On Spinsterhood

Wikipedia, states:

Spinster is a term referring to an unmarried woman who is older than what is perceived as the prime age range during which women should marry. It could also indicate that a woman is considered unlikely to ever marry. The term originally denoted a woman whose occupation was to spin. A synonymous but more pejorative term is ‘old maid.’ The closest equivalent term for males is ‘bachelor’, but this doesn’t generally carry the same potentially pejorative connotations in reference to age and perceived desirability in the marriage.

When I began this blog, I was in my forties; beyond the prime age range for marriage. I had never been married and had no children. Back then, I thought perhaps I might marry. I recently had ended a relationship with a man to whom I purportedly was engaged. I say “purportedly” because, looking back, I don’t believe I intended to actually marry him, when push came to shove. I considered marrying him, knowing that it likely would not work out, so I could point to the failed marriage and say: “Yes, I’ve been married. I was chosen. I’m not completely unlovable or undesirable. I am not so difficult that not all men would forgo making a lifetime commitment to me.”

Around the period the engagement and breakup took place, I had just started a job with BigLaw via a merger of my tiny nine-lawyer firm with a thousand-lawyer firm. At the initial reception celebrating the merger, a married, handsome, forty-something male partner who hailed from one of our offices in the Northeast, inquired whether I was married or had children. When I answered in the negative on both counts, he said, “It will be okay. We’ll find you someone.” Yes, he actually said this. (Apropos of nothing, it later would be revealed that this particular partner was having an affair with another married partner, both of whom would divorce their spouses to marry; but not before they were forced out of the firm. Whether they were forced out for breaking some unwritten firm moral code, or something else, was not made public.)

What I inherently knew had been confirmed: To be successful at this firm, it would be helpful to be the kind of woman men desired to marry.

A few months following the merger party, the firm held its annual partnership retreat. I wore the ring from my recently-failed engagement throughout the days-long retreat. (I had kept the ring because I paid for it.) Looking back, I cringe at my acquiescence and attempt to comply with the expectations of my male-dominated law firm by farcically wearing the ring. (The “male-dominated” descriptor for a law firm generally goes without saying.) I also cringe that I contemplated marrying someone who was abusive and exploitative, in part so I could say I’d been married.

I understand I am far from being the only woman to contemplate marrying because of societal expectations. I understand I am far from being the only woman to, at times, feel broken or flawed for never having found a partner worthy of a life-long commitment.

When I began this blog, I used the term “unconfirmed” because I was not yet prepared to declare myself a life-long single woman. I thought maybe, if I was lucky, I would one day find a life partner. And it would take luck, seeing as I was doing nothing in pursuit of finding a partner. In fact, I was doing quite the opposite. I might even go so far as to call it active avoidance. I used the term “bachelorette” because I thought “spinster” was too harsh; it had negative connotations. It generated images of unhappy, lonely, old, bitter women, living with dozens of cats. I was, and am, a middle-aged woman living alone with cats; four cats, to be precise. (I lost dear Sally, one of the original black cats, to intestinal lymphoma nine months ago, and so now am sharing my home with four cats, rather than five.) I am not lonely. I am not bitter. I am not unhappy.

So now, eight years after starting this blog, I have been contemplating changing its name. I considered “Confirmed Bachelorette,” but “bachelorette,” albeit tongue-in-cheek, has always felt a bit cheesy, particularly in light of the television show. (Will you accept this rose?) I tossed around the idea of calling it “Confirmed Spinster.” The feedback on that was entirely mixed. Two friends found it amusing. Others found it negative and a bit repellent. I saw it as a way to reappropriate the term and chip away at the negative connotations.

Why do women get a bad rap for never marrying? Why are there pejorative terms for unmarried-women-of-a-certain-age, when there are none for men? There’s even a card game, Old Maid, where the penalty card with which you do not want to be left includes the image of an old, gray, woman, often surrounded by cats. What’s wrong with being surrounded by cats?

In contrast, the term “confirmed bachelor” evokes the image of men like George Clooney; men who are handsome and dashing, who have escaped the fate (until recently, for George) of being tied down by a woman. Why am I not viewed as lucky to not be tied down by a man? Why is my independence, my ability to take care of myself, to live life on my terms, not celebrated, as it is for lifelong male bachelors of a certain age?

It’s going to take much more than changing the name of my blog to assist in this course correction. It’s taken decades for me begin to correct the course of my own thinking. I shall continue to strive to do so. For now, I leave you with this:

I am an Unapologetic Spinster.

Posted in Abusive Relationships, BigLaw, Cats, Female Attorneys, Feminism, Gender Bias at Law Firms, Law Firm Gender Bias, Lawyer, Marriage, Mid-Life, Practice of Law, Relationships, Settling, spinster, Spinster, Women Lawyers | Tagged , , , , , , , | 7 Comments

Here We Go!

