A bookmark from the past

My dad loved books, but he hated bookmarks.

Even though the library included free ones in every book, Dad insisted upon “dog earing” pages. My mother would nag him about it, saying the books were the library’s property and they probably didn’t appreciate him returning books with creased page corners. But Dad continued to do it, and to be fair, I never heard him getting chewed out at the library about it. Certainly he wasn’t the only person who dog eared books.

bookmark

As I was going through some books and sorting them for donations, I came across one of those library bookmarks. The bookmarks served dual purposes: marking your place in the book and reminding you when the book was due.

The bookmarks, with the sketch of the Downey City Library at the bottom, are so ingrained in my memory, having checked out hundreds of books from the library during my childhood.

The due date on this one was Aug. 29, 1981. I would have just turned 6 the month before. It would’ve almost been time for school to start, as we started just after Labor Day. I would’ve been entering first grade.

What’s even more interesting is that I found the bookmark in an old, worn copy of East and West, a collection of short stories by Somerset Maugham. That book is from the New Orleans Public Library and had a due date of Sept. 2, 1959. (Dad lived for a brief period in the Big Easy.) The next time I visit I may return the book just to see the reaction of the librarian!

Sorting through Dad’s book collection was the ideal task to mark Father’s Day.

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Heat waves a hot topic when caring for older loved ones

fans

Photo by komgrit/Morguefile

Whether or not you believe in global warming, every year there are deadly heat waves across the U.S. Many of those who succumb to the heat are seniors. Some cities have annual initiatives to make sure low-income seniors have fans in their homes and some cities offer cooling centers, air-conditioned venues that are open during the day free of charge for people who want to escape the heat.

No one should die from the heat because they can’t afford a fan, air conditioning, or are afraid of running up their electricity bills on a fixed budget. But a HealthCentral article I read by Carol Bursack pointed out another reason that is not often discussed.

Bursack told a story about her mother-in-law, who turned off the air conditioning she had in her condo every day after Bursack would visit and turn it on to a low setting just to keep the air circulating. This was in the middle of a heat wave, and Bursack would discover every window shut, the A/C turned off and it would be sweltering inside. When she discovered her mother-in-law suffering serious disorientation symptoms from the heat, she knew her days of independent living were coming to an end.

Bursack’s story reminded me of my mother. In her case, it was the heat during winter. My parents retired to a mountain town that usually receives a decent amount of snow and the temperatures often drop into the 20s and 30s overnight in the winter. Mom would insist on turning off the heat every night before going to bed, then getting up in the middle of the night, shivering, to turn it back on for a few minutes, then turning it off again until the morning. This was totally nuts to me. Mom thought she was saving energy (and perhaps Bursack’s mother thought the same thing) but keeping a home at a steady, moderate temperature is most efficient. So yes, by all means, turn down the heat when you will be bundled under the covers overnight, but don’t turn it off!

Mom also insisted, even on the most frigid of nights, in leaving the windows in the living room and bedrooms open a crack, because she thought she’d suffocate or die of carbon monoxide poisoning if she closed everything. Of course, this caused the furnace to have to work more and threw the whole energy-efficient argument out the window.

As a caregiver, I had to pick my battles. I never convinced Mom to close the windows, but by using a bit of reverse psychology, one night, she mentioned that it might be nice to just keep the heat on through the night, and I told her that was an excellent idea. From then on, she didn’t turn off the heat overnight.

The point here is that even if your elder loved one has access to fans or air conditioning, check to make sure they are actually using them. Whether they are just set in their ways or are beginning to develop dementia, we cannot take the use of such things for granted.

[Addendum: Just after I wrote this post, I went to stay at what was my parents’ condo for 2 weeks. The condo doesn’t have air conditioning, because it’s located in a mountain town where the average temperature this time of year is around 80. Not this year … it’s been in the 90s and hit 93 yesterday. I’m dealing with a summer cold on top of the heat, with only fans to offer relief, and it’s pretty miserable. I’ll be fine, but I’m 42. In 20-30 years, this situation might be more of a health risk.]

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Is dying at home best for everyone?

bed

Photo by Lillian Nelson/Freeimages

In recent years, a growing movement has embraced the concept of dying at home, versus a hospital or nursing home. In general, I support the idea, after my father had a difficult death in a skilled nursing facility while I was 1,300 miles away. But having experienced the challenges of being a primary caregiver for my mother, who died at home, I also understand just how traumatic such a death can be for family members. The latter is a viewpoint that is not often discussed.

Ann Brenoff, who covers aging topics for Huffington Post, interviewed me last week to discuss the potential consequences for the family caregiver when a loved one chooses to die at home. The article, When Loved Ones Die At Home, Family Caregivers Pay The Price, offers an important perspective on the subject. The article references my 2015 essay, Why dying at home is not all it’s cracked up to be. Brenoff discusses how financial concerns are behind the government’s desire for people to die at home. While it’s cheaper for people to die at home, caregivers pay the ultimate price.

In many cases, family caregivers shoulder the burden of care duties. Some have to quit their jobs or reduce work hours, impacting their financial status. Chronic stress can affect their own health. The emotional toll can be devastating.

To achieve a good death at home standard, we must offer greater support to family caregivers.

There are pros and cons to everything, including dying at home. The more we learn about each other’s caregiving experiences, the better informed we will be when we face a family health crisis or end-of-life care situation.

