Monday Memories With My Mom - RETURNS 7

The Adventures of Caring for a Mom With Alzheimer's Disease
     Well, we are finally pretty close to being caught up on my mom.  One sure sign that my mom is doing better is that she has called me a few times lately.  Those calls are rare and usually months go by with no phone calls.  I've thought many times that there would be no more calls from her, but then she is always full of surprises.
     I finally felt comfortable enough asking Sheri if I could take her picture with my mom.  She has managed to get my mom back on track in about two months time and I am so thankful for that!

      On January 15th I also had my six month meeting with my mom's case manager from the Area Agency on Aging.  She is the same girl who is now "on site" at my mom's senior home and she's trying to straighten out all of the problems that apparently many others have also had with the Med Team.  We met for quite awhile and she was pretty thorough.  Maybe for the first time in a couple of years, I finally feel my case manager has a pretty full understanding of my mom and her needs, and in spite of all the problems, strides have been made toward positive changes.  I even suggested to her that ideally we would somehow get Sheri to also help my mom with her PM Care and getting to bed.  I know Sheri is looking for more hours and I figured what do I have to lose at this point!!??  I even brought her a small gift 'cause I just can't help myself sometimes.

     I took this quick picture because our meeting was in one of the "model" apartments in my mom's building.  It's amazing how a little interior design can update the look of the whole apartment.

     A couple days after our meeting, I was a bit surprised to receive another "Redetermination" form for my mom's Medicaid assistance.  I just completed another one in June, and I thought I would only be receiving those once a year, but apparently not so.  It threw me for a loop as it's a lot of work to fill out, and I was hoping to have time to move onto some other things.  So the past few days I've been on polar vortex lockdown completing and gathering all the necessary paperwork.  
     With Sheri's assistance, I was also able to sneak some hair color on my mom just before my Agency on Aging meeting.  She needs a haircut really bad, but I haven't wanted to take her out in this weather!!!!  There's a lady who does hair in the building two days a week, but I haven't been too impressed with her work.  In a recent phone conversation with Sheri, she told me some of my mom's pants were getting snug on her.  She said I could "blame her" for that.  Wouldn't you know it, now my mom might be eating a little too well.  Sheri takes her to the dining room for breakfast and she keeps wanting more and more.  I'm going to have to make sure Sheri knows not to over indulge my mom.  I think she does know that, but my mom can be pretty relentless if she wants to eat something, and I'm sure Sheri wants to keep their relationship positive.  For now, this is a good problem to have.

     On a recent visit, Kristin wore her goofy "donut" shirt that she loves.  She got a big kick out of asking Grandma if she wanted a donut and my mom would grab at her shirt over and over!!!  Do we know how to have fun or what!!!??? 
     Thanks for hanging in there with me and letting me get caught
up on my Monday Memories!!!!!


Monday Memories With My Mom - RETURNS 6

The Adventures of Caring for a Mom With Alzheimer's Disease
    On January 4th I again received another one of "those calls".  The medical team called to tell me my mom fell in the dining room at dinner time.  She was at her dining room table and fell near her seat.  The staff did not witness the fall, but my mom was saying that she hit her head.  She was not bleeding.  The staff was asking what hospital I would like her sent to and said the paramedics were on their way.  Ugh!   Another sense of dread came over me...
     Several minutes later, one of the paramedics called me directly.  Upon their evaluation they observed no sign of trauma to my mom's head or anywhere else and my mom was answering questions reasonably in consideration of her dementia.  We decided a hospital visit was not necessary and only to return her to her apartment with dinner and the medical staff to keep an eye on her.  I followed up with a phone call to my mom.  The only problem I noticed was her repeating..."Do you like Lima beans?  I don't like Lima beans...nobody likes Lima beans."  Over and over....  Will I ever get "used" to this -- I don't really think so!!??


