As I Watch Her Fade Away…

My mother turns 90 on Saturday and I can see her slowly fading away.  This once vibrant, feisty, fast-walking, could-walk-any-distance woman is now a baby once again.

She complains that her legs are weak and can’t seem to “carry” her anymore.  Her hands shake excessively and holding anything is now hard work.  You should hear her favorite cup with a spoon in it jingle like a musical instrument.  She even laughs at that herself!  Feeding herself has become such a chore, she’d rather not eat until someone can feed her.

Taking a bath takes her ten times longer now, but she insists on doing so herself.  She has never slipped or fallen in the bath (safety mechanism installed) so she believes this means she should be the one giving herself a bath.  She’s totally resistant to anyone helping her with this.

I’m here to tell you that it’s pretty difficult watching a loved one fade away.  Year by year, month by month, I am witnessing her aging process.  She jokes about it quite a bit, but for me it isn’t a joke.  I know we all have to get old one day (as long as we’re still alive), but coming to grips with it requires a great amount of acceptance of that harsh reality.  To watch a person no longer be able to do simple things for themselves, become forgetful – even about something that just took place, not recognize their loved ones, change their preference of food due to the change in their taste-buds to a mushy baby-food like substance, become either extremely pleasant or in some cases, become extremely unpleasant and difficult to handle  — some of the many changes that take place with aging — is something that you have to be fully equipped physically and mentally to handle.

My mom is quite aware that she’s moving towards the end of her days here on earth and has different reactions to this awareness.  Sometimes she’s pleasant and other times, quite angry.  She feels she has lost her independence and just knowing that everything she used to be able to do for herself, has to now be done for her, she just can’t come to terms with that fact.

We understand and are now at the stage of acceptance that she may soon no longer be with us.  We truly believe she will be better off, as we definitely do not want her suffering in any way, shape or form.

The Elderly and Their Oral Health

Did you know that your oral health can indeed influence many aspects of your overall health? This is something I was told many years ago by a cardiologist when my eldest son, who had a heart condition as a baby, had to have some dental work done.

In particular, however, is the aspect of poor nutrition and poor health among the elderly.

In a recent article I read written by Rosalee M. Brown, a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services, she stated that the elderly population is often adversely affected by the dynamics of poor nutrition and poor oral health. Partial or total loss of teeth, gum disease, cavities, dry mouth and mouth ulcers are some of the oral health problems faced by the elderly. These oral health conditions directly influence the choice of foods these persons prepare. Avoidance of hard-to-chew foods such as fruits, vegetables and other whole foods, results in low micronutrient intake and low fiber intake.

Ms. Brown further stated that some elderly people may become underweight, as they often resort to liquid meals which are most times not adequate in nutrient and calories. Others use convenient foods like juices, which are high in sugars and can further compromise oral health by increasing cavities. Other convenient foods such as high-sodium, easy-to-prepare soups, can worsen chronic conditions such as high blood pressure. The inability to chew properly, resulting in the elimination of variety and complete food groups in the diet, can worsen oral health.

She said that many micronutrient deficiencies can lead to poor oral health. Iron is important for oral health, as, among other factors, nutrient-rich blood will assist in the integrity of the cells of the oral cavity. Meats and green leafy vegetables are good sources of iron and B vitamins such as folates, which are important in red blood cell health.

She further stated that calcium is important to the integrity of the supporting bone structure and teeth and vitamin C to wound healing and the health of cells in the oral cavity. Zinc is important to bolstering the immune system, wound healing and assisting with taste. It is found in large amounts in fibrous animal food such as beef, chicken and fish. Inadequate intake of macronutrients such as proteins can also lead to poor oral health.

I am currently the caregiver to my 89-year old mother and am facing the exact dilemma of ensuring proper nutrition for her. Her reluctance to eat what has been provided for her is quite a task for me. She would rather have all the sweets she could get her hands on and would much prefer everything to be in liquid form. As Ms. Brown stated above, liquid meals are most times not adequate in nutrient and calories. Also, that juices are usually high in sugar and can further compromise oral health by increasing cavities. My mother even tries to somehow liquefy any other meal given to her. Potatoes, rice, yams, vegetables and meats would become a semi-liquid mush as she adds water, butter and cooking oil (which I have to remove from the kitchen due to the amount she uses) in an effort to get it to her desired mushy consistency.

