The Slow Lane

While eating lunch today, I looked up and saw these 5 deer in our back yard. They were there for at least 5 minutes and I got several photos and some video. The video I wanted to post is too big, so I have to figure out how to edit it. Maybe I’ll post it later.

As you can see in the photo, we still have snow and ice and the roads have not been scraped. So I have not been to Sunrise today. I’ve tried calling her a half dozen times and got no answer. I talked to a Care Manager this morning who said Mom went down to breakfast and was seen holding her glass and drinking juice. The CM thought she is doing better today and believed that she ate some breakfast.

It snowed overnight about 4 inches and then sleet fell all morning on top of that. As the weather has cooled to about 20 about nightfall, there is primarily an ice pack of 2-4 inches. Much of the snow melted from underneath because the ground was warm (it was 63 on Thursday) and the sleet has packed down on top. It has been very pretty as far as I’ve ventured (not outside the yard), but the roads are very icy and still covered.  DOT crews have gone home for the night and will be back about 7:00 AM. It is too cold for the salt to be effective. One report was that it could be Monday before the interstates and main roads are cleared and longer for back roads and side streets.

In the mountains, my neighbor reported about 9 inches all snow and very pretty.

I did not go see Mom today because of the weather. When I talked to her Care Manager this morning, I learned that Mom looked out the window to see the snow and said, “Whoa!” (or maybe “Wow!). She ate a small amount of her breakfast served in her room and drank her coffee. Otherwise, she is saying very little. They planned to get her to the dining room for lunch and dinner. I will check on her again tomorrow.

On Wednesday, L and I went to Como to visit with her brothers (We try to do this about once a month) and I did not visit Mom. I talked by phone with a staff person who reported no problems on the daily report and she had been down to breakfast.

On Thursday, I went after lunch. She was sleepy. I gave her a letter from Jean and a birthday card and package from Dwanda. She was barely able to read the mail even when I kept her awake. She seemed to be reading, but I was not convinced that she was actually reading, or if she understood what she was reading. She had little to say even when I asked about her birthday and told her who was there, etc. She did not verbally indicate that she remembered any of it.
Today, I went over and had the pictures from her birthday on my camera to show her. I waited to give her time to wake up a bit. When I asked if she wanted to see them, I got no verbal response and decided to show them to her anyway. She did go to sleep from time to time, and even when she was awake, gave no verbal response to the pictures or repeated questions such as: Who is this? Do you recognize anyone in this picture. So eventually, I would tell her who they were. She did give a half smile from time to time which showed me that she was recognizing some people. I tried zooming in to make the pictures clearer for her without much different response until I showed her a close-up of her and asked if she knew who that was. She said, “I don’t think I’ll claim that one.” I don’t remember any other verbal responses. She did not appear to be in pain or uncomfortable. It’s more like she may have been responding mentally without being aware that she did not actually say it. She had been down to breakfast, but I did not get a report on how much she ate. Sleeping seems to be her most comfortable activity.

She has been sleeping through the phone ringing when I’ve called and I assume that is true for others as well. That must be tough for my siblings who live far away and for whom the phone is their only direct link to her. I suggest that they continue to call and leave a message. That way I can play the message for her and she will get to hear your voice. Otherwise, a call to me or directly to Sunrise asking to speak to Mom’s care manager will get you a report.

Mom has been less responsive since her birthday. Communication has been about the same as on her birthday, and she has continued to eat very little with some meals being brought to her because she seemed too weak to go to the dining hall. One decision made yesterday with her doctor was to stop one medication and evaluate what her current baseline of symptoms may be in order to re-evaluate her medication need level. Another was to ask for a hospice evaluation. Hospice of Wake came this morning and evaluated the situation and concluded that she is not appropriate for hospice services at the present time. I can understand because dementia as a primary diagnosis is so unpredictable and today she was sufficiently mobile to go to the dining hall for breakfast and was there eating when I arrived. That level of mobility and the fact that she has not lost weight (was actually up 2 pounds from last week) does not fit the criteria for hospice. On the other hand, she is doing better today and we hope that will continue. We will continue to monitor the need for hospice in the future.

