Reluctant Caregiver: The Pros and Cons of Hiring Your Own Caregivers

You’re struggling to hold down a job and take care of your mother with dementia.  You need help!  Do you hire caregivers on your own, or sign up with a home care agency?

Before you decide, you need to take stock of your resources.  How much money is available? How much time and patience do you have to manage the process?

Here are a few things to consider while you make the decision:

Benefits of hiring caregivers on your own:

1. You get to choose them. You can sift through as many applications and interview as many people as you wish, until you find the right fit – for both you and your loved one.
2. Your house, your rules. Agencies have rules about what their employees can and can’t do.  Need the aide to take out the dog?  Drive Mom to the doctor?  Give Dad his insulin shot? Some agencies prohibit such tasks.
3. You can communicate directly with your caregivers. Many agencies don’t let their employees have the client’s telephone number. This is horribly inconvenient, but designed to keep aides from working “off the books” for a client.
4. Not working out? No problem! If something goes awry, there is no middle man to get in the way. You can simply fire them on the spot (this could also be a con).
5. You set the schedule. Agencies often assign their employees to more than one job in a day.  If their relief didn’t show up at the house before yours, or they run into traffic, you could be faced with skipping your own doctor’s appointment or leaving Mom alone.  You can also offer things like their birthday (or their kids’ or significant other’s birthdays) off – little perks that make working for you a little bit better.
6. You set the pay rate. Agencies need to make money and pay their overhead; therefore, they pay their employees less than they would make at a private duty job.  Caregiving is hard – you know, that’s why you need help – and those aides who are paid fairly tend to do a better job. I also paid overtime on days that aren’t considered bona fide holidays by most agencies – Christmas Eve, Mother’s Day, Valentine’s Day, etc.  Nobody wants to have to work on a day that is special to them.
7. It’s cheaper. Agencies charge upward of $18 an hour, while paying their employees a fraction of that.  I know one client who paid their agency $21 an hour, while the agency paid the personal care aide $9 an hour.  I’ve hired aides who made minimum wage ($7.25 an hour in Virginia) at an agency.  No wonder aides quit to work retail or in the fast food industry – if you’re going to be making minimum wage, flipping burgers is a lot easier than wiping butts.
8. Employees are plentiful. Many agencies are understaffed and can’t meet the demand for their services.  There can be a waiting list of days to weeks – which makes it difficult if you need to go back to work right now.  Place an ad on care.com or another platform offering a decent wage, and you will be inundated with potential employees.
9. You do your own background check. Sure, agencies conduct the standard background check offered through a service or a local police agency. Depending upon state laws, they might hire an employee prior to doing the check, then dismiss them later if something disturbing appears.  In addition to the traditional check that you can conduct for a small fee (usually $30-$50), you can delve deeper into the employee’s background.  Sure, they list references, but you can talk to others at their previous places of employment.  You might call a former instructor.  Stalk their social media accounts.  Agencies don’t go to that much effort, but you will.  After all, these folks will be practically living in your house.
10. Bonuses. Most reputable agencies prohibit their employees from accepting bonuses or gifts from clients. But as an employer, bonuses are a valuable way to keep up morale. I gave bonuses on the employees’ birthdays, as well as at Christmas.  I gave Mom’s day aide – who had the brunt of the mess (and smell!) when Mom had c. diff – a special “poop bonus.”  Appreciation works.

While hiring your own caregivers could be more economical and better for your family, there are some serious reasons why you shouldn’t take it on.  Here are some of the cons of hiring your own caregivers:

1. Payroll. While there are numerous programs and apps to make it easier, you still have to do it. Track hours, write checks or send money transfers, and the worst of all – pay taxes.  Yes, you should do this.  While it’s easy to pay someone “under the table,” it’s also illegal.  And it deprives them of paying into essential programs like Social Security and Medicare.  They will thank you one day.  Really.  Agencies take care of all of the bookkeeping and paperwork.
2. Red tape. This is related to payroll. If you hire someone to work in your home (or your loved one’s home) and pay them more than $2,000 a year, you are considered a “household employer” by the IRS and state tax departments.  You must obtain a Federal Employer Identification Number from the IRS.  It’s a fairly simple, online process.  Different states have different rules for withholding and paying taxes as well as signing up for the state’s unemployment insurance program.  Also, the state and feds might have different schedules.  For example, household employers can pay their withholding and “nanny taxes” when they file their personal tax return.  Some states require quarterly reports, and there is a penalty if you don’t get them in on time.  I know – yours truly paid a hefty sum to the Commonwealth of Virginia for procrastination. Agencies eliminate the need to declare yourself an employer.
3. No backup. Someone is sick, or their babysitter doesn’t show up, and they can’t come to work. You have to scramble to get someone to cover.  Agencies often (but not always) have someone else they can send to fill in for the absent employee. They also are more likely to have someone who can stay overnight if you travel for work or pleasure.
4. You’re the boss. With the control of doing your own hiring and firing, you get the responsibility of doing the hiring and firing. You can’t blame something on the big bad boss at the agency – you have to discipline the workers, and even fire them, if necessary.  Not fun. Agencies take on the Big Bad Boss role for you.
5. Medicaid. If your loved one runs out of money and needs to sign up for Medicaid, the state-federal health care program for low-income people, already being signed up with an agency that participates with your state’s program will help immensely.  Even if you opt for “consumer-directed” Medicaid services at home (where you hire your own aides), you still need an agency to accept the Medicaid payments and pay the caregivers.  The program won’t pay families or pay your caregivers directly – you have to have a “Medicaid facilitator.”
6. Insurance. If your loved one has long-term care insurance, using an agency will make the process much easier.  Depending upon the terms of the policy, you might not be able to hire people on your own.  Providing the documentation and paperwork will fall to the agency, which is a load off of your shoulders.  Also, if your loved one needs equipment such as a wheelchair or hospital bed, agencies have contacts and expertise to make this happen without adding to your task list.
7. Liability. Your Mom’s aide hurts her back lifting your Mom off the toilet.  That’s a worker’s compensation issue.  An agency is covered.  Are you?  If the employee abuses your loved one or steals from you, the agency has procedures as well as insurance to cover it.
8. Licensing. Licensing issues for Certified Nurse Aides or other professionals are murky when it comes to household employment.  This is both good and bad.  For example a CNA for an agency or facility can’t give medications or injections, even if they know how.  There isn’t that oversight in your home, which can make life easier for you.  However, if they do something like abuse their patient, do drugs, or otherwise break the rules of their profession, you would want to deal with that with the state licensing authority.  Having an agency with a pipeline to the licensing organization makes that easier.
9. Contracts. You really should have contracts with each of your employees if you are hiring yourself.  If you use an agency, your contract is with the business to provide the services.  They take care of their own employee contracts.  Less work for you.
10. Bridging distance. If you don’t live near your loved one who needs help, it can be very difficult to recruit and manage caregivers from afar.  With an agency, you have a level of supervision and management.

