The Finalists

Nana went for visits at our two favorite facilities last week.  On paper, they were quite even-- while one place had more freedoms, the other one had more warmth.  One was large; one was small.  We took Nana to both, hoping that one place would clearly outshine the other; or perhaps Dad would send us a message from heaven that made our choice extremely clear.
   At the first facility, we walked in the door and were greeted by three very sweet, happy ladies- "Welcome!", they cheered as we walked in.  They were  taking the dog for a walk with a a guide and a  group of other residents.  Nana loves walks AND puppies, so this seemed like a good start.  She joined the group, while I toured the facility.  There was a class going on at the end of the hall-- a group was studying Italy, through photographs, games and short lectures.  As we walked down the hallway, a woman walked slowly by with a walker.  My guide called out to her by name. "Lena, how are you today?"
  "I'm hungry."
My guide excused himself and walked Lena to the kitchen.
  "What would you like to eat?"
  "I like ice cream."
  "Then let's get ice cream."  (It is 10:30 am.... :) )  Ten points to this first place!
Upon returning to the unit, Nana joined the Italy class.  The puppy joined us in the meeting room, resting her head on my lap.  This pup is a real treasure, moving around the room and visiting with every member. (There is also a few birds and a guinea pig here.  Nana definitely loved all the pets.)
Nana joined in on the Italy class, recognizing landmarks and sharing stories of her trip to Italy with my Dad.
   I asked Nana what she thought of this place.  She asked, "What is this place for?"  I explained that it was a home that specialized in helping people with Alzheimers. They worked with the Boston University Alzheimers research program, and that she would live there if she would like.  She was quiet for a minute or two.
  "Can I afford it?"
"Yes you can," I said.
  "Then I like it.", she answered.  Quiet for a moment, she added, "God bless your father." 

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Two days later, we went to the other facility.  We were greeted by the head of the Cognitive Specialty Group, which works closely with the residents who are the highest functioning, planning special events and activities. Nana was invited to join the group for the afternoon, and she readily accepted. I left for a few hours and then returned.
  When I arrived, Nana was sitting in the dining area, waiting for a snack. (There is no leaving when there is chocolate to be eaten!) I waited while Nana waited for her snack.  Nana seemed pretty content, but a bit confused.  She kept jumping from the table, asking me if I wanted to join her for a piece of cake.  I declined, enjoying the ability to watch Nana's interactions from afar.  I noticed that the group was mixed between two tables.  At Nana's table, there were three other women.  I introduced myself, and all three ladies stared blankly at me.  One woman looked a little angry (which, of course, is not unusual with Alzheimers sufferers.) The other table, a group of three men and three women, were laughing and interacting with each other. After Nana finished her cake, she packed up her napkin, paper plate and cup, and stood to find a trash can.  "AAACCKKK!," shrieked a woman on the other table, "Look at Jane-- she is throwing away her own trash!" She cackled again and slapped the hand of the fellow next to her, who then joined in the laughter.  I was reminded of middle school, and the Queen Bees and wannabes...
   "I think I'm ready to go, " Nana said.  Me too. Nobody laughs at Nana.  With her, yes.  But at her? No way.  She didn't ask any questions about the facility on the ride home.

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  The choice was easy, in the end.  Both programs sounded great on paper. But one program outshone the other upon execution.
 Plus my Father's Mom was named Lena.  And Nana's favorite food is ice cream (thanks for the help, Dad.)
 Compass Point in Hopkinton, here we come (once the bed is ready...)

A Nite to Remember (not)

Lunch with Nana and friends today.  A lovely gentleman walked in and pointed at Nana, with a twinkle in his eye.  Nana smiled, winked, and pointed back at him.
  "That was great fun last nite Jane.  I enjoyed spending time with you."
  "Me too!"
As the gentleman walked away, Nana said to me without breaking her smile, "I have no idea who that is, or what I did..."

(After a little investigating, I found out from her caregivers that there was a big Christmas party last nite, complete with a 16-piece swing band. Knowing Nana, she danced the nite away! :) )

Moving On...

