06:57 – I’m still working heads-down on the forensics book, putting together consolidated equipment/chemicals/specimens lists from all of the lab sessions. I should finish that up today or tomorrow, which means the manuscript is complete. I’ll then go back and do a quick clean-up pass, shoot more images, and so on.
10:01 – Barbara took her dad to an early appointment this morning with his doctor. She called about 9:00 to say that the doctor wanted her dad to go to the hospital. He has problems with fluid accumulation, which they’ve been treating by limiting his fluid intake and having him on a regimen of Lasix or some other loop diuretic. This morning, the edema was bad enough that the doctor thought IV diuretics were needed, so Barbara took her dad over to the hospital. I’m not sure if they’ll admit him or just treat him and release him. Barbara and her sister have been run ragged recently dealing with medical emergencies. I hope the hospital sends Dutch home today. Hospital stays are very hard on their parents, of course, but they’re also hard on Barbara and Frances. It’s fortunate that there are two of them to share the hospital visits and running around on errands for their parents.
13:41 – Barbara called to say they’ve admitted her dad to the hospital and he’ll be there several days. I guess their mom is going to stay with Barbara’s sister. It doesn’t sound like Dutch is in any real danger, but they have to get him dried out before they can send him home. He has a lot of fluids accumulated in his tissues, particularly his legs. The real worry, of course, is that the edema also occurs around the heart, causing congestive heart failure.
Here’s something weird. I just shipped a kit to California, which is in USPS zone 8, the most expensive zone. The kit, as all of them are, was in a USPS Priority Mail Regional Rate Box B. It cost $14.62 to ship. The weird part is that I could have used a USPS Priority Mail Large Flat-Rate Box–which is larger than the RR Box B and also has a weight limit of 75 pounds versus 20 pounds for the RR box–and it would have cost $14.61, a penny less. Very strange.
16:19 – The reason we assembled only 18 chemistry kits last weekend is that we ran out of one component, the 10 mL oral syringe. I’d been ordering those in bags of 100, and was just about to reorder two bags when I realized that was foolish. So I ordered a case of 500 instead. It’ll be a while before I need to reorder those. Our stock of chemistry kits is already dwindling fast, so we need to get more assembled in the next week or two. Other than the syringes, we have everything needed to assemble another dozen in a few minutes, but that’s not going to keep us for long. Once I get this forensics book put to bed, I’m going to order components for another 90 or 120 (we print labels in sheets of 30) chemistry kits and the same number of biology kits and get to work on making up and bottling the chemicals for them. While I’m at it, I’ll order components for 60 or 90 forensic science kits. Or maybe more.
Thought I’d mention that there is a comment editing plugin available for the current version of WordPress. If Bob were to install Ajax Edit Comments, then we could edit our comments for a limited time.
However, I ran into one issue with the plugin when I tried it. Every page has about six lines of gibberish above the header. The issue is known, and apparently related to certain themes doing not exactly correct things. The only issue is that I’m using the latest version of the default theme. I hope to have time to sort this out sometime next month, and if I do, I’ll pass it along.
Bob, sorry to hear about all the health problems. I convinced my M-I-L to move back to Vancouver to be closer to her real kids, rather than living here with me. I certainly don’t miss the 3AM “my heart’s racing again, better call the ambulance” phone calls.
Well, these things happen. Barbara’s dad was born in 1922, and her mom in 1928. What I’m sure Barbara really dreads is losing one of them, not least because of the effect it will have on the other. Barbara and Frances have tried to convince them to move to a retirement home, but they’re adamant that they’re staying where they are. If Barbara’s dad dies, I don’t see any alternative to moving her mom in with us. She doesn’t drive, and although Barbara and Frances would gladly run errands for her that would still leave her pretty isolated. If Barbara’s mom dies first, her dad would be better able to cope in terms of still being able to drive and so on, but that’d actually be even more of a problem. He can’t live on his own, if only because he’s likely to fall, and he’s too stubborn and independent to agree to move in with us.
We’ve always known the day was coming, but it’s getting uncomfortably close.
My father told my mum to stay in the family home (built in 1952, when they’d been married four years) no longer that six months if he should per-decease her. That happened in August 1997. Mum, of course, didn’t want to leave and stayed ’till April 2007, when she had a fall in the laundry, broke something, and lay there for seven hours ’till my brother got home.
