Holly was lost today

Holly has short-term memory loss. She said she had open heart surgery. I don't know if that caused it, or if there were other causes. But her memory is quite unreliable. Most of the time she's completely unable to pull up any short-term memories. She has no idea how old she is, and some days she has no idea where she is.

Yesterday Holly had some dental work. Part of her teeth problem was caused by her chewing on bedclothes when she is in bed resting. I think Holly is trying to soothe herself. Although, she says she chews on things to clean her teeth. She has loosened teeth on the left side of her mouth particularly from biting and chewing on cloth. She has made many trips to the dentist recently. Yesterday she realized her mouth was numb. But, did not remember she had been to the dentist, but she was quiet afterwards. Holly has to be prompted to do most things. She is 56 and still thinks she's in her 30s.

Holly sits at my table and tries to carry on conversation with the other residents and staff. But most of us are too busy eating. Holly avoids eating in order to talk. She seeks out socialization and appears to want validation from others. Unfortunately, it is hard for her to carry on a conversation. But she does know enough to seek to be social.

Today Holly was more confused than usual. Maybe it was yesterday's Novocain at the dentist. Holly has had similar symptoms before – general confusion – the day after going to the dentist. I guess last night they said she seemed high. Apparently Novocain does not mix well with her other meds.

This morning Holly was fretful. She did not know where she was. She asked aides and nurses repeatedly why she was here. She thought she was here for a meeting. Holly did not believe she lived here and wanted her family, and to find her car,  etc. etc. It it is strange when a resident is in a time warp and totally lost, without memory. Sometimes I wonder if it's some strange game that Holly starts so those around her, especially aides and nurses, have to continuously answer her. When she asks question after question, she is not being ignored. But today the aides and nurses wanted her to stop talking.

Holly was confrontational. She insisted she was an RN (which she was), and knew what she was doing. She was anxious about her purse and kept saying that she had to get going because she had things to do.

I wish I could say things became clearer for Holly. But that didn't happen.

The only good thing was that she was hungry enough to eat most of her lunch by herself. At least with this new table arrangement in the back dining room, she has more impetus to feed herself.,

The lack of veggies

When I first moved to a nursing home 21 years ago, they served the largest meal in the middle of the day. Back then, I did not like that much. But since I ate that way for several years, I eventually got used to it. I learned that eating lighter in the evening is better.

At this nursing home as the weather gets warmer the noon meal gets lighter. I don't know why things have changed. Nutritionists still think eating more in the middle of the day is good. But for some reason that doesn't happen here as spring starts.

I've also noticed that several noon meals a week do not include vegetables. Some offer a sandwich and feature lettuce and tomato. Now I know lettuce and tomatoes are vegetables. Well, actually, lettuce is a vegetable, tomato is a citrus fruit. But you get the idea. Some days the only thing that resembles a vegetable on the lunch menu are pickles. Now pickles come from cucumbers and cucumbers are vegetables. But seriously, four dill pickle slices are not the equivalent of a serving of vegetables. However, I do know that schools once considered catsup to be a vegetable. Maybe dietary managers are using old school rules because at some lunches the only thing close to a vegetable is catsup.

I have watched us being served fewer vegetables for probably a year. I do not remember bringing this veggie fact up to the dietitian or the dietary manager. If I did, I'm sure they looked at me perplexed wondering why I asked. It's simple, I like vegetables, at least most of them, and salads, and we don't get enough.

I would love to have raw carrots, or celery, or even cucumbers to dip in Italian dressing or something. That would be good along with a sandwich. I don't see why we can't do that at least once in a while.

Also, if frozen vegetables are too expensive to serve every lunch, then buy canned ones. I grew up on canned vegetables and they were good. I would enjoy them. The residents without teeth could eat them. They would purée easily also.

Today we had a pizza burger on a bun. The pizza burger has mozzarella cheese in the middle. Sometimes that mozzarella is more prominent then other times. We had shoestring French fries – a tad undercooked – and a piece of cake with a few strawberries and blueberries and whipped topping on it. That was it.

I asked if there were any extra veggies, possibly leftovers from last night, that I can have with lunch. (I saw cooked veggies on resident trays yesterday. But the veggies were not on mine.) Since they served a veggie yesterday and said veggie was not on the menu, I think I've established precedent. Nevertheless, I was told that since there's no vegetable on the menu, there was nothing to give me.

I went to lunch and ate what I was served but didn't have the cake. Instead I had applesauce and like a curmudgeon I said, "I guess I will have to start taking B vitamins because actual vegetables are getting scarce".

I got a few strange looks. But I made my point.

Madcap

I will call this resident Madcap (which is not her name). She is certainly a puzzle. She is seriously obese and arrived here on a Friday afternoon. She's pretty quiet except when she acts up. I think she thinks she is good at impersonations. She mimics voices like cartoon characters – loudly – from her room saying all sorts of things. It always sounds like there's a conversation going on in there. She's also mentioned that she's married to a celebrity and pregnant with his baby. Who knows whether these other sides of her are real, or are something she's using as part of her persona here.

A couple of weeks ago she made a mad dash for the front door. It's not really a means of egress. But, I suppose it could be if there was a fire. She ran towards that door like she was going to escape. It's amazing how quickly her heavy body could move with the right motivation. But she was taken off her feet easily by staff and kept from getting out the door.

I can't move enough to even try to escape. But that doesn't mean I haven't thought about it. I have gone out doors without assistance in my previous nursing home. But I really don't like to do that. After all the doors are glass and if something bad happens, glass can break, and then glass can cut. I don't really want to experience that.

For some reason, Madcap acted up this afternoon. It was right at shift change. Perhaps she knows the drill now and has learned the vulnerable times when it's easier to catch staff offguard. So, that meant staff had to chase her. I heard a lot of noise outside my door. This time she headed for the same exit. But they were able to take her down to the floor again.

Madcap was yelling and cursing and quite angry. There were several curt, sharp voices talking to her. One nurse said to call 911. That certainly sounded like a good idea to me. You have to remember that I was behind the closed door at the time. But I wonder if at any moment the scramble would come in my door.

The nurse manager came out and talked with Madcap. She told her if her guardian said she could leave she would open the door for her. I'm sure that was something Madcap was surprised to hear. But I'm thinking there is probably no way she could find her guardian in, let alone get to actually speak with him or her at 3 PM on a Wednesday.

I luckily am my own guardian and don't have that concern. But some residents complain because when they need to talk two their guardian they can't. At times I think they are are being put off, and that angers me. I know a compulsive person with behavior problems cannot have easy access to his/her guardian or all the guardian would do would be answer their calls.

After two sedative shots Madcap eventually calmed down. At one point she was back in her bed.

She'll learn it's very hard to fight the system here. You might try to. But most of the time its quite secure.

A change in dining room seating

For three years I have been eating at the same table in the dining room. In 2014, they moved me out of the assisted dining room where most people need help to eat, or need to be fed. I didn't like eating there because one male resident has anger outbursts and sometimes throws his food. A couple of times I've worn it afterwards. Though it may sound funny, it's not really easy for a quadriplegic to change her clothing, even with help. So I wanted out of there and three years ago I got out.

But, we have residents who have had problems eating. Sometimes I think their medicines are all messed up when they get here. Often, during the transition to other meds, residents are not able to eat much and need a great deal of assistance. It's so sad. I feel bad enough needing to be fed. Then, I see residents who are so weak they don't even act like they enjoy food.

