LEARNING AND MEMORY

 LEARNING AND MEMORY

     Most persons experience a modest increase in memory problems as they get older, particularly with regard to the ability to remember relatively recent experiences.  Decrements are found both in the ability to accumulate new information and in the ability to retrieve existing information from memory storage, although there is little decline in the ability to store new information once it is learned.

     The process of learning new information and encoding it for storage requires more time as individuals get older, because of the reduced efficiency of neural transmission and because of sensory deficits that limit one’s ability to quickly and accurately perceive information to be learned (as discussed above).  In fast-moving day-to-day experiences, this may prevent individual experiences (e.g., the name of someone to whom one is introduced) from receiving the attention needed for complete encoding into secondary memory.  In addition, the extensive life experience of older persons makes it more likely that new information will not adequately be distinguishable from previous learning (e.g., the names of other similar people one has met over the years), making it difficult to establish unique cues and linkages for new experiences.

     Older persons also experience decrements in their ability to retrieve information once it is stored.  In part, this is because of the difficulty identifying just the right piece of information from the vast store of information they have accumulated over a lifetime of experiences.  This can be particularly difficult when the new information resembles previously learned information ( d.g.,when one is trying to recall a phone number from the thousands of phone numbers that have been learned over a lifetime).  Consequently, older persons tend to do considerably worse than younger persons on tests of free recall, where they are asked to retrieve learned information but given only minimal cues.  However, few decrements are found when older adults are given sufficient orienting parameters to limit the scope of the search, or are asked to select the correct answer from among a small number of options (e.g., on a multiple choice test).

     Older persons seem to have a better memory for certain events that occurred in the distant past than for recent experiences.  To a larger extent, this is because the distant events that are remembered are those which either have special personal significance (e.g., the birth of a child, the end of ‘world War II) or are so unique that they are not affected by subsequent experiences, (  e.g., childhood occurrences).  Such experiences are apt to have been rehearsed mentally numerous times throughout one’s life, increasing their familiarity and making them easier to recall than are mundane aspects of one’s day-to-day  life.

     Finally, it is important to note that cognitive processes such as learning, memory, and intellectual functioning are extremely responsive to a person’s physical and psychological state.  Physical illnesses and medications can affect neuronal function and also reduce the energy available for cognitive processes.  Depression and other emotional conditions that involve impaired self-esteem and reduced confidence in one’s own abilities can significantly impair one’s motivation for  learning and remembering new information.  Among depressed older adults, for example, memory complaints can increase and memory performance can decline even in persons who do not have any actual impairment in cognitive functioning or learning ability.  Moreover, older adults who have adopted the popular stereotype that forgetfulness is inevitable in old age may experience increased anxiety and reduced self-confidence when confronted with normal memory tasks resulting in memory problems that would not otherwise have had.

     

                              

     

LEARNING AND MEMORY

 DECISION MAKING BY ELDERS

     

     When making decisions, older persons have been found to sacrifice speed for accuracy, rejecting quick, simplistic solutions to problems and preferring to work slowly, examining issues from a variety of perspectives before selecting a response.  Finally, many of the health problems which are more common in later life (e.g. cardiovascular problems) can significantly affect cognitive functioning as well as test-taking ability.

     Not all cognitive changes later in life are negative, however.  Older persons typically exhibit greater experience-based knowledge, increased accuracy, better judgment, and generally improved ability to handle familiar tasks than younger persons.  Such applied knowledge, or wisdom, may, in fact, be considerably more important to one’s ability to accomplish most tasks of day-to-day life than are the abstract abilities tapped by intelligence tests.

     Even when physical or cognitive competencies are affected by the aging process, older adults often are able to develop strategies for compensating partially or totally.  For example, older typists have been found to type as quickly and accurately as younger typists even though they are unable to move their fingers as fast, because they have developed a better ability to anticipate upcoming words and locate the proper keys on the typewriter.  In general, older adults can perform about as well as younger persons on tasks which provide sufficient opportunity to compensate for slower physical and cognitive functioning.

Chapter 9 continued

     We moved, and it was not much fun.  It just about killed Wayne to work so hard, even though our son-in-law and his crew did most of the heavy moving.  It was still a lot of work emptying and cleaning the two houses.

     Trying to fit two houses into one was a chore in itself, but we managed, although it meant getting rid of all my antiques, and packing up my art supplies and storing them for another time, since our new house didn’t have any place for me to do my artwork.  It was placed on hold and again I adjusted to the situation at hand.  Actually, moving may be a lot of work, but it is wonderful to clean out all the old items that aren’t really needed.  My cupboards had never been so clean.  

     Our portion of the house was split-level and consisted of two bedrooms and an office that was reached by climbing five stairs.  The living room and kitchen were on the main level and Mother was downstairs in the family room, now transformed into her living room.  With the bedroom, laundry room, and bath downstairs, she was perfectly comfortable.  Of course, she had to climb nine stairs to reach our portion of the house, which was almost more than her heart could take.  She loved living with us, so for a while she climbed the stairs.  However, that didn’t last long; her heart bothered her too much.

     We learned that stairs were not appropriate for a heart patient or a person on dialysis.  I knew that, sooner or later, Wayne would have problems with the stairs, and Mother already did, I was right.  Wayne began to have problems after living in the house for three years.  His legs grew weak and he had trouble mounting the stairs to the bathroom and bedrooms.  This was only the beginning of his problems.

     I learned enough from the three family members we had cared for to understand my mom when she moved in with us.  We were honest with each other.  If we were upset, we talked it out.  I tried to take her out of the house at least three times a week.  I encouraged her to invite friends over and to attend church and all its functions.  This kept her happy and in touch with the outside world.  As she became unable to get around much due to angina, I took her places in the wheelchair.  She hated the wheelchair, but he loved to shop and spend money.  I didn’t want to make the same mistakes with her that I had made with my mother-in-law.  Mom was a big help to me in preparing meals.  Even though she couldn’t mount the stairs, I brought her vegetables to clean, salad to make and beans to snap.  She felt a part of the family, even though she wasn’t upstairs with us.  When Wayne was gone, we went out to lunch together or shopping .  And I always took her too the beauty parlor on Saturday to have her hair done, sometimes even a manicure.  We had fun together and it kept her active.  She kept a positive attitude and so did I.

     One of the problems of grown children who care for their parents is underestimating the intelligence of people at an advanced age.  The notion that older people lose mental abilities with the deterioration of the body is simply not true.

