there, she didn’t even have her glasses, and was all worried because her floor wasn’t swept.

My sister was coming over to do some housekeeping for her!

She was going to get me to call my sister to cancel, and I told her, we couldn’t be that long. I did tell her that I would need to take her remaining bubble packs to have the new medication and vitamins included.

I am so glad she’s going to have someone come and help her with her medications.

When I told her about including them in her bubble packs, she started to get angry, saying, they get taken separately. Which they don’t, and I’m not sure where she got that from. I was still trying to explain to her about how home care can only help if it’s in bubble packs when the home care guy arrived.

He needed her list of medications, including the new prescription and supplement. As we were talking about her new prescription, she mentioned she’d taken it twice.

??

It’s once a day; the vitamins are twice a day.

Nope.

She took one last night, at about midnight, then taken one this morning… I’m not sure why she took one this morning.

Oh! Crap!

I need to call my mother right now…

Oh, I am so glad I wrote this out and caught on to this!

Yes, my mother took this once a day pill last night, then again this morning – and would have taken it again tonight, if I hadn’t just called!

And THAT is a good example of why she needs home care to help her take her medications!

That was one of the things the home care guy needed to hear her agree to, and sign for, along with the meal preparation.

She also needed to sign a form saying that yes, she agrees to going into a personal care home, when a space becomes available. We explained to her that this might not be where she wants to go at first, but once she’s in the system, she will be higher on the list for a transfer, should a space become available where she wants to be. She just needs that foot in the door.

While the home care guy was there, my mother just happened to launch into a tirade towards him, just like some of the examples I gave him earlier. Some of it, anyone in home care sees pretty regularly, but then she went sideways and made it about something else entirely, making connections where there shouldn’t have been any at all.

When he was ready to leave, I grabbed what was left of my mother’s bubble packs and her new stuff for the pharmacy and walked out with him, and we were able to talk about what just happened.

He told me it would probably take a couple of weeks for the process to work its way through. He has a lot of paperwork to submit, and needs to talk to a few people about my mother’s case – and he’s going to be away for all of next week, as well.

He is a total gem. Sadly, when he gets back, he won’t be staying for much longer, as he’ll be moving to another office, so we’ll be dealing with someone else before long. He’ll be going over all his case files with this person before he moves to the other office, though.

I then went to the pharmacy and explained the situation and asked if they could add the new items to my mother’s bubble packs. My mother had mentioned the pharmacy had called her before I got there, talking about her next set of bubble packs.

When I said who this was for, the pharmacist assistant I was talking to started telling me, I just spoke to her, and I’m sorry if I seemed a bit rude.

???

Every time the pharmacy calls about her bubble pack refills, my mother gives them a hard time, saying she still has lots, and it’s too early. I keep telling her, she needs to get her refills BEFORE she runs out, but she doesn’t get it. Well, the last time she did this, they held back. When she ran out and came to get her refills and they weren’t ready, she apparently chewed out whoever was at the counter about it not being ready. So when she talked to my mother today, and my mother tried to give her a hard time about it being too early, etc., again, she told me mother, no, this is the date. This is when they’ll be ready.

I think they were relieved to hear my mother is going to be getting home care to help with her medications!

There was only one hang up.

Bubble packs can only have prescription medications in them.

The eye vitamins are not a prescription, so they couldn’t include them.

The pharmacist asked me about the eye doctor, and it turns out they know each other. He will call the eye clinic and get an actual prescription for these supplements from him.

Until then, they would pack 10 days worth of the eye vitamins in their own, separate bubble packs.

As for the new prescription, it says once a day, but doesn’t say when. It’s at night that she has issues, so that’s why she was going to take them in the evening – and why she took one last night. That was the first one she took, even though I brought them for her the day before.

It was going to take them about an hour to update the current bubble packs, so I took advantage of that to go for lunch and update the family a bit.

By the time they were ready and I brought them back to my mother’s, my sister had showed up, done the housekeeping she was going to do, and was getting ready to leave. I needed to explain the bubble packs to my mother, so my sister stays so she’d be up to date, too.

So I went through it all, explaining why the supplements were in their own bubble packs, but she needs to take them with her morning and evening (breakfast and supper) pills, and that the new prescription was with that last pill of the day she’s supposed to take before bed.

That’s why I had to call my mother just now.

The new pill is in with tonight’s bubble pack. She’s already taken one this morning.

After confirming that yes, my mother did take the new prescription pill this morning, as well as taking one last night, I told her to NOT take the one that’s in the bubble pack for tonight, because she’s already taken today’s pill.

I repeated this a few times, and even told her to go ahead and take it out now, and put it somewhere else, but I’m not completely confident she’ll remember.

She was very glad I called about it, though, because yes, she would have taken that pill again tonight, if I hadn’t.

She also realized that I brought back the bubble packs, but not the bottles with the rest of the pills. I told her that the pharmacy is keeping them so they can be included in her new bubble pack refills, as she has already paid for them.

Anyhow… I’m ahead of myself.

It took me a while to explain the bubble packs to my mother, and the times to take them. Even my sister had to chime in to reinforce what I was saying. My mother has a very had time grasping the times on the bubble packs. She’s been taking her morning and evening pills at 5am and 5pm. Why those times, I have no idea, but that’s what she settled on. Only recently did she say she changed to 6am and 6pm, so she could sleep a bit more.

I told her, when home care starts coming to help with the pills three times a day, for the first two they’ll be coming for breakfast and supper – so she won’t have to get up so early anymore! She can sleep in.

She seemed to like that idea!

While we were talking, some mail was slid under my mother’s door, so I opened it for her. It turned out to be her ambulance bill. I was surprised it was only $250 The last I heard, it cost more than $400.

It included a survey on how the paramedics did, and so I started helping her go through that. She got really angry and first, saying, how can they expect her to remember? It was so long ago! (It’s been maybe 2 months?) Then she started saying, the paramedics treated her much better than the people at the hospital, before launching into a story that, at first, we thought was about the paramedics, but was actually about something in the hospital. It included some pretty racist comments, but she talked about how she was being moved around in a wheelchair while her coat and purse were left in an examination room. Long story short, while they insisted she check her purse to make sure everything was there (I’d say it was really obvious to them she believed they would steal from her), she said all her money and ID, etc. where there. However, she now says someone stole “pictures” (which could have included clippings from magazines, newspapers, printouts… ) from her purse.

Of course, the accusation included racist rants.

When I asked, why would anyone take pictures from her purse…

I didn’t get to add, instead of her money or whatever, when she started to get into “that” mode, at which point, my sister said it was time to go!

So we said our goodbyes, then I stayed a bit longer and talked some more about how it went with the home care guy. I explained how she’s just on the edge of things, because she can still do things like feed herself and dress herself, but has other issues. I told her, he needs to consult with someone about her situation, to figure out where is best for her. She was just really happy to know that going to a nursing home is an actual possibility now.

By the time I left, though, I felt like a wrung out washcloth.

But, it’s done. The process is well on its way.

Now, if she can just keep herself from getting evicted, that would be nice!

The Re-Farmer