Monday, December 8, 2008
It is with great excitement that I drove to Ottawa (from Muskoka, where I live). It was a two-fold purposeful trip.
Firstly, it was my granddaughter's first birthday and we had a party.
Secondly, to pick up 200 copies of my book!
Both of us are happy girls!
It was fun seeing the generations together. I often feel the presence of my mother and know that she looks down on us with love. She was so proud of her granddaughter, Caitlin, and would have loved Josephine so much.
They say that one should deal with strong emotional events by writing it down. I found it helps so much. I can look back on my story of caring for ailing parents with much more clarity.
The big book launch will be in February, but for now I am selling them from my car!
There are some new studies that have found the benefits of writing a memoir to come to terms with your own story. There is healing power in such a process. Dr. Gary Reker's work on spirituality and autobiography interests me, as well as the work done by Pennebaker, convince me that the writing process is a healing one.
"We are healed of a suffering only by expressing it to the full." -Marcel Proust, novelist (1871-1922)
Wednesday, September 17, 2008
From my strong, tall father, who could repair, fix or build anything, he lost the ability to figure out the function of things. He bitterly fought using a walker, eventually was in a wheel chair. He tried to get out of it all the time. We had to restrain him as he would be a danger to himself.
The tumour affected his balance.
He was unable to drink easily at the end. I would have to hold the cup for him, if he could not manage two-handed.
I loved dad's hands. They reflected his age and experiences, which make us all more beautiful human beings.
Friday, August 22, 2008
This list is found in the back of my book.
Activities of Daily Living (ADL)--bathing, grooming, toileting, dressing, eating, and other activities necessary for daily living and survival
Agnosia--failure to recognize objects
Aphasia--a disturbance in receptive or expressive language
Apnea--temporary cessations in breathing; this is a sign of approaching death in palliative care patients
Apraxia--loss of understanding of the uses of things
Assistive device--a mechanical aid to make ADL easier
Benign brain tumour--a slow-growing tumour that does not tend to invade nearby cells
Biopsychosocial issues--interrelated biological, psychological, and sociological issues
Carcinogen--a substance that has been proven to cause cancer in living cells
Caregiver--one who provides care
Care recipient--one who receives care
Comorbidities--the effect of all disorders or diseases on an individual in addition to the primary health issue
Dementia--an acquired, persistent impairment in two or more cognitive areas of executive functions; profound mental incapacity
Delirium--• Disturbance of consciousness
• Disorientation, wandering attention, confusion, hallucinations
Dysphagia--choking and swallowing issues
Executive functions--planning, organizing, sequencing, and abstract thought
Frail--premorbid: at risk for biopsychosocial issues; inability to manage physical, social, and emotional needs (ADL)
Geriatric--of or relating to old age or old people
Independent Activities of Daily Living (IADL)--caring for pets and dependents; communicating with others effectively; managing finances and health; doing housework, meal preparation, and cleanup; looking after transportation and safety procedures
Infarct--a small, localized area of dead tissue caused by an inadequate blood supply; can result from blood clots or diabetes
Incontinence--inability to control evacuation of urine or feces
Long-term care (LTC) facility/home--a health care facility for those with physical disabilities that offers 24/7 nursing staff; formerly called a nursing home
Malignant brain tumour--a tumour that grows quickly and invades surrounding cells; these kinds of tumours are the least likely to be totally removed surgically, since they invade and damage important structures
Metastasize--when cancer cells break off from the original site and spread to other parts of the body to cause malignancy there
Morbidity--the quality of disease; the extent of illness, injury, or disability in a defined population
Nurse practitioner--a nurse who meets primary health care needs, conducts physical examinations, selects treatment plans, and identifies medication requirements
Nursing home--now called a long-term care home; differs from a retirement home
Orphan patient--a person without a family physician
Palliative care--giving care at the last stages of life
Polypharmacy--taking too many pharmaceuticals/prescription drugs
Premorbidities--factors that may lead to death
Primary care--basic or general health care from the medical system
Registered nurse (RN)--a nurse who is licensed to practise and is a registered member of a nurses’ association
Registered practical nurse (RPN)--a person who is registered by a professional association of nurses as having been trained to perform basic nursing tasks under the direction of a physician or an RN.
Respite care--temporary institutional or home care of a dependent ill or handicapped person to give respite to the usual caregiver
Retirement home--a private residence for seniors (profit or non-profit); governed by the Landlord Tenant Act
Sleep apnea--intermittent failure to breathe during sleep
Subcortical issues--issues such as plaque and damaged brain cells; physical evidence manifests as dementia
Supportive living--also called assisted living, in which supports are on call 24/7
ADL Activities of Daily Living
ADP Assistive Devices Program
ALC Alternate Level of Care (hospital designation)
CT Scan Computerized Axial Tomography (takes x-rays of the brain)
CCAC Community Care Access Center
CCC Complex Continuing Care
CHC Community Health Centres
ED Emergency Department
ER Emergency Room
FHT Family Health Team (now mandated across the province in Ontario)
FIPPA Freedom of Information and Protection of Privacy Act
HHR Human Health Resources
HSP Health Service Plan
IHSP Integrated Health Service Plan
IADL Instrumental Activities of Daily Living
ICE Isolated Community Experience (to serve seniors in rural areas)
IGS Integrated Geriatric Systems
LHIN Local Health Integration Network
LTC Long-Term Care
MIS Management Information System
MLAA Ministry LHIN Articulation Agreement (data collection)
MOHLTC Ministry of Health & Long-Term Care (Ontario)
MRI Magnetic Resonance Imaging (MRI Scan uses a magnet and radio waves to take pictures of the brain. It provides more detail than a CAT scan.)