     I have to admit I was somewhat condescending at first to my mom and my mother-in-law, the two women I cared for, but I quickly learned to correct that attitude.  Of immense help to me was the Curriculum Module on the Aging Process, a study made possible by funding from the University of California.

     I have excerpted sections of the report prepared by Andrew E. Scharlach and Barrie Robinson and reproduced them here under heading that are mine.  I think you, the reader, will find that your conceptions of aging change as you take in the facts presented.

     

CHAPTER 9

CHAPTER 9

MOM MOVES IN

     During the time my Dad was ill, Wayne’s kidney function dropped to only five percent.  His condition made it necessary for him to begin dialysis.  According to his doctor he had a choice to make; to be on machine dialysis, called hemodialysis, or to use Continuous Ambulatory Peritoneal Dialysis (CAPD).  The CAPD procedure can be done at home every four to six hours, whereas the hemodialysis is done three times a week at a clinic and takes four hours for the process, CAPD allows the patient to lead a normal life and not to be tied down, so Wayne chose that one.  Since he loved to play golf and often attended golf tournaments with is friends, this was a perfect dialysis for him.

     We both took lessons for two weeks learning the procedure, then they surgically implanted a tube in his peritoneal cavity to accept the solution that would cleanse his blood and organs of the impurities and remove the fluid build up from his failing kidneys.

     He also had the option of putting his name on the waiting list of people who needed a donor kidney, but his age and physical condition were against him, or so the doctor said.  He was’t ready for that decision since he believed he could live a long time on the dialysis.  His doctor assure us that he had patients who had successfully been on CAPD for twenty years.  Since Wayne was sixty-five, he decided he could live out his life with CAPD.  Looking back I can see that we were rather naive to think he wouldn’t have any problems along the way.

     Not long after Wayne began dialysis and my father passed away, my mother became afraid to live alone.  This is quite a common reaction for a widow and I thought that eventually she would get used to the idea and settle into a normal routine.  How wrong I was.  She wanted me to sleep over at her house for the first month that she was alone.  I urged her instead to come to our house, but she refused, even though we lived right next door.  I think I agreed to stay with her hoping she wouldn’t need me too long.  It became a problem for me, because I had to get up early in the morning, go home, shower, dress, feed Wayne and get to work by 7:30 a.m.  I don’t know why I gave in to her wishes, because then it was hard to stop..  When I began tapering off on the nights I stayed at her house, I felt guilty when she started crying.  She finally suggested that we add on another room for her, but she didn’t think that would be enough.  She wanted at least three rooms, and that would have cost an arm and leg.  I don’t know why I felt so obligated; she had a nice house and so did I...why couldn’t she leave it at that?  i tried to convince her that she should take in another woman to share her home.  But she had her mind set to live with us.

     My mother and my husband got together and started to look for a new house, one that had plenty of room for all of us.  I finally gave up resisting the move and started looking for a house with five bedrooms all on one floor, with no stairs, because of Mother’s heart condition.

     The realtor looked for this type of house, but there was nothing available.  I was happy about that.  I thought if I could hold them off for a while, maybe Mother would forget about the whole thing.

     She didn’t give up..  We looked and looked until Wayne finally found a house.  It was every that we didn’t want.  Everywhere stairs, stairs and more stairs.  The one redeeming factor about this house was that mother would have a separate apartment downstairs.  It had a large family room with a wet bar that could be transformed into a kitchenette with a refrigerator, microwave and sink.  There was also a bedroom, a bathroom with a walk in shower, and laundry room on that floor.  Even though it was everything we said we didn’t want, Mother and Wayne loved  it.  We sold both our houses and bought it.  It was a nice house, just not what we started out to buy.  I knew that it would cause problems in the future, but I didn’t know how many.  I soon learned.

I BROKE MY CHRISTMAS TREE

     I BROKE MY CHRISTMAS TREE

     The time has come to shop for that perfect Christmas tree.  Some families take a weekend and go to the mountains to find their special tree, others go to a tree farm to cut one, but most people simply buy a tree in town.  Whether you buy it or cut it yourself the crop of trees this year is great.  I’ve spied pines and nobles that would take your breath away, expensive but great.

     Now, me, I opted for an artificial tree again this year.  I have used the same tree for about fifteen years now and I love it.  It’s always perfect and looks lovely with the flocking on all the branches.  However, this year I don’t have room for a tree as wide as the old one, so off I went to buy a new tree, a pre-lit tree this time.  All I should have to do is the fun part, decorating.  I do love to decorate.

     Well, I brought home a 6 1/2 foot tree, pre-lit of course, and started to put it together.

  Now, you would think that a moderately intelligent woman, such as myself, could assemble a tree with no problem, right?  It only had four parts, the stand, the bottom section, middle, and the top.  Okay that’s easy!

     I read the instructions twice, (I’m pretty dense,) and laid out the parts of the tree as they suggested.  The instruction sheet said to remove the extension cord strapped to the bottom section of the tree, which I did.  And then, I was to put the bottom portion in the stand and tighten it, which I also did..nice and tight.

     This is where I ran into trouble.  They must have attached the extension cord to the wrong section of the tree, because when I tried to add the next section I found it was bigger...Oh! Oh!  I put the wrong section in the stand.  Well, no problem, I thought I’d just remove it and place the bottom piece in the stand and start over.  That’s easy enough.  Wrong!

     I rectified my mistake, however, now the middle piece wouldn’t fit.  I figured the pipe must be out of round from putting it in the stand, (I didn’t realize I caused dimples in the metal when I forced it into the stand,)  so I took the hammer and tried to tap it down into the pipe.  It wouldn’t go, now what?  I was compounding the problem, for now the top of the pipe was bent over from hitting it with the hammer.  Smart, really smart!

     There I was sitting in the middle of the floor with pieces of my Christmas tree laying around me, laughing at my own stupidity.  How could I mess up such a simple job?

     
I thought to myself, “Well I can always buy another tree.”

     Now, my daughter bails me out of these little predicaments I get myself into, so I called Casey and through my laughter I said, “Casey, I broke my new Christmas tree.”

     Casey started laughing and promised to come over the next morning and look at it.

     “How did you manage this mother?” she laughingly asked.

     I said, “Believe me darling, it wasn’t easy.”

     We cut off the dimpled and bent parts of the pipe and finally got the tree together.  Although it was slightly shorter, I still enjoyed it.