Ms. Brown stated in her article that caregivers should be vigilant for signs of poor oral health in elderly people. Look for cavities, swollen gums, ulcers, mouth odor and poor fitting dentures. One sign is the elderly person’s refusal to eat some types of food as they are unable to chew them. It is not good enough to just eliminate these foods from the diet. Seek the help of an oral health specialist.

Ms. Brown further makes the following suggestions to include hard-to-chew foods in the diet:

1. Fibrous meats — chop and grind them.

2. Fibrous vegetables — cook then blend/ puree for soups.

3. Make juices with fruits and vegetables and include some fiber if this will be tolerated.

4. Ensure that these preparations are attractive and tasty.

5. Keep oral cavity clean.

Mom’s Back Home…For Now

My mother is back at home — for just a little while, though.  Please don’t get me wrong; I love my mother.  But she has become very difficult to handle, which has resulted in becoming a rather stressful situation for all concerned.
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You see, Mom had became ill due to her eating habits.  All she wanted to eat was anything that was super sweet (cakes, cookies, buns, juices, etc.) and with little or no nutritional value.  Any other food given to her, she would claim that “it’s way too salty for me”.  Could every single thing be salty, I wondered?  I even tried preparing her food with little or even no salt, at which time she then complains that “it’s too bland — is salt scarce or something?” Folks, this is just one single example of the feisty, abrasive behavior of this almost 90-year old woman that I had to deal with.  I was able to ignore it sometimes, but there were times when I was simply not able to do so.

Mom would allow several days to go by without eating anything substantial that has been provided for her, and as a result, she began to lose weight.  I became concerned and took her to the doctor, who suggested that she be placed in an environment where she could be monitored constantly, would start eating properly again, therefore gaining back some of her lost weight.  I found a nice, clean-smelling nursing home with friendly staff that I believed would work well for her.  They approved for a stay of up to 120 days in the Rehab section of the home.

After the first month, her appetite began to open up again, the salty complaints had diminished considerably, but she had other issues that needed monitoring.  As a result, the plan was for her to be kept for up to the maximum time allowed.  After two and a-half months, she began to do much better and started to feel as if she didn’t belong there.  She started going around the home all by herself (despite being warned not to do so by the staff and doctors for fear of falling), going to and from the gym, the kitchen and even going into the reception area making friends with residents, staff and visitors alike.  She would sit in the couch in the reception area, waiting for “friends” to come along and join her.  Now, my mother never used the word “friend” for as long as my siblings and I knew her, claiming she had enough sisters and didn’t need any friends!  But things seemed to have changed and she now spoke of having “friends” at this rather late stage of her life.

As if that wasn’t enough, she would chase any nurse/staff that came into her room to feed or assist her, claiming that “I’m not feeble! Why do they need think that I need help?” Of course, this became a problem for the people at the nursing home and they eventually discontinued the services that were being given to her, i.e., physical therapy, speech therapy, daily bathing, etc.  Her resistance was too much for them to deal with and they asked that she either be placed in the permanent section of the nursing home (where the staff there would be better equipped to handle her daily resistance) or that she be sent back home.

I discussed the issue with my sister and the decision was made to bring her back home.  If she again needs to be placed back into a monitored environment, I will need to apply for her to be permanently placed into a nursing home residence, which of course is something she is quite resistant to.  In any event at this stage, there isn’t much we can do because she is almost 90-years old and needs to be in an environment where she can be monitored constantly.

I’m taking it one day at a time.