African Elephants
Botswana

It’s 2019: three-hundred-sixty-five blank pages ahead. How shall I fill them? Will I reduce my consumption of anxiety-provoking news and current events? Will I use the new dumbbells I ordered last week? Will I add to my “home gym” (i.e., corner of the living room) the new weight bench I have my eye on? How about reverting to low-sugar and starch consumption: will I be successful at that, once again? Will I write (nearly) every day? Will I edit my NaNoWriMo “novel”? Will I get back in the kayak, even though I flipped it and landed in cold Lake Superior getting in, and getting out, tearing the seat of my pants in the process?

I failed so abysmally at kayaking, and yet, I was hooting and hollering and laughing at myself, as I splashed, and fumbled, and slipped on the rocks, attempting to right the damn thing and dump the gallons of water out. Despite my anxiety, and inability to glide across the lake effortlessly on my first go, I was thrilled that at fifty-five, I bought my first touring lake kayak and had the courage to get in it. It’s sitting in the snow-covered cabin, waiting for me to return, and try again this summer.

I feel optimistic about the new year. I don’t always feel optimistic at the start of a new year, so this bodes well. On January 1, 2017 and 2018, I was pretty much checked out, emotionally. I wasn’t in a pit of despair; I just wasn’t “there.” It’s interesting to feel like I’m beginning to stir, sniffing the scents outside my den, when we are here, in the dead of winter. I’m feeling optimism at age fifty-five, when a few years back, I thought the best was behind me. I am willing to allow, I may have been wrong about that.

Three-hundred-sixty-five blank pages in the year 2019 to be filled however I wish. Here we go.

Posted in Africa, Botswana, Elephants, Getting Unstuck, Healing, Kayaking, Lake Superior, Living Life, Mid-Life, Photography, Travel, Wildlife, Wildlife Photography | Tagged , , , , , , , , , , , | 8 Comments

The more things change . . .

Two years ago, as my mother was dying from Alzheimer’s, I wondered how my life would be different once she was gone. I felt as if I was suspended between my life before the deaths of my nuclear family, and the life I would have after they were gone. The “In Between,” I called it. As it turns out, there hasn’t been much of a transformation.

Granted, the stress I’d been under for years is greatly reduced. I’m not worrying about my father’s declining health and cognition. (He, too, died from complications of Alzheimer’s.) I’m not worrying about whether my brothers are killing themselves with alcohol. (They did.) I’m not worrying about having to see my sister’s horrible husband at holiday dinners. (Now that Mom is gone, my sister and I don’t do holiday dinners together any more. And, earlier this year, she finally divorced him.) And I’m not worrying about my mother’s declining health.

I miss my mother the most. I think this guy misses her, too.

SPOTTY

Work is better. The unpleasant partner in North Carolina is leaving the firm on April 1; pushed out, as far as I can discern. The partner who dragged me into the heinous BigLaw merger eight years ago has divorced his wife and married his girlfriend. He plans to retire in a year or two, which means I’ll be leaving the firm then, as well. I’d planned to leave sooner, but with the market tanking, I’ll be sticking around, scooping up the income for as long as they’ll have me. Reading between the lines, that will only be as long as newly-remarried partner is around. I suppose that saves me from doing the “one-more-year” thing for more than two more years. After that, I have no idea what I’ll do.

Although I have no idea in which direction my life is headed, I have begun to nudge it in the direction I feel I’d like it to go. Finally, after a two-year hiatus, I have begun writing again. In October, I started a daily writing practice, with a goal of no less than one hour per day. That segued nicely into NaNoWriMo, which is the acronym for National Novel Writing Month. The idea is to write a 50,000-word novel during the month of November, which translates into roughly 1,667 words per day. If you meet the goal, you’ve “won” NaNoWriMo. This year was my first ever attempt at NaNoWriMo, and I am proud to report, I won. I now have my first-ever shitty first draft of a novel. I wrote an entire story, from beginning to end. Whether I will continue to work on it, or start something new now that I’ve gotten that story out of my system (at long last), I am undecided.

I’ve also been giving some thought as to where this blog is headed, now that it’s moving again. I bought a new domain: Confirmed Spinster. To start using it, I’ll need to figure out if I can transfer everything from here over to there, including you all, or whether I’ll have to start from scratch. If I do have to start over, I may just forgo the whole anonymous thing and let the world see me. I don’t think that will be terribly difficult, seeing the most sensitive aspects of my life (and those around me) appear to be behind me.

Much has happened over the past two years, but I don’t think it would be ideal blogging to spill it all out here into this post. Now that I have this entree completed, I suppose I’ll come out with it all in bits and pieces. Topics that come to mind include, but are not limited to*:

  • Cat Update
  • San Miguel de Allende Excursion
  • Botswana Safari
  • Lake Superior Cabin Update (Including Bears!)
  • Condo Remodel
  • Minor Flirtation
  • Sister Update

*Goal: Stop writing like a lawyer.