     It’s funny how a simple job, like putting up a Christmas tree, could cause so much trouble.

     I still contend the instructions were flawed.  That’s my story and I’m sticking to it.

Chapter 7 continued

CHAPTER 7 CONTINUED

     Keep the lines of communications open with the whole family.  This is often hard to do when brothers and sisters ignore their duties to their parents, as the following story from Anne demonstrates.

     My husband is a lot of support most of the time.

     Right now, he’s getting a little tired of sleeping on the sofa bed in the living room so my mom can have our room.  For the first four months we slept on a futon mattress on the floor; the couch is actually a  step up.

     My brother and sisters are unfathomable to me.  My parents were always there for them and me.  How they could turn their backs when my mom needs them is a mystery.

     I believe the season they don’t call is because then they just don’t even think about it and they hope it will eventually a go away.

     The thing that most depresses my husband and me is that this cycle will never end for us.  We know that Mom will never be able to live on her own again.  She will be with us for the rest of our lives.  What worries us most is what will happen when we are no longer here for her.  We don’t want our daughter to feel that she will be responsible for her.

     But the bottom line with all of this is love.  When you love someone, as I do my mother, it’s not what you say that matters in the long run, it’s what you do.

                                                                                       

                                                                                            Anne

CHAPTER 8

MY WONDERFUL FATHER

     Daddy had been feeling ill for some time, but he refused to see a doctor.  He kept saying that he was just getting old and lazy.  Daddy was always that way.  He never wanted to cause anyone any trouble  He was getting on in age, so we didn’t think too much about it.  One night my mother called and said that Dad needed to go to the hospital.  I immediately thought that his heart had given out.  He had many heart attacks during hsi last years, but luckily he sprang back eah time.  When we first arrived at the hospital, no one knew what the problem was.  We admitted him and the staff began to run the ormal test, which showed that he had an aortic aneurysm.  They transferred him to St. Vincent’s hospital in Portland to perform surgery.  This was my first long visit to St. Vincent’s Hospital.

      After more tests, the surgeon talked with me.  He wondered why Dad’s liver was showing problems.  when I told him that I didn’t know, but that daddy was treated for colon cancer sixteen years earlier, he started looking deeper.  Ufortunately, when they opened him up he was riddled with cancer.  The prognosis was terminal.  He had only one to six months to live.  As it turned out, he didn’t even have a month.

     My father was a kind man.  even when he was ill, he didn’t want to bother anhyone with his pain.  he just waited until he could no longer tolerate it and then it was too late.

     We brought him home to care for him.  Of course, we could have placed his wishes.  Besides, we wanted him close to us during his last days.  We installed a hospital bed at my parent’s house and proceeded to take care of him ourselves.

     Hospice was a big help in his care.  As his condition worsened, nurses administered pain medication and we had a list of caregivers that could assist us at night.  Mom was getting worn out taking care of Dad day and night.  I helped her as much as I could.  Fortunately my parents lived right next door to us, so when Mom needed me, I could respond immediately.

     Naturally it is hard to watch someone you love die a little each.  We cried a little at first.  It was such a shock to know that our father was going to die in a short time.  But daddy said that everyone dies when it is their time.  “God will take me when he is ready for me,” he said.

     Every day he would sink a little deeper.  My father was determined that he would live until their sixty-fifth wedding anniversary and his birthday, which were both on the same day.  He didn’t want Mom to remember their anniversary as the day he died.  When September 20 came, he gave Mom a diamond ring that she had wanted.  Then he asked me if I would take care of Mom and I promised I would.  He lapsed into a coma, and never awoke.

     Our family came up from California, but he was already in the coma.  I think that he knew they were there, but he couldn’t respond.  He died on September 26, six days after his anniversary and his birthday, quietly, as he had lived.  With no fuss, no trouble to anyone, he just drifted into that eternal deep, content in the knowledge that I would take good care of his wife.

     That is all my dad ever wanted, to take good care of everyone.  He started young when he quit school in the tenth grade to earn money to help the family.  He sold papers on the street corner, he was so young people thought he was cute and bought his papers, and he always sold out.

     Dad love people and it showed.  he never had an enemy and he would give you anything he had, if you needed it.  He took care of his father and two brothers after his mother died.  In addition he raised four children of his own, while working two jobs and building a big house for everyone to live in.

     My journal entry for September 26, 1992

     Daddy is dead.  He went peacefully at 8:35 A,M.    I didn’t really think it would be so quick.  God was good to him, taking him without a long illness and a lot of pain.  I guess he has been going for the last year or so; we’ve all known it was coming but it speeded up when they tried to do surgery on him.  He might have lasted longer if they hadn’t opened him up.

     I wonder if his spirit was watching us cry for him as we stared at his lifeless body.  He was so still, with hands laying on his stomach.  You would have thought he was sleeping, if he hadn’t been so yellow.

     I really believe there is a crossing-over time, that the spirit is suspended on Earth for a time and can watch the transition of the family.  At least, I hope so!  Goodbye, Daddy.

     After Dad died our family sat around and talked about all the good times we had in our lives together.  We laughed at the dumb things we did, and reminisced about building our house in Michigan.  It was a time for reflection, a time to remember the good times...there were so many.

     When your loved one passes on, you still have memories, memories of better days when you were young and sometimes foolish.  These precious memories are locked in a special place in your heart, waiting to be brought out when you want to be close to him again.

                                           THOUGHT FOR THE DAY

                        The purpose of life is to serve and to show compassion

                        and the will to help others.  Only then have we ourselves

                                        become true human beings.

                     

                                                                                   Albert Schweitzer

CHAPTER 7

IT’S THE LITTLE THINGS THAT MAKE US HAPPY

     You may wrongly believe that taking in one person is inexpensive.  After all, how much can they eat?  You’ll soon learn that they will want special foods---their kind of food, not yours.  They want little things like Kleenex, special toilet tissue, a certain cereal, and many many items that you don’t have in your house.  Accommodating their wishes and making your home as much like their own life style as you can really makes your role a lot easier.  I found this out the hard way!

     When I brought my mother-in-law her lunch one Saturday, she said, “I don’t want this crap again.” (“crap” was one of her favorite words.)  I had warmed some roast from last night’s dinner for her, with potatoes and gravy, vegetables and bread, thinking she would like it.  But she let me know in no uncertain terms that she did not like eating the same meal two times in a row.  We were accustomed to leftovers the day after a roast beef dinner.  You know, hot roast beef sandwiches or cold sandwiches.  We liked leftovers.  She didn’t!

