Putting Ruth to Rest

Val has arranged for internment of Mom's ashes on Friday, September 17, 2010 at 2:30 p.m. at Oakview Cemetary in Royal Oak, Section K (to the left of the pond as you enter). Let Val or Dave or me know if you would like to attend. We plan to have a small get together afterwards either at Pete's Broadway Cafe in Ferndale (Woodward Heights West of Hilton) or another suitable location.

Attending for sure will be Val, David, Byron & Colleen, Rev. Miller, Maggie and Rob Robbins, and Patricia Kuxhaus.

If you missed it, Byron has Ruth's old phone number.

Consoled

We are all pretty pooped out from the whirlwind of the last few days, but consoled by the outpouring of sympathy from so many at the funeral home visitation Tuesday evening and Wednesday's service.. Mom affected so many lives in ways we never knew, and it was heartening to hear stories about her from those present. She was quite a gal.

More proper thank yous will be forthcoming, but I would like to acknowledge those who made the last few days tolerable and the service so meaningful. Besides Rev. Miller, the soloist Marlene Plum and organist Melissa Ambrose-Eidson, we want to express a special thanks to the ladies of the Mary Martha Circle, of which Mom was a member practically since she joined the church in the 1940s. The luncheon they put on was wonderful on many levels. Additionally, John Wilk from Wessels & Wilk Funeral Home provided invaluable assistance, the beverages and snacks Colleen's family brought during the visitation were greatly appreciated. The outpouring of sympathy and caring has been just remarkable.

We plan to eventually scan the photos from the picture boards and put them up on this site, as well as the audio of the service, so we're not done with this blog  by any means. We encourage those of you who have "Ruth stories" to consider sharing them with us here. As we've learned the last few days, there is a lot more to our Mom than we ever realized!

Details

We'll be receiving visitors at the Wessels & Wilk Funeral Home Tuesday, June 29 from 3 to 8 p.m. Click here for a map. The service at the First Congregational Church of Royal Oak begins at 11 a.m. Wednesday, June 30 and will be followed by a light lunch. A map to the church can be accessed by clicking here.

If you have any questions, please feel free to email us and we'll get back with you as soon as possible (sorry, no phone numbers are going up on the web!).

I had been staying with Mom at night since she was admitted to the hospital on Thursday, and Dave, Byron and Colleen were there during the day. She was still relatively lucid and responsive early Saturday, and we reminisced about all sorts of random things as the sun came up -- the old Westinghouse refrigerator we had that ended up at Rose and Sam's cottage, going to the Royal Oak Farmers' Market every Saturday morning before the crack of dawn, Byron making popcorn as we watched Saturday Night at the Movies, Sunday drives, her parents, her grandchildren ... it was truly a gift to have those tender moments with her.

It was heart wrenching to watch as she and her life-long best friend, Priscilla, visited on Saturday, both knowing it was the last time they'd be together. Lots of tears were shed all around. These two women were so different yet had a friendship that endured through good and bad times. They used to joke about who would go first. Well, now we know.

Dave arrived Sunday morning just as the doctor was making his rounds, and he advised us that it looked like she would not be around for more than 48 hours. I made a quick trip to Grand Rapids (no speeding tickets), and during the seven hours I was away, her condition had eroded significantly. As nighttime fell she became quieter and quieter.Shortly after midnight she took her last breath, and the nurse confirmed what I thought: she was gone.

Byron and Dave quickly returned to the hospital. We said our goodbyes and thanks to this amazing woman. There were many times she was a royal pain in the neck (and other places), and her Polish stubbornness was legendary, but she also was a loving person who always saw what needed to be done and did it, up until the very end.What a gal!

She's at peace

Ruth Esther Kuxhaus, 91, of Oak Park died peacefully surrounded by family on June 28.  Born in Detroit on May 31, 1919, she was the oldest child of Chester and Viola Kotowski. She grew up in Pleasant Ridge and graduated from Lincoln High School in Ferndale. For many years she managed several RB Shops, and later worked at Jacobson's in Birmingham. Generous, never complaining, Ruth was happiest in the company of family and friends. She showed great strength and bravery in recent years as she battled a series of difficult afflictions. A greatly loved mother, grandmother, friend, and aunt, she will be greatly missed. 