Posted in Blogging, Cats, Death and Grief, Death of a sibling, Early Retirement, Female Attorneys, Long Distance Caregiving, Mid-Life, NaNoWriMo, National Novel Writing Month, Writing | Tagged , , , , | 14 Comments

Lilac Breasted Roller

The Lilac Breasted Roller is one of Botswana’s most abundant and widespread species. I have dozens of photos of this breathtakingly photogenic bird. Here are a few of my favorites (so far).

Posted in Africa, Birding, Birds, Botswana, Nature, Photography, Travel, Wildlife | Tagged , , , , , , , , , , | 4 Comments

Thirsty Giraffe

I discovered on my Botswana trip that I am quite a good spotter of wildlife, beating our guide in some instances. But the giraffe was different. I had difficulty seeing them, even when they were pointed out to me, they blended in so well with the trees with their fabulous camouflage.

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It’s quite a production for giraffes to drink, having to get themselves into this awkward position. Notice the birds on her head.

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They’re sneaky, I tell you.

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This one, I could see.

 

Posted in Africa, Botswana, Giraffe, Nature, Photography, Travel, Wildlife | Tagged , , , , , , , , , | 8 Comments

Maned Lioness

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This lovely lady is a rare maned lioness. She lives in Botswana, in the Okavango Delta, where I went in May for my fifty-fifth birthday. She is one of five known maned lionesses in Botswana. She exhibits some male behaviors, like increased scent-making and roaring. I was instantly smitten with her.

Here, she smelled something on the road she wanted to roll around in. I didn’t crop out the Range Rover on the bottom right-hand side of this one, so you can see how close she was to us.

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I have so many images of this lovely girl, it’s hard to decide which ones to share. While she is one of several lions we saw, she captured my heart.

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I have thousands of Botswana photos, so expect lots more to come.

Best wishes to you all,

Ella

#ManedLioness #Botswana #OkavangoDelta #PhotoSafari #NaturePhotography #WildlifePhotography #NatHab #Lions #AfricaSafari

Posted in Africa, Botswana, Nature, Photography, Travel, Wildlife | Tagged , , , , , , , , , , | 21 Comments

Now what?

Being a mid-life “orphan” is disorienting. As I contemplate what I want to do for the rest of my life, who I want to be, I realize how much time I spend looking over my shoulder for objections, judgments, or approval. But now, each time I turn to look, there’s no one there. My mother, my only remaining judge (both real and imagined), died in September. My father and brothers are gone. My sister and I do not have the kind of relationship where she would express an opinion on my life choices; and if she did, it would not carry any weight. And so as I contemplate what to do now that I no longer am responsible to anyone or anything, save my five precious cats, I am finding the freedom a bit jarring.

I could quit my job tomorrow. There is no one to tell me not to: No parent, no spouse, no children. And the cats, well, they’re all for it. If I quit, I might have to work again some day, depending upon how my investments do and if my (formerly “my father’s”) business turns a profit. But common wisdom is to wait a year before making big decisions in the aftermath of a loss. And so I (or perhaps I am hearing the voice of my dead father) tell myself to stick it out at my law job for a year or two more.¬†The job hasn’t been bad this past year. And currently I am in a position of power. I don’t have to be there. I can walk away if they make my life unpleasant or difficult. I have the F$$$ You Money. And besides, it isn’t sensible to walk away from my career at fifty-three. It isn’t rational to walk away from the money. Who walks away from that kind of paycheck?

But what about the idea of using the energy of loss, of grief, to fuel change? If I don’t make the leap now, will I settle into a steady pattern (i.e., a rut) and stay there until the end of my days? If not now, when?

Some days, I want to turn my life upside down and give it a good shake. Other days, I want to stay in bed under the covers surrounded by cats. Either way, there’s no one to tell me not to. The only voice that matters now, the only voice still living, is my own. I can do what I want. If only I knew what that is.

Two images from today:

Bird-Bath Ice Sculpture

Bird-Bath Ice Sculpture

sophie-lucy

Sophie & Lucy

Posted in Attorney, BigLaw, Death and Grief, Early Retirement, Fuck You Money, Lawyer, Living Life, Mid-Life, Retirement | Tagged , , , , , , , , , , | 25 Comments

Cat Number Five

spottyMeet Cat Number Five a/k/a Spotty a/k/a the Damn Cat. Spotty came to live with me late in the evening on September 15; the night my mother died. He has settled in quickly and well. I thought I would need to help him with kitty grief. I thought he would need to help me with people grief. As it turns out, we’re both more relieved than sad.

We were sad when my mother’s heart broke when both of her sons and her husband died in an eleven-month period. We were sad when Mom nearly died herself from deep vein thrombosis four months after my brother Steve died. We were sad when Spotty was separated from her during her recovery until she settled into her new home at an assisted living facility.

During the three years Mom lived at assisted living, Spotty stayed by her side. Every time I visited, I brushed him. He’d attack my hand as I pet or brushed him. But I’d persist, filling the brush over and over, dropping the wads of fur into the trash. A couple of times I googled whether snowshoe kitties were more prone to shedding. They’re not. I wondered whether Spotty’s shedding was due to how warm Mom kept her apartment. Cats prefer warmth.

