Vilsack / Schwann's Axis

Okay, there is no truth to the rumor that Vilsack used to deliver Schwann's. I'm just going for continuity here. This picture was taken during a Kerry rally in Cedar Rapids. Caitlin was determined to get her picture taken with Kerry, but we got the Guv, which wasn't so bad. It's interesting how much younger the kids look here, and politically it was just yesterday.

Today is the last day of my vacation and I will descend into the mundane: lawn, housework, planting a bush, mulching said bush. I may get my mom from the Assisted Living Place and let her hang out a bit.

We had a staffing at the Assisted Living Place (ALP) during which the new head of nursing and the new social worker (recently an intern) attempted to persuade me that Mom needed to get into Memory Care (next level up, locked). Their data was pretty shaky and didn't distinguish behavior which occurred when she was drinking, from behavior since she has stopped. (I had thought they might celebrate how much better she's been doing since she stopped drinking!)

They cited the risk of her wandering off, her difficulty writing checks, forgetting whether or not she has eaten. She's wearing the same outfits, forgetting to do her laundry on time. Bottom line: nothing really seems to have changed. She's relatively happy and isn't really causing trouble. I am not clear on why she needs to be moved up a level. I think she'd be bored stiff at the next level.

I did what I always do: I let them know I was aware that their testing has little reliability, and that I would like to work with our neurologist on this assessment, the one who very recently stated that she did not feel Mom would benefit from being moved up a level. The memory care level is a large atrium, really well thought out, with it's own private garden and smaller suites, and lots of memory cues. There are residents there who are allegedly "higher functioning," and then there are many who sit passively, looking off into the distance, or sort squares of cloth (Montessouri). I know sooner or later Mom will move here, with cats, and will struggle with this transition. I feel I owe it to her to assure that it it "later," rather than sooner. I know that once she makes this move, there will be no coming back.

I sense the staff at ALP are impatient with me. I'm better at staffings than the usual resident's offspring, and their presentation data supporting the recommended move was poorly organized and reflected little preparation. I have learned stonewalling from clients over the years and I know the drill: agree to an assessment by the neurologist, play phone tag with the neurologist, have neurologist schedule a meeting with Mom, review of documentation et cetera, schedule a staffing/consultation that includes neurologist. This should take about six weeks. I imagine that the neurologist will agree that it's not yet time to make the move. Then in a few months we'll have another care conference.

I wish I felt that these people at the care center were my allies. There has been a lot of turnover and most of the people I built relationships with are gone. There is a large block of additional independent living units going in next door, built by the same for-profit organization. The people at the staffing indicated that Assisted Living was not memory care, but that was not how it was sold to us when we moved Mom in. I suspect they would like to market to active retired folk and don't want someone wandering in to the dining area inquiring if she's already had lunch. I suspect they feel Mom would be more manageable in a unit where she could recieve more supervision.

My mother has never been managable, and none of us much appreciate supervision. I can stall and duck and dodge, but I know much of my anger is not really because of staffings and poorly organized data. This is my own futile battle against entropy.

I quoted Yeats to my Mom not long ago:

Things fall apart
The center cannot hold
Winding and turning in the spiraling gyre
The falcon no longer heeds the falconer. . . .

Mom said "Oh shut up." I did.