We lost a friend today.  The halls are too quiet without the loud voice of the one who spoke for us all when she’d yell, ”Shut up!”  at the irritating cacophony of beeps and call alarms alerting, that are part of daily life in a nursing home.

Hazel was a ready source of entertainment and expressed love to anyone whom she deemed worthy.  I was a willing recipient.  We spent many an afternoon in the west wing day room, surrounded by family and friends, enjoying the banter between Sheila and Hazel, while listening to the comedic comments of Steve Harvey as he hosted Family Feud.

I would stay in her proximity even to the chagrin on my mother.  Hazel knew me as “a nice girl” that she “loved very much.” She would confide to anyone who would listen as I walked away from her that she loved me and I loved her, too. Not only did I enjoy being around Hazel, but grew to know and love her family as well.  They told me that this Hazel was quite unlike her  “old” self.  Before succumbing to Alzheimer’s disease, she was a quiet person – nothing like the incessant dancer, unpredictable talker and open expresser of love that developed.

As it is with Alzheimer’s disease, time changes things.   Hazel’s contributions began to slow and her interaction waned.  She began to have fewer “good” days and more “bad” days.   We watched her fade before our eyes.  I visited her at her bedside as her granddaughter kept vigil.  “I’ll Fly Away” was the song that flowed from my lips to her ears.  She listened to my voice as she had many times before.  By the next day, her daughter had arrived to see her off.  After considering what kind of music Hazel liked, we broke out in singing “You’re a Grand Old Flag”.  Uncanny, we both knew all the words and moved on to “God Bless America”.  Hazel’s son watched in amusement.  Hazel seemed to enjoy the attention and we enjoyed the camaraderie.

Then she was gone – but only out of sight.  She arrived at her final destination March 13^th 2014, in the morning hours, before her family was able to get there.  She slipped off while no one was looking.  A quiet exit for someone who had been so out spoken while I knew her.

Farewell dear friend.  I will miss your laugh, your smile, and the endless string of words that only you could weave.  You made life better on the west wing.

I love you, Hazel.

We wish you a merry Christmas wherever you are! May God give you the grace to enjoy precious moments by going with the flow presented today.  Smile and be thankful that you are trusted with the gift of loving someone unconditionally in your life.

If you’re having trouble finding evidence of God in your daily life, let me make a suggestion.  Go sit in a parking lot of a nursing home near the entrance.  You will see people coming and going that are busy doing God’s work. People from all walks of life, for a variety of reasons, enter and exit the building all day long.

As I sit in the sunshine, under a large oak tree alongside my wheelchair bound mother, we watch the people go by.  Two women, strangers before they both found themselves on a common mission, pause to speak to one another, each carrying a bagful of items, on their way to serve their moms who reside inside the building.  An x-ray technician arrives, unloads his machine for the hundredth time, and rolls it inside to clarify an awaiting medical situation.

Certified Nursing Assistant’s who arrive for and depart from their 8-hour shift of caring, give us a smile and say hello.  A car pulls in as close to the door as possible, and a frail resident gets out with the help of a friend who assists her inside. It wasn’t that long ago that this particular resident wasn’t able to walk at all.  However, with the regular visits to the physical therapy department and encouragement from her many visitors, she has improved a great deal – even though her prognosis is grim.

The nursing home bus arrives and unloads a group of residents who have been out shopping at the nearby Walmart.  They carry in their purchases with the help of the activity staff.  A stop by the activity room reveals one busy employee wrapping Christmas gifts for resident’s who are able to still collect gifts for their friends and families at Christmastime.

As we make our way into the depths of the building, we pass the gaily decorated halls, see Christmas trees at every wing, observe medicine being given out by nurses, smile at needs being met by compassionate helpers until we finally reach my mom’s room.  The quiet space and familiar setting welcomes and calms us.  The maintenance man enters to clean the heater filter and engages us in conversation.  Before long, Momma’s CNA brings in the afternoon snack.  While there, she informs the maintenance man about my mother’s ability to do handwork as seen hanging in frames on her walls. She points out the intricate work involved. I tell about my mom’s custom to make everyone in the family a special ornament that would represent a major event of the year and that I have 20 years worth of memories to hang on my tree.  As my mother listens intently to us tell about her accomplishments, she has a pleasant smile on her face.  For a lady who has advanced dementia, and is unable to speak, this is a good day.  God’s grace and mercy abound.

Thank you, God, for your loving people.

^“7 This is my command: Love each other” John 15:17 NIV.

While there is endless information these days encouraging us caregivers to take care of ourselves, improve our abilities through education, and receive support by connecting with other caregivers, let me remind you of the people we hire to help take care of our loved ones.