Anyway nursing management decided that my table would be put right smack dab in the middle of the assisted dining room. One thing about it that back dining room is bright and airy. We can see the view of a neighborhood and the street in front of the nursing home. Unfortunately, there's hardly any traffic except for the morning usual's:, school buses and trash trucks.

But, at least this morning I got to see a robin sitting on a wrought-iron fence near the front door. It's the first one I've seen this spring. To me spring's first robin is a sign of good luck and better weather.

The seating changed when I went to lunch. At least where the table is now, four people can definitely fit. There also is better access. Before, the table was beside two walls and was a bit inconvenient..

I made the comment that I think the back dining room will be quite warm during the summer. There is not much air-conditioning back there. Also, there are no blinds on the large windows, which could make it very sunny during parts of the day. I just hope someone remembers to get a fan for back there. Any fan would be welcome, but a tower fan would be the best to move air around. There used to be a ceiling fan. But it was removed over a year ago. I missed that ceiling fan last summer on the warmer days.

Because since that dining room is brighter, the residents may feel more awake. The main dining room is darker, and some residents put their heads on the table and nod off before they are served.

I heard a lot more conversation in the back dining room today. They put a female resident with memory problems across from me. She seemed to enjoy bantering back and forth. In the previous seating arrangement, she was beside me, not across from me.

I've always heard that a change of perspective in almost anything is good. Perhaps our dining room seating change will give us a more positive perspective during meal times.

Nurse aide call offs

The fact that we're shortstaffed here is getting old. The other aides are tired of it and so are the nurses. The residents here are most assuredly tired of it.

The problem is the existing aides are feeling the pinch somewhat. Some like to work extra hours for overtime and more money. While others may like the money, but don't like the pressure and fatigue of filling in.

It is unfortunate that an aide who works dayshift part-time called off for today. I don't know who took the call off, but someone did. I would have thought that person might've encouraged her to come in. Her absence left us us with two aides.

One night shift aide stayed over until after breakfast, which was a big help. Then, when the activity aide came in at 10 AM, she was pulled to the floor. However, she seemed like a reluctant floor aide today.

Lunch was kind of confusing, as was breakfast. We usually have more hands to help feed residents, and Mondays are particularly challenging. But there weren't that many hands to go around. I don't think any nurse could have felt comfortable working in the office today without assisting at mealtimes. I could not have done that knowing the other aides would be struggling.

We did get the administrative assistant/activity director to help in the dining room. She was needed because one aide had to do weigh a few residents, and another resident had a visitor. However, I think teamwork should happen all the time no matter what.

A second shift aide called off today also. She knew there would be two other aides without her and that the activity aide would be required to assist. So, the aides are figuring out how their empty spot can be filled. I doubt any aides will lose their jobs, since there aren't enough of them anyway.

A bit ago I heard a night shift aide called off. If she does not show up, an afternoon shift aide will have to stay over until 3 AM, at least. Only two aides were scheduled, and with the call off there would be only one. We definitely need a fill-in. Nurses were filling in on night shift, until a nurse went on maternity leave yesterday. Now they will need to fill in for her. A night shift aide on maternity leave still has four weeks before she returns.

It was a bumpy morning, and a somewhat bumpy afternoon.

And, it looks like, "it's going to be a bumpy night".

This nursing home is hot as hell

It is 65° outside today and this building was comfortable until the afternoon sun warmed the south side of the building. Since then the building has gotten quite warm.. It started about an hour after lunch.

This crazy building was probably built in the 60s. The heat vents are in the ceiling and the furnace air blows down on our heads during the cold weather. I wish I had the person who invented that type of heat so I could show him the error of his invention.

An aide came in an hour ago and told me she was sick to her stomach because it's so hot in this building. I personally think the heat could be turned off. I looked at the weather forecast for the next month and it does not look like we will have any temperatures below the 30s at night, unless there's a sudden change. Therefore, I would think the facility needs to turn the heat down. I thought maybe they had the thermostat set on 55°. That's what our neighbors did when they left their home to go to Florida in the winter. Setting their home's thermostat at 55°, should keep the pipes from freezing. But if the temperature would drop below 10°, the thermostat should be raised to 70° to ensure the pipes do not freeze.

The maintenance man here seldom comes in on a weekend. The only times he does is if he has to do a fire drill or another safety drill. But, in the spring when we have warm days, I think he needs to call-in to see if the building is comfortable. I think he is the only one that can raise or lower the building's thermostat. Though, that maybe what management here wants. Management does not live here – the residents do.

This building probably needs new ductwork and maybe even a new furnace. If the owner intends to let this building stand, then they need to redo the heat vents. Ideally, the heat should should be vented through baseboard registers, and it's not. However, it is probably too late to make major changes.

The easy solution would be to put heating/air conditioning units through the wall under the windows. Residents could then control their heat and cooling themselves. There might also be a way to lock the thermostat on a through the wall unit, to keep residents from having access..

I've lived here for over six years. Inside this nursing home, we have either cold-cold days or hot-hot ones. I think there needs to be a solution, and soon.

The hydration project

Over a year ago in September the nurse manager decided to have the activity aides pass ice water to the residents before meals. At this facility, water is not served with the trays meals. To me, that is strange because I drink water exclusively. Initially, the residents did not think getting water was much of a treat. However, that chilled water grew in value in the summer months when it was warm in the dining room. That glass of water was welcome.

On days when activities was shortstaffed, ice water was not passed before meals. Then, the residents complained. Some of the aides got really concerned. None of them wanted to do the ice water job – if they didn't have to.  At times, the nurses asked housekeeping staff to past the ice water since they know where the residents sit. And that seemed to work better.

I always knew once they started doing the ice water hydration project it would never stop. Some of the aides thought they were giving ice water so residents would drink it and fill up, and then eat less. I told them that was not the case. I thought that facility management knew drinking more water could make these residents healthier. They serve Kool-Aid, iced tea, coffee, or milk with meals. Since they do not serve water with meals, a frosty glass of water could be a welcome change.

I think they also thought passing ice water would prevent residents from carrying their water pictures to the dining room. Some bring their pitchers and fill them with the Kool-Aid, or iced tea, they get on their trays. Then, they take it back to the room. It caused fewer residents to carry a pitcher with them in order to have something to drink. When ice water was passed regularly, residents knew there would be something to drink in the dining room. Some still put meal drinks into their pitchers, but there are fewer of them.

A couple of residents with mental and emotional problems get quite anxious before meals. One female resident responds well to one or two glasses of cold water when she gets them before meal. It helps her to calm down and gives her something to do.

The other nice thing about ice water being served before meals is that residents I feel that they are enjoying a restaurant amenity.

Angry because he's here

A 69-year-old resident I'll call Henry came to this facility a few weeks ago. I did not see him come in. It might have been around supper time, since that's when some arrive..

Henry is quite unhappy that he was admitted here. A judge had him involuntarily committed to a psych facility in a town 50 miles away. At some point, he was sent here. He's not from this area. But I don't think there's any facility quite like this nursing home near where he's from, Eastern Ohio, (midway between Columbus and the West Virginia Eastern state line).

Henry always says a polite hello to me. But I'm quiet and I probably do not look threatening to him. However, no matter what happens here Henry finds something that upsets him and makes him righteously indignant. Not long after he arrived, a staffer took him out to buy some things he needed. One of them was a TV.. He also got a hot pot or coffee pot. I know he loves coffee and because he only gets it at certain times from the dining room, he is not happy.