Preceding her in death were her husband, Otto Kuxhaus; brother, Benjamin Kotowski; sisters Rose Tuma and Doris Steinberg. She is survived by her brother Arthur (Nancy) Kotowski, Newburg, OH; her children, Byron (Colleen) Kuxhaus, Royal Oak; David Kuxhaus, Ashland, KY; and Valeria Long, Grand Rapids; grandchildren Robert (Rebekah Winters) Long and Justin Kuxhaus, Seattle; Margaret Long, Oakland, CA; Laurel Kuxhaus, PhD Potsdam, NY; her life-long friend Priscilla Krippendorf; and many beloved nieces and nephews.

The family would like to thank the staff of Heartland and Beaumont Hospices and Hannah's Home Care for their care and compassion during Ruth's last weeks. Visitation at Wessel and Wilk Funeral Home, 23690 Woodward Ave., Pleasant Ridge, from 3 to 8 p.m. June 29. Memorial service June 30 at 11 a.m. at First Congregational Church, 1314 Northwood Blvd., Royal Oak. Memorial contributions may be made to the church.

Not good news

I neglected to include in the earlier post that in addition to the sigmoid volvulus, Mom has a bowel obstruction. That's what contributed to the excruciating pain and vomiting on Thursday. Given Mom's greatly weakened health, medical history, and age, the gastroenterologist felt she was an extremely poor surgical risk and would likely not survive surgery to remove the blockage and volvulus and recommended against it. Other physicans concurred. We -- Mom, Byron, Dave, and me -- sadly agreed that she has been through enough, and reluctantly have accepted that this will be the cause of her demise.

Mom is now an inpatient with Beaumont Hospital's Hospice, where she is receiving intensive palliative care. Her attending physician feels it is highly unlikely that she would reach the two week maximum stay for that unit.She is being kept comfortable with regular administrations of dilaudid, so is drowsy much of the time but manages to rally when she has visitors and as we have learned, hears everything!

As we face this passage, we are heartened by the support we are receiving from family and friends. We appreciate you keeping Mom and us in your hearts and prayers, and hope that you find comfort, as we do, that she is at peace..

A new development

An update ...

Over the past week or so Mom had a lot of abdominal pain, coupled with the inability to have a bowel movement. The pain became too much, and Wednesday morning Byron and Colleen took her to Beaumont's ER. She was given some dilaudid for pain, and had a CT scan of her abdomen (which the ER doctor said was the most puzzling one he had ever seen due to her colon resection back in the early 1960s).

The medical team's consensus was that she had a sigmoid volvulus (a twisting of the sigmoid colon). A gastroenterologist performed a sigmoidoscopy, which we hoped would take care of things so we brought her home. Unfortunately her abdomen is still distended and hard, and she's been in a lot of pain plus vomiting. The hospice nurse recommended we bring her back to see if more fluid could be removed and make her more comfortable,  so we came back to Beaumont where we are as I write. Please keep her in your thoughts.

Well, She Made It To 91

I spent a nice week with Mom and family, enjoying the hot Michigan weather and seeing friends. She continues to amaze me with her progress and what she is pushing herself to do.

My arrival Wednesday coincided with Julie from Hospice arriving to do the paperwork enrolling Mom in Hospice. The continuing, debilitating pain in her shoulders makes it possible for Hospice to provide care for pain management and other issues dealing with the deterioration of her health. Hospice will be providing some of her medication to include lidocaine patches for her shoulders as well as supplies and some other meds, their palliative care is great and Mom seems to like Julie and looks forward to her visits.

Thursday started off a little rough for Mom and Tanya. Both had some intestinal problems during the night but recovered enough for Mom to do some ironing in the afternoon. The young man who was supposed to mow her lawn didn't show up so I took care of that making sure the clippings were placed at the curb for pick up on Friday.