"I'm not happy. I need to move."
Nana has been saying this a lot lately.  At first, I thought it was just because her best buddy had been failing lately, and she had become very bitter.  But the more I watched her in her environment, I noticed the changes.  She no longer participated in many activities in the assisted living area.  I noticed also that there didn't seem to be as many activities that pertained to her. She seemed to spend more time wandering, and I was receiving reports from both staff and residents that she seemed more "lost" lately.  I also noticed that her gait was not as strong-- she tends to list a bit to the right, and her posture is becoming poorer. She no longer remembered anyone visiting, and she just seemed lost in her own mixed-up mind.  She needs more care.
  Becky is home from college right now, so she was able to help me narrow down the choices for Alzheimers units.  This has been very hard for me.  I feel like I am taking away more freedoms from Nana, and that my Mom is disappearing more and more each day.  But Becky reminded me that by keeping her safe and more engaged, I am actually giving her more freedom-- more peace of mind.
  We have found two places that are strictly dedicated to Alzheimer's care, deeply compassionate and very up to date on the latest in Alzheimer care.  We took one place off the list when the nurse director told us that no one could enter her facility unless they had a prescription for an anti-psychotic, "just in case..."  That went against both the nurse in me and the future pharmacist in Becky.  Another place looked lovely, but the residents looked completely disengaged.  The two remaining facilities are just so wonderful that I am having trouble choosing.  Both have offerred Nana beds.  Now, we need to decide....
   This week, Nana will visit each facility, at the same time of day.  She will see where she will live, and she will meet residents and interact with them.  Hopefully, the correct choice will become very clear.  If it doesn't, I am following Becky's advice and looking for my Dad to send me a great, big, easy-to-decipher sign....

Thanksgiving Week

Becky here checking in again.

Well, its official, Nana doesn’t know who I am. A vast contrast to being the only family member she could consistently identify when she lived in Indy. How do I know? We went over to visit a day last week and Mom asked Nana if she knew who I was. Her response “I am not sure I know which one you are because you have gotten so tall!” (while hugging me). Yes cousins, laugh all you want. Nana thought I, the family dwarf, had grown so much she didn’t recognize me. Her acting skills failed her here.

A few days later we returned to accompany Nana to the holiday celebration. I settled in to my role as one of Nana’s daughters and had a great meal of random conversation. The best topic had to be cancer. Nanas best friend tripped on the carpet on the way in, no major injuries but her shoulder hurt. She continued to complain and Mom went to fetch an icepack. Nana chimed in “if you think there is something wrong, you have to see a doctor. My Lou had cancer on his shoulder. Cancer will kill you and you need to make sure it isn’t cancer!”

Suppressing a laugh, I told Nana that she is in fact correct, Grampa had melanoma removed from his back but her friends pain was because she fell on her shoulder. “Oh, well cancer will still kill you, so be careful”. Thank you for the warning, Nana!

Thanksgiving Day was a whole different experience. After going to my uncles for a big meal, it was my job to go pick up Nana while Dad made her a small meal to have with us since the big crowds have become too much for her. I walked in to Southgate and up to Nana’s apartment. All the lights were on, bathroom fans were going, but no Nana. I checked the showers, bed, closets, still no Nana. I walked out to ask the nursing aides when they saw Nana, and they told me she was just in her apartment. Uhoh. I checked the other common areas of her floor to no avail and headed downstairs to check at the front desk. Nana had been down about an hour ago but she hasn’t seen her since then.

Minor panic begins to set in. I knew Nanas best friend was not there and Nana was MIA from all the places I could come up with. Did she go out a side door to take a walk? Did she leave with someone claiming to be her family? I couldn’t tell my Mom since she was in Boston and I didn’t want to put her in a panic too. Time to call in the troops. The nurse aides started checking door to door, maintenance went on a search at all buildings and I started driving around the neighborhood.

Forty five minutes later, I still didn’t have Nana. I went to sit up in her apartment and hope she returned. A few minutes later I heard dogs coming down the hall. Aha! She must be with the dogs. I looked out in the hall and there she was, walking down the hall with the aides who had a similar face of panic I had.

   Me- Nana, Ive been looking with you for an hour!

   Nana- You have? I was right here.

   Lady with the dogs- You were? She told me she doesn’t have any family that spends the holidays with her. (My heart breaks a little that Nana feels this way)

Now that I had her, we switched shoes and headed to my house. Dinner was ready to go and we sat around the kitchen table. In the middle of dinner Nana asked to call her grandparents to check in for the holidays. Hmmmm I’m not really sure how I can reach them, how do I tell her they died a long time ago. Quick on his feet, Dad simply responded that those who needed to know knew she was there. Phew, good save.

