I have been way too relaxed about getting Mom's things packed. I've also been very random about it. I have a theory, which I put to test every time I should be organized - if I randomly do tasks needed to get the job done, I will get it done faster. Addendum 1: When I don't get it done faster, I only do the things I really need to do.
So - things I really needed to do:
Fill out Registration Forms for Providence Senior Care Center and Gather Medications
Mom is required to have a doctor in Anchorage, so we made an appointment to visit with Dr. Farzin before taking her to Anchorage Pioneer Home on Thursday. I forgot to pick up the paper work .. actually, I don't remember seeing it in our mail. I also haven't seen Mom's March Medicaid stickers, so maybe it wasn't entirely my fault - but they had to fax it to me. Then I discovered the printer connected to the fax number I gave to them was totally and completely out of order. I provided a second one in our building today.
When I sat down to fill out the paper work, I put my name on it instead of my mother's. I couldn't reprint the forms and we don't have any type of whitening cover up, so I cut out pieces of white paper which I attached to the forms and then wrote over. The medical history itemizations were detailed - two columns running down the full page. Each column had condition, year, Yes/No, so you had to do something for each possible malady. I managed to answer one condition and then read the following condition and put its response in the row above - twice - on the same row in two different columns. I couldn't use my cover up trick for that mistake and simply crossed out the wrong entry, and then wrote it in the row below.
I did remember to ask the clinic in Anchorage to test her oxygen level. Her levels were very high on Saturday and I think it must be because she is getting enough oxygen now that the Apria delivery man corrected the issue with her concentrator. But, in any case, it was too high for them to prescribe oxygen through Medicare. This borders on being funny in that she has needed oxygen since 1999 and gets addled and/or start coughing without it. But the good news is, I don't have to take the portable oxygen tank with us on the plane.
I also need to take her current medications, of which there are only 5 and 2 of those are not used daily. I need to present them to the clinic in the prescription bottles, so I placed her weekly allotment in her pill dispenser and then placed her medication bottles in a plastic bag for TSA.
Sew-in Name Tags on Mom's clothes for Laundry
Anchorage Pioneer Home doesn't have a packet of do-this-and-don't-bother-to-do-that, so I have found out about things as it occurred to me to ask. Do I need to take sheets? No. Do I need to provide shampoo, soap, and other personal items? Yes. Do I need to provide towels; how about hangers? Do I pay for laundry? No.
We don't have time to get real name tags, so I will write her name on ribbon and then sew only the ends to her clothes. What do I do about socks and bras? I have not started this part of the preparation. I have visions of Teresa, my daughter, and I working feverishly on it tomorrow night and then, when we don't finish, my doing the same the entire time I am in Anchorage.
Packing Mom's Clothes, Toiletries, and Family Photos, and First Doll
I have started that, although I forgot what I packed in one suitcase. I packed some nice clothes that Mom could wear when she got there the next day, if I didn't get other things unpacked. So today, I did the same thing with a different small, carry-on suitcase. Then I wondered what happened to a particular pair of pants and thought to look in the first suitcase. Should I take carry on both or just one?
One is probably enough. I need to get all of the rest of the clothes packed in a suitcase or box so Gary can take them in the truck. Except for the name tag issue, this is actually almost done. See? Being random is okay sometimes.
I am holding off on packing her toiletries until after she has a shower tomorrow night. Teresa and I will do her photos all at once. Oooo - I need a box for those photos; I need to check the garage for a box or stop and get one at a liquor store or something. I feel sad taking down the photos she has on her wall, but I will only take down the 3 that she still recognizes who is in the photo.
Load Furniture into The Ridgeline
We are taking down her rocking chair, her dresser (which I emptied out), her tall corner bookcase (which I cleared of videos and computer hardware), a lamp, and a walker. She doesn't use the walker at home or at FRA, but she often looks like she would like something to lean upon while walking. I figure we might as well include it.
Check in Ahead of Time and Oh YEAH -
She needs an ID for TSA. I never bothered to get Mom an ID when she moved here. She wasn't driving anymore. I did order her marriage certificate. She had her birth certificate, but in order to issue an ID without a passport, the State of Alaska requires a birth certificate and a marriage license to verify the name change and pieces of information indicating her address. I have all that, which is a dang good thing because Mom and I are going over to the Department of Motor Vehicles tomorrow and getting a photo ID.
