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.

     

Chapter One of What to do When Moves In

    As far back as I can remember, my family was taking care of someone.  A few months after my parents were married, Dad’s mother passed away and Dad took in his father and two brothers.  My mother learned her fate as a caretaker early in her married life.  But she was young and in love and took it all in stride.  However, there were times when she longed for privacy.  Especially when she and Dad gave up their bedroom and slept on the couch in the living room---a major sacrifice for a newlywed couple.  Even their lovemaking had to wait until everyone was asleep, so they could steal a few moments of privacy.  I doubt that many young couples today would sacrifice their room or assume so much responsibility.  But that is the way that my parents generation was raised; you always took care of your family, no matter what.

     As I was growing up, I too learned how to care for others.  My sister was born when I was eleven.  Naturally, I was eager to help Mother take care of her; it was like having a live baby doll.  It was fun at first, but child care soon lost its thrill.  Then she was just my little sister who I had to look after.

     Our family included my two brothers, one two years older and one two years younger , my sister who was 11 years younger and me.  Of course, like most boys they fought all the time and we got into trouble, not serious trouble, though, mostly for avoiding our chores or fighting with each other.

     My two uncles lived with us from time to time along with Grandpa, then Grandmother on Mom’s side moved in.  It seemed to be one person after another, year after year.  It was a big job learning to care for each of them and each one’s particular problems.

     My grandmother posed special challenges.  She was very religious and she didn’t approve of many of our favorite radio programs.  Much to our dismay she would turn off The Shadow or Gangbusters mid-program, because she deemed them too violent.

      Grandma lived with us for years before she became bedridden and lost most of her sight.  She would sit for hours reading her Bible.  When she became too ill to read she liked to have me read to her.  I enjoyed it also, for I was raised in the Lutheran church and knew my Bible well.  I read until she fell asleep, then place the Bible on her lap with her hands on top of it.  She liked that, and kept her Bible with her at all times.

     I inherited Grandma’s Bible when she passed on, and it brings back memories of reading to her, the part of her caregiving that I liked most.  She was a very special person, with wonderful stories of her home in Denmark.

     Grandma’s health wasn’t too good toward the end.  She was terribily confused and forgetful.  She wouldn’t recognize me or my mother at times and often thought we were trying to kill her.  She fought us tooth and nail when we came in to tend to her needs.  For a frail old woman she packed a pretty mean wallop.  But, we had to overlook her actions because of her condition.

     I learned how to give her a bath without embarrassing her by watching Mom in action, and, of course, learned the bedpan routine,  She joined us at the table and always said grace.  Toward the end of her life she took her meals in her room, until finally we had to feed her.  In those days no one came in to help you, you simply did the best you could.  You would only put your loved one in a nursing home when it was absolutely necessary.  I think that is still the best way.

     As a teenage it was hard to entertain with Grandma there and before her it was Grandpa, with his smelly pipe and his crazy sense of humor.

     Uncles, aunts, grandparents, we were never a small family.  There was always someone special to care for.  As if that wasn’t enough, Mom took in boarders from time to time to supplement our income.  She also took in foster children from broken homes.  It was short-term care, but these children got all the love and attention that our own family received.

     We were a very happy, well-adjusted family, in spite of all the extra people packed in our house all the time---or should I say because of all the people we had in our house all the time?

MY BOOK, WHAT TO DO WHEN YOUR MOM MOVES IN

FORWARD

     When I make a diagnosis of chronic kidney failure, patients and their families invariably ask me,”How can we get through this?”  I tell them to take life one day at a time, and we do just that, day after day, year after year.

     Betty Kuhn’s book will be at hand now, when patients leave my office.  In a friendly yet firm manner Betty covers the basics of living well in old age.  None of us wants to address these issues, but infirmity will prevail.  I recommend this book to every family young and old.  An ounce of prevention with Betty’s “words to the wise” could indeed save your loved ones pain and suffering.

     As for the author herself, without her strength and determination, her husband, Wayne, would not have made his remarkable recovery.  I never cease to learn from my patients---they are your best teachers---and Betty Kuhn sets a fine example for us all.

WHAT TO DO WHEN MOM MOVES IN

IDEAS TO MAKE IT EASIER

BY BETTY KUHN

         What do you do when Mom moves in?  I suggest that you grab your suitcase and run out the back door as fast as you can.  Well, that may be exaggerating just a tad, but you’ll feel like fleeing, maybe not at first, but eventually you will.  You’ll want to escape from everything and everyone, hungry for a little solitude.  Luckily these feelings will pass.  If they didn’t you’d go crazy.  But you won’t run, you’ll open your arms and welcome Mom with a big hug.

