no longer on a plateau

When caring for an elderly person, you can measure status as being on a plateau or in a decline. As a friend said to me, “Over time, the plateaus get shorter and the declines get steeper”. This is true. My mother has experienced this pattern of a fairly even pace for years and then decline. She worked until she was 75 and she was still sharp and energetic, but had slowed a bit. She still traveled, did crafts at a high quality, and enjoyed her family and friends. By the time she was 80, she experienced mild decline. She no longer drove the 10 hours down to Baltimore, she chose to fly. She took on fewer projects and was a little less meticulous with her work. She was more forgetful. She was on a new (lower) plateau. By the time she was 85, she was into a new decline. She was having difficulty caring for herself, managing money and an apartment, shopping for food, and so on. She required help from family and friends, and eventually could not live on her own anymore. She came to live with me when she was 87.

For the first four years, Mom was okay. She could follow TV shows, particularly older shows with a slower pace and documentaries that grabbed her attention. She could knit well (so long as the pattern was not complicated), come up with her own patterns to color or paint, and decide for herself what to do with her time. She could get her own breakfast and lunch. She liked to go shopping with me. She was again on a plateau and actually had regained a little of the energy she had lost when she lived alone.

About two years ago, she started to decline again – a little at first, but then a plunge. She can no longer do most of the things she used to do. Even following basic plots on TV shows she has seen multiple times is a challenge. She needs help remembering how to get dressed in the morning and where she lives and who has died. This is a steep decline and it’s unclear how deep it will go and when (or if) there will be another plateau.

We now have someone who comes in to be with her later in the afternoons. These are the times when she is most lonely, scared, and confused. She loves having this new friend and having someone to talk and laugh with. They have been doing jigsaw puzzles. It has been lovely hearing her laughing with someone again. Prior to this, she would sometimes cry later in the afternoon when I was working, because she was alone in the living room and couldn’t remember whether I was at home or away.

I now help her dress in the morning and undress at night. I get breakfast and lunch for her, and help her find the bathroom. I find things for her to do during the day – knitting a cat mat, coloring, and so on. In sum, I help her navigate the slings and arrows of daily life. As a caregiver, it’s hard to figure out when to push her to do things and when to help. For example, I never help her get out of bed – she can do that on her own and as long as she is able, I leave it to her. I do come in to her bedroom to be there if she needs me. Yet, I always help her with her socks and shoes! Footwear is a bridge too far.

I’m fortunate that my job is flexible and that my supervisor is compassionate. So many of the people I work with have had an elderly person live with them. They understand the declines and the changing needs and the challenges. I start work early now, usually by 7 am, so that I have flexibility in the afternoon. Being a caregiver for an elderly person means lots of changes in routine (a bit of an oxymoron) as we adapt to changing times and capacity. Unlike with child care, there is an understanding that things will not get better or lessen over time. My mother will not become more independent or better able to care for and express herself. There aren’t many advances upward from the plateau – the changes measure loses of skills, abilities, joy, and accomplishment. She was so proud on her 90th birthday, but she seems surprised and a little sad to now be almost 94. She has started to see herself as “old” and to dislike the fact that she is the sole survivor of her siblings – survival doesn’t make her feel strong, only lonely and afraid.

thoughts on books: anna karenina

Anna Karenina, another tome by Leo Tolstoy, is a magnificent and sweeping book that focuses on two story lines – and three marriages: Anna and her husband Karenin, Dolly and her husband Stiva Oblonsky (Anna’s brother) and Kitty (Dolly’s sister) and Konstantin Levin. The dashing Alexei Vronsky is also in the picture as a key source of intrigue in two of the marriages. The book encompasses the history of Russia in the late 19th century by exploring how the changes in Russia affected and were affected by these characters who are trying to adjust to underlying evolution that sometimes seems a little too slow in their estimation. Because this book is so driven by the individual storylines, it’s difficult to summarize this evolution and the eventual changes to the characters – it is the movement by many small steps driven by a series of events.

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thoughts on books: a tale of two cities

Such a lovely book that captured the full range of emotions! I’m a fan of Charles Dickens – from my first read of Oliver Twist when I was in middle school and through Great Expectations, A Christmas Carol, and so on. The books often have elements of fun and adventure as well as unflinching views of poverty, oppression, injustice, and vulnerability. There is a reason why the word dickensian has entered the vernacular. And this is a fairly short book, especially for Dickens!

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working and balancing

I read an article in my news feed that talked about the important factors related to finding a job that will make you happy. The article, published in The Atlantic, pointed to having a sense of accomplishment, being part of something that makes the world a better place, and several other factors as being key elements. I agree that these things contribute to a better job experience. When I first started out after college, these were the key things for me. It wasn’t about money but about making a difference. Over time, my focus has shifted a bit but I still value the idea of contributing to making life better for people.

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hosting jeopardy!

I love Jeopardy! With Alex Trebek’s death in November, the search began for his replacement. There have been a series of guest hosts and the internet is abuzz over who is the best and who will replace Alex. One of the things people tend to overlook is that it’s not clear which guest hosts would actually like to make the hosting gig a permanent one. Some of the guest hosts seem to consider their opportunity as a bucket list item or a fun lark or a tribute to Alex. There are really only a few who have said they would like to be considered a permanent host, at least from what I’ve read.

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back again …

Between COVID, moving and other changes, it’s been quite a year. I’m finally able to poke my head out and start to rejoin the world.

As I said in a prior post (where have you been?), working from home has been a blessing because my mother needed to have someone around to help her get meals and function in daily life. When she moved down to Baltimore, she didn’t really want to go out and meet new people or go to a senior center or otherwise engage in the world unless I went with her. Being at home has allowed me to be around, so that was great.

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regrets … I’ve had a few

flower-1030408_1920I can almost hear Sinatra singing My Way in the background as I start this post.

My sister-in-law has an unusual talent for asking questions that stay with me for a while. Last year, when she and my brother came for a visit, the question was whether I was happy with my life. Apparently, my brother mentioned that he thought I was and that he was happy that I seemed happy. My SIL was more direct – she asked me! I said yes, but it was not the most enthusiastic yes. If you look at the past several posts, you can probably understand why. More about this question in an upcoming post. Continue reading