     Thinking I could make her happy by giving her something special, I asked her what she would like, if she could have anything she wanted.  That was a real mistake.  I thought she would request something easy, not a whole meal that was completely foreign to me.

     She answered, “You wouldn’t be able to fix it, even if I told you what I wanted.”

     I said, “Try me.”

     After a long silence while she thought about it, she said, “I’d like to have some friend chicken livers, black-eyed peas and some white hominy, both flavored with bacon grease and bits.”

     Boy, was I sorry I had asked.  This was definitely not the kind of food I keep in my cupboard.  But, I had asked so I thought I would make a stab at fixing it.  It was Saturday; my husband was off playing golf with his friends and I had all day to experiment.  If it made her happy, it would be worth the effort.  I drove to the store and found the chicken livers easily, but the black-eyed peas were a different story.  I went to two different stores before I found them and the hominy.  I hurried home to start my Southern fried dinner for Mother.  Actually I enjoyed the prospect of doing something that might make her happy.  I hoped.

     Mother gave me instructions for cooking this culinary masterpiece, so I breaded the chicken livers and placed them in the hot grease to brown, while I simmered black-eyed peas and the hominy in bacon grease, with a little of the liquid from the can.  I thought it smelled terrible, except for the chicken livers and onions.  When I finished cooking, I laid the meal on a pretty tray, with a flower in a small vase.  There was everything she wanted along with a hot cup of coffee, which she loved.  It really looked pretty darn good.

     I took it to mother and she gazed in amazement at the repast.

     “I didn’t think you would really make it for me,” she said.  She lit up like a Christmas tree and seemed happy for a change.  She took three bites of each item and quit.  that is all she ate of this special meal I worked so hard on, but at least she was happy for a change.  She drifted off to sleep, content.  It was a small thing, but it was important to her.  I’m glad I tried.

     I didn’t bother freezing the leftovers, thinking that she wouldn’t eat them again anyway, since she didn’t like to eat things twice in a row.  but it wasn’t long before she asked for a repeat of this meal.  Since I had thrown it out, I had to start over again.   Oh well, it was easier the second time.  At least I knew where to find the items and I froze all the leftovers, this time

     When I told my husband of the incident, he laughed.  He said that was the kind of food her family had always eaten.  I learned something that day.  It is the little things that make us happy.  I wouldn’t have imagined a heavy Southern meal was to her liking, but I started asking her each Saturday what she would like.  Saturdays were my days off and it was easy for me to find any unusual food items she might want, I was amazed at the difference it made in her attitude, and she began looking forward to Saturdays and her special meals---and so did I.

     It is the little things that make u happy.  They can be expensive, so if you have family to help ease the financial burden, now is the time to ask for help.  Siblings could relieve you once in a while or contribute financially to the patient’s care.  We would like to think that all of the family would take their turn with the care of their parent.

     Some family members have opted to move the parent to each of their houses on a rotation basis.  One or two months are spent with each child.  If the parent agrees and is able to get around, it can work.  It might be difficult if the parent is not ambulatory.  Moving so often can be hard on the parent, but it will be easier on the family when they all take turns caring for the parent.  Of course, the whole family should discuss the parent’s care.  After all, the parent belongs to everyone in the family.  If it is decided that one sibling will be the primary caregiver, while the rest could help monetarily.

     

CHAPTER 6

DAILY ROUTINE

     When my mother-in-law first came to live with us she was able to do some things for herself.  She could take a shower, fix her own hair and keep her room clean.  But, as her illness worsened, she relied on us to do for her.

     There were times when I had to help her bathe herself, helping her in and out of the shower.  She was a little embarrassed at first, but she soon got over that.  When she could no longer walk and had to be wheeled around in a wheelchair, at first she would get around under her own power, but soon got over that.  When she could no longer walk and had to be wheeled around in a wheelchair, at first she would get around under her own power, but soon she became too weak to do even that chore for herself.

     When she became bedridden was when she needed the most attention.  Her daily routine was laid out so that it worked around our schedule.  At first we hired someone to come in and clean her room, give her a bath, and visit with her for a few hours each day.

     I would still make all the meals and care for her in the afternoon when I returned from work.  my husband did most of the daily chores after he retired, but some were too personal for him to do.  It was hard for him to help her use the rest room or bathe her---that was for me or the caregiver we hired.

     Her day would begin with coffee and a light breakfast, followed by a little rest so she could catch her breath.  it took a lot of her energy to eat her meat (emphysema is like that).  next she would get her bath and put on clean pajamas.  If she felt up to it, we would help her to a chair so that she could read or crochet a little, while we cleaned her room.  We made a pot of coffee for the day, as she was a real coffee drinker, and placed everything within her reach.

     By this time it was almost time to prepare lunch.  When she could no longer join us at the table, we brought her lunch on a tray and joined her in her room from time to time.  She hated to eat alone.  She would always take a nap after lunch and that would give us time to shop or take care of outside chores.

     We made sure that on a beautiful day, she was wheeled onto the porch for some fresh air, and given time to care for her plants.  she did love her flowers.  She would get tired easily, but she loved the outdoors very much, so it was important to give her the chance to be with her flowers.

    We would lift her back into bed for another nap, but not before I gave her a back rub.  She enjoyed having her back massaged.  It seemed to help the circulation when she was staying in bed so much of the time.  I would place a pillow between her legs when she turned on her side.  This helped cushion the knee bones and made her more comfortable.  It is also good to place a pillow between the feet for the same reason.  Her skin was very delicate and would tear easily, so we had to be careful that she didn’t get bedsores.

     We tried to always have her at the dinner table, so she had time to catch up on what we were doing each day.  We would prepare her food first, as it took her a long time to eat, with the oxygen and the emphysema tiring her out so easily.  After dinner she would sit in the living room with us for a little while, then ask to be put to bed, as she got tired.

     Another back massage helped her relax enough to get to sleep, but she might wake up in the middle of the night.  If she did, she would take a broom handle and hit the wall with it.  That would wake us up and we could help her, usually to use the bathroom.  Then in the morning we would start all over gain.

     We had a very good routine, with medication, baths, cleaning and all the other little chores that had to be done.  Mother enjoyed having someone fuss over her, so we tried to be in her room every hour or so to visit while we worked.  It worked out well for all three of us.  She seemed happier when we were there.