      On to the happy part!!!  On January 9th we celebrated my mom's 70th Birthday!!!!!!!!!  To me, this was a major milestone!  It was nice to find her "chillin'" like this (see picture below) when I arrived.  It meant she was doing okay.  In light of her most recent fall, the terrible Michigan weather, and the fact that it was a weekday, my brother and I decided to celebrate with her by bringing in lunch. McDonald's to be exact!!!
     We told her many times that she was 70 and she seemed quite surprised and glad and said that she was an "old fart" now!!!  It was very low key, just me and my brother, Mike -- he brought the McDonald's and I supplied the balloons and Sanders hot fudge ice cream for dessert.  She was content and my brother and I were again able to catch up on some things.  My mom sometimes seems to do better if we just talk and talk and she just listens and occasionally asks some questions.  It's a hard balance, but it was her birthday and we answered ALL of her questions and did our best to make her happy!!!

     I posted a small birthday card campaign on Facebook asking friends and family to send cards in honor of her 70th birthday.  I am thankful to those who took the time to do so!  My mom still loves her cards, and I often find her reading them over and over.  I also brought her some lip balm for her growing collection.  At this point, it's definitely the little things that make her happy!!

A Card from my BFF's Mom... 
How does she always know exactly the right thing to say???
A Feast for the Birthday Queen
     Jacob also had fun sending Grandma a letter to see if she would "fill in the blanks".  Although we knew she wouldn't be able to send it back, we did get a kick out of seeing her attempt to respond to his letter. 

Happy 70th Birthday Mom!!!!
We love you and are grateful for all 70 of those years!!!!!!!!!


Monday Memories With My Mom - RETURNS 5

 The Adventures of Caring for a Mom With Alzheimer's Disease
    My next few visits with my mom before the holidays were somewhat uneventful.  I continued to see small gradual improvements in my mom mentally and physically in her appearance. 
     It was nice to see Christmas notes from school children and little crafts also made by children in her apartment.  There were a few Christmas programs during the holidays, and I am sure my mom enjoyed those.

     On one of my visits, I was greeted by "The Don" who was sitting right inside the door I always enter the building from which happens to be just down the hallway from my mom's apartment.  I was surprised as I have never seen him there he lives in the other wing of the second floor.  I have been gradually learning from Sheri (my mom's new personal aide) that for the most part my mom wants nothing to do with The Don these days.  Apparently, he tried to come to my mom's apartment recently and she emphatically insisted he go away so Sheri told him to go.  Meanwhile, Sheri has also told me that they have breakfast together most of the time and that their banter is a bit inappropriate and flirtatious!!??  My mom strongly denies this if you ask her (but I'm sure it's true).  It should also be noted that (thanks to Sheri) I also recently learned that "The Don" has now relocated to the first floor (same as my mom -- but his daughters put him in the complete opposite wing)!  I am assuming his memory and health have sadly declined.  As they may have already learned, once their memories get worse, one wing of the building is easily confused with the other.

     Among other things on my "To Do" list was to pick up a few new sweaters for my mom.  Hers have been looking so dingy, and I'm preferring darker colors and no buttons these days for her.  This is one of the sweaters I picked up for her -- sadly it has already "disappeared".  Many things never make it back from the laundry service that housekeeping provides.  Even though my mom's apartment number is labeled in each item, they were likely delivered to the wrong apartment and we may or may not ever see them!  Still trying to figure out how to get a handle on clothes that disappear...for now saving my energy for some of the more important issues. 
     This was the first Christmas Eve my brother and I decided my mom would be better off not attending her family's gathering.  It's also the first time I can ever remember not celebrating Christmas Eve with her.  As far as I know, it was the first.  This is her favorite party that she's always loved and it's heartbreaking to not include her and knowing that it was not her decision but mine.
     My brother visited her on the way to the party (she did not really know it was Christmas Eve) and I brought her to my house on Christmas Day.  Since we were staying home, I thought she could just relax and have dinner with us, sit by the fire, and enjoy her grandkids.  My conscience could not let her be home alone for both Christmas Eve and Christmas Day.
     Unfortunately, "relaxing" at home with us did not seem to be an option.  My mom seemed unable to relax and spent most of the day repeatedly asking how Grandma Frog had passed away and asking for more pop to drink.  After a couple of hours, it became clear that everyone would be more comfortable if Grandma was safe and sound in her own apartment.  My husband and Megan took my mom back for me as I was, honestly, a bit overwhelmed.  
     We were so distracted trying to keep my mom content, I forgot to give her one of her gifts...  I had made her a bigger "button tree" to go with the one she liked so much from last year.
      Between Christmas and New Year's my mother-in-law came and stayed with us.  She has lived in Maine the last several years and has always been a good friend to my mom.  On January 2nd we went for a visit with my mom who was doing pretty well.  She definitely had her unique sense of humor, the kids got a few laughs, and we had a nice visit.
     I was a little discouraged that nobody came to escort my mom to lunch at the time they normally do and should.  We waited an extra ten or so minutes and then decided to walk her to lunch ourselves.  In the hallway, one of the aides said she was "just coming to get her".  She happens to be one that I have not been able to count on in the past.  I may or may not believe she was on her way, but decided to go to their office to let them know.  As luck would have it, the Quality Assurance Manger happened to be there -- so I shared my disappointment with her ;) 
The Moms
     For some reason, my mom thinks if her jacket has a hood -- well, that you have to wear the hood!!??  So my kids all decided to put their hoods up too and join in on the picture below. 
We call it -- The Kids from the "Hood"!!!??? 
When life hands us lemons -- we always try to make lemonade!!!!
 With this post -- we've officially made it to January 2014 on my Monday Memories!!
Almost Caught Up!!

