Ten-Finger Exercises

Holy Wednesday

I can't say my day felt very holy today, whatever the (liturgical) calendar says.

I waited at home, making soup and doing laundry, till I heard from Bill about his flight physical this morning. The result was not good, but not permanently bad either. Whew. He should have seen the sleep doctor again, although he has had no trouble with sleep apnea ever since he got his CPAP machine 15 years ago, and the doctor knows this and agrees. However, the FAA is big on making sure about this, surer than necessary. Also, his blood pressure, that's been running around 140 leaped to 160 in the stress of the exam. He'll have to have it taken three more times and documented by medical staff in the next week. Unfortunately, he can't get an appointment to see the sleep doctor until the 31st. That may throw a monkey wrench in the works. The flight surgeon can't hold his report up that long.

After I heard the news, I made two patient visits in town, drove back home to get my tax return for the accountant (which he hadn't wanted till 1:30 today,) then back to work for an in-service from Adult Protective Services. Then more visits, a little shopping (at the grocery for fabric softener and Radio Shack for TV Ears,) and then to church. We have a service every evening this week at 5:30.

The in-service was pretty interesting. We are all mandatory reporters since we work for a health care agency, and all our patients are considered vulnerable adults, since they're hospice patients. Not all adults are legally vulnerable though, which I didn't realize. APS does not have the power that Children's Protective Services has-- for better or worse.

The speaker talked about various scenarios where we should report, but perhaps we might choose our way to do so carefully. Potentially, a neglecting caregiver could bar us from the home, and our patient who would be in a worse situation than if we were there. If there was actual physical or sexual abuse, the situation would be reported both to APS and to the police, but not so for neglect or verbal abuse or taking advantage of a person financially. Those last situations are what we are more likely to encounter.

It's a real dilemma when a person wants to continue to live alone beyond the time it's really safe to do so. I know a woman in the hospital right now who fits that category. She has only been home a couple of weeks and has fallen again, and has another respiratory infection.

Unfortunately, she has spent her life preferring to be in charge to being loving, and it is coming back to bite her. Her children do not want her with them, do not really want much to do with her. They want somebody else to "put her in a home." Well, she's been in a variety of adult living situations, but she tires of each one, and they of her as well. No residence or nursing home will be able to keep her from falling, but some could monitor her health and her breathing. The priest wants me to talk her into another such place "for her own safety." We'll see.

One of the social workers at hospice, a 72 yr old spunky, active lady whose home burned down a year and a half ago, has said she certainly intends to stay in her little cottage (without running water!) as long as she can. She is independent and loves her privacy, and it would be a terrible insult to her spirit to make her change. Fortunately, she has a healthy constitution and managed to avoid the flu bug that took nearly everybody else out for a week or more. She was out for two days.

My own mother would have much rather stayed in her own home and died there. It was because I couldn't be there to take care of her that I insisted she move to my town. Her dementia, Parkinson's, and faulty heart valves were all getting worse. Still, I know what it did to her spirit to have to do what I said instead of following her own way. I couldn't stand to see her neglected, so she moved for me.

Enough. I didn't intend to go there tonight.

Here's a laugh to end with. I asked a friend to help me tomorrow with a task at the Maundy Thursday service, and she wrote my name on her hand so she'd remember. She said that when she first opened a Head Start office, her hands were full of notes like: "diapers," "doctor's appointment," "juice cups," etc. When one teacher approached her for some staple she'd forgotten, Cindy handed her a pen, stuck out her arm and said, "You'll have to put in a requisition."