Sometimes Henry seems to be spinning yarns, or telling old tales. Maybe he does have delusions and what he says is not reality. But there is no story a new admit could tell to staff that they'd believe. I'm sure each one of us, when we were admitted, told a story that sounded uniquely crazy. Most of us feel so misunderstood when we are sent here, we want to invalidate it happening. But, there is virtually no way to change the fact that we are here.
Should
A few residents come here, end up not liking it, and go somewhere else. But those cases are few and far between. The residents who leave and go elsewhere, are usually those who have family assisting them. The residents with no relatives our friends nearby, don't have much chance of being transferred, or getting out.

I hoped to befriend Henry, listen to him, and help him feel validated. Then I was going to try to assist him to change his behavior which would improve the time he spends here. But, I don't know if that will happen. My only brief chat with him was during snack a week ago. He was all gallant and met me in the back dining room. That was the only place to be since most of the residents were at tables close to the lobby exit.

Henry helped me get a drink. I told him that's a nursing home no-no. A resident isn't supposed to help another resident eat or drink. He said he figured that, but did it anyway. I think he could tell I was thirsty and I was. I didn't get much out of our conversation. What he told me was probably his life 30 to 40 years ago. I wondered why he receded into that timeframe. He was talking about a wife being pregnant. When I asked if it happened in the past, he said yes. But while he was relating the story, he teared up like it just happened yesterday. However, I'm sure most of us feel that way about the things in life that hurt us deeply.

Sometimes Henry is anxious – almost to the point of being in pain. I wonder if he has heart problems. Or maybe his anxiety makes him short of breath.

The aides assure me that Henry is only nice to me, but not to them. I told them Henry is hurting and therefore deserves some sympathy. One of the aides just shook her head and said, "Well, he may be nice to you, but you're probably the only one. But, I have seen him be nice to others to others, housekeepers, cooks, and residents.

Unfortunately, I understand Henry only too well. I have been in his shoes, and watched from his seat. But, I have learned to deal with anger and try to get the best out of being here.

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A friend's vertical, aortic aneurysm procedure

My friend Mike had triple bypass heart surgery a little over two years ago. It wasn't a total shock. He had had some brief fainting spells, and A fibrillation. A couple years before he had abdominal surgery. Some of the blood thinning meds he had taken had caused internal bleeding. The abdominal surgery fixed that.

But Mike continued to have problems. In the 11 years I've known him, he's always had a lot of abdominal problems. After a meal he frequently had stomach cramps. Now I think that had more to do with his heart than his digestion. Women usually are the ones who mistake heart symptoms for digestive symptoms.

Before Mike had triple bypass he called me from the ER. He sounded afraid and very tired and told me that he might have to have surgery. When I did not hear back from him, I tried to call. When I got no answer on his cell, I called his wife's cell. When she did not answer, or return my call, I was concerned.

My sister visited soonafter and on our we to shopping, she told me about Mike's surgery. He and his wife did not want to tell me because they were afraid it would upset me. They called my sister and asked her to tell me.

After I heard about his surgery, I called his wife to check on him. When he was feeling better I called him. When he spent two weeks in a rehab facility (nursing home), I kept missing him because he was in cardio rehab therapy. So, I called him at a nursing home suppertime, 5 PM, and he answered. I only talked for a short time so it would not interrupt his dinner. But talking to him made me feel better..,

After he was discharged the cardio rehab therapy continued for several weeks. When he finished, he came to visit me. He told me all about the surgery. He showed me the "cell phone size" device which monitors his heart. It takes a heart rhythm every night while he is asleep. It also has a panic button that he can push if he feels ill. It was both creepy and comforting to know that high-tech is keeping track of him.

Since then, Mike developed a vertical, aortic aneurysm. It sounds scary to me and I'm sure it is for him. In the last two years his doctor has been watching as it increased in size.

Mike last went to the cardiac surgeon in December and his aortic aneurysm was 3.9 cm. The usually do surgery when an aneurysm reaches 4.0 cm. Mike will be away from his 30 hour a week, part-time job for at least four weeks.

Mike saw the cardiac surgeon a couple of weeks ago. When I called the next day, He Was Waiting for the surgeon to schedule his aneurysm strengthening procedure, either using a stent or a graft. It's done with a robotic device Thruway small incision. He would only be in the hospital for a few days.

Mike visited me last week and took a shopping and I took him to a Chinese restaurant for lunch. The weather got a bit intense and shortened the day. I feel badly that Mike's having surgery again. He is 74 and surgery is never easy when you're older. But Mike doesn't have much choice. If the aneurysm bursts, it means a stroke and probable death. I'm sure he thinks about that every day, as do I.

***

Mike had surgery yesterday. His wife texted he's doing well. After his surgeon saw him walk in the hallway Mike was released a day after his aortic aneurysm procedure.

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How to get good aides to work in a behavior facility?

Nurse aide staffing is short here. It has been for a while. I think we have three aides on night shift and only three on afternoon shift. A new aide was hired for night shift a couple of weeks ago. She was here a short time, but, long enough to report that a more experienced aide was rude to residents. After that, the experienced aide was fired. Subsequently, the new aide quit. So in essence the facility lost two aides, or one, depending on how the math is done.

I don't think they've ever been this shortstaffed. Also, it's income tax refund time and some aides would rather not work when they have cash in their pockets. Some take time off, or vacations, if they can. A few others just quit and then look for another.

Even though the company who owns the nursing home has nurse aide training classes every month. I don't think a student has been hired in a while. If I were running things, I would want to hire at least two aides. This is a 50 bed facility and it's pretty much full. Presently there are two empty beds.

I know there's a drug problem in this town. Maybe people are having a rough time passing the drug test. The facility also requires potential employees (including aides) to pay for their background check upfront, and then be reimbursed later on. We heard one aide was coming back to work over a month ago. I chatted with him on Facebook today and he said he does not have the funds to pay for the background check.

To me, if it was important to get a trained aide hired, the company would pay. I can understand why they want a prospective aide to pay for the background check. It shows responsibility, and indicates that potential employee will show up up and work the schedule that is given. It also might show that the potential employee is depending on the company reimbursing them. It costs companies a lot to hire a new employee. A few years ago I read it can cost as much as $200 to hire someone for a minimum wage job.  Most entry jobs here are minimum wage except for nurses and nurse aides. The aides wage is a bit higher. Of course, the more experience they have coming in, the better the pay.

Most aides here complain that the pay is low. I'm sure it is relatively speaking. But for the job they have to do here, it is not that bad. I sat here last night and counted how many residents here actually need care from these aides. There are probably only 10 residents that need moderate care and above. Five more probably need mild to moderate care. The rest pretty much take care of their own physical needs. They may need some assistance with bathing, getting shaved, and getting the supplies they need to care for themselves. But this is not a typical nursing home where all the residents are in bed most of the time.

I have told the aides their job here is easier then the aide jobs at my previous nursing home. There the residents were older and many were there to die, no doubt. There were some younger residents who had traumatic brain injuries, spinal cord injuries, mental and emotional problems, and paralysis. There were few residents who could take care of most of their own needs during the day.

I don't know what the answer to the aide's shortage is. But I know what the question is. How do you get people to be aides in nursing homes when many of the residents have behavioral problems and cognitive impairments?

I'd like to meet the person who has the answer to that.

Power chair meeting 03

Last week there was a meeting about my power chair here at the nursing home in the back dining room. Those in attendance were: vendor rep, manufacturer rep, facility therapist, regional long-term care ombudsman, myself and my friend Rush. In the beginning the vendor rep was rather condescending to me and I tried to ignore it.

