TAKING CARE OF OUR SENIORS

I know it’s been longer than planned since I’ve posted, but…life happens, or should I say COVID happens, LOL. It’s interesting that I can laugh about it now, but I wasn’t laughing about it when it was happening. I’ll tell you; I dodged that COVID bullet for two years and then BAM! I caught it and it was not fun, but anyway, that’s the reason why my post was delayed. Please accept my apologies. So, I went back and forth in my mind about what I wanted this second blog to be about, and I had so many topics, until I finally settled on a matter that is very near to my heart; “Taking Care of Our Seniors”.  Yes, I said it very clear because it is very important. For some reason, it seems that once people become seniors, they don’t really to matter as much as they once did when they were younger – or should I say they are just an afterthought. Well, we did not allow that to happen with my grandpa. Let me share a little of my story…

By now you all know that Joseph’s Heart was started in honor of my late grandfather Joseph Adams. He passed last year from gallbladder cancer at the age of 96. I remember the call from the doctor as if it was yesterday. The doctor called me on Sunday, October 10th while I was at church, he had just saw me at the hospital the day before while visiting my grandpa. Grandpa was in so much pain. He was in lying in the hospital bed, with the lights off, the TV was off, which was out of character for him. Grandpa told me that he was in a lot of pain and the pain was in his stomach.  Before I left the hospital that day, the nurse had told me that grandpa’s test results did not show any gallstones, just some “sludge” in his gallbladder, but the doctor still needed to call me to go over the final results. I can’t remember if he had an MRI, ultrasound, or CT scan, but he had one of those and on October 10th, the doctor told me they found a mass on his gallbladder that extended into his liver. There was also a blood test taken, I believe it was the CA-19, which was extremely elevated and that showed there was cancer in the body. The family needed to decide about treatment and due to grandpa’s age and his other health conditions, my mother and aunts decided there would be no chemo and when it was time, he would have hospice to keep him comfortable.

The next day, I took the day off work arrived at the hospital early and waited for visiting hours to begin. Since we are still dealing with this crazy pandemic, they hospital only allowed one visitor per day, and you had to show your vaccination card and ID just to go visit your family member (my have things changed). I went to grandpa’s room to find a very different man. Grandpa was sitting in the chair watching TV and the doctor had just sat down when I stepped into the room. So, when I walked in, I said my famous “Hey good lookin’”. He said, “Hey baby” as he face lit up. He asked if I was going to take him home. I told him only if the doctor is going to release you today. At that moment, I advised the doctor of my mom and aunts wishes and he said he would prepare his discharge papers so that grandpa could be discharged after lunch, and he gave me information for hospice for whenever we were ready. After the doctor left, I explained to grandpa that he would be going home after he had lunch. Grandpa was so funny, before he ate, he told me, “look in there and see if my clothes are in there (pointing to the closet)”. I got his clothes out of the closet and put them on the bed and after he ate his lunch, he shocked me by trying to pull his catheter out, oh my gosh I had to stop him. “He said it’s time to go.” LOL! I told him to let me call the nurse to take that out and we still have to wait on those discharge papers and then I would take you home, “I promise.” The nurse came in, prepared his physical body for discharge, and I asked for her to please get his papers while I help him get dressed. When the nurse left out, I helped grandpa transfer from the chair to the bed, put his clothes on, and when the nurse came in, I left to get the car. I picked him up in the front of the hospital and took him home. I’ll tell you, that was one of the best car rides I’ve had with my grandpa, because he seemed so at peace. I don’t even remember what we talked about, just random things. That was such a wonderful time with grandpa because I was able to spend time with just him, alone, just the two of us.

