June 2018 - The Artful Caregiver

When the Caregiver Needs Care

I woke up with vertigo – the bed was spinning, the room was spinning. But that didn’t stop my caregiver responsibilities. He still needed help going to the bathroom and getting back into bed. I tried going back to bed but it was worse. I got up with the hopes the dizziness was less when I was upright. Plus I had to feed and walk the dog. Brutal. It was a short walk. I had a little tea and toast. Couldn’t face coffee.

Then time to help him get up and get dressed. We both need showers but I can’t face it.

Got him some breakfast. Gave him his pills. Helped him use the nebulizer.

Vertigo happens when the crystals in the inner ear clump up and get stuck in one place – the wrong place. I tried the physical maneuvers I found on YouTube that are supposed to move the crystals. No help yet. I’ve tried the vertigo medication, which I have for motion sickness. No help yet.

He needs to go to the bathroom again. It’s good for him since he’s increased the medication that is supposed to relieve the swelling in his feet and lower legs by flushing fluids out of him. Maybe it’s finally working. But painful for me to get up and help.

Just like with a baby, caregiving responsibilities don’t stop because you don’t feel up to it.

I am going to let go of anything else that needs to be done. I will call for help if I need it. I will try not to feel sorry for myself. This will pass. I will muddle through.

Anniversaries and Anger

We celebrated our 22nd anniversary last Friday. Larry wasn’t feeling great. We had talked about going to a favorite restaurant for a late lunch/early dinner and then to a waterfront bar for a drink, but were contemplating staying home.

I encouraged us to go, even though I barely had the energy. I figured this might be the last one we got to celebrate.

So I showered and dressed, helped him shower, shave, and dress, and off we went in the wheelchair van, several hours later than planned.

I’m so glad we went. We found easy parking for the van. We chose from the menu carefully so I wouldn’t have to dislodge food that got stuck in his mouth. We sat at a table with lots of people-watching so the normal lack of conversation between us due to his speech challenges wasn’t troublesome.

He made a toast with a wry smile. I had to ask him to repeat it 3 times before I got up and leaned toward his mouth to hear. “I hope the next 22 years are as good as the first 22.” Hmmm. If only…

When we’d finished eating the restaurant was far more crowded and navigating the path through the tables and chair was challenging in the wheelchair. Most people got up and moved their chairs out of the way, but one young woman didn’t bother and Larry clipped her chair as he went by and his wheels carried her chair and her along with him. She wasn’t happy. I thought it was kind of funny!

After dinner, we drove over to the waterfront bar in a big hotel. They took good care of us and we sat side by side, he in his wheelchair and I in my rattan chair. He had a rum and ginger, I had a Prosecco. We watched the sunset and held hands. It was as romantic as all the other anniversaries. We came home smiling.

But then he had a breathing slog – when the phlegm gets thick and lodged in his throat and his breathing is shallow and gurgles with each intake.

I got him a hot moist cloth to breathe through, massaged his chest and neck, and then gave him one of those pillows with the seeds in them you put in the microwave for his chest. It’s frightening for us both, what I do isn’t really useful except in making me feel like I’m trying, and it underscores the helplessness I feel in the face of this disease.

He goes to bed with his heating pad and his CPAP breathing machine, saying “I love you” just before I situated the facemask. “Did you say that in case you die during the night?” I asked. He nodded. Romantic, right? NO – then I wasn’t awake all night listening to be sure he kept breathing. We laughed about it in the morning when I told him I’d consider myself loved if he’d stop telling me just before sleep.

Days later, though, we talked about the insidious emotions – the jealousy we feel toward other people who can do what they want, enjoy life without these challenges. We both feel so angry at times. It’s hard not to.

So I have to keep trying to get us to experience those more humorous, enjoyable, and even romantic moments, even when I don’t feel like it. Even a drive around the neighborhood in our ancient golf cart so we at least get out of the house helps to chase away the dark times.

