A Different Kind of Visit

Mom had been declining her meds a few days in a row, so was pretty comatose the last couple times I visited.  She wasn’t opening her eyes at all and hadn’t been talking with me.

During my most recent visit, I was sitting with her in this state, reading a sweet card to her that she’d just received from an old friend, not knowing if she was listening or what was going on inside her head.

When I finished, there was a void of silence.  Then all of a sudden she cleared her throat and said perfectly clearly, “Let’s get down to business here.  Are you aware that J. Lo is pregnant?”

“Mom!” I yelled, laughing hysterically with tears in my eyes.  “Are you faking this coma stuff?  And how are you keeping up with celebrities?”  (My mother’s not the tabloid type at all and used to really dislike that kind of stuff.  I had no idea she even knew who Jennifer Lopez was.  I assume the young caregivers might be keeping her up to date.)

Mom started laughing too, and then while she was alert, we had a little discussion about how she feels on the days she’s not so responsive.

“What’s it like in there?” I asked.

“It’s pretty much okay,” she answered.

I asked a few more questions to assure myself, and she basically said she feels peaceful and that it’s too much effort to open her eyes and talk sometimes.

That was a relief.

I thanked her for waiting until she had something really important to say to break out of her false coma, in a teasingly mocking voice.  She laughed and asked me to get the heck out of her room leave her in peace, still laughing, so I did.

I drove home with a smile on my face.  I never know what will happen with my unpredictable mother, but it’s definitely a good visit when we find something to laugh about and she’s not upset about me leaving.

Posted in dementia | 4 Comments

Letter to Hospice: How not to overextend a waning life?

Lately the caregiving has been in a good groove.  My routine has become to spend a lot of time with Mom on the weekends.  During the week I’ve stopped making the long drive to visit.  I completely let go from Monday-Thursday and hope for the best.  I don’t even call because she can’t remember to hold the phone up to her ear, and she just gets agitated.
Things on the surface are more calm and steady than they ever have been so far, but like many caregivers, I still have nagging concerns about my role, the ethical decisions and boundaries, where to set my expectations, and where I might need to let go more.
Below is a copy of the email I just sent to Mom’s hospice social worker, which I decided to share here because sometimes I avoid posting on this blog because it’s too exhausting to try to put all the things that have been running through my head and my heart into words.  So I can either abandon the blog, write sporadically on the months I can summon eloquence, or just post whatever I can muster.  Today I opted for the latter.

Dear (hospice social worker name here),
Regarding your question about what I was wanting help with, I have some ethical questions about Mom’s Parkinson’s meds.  It seems that to some extent they’re extending her life.  She asked me many times in the past not to do that, and I also have my own concerns about her going on and on in her limited life state for more years than would occur without medical intervention.  
 
In the last couple years, Mom’s asked me repeatedly to stop all her meds to help her “move on”.  I felt that was too risky under the circumstances.  She was often agitated and her behavior and moods could be unpredictable.  I didn’t want her to end up back in the psychiatric hospital having to take even more drugs.
 
But now that she’s much more at peace both on the days she takes the meds and the days she doesn’t, I really don’t know what’s best for her in the long term.  I do realize that she drools a lot more, sleeps a ton, and rarely opens her eyes when she declines the meds, but I haven’t noticed any discomfort, other than mine, since it can be hard to witness.  I used to think she was near death on those non-responsive days, but now I’ve come to realize that it’s probably the temporary lack of dopamine.  Whether or not that means anything about a shorter life if it were to continue, I don’t know.  
 
I don’t feel like we need to change anything with her med routine at the moment.  I’m content to let her decide whether she takes her pills or not and not worry about it either way, as long as she seems reasonably peaceful.  But I do feel like it would be helpful to gather more information about these issues for the future.  I’d be interested in hearing what your doctor has to say and the experience of your staff in these kinds of situations with advanced Parkinson’s/Lewy Body Dementia.  
Thanks much.
Megan
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Flower Power – Part 2

I love being a caregiver at this time of year because I know that all I have to do to get my mother’s eyes to sparkle again and bring back her smile is to bring her a bunch of fresh flowers from our yard.

I’ve written in the past about how Mom was always a gardener, with that magical green thumb.  It  seemed that all the plants needed to thrive was to be in her presence.  Our neighbors would dump their dying houseplants or perennials on the doorstep and Mom would have them sprouting new growth within days.