Following her Friday morning walk, which consists of walking up and down the driveway a few times, she and I sat outside the garage to enjoy the nice morning. She seems to enjoy sitting out there in the captains chair brought up from the basement and likes feeling the warm sun and enjoying the rose bush from Aunt Alice that has been full of blooms. Hospice Julie showed up as scheduled and the pain patches were applied. Within an hour the pain abated enough that she had almost full range of motion with minimum discomfort. Mom and Kim enjoyed a nice lunch from BWW with plans to have the left overs for dinner tonight.  John, the Hospice social worker, was with Mom when I returned from running around and they were having a nice chat sitting outside. Mom said she had walked the drive again and was feeling okay. When she got back in the house she was tired but looking forward to a visit from one of her friends.

Cousin Maggie came over Saturday morning and planted flowers in the front of the house, her birthday present to Ruth, and we enjoyed a nice visit before I took Mom to get her hair done. We discussed going to visit Priscilla but she wanted something for lunch and to go home. She spent the rest of the day resting, planning what she & Kim were going to have for dinner and talking on the phone. Val also was there with birthday presents and had a nice visit with Mom.

Following church on Sunday we went to visit Priscilla and her family. The girls had a nice time together and as always, enjoyed each others company. Val & I spent several hours with Denise and Sheila and her family and it seems everyone had a very nice time.

Dinner at Byron and Colleens Monday was a nice quiet celebration of Mom's 91st birthday. Byron grilled steaks, Colleen made a great salad and Sanders bumpy cake was complemented with Strohs French vanilla ice cream. Even the rain didn't dampen our enjoyment of each others company and Mom raved about how wonderful Byron's steaks were.

I left Tuesday morning, got home about 5:30 following an uneventful trip. I spoke with Maria from Hanna's Home Health Care about some concerns we had about her caregivers and was able to resolve the issues to ensure Mom continues to receive the care she needs and that she's paying for.

Mom looks forward to hearing from her friends and relatives and looks forward to visits throughout the day. Getting outside and the pain patches seem to have lifted her spirits and she is even turning the A/C on more frequently.

That's it for now. Hospice Julie will be making her weekly visit tomorrow and I hope her lawn gets mowed this afternoon.

That's all for now.

Busy Tuesday

Another busy Tuesday for our gal Ruth. Before we even left for her appointment with Dr. Weissman, she had physical therapy at home.Tanya came along to her visit with Dr. Weissman. He reviewed and reduced the number of medications she needs to take, and commended her on her positive attitude (she was fairly upbeat). She weighed in at 103 pounds, fully clothed.

Since it was around noon by the time we got done, we decided to go out to lunch at the Olga's Kitchen on 12 Mile and Southfield. Advice to any who may dine there: avoid the waiter named Jon. Following our rather strange meal, I suggested that since we were so close to Priscilla's house that we drop by. Mom managed to get up the steps into Priscilla's house, where she was having physical therapy. It was rather poignant to listen to their conversations. Here they were, these two young women who suddenly (to them) became old and frail.


They said their goodbyes and we returned to Meadowlark. Mom was adamant about making the cookies that they didn't get to on Monday, but it wasn't even five minutes after she sat in her chair that she dozed off. No cookie baking on Tuesday. Maybe they got to it today.

This coming weekend Kim will be staying with Mom. Next Tuesday is another trip to the wound clinic. We certainly know how to have fun!

The second weekend

It's been a quiet weekend thus far at Meadowlark. Mom's new Sizewise mattress came yesterday, and she slept so comfortably that she didn't get up until 9 a.m. Saturday. She's had some phone calls and an early afternoon visit from Byron while I was running errands. We had a late lunch and now she's taking a nap.

She continues to be frustrated and upset that she has physical limitations that prevent her from doing what she wants to do. That, plus her tendency to perseverate about some things that she has no control over gets her riled up. She's more guarded around Tanya and Kim (the new weekend caregiver) and they don't see this side of her. Which is probably a good thing. Today she was able to make her own oatmeal and dry dishes, but decided to postpone a project we talked about tackling this weekend.