Let’s Celebrate Our Mothers

Let’s celebrate our mothers; whether they’re here with us or gone on to a more peaceful place.Who is a mother?  What does a mother do?  A mother is not just someone who carried another human being to full term in her body, give’s birth to that human being and all is complete.  Oh no!  A mother is someone who loves unconditionally, nurtures, feeds, listens to, plays with, guides, and raises her child to the stage of adulthood before sending him/her off into the world.  Mother’s are champions.  Many mothers today play the role of fathers due to becoming single mothers, many times through no fault of her own.A woman somehow automatically kicks into the mode of raising her child(ren) if she does end up becoming single.  It’s usually never up for discussion and there are no alternatives that are even thought of, upon becoming a single mom.  All she knows is that this child will be raised – one way or another.

I raised my own three children as a single mother and in retrospect, sometimes I wonder how I did it. Seriously!  I was clearly in that don’t-know-how-where-when-but-I’m-raising-these-children-one-way-or-another mode, and then just totally went for it.  I remember having three jobs at one time, because child support was not forthcoming.  I had my regular 9-5 job, one in the evenings from 6pm-9:30pm and another on Sundays all day.  The children had to eat.  They had to go to school.  They had to look clean. They had to look, feel and be like other children who had both their parents at home.  So, holding down three jobs did not bother me one bit.  I never even gave it a second thought.

The three-job situation finally took its toll one evening after I arrived home after the second job.  As I opened the door to enter the house, I collapsed from exhaustion.  Upon a visit to my doctor the following morning, he promptly advised that I had to let one of the jobs go.  Do what doc?  So…wha ma podah do nah? (What am I supposed to do now?)  Who’s going to give me that extra money that is very much needed?  Anyway, after careful thought, I let go of job #2 and hung on to #1 and #3.  I did these for a while until raises on #1 brought me to a certain financial level where I could finally release #3.

My three adult children (ages 34, 31, and 22) often remark “I don’t know how you did it!”.  My reply to that is always – BECAUSE I AM A MOTHER!!  I HAD TO!  Got it! (Laugh). But seriously though, I’m not sure how I did it, but I did.  Motherly instinct is no joke.

And this, folks, is just my story.  I’m sure if you should hear the story of many other women, you would be amazed.  So on this another Mother’s Day, let’s thank our and everyone’s mother for the wonderful job they have done – no matter what their experience has been.

HAPPY MOTHER’S DAY!

Shopping with an 88-year old!

Have you ever gone shopping with an 88-year old? Well, I did this weekend. I took my mom market shopping. This is something she had always enjoyed doing her entire life. In the islands, going to market on a Saturday was the thing to do. It was, and probably still is, an absolute must do on a Saturday morning. Back then no one ever purchased ground provisions or cuts of meat at a supermarket. These items were purchased strictly from the market.

 

When my siblings and I were growing up (there were four of us), mom rotated us each Saturday as to who would accompany her to the market. We each eagerly looked forward to market day. After all, once we arrived at the market, we were placed in a corner close to one of mom’s favorite vendors with a huge bottle of our favorite soda and a warm meat patty, which was enclosed in a delicious crust. Yum! The highlight of our week. While we stood in the corner basking in that yummy moment, mom would saunter from aisle to aisle, stall to stall, carefully selecting her ground provisions and cuts of fresh beef from the butcher, while stopping to chat in-between with some of her friends whom she managed to make, visiting the market over the years. Mind you, we were never usually in a rush for her to come back as sometimes the vendors would give us fruits to eat on the spot while waiting for mom. This went on for most of our childhood years until my oldest sibling, my brother Max, “graduated” then there were three of us. The same routine continued until I “graduated”, then it was my sister Maggie’s turn then my brother, Richie’s turn. Soon we were all graduates of going to the market for shopping on a Saturday morning.

So yes, a time finally came when it was just my mom that would go market shopping on a Saturday morning — a ritual she never stopped until her body forced her to. We moved her to the United States in 2002 after dad passed away. She was quite reluctant to move, and understandably so. Having lived in one place for 70+ years of your life and to readjust at this fickle age is truly a major move. However, we succeeded in doing so.