Monday Memories With My Mom - RETURNS 4

The Adventures of Caring for a Mom With Alzheimer's Disease
     Despite the reality check with my mom's recent fall and trip to the Emergency Room, I remained optimistic that with my mom's personal aide, Sheri, in place things had to improve.  I should note that somewhere in these last few weeks her medical alert bracelet also "disappeared".  I was not aware of it right away and thought perhaps Sheri had it in a pocket or something.  Eventually, I learned Sheri did not know where it was either.  Supposedly the bracelet is waterproof and it really should not be removed.  So, come to find out she went a few weeks without one.  I would have been a bit more alarmed if  I thought my mom actually "used" the bracelet, but I can't remember the last time she did press that button when she fell.  Then again, considering what I've been dealing with who really knows sometimes...  Nobody bothered to tell me that I had to pay for a replacement and how to go about getting one.  I thought they would just give her a new one when I told them hers was missing.  The medical alerts seem to be a grey area between the medical staff and the actual senior facility.  I know, ugh!  I guess I should just be glad she has never lost it before in the two plus years she has been there.

     I recently came across some costume jewelry of my moms and decided to give her a couple of rings.  She still occasionally brings up the two rings we "lost" about a year ago.  (At this point, I am definitely thinking they may have been stolen by staff.)  I think sometimes my mom spends time still looking for those rings so I thought she might find some comfort just having rings back on her fingers.

     During this time, Sheri also got my mom's Christmas tree set up and put it in a new location in front of her balcony door.  As I said, it sure is nice to see signs of someone doing things for my mom besides me!

     Meanwhile, my friend Alyce was having her own struggles as a caregiver with her mother-in-law being in and out of the hospital.  As I mentioned long ago in a previous post, her mother-in-law also lived at the same senior home as my mom.  She quickly became my mom's first friend when she moved into this senior home.  Dorothy was known as "Grandma Frog" and had many many friends.  She was very friendly and very aware of all the goings on around the senior home.  My mom used to say "she's very popular" and she was.  Sadly, Grandma Frog went to heaven December 9th -- she would have been 90 years old in February.  She was 20 years older than my mom and yet so much more lucid than my mom is.  There were many times when I honestly thought that she would outlive my mom. 

     I was nervous to tell my mom that Grandma Frog had passed away.  I really did not know how she would react.  Although she had not see her much in recent months, I knew she likely still was very aware who she was and had a connection to her.  Years ago, when my mom's neighbor passed away my mom called me many many times to tell me of her death, over and over.  Initially, I told my mom about Dorothy on the phone and then later in person.  I had hopes of somehow bringing my mom to the visitation, but the weather and timing did not cooperate.  However, me and my family did attend the visitation and my husband and I attended the funeral service in support of our friends.  It was a beautiful funeral and my friend, Alyce, and her husband did soooooo much for Dorothy during her life.  She will be missed for sure!

