Saturday, July 30, 2011

Cat Treats

It is common for folks with dementia to repeat themselves, at least some of the time, on some question. From the first moment of the day until time to go to sleep, my mother's world rotates around the imaginary needs of her cat.  My mother's question is "have you fed the cats yet?"  Seven or eight times in an hour.  But it isn't just feline nutrition that drives her. Mom won't leave the house until she is sure all the animals are fed.   She won't eat her breakfast until she feeds them treats. But it works both ways. Because she is often too picky to eat what is prepared for dinner, I won't feed the dog until she eats her dinner. The dog does not mind, and mom eats.

not mom's cat
Clearly it is bigger than just the food.   She won't go to bed until they are located and secured. She cannot relax until her cat is taken care of. She wants to go hunting in antique stores so that her cat can have a throne like the one on her calendar.  I used to dress up her delivered snack with some of my best little dishes. I had collected antique salt cellars (tiny china plates) and used them with my dolls when I was young.  I put her pills on one on her tray one day.  Now that, and every other tiny dish I have, has become a special "treat dish" for her cat. She has usurped all my special little  dishes to be solely for her cat! I now have to bring her an extra fancy glass of water, having done it once, for her pills.  She now insists that her water glass be filled to the brim, after she finally gets her pills down, so that her cat can drink easily from it. "She likes it that way."  I try to stop the silliness but she broke three tumblers doing it herself when I didn't comply. They are just glasses, and it makes mom so happy.

 Mom sits with the cat on her lap in a recliner most of the time now.  She stopped coming downstairs regularly sometime before May, unless my husband was going to be there. Her arthritis being so bad, to ease her pain, we sometimes would take her her meal on a tray. Funny. When she is given her meal that way the cat climbs in the tray, making eating next to impossible.  If you try to remove the cat, my mother tells you you are mean and pouts. Forget going anywhere if the the cat is in her lap. As soon as that happens she will not get up, lest she disturb the beast. She will sit in uncomfortable positions, do without a needed item, even wet her pants, before she will move the cat.  It is as if this cat is her whole world.  It is quirky, demented and kind of cute if annoying.
In a world of such losses and pain, the happiness this beast brings mom is a gift.

Yesterday, when I was helping mom meet the people at an adult day care center we are hoping to use my cell phone rang three consecutive times.  It was a freind, trying to reach me in the hopes that, of all things, I would feed her cat while she was away for the weekend.  I had ignored each ring, allowing it to go to voicemail, in order to finish the paperwork with the program director so mom could enjoy her day.  When it rang a third time, I asked if I could be excused to take it.  Mom looked up at me in all seriousness and wet eyed asked if something had happened to her cat.  The calls were from a neighbor fifteen houses down the street.  The cat was at home where we had just left her well fed self less than 20 minutes ago, sleeping on mom's chair in her room while my husband worked at home.  Really mom?

still not mom's cat
I asked her why she thought her cat was hurt, and even  more interesting, why she thought that all my friends were calling simultaneously to inform me while her son in law, who was there, was not.
 She responded, "She is my daughter." "Mom, I am your daughter," I replied.  "You got married and left, but she stayed."  Really?  Apparently the cat is my good step-sister, and my friends are more loyal to her than me. Explains a lot.

Good to know I guess. How do I explain what comes next to her? It breaks the heart.  Few if any places will allow mom to keep her cat. The ones that will are way too expensive.

As we prepare to go get a birthday gift for a family member today she has reminded me six times. "We need Cat Treats."

meow, meow, meow?

Friday, July 29, 2011

Cicada silence

After two very hot humid oppressive weeks, tonight it is raining. As the rain falls it makes an incredible lullaby of splashing on the roof. As the sky releases it's pent up humidity, the air clears and we begin to breathe again.  The buzz of cicadas in the summer heat has transformed into a  sloshing chorus.  A wet baptism of change.

I write because it calms me.