After Mom fell and broke her hip in May, she was totally bedridden. She went on hospice care, and in addition, I hired a wonderful caregiver, Latrice, who stayed with Mom twelve hours a day, seven days a week. Three months after Mom went on hospice care, I decided to give myself a respite at the family cabin in Canada on Lake Superior. The idea was to spend two weeks writing, resting, and grieving. The grieving with Alzheimer’s starts well before the actual death. It is a series of small deaths, which begins at diagnosis, and ends at actual death. When Mom fell and broke her hip in late May, I knew she would not be with us for years. I knew it would be months. How many months, despite repeated and obsessive googling, I did not know. So when Mom had been bedridden for three months, I allowed myself to go to the cabin to rest. And grieve.

I called Mom each morning. Latrice would put her phone on speaker and I would talk. I described Lake Superior to her: it was as still as glass engulfed in a soft mist; or it was a clear windy day, the waves crashing against the rocky shore. I’d hold the phone near the water.

“Can you hear the waves, Mom? The loons are out front, fishing for breakfast.”

I’d call Mom each evening and tell her about her chipmunks, how I was taking care of them, feeding them seeds and nuts. How one little chipmunk sat in the palm of my hand as he stuffed the nuts I held into his mouth with tiny paws, making his cheeks fat.

I told Mom about the blue sky, the white bark of the birch trees, the yearling bear that was said to be nearby, but I never saw. I told her of the resident bald eagle that flew along the shore, and how I sat one morning for at least half an hour, photographing it as it pruned its feathers as it sat perched in the top of a tall pine.

Mom never spoke during my calls, but she listened.

During the second week of my trip, Latrice told me Mom had begun eating less, refusing meals. Latrice reported that in addition to the profuse shedding, she’d found clumps of Spotty’s fur on the carpet. Mom had begun clamping her mouth shut when Latrice tried to give her medication. Latrice, a strong and calming force, was upset. I asked the hospice nurse if I should cut my trip short. She thought there was no urgency, and my plan to return that Friday should be fine. I continued calling multiple times each day; I continued my monologues to my mother, describing the place she loved so much.

I returned to Austin late Friday night, September 9. Saturday morning, September 10, I drove to Houston. Mom was sleeping comfortably, and I sat with her, holding her hand. She’d refused the chocolate cream pie I brought. She refused lunch. After I’d been there several hours, she opened her eyes, smiled, and said,

“Hi, Ella.”

As she drifted back to sleep, I didn’t know those would be the last words she spoke to me. Mom ate supper Saturday night. And lunch on Sunday. But by mid-week, she’d begun refusing food entirely. On Thursday morning, September 15, Mom took a turn. She was having difficulty breathing and the consensus was Mom had only days left. So I packed a bag and planned to stay with her and Spotty at her assisted living apartment until the end.

When I entered her apartment, Spotty lunged at me, attacking my leg. He then ran into the bathroom and hid. Mom’s throat had filled with fluid and when she breathed, it rattled. Latrice, who had been so composed and strong throughout the preceding months, took leave, saying,

“I can’t stand to watch her suffer.”

I sat with Mom throughout the afternoon. My sister came with her husband after work. My brother’s ex-wife brought me supper. The hospice and facility nurses came and went, giving Mom morphine and showing me how to use the suction machine. A dear family friend sat with me for a bit after my sister and her husband left. And then it was just Mom and me.

I pulled a sofa up next to Mom’s hospital bed and lay down next to her, holding her hand as she slept. I described the sunset to her. I promised I would take care of Spotty and he would, in turn, take care of me. As I spoke, Mom’s breathing slowed and became calmer. I was relieved the morphine was helping her to relax. I continued to hold Mom’s hand, crying quietly as I spoke to her. Mom’s breathing became softer. The rattling stopped. I watched her grimace soften; the lines on her face ease. She looked peaceful. Her breathing continued to slow. And then, it stopped.

Late that night, after the funeral home had come and taken Mom’s body to be cremated, I loaded Spotty into his carrier and into the car. I put him on the passenger’s seat and talked to him as we drove the two hours to Austin. He was quiet and slept most of the way. I’d assumed he was upset, grieving. But over the next several days he remained calm. He ingratiated himself with the four resident cats nearly immediately. Lucy, Cat Number Four, was particularly taken with him.