When the job of caring became too much for me to do alone, I turned to others for help.  That came in the form of hiring strangers to entrust my mother’s care.  We started by having someone come into my mother’s home to prepare the noonday meal and provide some social interaction.  Although this arrangement only lasted two weeks, I have to say this young lady did what I asked of her even though my mother wasn’t so keen on having her in the house.  Not an easy job when the person you are there to serve doesn’t understand the need or resents your presence.

Very shortly after that, we moved Momma into an assisted living facility, where she had the help of Certified Nursing Assistants (CNA’s) to assist her with dressing and bathing.  I came to appreciate the confidence these (mostly female) workers had as they worked tirelessly all day long, going from one person to the next, to carry out their duties.  Some CNA’s seemed to enjoy their job more than others, some with genuine care and kindness, some just doing their job.  However, they all kept going, regardless of family or health problems or financial needs that was affecting their mood. Do I think that two weeks is a long enough time to be trained as an expert on giving care, especially to someone with dementia? No. Most of the learned care techniques are gained from each other while on the job.  So given the job qualifications required, the tasks to achieve on a daily basis are not easy.  After all, we needed help, too.

I’ve called the CNA’s our “friends” as I’ve explained their involvement to my mother.  We’ve taken their pictures and framed them along with their name underneath to remind us of how important they are to us.  We had to move into a Special Care Unit for a while and benefited from the new CNA’s we met there and their willingness to learn my mom’s habits and behaviors.  I have always tried to find ways to thank and encourage the work they do and report to their supervisor their diligence and good deeds.

Recently, I was considering  broken communication between a CNA and myself.  Instead of complaining, I decided to thank the entire unit for all their help by bringing in lunch for the day shift and dinner for the night shift.   If the pizza didn’t do it, maybe the Mississippi mud cake would bridge any gaps that had developed over the six months we’d been there.  While I have perceived that family members are viewed as potential trouble for the CNA’s, I feel these women need to hear what a good job they are doing and give them opportunity to take pride in their work.  They take the brunt of all complaints and expect to either hear it from the family, or worse, be reprimanded by their supervisor.  While this is appropriate at times, we need to know how to get along without fear of reprisal.

I hope we can change our perception of each other and be willing to work together for the good of the residents.  The care of our loved ones requires a harmonious team.  While we as family members might find that good care is hard to sustain, it’s is all our responsibility to improve communication and learn together.  Let’s start by thanking a CNA today.

Caregiversunite.org has it’s own Facebook page.  Visit us on Facebook for an easy conversation and the latest news.

My family did a cell phone intervention with me two years ago. I had held on to my original cell phone plan for many years and resisted any changes.  So when they transferred my number to a smart phone and a new company, I knew I was beat. I tried to keep an open mind. According to my family, now I would be able to text with them and do all the other things they could do—whatever that was.

My family was right. Once I mastered texting and using the phone, I began to explore apps.  First I followed recommended apps from my husband and son but then began to branch out and find what interested me. Since I am a caregiver for my mom who has Alzheimer’s disease, I soon found that my cell phone was my constant companion and record keeper. For example, I store information I need for doctor visits under Notes, as well as document what we discussed at the appointment. I set up Reminders for myself such as pay the private duty sitter and other bills or get medication and supplies. I have a Pill Finder app that helps me identify pills I find on the floor that Momma didn’t take and threw away. I can look up medications and their side effects if she is having some unexplainable symptoms. When we do her laundry, I can set the Timer to alert us to when the washer and dryer cycle is finished.

My phone has replaced the camera I once carried around. Just like everyone else with a smart phone, I am constantly taking photos of all the people in my family’s life. Once Momma moved to assisted living, we used photographs to help us remember faces and names of all the people that helped care for her. We set up a poster-sized frame in her room with pictures of all the employees, their job titles, and names. To boost visibility, it hung on the wall just inside her door, which encouraged many impromptu visits and comments. I was surprised to find how willing doctors are to have their photo taken with their patients. These photos would come in handy when we were about to have an appointment with the doctor and I could show Momma who we were going in to see. The pictures serve as our memory, and we can look at them over and over again.

The phone is also a resource for activities. We enjoy listening to Pandora’s easy listening music while accomplishing activities like brushing her teeth, painting her nails, or playing cards. I attach speakers to the phone to provide vintage music while leading a group exercise class for the other residents, and I can take requests without any prior preparation. Sometimes I look up words to old songs we can sing together because we’ve forgotten some of the words. Poems and even nursery rhymes are just a touch away with Internet service as part of the phone plan.