CHAPTER 5 ENDING

     Yes, there was a lot of resentment that welled up inside me when my mother-in-law came to live with us.  My resentment faded after the first month or so, however, i realized it was simply that I didn’t want my world invaded by anyone.  When our freedom was taken, I didn’t like it.  

     That must have been how she felt too.  If I had stopped to realize this, we could have understood each other’s moods.  Bu,t I was thinking only about myself and what this arrangement was doing to me and my life.  I failed to realize that everything she loved was being taken from her too; her house; most of her furniture; all the items that held memories for her, including the dishes she had had since she was married; and the comfort of her little home.  Now all she had was one room and a bath.

     The worst part was that she lost her independence.  She could no longer putter around in her lovely flower garden that she enjoyed so much.  She could no longer cook the type of food she enjoyed.  Now she had to rely on someone else and she didn’t like the way I cooked.  How she must have longed for the strength to do it herself.

     In retrospect, instead of feeling sorry for myself, I should have been thinking about how I could make her life happier in those first months with us.

     When you become self-absorbed you lose all perspective.

     Don’t make the same mistakes that I made!  Think about how your patient feels and try to make their room their home.  Keep fresh flowers or plants in the room.  Place them where they can care for them.  Involve your patient in their own care.  While they are able, let them clean their room, do some light cooking, and work in the  garden, if you have one.

     Your patient needs to feel needed, a part of the family, not just at dinner time, but all the time.  Ask for their help in preparing dinner and cleaning house.  Sure, it is easier to do it yourself, but knowing that you need their help will make them feel useful, and we all need to feel that we have a purpose in life.

     Remember, when you have been independent for most of your life, you are in control.  It is hard in give up that control to someone else.  Be patient and understanding and soon you will see a difference come over your loved one, a mood of calm and resignation to their situation.  They become thankful for your help rather than resistant.  You will find that it is a rewarding experience.  There is a period of adjustment of course, especially in the first months, but then you will settle into a normal family life.

     Give your loved one the opportunity to feel in control.  No one likes to feel that they have lost control over their life.  Include them in all decisions made on their behalf.  Don;t be overprotective.  It is easy to be overprotective of someone who is ill or frail.  However, it is important for your patient to feel they have control over as many areas of their life as possible.  If your loved one is capable, encourage them to do as many things as they can.  They should be making as many decisions as they can, too, even if they are just small things like choosing what they would like to eat for a meal.

     Everyone needs their privacy.  This is one of he losses that an elderly person feels.  They need time to be alone with their thoughts.  If their door is closed be sure to knock before entering.

     Just remember, they are giving up everything; you are just giving up a little privacy for a short period of time.  With the right attitude, it will work out just fine.

     My mother-in-law lived with us for four and half years.  In that time we worked together to make our arrangement work.  We eventually talked about how we felt and understood each other’s problem.  After that she knew what i was going through and I knew how she felt about giving up her home.  From then on, we got along famously.  She became the sweet neighbor that I once knew and loved and I enjoyed doing for her.  There was love in our home again.

                                         REMEMBER

•       Good communication with your patient can solve most of the problems.
•       Keep a smile on your face and love in your heart.
•       Do unto other...your turn is coming.
•       Look for the good and that is what you will find.
•       Do something nice for you loved one today.

                               THOUGHT FOR THE DAY

    As we get older we need very little, but we do need compassion and love very much.

CHAPTER 5 MORE OF CHAPT 5

      There was a high window, so she couldn’t see out, except to see the sky.  It did make the room a little dark.  We talked it over, again, and finally hired a contractor to install a large sliding door and a deck with a railing around it, just outside the door.  This way she would have a good view of the back yard, with the beautiful flowers and the shade trees, plus she could go outside for some sun and fresh air, if she wanted to.  We planted some of her favorite flowers along the edge of the deck and put some brightly colored potted plants on the deck to brighten it up.  She had always grown lots of flowers and we thought taking care of the plants would make her feel a little more at home.  When we finished, it was quite lovely.  I think she liked the flowers; they seemed to make her happy.  It was worth the expense just to see her eyes light up.

     My husband and I are golfers and we always attended a golf tournament in Reno, sponsored by the bank I worked for.  We were left with the dilemma of finding someone to care for his mother.  Hiring someone was out--it was too expensive for twenty-four-hour care.  Our daughter, Casey came to the rescue with the suggestion that Grandma move into her house for the four days that we would be gone.  It was going to be difficult for her, with her small child, but she knew we needed a break.  Of course, Mother hated the arrangement and let her know it, as well as giving us an earful when we got home.  But, we had our vacation and we relished every minute.

     Even though my mother-in-law was a handful, I’m glad we took her into our home.  If she had spent her last years in a nursing home, she would have been devastated.  She would have felt that she had been discarded like an old shoe.  We couldn’t do that to the woman who had worked hard to raise a good son.  She was our family and we wanted to be sure that she had the best of care, in our home.

     Sometimes it’s hard to get past the resentment of having your life turned upside down.  However, it does pass, especially when you realize that you have truly helped your loved one in their hour of need.  After all, they raised you, nurtured you, sat up nights when you were ill, and didn’t complain.  Now it is your chance to return the favor.

     Even if they make life a little difficult for you, they are family and family cares for family.  Your efforts will be returned a hundredfold someday.  Remember, you will be old one day and you will be in the same boat as your loved one.  Who will care for you?

     Don’t feel guilty about your feelings.  They are normal.  Just remember that you are doing the right thing.  You are taking care of someone you love, someone who can no longer take care of herself---your mom, God love her.

     It may make you feel better to know that others share your frustration and resentments.  What follows are either reports I’ve gleaned from the Internet or stories related to me by other caregivers.

     Here’s a story from a caregiver named Connie:

     Sometimes I feel like I am a member of one of the most dysfunctional families on the face of the earth.  They aren’t dumb people.  I know that they must understand just how sick Mom is, so that leaves me wondering if they are just selfish, and if they are, how in the world did they get that way, and how do they just go on with their lives like nothing in the world is wrong here.  I just don’t understand anyone like that.

     I really feel for anybody who has to take care of an aging loved one by herself.  My husband died in 1972, and I only have one child.  She is twenty-four and married and busy with her own life, which is as it should e.  I have one brother and he is busy with his family.  He stops by for about five minutes every week, and never asks if we need anything.  As I said, I just don’t understand, and maybe I’m not supposed to.  I have heard it said many times that God takes care of us when we can’t take care of ourselves, and I know that it is true in my case.  Sometimes, though, I have to find a place where I can yell and rave and rant and let it all out.  If I didn’t I know I would be as crazy as a loon.  Maybe I am now, and I just don’t know it..