Last week had some definite high points, though. Besides Art and Nancy's visit, a long time friend Bob Kennedy was in town from Chico, CA, and he and his sister Margaret came by to visit. Bob is no longer ambulatory, so he wasn't able to leave Margaret's car. The weather that day was perfect, making it possible for Mom to go outside and sit in the car and visit with him there. They had a wonderful time reminiscing, and Tanya thoughtfully brought tea and cookies for them to enjoy. And of course there were regular visits from Colleen, who brought Chinese one evening.

The week ahead brings a trip to Dr. Weissman, Mom's internist, who she hasn't seen since well before everything began to happen in November. We're hoping he can review the meds she's on and perhaps have her cut back on some of them.

Oh, the baby monitor tells me that nap time is over. Time to get back moving and help Mom "do her thing."

The first week at home

Mom had a busy Tuesday. In the morning the physical therapist came by, followed by an early afternoon visit to the wound clinic, which was the first time she left the house since coming home last week. Shortly after returning from the appointment, Mom's brother and sister-in-law Art and Nancy arrived for a visit. Mom was happy to see them, although she had to cut Tuesday's visit short to take a nap. Fortunately they're staying over and will see her again on Wednesday.

Mom's first week at home has had its ups and downs. She likes being home, but is too frail to do what she likes to do, which is to putz around and keep house. She's frustrated that she is lacking "pep." Tanya, who's with her Monday through Thursday, has been working to establish a routine. Unfortunately the  caregiver last weekend wasn't anywhere as competent as Tanya and the routine disintegrated. (That caregiver won't be back.) I'll be staying with her this weekend with hopes to keep the routine together and get her to eat more.

Receiving visitors and cards brings her great joy. Last weeks'  visitors brightened her days, and she was delighted to get a note from granddaughter Laurel. A note of caution to visitors, though: she's keeping the house at near sauna temperatures as she's always cold, so dress accordingly.

Mom At Home

Mom continues to adjust to being home. Much of the activity has stopped, OT, PT, and nurse have been here, evaluations completed and schedules established. Her former PT Ricky will be resuming his activities next week and she's looking forward to that.

She has enjoyed her companion Tanya this week, they have bonded slowly, but are getting along. They sorted out all the teacups this evening, matching cups and saucers and Tanya received one she expressed a liking for. She'll be leaving Friday morning when Phyllis, the weekend provider arrives and will return Monday morning for another fun filled week.

Mom has been sleeping late and not taking a nap during the day. She's been enjoying the visitors and phone calls and talking a lot about her life. She's still not sure about the cable TV, but is accepting it.

We've had a good visit and it will be difficult when I leave, on both of us, but she knows I'll be back in May for a while and has that to look forward to. She's also looking forward to seeing Val this weekend and visits from Byron and Colleen.

Not much more to report today. Stay tuned for further updates. Thanks

Home at last

Monday morning the bed, mattress and other equipment arrived from hospice, as planned. Monday afternoon Mom met with a hospice social worker again about becoming one of their patients, and after a 3-1/2 hour conversation, signatures and forms were completed. We figured all was well, but I should know better. Monday evening the hospice nurse called, apologetically telling me that they were mistaken; upon closer examination, at this time Mom is not a candidate for hospice care. They had thought she would qualify because of the need for pain control, but her wound by itself is not a terminal condition.

Nevertheless Mom returned to Meadowlark Tuesday morning after making her good byes to staff and friends at Heartland. She was sent home with her medications, supplies for wound care and best wishes. I discussed the equipment situation with the Heartland social worker, thinking an administrative event could take place and not disrupt what was in place. I should know better than to think!