     The stress of keeping everyone happy (except yourself), and balancing work, home, family, and an extra family member, is overwhelming at times.  the endeavor also has it’s lighter moments, which makes it all worthwhile.

     It can create hardships in a marriage too.  However, if you keep the lines of communication open with your husband, it can help your marriage become stronger, because you need each other and you must pull together to make it all work.

     Caretaking can be very rewarding at times.  The simple fact that you are taking someone you love into your home and preventing them from being placed in a nursing home makes it all worthwhile...well, most of the time.  When your parents need you, it gives you a warm feeling to be able to help them.  After all, they raised you for eighteen years; now it is your turn to raise them.  Sometimes they are like children, so the phrase rings true.

     It isn’t easy though.  It is one of the hardest things we had to face in our forty-seven years of marriage.  But, I’m glad we did it---four times---before my husband himself became critically ill.  Luckily, I had learned a little with each patient, so that I felt confident in my ability as a caregiver when my husband, Wayne, needed me.  After forty-seven years of him taking care of me, now it was my turn.  Perhaps that is why God gave me the task of caring for the others---to prepare me for the monumental task of caring for my husband.

     My biggest surprise was that I couldn’t handle it all myself.  I had been dealing with people for twenty-five years in the banking business, but when we took in my mother-in-law, it was a whole new world for me.  Surely, one little woman wouldn’t get to me.  But she did.  She managed to rub me the wrong way many times during her stay with us.  This woman with whom I had been friends for so many years was about to drive me crazy.  That’s when I knew I needed help.

     I hope that my experiences will help you know what to do when your mom moves in.  Good luck!

WHAT TO DO WHEN MOM MOVES IN

     I have many requests to give more information on caregiving, since I wrote a book on the subject.  So, I thought it might be a good idea to blog my book so everybody who needs the information can simply read my book.  I enjoy sharing information about caregiving and hope that the people who need it will read my book online.

     A chapter or more will be posted each week, as time will allow.  The name of my book is

                             “What to do When Mom Moves In”  

                                         Ideas To Make It Easier

     This book was written while my husband was in the hospital for eight months with peritonitis, due to End Stage Renal failure.   All of it is true...I lived it!  I learned so much about  how to care for others in my home.  But most of all, I learned a lot about myself.

     My loved ones came into my home for care.  First was my father-in-law with a heart attack, and then my mother-in-law with emphysema, next my father with colon cancer, and then my mother with congestive heart failure, and my husband on dialysis, at the same time.  It spanned a fifteen year period and it was the most challenging thing I had to face in my life.    

     My book offers help for the first-time caregiver, who may be overwhelmed by the task at hand.  It will cover:

          How to overcome the resentment of caregiving.

          How to locate other caregivers to share experiences.

          How to give a bed bath without embarrassing anyone.

          How to prepare for an emergency at home.

          How to choose a nursing home that is not a warehouse for the dying.

          How to keep a positive attitude in a frequently trying environment.

     The book will help you get through the time you spend helping your loved ones, and learn more about them in the process.  It will bring you closer to your loved one, closer than you have ever been before.  Read and enjoy.

     “Taking care of our elders is a privilege.  It is a redemption of their love, and a lesson for the heart.”

Betty Kuhn

MOVING TO CALIFORNIA

     We are moving to California, now that my husband is getting better.  It means that I will have to do all the driving, but I don’t mind.  

     First we are going to Oregon for a Birthday Party...Mine.  I will turn 80 this year and my husband prepared a lovely party at my favorite hotel in my home town.  All my friends will be there for cocktails and dinner.  I can hardly wait for the day we leave.  The moving van will be here next week and we will be on our way.  

     After the party, and a little rest, we will be driving to San Jose, CA which will be our permanent home.  It is so beautiful there, warm, sunny every day, and very little rain in the summer months, but a lot of rain in the winter.  We are just an hour away from San Francisco, so we drive up there often to enjoy the sights.  I can hardly wait to get home again.

     Our trip to see my grandson’s graduation turned into a seven week stay in the hospital for my husband, but all is well, and so is he.  

     The VA hospital did a wonderful job of caring for my husband in Intensive Care.l  Those nurses were Everyday Angels, as they looked after him for three weeks.  I can’t say enough nice things about the Veterans Hospital...it is fantastic.

     The next three weeks were at Promise Rehabilitation Hospital, where they got him back on his feet.

     We have put our home, in Utah, on the market for a very low price, hoping to sell it fast.  The Real Estate agent is showing it tonight for the first time.  Sure hope it sells.  It gets very expensive keeping up two homes, both in Utah and California.  But if it is meant to be, we will sell it.

     The people are knocking on the door right now, so I will cut this short and write more later.  Wish us luck!