One app allows me to scan important documents and even send them by email with FasterScan, which expedites duties like filling out paperwork for moving into skilled care. I no longer have to be home to receive phone calls, send emails, or handle bank business. I can manage these responsibilities and still be with my mom. I finally have learned to complete as much information as I have on a phone contact to save time for future communication. I can text messages with Momma’s private sitters and receive an immediate response when needed. For my peace of mind, they have sent me photos of Momma while she is in their care just to let me know what they are doing. When I’m with her, I can send a text and photo to one of my children and share a response on the spot.

Even though cell phones are relatively new, Momma has embraced the little rectangular box we carry around that emits music and provides amusement in so many ways. I usually hand it to her to hold when I am pushing her in the wheelchair when we have the music playing. Because of her failing eyesight, the bigger screen of a computer or iPad is a better choice if I want her to see specific pictures clearly. However, for daily use and ease of transporting, my cell phone is all we need.

Have you got your affairs in order?  Dave Ramsey calls it a Legacy Box, my uncle called it an Estate Book, and I call it an act of love.  The person who will be in charge of deciphering and fulfilling your wishes needs to know the who, what, when, where, and how to do it.

If you haven’t already done so, get yourself a Durable Power of Attorney.  This legal document allows the person of your choosing to act on your behalf when you are unable to.  Now is the time to have that prepared, while you can still make decisions for yourself. It’s never too early to have this in place.  If you are sixty or older, the Davis and Associates, Legal Counseling for the Elderly can provide that service for free through their connection with the Area Agency on Aging.  If you are currently caring for someone else, you know that a POA is required to make any medical or financial decisions for them.

Next, have a Last Will and Testament made even if you don’t have a lot of money. If you do have a large or complicated estate, you may need to create a Revocable Trust to carry our your financial wishes.  An Estate Planning Attorney can help you designate your long range plans.  Once you have made decisions concerning what goes to whom after you die, let your family members know what is in your Will and why.  This will help prevent any surprises and hard feelings between your heirs after you’re gone.

You may want to authorize a HIPPA Release in order to allow access to your medical records.  An Advanced Directive for Health Care (Living Will and Health Care Proxy) is also necessary to make your medical wishes known.  Again, you can call Alec Brown of Davis and Associates at 251-434-6848 for this free service.

Now place these documents in a labeled folder or box.  In addition, add any other pertinent financial and identifying information you have.  This includes bank account numbers and passwords needed to access them, insurance policies, burial plans and policies, social security cards and photo ID, financial investments, Bonds, Retirement Accounts, Property information and documents, and car titles.  You would be kind to include contact information of people you have dealt with that will be helpful in settling everything.  Phone numbers of friends and family is also helpful in communicating your death.  You may even want to write your obituary and include it. The location of the security box key is important but remember that someone else’s name needs to be on that box so it can be accessed after your death.  Include everything a person would need to know to carry out what you normally handle.  Put your spouse’s information in there as well.  Passwords for internet activity including social media like Facebook are necessary to access photos, etc.

Granted this is all valuable information and should be kept in a secure place.  Either make copies for your entrusted family members or appointed executor so they can access the information when the time comes.  Compiling this information before your death is one of the most loving acts you can do for your family.  Make a list of what you need to do and begin the process.  None of us will avoid death. Start today!

Now that two months have passed since we moved momma into a nursing home, I can step back and see how we have progressed.  Our goal to get as close to my aunt’s room as possible is why we moved next door to her in a semiprivate room that offered a very small area.  It didn’t help that the roommate sported an electric scooter that took all space and more to maneuver in and out.  Coupled with a bad design of the door to the hall and the door to the bathroom being back to back required adjustments to accommodate any movement.  Fiercely independent, we would often watch as the roommate moved back and forth in slight increments to weave between the dresser and foot of the bed to go through either door.  Often the furniture was knocked cockeyed from the attempts to get through, leaving the room in a state of dishevelment.

The tight living space inconvenience was overshadowed by our next challenge – getting to know the staff and they us.  We got off to a rough start as I was expecting Momma to maintain the routines she had before we moved her here.  Although Momma can’t express her position with words, she shut down her remaining communication skills other than the expression of fear.  Seeing her react to her new “handlers” that way was distressing to us both.  I responded by taking her off the unit to explore the building while I was there to distract us both from what we had signed up for.  We spent time meeting other residents from other parts of the building and even explored possible new rooms to transfer to.  A private room became available which was offered to us as I had made known that we hoped for a bigger space.  Since this opportunity resided in a different unit at the far end of a hall away from most activity, we chose to hold out for an opening in the current wing where we had begun to get acquainted with residents and staff and still be close to my aunt.