As current caregiver to her, I figured that I would give her the opportunity this past Saturday, to go market shopping — something she had not done in a very long time. Her current health has prevented this but I figured I would take a chance.

We arrived at the farmer’s market and realizing that she would not be able to walk around, I then placed her in one of their mobile shopping carts for easier mobility. I also realized that I would have to “drive” this thing because she couldn’t! It was now too late to change my mind and head back out as she was already in the store, all set to go shopping. I pressed the pedal on the right-handle bar pedal and must have pressed it too hard, the cart made a sudden spring forward, almost crashing into a stall. Thank God no one was standing there! I was now thinking “this is not going to work; I will not be able to do this; I need to leave!!” Okay. I stood still and thought of the next move because I didn’t want to disappoint her. So, I decided that I would go a little softer when pressing that right-handle bar pedal. It worked!

You should have seen us! Me bending over her to place my left hand on the back of her seat with my right had on the pedal, going from stall to stall in the market. She enjoyed stopping and actually picking up one item after another, carefully selecting “a good one” as she went. I must admit it was fun to see how happy she was doing it. In any event, I’m not sure if I’ll be doing this again. It was a piece of work!!

Make Your Home Liveable For Your Aging Parent(s)

I found out today at a monthly caregiver meeting that my employer offers, that statistics show that just over eighty-five percent of the elderly would prefer to reside at home – either by themselves or with a relative (preferably one of their children), rather than to move into a nursing home. My friends, that is the story with my mother. She made it clear many years ago and still today, that she will not be caught dead or alive “inna dat deh place deh!” (translation – in that place there).

She has hung on for dear life to a scenario that was painted to her way back in the early 70s, by her sister-in-law (my Aunt Gertrude) who resided in Brooklyn, New York, and worked in a nursing home there. The horror stories Aunt Gertrude apparently told her made her cringe and God forbid…they may just happen to her too! No matter how much we tried to convince her that things are different now than they were then, that there were and still are, rules and regulations regarding treatment of the elderly, etc., she did not care one bit!

Our only alternative was for her to reside with one of her children and that turned out to be… yours truly. Mind you — I don’t mind it one bit! She took care of me way back when so…I can return the favor – oh, sorry – let me retract that! It’s not a favor…it’s my duty, I believe.

After giving the nursing home scenario a two-and a half week trial run, the unanimous decision was that, unless she becomes totally incapacitated, she will reside at home. She says that God will take care of her and that at least when she passes, she would have done so peacefully and comfortably. Who wouldn’t agree with that?

I had to transform my house into one that was conducive to her needs. I even moved to a ranch-style house for freedom from staircases, which were often a struggle for her. I’ve installed a bath chair which she was e-x-t-r-e-m-e-l-y thankful for, a portable potty, hand grips in the bathroom, night lights in her room, the bathroom and the hallways. For the kitchen (because she still insists on cooking her Jamaican-style kind of “bickle” like green bananas, various kinds of yam, sweet and Irish potatoes, cocoa, dasheen, chocho…you name it and of course – cornmeal or oatmeal porridge), I bought her a one-burner electric hot plate as she is forbidden to touch the gas stove. Thankfully she’s afraid of the gas stove anyway so no worries there!

Her food items (and only hers) are put at a certain place in the kitchen; in the fridge – her fruit juices, protein drinks Ensure or Boost (she loves having one every single day) and her famous water jar with the handle, are also placed at a certain section. Also, a certain section of the kitchen counter belongs to her and that contains her Stevia (sugar substitute), Milo (a great chocolate drink), Lasco milk powder, and a huge silver bread pan with unsalted water crackers, whole wheat bread, something sweet like Bulla, Shirley Biscuits or HTB Bun. These are all items that every Jamaican know and love.  She is never ever out of any of them as they are constantly replaced.

So as you can see, even though she no longer resides in her homeland Jamaica, she has made this her Jamaica by always having these items ready and waiting for her consumption.  What a life!!

So…she has no plans to give any of this up by moving to a nursing home. As she would say…no way in hell!! Alright! We hear you loud and clear, Mama!!