Different Degrees of Healthy

It appears fraud is running rampant in Hospice. At least that's what the counselor indicated as she dismissed mom from the program for being too healthy. At almost 93 and with advanced Alzheimer's I would hardly consider her healthy. Granted, mom has gained three pounds and now weighs 103 but since she is 5', 10" tall, that doesn't seem like much to me. She is also "stable." Stable in Hospice language means she isn't declining at the rate they require. Her legs are like jello which is definitely a decline but apparently not the type of decline to which they refer. My sister and I decided to not fight Hospice on this issue as only 3% of the cases which challenge the system are allowed to remain in the program. I guess we are too worn out to do battle right now. We all know she will eventually show a decline again and will re-enter the Hospice program then. In the meantime, we have to pay an additional $60 per month for the overnight diapers and unlimited wipes. The Care Associates (aides) have to try and shower her and call in Home Health Care to dress any skin wounds as they appear. We love Hospice and the wonderful care they gave mom. So, while we are in a hurry to get mom back under their care, that would mean we would be closer to losing her and I'm not ready for that. The upside is she is "officially" no worse. I have to admit she has many moments of clarity and seems happier and less worried than before. It could be she has moved on to the next stage of Alzheimer's and is less aware of things that used to bother her. Also her medications have not changed for many, many months so we have found a good combination at last.

Some of the comments she has made in the past few weeks:

"I want everyone to know about this place because it is so nice. I love it here."

"I don't want any more responsibility. I just want to be comfortable and warm." To which I asked, "Are you warm now?" "No", she said. So I put another blanket on her.

"I want to go home."

"I'm confused about something."

"I had a good husband."

"Why are you so kind to me?"

"I'll never forget Dave."

"Where is my bed? I've never seen it."

"Isn't she (Betty the dog) the best ever?"

"I'm terribly worried."

While telling her stories about her great-grandson, Benjamin, she said, "Isn't he just adorable!"

After a story about her granddaughter, Lindsay, she said, "She is a good mother."

I told her about her grandson, Matt's new job. She said, "How wonderful. What does he do there?" Then I had to try and explain about computers and a job-board similar to Monster and could tell she was lost. Finally, I said, "He is in sales just like your father used to be and he is as good as your father." She was delighted and said, "Well, then he will be successful."

I told her my husband and I were going out dancing one night. She said, "It sounds like fun but I don't think I'm up to it anymore."

I purchased new slipper/boots for her that are warm and fuzzy...similar to after-ski boots but soft. After putting them on her feet, she said, "I bet all of the other people will be jealous."

Mom still enjoys food and often says how delicious her meal is. She also is known to say she hasn't had lunch about 5 minutes after eating it.

Often when I am talking with a Care Associate, I don't think mom is listening or paying attention to the conversation. However, upon my return from vacation I was telling the new C.A. that Carolyn is my sister. Mom bursts in with, "Carolyn? My daughter, Carolyn?" This was particularly amazing to me because I haven't heard mom use either of our names for months.

If mom initiates the sentence, it is either gibberish or we are left hanging waiting to hear the rest of the sentence that never comes. I do my best to try and complete her thoughts as she is clearly trying to communicate something, I just don't know what. Sometimes I can figure it out but usually not. Then it's time to reassure her that everything is o.k. and that she is safe.

I visit mom to try and give her some companionship and happiness, but most days she manages to make me either smile or laugh out loud. They say laughter is the best medicine. Maybe that's why mom is doing so well. Her wonderful sense of humor is still here and it's fun to share a laugh with her, especially since I never know if it will be the last one.