Once home she was greeted by Tanya, the caregiver from Hanna's Home Health, who will be staying with Mom Monday through Thursday; another caregiver, Phyllis, will stay Friday through Sunday. I left Tanya and Mom alone so they could get acquainted. The topic of food came up and I made a run for corned beef, chicken noodle soup and fries from the Bread Basket. When I returned, her first visitor was drinking tea and eating cookies. Jean brought some flowers from the church altar on Easter and left with her teacup after telling Mom how she liked it. I proceeded to make several telephone calls with medical equipment companies, resulting in arrangements for the removal of the hospice equipment and delivery of replacements by Beaumont Home Health on Wednesday.

After taking a much deserved, long nap, Mom and Tanya discussed dinner options and I went out to spend some time with friends. Sometime during the afternoon her telephone quit working so when I got home and determined the problem was outside my realm of expertise, I went online and placed a trouble ticket through AT&T's automated system. I was informed that the problem would be resolved by 8:00 p.m. Thursday, which didn't sit well, but Mom wasn't worried.

Mom slept until almost 10 a.m. Wednesday and woke up feeling cold. After getting cleaned up, having Tanya clean her wound and eating breakfast I reminded her that her bed was going to be picked up and a new one delivered. "Whatever," was the response. I also explained the problem with the phone and received the same response.

The equipment hospice delivered on Monday was removed Wednesday morning, the room vacuumed and made ready for the new equipment. AT&T repaired the problem with the phone, the Heartland Home Health nurse came by and Beaumont delivered their equipment. OT came by, PT called for tomorrow and all is well at 23110 Meadowlark.

Needless to say all the changes and activity has been a little overwhelming for Mom. She's dealt with it all with her usual aplomb and we talked about now that things are settling down, she'll be able to develop a pattern of living that works for her. Tanya helps her as much as necessary but allows Mom to do what she can. So far she hasn't been cooking, but I think that may change in a week or so as she regains some confidence. She has had several calls this afternoon, is enjoying being home, and getting comfortable with Tanya. Giving them space is difficult for me, but necessary. I hope to leave Friday even though I know Mom would prefer I stayed, but Byron & Colleen will be coming by, Val will be down again this weekend and hopefully other family members, friends and neighbors will stop by often.

Throughout all that she has gone through Mom's attitude remains positive and hopeful. She's where she wants to be. What a trooper!

Getting ready for Tuesday

We've had a busy week. Last Tuesday brought the every-other-week visit to the wound clinic. Mom's wound is looking  better, but as it was explained before, because of the severity of the radiation damage it will never completely heal. Call it medical semantics or what have you, we were told a stage IV wound remains a stage IV wound; it may resolve somewhat, but it will not become a stage III.

With that knowledge and weighing the options for bringing Mom home, the social worker at Heartland suggested we consider hospice. Mom and Dave met with hospice representatives, and Mom has decided that at this point, having hospice would be the best course of action to take. Hospice will help with coordinating the medical piece of in-home care and pain management. This also defines what path we will be taking with future medical decisions. Right now we are planning on having a caregiver with her 24/7, at least until we get a handle on how things are progressing and what she's capable and comfortable with.

In anticipation of Mom's return on Tuesday, there was a flurry of activity at Meadowlark this past weekend. Cable TV (yes, she did not have cable) and wireless internet were installed, the many layers of wax were stripped from the kitchen floor so the carpet adhesive would stick, a new twin bed for the little bedroom (aka Val's room) arrived, the carpeting was laid, a new stove was delivered, Mom's room thoroughly cleaned (which didn't take much, as everyone knows Mom is the queen of clean), the refrigerator stocked with basics, and a bunch of other things.

The rationale for the cable was so Mom and her caregivers would have some more viewing options, and the internet for us and the caregivers. Mom's kitchen floor was in bad shape and we decided carpeting would be a good option, providing a smooth surface for a walker or wheel chair and also lend some warmth. Her 30+ year old range was ailing and unreliable, so we replaced it. Same was true for the twin bed in the little bedroom, and since that's where her caregivers will sleep, we felt it best they be able to get a good night's sleep while they're there. Mom's bed got moved upstairs (the "boys' room") and a hospital bed will arrive for her on Monday.