So this is a part of her life I’ve wanted to keep going.  She’s had to give up so much of herself.  I often hear her say things like, “I don’t know who I am or what I can do anymore,” but when a plant project ends up in front of her, it jolts her back to a self she knows, and she gets bossy.  I love it, because to me that means she feels competent, knowledgeable, and useful again.

After a string of days when she’s been barely able to get out a coherent sentence, when I brought in the flowers she found the words to tell me exactly how she wanted this vase arranged and where to put it in her room:

I’ve noticed this effect with many of the residents at her memory care.  When I bring in plants or flowers, their hearts and stories open up.  The smell of fresh dirt or the sight of a peony seems to be a powerful memory elixir for their generation.  (And as I write this, knowing so many people my age and younger don’t connect with the natural world anymore, this leads me to wonder what their memory portal will be.)

When I brought in the lilacs today, Mom ordered me to put them out in the living room so all the residents could enjoy them, rather than keeping them in her room.  I love that despite all her struggles and increasing self-centeredness as she shrinks back into herself more each month, she still has these grand moments of generosity and thoughtfulness.

After she said that, I told her that when I grow up I want to be just like her.

She smiled and said, “Well that’s kind of nice.”

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Hospice and more ethical-emotional dilemmas

Mom has been with hospice a few months now.  I’d only heard the most fantastic things about them, so felt positive about this transition.  Mom qualified not because she was dying, but because her doctor knew we’d both reached our limit with trying to haul her to appointments, knew how hard life is for her all around, and knows she’s in the last, very nasty stage of Parkinson’s with Lewy Bodies, which unfortunately could last many more years.

I thoroughly enjoy my time with Mom, even when she’s vile to me, which has come back around lately, but I’d never try to extend her life at this point.  I like that hospice GETS that 100%, when much of the world cannot understand why you wouldn’t do everything you could to prolong a parent’s life, regardless of the situation.

This is how Mom’s been spending a big chunk of early spring:

The hospice experience so far has been a mixed blessing.  Mom’s team (nurse, social worker, CNA, volunteer, and pastor, who Mom promptly dismissed) is super young and not incredibly experienced, it seems.  I suspect they place the “greener” teams with the memory care residents where families are less present and demanding – I think it’s human nature that they tend to give up and show up much less at this final, frustrating and tedious stage of caregiving.

The first month of hospice was frustrating for me.  The team made a lot of suggestions that weren’t relevant, which there’s no way they could know- they didn’t know Mom yet or her history.  It felt like a lot of work to educate and “train” them about Mom, but they’re very nice and I feel grateful each week for their extra presence, vigilance, and ideas.  Mom despised the young pastor they sent to talk to her about her “spiritual needs”, and eventually “fired” him!!!  I had to intervene and tell him she meant it when she said that she was done with him when he kept coming back.  She has a thing about men she doesn’t know touching and hugging her, so he never got a second chance after that.  Probably good training for him!

The struggle I’m having recently is that Mom’s been refusing meds several times per week which causes her to fall into a more comatose kind of state.  She ceases to eat or drink much, and mostly sleeps, seeming as if she’s closer to dying.

As soon as she starts taking the meds again, her consciousness returns, as does her personality, alertness, and some of her physical skills.  I strongly suspect that Mom would die faster if she ditched the meds completely- maybe within a few months.  If she continues to take her dopamine drugs, (for Parkinson’s/Lewy Body Dementia) it seems she may go on living her frustrated and not so full life for several years or maybe more, gradually losing body functions, painfully aware of each decline.

I want and need to talk these issues over with Mom’s geriatric doctor, the one who signed her DNR order and understands such dilemmas very well.  I requested an appointment with him for this purpose through hospice, since I wanted them to be there too.  They accidentally scheduled the doctor to come see Mom instead, and without notifying or inviting me, which was incredibly frustrating, since I was the one who’d requested the meeting, AND since I’m Mom’s legal guardian and health care agent.

Anyhow, that’s why I still haven’t been able to sit down and hash out my insecurities about the med question with Mom’s team.  I want to follow Mom’s wishes as closely as possible, which in her words are summarized like this:  “When are you going to find Dr. Kevorkian for me?”