Regardless whether you use an agency or hire caregivers on your own, research is essential.  Make sure you do your homework before you dive in. If you are considering hiring your own caregivers, the IRS has a handy guide for household employers.  You can compare home health agencies on Medicare’s website.

 

Ginger Thompson has been a family caregiver since 2015. 

 

How the System Fails the Frail

Mom with her grandog Pixie at the SNF that kicked her out because she couldn’t pay a month in advance.

Today for me was a lesson in how the long-term care system is failing.

Mom was home a little over 24 hours last week when she had to go back to the hospital. She became unconscious when we had her in the lift changing her Saturday evening. I had already had to call the paramedics on Friday, about 2 hours after she came home, because she slid out of her wheelchair and I couldn’t get her up.

She was discharged today to a Skilled Nursing Facility (otherwise known as a nursing home with a physical therapy department) for rehab.

After she was in the ambulance on the way to the SNF, the SNF received a Notice of Denial of Medical Coverage from Humana, her Medicare PPO. I got on the phone and filed an expedited appeal, which takes 72 hours.

Meanwhile, the facility admissions director was telling me that since she was coming in as private pay, I needed to go to the business office and pay for 30 days up front, or $8,280. I told her I couldn’t do that, but I would pay for a week up front to leave her there long enough for me to get things ready to bring her home.

I was standing in the social worker’s office, explaining the appeal and how it will take 72 hours, when the Executive Director came to the door. He’s a tall, burly man, with a crew cut, and a sour look. Standing in the hallway, he told me quite tersely that I needed to go to the business office and pay for 30 days. I told him I didn’t have that much, but could pay for a week. He said no. I asked him why, and he said, very rudely and loudly, “Company policy! If you do not pay for 30 days, she cannot stay! She has to leave now!” He was getting really loud. I was crying. People in the hallway and lobby were looking at us. I looked at the social worker and said I would take her home. He said, “Good!” and spun and left.

This was the same SNF she had been in just a week prior.  Her Humana Medicare PPO had required her discharge on Sept. 2, but I kept her there a week on private pay, to a tune of nearly $1,700, in hopes of winning an appeal.  I didn’t.  Ironically, I got word that my appeal was denied yesterday, too, just a couple of hours prior to this incident.  Had Humana authorized her to stay longer, she probably wouldn’t have ended up back in the hospital a little over 24 hours after coming home.

Apparently, Humana has given up on Mom — believing she can’t improve with rehab.  No matter that she walked with a walker prior to her first hospital admission on June 26.  Who would be able to get around well after spending the most of two-and-a-half months in a bed?

The ambulance company brought Mom home and put her in bed because I can’t transfer her from wheelchair to bed, etc. One of the aides I use works at the assisted living facility where Mom used to live, and is trying to rustle me up some extra help.

This is an example of how the system sets people up to fail. Denying her rehab means she will continue to decline. This is how people die. And this is how family caregivers have nervous breakdowns, have to quit their jobs, etc. Luckily, I have a job that is flexible with a company that “gets it.”

Something has to change. As our population ages, more and more of us will need help like Mom. And there are more and more of us to slip through the cracks of the system.

Be aware. Plan. Save. Most importantly, advocate for the frail.

A day in the life of a #ReluctantCaregiver

It was 1:44 a.m. on a Thursday morning when the electronic box by my bed started blaring a very loud tune that was way too cheerful for the hour.  It meant Mom had pushed her “call button,” a wireless device I had purchased so that she could summon me when she needed help.

I jumped out of bed and, in a zombie-like state, headed for the stairs.  When I arrived in Mom’s room (previously the master bedroom), the lights and TV were on, as always.

“What’s up?” I asked.

“I’m cold,” she answered.