Dave interviewed some home care agencies recommended by the geriactric case manager and has another to interview Monday. Mom is a favorite of many of the Heartland CNAs, and several offered their services for home care on a cash basis. While we're appreciative of their offers, we felt it best to go through an agency to insure there is backup and also to have bonded and screened people. We are also considering one agency we hired last spring before she broke her hip.

If all continues to fall in place, Mom should be sleeping under her own roof Tuesday night and be able to enjoy her magnolia tree, which is ready to blossom any day now.

Plan B, as it stands today - Part 2

Yesterday mom expressed a surprising desire to go to a nursing home. We had a good discussion about her fears, concerns and thoughts. I reminded her that her focus has always been on returning home and she should consider giving it a try so she can make a decision based on experience rather than fear. I also reminded her that she is very determined to do as much as she can and her continued positive outlook is an inspiration and motivator for many of us.

The plan for Byron & Colleen to stay at the house has changed. After much soul searching they realized that with their other commitments and schedules it just would not be possible. Their hearts were in the right place and the offer appreciated, but realistically just not feasible. Colleen did say she will be able to do the wound dressing twice a day as planned.

Like Val, I'm hoping the change in weather will provide the opportunity for visits from friends and even if she can't walk the sidewalks, they are pretty bad, she can and did walk her driveway frequently and as long as someone is with her and she should be able to resume that activity as well.

Not sure about baking cookies, but who knows.

Plan B, as it stands today

After our disappointing and frustrating foray into the world of assisted living, and weighing the options -- nursing home or going home with lots of assistance -- we've opted for the latter. The plan at this writing is to make the necessary changes (carpeting the kitchen, putting in a new stove, getting a hospital bed delivered, having cable and internet installed) and bring Mom home, hopefully on Easter or Easter Monday. Initially Byron and Colleen will stay with Mom at night Sunday through Thursday, and Dave and I will alternate weekend nights and days. We'll get a granny sitter (who should be able to do housekeeping and other tasks) for Monday through Friday daytime. Fortunately Dave is here this week so he will do most of the leg work in getting this arranged.

After a couple weeks we'll reassess and possibly hire someone to stay with Mom during the night as well as during the day, but continue to alternate the weekends. Or we may find that a nursing home placement would be more realistic. This won't be easy, but (a) she has wanted to come home all along and (b) not being in a nursing home environment will lessen her exposure to infection. We can do the twice a day wound dressing changes. Having her home will definitely have drawbacks; she will be isolated, and in an institutional environment, she has more opportunities for longer strolls down the hallways. But now that it's (finally) spring, perhaps more people can get out to visit her, and we could always take her to a mall, Meijer, or church for a longer stretch of walking (we found after she broke her hip that sidewalks are not very walker-friendly).

So with any luck, today should be her last Monday at Heartland. Fingers are crossed!

Now For The B Plan

Byron, Val & I spent several hours at Sunrise-Troy last Saturday, discussing Mom's possible move there. We talked about their assessment of her, expressed our concerns about the wound, but were told that she most likely would be able to move in, providing nursing care was arranged to attend to her wound. The nursing director wanted to see the wound herself, and said she'd visit Mom on Monday.

All of us liked the facility, and after viewing several rooms we chose one we thought she'd like. The measuring tape came out so we could determine furniture placement, Val wrote the check for the deposit, and after grabbing lunch (and watching a bit of March Madness), we visited Mom at Heartland and talked with her about moving into Sunrise for at least three or four months, until she regained more strength and the wound healed more. She reluctantly agreed that it would be a good thing and we moved on to discussing the move, which we planned for this coming weekend.

Kathy, the nurse from Sunrise, visited Mom Monday to assess her wound and review her medical records. She reported back to her higher ups at Sunrise, and on Tuesday we were notified that Sunrise's corporate office determined that because the wound is still Stage 4, she would not be eligible to move into Sunrise at this time. Needless to say we are disappointed.