My sister scouted a good retirement village for her and she quickly moved in and loved it. She’s 88 now and I don’t think she’d ever want to go back to living alone. At that age it’s just not feasible for most people.
The only discordant note was when one of my mum’s neighbors said to my brother in a sneering voice: “You’ve put her in a home, have you?” I’m glad I wasn’t there, or I might have put him in hospital, and the cops would have got interested in me, which I don’t want. Some people may say the same about you and Barbara, but I think it would be best for her parents.
It’s not easy. After my dad died in 1990, my mom lived on her own for a year or so, but we weren’t comfortable with that. We converted our finished basement into an apartment for her, complete with kitchen and handicapped-accessible bathroom. After a few years, we ended up moving her upstairs to a spare bedroom, where she pretty much lived in her powered reclining chair. Eventually, she broke her hip and fell (which was the actual order it happened in). She was in the hospital for a month, and I knew there was simply no way I could take care of her myself at home. So we moved her to a nursing home, which she absolutely, positively hated. We did what we could. We choose a good nursing home only a couple miles from our house. Barbara and I visited her at least once a day, each. Usually Barbara in the morning on her way to work and me in the afternoons and sometimes evenings. We’d frequently take her food from McDonalds, which she considered a treat. And despite everything, she just wanted to be back at home with us. I’d have done it if I could, but I simply couldn’t do it.
It wasn’t an emotional or stress issue on my part. It was simply impossible physically, even if we’d bought a hospital bed. She needed more help than I was capable of providing. But it really sucked for her, and I hated it too.
One of the worst things was the fact that it’s no longer politically correct to separate Alzheimer’s patients from the general population in nursing homes. So my mom always had Alzheimer’s patients near-by, some of whom were quite loud. The mild cases generally weren’t a problem, but the profound cases were often violent, stole things, and screamed or cried for hours.
And my mom grew quite attached to many of the staff. Shortly before my mom had her final illness, one of the young women on the staff died of a genetic disease. She was a real sweetheart, only 23 years old, and left an orphaned baby. She was working one day, off in the hospital the next, and two days after that they told us she’d died. That hit my mom really hard, and I’m convinced it was at least in part responsible for her death.
None of this is ever easy.
Well, as the bumper sticker says: “Be good to your kids. They pick your nursing home.”
My mom is 82 and living on her own in a retirement condo. She uses a walker to get around and my fear is that she will fall and lie there for days, as she can’t get up on her own due to two artificial knees. She has a cell phone that we provide, but won’t carry it. I get worried if I call her and she doesn’t answer.
Her mom lived to be 99.75 and lived on her own until she was 96. I expect my mom to do the same – she’ll give up if she has to go to a home.
It must be something in the water.
I’m off Thursday to Wisconsin to bring my Mom back to live with us (she’s 87). She’s lived by herself for 40 years after my Dad died (only 52, I’m 57). She broke her hip in March and after therapy, thought she could just keep living alone. The town’s population is 7,500 with one nursing home. She refuses to move there “that’s where old people go to die”. After two falls in the house (she’s got one of those life alert pagers) she finally conceded to move to Vegas with my family. It’s going to be quite a transition. Just getting her residency and an ID so if a nursing home is eventually needed, I can tap into Nevada Medicaid.
Check with your local senior services organization. There are often services run by a hospital or local government that provide discounted or free emergency pendants. They hang on a lanyard around the elderly person’s neck and have a push button. Pushing the button causes a console to sieze the telephone line (some also work with cell phones) and dial 911 to deliver a canned message. Some units can be programmed to call other phone numbers in sequence until the person called presses a button to acknowledge that they’ve received the call.
A lot of elderly people who refuse to carry around a cell phone or cordless phone are willing to wear an emergency pendant.
To make matters worse, you can’t put the profound cases in restraints or sedate them.
It wasn’t an emotional or stress issue on my part. It was simply impossible physically, even if we’d bought a hospital bed.
You have to seperate the emotional from the logical. My aunt wrote one of the nastiest letters I have ever read after I put her in assisted living. Oh well. It was in her best interest and had to be done. To do otherwise would have been irresponsible on my part. Having her live with us, especially with dimentia, would have been a major safety issue. She could have used the stove or oven and left them on or any other numerous issues. The people in those facilities have the training and the facilities to handle patients in all manner of physical and mental condition.