I also want to do the best I can to ensure her comfort and peace, without neglecting my own.  I’m not sure how comfortable I am (or will be in the future) about being the one to decide when it’s time to let go of the meds.   Since I have no idea what’s best, I’ve been letting Mom decide in her unpredictable way.  One day she refuses, another day she takes the pills.  It’s up and down, and therefor so is her functioning and her moods.

I’m pretty sure that she’s not getting much pleasure out of life, though I know she enjoys a couple of her staff, she likes our outings, enjoys eating her favorite foods when I bring them, anticipates watching 60 minutes and British comedies (as much as she can follow them), and seems to enjoy making sarcastic comments about her state of being and the facility she lives in.

I know that part of my fear about her prolonging her life with the medication has to do with my exhaustion, worries, and stress with the situation, and most of all the emotional agony.  It can seem pretty selfish, though maybe not unreasonably so.  I’m in my early 40’s and I fear that if my husband and I don’t start our path to parenthood soon, it just won’t happen. He doesn’t think it makes sense to head that direction when Mom needs so much.  Some days I think he’s right, and other days I fear life will speed by and Mom will outlive one or both of us.

For now, I have no answers, but as usual am groping along in the dark, trying to make some sense out of each day and hoping I’ll have the strength to make these big decisions when I need to.

Posted in caregiver stress, support, and respite, dementia, lewy body dementia, parkinson's | Tagged , , | 6 Comments

First Outing of 2012 – Accidents happen

Mom lost her glasses 2 months ago.   I haven’t noticed any difference since then in how well she can see or read.  When she started saying that her glasses “didn’t work” anymore, only a month after her last eye exam, I’d been concerned that cognitive barriers were making it difficult and sometimes impossible for her to remember which part of the bifocal lens to look through.   She kept throwing the glasses in the trash, thinking it would get me to take her back to the ophthalmologist faster.  I knew insurance wouldn’t pay for a quick return and I knew the doctor said she was good for a year, so I was pretty stubborn about it.

Carol Jean was much MORE stubborn than I, though.  Feeling wronged, she kept throwing the glasses in the trash.  I’m guessing that’s how they finally completely disappeared.  The staff must’ve missed them, since they usually fish them back out.

Ever since Mom mostly stopped walking in the late fall, she hasn’t wanted to leave her residence.  I honored that all winter, but finally got her the much anticipated eye appointment a few days ago, and decided I could somehow haul her in my car.  A staff helped me stuff Mom in the car.  Yes, you heard that right- there’s no pretty way to say it: we pushed, poked, prodded, and ultimately STUFFED her into the car.  It was an ordeal, despite the slippery seat cover I’d prepared in advance for easy pivoting, etc., mainly because Mom was so tense and was convinced we were trying to kill her.

Once I managed to get her door shut and drove off, Mom seemed enchanted to be out of her facility in the sunlight, watching and trying to describe everything that passed by her passenger window.  When we pulled up at the clinic, an angel appeared – a clinic greeter who helped me prepare Mom and the wheelchair for the transfer and stayed with Mom, reassuring her that I hadn’t ditched her forever as she suspected, while I parked.

During the transfer, I realized Mom was soaking wet, right through her super-absorbent generic “Depends”.  People reading this post who’ve never been desperate caregiver once or twice probably won’t understand the way the story goes from this point forward, but no way was I going to head back now.  Mom had been begging me for this appointment every week for months, nearly bursting into tears each time I said we had to wait.

I wheeled her up to reception for the eye doctor on the 3rd floor and explained to the desk person what had happened, asking if they had any kind of pad or disposable underwear that I could use.  This receptionist was the ANTI-angel.  She glared at me, looking disgusted, and said “no” coldly, then looked the other way.  That was when I noticed that her desk was also check in for UROLOGY.  Please!!

I lost my clear thinking at that point- in retrospect I could have recomposed myself and gone to ask one of the urology nurses which probably would have promptly solved the problem.  But at the time, in my distress I felt ready to burst into tears or have an angry fit right there until someone would help us.  But instead of fight I chose flight, and took Mom into the bathroom to see what kind of improvising I could do myself.  She was happy as a clam to be at a doctor’s office and had no idea she was wet. (Mom has always been somewhat of a hypochondriac, most happy in a medical facility.) Fortunately, she didn’t smell at all, and for better or worse the wetness seemed to be drying or reabsorbing somewhat.