Spotty working up the courage to meet Lucy on Day 2

Spotty working up the courage to meet Lucy on Day 2

Whenever they got cross, Spotty would flop down onto the floor, showing the girls his belly. Within a week of moving in with us, Spotty’s shedding stopped. He hasn’t attacked my hand once in the two months he’s been here. He likes to sleep on the bed lying next to my hip. He (clearly) likes treats. He eats the girls’ leftovers. (But he’s lost half a pound!) He’s the kind of cat you trip over; the cat who follows you around, always at your feet. He nuzzles me with his wet nose when he wants pets. He awakens me in the morning, always the first one up. He is my solace. He brings me peace. And he’s a big fat lovable hunk of cat.

big-boy

Chillaxin

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Cats Number One, Two, Four & Five (Cat Number Three, Sophie, still a weirdo who won’t come downstairs)

chill

Lap Cat

chillaxin

Poser

half-pound

Roly Poly

spotty-face

Out of focus, but That Face!

tub

Living on the Edge

Posted in Alzheimer's, Bald Eagle, Canada, Cats, Death and Grief, Dementia, Dying, Elder Care, Elderly Parents, Grief, Grieving, Love | Tagged , , , , , , , , , , , , | 60 Comments

The Decider

My mother has Alzheimer’s, diabetes, and as of three weeks ago, a broken hip. Shortly after my father died (coming up on three years ago), she made me her legal decision-maker in all things financial and medical. Taking care of mom’s finances turned out to be the easy part. Making medical decisions is decidedly more complicated.

Mom’s decline has sped up over the past six months, with repeat infections (urinary tract and MRSA), as well as a more pronounced diminishing of cognition. She’s fallen several times, which resulted in numerous trips to the emergency room. Sometimes she was admitted for IV antibiotics. Sometimes she was sent to a rehab hospital for physical therapy before returning to her assisted living (AL). With every hospital visit the dementia progressed. She became more confused. She began speaking less. She could no longer answer the phone when I called. Every time she was sent to the hospital with a new emergency, she returned to AL with a new, and lower, “baseline.” She was always worse in the hospital and rehab facilities, and would regain some cognition once she returned to AL and familiar surroundings. And her damn cat. Because of the toll the hospital visits were taking on mom, I began to question whether they were strictly necessary, or whether they were more of a CYA for the AL. On the day before mom’s 80th birthday, I refused to allow her to be taken to the emergency room when she appeared to be fine after a fall. (Had she gone, she likely would have missed her party.) My sister did not agree with that decision. Luckily, it turned out to be the right one, and mom was fine.

I’ve thought a lot about what it means to be a substitute decision-maker. In the beginning, I thought it just meant to make sure the doctors and nurses take good care of mom. And maybe, somewhere down the road, to not allow mom’s life to be lengthened by feeding tubes, CPR, or other “extreme” measures. But over time, I’ve learned that in between those two goals, there are a lot of nuances when it comes to treating a loved one with Alzheimer’s. No feeding tubes. No ventilators. No CPR. That much is clear. But what about pneumonia or flu vaccines? Hospital visits for infection? IV antibiotics? Replacement of a pacemaker battery? Surgery to repair a fractured hip?

I did not have to make the decision about whether my mother should undergo surgery to repair her hip fracture. The fracture was nondisplaced and not causing mom any discernible pain, so the doctor said surgery was not warranted. I’m unsure how much of his decision was related to mom’s diminished mental status, and how much was due to the nondisplacement of the break. Mom is now back at her AL on hospice care. She’s also on bedrest for six weeks to allow the fracture to heal. The orthopedic doctor said he wanted to see her in his office in two weeks for x-rays. I asked the physician’s assistant if we could do mobile x-rays since office visits are difficult for mom. He insisted mom needs to be seen by the doctor. My sister also is pressing for mom to be seen by the doctor. I’m hesitant. Since mom is non-weight-bearing due to the fracture, she’d have to be transported to the doctor’s office by EMS. Since mom is not talking, I don’t anticipate that a physical exam would be of much value. She can’t tell the doctor anything. He may get a barely discernible nod or shake of the head, but how are we to know she’s accurately answering the question being posed to her? And then there’s the stress of the doctor’s visit. She’s hardly communicative at this point; how much would a visit to the doctor set her back?

I talked it over with the hospice nurse. She suggested I look at it in terms of cost to mom, versus payoff. The stress of the transport and visit would be great. The doctor likely would not get much information of value via an examination. The x-rays can be done by a mobile technician at mom’s AL apartment. And then we took it a step further: if the doctor finds the fracture is not healing, would we opt for surgery? I would not. So rather than transporting mom to the doctor, we’ll get mobile x-rays in a few weeks and send them to the doctor. Hopefully the doctor will tell us mom can begin to bear weight on her hip and she can move from the bed to the wheelchair. And once in the wheelchair, we can push her outside to sit in the garden and watch the birds.

My sister isn’t speaking to me. I’m not sure if it’s because I haven’t made arrangements for mom to see the orthopedic doctor, or because I gave her hell for taking away the strawberry shortcake I brought mom last weekend after I had gone. (The caregiver tattled on her.)

“If you take away her favorite pleasures, what’s the point of keeping her alive? Then you’re keeping her alive for you. Not her.”