My Finely Tuned Race Car Needed Dental Work

It’s early and I couldn’t sleep but I also don’t want to start the day. It’s been a hard week, for what seems like a small thing. He had dental work three days ago.

I joke that he’s like a finely tuned race car – doesn’t take much to throw everything out of whack.

It started with a broken tooth. No pain, but obviously problematic. The choice was a root canal and a crown, or pulling it and adding a replacement to his existing partial plate which fit well and gave him no problems. He opted for the latter, a relatively simple procedure.

Two appointments for Tuesday were scheduled. He took an anxiety pill in the morning. That appointment didn’t require novocaine. The afternoon appointment did. All went well – at least for his teeth.

But the day seemed to throw his balance off and make him weak. He didn’t have much of a toothache but instead said his whole body felt beat up. He’s been tired and achy ever since. Which means he doesn’t really want to exercise.

Eating, already a challenge, has been far more difficult with a swollen lip. He’s had problems to get the food all the way into his mouth so it gets stuck between his lips. Obviously that’s worse with the dental work.

He’s depressed, too. Not smiling much. Hardly talking. I realize his smile is what keeps me going.

So is this just the dentistry and it will pass? Or is it a new level of symptoms that will just have to be gotten use to? That’s really the problem – which is it? That’s always the question.

I spend so much time wondering about the cause of each new symptom and trying to figure out if some tiny change is the culprit and if I change that change, can we improve things. It’s an exhausting round of thinking.

All our lives when something goes wrong, you figure out how to make it better, or wait it out until it gets better on its own. Got a cold? Wait a week. Got a fever? Take an aspirin. Infection? Antibiotics will make it better.

There is no better in this scenario! There is only the same or worse. That’s what is so damn hard! So hard! Each transition to a new plateau upsets the finely tuned balance.

Time to start this day. It will probably be fine once we get going.

Aging at Warp Speed

This was a journal entry of mine four years ago, about 2 years after the initial diagnosis:

For me this disease in our lives is like watching someone age before my eyes. He was a big strong handsome guy – think Tom Selleck (I always did). He could lift anything and never needed to ask for help. He told me once he’d never felt physically vulnerable, which was the opposite of me since I’m 5’2″ and grew up in New York City. I always felt vulnerable.

He’s got a hunched over posture now. One of the things I noticed even before he was diagnosed was the change in his smile. I didn’t know then that it was increasing rigidity of muscles in his face. He has trouble getting up from a seated position, particularly from soft chairs or couches. He has far less energy and stamina. His speech is slurred and his voice is quieted. We no longer play golf, or go skiing.

There isn’t a day that I can forget about his PD. Although the symptoms aren’t that bad yet, there’s always something new to notice. A crash signaling a fall from halfway up the stairs. A glass slipping out of his hand and smashing on the kitchen floor, again. The help needed to button a shirt, or get on a winter glove. The inability to fold laundry anymore.

Each symptom I noticed threw me into anxiety about what would come next. If he couldn’t do this now, what would become impossible next month or next year.

Three months ago something changed. I decided I had a choice. If I kept on fearing what would happen in the future and making myself miserable in the present I was suffering twice. Instead, I started asking myself a simple question.

“Can I manage what is going on right now? Is today okay?”

I made myself notice all the good in the day. I started seeing that though he was had trouble cutting up things in the kitchen (he always enjoyed cooking), he can still make wonderful meals. Although we can’t go skiing, we can take walks in the snow with hiking poles. Although we can’t hike up big mountains, we can enjoy the lower trails. And when he struggles to get up from the couch, sometimes I joke and push him back down and we both laugh.

I know things will change from day to day and month to month. I don’t know what the future will bring. Right now, I’m focused on now.

NOTE: As I read this now, although 4 years have gone by, it’s about 20 years of aging. He has more daily challenges now than my mother had at 95 years old. We can barely go an hour, never mind a day without the disease saying loudly “I’m here!!!” Without a new symptom cropping up, without struggling to figure out how to mitigate the impact of the disease. I try to stay in the day, and in the hour. I try to stay in the now. That alone is hard work.