Mom complains daily that my house is too cold.  At an average of 75 degrees (my heat pump is on its last legs and I can’t get it any cooler), I think it’s rather balmy most of the time.  Mom wears long sleeves and a sweater, or wraps up in a blanket, as she goes about her day.  But at night, she insists on sleeping without covers.  Her feet, especially, must be exposed.

This is the second time she has called me to cover her up.  I make a mental note to make sure the sheet and comforter are within her reach next time.  I cover her up, and head back to bed.

At 7:24 a.m., the machine blares more annoyingly perky music.  I had hoped Mom would sleep until her aide arrived, but not today.  She has to go to the bathroom, so I help her get up.  She complains again that I took away her bedside portable commode at the behest of her physical therapist.  She needs the exercise of walking to the bathroom if she is to regain her mobility.

She’s wet, so we begin the process of cleaning up and dressing.  I insist she wash the parts she can reach, and wash the healing pressure ulcer on her bottom with wound cleanser spray.  Then I slather her in Calmoseptine ointment — a kind of diaper rash cream for incontinent adults.  I check her blood sugar and write it down in the chart I created to track her health and activities.

The hardest part is the compression stockings.  I bought her some snazzy argyle ones — and they are just as difficult to put on as the hospital-issued ones.  I sit on the hard bathroom floor and finally get them on her.

Breakfast is next — tricky for someone with kidney failure.  Not too much protein, sodium, potassium or phosphorus.  Cereal with blueberries and coconut milk, coffee with coconut creamer, and a dinner roll with coconut spread (we’re avoiding dairy as much as possible). It seems like a bad meal for a diabetic, but you can make up for the carbs with insulin.  There’s no way to counteract the excess phosphorus, protein, and potassium in foods like eggs, oatmeal, orange juice or bananas.  A diuretic takes care of the sodium, but we still watch her intake and try to keep it under 140 mg per serving.

Finally, her aide arrives.  I fill her in on the morning progress and head upstairs and back to work.  I’m lucky that I have a flexible job that permits me to telecommute regularly — otherwise, I could become one of those family caregivers who has to take a leave of absence to care for a loved one.

During the day, I try to stay hidden away so that I can work.  The occupational therapist arrives; I greet her and return to work.  The home health nurse is next — I have to be there to help Mom answer questions, because she doesn’t remember her symptoms.  The nurse checks the sore and declares it healing.  Yay!  A victory!

At 1 p.m. the aide from an agency that I reserved through a “backup care” benefit offered by my employer comes to relieve the morning caregiver.  While I work from home, I have found it difficult to be interrupted every 40 minutes when Mom (who has urge incontinence that is probably due to her dementia) has to go to the bathroom.  So I called in extra help until she is strong enough to make it to the restroom alone.

My dog needs to go out, so I take her out to the front yard.  When we come back inside, she decides to scoot her butt along the wood floor and all of the throw rugs — making a mess two days after the housecleaner had mopped.  I decide to take care of it later and return to work.

The rest of the afternoon rolls along smoothly, with the aide keeping Mom company and helping her out by getting snacks, refilling her water-glass, and making sure she changes position regularly.  And of course there are the frequent bathroom trips.

The aide leaves at 5:30 p.m., and I take my computer downstairs and continue to work, in an effort to avoid too many trips up and down the steps.  During one of her bathroom breaks, I mop the floor.

After about an hour, I start dinner.  I’m putting rice on to cook when Mom calls me to help her go to the bathroom. Again.  I get her settled on the toilet and go to check the rice, hurrying to the stove — where I step, with bare feet, on my dog’s bone.  The hours of her gnawing on it have sharpened it into a dagger, and it’s sitting on the floor like a jackrock.

I scream with pain as the sharp bone punctures the bottom of my right foot in the arch.  I hop around a bit, cursing the bone and the dog.  Finally I hop into the bathroom where Mom sits on the toilet.

“Is something wrong?” she asks with a deadpan look when she sees the tears on my cheeks.

“Didn’t you hear me screaming in there?!” I ask.

“Yes, I wondered what was going on,” she said.  It was obvious she had forgotten hearing my hollering.

She offers to help me clean up the wound and bandage it, so I hold my foot over the bathtub and pour hydrogen peroxide over it, leaving a trickle of blood going down the drain.  Mom applies a bandage, and I help her get up and back into her recliner.

At dinner, she claimed not to be hungry, but ate a steak, rice, and a salad.  Then she asked for dessert.

We sit on the porch and I drink wine while she repeatedly asks why I don’t have blinds on the porch.  I’ve learned she hates the dark, and insists on pulling the curtains as soon as dusk arrives.  I repeatedly answer that I enjoy looking out into the dark.  She repeatedly asks if anyone (meaning an aide) is coming tomorrow, who is coming, and what time they will be there.  The answer is always the same:  “Yes. Ashley. 8:30.”  I’m used to the repetition and don’t let it bother me.

By 9 p.m., I’m exhausted and head her to her bedroom.  She complains it’s too early to go to bed.  I insist that I’m tired and need to retire to my quarters.

The bedtime routine ensues — blood sugar check, insulin shot, cleaning up, nightgown on, teeth brushed.  Then the hard part — the adult “nighttime” diaper that her experienced aide advised she wear.  Unlike the Depends she wears during the day, this garment has tabs like a baby diaper.  She can’t stand up long enough for me to fasten it.  Attaching it while she’s sitting causes it to sag.  She complains about the sag.

I give my usual answer:  “Sorry, Mom, I never had kids.  I don’t know how to do this stuff.”  She laughs.