 

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Don’t miss “Care,” a powerful documentary about home care

care poster custom

Courtesy of Care.

A frustrated caregiver recently posted on social media: “We need more than awareness, we need action.”

I totally agree, and while raising awareness of conditions like Alzheimer’s and the sacrifices that family caregivers make is important to push these issues into the mainstream, at some point, messages of support are not enough. Action, from community involvement all the way to federal funding is essential to truly make a difference.

That’s why I’m excited about a new documentary, Care, that examines the hard, often thankless and definitely underpaid work that home-based caregivers perform and offers a call to action on how we can better support these caregivers and families. Caring Across Generations is hosting screenings across the country.  In addition to in-person screenings, the documentary will become available via streaming options later this year.

The documentary profiles caregivers from different ethnic backgrounds and from different regions of the U.S., spotlighting challenges but also providing a testament as to why some people feel called to provide care to those in need. The documentary doesn’t shy away from the harsh realities of caregiving, showing in detail the difficult physical and emotional work involved. Family members discuss the difficulties of caring for someone at home and those receiving care talk about the loss of independence that often accompanies disease and aging.

For anyone in the metro Atlanta area, I will be participating in a Care screening and panel discussion at Amy’s Place in Roswell on June 7 starting at 6:30 p.m. As I’ve mentioned before, Amy’s Place is a memory care cafe that hosts wonderful community events for those with dementia and their caregivers.

MORE INFO: CARE poster_Roswell Screening

Caring Across Generations is also looking for people just like you, current and former caregivers, who are willing to share their stories. If interested, you can reach out to me via email at joyjohnston.writer@gmail.com.

Check out the trailer below:

 

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Marking 2 years since Mom died

Mom school

It’s hard to believe it has been two years since my mother died. The world seems like such a different place, even though two years is but a speck over the course of history.

While merely coincidence, Mom’s death seemed to send the universe into a chaotic spiral. I feel like I’m living in perpetual survival mode, just like I did when I was a caregiver.  Mom’s eternal optimism would have been sorely tested over the last year or so.

The grief is less oppressive and not as constant at this point, but it continues to lurk in the dark alleys of my mind, popping out like a villain in a movie from time to time. The “should’ve, would’ve, could’ve” mantra hasn’t been silenced quite yet, but I’ve been able to turn down the volume on the second-guessing for the most part.

Just like in this photo of Mom, I will spend the day writing. She always loved this photo, which appeared in the yearbook. Mom took her education seriously, which wasn’t always a given for farm families when crops could trump classes. I inherited a similar love of learning from both of my parents, which is a precious gift that I use every day.

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Thinking of Mom

joy-mom-lamirada

Mom and I at the library, before taking a stroll through the park.

Happy Mother’s Day to all of the wonderful, patient and loving mothers out there, both living and departed.

Even though it is easy to roll one’s eyes at this “Hallmark holiday,” it is a good opportunity to remember those who have cared for you and those you love. Mothering comes in many forms, from traditional to caregiving to caring for pets. A simple thank you, a sympathetic ear, a helping hand, all of these go a long way to honoring the mother(-s) in your lives.

Mother’s Day is extra difficult for me because once I get past today, the anniversary of my mom’s death looms on May 21. It’s a double gut-punch of a month now.

I’ll remember Mom today by doing some birdwatching in the backyard (our birdfeeder has become quite the hotspot) and taking a walk to appreciate other wonders of nature that my mother loved. One of Mom’s best qualities was always “stopping to smell the roses.” She appreciated every flower, every bird, all of nature’s offerings. It’s a good reminder for me to take time to enjoy nature as well and seek a healthier balance between work and other demands of modern life.

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‘Senior ER’ designed to reduce stress for dementia patients

emergency room

Photo by Kenn W. Kiser

One of the most frightening calls I received when Dad was in memory care was that he had been taken to the emergency room. Unfortunately, I received several similar calls over the course of the year Dad was in residential care.

The emergency room visits were usually prompted by falls. Even if Dad seemed OK, regulations required the memory care staff to send Dad to the hospital to be checked out. The worst part was that no staff member accompanied Dad. I can’t imagine the confusion Dad must have experienced, on top of his dementia, with the chaos that accompanies an emergency room visit.

Even for a person without dementia, the emergency room is a daunting experience. I’ve only been to the ER  once as a patient, in high school, and it was an exhausting, fruitless experience. I’ve been to the ER several times with others having medical issues, and it is always a nightmarish experience. Why do medical emergencies seem to always happen in the middle of the night? Really though, it doesn’t matter if it is high noon, emergency rooms and hospitals in general seem to be caught in a time warp where it always feels like it’s 3 a.m.

There is so much hurry up and wait. People rushing in and out. Poking, prodding, medications being shoved in your face, or pumped into a vein. So many questions that have to be answered rapidly, and repeatedly. It’s enough to rattle a mentally sound person.

That’s why I am optimistic that some hospitals are reinventing the ER experience for those with dementia. Lutheran Medical Center in Denver was recently profiled for its Senior ER program. They’ve taken half of their emergency room space and retrofitted it to make it a more soothing, less chaotic experience. Everything from mattress thickness to lighting and noise level has been moderated to prevent the onset of delirium, which can hasten death.

The Senior ER has been such a success that people of all ages are asking to be admitted to that wing.

 

 

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