staying on schedule, logging progress and facing fears

heart-875771_1280My mother has always been diligent about taking her medicine every day. One reason for her success is that she has a container with compartments for each day of the week. She then knows whether she has taken her pills or not. 

We modified this a bit when Mom came to live with me – we have two containers, so we know two weeks out whether she needs a new prescription. The second container is kept in another room, so that she doesn’t dip into it by accident. On Sunday, when the first container is empty, she switches it with the second container, refills the first after breakfast and puts the first into the other room. This system works really well – she doesn’t run out of anything and it gives us time to check in with her doctor or the pharmacist when something is coming up. Setting up a reminder and notification system with the pharmacy also keeps us on top of things.

Exercises suggested by Mom’s doctor don’t have containers to track progress, so we needed something else. Mom was a bookkeeper for many years and so was comfortable looking at spreadsheets. I was able to build on those skills by downloading and modifying a free exercise log. We tried a few versions before hitting on one that she understands and can easily use. She is incredibly proud of the spreadsheet, not only because she uses it consistently but because we worked together to come up with it.

Her daily log is really just an Excel spreadsheet with times (from 9:00 am to 8:00 pm) in the columns and exercises in the rows – I can fit four days of rows on a page. The additional block of rows at the bottom of the page include: the apartment’s address and phone number, my cell phone number, the front desk phone number and other helpful hints. That way, she always has key information handy.

I am fortunate that Mom is committed to doing her exercises and tracking her progress. The exercises are to stand and sit (five times every hour), lean back and sit up straight without using her arms (five times every hour), lift a one-pound weight straight up (10 times per arm every hour) and walk to the kitchen or bathroom several times per day. It is less important that all the cells on the spreadsheet are checked and more important that she at least does something every day. Even though she is nearly two years older than when she moved in, she is much stronger and steadier on her feet now. Other things contributed to this success – see prior post.

Organization and consistent routines are very important for older people. When Mom first moved in, I was tempted to make her coffee in the morning or get her breakfast. But I soon realized that, while kind, it was not a good idea for her to become dependent on me. When she stops doing things on her own, she forgets how to do them and becomes frustrated with herself. So we have an agreement that I will help only if she is not feeling well or her knees hurt so much that she cannot tolerate standing for the coffee maker and toaster to finish – even then, she starts them and I just handle delivery.

An example of losing skills is her use of the Kindle to read books. Several years ago, she used her Kindle all the time. Then, she got sick and stopped using it for a while. Even after her recovery, she could never get back into the swing of using it. Finally, she became afraid of doing something wrong, so convinced herself that she shouldn’t use it. Today, we started simple instructions on opening a book and turning pages; she is zipping along. But, if she doesn’t use it tomorrow and the next day and the day after that, she will forget what the buttons mean. I have written out instructions, complete with pictures, so I’m hopeful that she will continue. But she doesn’t use instructions as well as she did in the past – she has difficulty following them no matter how clearly written.

Adopting new approaches is not only important but tricky. In the past, Mom had beautiful handwriting and wrote lovely letters. Now, her handwriting is pretty good but she has to think about what to write and letters often end up choppy. So, we are starting a new process for writing letters where she will jot down notes and I’ll type up a letter. We will then work on honing the letter. I showed her that we can use tools on the computer or buy pretty paper to use in the printer to make the letters look a bit nicer. We have only written one letter, but she thought this was pretty slick! Yet, the thought of not writing them herself reminded her of the fact that she is losing that skill as well.

It’s not so much that she needs to track exercises or make coffee or use the Kindle or write letters, but each time she forgets or is scared off from doing something, she loses confidence in her overall ability. That is the real loss … when she starts to view herself as a failure or as “stupid” (her word), it’s much harder or sometimes impossible to get back on track. So I need to help her when she forgets and to remind her that sometimes new ways of doing things can be just as good as the old ways and that it’s not really a loss, but a gain of something new … needless to say, that’s a pretty tough sell.

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