To make matters worse, you can’t put the profound cases in restraints or sedate them.
You cannot do that in assisted living facilities. You can lock doors to keep them from leaving the facility. Of course there has to be staff in the area at all times in case of emergency egress.
Nursing homes can restrain patients if they are a danger to themselves or others. They restrained my aunt on several occassions. The state does allow it especially for medicaid patients.
You can also sedate such people. My aunt was on a couple of medications that calmed her down. The nursing home had to have my permission. If I refused they would send my aunt to another facility, sanctioned by the state, that could drug her and restrain her without my consent. Once the person has been deemed to be a danger to themselves, and especially to others, drugs and restraints are allowed.
Medical ethicists could make a pretty sound case for euthanizing patients with profound Alzheimer’s. Their minds are gone, and not coming back. And what, other than our minds, makes us human?
Of course, then someone has to make the decision. Patients exist somewhere on a continuum, from mild cases of forgetfulness to profound cases where their minds are entirely gone. As far as I know, once the slide begins it never reverses. The rate of degeneration varies, and there may be periods when the patient appears to get no worse, but I’ve never heard of the course of that disease being reversed.
I’ve always thought it was outrageous that we humanely put down animals that are suffering and have no prospect of recovery, but our laws passed on religious grounds refuse to allow humans the same kindness. Yet another thing that religion has to answer for.
That’s just not enough. “Annoyance to others” should be sufficient grounds. Can you imagine listening to someone screaming non-stop for hours on end? Or coming into your room while you’re asleep and stealing your stuff?
Medical ethicists could make a pretty sound case for euthanizing patients with profound Alzheimer’s.
Having watched my aunt I would also make a case for life termination. The last year of her life she slept 22 hours a day. They woke her up to shove pulverised food in one end and scrape yesterdays off the other end. The consistency for the most part did not change as it passed through her system. All this at a cost of $130.00 a day to taxpayers while she paid $50.00 a day. There was no benefit to keeping her alive. Living is markedly different than a simple existance.
“Annoyance to others” should be sufficient grounds.
Actually I think they can sedate someone who is constantly screaming and disrupting others. At least in a nursing home I believe they can. The level of care is higher and therefore what the nursing home can do with medications is broader than what you can do in assisted living.
Or coming into your room while you’re asleep and stealing your stuff?
That happened all the time at the assisted living facility. A couple of residents thought they were constantly at Walmart and would shop in other peoples rooms for clothes. Did not matter much as the clothes were marked, laundered together, and eventually put back in the residents room where the shoppers would strike again.
The thing that irritated me most was when we had to start purchasing diapers for my aunt. We would purchase enough for a month and 10 days later she was out. I complained loudly to the facility that I was not footing the bill for everyone else’s diapers. The stealing would stop for a month then it was back. I finally made my point when I sent in the monthly check and deducted the cost of the diapers that were stolen. After that the diaper stealing stopped.
A lot of residents in the assisted living were just dumped by the family. Never had visitors. Family just sent a monthly check. The dumping in the nursing home was even more pronounced. Many residents that were on Medicaid were completely abandoned by their families, after the families got their money of course.
I don’t relish the thought of going into a nursing home but I suspect that will be my ultimate journey. Dimentia runs in the family. I told my wife when I go into the nursing home to divorce me immediately. At least she will have some money without the state taking all of it and leaving her to live below the poverty level.
My mother moved to a retirement village in town after my father’s death. They are small one- or two-bedroom apartments (townhouses, actually – all on ground level with disabled access). She has friends and neighbours living around her whom she’s known for decades, and she’s very happy there. She’s still active and independent within her limits, but has a town-subsidised cleaning lady come in once a fortnight to handle any heavy work that’s too heavy for her. Her family visit whenever they go shopping or work in town, and she probably sees more of them than she lived at home.
She has one of those VitalCall pendants, and they have a dedicated phone line right beside her normal phone. If she sets off the alarm, they call on the dedicated line, and if she doesn’t answer they’ll direct an ambulance to her. On a regular schedule, they’ll do a test call to her, and have her use the alarm as a test of the whole system.