Prior to the cancer diagnosis, I would visit grandpa once a week, but after the diagnosis I made it a point to visit even more. I just wanted to take care of him and keep an eye on his behavior and make sure I was able to notice if there was a change in his condition. I know there were capable people in the home watching out for him; however, I’m the type of person that needs to see for myself. When grandpa got to the point where he could no longer groom and bathe himself and also became incontinent, I knew that had to be difficult for a man like him. He had so much pride and independence. All I could think was, how could I take care of this man that I love and still allow him to keep his dignity. I would talk to him about what I was going to do before I did it and would talk to him about the task while I was completing the task. He was sick and not stupid. There were many times grandpa did not want his diaper changed and he would say it wasn’t wet and didn’t need to be changed. I would then talk to him about letting me check to make sure that it wasn’t wet. He would give me an interesting look. This is what I told him, “How about you let me check to see if the diaper is wet and if it’s not wet, I won’t change it, but if it is wet, we have to change the diaper? If I let you sit in that wet diaper, you can get a rash and it can get bad and you will have to go to the hospital to get treated.” With that question and statement, he allowed me to check him and most of the time he was sitting in a wet diaper and needed to be changed and my aunt and I would change him. To ensure he was comfortable, I used his shirt to cover his private part when we were not cleaning him because that is what mattered to him. The same when I had to go with him to the bathroom and he was on the toilet, if I had to stay inside with him, I used his shirt to cover him up because that mattered to him. If he told me he was okay enough to stay inside the bathroom alone, I allowed him to, I just stayed outside of the bathroom door until he was ready to get off of the toilet because he could not transfer alone and then I allowed him to tell me when he was ready. I know he couldn’t have been happy with his granddaughter changing and cleaning him periodically, but he allowed it anyway, and I know he was grateful. I also know that he trusted me because one day he called me into his room and asked me to take his dentures out of his mouth because he was too weak to do it himself. That request right there let me know how much he trusted me to help take care of him.

The reason why I shared this story with you is so you would understand why I feel it is important to take care of the seniors in your life. No, my grandpa was not the only senior in my life, my mother is considered a senior and she now lives with me, and I have become her caregiver for the things she is unable to accomplish on her own. I also make sure that she doesn’t feel isolated or lonely. Just because she lives in a house with my husband, three adult children and I, does not mean that she isn’t at risk for feeling lonely or isolated and being neglected, just the same as a person would feel if they were in a nursing facility. I hear people say that when you allow a person to enter a nursing facility, they are sure to die in there. That wasn’t true for my grandpa. Now, please understand, he did not want to be in that place and tried to escape a couple of times. Let me share this story…

The first time the nurses allowed grandpa to sit in his wheelchair in the lobby, he inched his way closer and closer to the front door until he made his way out and was at the end of the parking lot on the sidewalk when the staff found him, he said he was “going home”. Then they decided to put an ankle monitor on him so if he left out of the door, the alarm would go off, and he tried to leave again, and the monitor made the alarm go off. Grandpa’s solution to the ankle monitor was to cut it off and we still don’t know how he got access to a knife sharp enough, but he did. I went to visit him, and he told me, “They put that thing on my ankle, and I cut it until it came off.” All I could do was laugh because he was determined to find a way to get out of that place. Anyway, back to what I was saying, my grandpa didn’t die in a nursing facility. He was there for a month for rehab and our family made sure that we visited him regularly, during the week and weekends. We wanted to make sure that he knew that we did not forget about him, and the staff knew that we were watching them. I don’t believe that he felt any isolation or loneliness because we were able to visit whenever we wanted (during visiting hours). The staff even gave us the dining room to ourselves one Saturday, and we played grandpa’s favorite music and was able to laugh and get as loud as we wanted. I think I even had Prince (my maltipoo) with us that day. I would sometimes take my dog to see grandpa while he was there to brighten his day. My cousin would also bring her dog as well. This was clearly pre-COVID. 

Grandpa with Prince @ the nursing facility

In September 2020, grandpa had a stroke and after being hospitalized, he had to go into a nursing facility for rehab again; this was in the middle of COVID. We were not allowed to enter the nursing facility to visit per their COVID restrictions. However, the family was able to schedule an appointment twice a week and were only allowed to visit for 20 minutes. Get this, we were only allowed to see him from a balcony. I understand we must protect the physical health of our seniors because of COVID, but what about their emotional and mental health? Grandpa was very happy to see us, but at the same time, he looked so sad because there was no physical contact. We are a family that always greets him with a hug and a kiss on the cheek or forehead. You can’t do that if he’s on a balcony. Later after he was discharged, he shared with me that he did not like being in that place because he was not able to see his family other than on the balcony. Yes, the nursing facility allowed us to FaceTime with him and talk to him on the phone and have the balcony visit, but it’s just not the same. I believe it was during that time that grandpa actually felt isolated and lonely and if he felt that way, imagine how many other seniors feel the same way.

