Wednesday, August 27, 2008

caregiving: a comet tale

Patti remarked that she had not been to Hershey Park in a couple months. Actually it has been a couple years but with Patti’s Multiple Sclerosis memory loss and mental confusion I can never be really sure where she is time wise. From her point of view of the moment perhaps it has only been a couple months. Recall for her is not unlike stepping into a broken time machine. 


She talked of wanting to ride the Comet and the Wildcat. The last time Patti rode a coaster her brother was with us and the two of us struggled to get her in and out of roller coaster cars.


Since then her progression has only worsened and she can no longer offer any self assistance with transferring.


Tuesday was one of those rare 70 degree evenings in August so I decided to go for it. The Comet seemed doable as it is an old school coaster with bench seating and a grab bar vs the contoured seating of modern launch coasters.


My plan quickly unraveled at the Comet. Frankly I was hoping to appeal to the eager, strong high school and college age students that usually staff the rides for assistance. However with schools back under way, seasoned citizens take over staffing. … A kind but frail senior gentleman attending the ride did offer to hold her wheelchair while I tried to transfer her. <grin>


Forced to invent a one person transfer from a wheelchair to a coaster bench lower than the wheelchair, I somehow got Patti into and out of the Comet car.


Patti had a grand time as we made the first 80 ft drop and raced around the track at 50 mph.


The Comet both the ride and the thrill of transferring in and out of the car was enough for both of us and Patti happily settled for enjoying the park atmosphere, games, food, “smoking huts”, and the Dry Gulch Railroad which has a wheel chair accessible car.


There are times that caregiving is more than care giving. Sometimes a caregiver may want to try to empower the improbable.


Caregivingly Yours, J Patrick Leer 




(also available in Blogger edition, Caregiver Blog: "Caregivingly Yours")

Friday, August 15, 2008

caregiving: back to school with autism

U.S. Department of Education found that an autistic student costs an average of $19,000 a year, or triple the cost for a typical child. Where districts offer one-on-one programs and more, spending can exceed $75,000.


Do not make the mistake of thinking this does not affect everyone. School systems are tied to property tax in the US.


“The federal Individuals with Disabilities Education Act guarantees "free appropriate" public education from age 3 through high school or age 21, whichever comes first, to all disabled students. But the government has never fully funded the act.”


Nationwide Autism affects 1 in 150 children. In some states such as New Jersey that rate is 1 in 95.


20,000 students diagnosed in 1993 are in their later years of extended high school. 6X that many are now in elementary school and increasing percentages enter every year.


From “edutopia” the George Lucas Educational Foundation:


Overcoming Autism: Public Schools Deal with a Growing Problem

As the number of special-needs students soars, public schools grapple with ways to offer high-quality education without going broke.


(from comment section)


“I realize that my comments and my feelings are politically incorrect. I feel really angry about this. Why doesn't my bright creative typical child get $19K worth of resources every year? She's probably more than likely going to make a bigger impact on the future than a child with severe autism. Why can't resources be spread evenly amongst all kids? You get the best you can for your particular situation with the per capita amount for all kids in your district? Why is a child with disabilities entitled to more of my hard earned tax dollars than my own typical child???”

Sandra from Phoenix


Who amongst us can answer Sandra any better than we can answer a parent of “a child who by choice spent his time blocking out the world and spinning under his crib … without the education he received he would require more total care than he will in the future … and THAT will affect everyone as well.”


Life may be like a box of chocolates but education is not as simple as a box of crayons.


Caregivingly Yours, J Patrick Leer 




(also available in Blogger edition, Caregiver Blog: "Caregivingly Yours")

Tuesday, August 12, 2008

caregiving: memory loss and knee contracture

Last week included Patti’s latest Care Plan Review. Patti’s care facility schedules these sit downs every two months.

Two topics dominated conversation, is Patti’s memory/mental confusion worsening and physical therapy.

An advantage to the care facility era has been this collective comparing of notes and observations about Patti’s MS symptoms. Though when it comes to memory, I believe Patti sums it up best herself, “it sucks!”

While a MRI contrasted with a previous MRI could graphically demonstrate deterioration, what does that really tell us. “It sucks” worse?

MRI testing is an ordeal for Patti and eventually requires general anesthesia. … The patient is content with “it sucks”!

Physical therapy confronted with a most uncooperative patient, decided to try stretching her legs by splinting to address contracture. Patti now wears a SoftPro Static Gel Knee Orthosis on each knee an hour a day while napping; they hope to work this up to overnight.