My friend Rush went over the Medicaid prescription/order because she another copy I sent on her iPhone. The order was for a different brand of chair than what I received. There was also specialized accessories on the chair that I do not use. I wondered how Medicaid could improve accessories I had not used before. But I thought maybe the vendor had to get everything he thought I might need on the new power chair. Unfortunately, we did not get an explanation for the different brand of chair. They said the brand mentioned one is from a company that had a couple of its chairs catch on fire, and it was sanctioned by the government. I read it online. The vendor rep said those chairs were unreliable. In fact, I don't even think that brand of chair was for sale in 2016.

We discussed the various parts of the chair that I do not use. The vendor tech removed the extended headrest when it was delivered because I asked. A friend of mine removed the bottom of an 02 bracket because I do not use 02. After some discussion, the manufacturer rep removed the vertical bracket (the rest of the O2 bracket).

The vendor rep told me they extended headrest was for my use when I used my van, or other vehicle. It's like a head restraint. But the manufacturer rep said the head restraint was included because the chair tilts and reclines. It's there in case the chair reclines and leaves you stranded. So, it's probably standard on tilting, elevating, and reclining chairs. But, my chair does not tilt or recline. I did not want those features. The head restraint will stay in the box that is in therapy.

They mentioned that the brains of the controller is a horizontal bar about 1 1/2 inches thick on the back of the chair.. I was never told that bar was like a CPU. I think that is vital information I should have been told. That bar has to stay where my backpack runs into it. I don't understand why it was put there since the vendor knew I would be hanging the backpack on the back of my chair. I think it could maybe have been positioned in a different spot. The lower part of the back of the seat might have been better.

I said I slide easily on the material on the chair seat. I said the seat is 20" deep, per the Medicaid order. That was mentioned and I told them I wanted the seat to be 18" by 18", like all my other power chairs. They said I needed a longer chair seat to allow me to sit straight.

The removable arm pads were discussed. I wanted higher armrests (13 inches from the seat), and that's what they came up with.. They Velcro on and the Velcro gets stuck on my pants and my shirt and pulls my pants down and my shirt up.. They said they would return and redo the Velcro.

My friend Rush also mentioned that she does not like the way my arms are propped when I am at my desktop PC. The manufacturer rep said that is done to stabilize my trunk. I told him I use my left thumb and forefinger to operate my touchpad on my desktop PC. In order to do that, my elbow is elevated which allows gravity to pull it forward and keep it there. I elevate my elbow when I'm in bed using my laptop. Maybe propping coincidently supports my trunk, but that was not the reason I did it..

I asked about the left lateral thigh support which is missing. I was told that I wanted it removed. I don't remember asking that it be removed.. I may have wanted it removed because it's not aesthetically pleasing. It's quite institutional looking. After sliding on the seat so much, I thought maybe the left lateral thighs support might make me more stable in the seat. They found the left thigh lateral support and put it on the chair.

They repositioned the controller located on the right side so it is more visible for the aides. They need to be able to see what speed I am in.

The manufacturer rep reprogrammed the joystick speed and sensitivity. He said the turning would have been quite jerky at the settings it was on. To me, the chair has always been jerky. I said I would have to use the chair when I was not tired to see improvements he made and if it needed to be more sensitive.

I wanted Speed 5 programmed. But the therapist said she was not comfortable with that. I told her I would only use it outdoors going across parking lots. But, she did not want it reprogrammed, and it wasn't.

The nonslip surface on the foot rests began to shred off when the chair was two months old. I reported it to a vendor rep and he suggested re-gluing it.. I said I wanted better nonslip tread to stabilize my feet. They suggested heel loops/slings. I explained they make my feet too far forward and I slide down in the chair.

I said the foot rests are smaller. They said they are 6" by 8". They said the large size in my brand of chair are 10" by 12" instead of 8" by 10" like those on my last power chair. They said the foot box could be used for foot/leg positioning. I did not see one of those on the chair.. But, it was on the order form priced at $636. They thought I should try it. I told them I've never had one and think it would cause me to slide forward much like heel loops I could not use. I asked if the foot box could be returned and may be able to pick a different accessory of equal value. I was told it couldn't.

They mentioned a device which goes on front rests to stabilize my feet from sliding. As these described it, I told them it sounded very restrictive. They said they would bring and attach a stronger type of nonslip material to attach to the front rests. Hopefully, it will wear better..

I asked why the tires look like they have been through salt during winter storm. The therapist said it may have been in snow and salt. No one really had an explanation. They said my tires looked like tires. But they are black tires with white spots of something from somewhere on them. It actually looks like rocksalt used when it's snowing.

They told me the seat back is set at 110°. I said it could be moved up 5° or so, so I will sit straighter in the chair. They suggested adjusting it right then. My friend Rush said since I was tired and they were going to return anyway, it could be done at a later time, and they agreed.

Since mostly all of my issues were addressed, and it was 4:30 p.m. or after, the meeting ended.

A few things were worked out but not enough explanation was given.

4:30 AM – 20 minute wait – for help

I was awake from 4 AM on. But I decided to wait until 4:30 a.m. to put my call light on. The nurses and aides are used to this because I've been doing it for years. It's not that I want to get up then. But I usually need to move after six or seven hours of sleep. I don't like them to wake me on night shift bed checks, like they do at most nursing homes. I told them not to come in unless my call light is on. Most of the time they respect that.

I put the call light on this morning. When the nurse did not come in right away with my fiber supplement and Synthroid (hypothyroidism hormone), I thought something must be going on. But I know most of the nurses and aides smoke. They have to smoke outside somewhere near the smoke shack. Because it's still wintertime, they probably sit in the smoke shack. It's not warm there but it should be dry. I can understand them wanting to be outside, smoking and being social, as opposed to being in here with all of us. But it would be better to take turns. That way one of them could keep an eye on the call light board to see if a resident needs assistance.

Five minutes later when no one came in my door, I was almost relieved. I thought I'd just snooze while I was waiting for them. But after a couple of more minutes, I wondered what was going on. I wear earplugs to keep out the noise that would keep me awake. But, that means there are things I miss out on. I wondered if something was going on that I could not hear.

Ten minutes after I put the call light on, I was getting resigned to the fact that they probably were going to be late getting to me. I thought they might be showering a resident, needed another aide's help, and neither of them could get away. That leaves the nurse. I always think she could come, if she's available, and not smoking.

Fifteen minutes after I put the call light on, I started to wonder if a resident was ill and had to be sent out. I didn't really wonder if a resident was dying. At least no resident appeared to be near death yesterday. But, that  doesn't mean anything. Since there was nothing else I could do, I tried to relax. Sometimes I pray to relieve anxiety. It's harder to be anxious when my mind is busy.

Twenty minutes after I put my call light on, my door opened. Two aides came in followed by the nurse. She gave me my fiber and Synthroid and promptly left.

Then I got to use the bedpan and was repositioned so I was more comfortable.

I don't know if I said anything to the aides like, "Where were you?". If I said that, they would become defensive. Sometimes I ask if they are okay. It may sound dumb to the uninitiated person hearing it, but it makes them feel less ruffled than if I ask why they are tardy. Sometimes, when they're late, I wonder if they wondered if I was okay. If there was another situation they could not get away from, probably not.

Though I wonder why it took them so long, if I ask, because of HIPPA, they say they're not allowed to tell me.

A larcenous driver

A few years ago I had a female driver I will call Betsy. Betsy was a great person to be around. She was upbeat and she liked to do things. As long as I paid her, she would take me places and do things. She was always so enthusiastic, at least in the beginning.