Within 40 minutes, she’s in her hospital bed, bare feet propped up.  No covers.  The woman who has been freezing all day is now overheated, even though she is more scantily clad.

This time, I push the sheet and comforter beside her on the bed and make sure she can reach it.

My glass of wine and I go upstairs — so that we can do it all again tomorrow.

Ginger Thompson is one of more than one million family caregivers in Virginia who take care of a relative at home in order to keep them out of facilities.  She feels very lucky to have flexible work hours, the ability to telecommute, and the financial resources to hire experienced caregivers to help her care for her mother, Helen, who suffers from kidney failure and mid-stage dementia.  Follow her on Twitter @gingwrites, with the hashtag #ReluctantCaregiver.  Her mother’s anecdotes are hashtagged #HelenQuips.

 

An Open Letter to Keysa

Dear Keysa,

I’ve tried to avoid making my search for you so public.  Ever since I felt compelled to find you, and told The Hunk I would try, I thought I could find you easily through social media.  After all, almost everyone – except, ahem, The Hunk – uses Facebook, Twitter, Instagram, and other sites.

But you have been elusive to me.  I am pretty certain I found you on Facebook.  You have an obscure profile photo that might be stock art.  You have very little public information visible.  But there is enough for me to think that you are the one with the photo of a woman standing on what could be a sand dune, arms outstretched.  I’ve sent countless emails and Facebook message requests asking people with your name to contact me. Several women named Keysa have written me back, politely explaining they aren’t the one I seek and wishing me luck.

What I’ve been able to piece together is this:  you have a child with a disability, you struggled with fertility about 13 years ago (your middle child should be about 12 right now), and you worry about your kids.  You might be a domestic violence survivor, and you have a serious beef with the military.  You support an organization that helps special needs children.  Your ex-husband obtained a child support judgment against you five years ago. You likely live near your hometown of Fallbrook, CA.

It’s been a decade or so since you changed The Hunk’s life.  I’ve known him for nearly seven of those years – or more than half that time – and he just recently told me the entire story.  The woman he married about nine years ago (and who left him two years ago) didn’t know.  His current girlfriend doesn’t know.  His parents, children, colleagues and friends are completely in the dark.  Only a male friend and I know the full story.  And I’m sure that I know more than anyone else, because guys just don’t talk about feelings with other guys.  That’s why I want you to contact me.  I’m the only one who knows the whole story, and the only one who can help.  It’s a huge responsiblity, and I take it seriously.

You met him on an online dating site and he fell hard for you.

“When Keysa responded, I thought for sure her pic was a fake.  She was drop dead gorgeous.  I’m talking head-turning kind of beautiful,” according to The Hunk.

When you finally met, he learned that you really were a beauty.

“My jaw dropped,” he told me. “I literally felt my jaw drop and my mouth was hanging open.  She giggled and I couldn’t believe she was real.”

I’ve never heard him talk this way before:  “She was SO much fun —  down to Earth, real (or so it seemed), highly intelligent, personable, no airs or thinking she was all that, just…perfect.  I fell head over heels for that girl.  She was 32 and I was 38 at the time…I was smitten.  It was October and we went EVERYWHERE together.  We cooked together, we took trips, we were all over town wining and dining and seeing movies and dancing and just having the times of our lives.  We were inseparable.  We couldn’t take our eyes off one another.  We spent Thanksgiving and Christmas and New Year’s together and had a phenomenal time.  It was the best time of my life.  I have never been happier or more content.”

He thought you fell for him, too.  When he told me the story, I sobbed.  I still cry when I think too much about it.  But after he told me, I suddenly understood him even more completely than before.

Keysa, you were The One.  You were The One who changed his life.  Most people would say you ruined his life, but I know better.  For the first time, when he fell in love with you, he let his heart triumph over his head.  Before you, and since you, his relationship decisions have been made based upon logic – the head wins, every time.

That is the real tragedy.  Not the horrid aftermath of your romance.  Not the abrupt ending of a promising career, or even the heartbreak he suffered from losing you.

You changed him for the better.

That’s why I have to find you.  He needs to know how the story ends.  He tried unsuccessfully to find you a few years ago.  He heard that you fell on hard times, that your children don’t live with you, and that you had some very serious struggles.  Maybe you still do.

Your kids were easy to find.  They seem to be doing well, and I get the impression you aren’t part of their lives.

I have to admit, Keysa, I doubt the sincerity with which you entered your relationship with The Hunk.  I know that he is incredible – tall, lanky, and handsome with dreamy blue eyes.  He is intense.  And he has certain attributes that women talk about with other women after they have had too many cocktails.

He’s also incredibly kind, generous, and a good friend.  He has an unflappable, amiable personality.  He’s a lot of fun – unassuming.  He tends to attract needy women who take advantage of his kindness and generosity.

He’s an amazing guy, and you caused him irreparable harm.  Yet he holds no grudges.  He’s not angry.  He’s thankful for the time he had with you and your ability to open his heart.

In case you’re wondering, he’s doing very well.  He hasn’t changed much at all in 10 years.  He’s still hot and fit.  He still runs.  He has a successful second career, terrific kids and grandchildren, and a beautiful girlfriend.  She’s a blonde, too.

You can give him closure, Keysa.  Even if the story is a bad one.  I’m fairly certain you are still alive – obituaries usually surface, and I can’t find one for you.  Even if you aren’t, he needs to know.