When Multiple Sclerosis causes loss of movement in the legs this triggers changes in the muscle, tendons and ligaments which in turn complicates bending or straightening.

In Patti’s case this has worsened to severely impacting transferring.

When I transfer her myself, now days I have to just dead lift her up because her feet practically tuck up under her when lifted.

The other day I arrived to find three staff members PLUS a mechanical lift needed to change and dress Patti, again knee contracture the major culprit.

MS symptom relief research is rare among US Multiple Sclerosis organizations; fortunately that is not the case with the UK Multiple Sclerosis Society.

Their study “to investigate the effectiveness of stretching the knee and then positioning the leg in a splint for two hours” I believe is worth a visit to and the 6 minute video presentation, Relieving tight painful joints.

(Some of the Scottish accents may leave Americans wondering if we speak the same language. <grin>)

Or better yet, the Care Plan Review in Patti-speak: “MS sucks! … Why are those birds so loud? … Those knee things are annoying. … When do I get a cigarette?

Caregivingly Yours, J Patrick Leer

Saturday, August 09, 2008

what can friends do to help someone who is a caregiver (Pt 4)

Part 4 ... what can friends do to help someone who is a caregiver?

#7 Many caregivers find themselves longing for companionship with others who are going through the same situation.

Some caregivers, well actually two that I know of, were pondering and discussing taking this thought into uncharted territory.

Can two caregivers of two different conditions (Multiple Sclerosis and Autism) supporting each other equal something better?

32 combined years of experiences with family caregiving is more than a resource, it IS a force.

Family caregiving traditionally has no safety net. An in house back-up is revolutionary.

You never retire from caregiving. … “Well, pilgrim, what are ya gonna do?”  Why not kick the box open and pioneer a new trail?

Caregiving is life on the economic brink. Shared expenses could be a step back from that edge.

Splitting chores and errands could be the alchemy to creating more time.

Being able to wind down and wrap up each day’s unique life of caregiving with another caregiver is inconceivable, or is it?

Readers of ‘Caregivingly Yours’ met Jennifer and Tyler in caregiving: fortunately smiles speak”, additional visits have yielded more success than challenges.
Outings with our unique posse diffuse the impact of disability. Is there strength in numbers?  

Visiting our local high school, Jennifer left feeling it is as good if not better for Tyler’s autism related specific needs.

Fate dealt the cards this past winter when their home in Massachusetts changed from years of stability to unknown. We have the extra bedrooms and bathrooms to begin the journey.

Patti’s memory and attention span challenges discussion. When she does focus, her awareness of the demands and toll of caregiving on caregivers is sensitive and concerned. She has enjoyed the visits and companionship. Important to her, this should create more time for outings both collectively and separately.

Like many 20 yr olds Megan’s world revolves around her and lies beyond. Even though I have repeatedly offered her veto over the idea, she has been a solid supporter since earliest discussions.

So in a week, we again open our home and in a sense we all jump off that proverbial cliff together.  

Butch Cassidy: Then you jump first.
Sundance Kid: No!
Butch Cassidy: What's the matter with you?
Sundance Kid: I can't swim.
Butch Cassidy: Are you crazy? The fall will probably kill you.

Caregivingly Yours, J Patrick Leer 

Wednesday, August 06, 2008

what can friends do to help someone who is a caregiver (Pt 3)

Part 3

#5 Help the caregiver get away from their everyday responsibilities. Provide opportunities for play. 

I would reverse this; help the caregiver “with” everyday responsibilities. Companionship for errands or outings is invaluable.

Having an extra set of hands along revolutionizes outings. Unable to leave Patti unattended, I can never drop her off at the entrance to anywhere and park.

In the early years there were no ‘family restrooms. My presence in a women’s room either to accompany our young daughter or to assist Patti seemed to unnerve other women. Come on now ladies, unlike a men’s room all the stalls have doors.

Ventures into women’s clothing departments both as a spouse caregiver and a single parent of a daughter were travel to another galaxy. Men’s clothing is a function of width and length, a female translator would have been soooo welcomed.

More often than not caregiving is opposite sex. In our story not only was caregiving opposite sex but so was basically single parenting. My first attempt at buying feminine care products could have been a candid camera skit. <grin>

I simply approached women shopping in the feminine care aisle, “Excuse me, do your prefer a tampon or a pad?”  or “Why does one want ‘wings’ on these pads?” and so on. Shoppers stared at me dumfounded as if I was an alien and hurried from the immediate vicinity. <grin>  …

#6 Help keep humor in the lives of the caregiver and receiver.