Other Important Papers
I am taking documentation for my status as POA and Medical POA. I think Providence Senior Care Center will want those on file. I am also taking copies of her Medicaid number and Medicare card along with her prescription drug supplement company. I am taking her burial arrangements, for Pioneer Home to copy ... I think that probably covers it. I sure hope so because we leave for Anchorage is less than 36 hours.
Wednesday, February 29, 2012
Wednesday, February 15, 2012
Anchorage Pioneer Home
I visited Anchorage Pioneer Home yesterday. I was given a general tour of the entire facility, and also given a more in-depth tour of the Level III facility. The residence areas for Level I and Level II are wonderful. There are many lovely areas to sit, gather with friends, have activities all in addition to the privacy of each individual room. Level III is a converted nursing home and has that hospital feel to it, but they are slowly changing it so it is more home like.
Two aspects of the Stage I, Level III living area that I did not find entirely comfortable were the set up of the semi-private rooms and the arrangement of furniture in the TV/common area.
The semi-private rooms are used just as they were in the nursing home. They are not huge rooms, but they are bigger than any of those I saw in assisted living homes in Fairbanks and allow for more privacy and individuality. The rooms do afford clear distinctions between living areas for the two that share the space. All residents start out in the semi-private rooms. They are moved to a private room as they become available. I have no idea how long it would be before she moves to a private room, but I know that the hardest thing for her besides not having her cat will be the lack of privacy.
But, whether they have a private room or not is probably not so important; they are brought into the common room for most of the day so they have social interaction and activities. There were chairs here and there throughout the area and then one very nice collection of couches and chairs facing a gas fireplace in the center. But beyond that was a large area where activities are held, along with TV watching. All around the edges of the room were recliner chairs. I have noticed this in other facilities for elders. Instead of putting chairs so people can look at each other closely, they are lined up against the outside wall of a room. This made no sense to me, but since I have seen it several times now, I know it must be used because it suits that stage of aging.
Yet, it makes me uncomfortable. All the chairs are the same color, sky blue. All covered in the same velour fabric. All face the center of the room, a large area; all are recliners. When I was there, every one of them was filled. Sadly, one woman saw the social worker and called her over, clinging to her. She said, "You are the one who will help me go back home, right?" I suspect Mom will have no such illusions about returning. Inside her is a place that is very aware of reality. Combine that with a flight by airplane to a totally different city and she will be clear that this is not a normal excursion from which she will return.
This makes me all very sad to talk about. You can not imagine the hurt I feel that she will be so far away. I have reconsidered the home in North Pole several times, and each time I find myself thinking it is not right for her, but I am not sure why I think that. Despite the size and lingering hospital feel of the Pioneer Home in Anchorage, I feel certain she will receive the kind of care she needs.
The staff ratio was probably 5 to 1, which is not bad. I saw staff every where and every place, all the time. All residents were clean, well-dressed, and many alert and smiling. She told me that they do not have enough room on the second floor, Stage II, Level III, so some residents are no longer suitable for the floor into which my Mom will move, but must stay there. I suspect some of those I saw sleeping with blankets for the entire time I was there were among those residents.
I do not think many of those seating in the chairs were capable of getting up and moving around the facility on their own. I think once placed in a chair, they would stay there until moved to a new spot. I wondered if the insistence on them being in the common room was because they had to be sure all members of the facility were visible and attended to. This would mean that my mother would never have the kind of privacy she has needed up until now.
These are things to ask about. I would like to speak with the head nurse tomorrow when we visit again.
Two aspects of the Stage I, Level III living area that I did not find entirely comfortable were the set up of the semi-private rooms and the arrangement of furniture in the TV/common area.
The semi-private rooms are used just as they were in the nursing home. They are not huge rooms, but they are bigger than any of those I saw in assisted living homes in Fairbanks and allow for more privacy and individuality. The rooms do afford clear distinctions between living areas for the two that share the space. All residents start out in the semi-private rooms. They are moved to a private room as they become available. I have no idea how long it would be before she moves to a private room, but I know that the hardest thing for her besides not having her cat will be the lack of privacy.
But, whether they have a private room or not is probably not so important; they are brought into the common room for most of the day so they have social interaction and activities. There were chairs here and there throughout the area and then one very nice collection of couches and chairs facing a gas fireplace in the center. But beyond that was a large area where activities are held, along with TV watching. All around the edges of the room were recliner chairs. I have noticed this in other facilities for elders. Instead of putting chairs so people can look at each other closely, they are lined up against the outside wall of a room. This made no sense to me, but since I have seen it several times now, I know it must be used because it suits that stage of aging.