He needs to know how you are, and how this story ends.  He deserves that.  Please contact me.

Warmly,

Ginger

Remembering Mopsey

Almost  a year ago, my mom’s dog Mopsey came to live with me and my partner, Tim.  Mom was in the hospital in another state, and her neighbors who were taking care of him were about to be too busy to look after him.  We didn’t know when Mom would be home or able to take care of him; my sister had two small children to care for (one of whom is terrified of dogs), so we took him in.

As I camped with Mom in her hospital room in Morgantown, WV, Tim and Mopsey headed back to Williamsburg, VA.  None of us knew that Mopsey, Tim and I would be a permanent family.

We thought Mom would be released from the hospital to a nursing home for rehab, but would get to go home where she and Mopsey would once again be roomies and best buds.

It soon became apparent that Mom’s physical disabilities and cognitive decline meant she could no longer live independently.  Mopsey was ours, as the assisted living facility where Mom now lives only allows pets if the resident is able to care for it.  Mom — wheelchair bound — is unable to take a dog outside.  Mopsey was ours.

Both of us have had dogs as pets in the past. My partner left his dogs with his ex-wife when he was transferred to Puerto Rico with the military several years ago.  I had lost both a Doberman mix with a seizure disorder and a Boston Terrier with heart failure.  I gave away my Chow mix when I moved to Virginia in 2009 — because my first home here was a second-floor walk-up apartment, a total of 835 square feet.

Several times, when we babysat my partner’s daughter’s dog, we vowed never to have a canine.  Getting up early to go for walks, having to come home right after work, boarding at kennels during trips — our lifestyle wasn’t cut out for a dog.  Or so we thought.

Mopsey’s addition to the household was quite an adjustment.  My cat, Nala, was so displeased with the new addition to the family she fled to the second floor of the house and still refuses to come down, nearly a year later.

We couldn’t give Mopsey the attention Mom did.  She took him out every two hours, whether he wanted or needed to go or not.  He rode with her in the car everywhere when the weather wasn’t too hot — the supermarket, hair salon, church — Mopsey was riding shotgun.  At her house, his spot was on the sofa.  She covered her white carpeting with towels to absorb any dirt he tracked in.  She carried his food to him wherever he happened to be:  the sofa (as children, we were never allowed to eat there) or the floor, it didn’t matter.

And it was a fall while walking Mopsey that led to a broken wrist and her rapidly declining health.

Several months ago, Mopsey had an episode that I described to the vet as “he acted like a person with Parkinson’s Disease.”  My vet advised that I should think about putting Mopsey down, and recommended that I keep track of his good days vs. his bad days and think about his quality of life.  She put him on two medications, which cost a total of $165 per month.  He ate them happily every day in Greenies organic pill pockets, which he loved.

Mom strictly regulated Mopsey’s intake of people food.  She insisted it would make him sick.  We ignored this advice.  Every meal, there he was, sitting at the table begging.  We made sure he had his own plate.  We learned our lesson on some meals — pork fat and cashews caused gastronomical disturbances from which our carpet will never recover.  But usually he just appreciated the attention and the few bites of people food we tossed his way.  It was the highlight of his day.  We also switched him to a better grade of dog food that was easier for a dog with few teeth to eat.

When we recently replaced the carpeting with wood laminate flooring, poor Mopsey couldn’t adjust.  There he was, “swimming” across the floor. We put down rugs and scraps of carpeting to give him traction and a path through the house.

After joining our household, Mopsey was boarded at a kennel for the first time, ever.  We enjoy traveling, and Mopsey didn’t seem any worse for wear by spending time at the pet resort.  I paid extra for cuddle sessions and “outdoor adventures,” where he got to run around outside off a leash.

Mopsey was never a vocal dog. Even when he was young, he didn’t make much noise.  He would get excited when people (like me) visited my mom and stepdad, but he never barked, howled, or whined.

The oddest adjustment we had to make with Mopsey was the way he signaled he needed to go outside.  Other dogs would bark or whine.  Not Mopsey.  He would walk to the door, then walk back and look at you.  This system was not effective if you were asleep — or busy and simply not noticing.

Mopsey never barked.  Not ever.  Occasionally — very occasionally – he would whine.  Usually that involved riding in the car, or during the few times we crated him at night and he wanted out.

There were many times throughout the years I thought Mopsey was depressed.  He was the most lackadaisical dog I knew.  He never got excited about anything.

After he came to live with me, I realized that was just his personality.  He was even, calm.  He was sweet — but didn’t want to be loved on too much.  He would tolerate being on a lap for a few minutes, but not for an evening.  We respected his wishes.

That’s how I knew that today was the end for him.  After his incredibly long and very scary seizure, he climbed onto my lap.  I had been sitting on the floor beside him, petting and soothing him during the seizure.  Tim was on the other side of him, doing the same thing.  He pooped.  He peed.  He slobbered and foamed at the mouth all over me.

Then Mopsey climbed into my lap — something he’s never done before — and then he bit me. On the breast.  And he wouldn’t let go.  I know this was some sort of reaction to the trauma, and not aggressive behavior.  It was surprising, and I dismissed it.  A couple of band aids and some Neosporin and all is well. But it wasn’t the sweet, calm Mopsey we knew. He was obviously very scared, possibly in pain, and it was his way of saying “Hey, lady, I feel like crap!  Help me!”