There was always something about Betsy that made me uncomfortable. I wondered what it was that I noticed that was so offputting. One thing she did that bothered me was she wanted me to write her paychecks at the end of the week before the day was over. She had to cash them at my bank. She said the bank told her I had to be in my van with her when she went through the drive-through. So, that's what I did.. The rationalization was if she withheld her services I would not get to go out. When you live in a nursing home, getting out is important.

But I got so tired of signing checks in strip malls, in winter, when the wind was blowing. I also did not like doing things under duress. But I realized many people are under duress and just deal with it. My bank required two IDs. A driver's license or state ID and either a credit card or some type of employer ID. I eventually found out that Betsy's individual provider ID had been confiscated. She had provided care services for Medicaid.

She told me there were disputes with former patients. They accused her of billing for hours that she was not at their house. I asked if she ran errands and she said she did sometimes. I told her she had a right to bill for the errand time she put in. But, I told her there was no way she could bill for a lot of hours spent away from her patient.

That subject got dropped and then picked up again at times. It was always when Betsy needed extra money. She would try to stay longer even though I tried to limit her hours with me. She only worked two days a week for five or six hours. But she tried to stretch it. She would call me and want to come on weekends. To someone who's in a nursing home and wants to have company that is not a hard sell.

Betsy had worked for me about five months. One day in March we had lunch at a restaurant. When she went to get my usual credit card out, it was not in my credit card case. I wanted to pay immediately with another credit card and go back to the nursing home, get online, and check my credit card balance. Betsy told me not to worry because I was only responsible for $50 worth of fraudulent charges. Somehow that did not make me feel better. But I thought I was being a reactionary and just let it go. Besides, there was no way I could have checked unless I had called right then and without the card I did not have the credit card company's phone number. Nevertheless, I put it in the back of my mind.

A few days later I checked my credit card balance and saw that almost $1000 had been charged on my card. I called the credit cards fraud division. The charges were at two big-box stores and one gas station. I knew the gas station charges were not mine because it wasn't the receipted day/date I bought gas.

The fraud division asked me if I had buyers regret. I was aghast. I told them definitely not. I told them to check my previous spending patterns which would show I had not spent $1000 in one place for a while.

They told me I had to call the police. I called them and they told me to call the Sheriff's department. Then, I was told to call the police again. At some point the police took a report.

My driver was a bit suspect to me. That little inkling I had prior came to fullbore when I realized someone had charged on my card. I thought she was capable of doing it. I think we all are.

I found out later her boyfriend did it. Anyway he's the one who owned up. It was horrible. He was prosecuted and had to spend 30 days in jail eventually. It was almost a year later and I don't know that it was much of a deterrent. For some reason they only went after the charges at one big-box store, not both, which I did not understand.

Within a couple of weeks, I had to let Betsy go. Wondering if she would do it again, or if she would get in cahoots with someone who would, made me really nervous.

Strangely at this time she started talking about her days working for Medicaid. She told me that she was suspected for fraud and was under investigation. That kind of scared me.

The next day I emailed Betsy that her services were no longer required. The nurse manager here made sure she could not get back in the building.

It's four years later, and I have not seen Betsy again.

A bad food day

I'm supposed to be able to get the whole meal from dietary each evening if I want it. Some nights I get it, and most nights I don't.

Since we have fewer aides, the food from dietary has been cold. Most of dietary's food is not good enough to eat cold. But sometimes the comfort food like Johnny Marzetti is okay. Some aides endeavor to get here right after supper when the food is still warm..

But tonight it was after smoke break before my tray got to me. I think the nurses could help with smoke break so I could get a tray that would be warm. I would think my aide would want to heat it before she brought it to me. But this month, since staffing has been short that has not happened.

I don't want to "get in the habit" of eating the whole meal every night. I need to curtail my calories or I will end up gaining weight. The nights the food was cold I did not eat as much of it. I guess cold food is a deterrent to me over eating.

Today's food was really not up to snuff. Lunch was baked potato soup which has a yellow cheese in it, which I do not eat, and pea salad. They had an ice cream cup for dessert. The only protein in the lunch was the bacon in the pea salad. I saw the pea salad other residents had, and there was little bacon in it.

After breakfast, when I saw what was for lunch, I asked my nurse if she could ask if dietary could give me some protein. Dietary said that was all they were having. The cook said I could bring peanut butter or whatever to add to my lunch. I asked my nurse if I could bring a 3 ounce can of tuna from my cupboard. She said that was fine.

Because of the lack of protein, I emailed the nurse manager, even though it's the weekend, to let her know how little protein was in lunch. I told her my nurse gave me the okay to add a 3 ounce can of my tuna. I asked dietary for a piece of bread and a pack of mayonnaise to put with the tuna to make a sandwich.

At lunch when my tray came I had very runny vegetable soup (the backup), a side serving of veggies, and one piece of bread. I asked one of the aides to get me another piece of bread to put in my soup and a pack of mayonnaise. When she brought it, my aide put the mayonnaise on the tuna, mixed it and made a sandwich with one piece of bread. She broke up the other piece of bread and put it into the vegetable soup. I had her add the side of veggies to the soup. Putting the bread and extra veggies really cold the soup. But, after having veggies and bread the soup was still runny and difficult for my aide to feed to me.

I managed to get that lunch in me. Adding tuna made it a bit more filling. I ate applesauce for dessert, which did not make me feel full.

This afternoon, after a less than lovely lunch, I asked my aide to bring me the vegetable lasagna and veggie side dietary was serving for supper. When they did not bring it around 6 PM, I wondered if it would end up being cold.

When the aide arrived with my tray, I asked if the food was warm. She said it felt warm. I asked her if she nuked it and she said she hadn't.

I tried the vegetable lasagna and it was stone cold. The veggie side was even colder. That vegetable lasagna was horrible cold. I told my aide I was sorry I could not eat it.

I had her get a two pack of granola bars which I ate with a couple of pieces of dried fruit, I have been my cupboard.

Though I probably had enough to eat, I do not feel full. There was also not much that was comforting about eating granola bars.

But my diet will probably be better for it.

Partying hearty

I went out with a friend shopping and two lunch, and we got back to the nursing home sooner than I expected. I was going down to 2 PM snack, when I realized there was St. Patrick's Day party for the residents. I went down to the dining room door to see what was going on. They had food stacked up on a cart. As I got closer, I realized that they were maybe going to sell "snacks and pop" to the residents to have over the weekend. But I also knew they would also give them free snacks for the party. I wanted to see what they were serving.

The free food appeared to be: green cupcakes, maybe two kinds of ice cream, cookies, chips, pop, and 3% green beer. At least that's what I saw. I left when I realized I could not get to an empty table in the dining room because there were so many residents in one corner of the room. I went through the back way. I ended up sitting back there and talking with a fairly new resident who is quite upset about being here. I tried to sit and just listen to him. I know it's frustrating to put somewhere against your will.

An aide came back and got me an artificially sweetened Kool-Aid and about five potato chips. I just wanted to fit in with the crowd but not eat that much. I ate and drank my little bit of cheer and said I headed back to my room.

There were still plenty of residents in the dining room when I left. I think the food had been put away. The residents were just finishing up what they already had. I know the staff all went down and got goodies also.

As I went up the hallway the nurse manager asked me if I had anything to eat. I told her I had five or six potato chips. She said, "That's not much". I told her I know that but I had just eaten lunch. I said, "I do not want to gain weight and end up being back at 214 pounds like I was when I came".