Once it was desert time, Nana was in her element. She wanted apple pie with ice cream. I was sitting at the table with her talking to my aunt and noticed Nana had a spoon. Where did that come from? We only put out forks. Oh, she has the serving spoon from ice cream. I laughed to myself and continued talking to family. Another 5 minutes later I notice the ice cream is missing. Did dad put it away? Nope, there it is, ON NANA’s LAP. Little sneak was eating straight from the jar. Me- Nana, where did you get that ice cream tub? Nana- Hehehe, I don’t know where it came from! Take it from me so I don’t eat it all.

I took the ice cream to place it back in the freezer and got Nana ready to go. We returned to her apartment and she gave me a hug and said thank you for a great day, I love you. Then she asked me if I could take her back to my house, she didn’t want to live at Southgate.

Once Mom got home that night, the decision was made. Nana needed to move to a more secure unit that fit her needs. Memory care units, here we come!

Confused? I think not!

Becky and I went to see Nana today.  Unfortunately, this wasn't one of her more lucid days.  She didn't recognize Bex, and barely recognized me when we came through the door. But as we were leaving, she seemed to know a bit more.
  I received my usual hug, kiss and thank-you.  Today she added, "I am so glad I had you.  And as I recall, you are one of the ones that never caused me any trouble."
  "Boy, that shows just how confused she is today," whispered my loving daughter, "if she thinks that you weren't any trouble..."
  Nice, Bex. Really nice.

"I'm not Dead Yet ;)"

Nana and I decided to take things of value out of her apartment after several pieces of jewelry were hidden and then she couldn't find them.  I was going to see my siblings out in Indiana, and thought this was a good time to take the baubles and let the granddaughters pick out some jewelry.  Nana absolutely agreed-- "I know they would probably rather have money, but that sounds great!"
  I went over on Thursday to pick up the jewelry.  Nana sat on her bed and watched me. "Now, don't take it all.  I might be going somewhere special, and I want to have some jewelry just in case." 
  "Absolutely, Mom."
  "You see, right now I don't have a beau.  But things change quickly around here. Who knows who could be moving in right around the corner?"
  Heeheehee. You go, Nana

Minerva

When my great-grandmother's estate was being settled, there was only one thing that Nana wanted: Minerva.  Minerva is an old marble bust of a cherub's face, which a collector believes was part of a building in NYC many years ago. Nana loved the innocent, playful face, and Minerva sat beside our fireplaces when we moved around the country.
  After Nana moved to Southgate, Minerva was given a special place outside her apartment door, on a small table.  Every month, we decorated her, and the other residents looked forward to seeing her monthly "outfits".  As Nana learned her new environment, she often told people that she lived with Minerva, and they could  find her home by looking for this landmark.
  In the last two months, Nana has become very concerned that someone is going to steal Minerva.
  "Will you take Minerva when I can't live here anymore?" has changed to, "Take Minerva to your home. Someone will steal her if she stays here."  I have tried to ignore her pleas, saying, "Mom, Minerva is safe. No one will take her.  And I will take her when and if you move."
  Yesterday, Minerva was gone from her perch.  "She was stolen last nite! Someone took her!"  I found her inside her apartment, covered by a sheet.  Minerva weighs 40 pounds.... who brought her into the apartment?  I asked the staff, but no one moved her... I am pretty sure that Nana moved her by herself.  This is pretty scary... Luckily she did not hurt herself.  "You better take her home.  Someone is now moving her, and next time they might steal her.  She needs to stay with you.  She needs to stay in the family." 
  I couldn't do it.  I couldn't take Minerva out of the apartment.  I moved her to a table in Nana's livingroom, and Nana seemed very satisfied. As I was leaving, I spoke to the receptionist about my dilemna.
   "I think of Minerva as an extension of my Mom.  She adores that statue.  It has always reminded her of her childhood. I hate to take it away from her, even if she is asking me to do so."
   "It seems you are having a harder time with this than your Mom is..."
  She is right.  That cherubic smile is an extension of my mother's own positive spirit. I have this irrational fear that if I remove Minerva, I will remove some of Nana's beautiful spirit.  But if the statue is causing her distress, or if she hurts herself moving that statue, I am not doing Nana any favors.
   I have decided that if Minerva is moved again, or if she asks me to take her again, I will.  I will place her in my livingroom during the winter, and take her to our family's summer cottage in the summer. That cherubic face can be shared with all her grandchildren as they spend time at the beach-- perhaps it will feel as if Nana is close to them as they enjoy a place that holds so many happy memories within its walls.