NSM North Simcoe Muskoka
OCSA Ontario Community Support Association
PACE Program of All-inclusive Care for the Elderly
PASD Personal Services Assistance Device
PEC Public Education Coordinator
PHIPA Personal Health Information Protection Act
PRC Psychogeriatric Resource Consultant
PSW Personal Support Worker
RAI Resident Assessment Instrument (used in home care and palliative care)
RGP Regional Geriatric Program
RISC Regional Integrated Senior Centre
SGS Specialized Geriatric Services
TPO Transfer Payment Organization (governments have been outsourcing health care to various agencies, transferring money to them. They are governed by boards of directors.)
Monday, January 28, 2008
This morning, the blue jays were puffed up for warmth. I had filled the feeders last night--I knew it would be a cold night, ten degrees below zero or even less, and they would be hungry. I counted five jays negotiating for a spot at the feeder. The squirrels, in that endless hide-and-seek game, had wee faces covered in snow as they doggy-dug trying to first bury and then find sunflower seeds or peanuts. They were a hungry lot today, and I may give them all a second sympathy feed. The rest of us were on diets, but we don’t have to live outdoors. I was glad for no yard duty anymore. Supervising inadequately dressed teens, hell-bent on jockeying for yard position, was no fun. I spend longer outdoors now, but it is my choice and I can move around, take photos, and explore nature.
I am so glad to be on the upturn emotionally. I still find it hard being in large groups. The winter was passing, and spring would come, just as it had for the previous fifty years of my life! I endeavour to get out every day to walk or do other outdoor activities. The Vitamin D is necessary for us old folks. I have been off meds for long enough to know that I don’t need them right now, but I know that my doctor is there if I need him, and he is happy with my progress. Quitting antidepressants too quickly or suddenly can result in setbacks.
I had worked hard at doing my M.A. coursework: research to help me navigate through the past few years of depression and stress. I feel that I have made many gains. There have been days when I felt sad and tired, and re-experienced some of the warning signs of depression (sadness, anger, fatigue, inability to make a decision, and insomnia), but they are less frequent. When I recognize the warning signs, I make sure I work out more, get outside in the sun, take time for me, do something for myself, and it passes. What a relief.
In the spring, Caitlin and Jean-Luc brought our granddaughter for a visit. She was thriving in the joy and love of a wonderful home. We visit lots with Jesse, who lives the closest, in Toronto. I regularly communicate with Terry, too, and he visits from time to time. All have been grieving the loss of their grandparents. We often speak of the fond memories that we hold dear: trips to the cottage and trips to town; tons of photos and slides are on hand.
Thursday, January 10, 2008
The difficulty with parenting has been that many parents have passed through a laissez-faire phase in which the child was allowed to flourish and thrive. I remember in Grade 7 we were to self-select learning activities, with little direct guidance from the classroom teacher. I learned very little in that class and became frustrated. This philosophy of parenting had to be changed; many books were published to teach us how to say no to our children. Rabbi Shmuley Boteach offers a show called Shalom in the Home. He is re-educating parents in how to be fair and firm. He is teaching parents to give unconditional love with the right hand and discipline with the left. Both are necessary.
In my experiences with family and friends, I have heard endless stories of adult children who are unable to say no to frail and ailing parents. It is a reversal. Adult children have to lie and deny in an attempt to protect themselves from their parents’ wrath.
Frail adults refuse the help of outside agencies, whether or not money is an issue. It is the less frail spouse who suffers. One fifty-year-old daughter, whose mother had survived breast cancer in her seventies, is trying to persuade her father to allow people to come in to help them. When he falls, the mother cannot pick him up. The mother is now fighting high blood pressure with the stress of caring for this ill man. Tough love is a concept that must be applied to adults as well as children. In this situation, it should not be up to one spouse to refuse care if family members determine that there is a need.
One family, whose father lived in the family farmhouse as he had as a boy, promised their father that his stay in the long-term care home would only last a month. They are now using more excuses to keep him in. He doesn’t like his roommate, who turns up the TV too loud, and is fighting to keep his old life. Frail and ailing adults deny that they are unable to stay in their homes; they experience falls and break limbs, which land them in an LTC home. As seniors, we must make adult choices or we will not be treated as adults.
Our favourite librarian, Mari, who kindly delivered books to my mother, told me that she tried to persuade my mother to get some help with ADL. She offered to put my parents on the Meals on Wheels program, which my father and my husband delivered. Mom would not buy into any of this. Only old, sick people needed home support!