For now, my sister’s silence is making things easier. I feel more clear-headed. I’m attempting to make decisions based on what my mother would want. Not based on what my sister wants. Or based on my pushing back against my sister in anger. I try to put myself in my mother’s place and imagine what she would want for herself at this point in her life. I think back to when my father died, when my mother said she didn’t want to go on living without him. I think about how she wanted to do less and less for herself, and told me more than once she’s taken care of everyone else her whole life; now, she wanted to be taken care of. I think about my mom’s increasing reluctance to engage in physical therapy. (She’s been labeled “non-cooperative” more than once.) And about the times she’s told me she doesn’t care if she can use her walker; she’s fine being confined to the wheelchair. She’s likes being fed by the caregiver, instead of struggling with the utensils. And she wouldn’t mind if she died of eating too much chocolate cream pie. (Yesterday I brought her coconut cream pie and an empty Greek yogurt container in which to hide the leftovers so my sister wouldn’t take it away from her.)

Yesterday for my visit, the caregiver had dressed mom in real clothes for the first time since she got home from the hospital two weeks ago. The caregiver said mom seemed pleased to be out of the nightclothes. Mom was wearing lipstick, her glasses, and her watch. Her hair was fixed and the caregiver had painted her fingers and toes. Mom talked little. But she said “hi” when I came in. She nodded in response to a few of my questions. When I gave her kisses, she smiled. She petted the cat when I put him next to her on the bed. I brought mom flowers, which I arranged in a vase and set on a bookshelf next to the tv. When I turned my back to the flowers and faced mom, she blurted,

“Watch that cat!”

I turned around, and sure enough, her cat was eying the flowers, his tail swishing back and forth. It was mom’s only full sentence of the day. I love that damn cat.

Being the decider isn’t easy. But I think I know my mom well enough to know she wouldn’t want us to attempt to extend her life by any means, let alone by any means possible. And so I’ll keep the focus on pampering her and keeping her comfortable. And making sure she gets lots of her favorite simple pleasures: pie, the damn cat, and kisses. I may end up completely estranged from my sister in the end. A risk I’m willing to take. Because as the decider, my responsibility isn’t to do what my sister wants for our mother, or even to do what’s best for our mother by some medical standard. It’s to do what our mother would want for herself.

Posted in Alzheimer's, Assisted Living, Dementia, Elderly Parents, Feeding Tube | Tagged , , , , , , , , , , , , , , , , , , , , | 254 Comments

Mom and Her (Damn) Cat

Last Sunday, May 22, mom fell again. This time, despite my attempts to avoid it, she was hospitalized. They ran the usual battery of tests. Not surprisingly, mom had another urinary tract infection. What was surprising is that it occurred less than a week after she finished the antibiotic for the last UTI. And then we got the big news: mom had fractured her hip and jaw. It’s quite possible this happened in the last fall, but they missed it. In fact, the x-ray report said as much.

When she fell last time and the nurse thought she may have fractured her hip, I pondered then what we would do if mom was faced with having surgery. Given the progression of her dementia, I didn’t think she’d do well with surgery, anesthesia, or rehab. Given her co-morbidities (dementia, diabetes, and deep vein thrombosis), I wondered whether she’d be a candidate for surgery. The last time she fell, we didn’t have to make that decision. As it turns out, we wouldn’t have to make that decision this time, either.

Mom’s hip fracture was non-displaced so the orthopedic doctor said surgery was not indicated at this time. He said he’d put her on partial toe-touch weight-bearing (TTWB) for six weeks and then see her in his office for repeat x-rays and examination. I explained to the ortho doctor’s physicians’ assistant (PA) that we could not explain to mom what TTWB meant or how to do it. They switched her to non-weight-bearing for six weeks. I then asked if we could do a mobile x-ray rather than having her come in. The PA insisted he needed to see her. As for the fractured mandible, it was only minimally displaced and did not seem to be bothering mom. So no surgery or treatment was indicated for it, either.

The first couple of days after mom was admitted, she spoke little. I stayed in Austin, but kept in close contact by phone. The nurses would hold the phone up to mom’s ear, and I would talk to her. Once or twice she would answer “yes” or “no.” By day three or four, the nurses and my sister were reporting that mom wasn’t talking at all. But she was eating, always a hopeful sign.

On Tuesday, my sister informed me that she would be leaving Friday to go to Galveston for the Memorial Weekend.

After discussions with the nursing staff at her assisted living (AL), as well as the PA for mom’s geriatric physician, we decided it was time for mom to be evaluated by hospice. With the hip fracture and mom becoming increasingly non-verbal, the consensus was mom would almost certainly be accepted. I finally had the opening I’d been waiting for to have the hospice discussion with my sister. After much texting and a few calls, my sister agreed with the hospice evaluation.

Mom’s AL worked with several different hospice facilities. The nurse they liked the best said she didn’t have the time to give my mom the attention she needed with her current case load. I then selected a hospice provider that had been doing mom’s home health, thinking the transition would be easier that way. The evaluating nurse went to the hospital, looked at mom’s chart, talked to mom, and called me after the visit.

“Your mom is ineligible for hospice. She is not terminal.”