We wrapped him up in a towel, got in the car, and headed to the emergency veterinary hospital.  I knew it was 35 to 40 minute ride in the car, and I tried to make it as comfortable as possible.  I held Mopsey and stroked him, but still he howled regularly — a mournful howl that was loud and disarming.

When we go to the hospital I had to fill out a lot of paperwork.  Tim took Mopsey, who was very agitated, outside.  He set him down in the grass, and he sprawled out, stopped making noise or moving around, and seemed to relax.  I went and got them when it was “time.”

The technician took Mopsey  to a back room to have an IV catheter put in.  They then brought him to us — in Room Zero — to spend time with and say goodbye.  I held him in my lap and loved on him.  Tim snapped a few photos with my phone.

A tech stopped by and asked if we were ready.  I confirmed we were.  Several minutes later a vet appeared with syringes.

He asked if I wanted to put him on the table. I looked at the cold stainless slab and declined.  I held him in my lap and the doctor pushed the various drugs through the IV catheter.  At first he seemed “high,” then a few minutes later the euthanasia drug was dispensed.

“It will be quick,” the doctor advised.

It was.  The vet had to leave the room to retrieve his stethoscope.  He inserted the device between Mopsey’s chest and my arm.  “He’s gone.”  He reported.  I gently handed my baby brother to him and he left the room.

I paid the bill and made arrangements to have him cremated and sent to my veterinarian.  $257 ended his life. It seems surreal.

He will live on in our memories.  He loved his people, especially Dale (my stepfather) and Tim, my partner.  He was a sweetie, who never was angry, aggressive, or even upset.  About anything.

Farewell, my sweet baby brother.  You deserve an eternity of rest and relaxation.

 

Father’s Day: Tribute to Jim Thompson

Dad and me when I was about 4 years old.

It’s no secret that Dad was my favorite parent.  I was “Daddy’s little girl.”  I was a superstar, and could accomplish anything I wanted.  To have not had sisters — or a mother that he could remember — Dad had a knack for raising girls.

It was Dad who was the nurturer — the one who kissed the boo-boos, affirmed me, told me I was smart and beautiful.  He was kind, loving, and steady.  Even when he was angry, he wasn’t prone to outbursts.

It was Mom who spanked, yelled, and always found something wrong with me.  My hair, my clothes, my makeup, the condition of my room — nothing was ever good enough.  It didn’t matter what I did, it wasn’t right.  Oh, sure, she praised me when I brought home straight-As or other successes.  But she didn’t love me like Dad did.

Dad wrote me letters while I was in college, carefully printed on yellow legal paper, using yellow correction fluid to fix his mistakes.  He would visit me periodically.  He bought me my first car — and took out a credit life policy so that it would be paid off if he died.  Which he did.  I wonder now if that was foreshadowing.

When Dad died suddenly at age 60, I was on the phone with him.  It’s a fact few people know, and something we never talk about.  Ever.  I still wonder whether I did the right thing, if I waited too long to call for help.  By the time the rural volunteer paramedics arrived, he was long gone.

When it came time to plan a funeral, choose a burial plot, and other such tasks, Mom was a mess.  I was the rock, the one who ushered her along to make the necessary decisions.  I remember standing with Mom, staring at Dad in his casket, and her whispering, “It’s OK to cry.”  I didn’t cry at all.  Later, with my friends, on a dark night outside my parents’ house, I cried until I threw up.

And I still cry today.  There have been many times I’ve thought that Dad was the only person who truly loved me.

While I know that’s not true, it remains a fact that he loved me best.

 

 

Embracing “Voodoo Medicine”

I’ve started seeing a witch doctor.

No, I don’t sneak off during the full moon to chant incantations in the graveyard.  I go to a modern medical office in broad daylight.  And I don’t have to bury bodily fluids and sprinkle potions on the spot  — but I do have to mail them off to a lab on the west coast.

“Black magic never stops. What goes from you comes to you. Once you start this s—, you gotta keep it up. Just like the utility bill. Just like the grocery store. Or they kill you.”

 

Minerva in “Midnight in the Garden of Good and Evil”

The health care practitioner I’m seeing wouldn’t appreciate being called a witch doctor or his practice voodoo.  That’s what traditional medical practitioners call their brethren who embrace homeopathic or alternative medicine.  Not to their face, but behind their back.

The purveyors of non-traditional therapies call their practice “integrative medicine,” and there are official organizations that provide board certification and continuing education for the high priests and priestesses of homeopathic treatment.  They combine evidence-based (traditional) medicine with homeopathic or non-traditional treatments.  To the hard-core, traditionally trained medical doctor or osteopathic physician, it’s a betrayal of the brotherhood (or sisterhood).

I didn’t find this new-age doctor in a voodoo shop.  I clicked on a Facebook ad offering relief from my thyroid disorder.  I had rapidly gained 20 pounds, feel fatigued all the time, and suddenly developed high blood pressure and high cholesterol.  Despite taking synthetic thyroid hormone, I still feel like crap.  My primary care physician, a graduate of a traditional medical school who operates within the usual volume-based practice, refused to prescribe natural thyroid hormone.

When I went to the voodoo appointment, I went with a healthy dose of skepticism.  While I’m not in the health care field, I was previously married to a provider.  Therefore, I have about six years worth of second-hand medical training.  What I was going to experience would have been called “hooey” by my Ex.