There’s another level beyond that if people become further incapacitated – a medical multi-purpose service which incorporates a nursing home and a hospital. My father spent over a year there once he’d got beyond the ability to look after him at home.
There are a number of retirement villages and nursing homes that run familiarisation services. Often they put it over as public-service days, and run bingo or outings for both residents and the elderly general public.
Not only allowed but encouraged. But how did the conversation change from nursing homes to my wife’s and my private time?
RBT wrote:
“I’ve always thought it was outrageous that we humanely put down animals that are suffering and have no prospect of recovery, but our laws passed on religious grounds refuse to allow humans the same kindness. Yet another thing that religion has to answer for.”
We also put them down when they outlive their usefulness, such as working BCs on farms that *might* start attacking sheep when they start getting on in years.
I think there’s a certain degree of revulsion at euthanising humans, partly because the Nazis wanted to euthanase sick people who were a burden to the community, see http://en.wikipedia.org/wiki/Action_T4
I don’t object in principle to euthanasia where the person on the receiving end is competent to consent, but once we start getting rid of people because they’re bed ridden, or have some sort of mental illness, we’re on a very slippery slope. There are some obvious cases where it would seem okay, but lots of borderline cases where good people of any or no religion might not agree. The devil, as they say, is in the detail.
I largely agree, Miles_Teg. It’s not moral revulsion, exactly, though I’m not comfortable with giving some the axe, no matter how humane, simply because I don’t think he’s a benefit to society any longer. And there’s the core of my objection: who decides? Politicians, bureaucrats, and faceless drones at large corporations in the medical industry? Yah, good choice.
Well, Robert has said in the past that people who can’t pay their own way, or be paid for by their friends and relatives, have no claim on the public tit. If that means they die, they die.
I’m not completely opposed to this idea, but it repels me nonetheless. If a person is mentally and physically reasonably healthy but couldn’t afford treatment for, say, diabetes, or a hip replacement, I wouldn’t like to be the one to tell them they were going to be euthanased if they or someone else couldn’t come up with the dough. I know this happens all the time in the third world, but I’m not comfortable with it, nor would I like to be the one that pushes the button on someone. I wouldn’t have liked to be the one who sent Bundy or OBL on their way, but I approved of it being done by others. I guess I’m just a bit squeamish.
My siblings and I have been through a good chunk of this with grandparents, a great-aunt, an uncle, our dad, and now our mom. The three most common causes of death on both sides of our family are cancer, some form of senility, dementia or Alzheimer’s, and gunshot. My wife’s family all live into their 80s and 90s but MIL is not doing very well right now at 84.
We’ll do the best we can, as everyone here has obviously done, but in this system and with these political circumstances, it ain’t easy. As for myself, I do not intend to end up in a nursing home if I can at all help it, and will mos def go out in a blaze of glory somehow, and I am deadly serious about that.
Well, Robert has said in the past that people who can’t pay their own way, or be paid for by their friends and relatives, have no claim on the public tit. If that means they die, they die.
My aunt paid for her assisted living for six years and went through $300K+ during those six years. No one can plan beyond for their care that long. Even Medicaid has a five year look back for funds. To have enough money for six years worth of care is better than most of the population. My aunt paid into the system all her working life and continued to pay even while she was in assisted living and the nursing home. To collect on those benefits was not sucking off the public tit.
I really don’t like people that have made welfare a career choice then demanding the best care that money can buy when they need some surgery. For those that have not contributed to the system you get what you get, not what you demand.
mos def go out in a blaze of glory somehow, and I am deadly serious about that.
Problem is when your brain goes soft will you really remember that statement and more importantly, remember how to go out in a blaze of glory.
I have given thought to pretending to be a bug and stand on the tracks of a high speed train. But that would not be fair to the train operator and the cleanup crew. However, when my brain gets that soft will I even remember how to find railroad tracks.
That could be excruciating around here. Trains coming through go so slow you would definitely know what hit you, and you would be wishing that you had chosen a quicker and less painful method.
My brain can’t possibly go any damn softer than it is right now. I soaked it in all kinds of stuff for over forty years. I was once smarter than Einstein and Oppenheimer and Sir Isaac but that all went away. And I majored in English, can ya imagine *that*?
No, not gonna do the train thang. That just ain’t right. I will know when the time comes.
Are you sure you will know? Or just know you were supposed to do something, but forget what it is.