Now for the B Plan. We don't exactly have one. Mom will continue at Heartland for the time being with efforts being made to either get her placed in an "active" nursing home, or have her return to Meadowlark. We are looking at home health care, 24/7 care and what modifications will be necessary to accommodate her continued use of assistance devices.

When I spoke with Mom last night, I shared the news that Sunrise was out for now because of the wound. She accepted this with her usual stoicism and is quite content at Heartland for the time being.

I'll be back in town tomorrow and will stay for a while to assist in any way I can. Val will come down Saturday and Tuesday when we take Mom to the wound clinic again.

That's it for now.

Another Field Trip

Yesterday mom and I visited Sunrise-Troy, the assisted living facility at Crooks & South Blvd. We toured the facility looked at two types of accomodations and enjoyed a pleasant lunch in the dining room where mom was able to talk with some of the residents. It was very enjoyable and while she would never admit it, I think she can imagine herself living there. A representative from Sunrise did an assessment of mom this morning and they see no problem with her becoming a resident. Stay tuned, there may be a new address soon!

We also spent a pleasant hour or so with her lifelong friend Priscilla, who has been in Evergreen Nursing & Rehab for a few weeks. It was a pleasure to see the two of them together and I made myself scarce so they could have a nice private visit. We returned to Heartland so mom could have her dressing changed, lay down and get some rest.

When I spoke with mom to remind her of the assessment today, she said felt the rooms were too small and wouldn't accomodate a wheel chair. She toured the facility, to include the rooms, in her wheel chair yesterday with no problem so I think she's just looking for excuses. I look forward to seeing her this afternoon and spending an hour or two with her, talking about this pending change to her living situation. Should be fun!

The Week So Far

I arrived at Heartland Monday afternoon about 4:30 and spent an enjoyable hour with Mom before heading to Meadowlark and unloading my car. She had her hair done earlier in the day and was looking quite nice. We sat in the hall by the window enjoying the warm sun and getting caught up. I reminded her I would be taking her to the Wound Clinic on Tuesday and Dr. Hale on Wednesday. We also discussed the plan to contact the facilities Darcy mentioned to see about moving on to the next phase of her recovery. It was late in the day so I didn't get much of an argument and encouraged her to think of assisted living as a short term stay, 2-3 months. She could think of reasons why not to go, it's not Meadowlark, and was unable to come up with anything positive to mention. She appears to be willing to try this option, though, so we will see what happens.

Tuesday morning I contacted Wynwood of Troy and scheduled an assessment appointment for Wednesday the 17th. I also called, and visited, Sunrise of Troy, and discussed an assessment with them after a brief tour of their facility.  We'll go there Thursday morning for a tour and assessment and then visit Priscilla. The weather has been so wonderful, it's a shame to stay inside all day.

After a nice lunch with Mom and Val we prepared to depart for the Wound Clinic. Cousin Tara & her daughter Andi (aka Dr. East) accompanied us on the journey to Beaumont. Val & Andi participated in the unveiling and assessment of the wound in Dr. Ordano's office while Tara and & visited in the waiting room. The staff at Heartland had commented that the wound is healing and looking pretty good. They didn't mention anything about the dead tissue around the wound resulting from Mom not getting out of her chair with any regularity and either standing or laying down to relieve the pressure. Dr. O did say the wound is healing, but is still considered a stage 4 wound. That being the case, twice daily dressing changes will continue until the wound reaches a point where a Vac-Pac can be used.

While her assessment for Wynnwood was taking place, I sat in the hall reading the Free Press. While paging through the paper I saw an obituary of someone I was sure Mom knew and noticed the memorial service was scheduled for 11:00 this morning at FCCRO. After the interview concluded I showed her the paper and she decided she wanted to go to the service. After she took care of her personal needs we made it to the church with about 10 minutes to spare. Following the services Mom enjoyed visiting with her many friends and admirers (surprise) and held court in the fellowship hall while eating a terrific church food funeral luncheon.