     True to the spirit of Dorothy, most of her frog collection was scattered about the funeral home and after the funeral service visitors were encouraged to take a something with them to remember her by.  I had never seen anything quite like it before, but it was a nice personal touch.  I brought a frog to my mom and I think she was very happy to have it.  She did show some sadness and concern and has asked many times about her death.  She seemed to find comfort when I told her that Dorothy had lived a good long life.

     Having this happen during the Christmas season made it bittersweet for everyone, and I'd be lying if I didn't admit it hit a little too close to home for me personally.  I know my friends didn't have much of a Christmas because of their loss and that made me sad for them as well.  In the midst of everything, they had the responsibility of clearing out Dorothy's apartment before the end of the month.  They kindly offered to give my mom the lift chair from Dorothy's apartment.  You may recall, I was searching for an arm chair for my mom a few months back.  Funny how things sometimes come to you when and where you least expect them.  My mom loves her new chair and she loves that it came from a friend.  This chair actually has another bit of history -- it also once belonged to my former (billionaire) boss! 
     For all of these reasons and more, my mom and I are counting Grandma Frog and her family among our blessings!  May she rest in peace!


Monday Memories With My Mom - RETURNS 3

     On December 2nd, just as things were starting to look up and I was seeing signs of hope for getting better care for my mom, I received the dreaded call.  My mom had again fallen.  Although my mom has had a number of falls these past few months, this time was a bit different as I was told that when the aides went to get my mom for dinner, they found her on the floor in her living room.  They wanted to know if I wanted her sent to Emergency.  Normally, my mom rebounds rather quickly from her falls.  In this case, they reported she was tearful and complaining of back pain.  She was also saying that she DID want to go to the hospital.  Normally she says "no".  This is such a hard call -- how do you determine whether the nightmare of an ER visit is necessary when you did not see what happened and aren't there to see what's going on.  This time, I was a bit scared so I ultimately decided not to mess around with it, particularly since she was complaining of back pain.
     I asked that she be sent to the hospital a little further from her place and a bit closer to me and my brother -- just in case it ended up being long term!?  My kids happened to have the day off school that day and I got the emergency call just as I was making dinner.  I contacted my brother by text and asked if he could meet me at the hospital.  I live about 30 minutes from my mom's apartment so running up there isn't super quick.  I asked the Med Team to call me once the ambulance had left with my mom.  I also reminded them to make sure "Muffin" went with my mom as well as her list of medications.
     I began to gather up some reading material for myself, my mom's identification and insurance information as well as my Power of Attorney.  It was well over an hour before she actually arrived at the hospital.  I arrived before my mom and had already gone through the admissions process before she even arrived.

     In the Emergency Room, things were incredibly slow as they always are.  I did find that doing things like standing in the hallway or just approaching the nurse's station and asking what we were waiting for did seem to get some attention.  I was very patient, but after hours of not much, I needed some action!! 
     I was grateful to have my brother there.  The moral support was nice as there have been many times in the past that he was not around to help and these trips alone are not fun.  Eventually we were moved around a bit and my mom was taken for a head, back and hip CT.  After waiting and waiting again, the results showed no signs of any breaks and only showed some arthritis in her back.  Meanwhile, it was getting later and later and minutes seem like hours in the ER.  My mom had not eaten or had anything to drink and they did not want her to.  She also had not had her nighttime meds.


     The upside was that my brother and I had plenty of time to talk about our Christmas plans and catch up on some things.   Although my mom did have many many questions, eventually she seemed content to listen to me and my brother talk and would occasionally ask some questions.  I may have mentioned before, my brother is a firefighter and is not the least bit flustered when it comes to these emergency type situations.  He even took the liberty of writing on the white board in my mom's room under "Things I Would Like My Care Team To Know" -- "I Like Channel 4 and 147".  Two of my mom's favorite things to talk about -- her favorite tv channel and her apartment number.  At that point we were getting a bit giddy and we regressed back to our childish ways!!