Good Day or Cranky Day

I was cranky with my husband yesterday as I tried to complete a project. In finishing I had to call a neighbor to help put boxes up on the high shelves in the garage – something Larry could have easily done in years past. As I do all this, I wonder if he is sitting there frustrated that he can’t help. Or is he so in his own world of challenges and pain that he doesn’t even notice?

I found myself very impatient, yesterday, with all his incompetencies, then guilty for my impatience. He can’t get out of a chair alone so I have to help – even with his lift chair. He was trying and couldn’t, trying to shift his weight with such ineffectiveness! So I jumped in to help before he even asked. I need to cultivate more patience – it would allow him more independence and make me feel less responsible. There’s rarely any rush.

Eating is really becoming difficult – finding the right foods, cutting them to the right size, finding the right implements. He wanted a big breakfast. But the tiny sausage pieces and home fried potato chunks kept getting stuck in the roof of his mouth. Even though I thought I’d cut everything small enough. He doesn’t have the tongue strength to move things around in his mouth easily. So I had to keep sticking my finger in his mouth to dislodge things.

His eating is so slow that I am done way before him. Then the question becomes what do I do while he is finishing? Do I stay with him and read the paper? We can’t have a conversation because he can’t talk and eat because of the risk of choking. I have to stay close in case things get stuck or he chokes. Do I get up and start cleaning up the kitchen? What I sometimes end up doing is getting myself more food, which I don’t need, because if I’m sitting there I should be eating, right? Cultivating more patience, eating more slowing and mindfully would both help.

The real problem was that my focus was on getting my project finished, then cleaning up all the mess that made.

Whenever I have a task that takes my time and energy, I lose my patience and resilience to be available for his needs, not just physically but available emotionally, to help with grace rather than with resentment.

Lesson for the day: Ask myself whether it’s worth the price of impatience and resentment, to get the task done. Make a conscious choice with awareness of the consequences. Did I really need to get all that stuff done in one day? No! Did I think about how cranky it would make me? No. We both would have had a better day if I’d chunked the project into several days.

I try to remember that my goal now is creating a good life for both of us, one day at a time. It’s a different life with different goals. The old way of thinking, of living, of checking off my to-do list, of putting things on my to-do list in the first place without thinking of the importance versus the consequences – that’s what messes up a good day.

Each day matters more now. It’s important to have as many good days as possible.

Losing Equilibrium

How easily our equilibrium tips out of balance. This time it was a hard fall.

We had just started the standing portion of his exercises. I had to bug him to even start them. Some days are just like that. All of a sudden, I saw him lean to the left, tring to catch his balance. I was only 3 feet away and I reached out to grab him but just missed.

CRASH! He hit the tile floor hard with his hip and his elbow, and his head slammed into an antique victrola case next to him, bouncing open a door.

Okay, we were lucky. He didn’t break anything. There was no bleeding. It wasn’t a crisis.

Most of his falls, which happen at least once a week even with the walker, are slow and soft. His biggest concern when he lands on the floor is how to position himself so I can help him up.

This time he just wanted to lay on the floor and not move. I go through the whole routine – checking his head for blood, checking his pupils, asking about dizziness.

I feel adrenaline and fear that morphs into anger – at him for falling, at me for not catching him and for urging him to exercise in the first place.

So after just a few minutes his self-assessment is that he’s okay. We figure out how to get him off the floor, without hurting my already aching back.

He takes it easy all day. The outing we’d planned for the day is off. I readjust my mind to a different day.

But the fear sits with me. The unpredictable nature of each day eats at me. I find it hard to stay present with the fact that things are okay for now. My body stays tense, as if waiting for the next blow.

I’ve lost my equilibrium, just as surely as he lost his when he fell.