When we got out of the bathroom, I had done some wiping and adjusting, but hadn’t improved things much in the wetness department.  Mom was still soaked (invisibly so), not stinky, and happy, and the medical assistant was in the process of calling her name to enter the exam room.  I wheeled her in, transferred her as quickly as a could with the M.A. spotting for me, and pretended there was no wet spot on the wheelchair pad, which I grabbed and flipped over.

The tests they normally do for vision wouldn’t work with Mom because she couldn’t remember where the nurse instructed her to look and where not to look, even with my constant prompting, and kept getting distracted by other things in the room.  The nurse tried using pictures instead of letters, but Mom couldn’t get focused enough to see them in the mirror on the wall either.  Finally the nurse gave up and held up her hand.  “How many fingers do I have up?”

Mom did great with that.  It was comical to see that kind of primal vision test in a state of the art facility.  I might have found it more entertaining if I wasn’t worried about Mom’s chair starting to drip onto the floor.

For the close-up test, Mom read the numbers just fine.   When the doctor came in, he said that she had the same prescription as he, which wouldn’t necessitate glasses at this point in her life.

“She can see her food, the TV, people around her, and she can read,” he stated.  “If she’s not walking on her own, then that’s probably good enough, and it’s probably not worth the hassle of glasses for her.”

I looked at him, ready to counter his assumptions as Mom’s advocate, but then took a breath and realized he wasn’t being condescending.  He understood and he made complete sense.  Mom would probably just throw out the new glasses when she felt frustrated, even if we didn’t go with bifocals again. She can see what she needs to see, and his recommendation was my recent suspicion anyhow.

We got Mom back into the wheelchair and I was relieved that she’d left no wetness on the vinyl chair, which alerted the nurse about before we left.  Once we got into the car, Mom was ready to hit the town, listing all the things she wanted to do out in the community.  I felt that I SHOULD take her home and get her cleaned up, but it felt like a huge victory to have her out on a nice day in a pleasant mood, so my inner Thelma and Louise decided we should go for a joyride and try to do everything she wanted to do instead, and forget the rules of hygiene for a couple hours, as long as she was comfortable.  I don’t get a full day to dedicate to her very often, and I didn’t know if she’d return to her fear of the outside world again, maybe refusing outings for a month or more.

First, she wanted lunch, so I ran into a nice cafe, got her an incredibly messy salad I knew she’d love, with pecans, apples, cranberries, greens, red onions and goat cheese, and a snickerdoodle for dessert.  I then had to stop at the drugstore because all she’ll drink when we’re out is ginger ale.  She’ll accept any beverage the staff give her at her place, but it’s ginger ale or nothing when she’s with me. Maybe she knows I’ll pull through.  ??

I stayed parked in the sun by the lake and let her devour the salad with her hands in my car.  Thankfully I had a towel in there, which I draped from her neck to her knees just in time.  She had a ball stuffing it all into her face while I ate the lunch I’d packed, and every once in a while we traded, because whatever I’m eating is almost always more interesting to her.

She next wanted to go shopping at her favorite variety store, which I managed to convince her to stay in the car for while I dashed in for the 3 items she “had to have.”

“I need 5 boxes of softer tissues, gum that won’t stick to my teeth, and a Time magazine, ” she proclaimed.

When I returned she asked if I remembered the notepad and birthday cards.  I smiled silently and handed her the bag, which satisfied her for a minute.  Then she wanted to go to the “gardens”, so I drove her around the lake, trying to explain why there weren’t any flowers yet, instead pointing out the water and birds, which seemed to please her desire for nature.

Right about then, I realized I was feeling sapped, and needed to get her back home because I still had an hour’s work to get her back to her room, be sure the staff got her fully clean and dry, and deal with a handful of things at her place that needed attention.

Mom was sad to see she was back at the facility and explained that she’d expected that we would’ve hit the mall, but as soon as she was cleaned up and we got her back in her cozy reclining chair in her warm room, she passed out for a hearty nap while I got to work on the projects that needed to be done.

When I kissed her goodbye she woke up and asked me about her glasses.  I explained again that she was done with those – didn’t need them anymore.

“Well then, we better make an appointment to go see the eye doctor to check my vision,” she said in her stern mother voice, as if she didn’t trust me to follow through.