     Finally, the doctor came back and did some more evaluating with my mom.  She seemed to be getting a bit feisty and was fairly entertaining in her banter with the doctor.  As it got later and there was talk of releasing my mom, I told them I was fine with that.  However, I was not sure if we wanted to transport her back by ambulance or possibly have my brother do it.  I told the doctor I was fine with releasing her, but first I wanted to confirm that she could walk.  There was a time a few years ago that my mom was released from the hospital, and she couldn't even walk the two steps to the car.  I am not sure I will ever understand how hospitals receive someone transported by ambulance, who has been on a gurney all night, flat on their back the whole night and then they talk of discharging without the patient EVER getting up!???  It just doesn't make sense to me.  How do they know everything is in working order!?
      The staff grabbed a walker and with a little initial assistance, my mom cruised down the hallway fairly easily.  I almost wanted to laugh because I was not sure if we had all been "duped" by my mom!!??  You have to wonder if she really was having back pain -- I doubt we will ever know for sure.  Of course, in the end I was relieved.
      By this time it was after midnight and my brother offered to bring her to the apartment in his car.  I met him at the apartment and he left soon after as my brother had to be at work at 6 am.  I continued to get her settled back in eventually was able to locate and update the Med Team staff to keep an eye on her.  As luck would have it, I had a mammogram scheduled for that morning that I was trying to get in before the end of the year and I knew I probably wouldn't be able to reschedule it.  It was hard to leave and trust the staff, but I had to think of myself, too.  I got my mom to bed and prayed she would be okay through the night.
     In the morning, I talked to Sheri by phone to update her on our adventures.  True to form, the Med Team staff (she works for the same company) did not advise her of any of my mom's fall or her Emergency Room adventures.  There seems to be a definite lack of communication between shifts and coworkers.  She has quickly figured out that they do not pass information on to her.
    Because of this recent experience, I now have on my list of "Things to Do" putting together an "ER Bag" with all the necessary things to bring to the hospital, including clothes for my mom, a checklist of things to ask the Med Team or paramedics, important paperwork and identification as well as things to pass the time.
     Thankfully, there were no apparent repercussions from the fall, but it was a very long night!!



Monday Memories With My Mom - RETURNS 2

The Adventures of Caring for a Mom With Alzheimer's Disease
     On November 20th I had scheduled another routine neurologist exam for my mom.  I was anxious to get that appointment done "before the snow" started flying too much around here.  As with all of these appointments, I go in with a positive attitude and try to limit the sense of dread that sometimes comes over me.
     I was encouraged as it was this day that I met Sheri, my mom's new private aide.  She works with my mom seven days a week from 8am - 11:30am.  Although I had talked with Sheri by phone, I was happy to meet her in person and find my mom dressed and ready to go.  I even got some assistance getting my mom out the door.  We also finally straightened out with her supervisors that Sheri would now be giving my mom her showers on the morning shift.  This way there should be more consistency and they will be catching my mom at the start of her day.  There will be more about Sheri to come, but let's just say she has been the saving grace in all of this caregiving fiasco I have experienced over the last six to nine months or more!
      Our trip to my mom's appointment started off quite well!  I immediately attributed my mom's improvement on our car ride to Sheri and had hopes that perhaps my mom was finally getting some sleep.  What I am trying to say is that there were moments of "real" conversation between me and my mom.  I remember my mom saying in the car, "Do you miss Grandma and Grandpa"?  To which I said, of course I do and she said "me too".  Then, my mom asked, "Do you and George ever get to go out on dates"???  To which I said, a little bit but not very often.  She brought up about a few such meaningful things, and it was almost liked she had them stored up to ask me just waiting for that moment of clarity to do so!!  I was thrilled and started imagining how we would have such a lovely lunch afterwards and have more of this type of conversation.
      Then, by the time we arrived at the doctor's office the anxiety and loss of confidence set my mom into continual repetition of all sorts of questions.  The waiting room was extra crowded and my mom was the only one who seemed to be a bit of handful during our wait.  Thankfully, it was not too terribly long before we were seen. 
     The routine questions and lack of my mom's ability to give accurate or relevant answers is always a bit discouraging to me.  However, we went through the drill of getting her blood pressure checked and updating the doctor on falls and new or continued behaviors.  In turn, we receive very little advice of how to cope or what can be done to help manage them.  Just some knowing looks and nods from the doctor.
The Waiting Room