I felt like I was in a college biology class as the doctor explained the relationship between the liver, brain and adrenal function.  I had read about “leaky gut syndrome,” and was ready for the lecture.  I have a colleague who has undergone a similar regimen.  I was ready for the spiel — the sales pitch — for a treatment that is likely not covered by my health insurance.

When I walked into the office for the $49 consultation, my plan was not to buy into the program, but to walk away with the info.  However, the program was dangled in front of me, and I felt bad enough that day to say “I’m in,” and plunk down a credit card to pay the fee.

The new dining room suite can wait a bit.

Tomorrow I embark on the big step of the program:  The Diet.  The philosophy is this:  if you cut out everything that can cause inflammation in your body, you can rid yourself of toxicity and heal from the problems caused by the bad foods and chemicals that cause it.

This morning, I drank my last cup of coffee.  At lunch, I ate my last sandwich and drank my last diet soda.  I’m preparing to cook the last meal of shellfish and processed frozen vegetables (broccoli with cheese sauce).  I’m sipping on my last glass of wine.

For the next 30 days, I can eat only poultry, beef or fish (no shellfish or pork), certain vegetables (no potatoes, beans, corn or peas) and specific low-glycemic fruits.  No gluten, grains, nuts, caffeine or alcohol.

Yikes!!! I can live without gluten, grains, sugar, artificial sweetener, preservatives, or nuts.  But caffeine and alcohol are the foundations of my existence.  They are how I cope.  How will I survive?!

This blog will be the diary of my penance.

I’m putting my faith in “voodoo medicine.”  I’m turning my health over to a so-called “witch doctor.”  I’m also investing a significant amount of money in this program.  But it’s time for a change.  Traditional medicine isn’t serving its purpose.

Stay tuned!

 

 

 

 

 

 

 

 

 

 

 

 

The Reluctant Caregiver: When the Brain is Living in Another Time

Recently, when Mom asked me the date — as she often does — she said, “Cathy’s birthday is tomorrow.”

Cathy was Mom’s first cousin who was raised by Mom’s parents from the age of four.  In reality, they were sisters, although Mom was 14 years older.

The next day, Mom asked me the date.  Although she has a “memory clock” that informs her of the day of the week, the date and time, whenever we are together or talk on the phone, she asks me the date about four times.  That’s because she forgets about the clock that expresses the precise date.

“Today’s Cathy’s birthday,” Mom said.  “I wish Cathy and Kenny would come visit me, but they probably can’t afford it.”

I was in her closet, hanging up her clothes.

“Probably not,” I answered.

This would seem like a normal conversation under usual circumstances.  However, Cathy died in 2008 at age 56 after a long battle with leukemia.  It wasn’t the leukemia that killed her; a blood stem cell transplant cured her of the cancer.  But years of chemotherapy weakened her organs, and she succumbed to heart failure.

In 2008, I drove Mom to Cathy’s funeral.  She was there and mourned with Cathy’s husband, children, grandchildren and other relatives and friends.  Cathy’s widowered husband, Kenny, has since remarried.

In their later lives, Cathy and Kenny were financially secure, traveling and enjoying themselves despite her disabilities from her illness.  In their younger days, when they were first married, they struggled as many young couples do.

It is the young, newlywed Cathy and Kenny that Mom’s mind remembers. The disease of dementia has destroyed the part of Mom’s brain that remember’s Cathy’s illness and ultimate death.  The part of Mom’s brain that stores the memories of Cathy’s young married life is the one that survives.

I told the story to a friend, who asked me why I didn’t tell her that Cathy was dead.  Couldn’t she learn that Cathy is dead?

The answer is No.  Mom has dementia and isn’t capable of learning new things.  The part of her brain that remembers Cathy’s demise is destroyed.  She has stored her memories of Cathy is an area of her brain that is not yet damaged — but it’s the section that remembers Cathy’s youthful newlywed days.

My rationale is that it is better for Mom to remember Cathy as a young newlywed instead of the middle-aged woman lying in her casket at the funeral home in 2008.

Dementia destroys memories.  But sometimes it destroys the painful memories and leaves the pleasant ones to live on forever.

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Ginger’s Soapbox: Flags

If you display the Swastika or any of the flags of the Third Reich in Germany today, you face a prison term of three years. Six million Jews were murdered during the Holocaust under Nazi leadership.  It’s not a history the country wants to remember.

Four million African natives were enslaved in the United States in the 18^th and 19^th centuries.  The appalling practice of slavery ended with the American Civil War, and a symbol of the South is the Confederate flag.

Let’s not forget that the Confederates were, by today’s definition, terrorists.  They staged an insurrection against the federal government.  Those who want to make the Confederates seem not so terrible say the conflict was about state’s rights.  That technically is true.  But the primary reason was the southern states wanted to maintain the right to enslave other human beings. The other reasons the states wanted to maintain their rights are long forgotten.

Descendants of Confederate military veterans say the flag is a symbol of their heritage.  Do they think we are stupid? Have you seen these people?  They aren’t historians or even genealogy buffs.  They are racists.  If the descendants of the Confederates were truly interested in preserving their history, they wouldn’t have permitted their flag to become a symbol of racism and white supremacy.

As a former journalist, I usually support the right to free expression.  But when it is something that has become so divisive to our nation and society, there should be limits.

It’s time to burn the Confederate flag once and for all.

Reflections on Father’s Day

Dad and me in our house in Bergoo, WV. I was about 5 years old.

