Thinking about Next Steps
May 26 2012 in Elly's Granddaughter by EllysGdaughter
We’ve seen some decline in memory the last few months resulting in extra books being ordered online, not paying off the credit card bill and not understanding informational notices from the utilities. After mulling over some of these events in the last couple of months, I decided to start by visiting with Elly’s primary care doctor. I scheduled a consultation without Elly, of course, and my plan is to find out a couple of things.
First of all, I want Dr. B to be on the same page as us, the family. I haven’t ever been sure that he really is. We want Elly to live out the rest of her days without drama and extra life saving measures. We have an issue with an RX. One of Elly’s meds is being yanked from the market, Valturna. We like Valturna and with the other BP meds it has leveled out her pressures. I am hoping to get it refilled just before it is removed. She hasn’t had any problems with it or her heart so I want to check that with Dr. B.
I want to also discuss with Dr. B Elly’s memory issues. I wonder if we should do some kind of test that would present to Elly that it is reasonable for us to begin taking over her finances and RX refills. Whenever she has forgotten something, she gives an excuse. She tells me that sometimes she decides something isn’t important enough to remember – I have to laugh with that one. Other times, she’s hunting around for whatever’s missing or doesn’t realize she’s ordered the same book or Prescription twice.
Nothing is life threatening, but may become a tangled mess if not monitored. Elly is logical like me and we are the kind of folks who like to know why and how come. So, I am thinking that showing her that her mind is slowing down and not allowing her to make “perfect” decisions will help justify our actions. We do step lightly so that we aren’t pushing “her way” out the door most of the time. There are many things that we allow her to do that she just does because it is a habit or how she has always done it. I get asked about locking the doors every night and admonished as if I’ve never locked up a house before. I wish she would relax and trust us with those things that she struggles with.
My grandma is in much better shape than some folks out there and I truly am grateful that my kids have experienced my wonderful grandma. My grandma has faded quite a bit and tries hard to keep up the same attitudes and graciousness she has imparted to us in earlier years but even that has faded. I am really okay with this process.
We need to move on to the next steps in her care that will keep her safe and us sane. Even after two years I still wonder how much I should nag her about using her cane – she is so vulnerable to falling without it and forgets to use it to go down the steps and out to the garage. Should I remind her to pick up her feet because the few rugs she insists on having by the counters are serious trip hazards? If she falls, we can just deal with it, it is her life after all and she says she accepts that it will be her fault. When she’s grumpy her words are cutting. I may need to get thicker skin or an extra jacket to protect the little granddaughter within me.
We’ll see how Dr. B responds on Thursday to our little chat, until then I continue to bring these issues to my heavenly Father.
Trish said on May 26, 2012
EllysGranddaughter, It always amazes me how the stories and specific situations are different yet we all deal with very similar dilemmas. Robert is my 46 year old brother but he is a walking fall hazard and needs reminders to wear his helmet or pick up his foot (he drags his right foot and tends to trip). Most of the time he says “I am” but I can’t let that bother me. He’s a sweetheart most of the time but he has trouble admitting that he has to pick up his foot or even that he just had a seizure. I let those denials pass (hey, I just realized, denial is a family trait!).
It sounds as if you are taking all the right precautions and steps. Talking to the doctor is a great idea and I hope after your visit you feel more confident in the care he’s giving your grandmother. If not, it might be time to switch docs. While she is still mostly herself, you might also broach the subject of a power of attorney so someone (you or someone else) could make financial and healthcare decisions for her. I’m not sure if you’ve already said you have this in a prior post so sorry if I’m being redundant.
There’s never a magical, definitive moment when one “knows” when extra help or resources are needed. It often comes on gradually and then one day we just realize finances need to be taken over or a walker needs to be used. You are being thoughtful and caring in your approach and that will always work to your advantage.
Please let us know how it goes on Thursday.
ejourneys said on May 26, 2012
EG, it is such a delicate balance to keep your spirit intact while giving Elly both care and dignity. When my partner gets grumpy with me I still hurt, but I have learned not to take it personally. I tell myself it’s her disorder talking. Eventually (with rest, food, etc.) the grumpiness passes. You are doing a wonderful job dealing with all the variables — including nurturing the little granddaughter within.
I wonder if Dr. B could write a large Rx for Valturna before it disappears. Back in 1983 I had asked my doctor for as large a Rx as she could write for a painkiller called Zomax, because it was the only medication that worked for me (however irregularly). I knew that if it worked for me, it would be taken off the market, which indeed happened shortly thereafter. By that time I had filled a 100-pill Rx that enabled me to work. (My own pain issue has since been remedied, thank goodness.)
It’s good that you are raising these issues with Dr. B. During a particularly tumultuous time last year I had also spoken with my lawyer, to find out what steps were needed to determine competency.
With respect to POA, what would make Elly feel comfortable about granting those rights? I wonder if focusing on her strengths might help — a way to honor her strengths and all the gifts she has shared, through recognizing that she now has some limitations that could compromise the things she’s worked so hard to maintain. Would keeping a record of her memory lapses help, in case she has forgotten those?
I hope Dr. B is in your corner, and that you have an encouraging meeting on Thursday.
Jo said on May 27, 2012
EllysGranddaughter, indeed it does appear that you are being both thoughtful and thorough. I would also agree with Trish that there doesn’t seems to be a magically moment, agreed upon by all parties, that a caregiving threshold has been crossed. It is not uncommon to look back and realized you crossed that threshold and were already providing the extra help needed, long before it was ever discussed. Anyway love your approach. Do let us know how the meeting goes with the Dr.
Denise said on May 27, 2012
Hi EG–I think you’ve got a great plan, which also includes back-up plans (perhaps another doctor if Dr. B. isn’t a helpful resource for you).
I would just offer one other suggestion: Act now in a way that will bring you comfort in the future. Meaning, the days are long but the years are short. We can get so caught up in worrying and fretting about the day that we lose sight of the years (the big picture). You may worry about reminders and decisions which keep her safe. If you can move into the big picture, using reminders and making decisions which keep her safe, you can let go of the worry.
So glad you’re keeping us up-to-date. Let us know what happens after you meet with Dr. B.
Bette said on May 27, 2012
Hi EllysGdaughter,
Your writing shines with the love and respect you have for your grandmother. She is so blessed to have you caring for her.
It’s so hard to have to help with things that our carees have always accomplished on their own. She is fortunate that you are so thoughtful as you help her and yourselves find and address those things.
Please let us know how your appointment goes. I hope you get just the right amount of support that each of you needs.