Yet, it makes me uncomfortable. All the chairs are the same color, sky blue. All covered in the same velour fabric. All face the center of the room, a large area; all are recliners. When I was there, every one of them was filled. Sadly, one woman saw the social worker and called her over, clinging to her. She said, "You are the one who will help me go back home, right?" I suspect Mom will have no such illusions about returning. Inside her is a place that is very aware of reality. Combine that with a flight by airplane to a totally different city and she will be clear that this is not a normal excursion from which she will return.
This makes me all very sad to talk about. You can not imagine the hurt I feel that she will be so far away. I have reconsidered the home in North Pole several times, and each time I find myself thinking it is not right for her, but I am not sure why I think that. Despite the size and lingering hospital feel of the Pioneer Home in Anchorage, I feel certain she will receive the kind of care she needs.
The staff ratio was probably 5 to 1, which is not bad. I saw staff every where and every place, all the time. All residents were clean, well-dressed, and many alert and smiling. She told me that they do not have enough room on the second floor, Stage II, Level III, so some residents are no longer suitable for the floor into which my Mom will move, but must stay there. I suspect some of those I saw sleeping with blankets for the entire time I was there were among those residents.
I do not think many of those seating in the chairs were capable of getting up and moving around the facility on their own. I think once placed in a chair, they would stay there until moved to a new spot. I wondered if the insistence on them being in the common room was because they had to be sure all members of the facility were visible and attended to. This would mean that my mother would never have the kind of privacy she has needed up until now.
These are things to ask about. I would like to speak with the head nurse tomorrow when we visit again.
Friday, February 10, 2012
Transitions Ahead
My previous post was written over a week ago and I did not publish it. I wish I had the date on it because it would help frame what I am about to report more clearly.
My mother's caregiver has provided consistency, but she has become increasingly frustrated with Mom. For whatever reason, Mom is refusing to do as she asks more often. Pam and I had experienced it as well, but the frequency of her refusing Marilyn's help has increased. She still does as I ask, so I have stepped in more often to care for her. My only answer to Marilyn was that she had an appointment with a new Family Practitioner and I would discuss the changes we were seeing with her.
That day arrived, and Wednesday I took Mom in to meet Dr. Leitiskow - and just in a nick of time. The day before, Mom had eaten breakfast and then gone back to bed; she had refused to take her medication, refused to get dressed, refused to let herself be cleaned. Gary was at the dentist with the car, so my daughter gave me a ride home. We walked in to find Mom standing facing the door, arms akimbo with a pose of "Well, where have you been?" She was in good spirits. I cleaned her, fed her, and then went upstairs to continue working, but I was rattled.
I wanted to hear it straight, but I don't think I was prepared to hear it as clearly and fully as it was delivered. But Dr. Leitskow did not hold anything back; she wanted to be sure I was thinking through the situation clearly and looking into what was best for my mother 24-7. Her refusal to cooperate was becoming a more serious issue.
She told me it did not matter if Mom suffered from vascular dementia or Alzheimer's disease. The progression was very similar. There would be a day when my mother would not recognize me. She also told me that I needed to put in paper work for Denali Center, and tell the State of Alaska that I would be willing to place Mom in any available space. If the space opened up in North Pole, well and good, but I could not wait for too many more opportunities to pass me by.
That lit a fire under me. I drove over and got the paper work for Denali Center; I called Teri at Lilley Lodge who said she would call me back later or I should call her the next day. There was an opening in her home now. Then I called the State of Alaska. There was a part of me that always thought about how I'd not taken the opportunity to move Mom to Anchorage when I was given a chance at it a couple of years ago. I knew I wouldn't see her, but I felt it was when she would have made the adjustment most easily and it would become home. Now I was opening myself to the possibility of her living in Sitka, Juneau or Ketchikan because it was safer for her and she would not be moved again.
Then an unexpected turn of events once again presented me with the opportunity for Mom to move to Anchorage Pioneer Home. I really have no idea how it happened or why, but the state intake coordinator told me to call Anchorage immediately and to tell her Mom's application date was 11/4/2010. I did. The next thing I knew, I was going through a preliminary interview for a spot in Level 3 at the Anchorage Pioneer Home. Once the preliminary interview was complete, I was cleared to interview with the admitting nurse.