I am happy to report that my concerns did not go unnoticed by most staff involved.  The day a larger semiprivate space came available across the hall from my aunt, I felt sure we would be moving soon.  I even arrived the next day with my hammer and tape measure for hanging pictures just in case we were given the go ahead.  Sure enough, upon my morning arrival I was greeted with smiles and an offer of moving.  I said yes and immediately we began the quick task of moving from one room to the next.  The hammer came in handy so by lunchtime, the space was as cozy and familiar as possible.  Momma did not seem unsettled by the change and accepted the bigger accommodations without complaint.  The window view and better tv reception brighten the room and our new roommate and family visitors are congenial.

Meanwhile, we have become more relaxed with the staff on all levels and many times prefer to join the other residents in the day room over going to activities in the larger activity room away from the unit.  The residents have become endeared to me and I enjoy interacting with them as a group or one on one.  Momma does enjoy my undivided attention, however, and I am sensitive to her needs first.

All in all, I can look out our open door into my beloved aunt’s room across the hall when we are in the room, enjoy the day room down the hall, get ice cream out of the freezer or ice and water at will, or check at the nurses station of any recent information concerning my mother’s daily habits.  We’ve learned to stick around until momma is cared for before wandering off somewhere else in the building and make an effort to be back in time for the afternoon snack.  We learned we can use our earned funny money from the activity department to buy a box of Kleenex  from them when needed and purchase other items from their monthly store.

This journey we’ve been on began in late 2008 with the first move to assisted living.  After three and a half years, we moved to memory care.  Less than a year later, we moved to skilled care.  Enduring the transition each time was difficult but necessary to keep moving forward.  As expected, it wasn’t an easy two months this time but worth getting through. I am free to come and go, Momma and my aunt are settled in and are both under the care of hospice and the facility.  Their affairs are manageable now as long as I keep things going on a regular basis, paying bills and balancing checkbooks frequently.

I am thankful for where we’ve been, who we’ve met along the way and where we are.  My main emphasis now is to enjoy the relationship I have with these precious treasures who have my undying love.

If you provide care for a U.S. veteran, the following may be of some interest to you.  They may be eligible for financial assistance for home care through the U.S. Department of Veterans Affairs.   This program is only available to service members who qualify for a veteran’s pension from the government.

Your loved one may qualify for a program called Aid and Attendance, which offers a monetary benefit for assistance with activities of daily living.

All veterans are eligible for up to 30 days of respite care per calendar year.   On top of that, if your loved one was injured in the line of duty (“service-connected” veteran), they may qualify for additional services.

For specific eligibility requirements, visit. www.va.gov/geriatrics or call 800-827-1000.

This information is from the careADvantage magazine produced by Alzheimer’s Foundation of America.  For a free subscription, visit www.alzfdn.org or call toll-free 866-AFA-8484.

An activity I’ve discovered that my mom and I can enjoy is the card game of solitaire.  Although the name of the game would suggest a solitary player we’ve teamed up to play separate parts to reach the goal of the game.

Originally, we played solitaire as an afternoon diversion in Momma’s assisted living apartment.  As time has gone by, it has also become a tool for me to gauge her state of being.  Since she has stopped talking, I read her body language to determine how she is feeling, i.e., does she have a urinary tract infection that needs to be treated.  The way she plays cards says it all.

Whether we are seated side by side at a table or we have a table between us, I initiate the game after we have accomplished the daily ritual of cleaning her teeth, hands, and fingernails, which I follow by rubbing lotion onto her arms and hands.  Now I know her hands are clean and how well she cooperated tells me if we can proceed with card playing.

Some days, her answer is no to the suggestion of cards.  However, I may go ahead and deal out the cards in front of her and see if I can engage her interest.  I count out the seven cards out loud, over and over, each set of seven, until the game is set.  We look over the hand that we’ve been dealt and see if any cards can be played.  I play those cards, naming what I’ve done like the red six goes on the black seven, until  we’ve played all we can,  Then I set the remaining deck in front of her on the table and see if she’ll pick them up.  Here’s when I need to wait for her to make a decision.  She may eventually reach for the cards to begin the game. I may offer the deck to her and she may accept them.    If not, I pick them up and count out the first three cards to lay face up.  I go on like this until she decides to join in. When the game calls for a card to be turned over, I tap my finger on the card as a queue for her to do so.   If she has become interested in the game, she will comply.

I have found that the longer we play, the more engaged she becomes.  We may play multiple games, hoping to finally win and when we do, I celebrate with a lot of cheering.  This generally elicits a chuckle or smile from her at our success. Eventually, with repetition, she may even initiate laying out the beginning cards, which is quite an accomplishment compared to where we started.

This time we spend together has become not only a diversion and a communication tool, but also a philosophical attitude. Although the game of life is often played alone, we’ve teamed up to play the hand we’ve been dealt together.