Yes, humor above all! However even just sharing your life is appreciated. We live vicariously through others. <grin>

Fortunately humor often finds me. Not so long ago, I was in a check out line holding a package of feminine care pads ‘with wings’ when an unusually heavy gentleman notices my package and conversationally though loudly remarks, “Hemorrhoids? Huh? ‘Wings’ are the only way to go! That’s what I use.”

Even though the image is forever scared in my mind, you can rest assured that conversation kept humor in our lives for weeks. <grin>

(Oops! Approaching that 350 word cap on entries … to be continued … only one to go!)

Caregivingly Yours, J Patrick Leer

Sunday, August 03, 2008

what can friends do to help someone who is a caregiver (Pt 2)

Part 2: what can friends do to help someone who is a caregiver

Time gets so out of sync when caregiving that it may as well be a parallel universe. This challenges communication.

Concerns about disrupting caregiving or a ringing phone waking a napping person with MS or even a caregiver who is catching a quick power nap create a communication maze to get through.

By the time I finished juggling each day's caregiving needs for Patti and basically single parenting our daughter it was late. West Coast friends were my only possible ‘conversations’.

Don’t rule out email. It enables communication when convenient.

The thing is if you are genuinely committed to being a friend and helping, it will not be easy but it will be appreciated. Stay with it.

#3 Get to know them better. Share their feelings. Be genuine.

This was penned by a visionary. Over time caregivers too often become shadows of the person in need.

Remember unlike the person being cared for your friend ‘chooses’ to be a caregiver. Believe me they have a vault of feelings to share.

Getting to know your friend better, I would venture to say that you may also get to know yourself better.

#4 Give the caregiver opportunities for leisure time. Stay and watch the care recipient while others go to dinner or a movie.

In principal a great idea, however the reality of the level of disability or care required could determine this option.

We were blessed that Patti’s parents could host Patti when they were younger and Patti was less disabled. This support enabled our daughter and I to spend ‘able bodied’ time together, hiking in the mountains, boogie boarding at the beach … parts of childhood and parenting that we would not have been able to experience.

“Dinner or a movie” reads kind of frivolous but empowering ‘moments in time’ can be priceless.

(Oops! I’ve hit my 350 word cap on entries … to be continued)

Caregivingly Yours, J Patrick Leer

Saturday, August 02, 2008

what can friends do to help someone who is a caregiver (Pt 1)

Caregivingly Yours is often surprising interactive. Recently I received a most kind email including a question about what can friends do to help someone who is a caregiver. 

I cannot speak for other caregivers but in our story most friendships have faded over the years as my life as a spouse caregiver become so different than anyone else.

Now don’t go getting Lifetime Channel on me and claim ‘real’ friendships last forever. Traditionally friendship is a two-way street. Caregiving consumes ALL available time. Friendship is a challenge.

Since I certainly have no personal formula for success, I Googled the question and found a collection of 7 tips from Ohio State University, Care for the Caregiver.

With due respect to the Buckeyes I will borrow their tips as a framework and insert my experiences and thoughts.

#1 "Ask how the caregiver is doing? How are they coping? Be sincere in your efforts and be willing to listen to their response."

“How are YOU doing?” or “How are YOU feeling?” still is such a rare question that it often throws me, though always in a feel good way. This is a great tip.

As for coping, I would say NEVER ask. That cannot come across well, “Hey dude! How are you coping?”

As for being sincere and listening, this would be a treat to any caregiver. Please LISTEN do not just hear. PLEASE no condescending hyperbole.

Ask questions. Learning makes you easier to talk "with". 

#2 "Be understanding and compassionate. Don't try to give advice or fix their lives. You are a friend."

NEVER try to give advice! Even caregiver to caregiver you will not find advice being ‘offered’ unless asked for.

As for fixing any caregiver’s life, <grin> if a superhuman caregiver and God cannot do it where did you come up with the answer? Bite your tongue. Shhhh!

Even though caregiving is exhausting, the loneliness can be incomprehensible.  Understanding, compassionate friendship would be appreciated beyond your imagination.

(Oops! I’m approaching my 350 word cap on entries … to be continued)

Caregivingly Yours, J Patrick Leer

(also available in Blogger edition, Caregiver Blog: "Caregivingly Yours")

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