I did that this morning and then waited for them to call me with the results of their evaluation. In a short time I was called back with an offer for Mom to move in. I accepted. Right now we are set to move her at the end of this month - in 19 days.
I did talk to Teri to let her know I simply went with it. I feel good about her going to the Pioneer Home. In talking with my husband this morning, before the admitting nurse interview, his perspective was very clear. He said there was little chance she would last long at Lilley Lodge. It wasn't the home itself, but her state of continuing decline that made him think she would do better in a facility where they were prepared to have her live with them until she passes. This is what I need to know. I need to know that she is moving to her final home and not a stop along the way.
My mother's caregiver has provided consistency, but she has become increasingly frustrated with Mom. For whatever reason, Mom is refusing to do as she asks more often. Pam and I had experienced it as well, but the frequency of her refusing Marilyn's help has increased. She still does as I ask, so I have stepped in more often to care for her. My only answer to Marilyn was that she had an appointment with a new Family Practitioner and I would discuss the changes we were seeing with her.
That day arrived, and Wednesday I took Mom in to meet Dr. Leitiskow - and just in a nick of time. The day before, Mom had eaten breakfast and then gone back to bed; she had refused to take her medication, refused to get dressed, refused to let herself be cleaned. Gary was at the dentist with the car, so my daughter gave me a ride home. We walked in to find Mom standing facing the door, arms akimbo with a pose of "Well, where have you been?" She was in good spirits. I cleaned her, fed her, and then went upstairs to continue working, but I was rattled.
I wanted to hear it straight, but I don't think I was prepared to hear it as clearly and fully as it was delivered. But Dr. Leitskow did not hold anything back; she wanted to be sure I was thinking through the situation clearly and looking into what was best for my mother 24-7. Her refusal to cooperate was becoming a more serious issue.
She told me it did not matter if Mom suffered from vascular dementia or Alzheimer's disease. The progression was very similar. There would be a day when my mother would not recognize me. She also told me that I needed to put in paper work for Denali Center, and tell the State of Alaska that I would be willing to place Mom in any available space. If the space opened up in North Pole, well and good, but I could not wait for too many more opportunities to pass me by.
That lit a fire under me. I drove over and got the paper work for Denali Center; I called Teri at Lilley Lodge who said she would call me back later or I should call her the next day. There was an opening in her home now. Then I called the State of Alaska. There was a part of me that always thought about how I'd not taken the opportunity to move Mom to Anchorage when I was given a chance at it a couple of years ago. I knew I wouldn't see her, but I felt it was when she would have made the adjustment most easily and it would become home. Now I was opening myself to the possibility of her living in Sitka, Juneau or Ketchikan because it was safer for her and she would not be moved again.
Then an unexpected turn of events once again presented me with the opportunity for Mom to move to Anchorage Pioneer Home. I really have no idea how it happened or why, but the state intake coordinator told me to call Anchorage immediately and to tell her Mom's application date was 11/4/2010. I did. The next thing I knew, I was going through a preliminary interview for a spot in Level 3 at the Anchorage Pioneer Home. Once the preliminary interview was complete, I was cleared to interview with the admitting nurse.
I did that this morning and then waited for them to call me with the results of their evaluation. In a short time I was called back with an offer for Mom to move in. I accepted. Right now we are set to move her at the end of this month - in 19 days.
I did talk to Teri to let her know I simply went with it. I feel good about her going to the Pioneer Home. In talking with my husband this morning, before the admitting nurse interview, his perspective was very clear. He said there was little chance she would last long at Lilley Lodge. It wasn't the home itself, but her state of continuing decline that made him think she would do better in a facility where they were prepared to have her live with them until she passes. This is what I need to know. I need to know that she is moving to her final home and not a stop along the way.
Interlude
We have reached a pleasant balance in our lives.
Marilyn cares for Mom morning and evening. Her schedule with Mom is consistent. Mom is calming and her routine is even. She is not always angelic in her response to her or me, but more often she is accepting and comfortable. I steeled myself for Mom being gone soon, but things are not working out that way and right now, I don't mind.
We are doing okay.
Marilyn cares for Mom morning and evening. Her schedule with Mom is consistent. Mom is calming and her routine is even. She is not always angelic in her response to her or me, but more often she is accepting and comfortable. I steeled myself for Mom being gone soon, but things are not working out that way and right now, I don't mind.
We are doing okay.
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