I feel sorry for the residents here. It would be nice if they could be playing a game and maybe occasionally eating. But this feasting is way too much. I lived in a different nursing home and most of the residents there did not eat that much food. There were some, mostly younger males, who ordered out frequently to get the kind of food they liked. But still, they could only do it when they had money, not every night. I really don't think the residents here should be spending their entire personal expense allocation of $50 a month on snack food and "order in food". But, it looks like they are.

I know it took time to clean up the party remains after the residents were finished. It's too bad they can't let the able-bodied residents help with the cleanup. I don't think it would hurt anything, and it might actually make them feel like they were contributing.

St. Patrick's Day celebrating is over for another year.

What housekeeping doesn't see, or overlooks

At this nursing home John is a resident who eats in the "assisted" dining room. He needs help to eat and sometimes he has behaviors. He gets short tempered or uncomfortable and can get pretty rowdy. He can use one side of his body pretty well and sometimes throws the dishes his food is in. Sometimes the food goes everywhere. Since I've been here come his food has been on the floor, walls, ceiling, windows, tables, and chairs. He even got my new blue suede shoes a few years ago come when he tossed his tray and puréed green beans landed on them. I was mortified. Thank heaven, they cleaned up well. But it made me shy of sitting beside John at mealtime.

I'm sure the housekeepers get tired of cleaning up after John. His food is puréed so it is pretty runny and messy. They put thickener in it to make it easier for him to swallow. The thickener is modified food starch, so the food is extra sticky. If they don't get it wiped off right away, it sticks to the wall better than the paint they use here.

It's really strange because some of John's food – blueberries for instance – have stained the metal kickplate at the bottom of the double doors between the assisted and regular dining rooms. I don't even think they know what the stain is anymore. I think I'm the only one that remembers the one day that John threw the plate with his puréed blueberries and they hit the door. Now, I'm sure they could clean that stain off with brass cleaner, stainless steel cleaner, or something. But yet, it remains there.

Two years ago John threw his plate which contained puréed meat among other things. It went on to the wall and just about everywhere in the corner. I noticed afterwards that they missed a fairly large spot of it on the vinyl baseboard in the corner. I watched it every day for several days. I wondered if I should say something to one of the housekeepers. Then I wondered if they tried to get it off, and it would not come off. Then I wondered, if they scrubbed it and marked up the baseboard. All I know is, that spot of, what looks like puréed meat stain, is still there.

It is now over two years later. I first saw that stain in  October 2015. Sometimes it's interesting to watch the most minute things, like I have been watching that spot on the vinyl baseboard in the corner. Many times I've been in that back dining room passing housekeepers. And I wondered if they can even see that spot. That puréed meat stain is dark brown, the vinyl baseboard is a worn tan color. It is noticeable.

I have no idea why no one in housekeeping has removed that spot. Perhaps it will not come off. Another thing might be that the maintenance man said that some vinyl baseboard would be replaced, and they thought that part might be. The lobby area outside the dining room did have new vinyl baseboard installed last spring. But they did not replace it in the back dining room.

Maybe housekeeping thinks it will be done this year…

A comforting meal substitute

Today were having pork. It is the other white meat and they seem to have a lot of it at this nursing home. I do not like to eat pork as it tends to upset my stomach and cause abdominal cramping. But sometimes it's almost unavoidable. Some days they substitute ham with pork, or the reverse.

When I saw that pork was on the menu today, I wondered what the substitute would be. I found out it would be yesterday's spaghetti and meat sauce. That sounded much better than the dry pork they usually serve here.

I gave up pork on my own along with beef back in the 80s. The price of beef and pork was pretty high and at the time the store where I shop for meat did not have the best all the time. Many times after I worked I did not want to come home and wait for my caregiver to cook for me. Sometimes we did fast food. After a while I knew that was not good. It resulted in weight gain.

We started having a hard time figuring out what to do with the pork and beef. I put it in the freezer and it was a challenge to use it up. I've referred to have chicken and fish because it took less time to cook them. I gradually gave up beef and pork.

It was difficult going to a nursing home. Beef and pork were most definitely on the menu. I had to eat the beef and I ate the pork. I guess I wanted to see what the food would be like. I was used to nursing homes in the late 70s that served beef, pork, and chicken made into patties that had been flash fried and frozen. They weren't very appetite appealing, but they were sustenance. At least the food a nursing home is not quite that bad now.

We have gone 13 days without a pork entrée at lunch. During that time I did have to eat pork once. Ham with beans was the main meal. The substitute was a breaded pork chop. I ate it because it would be either that or a peanut butter and jelly sandwich. I eat the pork and was sorry afterwards. To me it tasted a bit old.

Today pork was on the menu for lunch. In the last two weeks the pork on the menu was served in the evening. I don't go to the dining room for that meal.

When I checked to see what the substitute was, I was told spaghetti and meat sauce. It would be warmed over yesterday's lunch. Even so, I always think spaghetti sauce is better on the second day. I just hoped they would have enough to give us a good portion.

When I received my plate, the spaghetti noodles and meat sauce filled up about two thirds of the on the designated entrée spot on my dietary tray. I was dejected and hungry. I ate the spaghetti with meat sauce and the piece of bread with butter so I would be filled up. I think spaghetti brings back comforting memories from home and childhood.

I remember watching mother making spaghetti sauce, over many hours, in her kitchen. I also remember the many years that I helped her put things together for her spaghetti sauce. As I said, a spaghetti dinner brings it all back.

A one aide short Monday

Dayshift is hard enough in a nursing home when there are enough aides, let alone when they are one short. That was the situation today. The Restorative Aide had to be a floor aide. I don't think she was feeling it this morning. She felt put upon and we could all tell. Sometimes when you're asked to step in, you just have to keep going and forget about all the other things that are going on all around you. But that wasn't happening today.

Breakfast was a rush and a swirl of activity. We had no extra activity aide to help pass trays and possibly feed residents who needed extra help.. We got through it without major problems. But the aide who cared for me felt more of the stress. She took it on herself. She verbalized so much that I felt like I was living inside her brain. Take it from me, her brain was not a pretty place to be this morning.

Right after breakfast the mobile dentist showed up. He brought in two carts with his dentistry tools, computers, and whatever else with him. There's no really good place to put the dentist. He usually goes in the back dining room. I never think that's a good choice. But that's where he's usually put.

Not many of the residents responded to calls to go to the dentist. Most residents at this behavior facility are not morning people. They are reluctant about getting up for breakfast. So I know how they must've felt about something that could be painful like seeing the dentist.

I heard several residents refuse to come. Others were told the nurse manager expected them to go.

The aide who cared for me, would normally have handled getting residents to and from the dentist. Instead, she had to be an aide and the dentist gofer also. I'm sure she felt that was unfair. Perhaps all three aides could have tag teamed the task to make it easier. But it's just really hard for three people to do the work of four.

When I went down to lunch and started through the back dining room door, I saw the dentist was still examining residents and stopped dead right in the doorway. I guess I should have backed up. I didn't know quite what to do. I didn't want to interrupt the dentist. But I didn't want to miss lunch either. In the end, an aide told me to move and I did into the room and towards my table.

I usually sit in the back dining room and enjoy the view out the window for a while before lunch. Today that could not happen the back room was taken up. Then, the dentist had to move his equipment out and the room had to be quickly readied for lunch

That meant the residents at my table sat together too long. I wanted to move away from that room so badly. The dentist was gone and it seemed like the meal took forever.

Later my aide bemoaned the fact that she had to do so much on a Monday when they were one aide short. I thought to myself, Mondays are like that sometimes. Except for when we have a week's worth of Mondays.