     

CHAPTER 5 CONTINUED

CHAPTER 5 CONTINUED....WAYNE'S MOM MOVES IN

     I went to the living room to bring her to see her nice new room.  I opened the door to show her our handiwork.  I said, “Here you are Mother, a nice, big room with your own bathroom.  How do you like it?”

     She looked around and answered, “It’s not big enough.  Where am I going to put my refrigerator and all the kitchen things?  Where am I going to cook?”

     At that point, I was so angry, frustrated, and just plain tired, that I wanted to hit her--so bad I could taste it.  I turned and left her and went into my little room and hit the bed instead, while big tears streamed down my cheeks.  Here I was squeezed into a small bedroom, with so much furniture and clothing that I could hardly move, while she had a big, beautiful bedroom that she didn’t seem to appreciate one little bit.

     We couldn’t jam our clothes into the small closet, so we split everything into two rooms.  We bought two more single beds, one for my husband and one for me.  this meant that we wouldn’t be able to sleep together, but there was nothing else to do.  It certainly wasn’t the best arrangement but we vowed to adjust.

     Having someone else living in your home is rough to handle, even for a short period of time, but this was a permanent arrangement.  It meant that we had no privacy, no time alone, and there was certainly no whoopee made in our house for a long while.  The problems seemed endless.  As if the situation wasn’t bad enough, she was also depressed and angry about her lot in life.  I realized her attitude stemmed from giving up her freedom and her home and relying on someone else for everything, but knowing that didn’t make dealing with her any easier.  We decided that this was the way it was going to be and we had to make the best of it.  We tried to make her as comfortable as we could.

     We moved as many of her personal belongings into her room as would fit, including her toaster oven, microwave, coffee pit and small refrigerator to keep her snacks and milk fresh.  The room was filled to capacity, but she could do a little cooking for herself.  Unfortunately, nothing really made her happy.  I realized that her pain was affecting her actions most of the time, but this knowledge didn’t make it any easier to swallow.  It seemed that the frustration of dealing with her was slowly dragging my husband and me down.

    It didn’t help that menopause was plaguing me with hot flashes and mood swings.  Tears came easily and I cried myself to sleep many nights.  Eight hours pent at my job followed by eight hours of caring for her was wearing me to a frazzle.  I knew that I needed an outlet for my anger and frustration, so I started keeping a journal.  Looking back, I realize that it saved my life!  The cathartic act of putting the words on paper somehow made it easier to forget my problem and get on with the work at hand,namely caring for her.  It seemed to me that once the words were written, they would leave my mind, giving me the opportunity to replace them with more positive thoughts.

     Before my mother-n-law moved into my home, I always thought of myself as a positive person.  I could usually turn negative thoughts or situations into positive outcomes with a little effort, but this predicament was a real challenge.

     When I talked to her doctor about her attitude, he suggested that I give her something to do.  He suggested that even little tasks like snapping beans, cutting up vegetable for a salad, or peeling potatoes would go a long way toward making her feel that she was needed. I tried his suggestions, she thought that I was making her work for her keep and became upset.  I tried to explain to her that I just wanted her to feel welcome and a part of the family.  I guess she didn’t see it that way.  But, I tried to ignore her attitude and just keep including her in everything we did.

     We did all the adjusting  from then on.  We tried to please her and give her the things that she wanted, or thought she needed, even when it strained our budget.  As her condition worsened she spent more time in her room, and she decided it was too dark in there.

CHAPTER 5 WAYNE'S MOM MOVES IN

CHAPTER 5

WAYNE’S MOM MOVES IN

     In the beginning I thought it would be easy to take my husband’s mother into our home and care for her.  After all, we had always had a good relationship.  She lived right across the street when I was growing up, and when I was fourteen, I used to help her around the house quite often.  I don’t know why it is more fun to do chores at someone else’s home, but it is.  Maybe because they thank you more often than your own family does.  Anyway, we were friends and our families were friends, as well.  It didn’t hurt that I was attracted to her son, either.  I liked being at his house when he came home from work.

     He was four and a half years older than I was and probably thought I was a baby but I was determined that he was the man I was going to marry.  Little did I realize that eventually is family would come along with him.  I loved his parents, so when we had to take care of them, I didn’t think it would be bad.  Boy, was I wrong!

     This was probably the most difficult thing I have ever had to do.  Now, don’t get me wrong, I loved my mother-in-law, at least I did when she was living in her own home.  She was a different person then, sweet, easygoing, and caring.  Illness changed her into someone I didn’t know.  I tried to make allowances for the illness, but it wasn’t easy.

     Caring for the elderly is a heartrending task at best.  It’s as though they become children again.  They often crave constant attention and resort to strange actions to get the attention they need.  And sometimes they seem to enjoy sending you on a guilt trip.  Ultimately, these changes may take a toll on your relationship.

     When Wayne’s mother moved in she had a bad case of shingles in her ears and mouth and on one side of her face.  Her doctor explained that this condition was very painful.  She also suffered from an advanced case of emphysema, brought on by a lifetime of heavy smoking.  This was almost too much for her to take.  Her frail, little body was wasting away.  But she needed help and we were determined to do what we could to make her comfortable.  The first step was to set her up in our spare bedroom.

     In the beginning, she wanted to be in the living room all the time.  I understood her need to be near our family so she wouldn’t be so lonely, but I couldn’t understand why she needed to be in the thick of things when we had guests.  She would lug her oxygen hose, pillow, blanket and many medications into our living room, all the while choking, coughing, and spitting out phlegm into issues that would land everywhere.  I would find her tissues in the darnedest places.  Now, I can take a lot, but it was difficult to entertain guests amid all this mess.  We tried to coax her into her room, but she wanted to be in the front room.

     Because her living with us was supposed to be a temporary measure, Mother was occupying the extra bedroom that was a mere nine by nine feet.  After she had been living with us for awhile, she decided it wasn’t big enough for all her things.  We tried to soothe her by explaining that the situation was temporary and she would soon be home again, in her little trailer.