Mom’s picture was taken after eating lunch on her 91st birthday. She was not as alert as she had been Tuesday through Friday, but was much better than she was on Monday. We celebrated her birthday in the private dining room at Sunrise. Both of her sisters and both of her sisters-in-law were there for lunch along with two nieces, me and my wife. My two daughters and my three grandchildren arrived in time for chocolate birthday cake made by Mom’s sister.

The second picture is of her sisters and sisters-in-law.

The third picture is of Mom with her friend, Mae, who recently moved to Sunrise.

The last picture is of Mom with my three grandchildren (her great-grandchildren).  Responding to the children brought the most positive response of the celebration.  Otherwise, she had very little to say, ate very little and was too “full” even to eat a piece of her birthday cake.  After almost three hours of celebration she was completely tired out and needed help to get into her chair. 

I went back to visit this afternoon and she was in her chair, seemed to be comfortable, and when asked if she was still tired, said “No, I’m OK today.”  However, she seemed to have very little memory of her birthday and was unable to name the people who attended.  When I said she had a very good chocolate birthday cake and asked if she knew who made it, she said “Jean”.  Perhaps she’ll remember more another day.  If not, we’ll keep  telling her about it and that will please her. 

For the rest of us, Mom’s birthday celebration was more of a memorable and nice occasion.  It was great to be able to get this part of our family together on this special occasion and enjoy the time together.

Mom seems to be maintaining her improved state. Her care manager indicated that she went down to the dining hall for breakfast and lunch. She ate about 50%of her lunch and walked there using her walker. I’m thinking this really looks like the change in the medicine is making the difference. Then I learned that the change became complicated in its implementation because the prescribed dosage was half the lowest dosage available and the pharmacy would not deliver half a pill. As I currently understand it, Mom continued to get the same medicine in the same dosage Monday, Tuesday, and Wednesday. Today she began taking a different medication that she was taking some time ago.

I am glad she’s better and that overrides my lack of understanding as to what made the difference. I expect that I will be told of changes more promptly from now on.

On a different note, L and I went to the mountains yesterday afternoon and were back home 24 hours later. We were pushed to leave sooner than planned by observations and predictions of freezing rain. We made it with no problems. Also, we were delighted to find no problems from the long cold spell they had.

Mom ate breakfast today at the Med Tech station near the elevator. That is where she was when I arrived. I walked with her back to her room. Monday she seemed barely able to stand. Today she was able to stand from a chair and use her walker to get back to her room. Her gait was slower than it used to be, but she could do it.   The quarantine at Sunrise has ended today and activities have resumed.  All of this suggests that Mom’s birthday event on  Saturday will go forward and she will be able to enjoy it.

I was encouraged today to see Mom more alert and feeling better. It is too soon to know if this is temporary or if it indicates a pattern of improvement.

Mom will be 91 on Saturday. Unfortunately, Mom is unable to show much excitement about her birthday. She is sleeping a lot and very soundly. It is difficult to carry on a conversation with her in person and more difficult over the phone. She has little energy and is not steady or strong in trying to stand up. The change is significant over the last 4 to 6 weeks. I have consulted with her doctor weekly for the past three weeks. Today we decided to make a small change in her medication that may help us know whether her medicine is causing the changes we’ve noticed. It is difficult to know, because her symptoms are consistent with both progressive stages of dementia and with some side effects of the medicine. I am comfortable and pleased that her doctor and I are in agreement with the effort to determine what if anything we can do to make things better for her.

We are planning to have a few family members get together at Sunrise on Saturday to help celebrate her birthday.

Here’s a brief report. Mom seems to be doing better this week than she did the last two. She did not have a good week last week in particular. She did not feel well, complained of headaches, did not eat well, and was very restless and fidgety most of last week. For the last 3 days she has seemed better. She is eating better and says she is doing ok when I talk with her on the phone or in person. I have not been there in the evenings in the last 3 days and can not personally assess the extent of her restlessness which was more pronounced when she was trying to go to sleep.

I am checking with her by phone this week and with staff as needed because all residents are being fed in their rooms and all activities have been cancelled because of a stomach virus that some residents have experienced. The quarrantine began yesterday. So as long as I am comfortable that Mom is doing ok, I will honor the request to limit visitations while they do extensive cleaning and try to prevent further spread of the virus.

Mom’s problems last week were unrelated to the virus.