Looking for a good sale

I buy most of my clothing from Blair.com. I have done that ever since I've been on the Internet. They have a more classic clothing line, offer slacks with all-around stretch waists, and have plus sizes. It's not the cutesy clothing I would rather have had when I first moved to a nursing home. But I needed clothing that was functional and would hold up in the nursing home laundry.

I only shop when I have money. But I usually only shop when there's a sale. The sales I like best are 25% to 30% off and free shipping. But, those kind of offers and me having money at the same time do not coincide very often.

I probably go to Blair to look at clothing once a week, when I have an unused gift card. I have a friend who gives me a $50 card every Christmas and I want to get the most I can with it. This morning I headed there clicking through a 25% off email. There's nothing like looking for clothing to perk up your mood. I was looking for spring things. I also looked for midweight clothing, like longsleeve T-shirts and knit shirts in vibrant colors to wear in early spring. I wasn't being very successful.

In the last few months the prices on Blair have increased. But some customers might feel higher prices mean more wearable and sturdy garments. I never buy their top ticket items, unless they go on sale. I've had to pinch my pennies in the last few years and I can't buy everything I want.

It was more fun when I had more money. But this way I have to use my money wisely and make better purchases. I've lost some weight and have to buy smaller sizes. I'm still wearing some 2X tops and pants which are a bit large. But living in a nursing home and having them do my laundry, causes me to be careful about what size I buy. I don't purchase clothing made from fabrics that shrink easily.

Sometimes I think it would be nice to be able to see and feel the clothing I'm buying. But then, I still like how easy it is to buy online. I love looking at clothing. But I hate paying for shipping and avoid it when I can.

Blair doesn't email as many specials as they did even a year ago. I have no idea why. They feature several websites on the top of the main Blair page. They even have an outlet site where they have clearance prices supposedly all the time.

I like Blair's Tropicool cotton blend pants for summer. They are lightweight, comfortable, and wash well. I noticed they no longer have them in the regular price women's section. They were only available in the clearance section. I wonder if they are being discontinued.

I was looking at crinkly (looking already wrinkled) pants that they're selling for summer. They are bit out of my price range unless I can get a good discount. But I know from past experience that they hold up pretty well and are nice and thin. Since I do not wear shorts, they are the nearest thing I've worn that feel like having absolutely nothing on my legs.

I also wish Blair would sell shawls or ruanas for those of us who like to throw something around our shoulders when we're chilly. I think I saw one short shawl there once. Obviously shawls are not something that women customers are requesting, or they would have them.

I guess that gift certificate from Christmas is burning a hole in my pocket. My desire to spend it has risen. I will be on the lookout for good sale between now and Easter.

Medicare does not pay for ultrasound screening for breast cancer

A year ago I was scheduled to have a mastectomy of my left breast. But, at the last minute, I changed my mind and canceled the surgery.

I have had breast cancer three times: in 1990, 2007, and in 2009. I had chemo and radiation twice, most recently in 2009/2010. After that, I got  Faslodex injections (chemotherapy) for five years. I was able to get it despite the fact that my breast cancer was Stage III and not Stage IV. I don't think that happens often.

After I finished Faslodex, I was afraid. I was certainly tired of the shots, the nausea, and the aching which followed them. But I was concerned that breast cancer would return with a vengeance. While I was on Faslodex, I got a left breast ultrasound each year. It was probably part of the treatment protocol, maybe because it is difficult for me to get a mammogram.

I finished Faslodex in July 2015. Since my oncologist suggested I be tested for the breast cancer gene mutation BRCA2, I asked about it. It took a while to get it approved. Genetic screening was done with a simple blood test and August 2015. It showed I was positive for BRCA2. When I told my oncologist,, he suggested a mastectomy to prevent further breast cancer in my remaining breast. I questioned whether having the mastectomy would increase my individual survival chances.

Back in 1970, when my mother had a left breast mastectomy, they removed her breast, lymph nodes, underlying tissue, muscle, and a lot of skin. They don't do that now. Now they think I woman should not have radical mastectomy if it does not raise her chances of survival.

In November 2015, I told my oncologist I would see a surgeon. He had told me I could no longer have ultrasounds to screen for tumors. I scheduled the mastectomy for February 2016. The day of surgery I change my mind. I decided I did not want to have a mastectomy, which would put my life in jeopardy, to try to maybe increase my survival chances.

Instead, I wanted a left breast ultrasound to see if I had a tumor. I almost had to move heaven and earth to get it. It was scheduled and canceled again and again because providers felt Medicare would not pay. But somehow I had the ultrasound.

I had an ultrasound at the end of February 2016. It's over a year later. I asked the nursing home about scheduling another left breast ultrasound. But, I have heard nothing.

I will ask my physician (the medical director here) if Medicare will pay for a left breast ultrasound in 2017. Medicare has a rule that it will not pay for breast ultrasounds as a cancer screening tool. It can be used for diagnostics, such as to do a biopsy.

When I first had breast cancer in 1990, I had to have a mammogram. That was so difficult because of my paralysis. I stood for the test which was torture. I am also sure that the quality of the mammogram was not good. After that, my oncologist said it was pretty much useless to have another. He told me hospital radiologists would require a mammogram first, before they would do an ultrasound.. He told me the ultrasound was as accurate as a mammogram. However, he said hospitals and clinics have to pay for their mammography machines, and they do that by doing mammograms.

For the following four years after that first breast cancer, I had no further breast screenings. I had x-rays, abdominal CAT scans, and bone scans to check for metastasis. But no ultrasounds were done. I did have two or three mammograms after I moved to my first nursing home. They were done as a cancer screening. I stopped getting mammograms because I was bruised so very badly during it.

I understand Medicare cannot pay for useless tests. But if Medicaid will not pay for an ultrasound. I will no longer get a screening. I know a chest x-ray could be done. it would show if there are any tumors in my lungs. I may have to settle for that. That's what I did from 1991 to 1995.

I would think Medicare would have some type of waiver policy for people like me with be able to have a simple breast cancer screening without all this uncertainty.

The noisy man

We got a new male resident a few weeks ago and he is something. I know nothing about him. The staff are not allowed to tell and none of the residents talk much. I don't ask questions. So I only know what I hear in the hallways.

Mr. C has mostly silver and white hair. He uses a walker sometimes and other times he does not. A few times a day he is totally irate about something. I don't know where he came from; it may have been a hospital psych unit or another type of psych facility, but he wants out of here. He says he is way too restricted here. But, as a smoker he gets to go outside to smoke seven times a day.

I don't get to go out that often. Residents who don't smoke are not allowed to go out with the smokers. I guess they're afraid a resident will run away. Some residents here have been flight risks in the past. I'm sure there are a few of them now. They don't want to have to watch non-smokers and smokers at the same time. This is not a more traditional nursing home. We don't have mostly old people who have dementia and who are very near death. Although, some may be near death and have nothing visible that we think would cause imminent death. But, none of us knows when someone will die. Do we?

Anyway Mr. C was mouthing off the other day because he could not find his TV remote. It was right after breakfast when the aides were getting residents out of the dining room, and the nurses were passing medicine and sometimes being called hither and yon.

Mr. C was not getting enough attention and he spouted off. The nurse manager came out and talked with him. She told him he would have to wait. He ended up throwing his walker a few minutes later in the hallway and losing his first smoke break. He was really irate about that. But here, actions have consequences, especially if you smoke. That's one thing they can take away from you if you act up.