At first I slipped into the habit of trying to remind her we just did that, which of course annoyed her.  Then I remembered to let her be the mom and agreed that her idea made a lot of sense.  “But how about not today,” I added.  “We just got home and we’re both exhausted.”

“Alright, but first thing tomorrow,” she answered, barely finishing her sentence before she drifted back to sleep.

Posted in advocacy, caregiver stress, support, and respite, dementia, doctors and medical, humor | 8 Comments

Riding the Waves of Dementia

The extremes of Mom’s lewy body disease have lent plenty to write about lately, but making the time and space to emotionally process and translate it for others has not been something I’ve done.  Some if it still feels too raw, and sometimes just keeping up with the present in my own mind is plenty of work.

I’ve also been working a lot more (teaching and tutoring), playing with the idea of easing myself back into a regular schedule.  This means I’ve had to let go of some of my caregiving ideals.  So Mom’s teeth don’t get clean enough most of the time, she didn’t yet get the new eyeglasses she needed a while ago, and she’s sorely needing some new clothes to replace the ones that keep mysteriously disappearing, even with her name loudly labeled on the collars and waitbands.

At times letting go and stepping back feels like a healthy progression.  Other times I feel sad and scared about missing a big chunk of her life when I visit less.  It’s like witnessing a very young child grow, but in reverse; people with dementia at certain stages change extremely rapidly in personality and abilities from week to week – even day to day.  I don’t want to miss any of her last steps, words, or jokes.

When I come on the weekends and find Mom in a state of disarray with crusty eyes, food in her hair, drool in her lap, and other yuckiness that seems unnecessary, I feel horrible – I want to give up residential care completely and bring her back home full-time, against the odds that we could ever do so safely or successfully.

One thing’s for sure in Mom’s situation: everything’s constantly changing.  A lot of the time it feels like surfing, never knowing how long you’ll ride along smoothly until a tidal wave comes along, smashing reality and rearranging everything you ever knew.  And if it feels that way for me, I can only imagine how the person with dementia experiences her shifting world.

Between the hard spots, we had a blissful 2 weeks where Mom was lucid, content, and fun in a way I haven’t seen her EVER.  I reveled in it as long as it lasted, with lots of good visits and laughter, and then things changed again, as they tend to.

I got a call the following week that Mom was refusing her meals, her medications (the thyroid and Parkinson’s meds can be a big deal for her functioning), and then got a call 3 days after the fact that she’d “attacked” a caregiver.  That’s saying a lot for a woman in a wheelchair who has no arm strength, so I immediately felt defensive.  When I received more details and heard that she’d bitten a certain staff she’s complained about for months, I wasn’t surprised or sympathetic.

Mom’s always felt threatened by that staff person’s manner of speaking loudly and touching her more roughly, with little patience for Mom’s desires and timeline.  Mom has told this staff person to stay out of her room, that she doesn’t want to work with her.  Instead of accepting that and giving Mom space, the young person argues with her and says her feelings are hurt.  I’ve asked the director to respect my mother’s wishes if she feels uncomfortable with a specific person helping her, which also means no men.  Mom won’t accept male staff doing intimate work with her, but the corporation has been moving their administrative people around, and when staff changes the little details about each resident tends to get lost in the transition.

On the biting day, this woman and her helper were physically trying to put Mom to bed right after dinner (6:30PM), which is convenient for the caregivers, but not okay with my mother, who’s always liked to sit up and watch TV in the evening.  Mom says they wouldn’t listen to her and were trying to haul her off to the bathroom to change into her PJ’s, so she defended herself the only way she could.  I believed her.  The staff did later confirm that they were indeed trying to put Mom to bed after dinner.

People with dementia are still adults with their own priorities!  The director backed me up on this, but it felt like an empty gesture to me.  The staff person is still working there and their routine of starting to put the less able residents to bed immediately after dinner seems to be intact, though Mom is now exempt since she has a persistent advocate.

I realize they have logistics to deal with – many residents with endless needs, especially near sunset.  My struggle is the constant compromise of turning over your family member to strangers who might never be able to give the same quality of attention and care – something I’ll probably never get used to, even though I’m constantly working on letting go of whatever I can.