Seeing Mom sitting with her dear friends, watching her interact with people that came by to visit with her was such a treat. Her whole demeanor changed. There was a wonderful smile on the her face, she sat up straighter, was pleasant, caring and concerned to everyone who she saw. She looked and acted like she didn't have a care in the world. It was great.

We finally got out of church about 2 p.m. with enough time to get to Heartland so she could use the facilities, have her wound dressed, and get to her 3:00 appointment with the infectious disease doctor, Dr. Hale. Dr. Hale discontinued the IV antibiotics and the PICC line will be removed at Heartland this afternoon. We returned to Heartland, Mom needed to rest and I needed to get this post out. Sorry it's so long, but I wanted to get everything out before I forgot things. I'm sure there are some things I failed to mention, but will add to my next entry, if I remember. It'll be interesting to see how the visit to Sunrise goes on Thursday. They say they can accommodate a stage 4 wound; we just have to pay for the nurses to come in and deal with it.

That's it.

Next steps

Mom was delightfully surprised by a visit from Tim, Lori, Travis and Trevor Tuma on Saturday around lunch time. She walked with them from her room to the day room, where they enjoyed a nice visit. It's always good to see Tim and his family, and Saturday was no exception. Later that afternoon Margie, Mom's roommate until last Wednesday, came by with her sister and brother-in-law to visit and deliver several boxes of Girl Scout cookies.So if you stop by to see Mom, she can now properly entertain and offer cookies.

Last Wednesday Byron took Mom to her appointment with Dr. Hale, the infectious disease doctor. Mom continues to receive intravenous vancomycin for MRSA, and seems to be responding well to it. She'll see Dr. Hale again this Wednesday. She has an appointment at the wound clinic on Tuesday, and I'm curious to see how things are going because Mom says both Dr. Hale and the wound team at Heartland say her wound is healing quite well. Dave, who's coming in on Monday, and I will take her to the wound clinic appointment. 

Mom's Medicare eligibility for rehab expired on Saturday, but she's staying at Heartland for a bit longer as a private pay patient in order to finish up her IV therapy and determine her next living situation.She will not be receiving physical therapy, so visitors, take heed: that means she's likely to be in her room if you wish to visit. The geriatric case manager we met with felt that despite what St. Anne's said, Mom was a good candidate for assisted living and identified a few places that could do the wound care that she requires. One of the tasks Dave has on his dance card is to have Mom assessed by one or more of these places and hopefully move ahead on this. Mom, of course, would prefer to go home, but understands (or at least on Saturday understood) that assisted living is the best place for her to go next. Hopefully in a couple weeks we'll announce a new address for her.

An RB shop connection

Just after lunch on Wednesday, Mom and I met with Darcy, the geriatric case manager. She spent several hours with us, asking questions and listening to Mom's answers. She also assessed Mom, using the same tool that they used at St. Anne's. 

In response to Darcy's question about what kind of work Mom did, Mom said she had been in sales and for years managed the RB Shop in Royal Oak and later Birmingham. Turns out Darcy's father was a regular there when he needed to buy a gift for Darcy's mother. Mom claimed to recognize the last name; who knows, it's possible. The RB Shop connection elevated Darcy's credibility in Mom's eyes (never mind the nursing degrees and other credentials), but not that she needed it; we both felt at ease with her and it was clear she knew what she was talking about.

Darcy will use the information we provided, plus Mom's medical records, to recommend a placement for when her Medicare runs out at Heartland (March 13). Mom can stay on at Heartland as a private pay patient, too. A couple of the challenges we faced are the wound and the MRSA infection; they're two things no extended care facility likes to have.

After our time with Darcy, we dashed off to the wound clinic for our bi-weekly visit. It looks like we'll be making this trip for the foreseeable future for wound debridement. They'd like Mom to limit the amount of time she sits to two hours three times a day.

Tomorrow my cousin Tara and her daughter Andrea, who's a surgery resident at U-M, will be visiting Mom in the afternoon. It'll be interesting to get Andy's take on things. We're also looking forward to Dave's return in the middle of the month.