Despite the fact that the hospital nurses and my sister said mom was non-verbal, this nurse insisted she’d had a conversation with my mother. Rather than talking with her primary doctor who’d been seeing her for the past two years and talking with the nursing staff at AL, where she’d been living for the past three years, she made the decision based only on mom’s hospital chart. So, mom was deemed not a candidate for hospice at this time. A decision that surprised her primary doctor, who’d written the orders for the evaluation, as well as the nurses at her AL and the nurses at the hospital where she currently was admitted.

The hospital wanted her out as there was nothing more that needed doing. The AL couldn’t take her back due to the fractures and her inability to transfer. The hospital, I am certain in an attempt to buy us some time, said she needed five more days of IV antibiotics, and so would write orders to send her to skilled nursing. If mom did not improve within those five days, they suggested we get a second hospice evaluation. That was the plan as of Thursday. Meanwhile, I’d made several calls to the AL nursing staff, as well as mom’s primary care PA. The PA said she was going to re-review mom’s chart with hospice-care criteria in mind. The AL nurse said she was going to call a different hospice with whom they have worked, and discuss mom with them.

Friday morning I got a call from another hospice service. They talked with me about mom and her history, and said they’d like to meet with us. I had planned to drive to Houston Friday afternoon, but another round of severe storms was rolling through, so I delayed my trip until Saturday morning. I planned to meet with the hospice representative at noon in mom’s hospital room.

Since mom’s house was now empty in the wake of the estate sale, I packed my car with things I’d need to stay the weekend. I bought an air mattress, a coffee maker, and a soft furry bunny at Target. I packed towels and sheets and coffee. I filled a cooler with Greek yogurt and blueberries. I arranged for the pet sitter to take care of the kitties (now, four) and give Sadie her subcutaneous fluids. Saturday morning, I headed to Houston, unsure of what lie ahead.

I arrived at the hospital thirty minutes before the scheduled meeting. Mom was asleep. She didn’t awaken when I greeted her, or when I kissed her, or when I stroked her cheek. The nurse told me mom had eaten about twenty percent of her breakfast, and they’d bring lunch soon and I could try again. I gave mom her bunny, “a bunny for my honey bunny,” I told her. She didn’t awaken until the caregivers came in to change her. She seemed to register my presence, but the bunny made no impression. Now that she was awake, when I gave her kisses and stroked her cheek, she smiled. Her skin was so soft. Her smile beautific.

The hospice representative arrived on schedule and we sat in the window seat of mom’s hospital room and talked about their services and whether mom qualified. The representative thought she did but she would call her nurse to be certain, and if there was any question, the nurse would come and meet with mom before making the decision. She too seemed perplexed that mom was deemed to not qualify by the prior hospice provider. The hospice representative left the room to make calls and review mom’s chart. They brought mom lunch and I fed her. She had a few bites of mashed potatoes, and a few bites of turkey. I mashed up the turkey with a fork to make it easier to chew, imagining I was the mama bird and she was the baby bird. I opted not to go full-on mama bird, using a fork to mash it rather than pre-chewing it for her. Mom also ate some fruit, the grapes being the easiest to chew.

Mid-fruit-cup, the hospice representative returned and told me mom qualified and they’d accepted her. I filled out the paperwork. I filled out the out-of-hospital DNR (do not resuscitate). Because hospice had accepted mom, her AL would take her back. She wouldn’t have to go to skilled nursing and undergo yet another disorienting move. I updated my sister by text. I got a one-word response: “OK.” Within thirty minutes of the hospice representative leaving, the EMTs showed up with their gurney to transport mom back to her AL apartment and her cat. By early Saturday afternoon she was settled back into familiar surroundings, with familiar caregivers, the cat standing guard.

Mom seemed pleased to be back. She smiled more. She followed me around the room with her eyes. She stared at me and smiled. I brought the cat to her bed and helped her stroke him. She seemed more interested in looking at me than the cat. I took that as a sign that I am indeed her favorite child, even over the cat. The highlight of the afternoon was giving mom kisses and stroking her cheek, and watching her smile and her eyes light up as I did so.

Late in the afternoon, the hospice nurse came by and we went through the initial plan of care. More papers to sign. More information to absorb. The nurse would come by one to two times a week to check her vitals and give her a full examination. An aide would come by three times a week to bathe mom, wash her hair, take care of her nails, put lotion on her, change her sheets (once a week minimum), and massage her. We were assigned a social worker and a chaplain. Hospice ordered a better bed for mom with an air mattress, a bedside table, and an oxygen machine, should that become necessary. All of those items arrived within hours. The EMTs came back to move her from her old bed to her new bed.

Despite all hospice does, and despite the excellent care mom gets at AL, she needed more care than they would be giving. While Medicare pays 100 percent of hospice, the benefit does not include continuous care. Nor does the AL. I would need to hire an aide at mom’s cost to watch over her and assist in her care. The hospice social worker provided referrals and I managed to get care in place, despite it being Memorial Weekend. I made sure they knew about the cat, and that the aide would be expected to take over cat care.