There are many articles that have been published about senior isolation and loneliness and how it affects their health. According to the CDC (2021), loneliness and isolation puts seniors at a higher risk for dementia as well as other health conditions simply because they are more likely to face circumstances such as losing family and friends, living alone, hearing impairments, and chronic health issues. The CDC (2021) also reports minorities, immigrants, LGBTQ, and victims of elder abuse are among the elder population of that suffer for loneliness; however, the information to support these populations is scarce and more research is needed to determine the “risks and impacts.” Now why doesn’t this shock me???

The National Institute on Aging (2019) also states that loneliness and isolation has been linked to increased risks of physical and mental health conditions such as Alzheimer’s, obesity, high blood pressure, weakened immune system, anxiety, cognitive decline, and sometimes death. Please note that being around family does not mean that a person is not lonely, we must be careful not to make assumptions. Make sure that when you have family functions your senior family member is included. If you have a senior family member is living with you, be sure that he/she is included in your household activities.

Grandpa at the nursing facility during a balcony visit.

Sit and have conversations with that family member, don’t just go visit them and talk to the other members of the household and then say you visited that person because you did not. You said hello and visited the other household members. When I would go to visit my grandfather on my lunch breaks, I spent the hour with him, in his room unless he was asleep. That time was carved out for us and us alone. Yes, I would speak to my aunts and asked how grandpa’s day had been going, but that time was for him only and that’s how it should have been because it’s what he deserved. Giving our seniors that time allows them to feel respected, loved, special, and important. My cousin would sometimes go over to his house and cook for him because he loved her cooking and he loved being around his grandchildren and great-grandchildren. My mother once told me that when she and my grandpa moved in together (1994), my grandpa told her that he just wanted to be around his family, that was two years after my grandma Nene had died. For 28 years and 10 months after Nene’s death, we made sure that grandpa was not lonely or isolated, I began to take care of his finances when he no longer could, my aunts and mom took care of the home by cooking, cleaning, and doing laundry; grandpa was well taken care of.

 

When he entered that nursing facility during COVID, he was so unhappy. After being there for 2 ½ weeks he called me for a week straight asking me to “get me out of this place,” and I did just what he asked me to do. I spoke with the social worker, administrator, PT and OT and found out that grandpa was already back to his baseline and there was no need to keep him any longer even though they wanted to. I told them that they needed to discharge him immediately because he was ready to go home, and I was a social worker with the county, and I knew how things worked. My grandpa had Medicare and a supplemental insurance from his union, and they would not keep him so that they could continue to get paid. I would not wait for them to have another meeting simply because they had to reschedule the one that they missed. A day and a half later, my aunts and I picked up grandpa and took him home. In my mind, whatever it takes to make grandpa happy and at the same time will keep him safe, I would do whatever was necessary to make it happen, and that’s what I did. I refused to have my grandpa unhappy and lonely in that place where it was affecting his emotional and mental health and it was not improving his physical health anymore.

We must make sure that all of our seniors are taken care of and protected. I believe my grandpa lived as long as he did for two reasons, 1. The grace of God and it wasn’t his time to leave and, 2. He was surrounded by a loving and caring family that took good care of him and made sure that his needs were met. We did not isolate him, and we did our best to make sure he was not lonely. If all families treated their seniors this way, then there would be less seniors that are neglected and abused. So, let’s all do better by the people that paved the way for us to be where we are now. Let’s see about them and make them a priority and not an afterthought (if they will allow us).

Below are some websites and useful information from the National Institute on Aging, CDC, Aging in Place. Hope it’s all helpful.

Social isolation, loneliness in older people pose health risks (2019)

https://www.nia.nih.gov/news/social-isolation-loneliness-older-people-pose-health-risks

Loneliness and Social Isolation Linked to Serious Health Conditions (2021)

https://www.cdc.gov/aging/publications/features/lonely-older-adults.html

A Guide To Caring For Elderly Parents (2022)

https://aginginplace.org/a-guide-to-caring-for-elderly-parents/

 

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