The Waiting Game

The Long Walk Down The Hallway
       I also remember that on this day, went I went to the drive thru to get my mom her beloved Icee drink, they said their machine was broken.  By then, I was also feeling a bit broken myself.  My mom was in full agitation mode and a 30 minute car ride with this kind of agitation can be grueling.  However, once back at her apartment, I immediately sensed that more and more my mom is most comfortable safe and secure in her own apartment.
     At this point, I am starting to call my mom's and talk with Sheri every few days.  I am gradually letting her know some of my mom's history and that I am hoping she can help me determine if and when my mom is getting to bed at night.  At this point, it still doesn't appear that she is from what Sheri can tell.  However, I begin to see signs that someone besides me is caring for my mom.  Her Christmas d├ęcor has been displayed...and there is an angel watching over her!  She is even wearing her new shoes!  Although she is still sleepy, she appears better groomed and for that I approach Thanksgiving with gratitude.
      Because Sheri works seven days a week, I learn that she is even working on Thanksgiving.  Aside from the relief of knowing that if all else fails, every morning Sheri is getting my mom back on track -- I am also happy for the companionship she gives to my mom each day.  Gradually, she is getting to exercise class again, to church, and some of the other social activities in the building.  Somewhere along the way "The Don" and the frequent visits to his apartment seem to have almost completely subsided.  I wish I could piece together exactly how or why that has come to be, but for now my mom seems irritated by him when we mention him. 
     This year, me and my family had a quiet Thanksgiving dinner at home and after some indecision about whether to include my mom, we ultimately decided to bring dessert to her instead.  To date, sweets have never been declined by my mom and her apple pie a la mode was no exception.  Even though when I arrived I found my mom in some definite need of assistance, we ended up all having a few laughs with Grandma.

A Four Person "Selfie"
      More and more, I am keenly aware of my mom's overall declining health*.  Meanwhile, I am determined to try to get her sleep and schedule back on track so I can figure out how much of her decline is sleep deprivation and lack of care and how much is attributable to what inevitably lies ahead of us....



Monday Memories With My Mom...RETURNS!?

The Adventures of Caring for a Mom With Alzheimer's Disease
 It's been awhile... Truth is, this past couple of months have definitely had some ups and downs.  Perhaps more downs than ups when it comes to my mom's health and the quality of care being given to her.  As a result, my energy for reliving them through this blog is, to be honest, it's sometimes the last thing I want to do.  Obviously, recounting happy experiences is a lot more fun!!  
       The good news is that the kindness continues to come from people and places you least expect it.  The emails I have received from several people I had no idea were following along and who understand and share my concerns -- well those surprise connections and words of encouragement help make it all worthwhile! 
     I also realize I don't have to hit  "publish" on all of these Monday Memories.  I chose to do so awhile back to raise awareness from the standpoint of a family caregiver who happens to have three busy kids.  I have been rethinking whether or not sharing all of this is what I want to do.  For now, I have decided to continue...  So without further ado, here it goes.  (If you want a refresher on where we left off, you can do so here.)
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 

    This dates back to the first few weeks of November, 2013.  I was able to getaway for a few days, but before I did I went for a quick check on my mom to make sure she had everything she needed before I left.
     What I discovered was, portioning out snacks and "hiding" them away in my mom's cupboards is probably not going to work.  Every last snack was gone!  You may recall, I was only doing this out of concern that she was not getting escorted or eating her meals properly.  So, at least I know she got some food even if it was snacks!
     I also was excited to find her some new Croc shoes.  She loves the pink ones a little too much!  They are very worn, but still okay for indoor use.  Basically her Crocs have become a glorified slipper at this point.  I found her some nice beige neutral shoes that I thought would be great for Fall and she seemed pretty excited about that.  But, like most things, she still wants the pink pair and, depending on the day, may or may not willingly to wear the newer ones.
     Although my previous post indicated the possibility that my mom's new private aide had started working with her, I soon realized that was not yet the case.