The Buzz of Cicadas:
It has been a long time since I was able to write.  Care-giving for mom increased in intensity at the same time that work increased in intensity. My self care strategies only went so far and after two successful but too brief spiritual retreats (of sorts) I was immediately slammed with the necessary losses of summer, family depressions, mom's dementia and continued collegial burnout leading to work outages and with a different colleague, another hospitalization. On bad days I start thinking of Job.  I awake now, already tired, to battle my way through the day.  Mom's continual decline in functionality, my sisters well meaning but sometimes destructive help, my husband's growing depression and its considerable physical  symptoms, combined with mounting financial losses associated with the increase of PCA and HHA hours after mom's completed spend down have made things pretty bleak in the house.  Each hour of my days have been filled with painful and obligatory tasks related to the future and imminent placement of my mother in a facility.

I struggle with the idea that I am giving up.  In my mind I know that I have not.  I relate too well to her feelings of loss and frustration.  I find I feel selfish for the glimpses of hope I feel when we speak of "getting our life back."

The Summer Heat:
In my heart there is such greif and loss as I know that when she goes in, she is going to never return.  That was always so, but somehow, I thought this transition would be clearer.  I did not expect it to be my husband or my health that would exacerbate the move.  I guess in my heart of hearts, I hoped she would be the one that was so sick it would be clear.  That is not what has happened.  She has lost more cognition, yes.  Her personality has become resistant and feisty at times, which is new and unpleasant. She is so lonely and frustrated. Oddly it is the caregivers physical and psychical breakdown that is pushing her out.  She is the healthiest one here.
 With all the "help" I am getting from others, as welcome and needed as it is, my center is off kilter. I find myself making really difficult decisions with too many voices in the space.  I really need that clarity now. I seek that clarity I have prayed for, that vision that is sharp and obvious.

Cicada Buzz:
Now, it is as if I see the world through new multifaceted fly eyes and my human brain cannot make sense of all that it perceives.  So many choices- Independent living, assisted living, Nursing home, rest home, long term care, memory units, respite beds and respite rooms, Adult day care, Adult Group Foster Care, and now medicaid. Insurance covers this, but not that. If we pay for this, then we lose that.  All the trade offs, all the compromises, all the money, and lack of money, my head is cyclonic.  This program pays this much and these four people must see her first before it kicks in, and then when it does these three people must repeat the process.  If we want to add one more level of care, well that is four more people that must "check her out".  Now if we paid for this before the insurance was approved, well "we cannot replace what you were already paying out of pocket." So now sixteen weeks in and we are still paying out of pocket for things that now are not working or are not enough. 

And did I mention work?  With our staff at 50% capacity the need to find time out is, well, frustrated.

I follow some other chaplains on forum online.  Recently they have been sharing with each other how they handle the stress of the job and balance their lives.  I read their recounts of wonderful retreats, stories of mutual support over desserts and coffee. I wanted to share my own strategies for staying centered, and wept. It was in composing my post, suggesting lunch with friends, writing, therapeutic massage, prayer and the liberal use of humor that I realized I was not practicing what I preach. How easily I had allowed my own soul care to be subjugated to the needs of both my chaplaincy and my mother. As I wept, I slowly understood I am not staying balanced and finding that serenity.  My intentional spiritual practice of natural awareness, my sacred walk of constant gratitude and prayer, that soul connection which has been my ever renewing source of strength and divine solace, has become reduced to a constant barrage of intense encounters with vivid holy moments.  The gentle quiet I cherish encourages ideas and calm to settle. That which allows experience to integrate into the soul has been crowded out. Everything in my world has somehow become adrenaline filled and crisis driven.  Oppressive.

The Rain:
Now comes the hard part. If I have to fix this, then I need to own my role in the chaos.  Grimelda, help me to make the time to care for me now, before I step in to care for anyone else. Bless the selfishness that lets us survive. Remind me that  I am responsible to slow down, to say "no", to prioritize and to accept, (ouch), that I cannot fix this. All I can do is ... all I can do. Let me see that while it will not be enough, that it will have to be, enough.

I write because it calms me.

After two very hot humid oppressive weeks, tonight it is raining. As the rain falls it makes an incredible lullaby of splashing on the roof. As the sky releases it's pent up humidity, the air clears and we begin to breathe again.  The buzz of cicadas in the summer heat has transformed into a  sloshing chorus.  A wet baptism of change.

Amen, Amen and Amen.