     It wasn’t long before we realized that this wasn’t going to be a temporary stay, so if we wanted her to be happy we were going to have to give her a  bigger room.  We decided that our best option was to move out of our room and give her the master bedroom.  It was thirteen by fifteen feet and had a bathroom with a walk-in shower that would make it easier for her. It isn’’t what we wanted to do, but it was all we could manage at the time.

     We took her to her trailer so that she could pack her belongings and select the things that she wanted to keep with her.  Most of the trinkets and small items would be sold at a yard sale and the rest of her belonging could stay in her trailer, so we could rent it furnished.

     I wanted this big room to be special for her. I wanted to make it as much like home as possible, so I moved everything out and painted the walls and ceiling in the bedroom and the bathroom.  This make it fresh and clean, and light.  We moved our queen-sized waterbed (my pride and joy) to storage, since it wouldn’t fit in the smaller bedroom.  The large dresser was too big for any other room, so we left it for her things.

     The mirror had a china closet along one side to display her special treasures; the nightstand beside her single bed provided storage space and a drawer for her medications.  We chose a single bed to give her more room  I bought a new bedspread and curtain to match, in green and yellow to brighten up the room.  We placed her coffee maker in the bottom of the end table (she drank coffee all day) and her dishes in the china closet.  We hung her favorite pictures on the wall and placed her husband’s picture on the nightstand, along with a reading light.  I added a comfortable rocking chair that I thought would be perfect for her to sit and crochet.  The room really looked fresh and clean, and I was proud of the work we had done.  I just knew she would be excited and happy when she she it.  Wrong again!

Betty Boop: CHAPTER 4 MY FIRST PATIENT

Betty Boop: CHAPTER 4 MY FIRST PATIENT: MY FIRST PATIENT My caregiving career started out slowly with a part-time patient, my father-in-law, E.T., who I affectionately ca...

CHAPTER 4 MY FIRST PATIENT

    MY FIRST PATIENT

     My caregiving career started out slowly with a part-time patient, my father-in-law, E.T., who I affectionately called “a cantankerous old was an intelligent man.  He and I debated many an issue.  You had to have all your ducks in a row before coming up against this man, for he knew his subjects well.  Good research would make a good debate with him.  I knew him before I knew his son Wayne.  They lived across the street from us in Pasadena, California. I spent a lot of time at his house, even before his son came home from the service.

     I set my cap for his son and after we were married, we lived near his parents.  Eventually, we went into business with them for about fifteen years.  A few years after moving to Boardman, Oregon, we opened a garage, where the farmers got their equipment repaired and we would service cars that broke down on the highway.  Boardman was a town of 153 people at that time and it was culture shock, moving from Pasadena to Boardman, but we took it in stride.  When the John Day Dam went in, we moved our business to the new highway and together we owned a service station and auto repair shop.  It took me a long time to get used to small town living, but now I love it.

     my father-in-law believed that his way was always the right way.  When we started our business, he tried to tell me how to keep the books at the service station.  I listened to what he had to say, but the Union 76 representative showed me how they preferred to have the books kept, so of course, I followed their system.

     One day my father-in-law came in and was giving me a bad time about my bookkeeping method,,,again.  I’d had it up to my ears with the constant chatter and his suggestions.  I asked him if he wanted to sit own and do the books, instead of me.  When he declined, I told him to either sit down and do the books or get out of my office and let me do my job, my way.  With that I pushed him out the office door and slammed it shut.

     I guess that did it.  I had asserted myself and he must have respected that, for he didn’t give me a bad time ever again...at least  not about the books.  Even when we were on vacation and he had to do the books for me, he did it my way.  That astounded me!

     When my father-in-law retired from the service station, it wasn’t long before his health began to deteriorate.  On day in August 1983, he had a heart attack; in fact, his heart stopped completely.  His wife called 911 and the ambulance responded with the Emergency Medical Technicians, who struggled to resuscitate him and get his heart started again.

     He was in the hospital for a week then home for a few days.  It didn’t last long---he had a gall stone attack that put him back in the hospital for surgery.  In a couple of weeks he was home giving his wife a bad time again.

     She worked hard at taking care of her husband, but didn’t complain until she entered the hospital with congestive heart failure in October.  The burden of taking care of her husband, was beginning to show in her health.

     While she was hospitalized, my father-in-law moved into our house for a while.  Then my mother-in-law joined him in a week, when she was released from the hospital.  I had my hands full since neither one was doing too well but we got through it.  They were able to do some things for themselves during convalescence, so it didn’t interfere with our work day.

     During this time, my parents planned to drive from Sequim, Washington for a visit, so we moved my in-laws to my daughter’s house for a while.  We didn’t have enough room for both couples, and they weren’t ready to go home yet.  Casey kept them for a few days, until my mother-in-law was back on her feet, then they moved back to Boardman and their little trailer.

     My parents stayed with us for two weeks, and just after they left to go home, we brought my father-in-law back again.

     This time he was suffering from a ad case of hiccups.  We drove to Boardman to bring him to the hospital.  He was given an injection to relax him, but it took effect before we could get him home to Boardman.  He went limp, really knocked out.  His body was like a rag doll, all floppy and loose.  Too loose!  The relaxant must have been too strong, because he started vomiting all over the bed.  He collapsed and we took him to the hospital again.

     He was out of the hospital in a week and back in Boardman.  However, after this incident Wayne’s father went downhill fast.  Mother kept him in a hospital bed in the front room of their trailer and cared for him as best she could.  When the task got too much for her, she would bring him to our house so we could take over and she could rest for a while and regain her strength.  We drove to their house often to help my mother-in-law and visit over dinner.

     By the beginning of January in 1984, Wayne’s father became seriously ill.  His wife again brought him to our house, where we cared for him for a few days.  This is when I learned my first real lesson in caregiving.  Always use  rubber sheet or  draw sheet on the patient;s bed.  He was resting in bed, before going to the hospital for three days in preparation for entering the nursing home, when he lost control of his bladder and his bowel.  Wayne and I struggled to get his soiled clothes off, while Mother Kuhn stood nearby apologizing and sobbing.  She was so worn out trying to care for her husband that she was close to a breakdown.

     Finally we got the bedding off the bed, scrubbed the mattress and flipped it over, bathed him, dressed him and took him to the hospital.  I’ll never forget the look on my mother-in-law’s face.  It was as if her world was coming to an end and she could do nothing but watch it happen.  

     Looking back at what he endured for his last six months, it might have been wiser to have let him go during the first heart attack.  Wayne’s mother said that if she had known how he was going to suffer, she would have told the paramedics to let him go.  His life became hellish, and he was forced to depend on a nurse for everything.