Everything was done. Mom was sleeping. I’d decided to stay in mom’s AL apartment that night, rather than going to her empty house. I went out to the car and got my bags and the coffee maker. I set up the new coffee maker and made a pot. I ate some yogurt and blueberries. I brushed the cat, who was starved for attention having been alone for a week. We settled in on the love seat to watch a Harry Potter marathon on television.

Mom slept well and snored like a lumberjack for most of the night. The caregivers came in every two hours to check on her and change her if she was wet. I slept minutes at a time. Mostly I was awake, watching Harry and his friends defeat He Who Must Not Be Named.

In the morning, my sister began accosting me with text messages, second-guessing everything I’d done.

“Wouldn’t mom be better off at a nursing home where she can get twenty-four hour care?”

“I am not sending mom to a nursing home,” I wrote back. “She will do better in familiar surroundings with her cat.”

Then she called me. She put me on speaker. Her daughter and her husband were in the room. Suddenly I was being ganged up on by my sister’s family. And I was a force of one; no daughter or husband to meet them in numbers.

“Why didn’t grandma go to the nursing home for antibiotics?” my niece demanded. “The plan was one thing, and then suddenly we’re being told it’s entirely different. We all have a stake in this. We all care about grandma.”

“Stop yelling at me.”

Which is as far as I let my temper go. What I wanted to say was, “Fuck every one of you. And if you were so fucking concerned, you’d be here helping me make these plans, instead of at the beach for Memorial Weekend.” Instead, I patiently explained that mom was getting the care she needs, hospice had a plan of care in place, and that, coupled with the private aide and AL caregivers, would be a much higher level of care than she would get at the nursing home. I reminded them of the care my father got in the nursing home, and how heartbreaking that whole experience was. I told them mom would be better off in familiar surroundings with her cat.

“I don’t care about the damn cat,” my sister said. “I want her to get the level of care she needs.”

“She is getting the level of care she needs,” I said. “I was here all night. She slept. They checked on her every two hours. They changed her. The private aide will be here this afternoon. I’ll meet with her and give her instructions. She will stay until 7:00. Starting tomorrow, we will have a private aide from 7:00 a.m. to 7:00 p.m.”

My niece jumped in: “How can she be left alone? What if she decides to try to walk again and she falls again? That would be a disaster.”

“If you saw her you would not be worried about that. She’s bedridden. She’s not going to try to walk. She’s too weak. She can’t even feed herself. She’s not talking. She’s sleeping all day and all night except when we wake her to feed her or change her. I approved bed rails so she can’t fall out of bed. If she starts moving, they’ll lower the bed and put mats on the floor beside the bed.”

My sister’s turn: “If she was at the nursing home, we wouldn’t have to pay for her apartment or the private caregiver. This is expensive.”

“Mom has money,” I told her. “She can afford to do this for quite a while. She needs familiar surroundings and faces. She needs familiar caregivers. When the night aides came in last night, she smiled at them. They talked to her. You could tell she knew them. And you could tell they care about her.”

“This is a lot of money.”

Finally, I heard my brother-in-law say, “It’s not about money.”

“Well, what if she runs out of money?” my sister said.

“She can afford this for a while,” I said. “I’ll run some projections next week when I’m back at the office.”

“Well, you should go out and look at nursing homes while you’re there and find one to move her to when the time comes.”

“No, I’m not going to do that. I have enough to do right now. Not to mention, I want to sit with mom. I want to spend time with her.”

I didn’t bother to tell her Medicare would pay for only 100 days of skilled nursing, and after that we would be on self-pay and nursing home costs are more expensive than AL costs. And with the shitty care at nursing homes, we’d likely want to pay for a private aide, just like I’d set up at AL. My sister continued to bombard me with orders, including making arrangements to move mom into a smaller, less expensive AL apartment since we now had a hospital bed in the television room. She insisted we no longer need “all that space.” I told her I’d consider that at a later time. Right now, I was focused on getting mom settled in and comfortable in the home she’s lived in for the past three years.

Meanwhile, my mother was sleeping in the next room, blissfully unaware of what an asshole my sister is. It has become more evident with each passing day why my mom made me her decision-maker. And by God, I am going to make the decisions no matter how many members of her family gang up on me. Luckily, my niece and brother-in-law both seemed to come around by the end of the call. They seemed to understand that familiarity of surroundings and comfort are key, and that even though my sister doesn’t give a damn about the cat, my mother does. Mom made herself clear on Mother’s Day that she wants to be with her cat and she wants to eat pie. I had now reunited mom with her cat. After the private aide arrived, I went to the bakery and got mom a big slice of chocolate cream pie.

And now, having made it through the transition to this new phase, we settle in and wait for what’s next. The hospice certification means they believe mom will not be with us for more than six months. My sense is, they are correct. Especially if mom continues to be non-verbal and if she is unable to begin ambulating after her six weeks of healing of the hip fracture. I don’t think she will walk again. I don’t think she’ll be with us long enough to run out of money. If she does, I’ll pay for her care. I’ll pay to keep her home at assisted living with her damn cat.

Mom petting her damn cat

Mom petting her damn cat

 

 

 

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