Posted in advocacy, dementia, lewy body dementia, memory care and residential options, parkinson's | Tagged , , | 2 Comments

Farewell to the Watcher

Mom and I are both feeling more than a little heartboken that her sassy best friend at the memory care facility got whisked into a nursing home by her adult children with no prior notice.  This family didn’t visit often, so they would’ve had no idea about the bond that she and Mom shared, and how much Anita meant to us.  We never got to say goodbye or get her new phone number.  This spitfire 94-year old, who I’m calling “Anita” to protect her identity, called herself Mom’s “watcher”.  In the picture above she’s modeling her favorite heels for me, standing next to her walker.

She was actually quite disappointed that I didn’t get her huge sparkly earrings and purple eyeshadow in the photo, but without knowing her family and how they’d feel about a total stranger blogging about their elderly mother in dementia care, I decided to maximize her anonymity.  I couldn’t resist a few pictures, though.  Anita will no doubt be the Centenarians of America’s next top model.

Not known for her tact, I pretty much despised Anita the first month she was around.

“What the hell is wrong with you,” she’d yell at Mom at every meal I witnessed.  “We all have problems.  Stop feeling sorry for yourself and eat your damn potatoes before I shove them down your throat.”  She’d bark it out with a giant smile, always adding, “I’m just teasing you, sweetie.  Pick your head up.”  Then she’d rub Mom’s hand and tell her how beautiful she was.

Mom took a fancy to her (as did I), though she understandably got overwhelmed by Anita following her around all day making her loud, pungent comments.   It was a love-hate relationship, or so it seemed, and maybe not the healthiest one, but now that she’s gone, we both yearn for her bittersweet humor that kept slashing through the reality of the institution.

“This isn’t food,” she’d yell at the staff.  “This is fodder!  But I’m not sure what kind of animal would eat it.”

As you might guess, Anita, Mom and I bonded on the desire for good food, so she was always the most enthusiastic and faithful guest at our real food parties in the main dining room, whenever I could bring meals in.  Anita would rave with pleasure, and shuffling in her heels, helped me pass bites around to the residents.  She would especially be sure the ones seemingly on their last leg, who never smiled got a taste.  She got a kick, like I did, from the look on their face when they got to eat something they recognized.

“You’re an old fashioned girl,” she’d tell me on every visit.  “You know good food and you take great care of your mother – they just don’t make those these days.”

To get a compliment from Anita, who was unsatisfied with everything, made my day, even though she said the same phrase every time, and even if she said it only to motivate me to bring her more feta and olives.

Anita did such a great job keeping tabs on Mom that I never worried if I missed a visit.  She would make the staff call me if she had any concerns about Mom, grab the phone from them, and fill me in.

94-year old Anita in her purple heels and designer jeans after dinner, trying to convince Mom to get out of her wheelchair and practice walking.

Anita told me many times about how she’d grown up from poverty in a huge single parent home, graduated with honors, and found a powerful position with the Chicago Tribune Newspaper at a time when most women didn’t do such things.  She’d had to pull no punches to get there, which is maybe why at 94 she could still tear the staff members to shreds with her tongue, and the same night could charm their pants off with parties for them in her room every night, feeding them expensive chocolates.  Anita could still move mountains, even with mild dementia, and she took Mom on as her retirement project, something I became incredibly grateful for.

Despite a touch of dementia, Anita knew her rights, knew how the residents should be treated, complained loudly about injustices, and wasn’t afraid to use throw the immense, righteous weight of huge personality around.  I never saw her in flat shoes, though sometimes she wore her leopard print pajamas to dinner with her gold heels.

“Why not,” she’d smirk, “I’m retired, aren’t I?”

It took me a long time to see behind Anita’s irritating sense of entitlement and notice her gigantic heart.  At dinner, she liked to sit next to one of the men who was mute due to Parkinson’s, and hold his hands steady so he could grab the food with his fork.  It gave her so much pleasure to get a smile out of him that she’d work at it for over an hour sometimes, teasing him and cracking jokes.

I could tell five other similar stories about that side of her- Anita the guardian angel.  Most of all, she kept the staff on their toes.  There was a lot that slipped through the cracks before Anita moved in.  Now that she’s gone, there’s no resident with her stamina, verbal capacity, or mental connections to advocate for peers and serve as the sentinel.

Anita’s presence made a huge difference.  I wonder if her family had ever known all the little details of her days that showed the impact she had on so many people, if they still would’ve moved her away so abruptly.

Posted in advocacy, caregiver stress, support, and respite, dementia, inclusion, memory care and residential options | 3 Comments