On the occasion of Father’s Day, I’m taking a break from my usual upbeat or sickenly sentimental blog posts for some reflections on Fatherhood.  When it comes to my thoughts on Fatherhood, I forfeited my feminist card many years ago.  Fathers get a bad rap all the way around.  As a woman, I truly believe that we won’t be equal in the workplace and elsewhere until we permit men to have equal parenting responsibility.  I also believe that men aren’t equal parents, not because they don’t want the responsibility, but because mothers won’t permit them to be.  Those women are shortchanging their children at the expense of their own identity.  That is sad.

Those who know me well know that I had a close relationship with my father.  Not so much with my mother.  I grew up in a traditional family of the time — Dad worked.  Mom stayed home and took care of my sister and me.  She was a housewife, which wasn’t so unusual in the 1960s and 1970s.  Today, my sister has the same lifestyle — except she’s a stay-at-home-mom, not a housewife.  Honestly, the role is different today than it was 40 years ago.  More on that in a future post.

I idolized my dad.  He was kind, soft-spoken and loving.  He was very wise.  He liked to read.  He was curious.  An electrician by training, he read up on everything from fly fishing to bird watching.

What many don’t know is that my dad was raised by a single father to five boys.  His mother — my grandfather’s second wife (his first died in the flu pandemic of 1918) — died when my dad and his twin brother, Gene, were nine years old.  My dad and his four brothers were raised by his father, albeit not really well.  He was raised mostly by people in the community, his friends’ parents, and his older brothers and their wives.  He was a bachelor until the ripe  age of 32, which was old for a single man in 1961 when he married my mom, who was a spinster at 23.

And what few people know is that he died in 1990 of a massive heart attack while he was talking on the telephone with me.  I still cry when I think of it.  I still miss him, dream of him.  And I wonder how my life would be different if he were still around.

My mom, who was only three years older than I am now when Dad died — eventually remarried.  My stepdad was a great guy, an educator and hobby farmer.  His wife had passed away after a long battle with cancer.  When I looked back through old photos, I realized it was he who handed me my diploma when I graduated from high school.  Like Dad, he was wise and quiet.  Unassuming.

My dad’s last words to me were, “how are the floors coming?” I was living in an apartment that was the first floor of a circa 1800s mansion.  My roommate and I had made a deal with the landlord to refinish the hardwood floors in exchange for lower rent.

Some shrinks say that people typically choose partners that are most like their primary caregiver parent.  I have to say that is true for me.  Most of my romantic partners are more like my mom than my dad.  Only one stands out as being like my dad — both physically and personality-wise:  tall, thin, blue eyes, brown hair, square jaw, unassuming, quiet, intellectual, goofy sense of humor. I blame his similarities to my dad for the reason I kept going back to him, despite the fact I should not have done so.  I’ve learned my lesson.

But I’ve always chosen men who are good fathers with strong family ties.  Perhaps it’s because I didn’t have strong family tie of my own..  After my dad died, my sister and I drifted away.  We both maintain an arms-length relationship with our mom.  Those who are closest to us know why.

My ex-husband and I spent the better part of our 13-year marriage fighting for custody of his son, lobbying for changes in West Virginia’s child custody laws (which we achieved) and counseling other disenfranchised parents who were cut out of their children’s lives for no reason.

My current partner was a single father, gaining custody of his toddler twins at a time when fathers didn’t get custody of their children.  His kids are adults now, He did a terrific job raising them, with a lot of help from his parents, sisters, and his second wife.

My former stepson is a wonderful young man now.  I marvel at how he has developed as his own person — despite his parents and step-parents — since I met him when he was three years old.  Now 21, he lives in a major city, attends a prestigious university, and asserted himself against the influence of both parents in a manner that I uphold and admire.  I can’t take complete credit for his greatness, but I like to think I contributed to his upbringing and shaped him to be himself, despite opposing forces that might disagree. We stay in touch, and I consider him my son.  I’m deeply proud of him and admire him for being courageous enough to assert himself at a young age.  He has a terrific shot at being happy.

I was childless by choice.  Honestly, it never occurred to me to have children.  My father imparted the implication that intelligent, successful women don’t give birth.  My mother seemed so very unhappy with motherhood it made the institution very unappealing (my sister, however, is blissful as a full-time mom to her kids, so it wasn’t an attitude universally applied).  I greatly enjoyed my role as Stepmom, which is a lot like being an aunt or grandmother.  You get the glory without the responsibility.  I wish I were closer to my own niece and nephew, who are delightful, if challenging, and adorable children.

My current partner’s children are adults who are very different despite being fraternal twins.  They were largely raised by a stepmother who is no longer part of their lives.  They don’t need a parental stepmother’s relationship with me.  I appreciate each of them for the individuals they are, and contribute by offering my own observations regarding their parental needs to their father.  The daughter is beautiful, successful and independent.  The son is a sensitive free spirit (more like me), who doesn’t seem to care that he isn’t living up to his parents’ expectations.  I like that.

Sometimes I think that the only man who ever truly loved me was my father.  Intellectually, I know this isn’t true.  I know my partner loves me.  I know my former partners loved me, too.

But nothing will ever be the same as a father’s love.  And that’s a good thing.

To all of the fathers in the world — especially those who have been disenfranchised from their childrens’ lives for no reason– I wish you much more than Happy Father’s Day.  I wish you a very happy life, and an amazing relationship with your offspring.