Sunday, September 25, 2011

The Most Emotional Decision: Home Care for your Parents

Sept. 25, 2011

After reading about BrightStar home care coming to the eastside, residents have been calling to inquire about getting help for their parents, their spouses, even themselves. The details of their stories are unique. But the pain and frustration in their voices are not. It is all so familiar. Not so long ago, that was me on the other end of the line.
There's a process we all go through before the caregiver knocks on the door. For some, the processtakes longer than it does for others. It often starts with an internet search or a newspaper article that catches our eye. We do considerable research to learn what kind of care is available and who provides it.

There's companion care -- keeping your folks company and helping with meals and housework. There's personal care for those who need assistance with their daily activities -- bathing, dressing, toileting. And there's skilled nursing care for those with more specific medical needs.
During the research phase, we go back and forth. Do we really need to hire someone to come and do what we can do, what we should be able to do?

Here was how my sisters and I thought for almost two years: "They just need a little company, I can stop in after work on Tuesday." "He needs a ride to his doctor's appointment. I can take a long lunch next Wednesday." "She needs a reminder to take her insulin. I'll tape a note to the refrigerator door and call every morning."
In time, the facts become all too clear: "a little company" really came to mean "Mom can't give herself a shower." "A ride to his doctor" really meant "setting up a series of blood tests and followups for his out-of-whack coumiden levels." "Reminder to take her insulin" really meant "we need to be there every morning to hand her the syringe."

In time, I went from internet searches and newspaper clippings to phone calls. I gathered facts. I did the math. I called family meetings. I advocated for outside help.
Then I went home and tried to imagine what it would be like to open the door to a stranger -- coming to do what I can do, what I should be able to do.

Even after winning agreement from my grumpy, frugal (that's putting it politely) Depression-era dad and my less-than-supportive siblings, I had a hard time taking that final step. Inviting someone into my parents' home to take care of them was one of the most difficult, emotional decisions I've ever had to make.
I understand what my callers are going through. It' a process. And when they're ready, BrightStar is here for them. One hour or 24.

A side note: Michigan has no licensure requirement for private duty in-home care and caregivers are not required to have formal training. To set ourselves apart, BrightStar is pursuing accreditation by the Joint Commission, a national health care watchdog organization that audits hospitals and nursing homes. Additionally, our caregivers are trained Certified Nurse Assistants, insured, bonded and background checked. They report to our Director of Nursing, Anthony Pizzo, a long-time eastside nurse with an extensive background in emergency medicine.

n  Anne Marie Gattari, president / owner, BrightStar of Grosse Pointe / Southeast Macomb, can be reached at 587.279.3610. am.gattari@brightstarcare.com ;  http://www.brightstarcare.com/grosse-pointesoutheast-macomb

Saturday, September 3, 2011

Alzheimer's Test is Back, No Surprises

September 3, 2011

Mom's tests for Alzheimer's are back, and last week we went to see Dr. Shyam Moudgil of Lakeside Neurology in Grosse Pointe. www.lakeside-neurology.com He asked us (me) general questions and read the CT report. Then he scooted his seat over to Mom, facing her.
He leaned in as he asked her a set of questions about time and place. She passed.

He tested her upper body strength. Not bad. He watched her take a few steps -- with assistance.

He asked her to do some simple math -- take 3 away from 20. 17, she said. Good. Now take 3 away from 17. She thought and sighed and said she didn't know.
He gave her a piece of paper and pencil and asked her to write a sentence. She thought and sighed again. She looked up at him, frustrated.

 You're a tough doctor," she said. Then she scribbled on the paper and handed it to him.
He read: "Share my seat."

"That's a sentence," Mom said with confidence. And she was right. I smiled, remembering diagramming those declarative sentences on the blackboard in elementary school.
When Dr. Moudgil left the room to read the film of her CT scan, I told Mom I liked her sentence.

She wasn't interested in my complement. "I knew he wouldn't do it," she said.
"Do what?"

"Share my seat. I knew he wouldn't because there's not enough room," And she tried to scoot over a little in her chair as if trying to make room.
I smiled. She didn't. "I know you think I'm losing my mind," she said. "That's why we're here."

In July, I wrote about taking Mom for CT brain scan http://www.brightstarcare.com/grosse-pointesoutheast-macomb/2011/07/20/alzheimers-going-for-the-test-awaiting-the-results. Unsure of what was causing her dementia -- Alzheimer's, weak heart, lack of oxygen, a stroke -- I wanted more information.
Alzheimer's, the sixth leading cause of death in the United States, continues to steal away our parents and grandparents. Some research is pointing toward genetic trends. The number one risk of Alzheimer's is age. The number two risk is family.

Dr. Moudgil returned and reported he saw "nothing out of the ordinary." No tumor, no bleeding, no sign of stroke. "So what's going on?"
"Her symptoms fit Alzheimer's," he said. www.alz.org That's the most definitive he could get. Because Alzheimer's cannot definitively be diagnosed without

"Not vascular dementia?" I asked. I was sure her weak heart was the culprit. A smoker for 50 years, Mom has congestive heart failure.
"No, there's no sign of stroke."

But, Dr. Moudgil said, her brain is shrinking. And apparently, he finds that pretty normal.

He noted my discomfort with his nonchalance. "Look," he said. "The body and brain are built to live only so long, and we're living longer. If we all lived to 140, 100% of us would have Alzheimer's."
We talked about drugs to slow the process, but agreed not to. Dr. Moudgil explained that he considered such drugs important if they can delay the move to a nursing home.

"But that doesn't seem to be an issue in this case," he said.

"You're right," I said. I know: "Never say never." But I can't imagine why Mom would ever need to move to a nursing home.
I know many exceptional caregivers. Thankfully, they're finding their way to my business, BrightStar of Grosse Pointe / Southeast Macomb. They're going through my rigorous testing and hiring processes as well as a thorough new employee orientation -- all supervised by my Director of Nursing, an expert RN who demands the best from them.

It won't be long until I entrust one of them with my mother.

n  Anne Marie Gattari is president/owner of BrightStar of Grosse Pointe / Southeast Macomb, providing top quality care to seniors, children and disabled in their homes. Contact: 586.279.3610; am.gattari@brightstarcare.com; www.brightstarcare.com/grosse-pointesoutheast-macomb