     Accustomed to being in control of his life and his family for more than eighty years, he was now dependent on someone else for everything, including his bodily functions.  The indignity of his situation tore him up inside.  He couldn’t even eat by himself, and the food wasn’t to his liking either.  Finally he simply gave up.  His wife sat with him for long hours, every day, watching the man she loved die by inches.

     He was admitted to a nursing home of January 18.  He finally had another heart attack during the night of February 11, and my “cantankerous old goat” left this world with its pain and suffering.  the whole town turned out for his funeral.  This gruff little man was loved by all who knew him...including me.

     We knew so little about caregiving in our home back then and we did many things wrong.  The one thing we didn’t do wrong was love and care for my husband’s father.

CHAPTER 3 OUR FAMILY

OUR FAMILY

     We had a loving family when I was growing up and I believe that the new family created when I got married was just as loving.  Our two girls, just like most young people, were full of fun and busy with school.

     My husband, Wayne, has always been a wonderful husband, although he found it hard to show his feelings.  He loves to tease and put his arms around me, so even though he doesn’t put it into words, I know that he loves me very much.  That wonderful feeling when he touches me...it makes me tingle clear down to my toes...even after forty-seven years of marriage.

     We lived modestly, saddled with a large mortgage payment and a car payment.  With two children including one in college, we didn’t have much saved.  Like many families, we lived from paycheck to paycheck, but we managed.

     When our children married and left home to start their own families, we concentrated on saving everything we could toward retirement.  We had plans to spend the winters in Arizona, close to his relatives and childhood friends, and summers in Hermiston, Oregon, where we would be close to our youngest daughter, Casey, and our two grandchildren, Nikki and Cody.  Casey’s husband Gary, is a rancher and quite a businessman.

     Our oldest daughter, Pamela, lives in Connecticut, where she pursues a career in opera.  Her husband Chris works for a large bank in risk management.  We visited them in 1983, when they lived in London, but haven’t been to Connecticut, at least not yet.  Our plans were to return to London while they were still there, but things kept getting in the way.  She and Chris travel all over the world in their respective careers.  it’s an exciting life that we love to hear about when she and Chris comes to visit, and we look forward to the tapes of Pamela’s performances.

     Wayne and I both loved to play golf and played at the drop of a hat, or should I say visor.  Of course, Wayne’s played on Sunday, men’s day, and I played on Wednesday, women’s day, when I wasn’t working.  We loved sports and liked to be outside in the fresh air as much as possible.

     All that changed when Wayne’s mom moved in.  Our carefree style had to accommodate caring for his mom, with one of us at home all the time as her condition worsened.

     We adjusted our lives around her needs.  Our plans for retirement were put on hold and we used much of our savings to buy the equipment we needed for Mom’s room.  The free time we used to have was gone.  Golf tournaments were for one of us, not both of us, dinners out were few, even company was curtailed because of Mom.

     We tried our best to adjust, but it wasn’t easy.  It wasn’t easy to stay home on Saturday and Sunday, when we wanted to be out golfing with our friends.  It wasn’t easy either to work nine hours a day and come home to a complaining mother-in-law.  But, the worst thing was watching my husband’s health deteriorate as he worked all day and took care of his mother too.  It was hard on Wayne to lift his mother from the bed to the chair, while she fought  against him every inch of the way.  His back suffered along with the rest of his body.  But Wayne loved his mother and would do anything that was necessary to keep her comfortable and happy.  

     His own health wasn’t good.  He was headed for renal failure and grew progressively weaker as his kidneys shut down.  Wayne decided to retire early, at sixty-two, to help take care of his mother.  He would care for Mom in the daytime, while I took over during evenings and weekends.  I came home at break time, plus at lunch to fix the noon meal.  It was a busy schedule, but we managed.

     My boss told me to go home any time I was needed.  He realized I was doing a balancing act with all my responsibilities and gave me all the time I needed.  Even though I knew that it costs a business when an employee is off the job too much, I appreciated my boss’s consideration and tried to give him extra time to make up for it.  That was before the Family Leave Act was in place.

     I wished I had someone to guide me though those years.  I know now that I tried to take on too much.

     It took its toll.

Chapte Two of When Mom Moves In

     One of our greatest fears about growing old is not death, but becoming dependent on someone else for our care.  As our parents and grandparents advance to the age of needing help, they look to their children for assistance.  What do you do?

     Your children are gone, the nest is empty, and you finally have time for yourself.  You are about to retire and enjoy the “Golden Years.”  A little travel and a lot of relaxation with your spouse.  Then one of your parents falls ill and you are elected to care for her.  So much for the Golden Years.  They become a little tarnished.

     You take on a new job.  You are now known as a “caregiver”; one who provides assistance to someone who cannot care for himself---usually an aging parent.

     A good caregiver provides help where it’s needed but encourages the parent to stay as independent and self-sufficient as possible.

     Sometimes a parent may want to stay in her own home and hire a part-time caregiver to do the little things she can no longer do for herself.  If she can afford the help, great.  This type of care will give her the feeling of independence and keep her content.

      Others will want to sell everything and move in with you.  If this should happen, you should make plans for the future, because it will change drastically.  At this point the whole family should get together with the parents and plan their needs.  It is important to include the parents in all your plans.  They need to be a part of planning their own future.  This includes discussing the possibility of living in an assisted-living facility or even a nursing home and when the time would be right to place them there.  They are much more content in a facility when it is their decision to go there.  It makes it easier on the whole family.  Your parents will feel they are still in control.  You wouldn’t like to lose control of your life either. Iin a small part, you will lose control of it.  For now the needs of your aging parents will dictate your daily routine.  

     They will be changes, but nothing you can’t handle if you keep a positive attitude about the whole situation.  A good attitude will help you maintain a constructive outlook in the days to come.

     On the bright side, many happy hours can be spent with your parent, reliving memories of childhood and uncovering family history to preserve for new generations to come.  You will probably discover events that you have not heard about before. Parents love to talk about “the good old days.”  This is a perfect time to start a family history of special events in the lives of your parents and grandparents.

     When the time comes for your parent to leave this world, you will treasure the time you have spent together.  Precious moments--mother and child--good friends!  These memories are something that you wouldn’t have if your parent lived out their life in a home other than yours  There is a warm feeling that comes with knowing that you have done the right thing when Mom Moves in.