I got her clothes better organized for the weather...pants in one closet and shirts and sweaters in the other.  Also moved the short sleeved clothes to the other room.
The last several visits were still going like this...  A very tired mom!
    I returned from my trip feeling more energized and I was (or so I thought) ready to tackle another sleepover on November 12th to again get a better feel how things were going with my mom and her care.  There was to be a Meet and Greet type introductory meeting the next day for the residents and their families.  They were officially introducing Nicole, the new on site Area Agency on Aging representative whom I had already been working with for about six weeks prior.  (You can read more about her and my previous meeting here.
     Not too long after my arrival, I was happy to see my mom was escorted downstairs for dinner.  I also met a new resident, Barbara, who was seated at my mom's table.  Barbara knows what is going on and was able to tell me that my mom barely eats her salad and gave me some other insights which is always nice.  We waited and nobody came to escort my mom back to her apartment.  It's been months since I've seen anyone do that on a regular basis, but they do offer the service and used to provide it during the first year she lived there.

    Back in her room I waited to see what kind of care was going to be given.  Around 8:30 pm an aide came and gave my mom her medication.  Then, about 9:15 pm an aide came to give my mom her "PM care".  I listened in the other bedroom.  The aide did not know I was there.  The aide wanted to give my mom a shower.  My mom kept asking why and was not very cooperative.  After several minutes, I intervened and told my mom she should take a shower.  My mom easily gave in.  I also told the aide that showers were supposed to be given in the mornings for a number of reasons.  Nights and evenings are not the best time of day for my mom due to sundowning.   By 9:45 pm my mom's shower was given and she had her pajamas on for bed.  In my view, the aides need to approach with an attitude of "wanting to help" rather than an "I hope she doesn't cooperate so I don't have to do it" approach. 
     Then, as I kept patiently waiting, and waiting...it became 12:30 am.  My mom was still on the couch watching TV.  I was in the other bedroom.  We have requested that my mom go to bed in the 11-11:30 pm range.  Next thing I knew it was 1:30 am and still no signs of anyone coming in.  By then my mom was up and about and busily spent the rest of the night "rummaging" through things.  TV on, all lights on...  She was busy!  
     By 4 am or so (I had dozed off myself!), I couldn't take it anymore!  Clearly, my mom was never going to bed on her own, nor was anyone ever going to come to prompt and help her to do so.  The realization that this has likely has been my mom's routine for months was a bit overwhelming to me, and no wonder she sleeps all day!  I put her to bed myself at that point.
     Then, in what seemed like a blink of an eye, an aide came in at 6:30 am the next morning and I could hear her telling my mom to get dressed.  (I recognized her voice and was quite sure I knew who it was.)  My mom kept asking "why".  The aide kept repeating "C'mon Mary"...  My mom said she was tired and two minutes later the aide said "Bye".  (She did not know I was listening in the other room.)  She gave up on my mom without really trying and more importantly not even realizing that her own coworkers never did the job they were supposed to by getting my mom to bed the night before.  It was still dark out and my mom had barely slept.  At 7:15 am another aide came in and gave my mom her medication in bed.  At 8:20 am her weekly laundry was picked up.
      The "Meet and Greet" meeting I had originally came for was to start at 9:00 am.  I decided to sneak out and let my mom sleep -- all the while I was more and more uncomfortable with what I had learned from my visit thus far.  The dining room was filled with mostly residents and only a handful of family members.  There was to be another meeting session later in the day, but I doubt that one had much of a different turnout.  I was a bit disappointed that the meeting did not have much substance to it and was filled with mostly information that I already knew.  I was so exhausted and felt a bit gypped that my efforts to be there appeared unnecessary.  However, towards the end introductions were given -- this is "so and so", the Director of Quality Assurance of the Med Team, and this is "so and so", the supervisor of.....  Well, you can bet I was jotting those names down pretty quickly.  Even though I had already spoken to my share of "managers" and "supervisors", I had never met or heard about their Director of Quality Assurance.  At the end of the meeting, I spoke with the Agency on Aging care manager and briefly filled her in on my night with my mom.  She insisted I speak right then with the Quality Assurance Director and after waiting my turn I did.  She was extremely nice and compassionate.  I felt I was able to convey the situation and problems I've had in a nutshell.  We agreed we would be in touch and that she would get with her staff immediately.
     Many phone calls and updates and less than a week later, my mom finally had the private aide that I was promised.  Although at this point I had not yet met her, I was happy to see her looking more relaxed and well cared for on my next visit...