I have empathy for Mr. C. This is a strange place to come to and I know all about that. It's too bad there isn't a counselor here who could listen to him. Instead, therapy takes people downstairs to exercise or maybe do eye hand coordination things, like crafts. I think that's a good idea. But, therapy serves as a timeout. If there is no therapy possible, a resident must go to their room and stay there.

Phone usage here is restricted. Residents can only make so many calls out each day; it's the same for receiving them. Even though I have a Skype phone, I don't use the phone much. I use it mostly for business not for pleasure calls. I use email instead of calling. That cuts out the waiting part – which I like.

I understand why Mr. C was upset. He can't call anybody to vent because calling is on a schedule when enough staff can assist him him to call out and hand him the phone. Even if you have a cell phone, as one resident who's soon moving out does, the nurses keep it and let her use it periodically. She probably is following the same rules as all the other residents who use the facility's phone.

I know some past residents received many calls in a day. When they announced those on the PA it was noisy and redundant to hear someone called numerous times. Luckily, residents are no longer paged to the phone, and no resident gets call after call either.

On the way to the women's shower this morning, Mr. C was in the hallway sitting on the seat of his walker. He said he wanted to shower when I was finished. I could tell he wasn't happy. My aide told me she kept him out. She told him I had to be showered before breakfast, because that's the routine.

I told my aide that he might have been in a better mood if he had showered. I know it is hard when you can't do anything on the spur of the moment. I suppose people with mental and emotional problems do way too many things too fast for those around them. I guess that's why they make the residents wait. I have learned to put most of my emotions on hold, but that doesn't work all the time.

The longer Mr. C is here the more he will see the facility's system in action. He may not ever like it. But he will at some point appreciate it.

You're getting a roommate

I don't how many times I've been told that I would be getting a new roommate. Usually I hear about it the day before. But several months ago I was told I'd get a roommate in an hour sick I'm glad she gets to make it tomorrow.. So I have learned to always be prepared. Ever since I became disabled at 19, I have lived with my bags packed – mentally. I knew any situation could put me into a hospital or nursing home. It may sound weird, but living with my bags packed mentally keeps me on my toes. It makes me ready for almost anything. It does not allow me to become complacent or comfortable no matter where I am.

I realize I live in a building owned by somebody else. Yes, they do healthcare. But they do it for a fee. That is a different perspective than paying rent. We don't have the luxury of being able to purchase contents insurance. Of course, even if we could buy some type of contents insurance, it would have a deductible. That deductible would not cover the small things (those under $100) that go missing or get broken.

Anyway back to the roommate scenario, I live in one half of a semi private room. But, my things have encroached onto the other half. I don't really do this, the aides do. They put things on the other bed. Sometimes it's new clothing I have purchased or received as a gift. The closet is not extensive enough to hang everything. I know, I know I should just put these unopened packages in some type of a sealed plastic bag beside my closet, and keep them until I need them. That's what I'd like to do, if the aides had time. Even though I like to live with my bags packed, not is difficult to do when I need someone to help me. I constantly think for new ways to coordinate it.

I have to keep improving the plan. The clothing plan often goes awry because of laundry and there coordination of our off-season clothing. If I saw everything go into clear storage bags, I could probably find it. But once it's out of my hands, it's gone.

I also think nursing home residents intentionally hoard. But that does not make it bad.. When you live in a facility, and you run out of something, you're out. There is not much you can do to replace it. Residents have to wait until a staffer goes shopping to get what we are out of – if we don't have family or friends to get it. I do have family. But, my sister is too far away to do much very quickly.

I've had so many almost nervous breakdowns because I was told about a roommate coming, anywhere from an hour later, to that afternoon, or the next day, that I try to let the sound of that phrase roll off my back.. To defray the onslaught of the roommate coming, I remind nursing home staff that my things, which were placed on the other bed, will need to be stored. I try valiantly to keep the pile down over there. But, it's so convenient to put things on the other bed, and leave them there. Storage is scarce in nursing home rooms, and I don't have other options.

I was told today the perspective roommate uses a wheelchair. I reminded the aide there is not enough room for two women who use wheelchairs all the time to be in this room. Now maybe if the roommate used a wheelchair for longer trips, outside the room, it might work. Since I need assistance to transfer in and out of my power wheelchair, the roommate would need to be able to walk. At least, those are the kind of roommates I have had in the past.

I heard later today that another female resident is leaving tomorrow. She is up the hall a few doors. She has wanted to get out of here every since she came in December. The new resident may go in that room room. But I won't know until tomorrow.

In the meantime I'm going to stay with the plan to minimize my things on the other bed. I will need to do a lot of encouraging and cajoling of the staff. I will also have to speak to management so that appropriate staff assist me. There is bureaucracy in a nursing home, but I'm used to it.

Laughing at tension, or not

I go through life observing a lot. The reason for this is because when you have a disability you have to learn and adapt to the pace of others. They end up being your helpers so you have to get to know them and try to understand them. Some days I do a better job than others. Today was not one of them.

An aide I will call "J" has been here on and off for over five years. She is young enough to be a grandchild – if I had gotten started early having children. Otherwise, she could be a younger daughter if I had a child in my 40s – which I think would've been doubtful. But, you kind of get the idea, there's a generational gap or more between us.

It's not that I don't like "J", I do. At least I like her to an extent. She's a single mom with three children. I don't know anything about what's going on in her life because I don't have children. But I have an appreciation for children and I can understand that they have many needs. I also understand that a person in their late 20s, especially a female, has things she wants out of life. I can only wonder what it's like inside "J's" brain.

"J" is a whirlygig, a flibbertigibbet, a will of a wisp, and sometimes a clown. But today was not one of those times. Today she was being a bit too bipolar for me. She was already hyped and running on 78 when 33 1/3 what have been just the right pace.

I made it through my shower, through breakfast, after breakfast, through the morning, and was doing okay until lunchtime. "J" on the best day is hard to follow. At lunch time she was tossing my salad and getting it everywhere. It's not really her fault. We eat food on a tray similar to what they used on the M*A*S*H TV show – except ours are plastic. She had no rim to keep the lettuce in. So it was going everywhere. There was not much lunch to lose and I was trying to encourage her to hold onto my portion of it.

But, "J" was still having a difficult time and dropping my entrée, sometimes liberally, on the towel that was on the front of me for protection. I was wanting to dodge the spills. I didn't really know what to do. I should have laughed, it would have changed everything – I just know it. But I did not laugh. I asked if she could be careful. That was not good, I know.

I think "J" may have given the "hairy eyeball" to one of the other aides in the dining room indicating that she wanted help. All of a sudden a resident in the back dining room started to act up. His aide was getting frustrated and felt she needed a break. Was this a set up? I wondered…

Nevertheless, I crossed my fingers mentally hoping that the aides would swap spots so I could have a less messy feeder on this day. A few minutes later that's exactly what happened. Another aide "JJ" came to feed me. I said, "Oh, thank God you're here. I thought I was going to have to kill "J"". She smiled and fed me the rest of my entrée.

It would have been nice if the day had stopped right there. But it didn't. It went on and got much worse. My nerves were racked and rattled and I blew up at "J".

That's what happens some days when you don't remember to laugh when things are frustrating. I usually laugh when it's funny. But, sometimes I need to remember to laugh to break the tension.

Power chair saga Update 02

My power chair vendor's CEO emailed me asking if I still had a complaint about the chair. I went on to tell him it was not what I expected. It was the brand they told me I would get. But it was not set up the way I thought it would be. He knows about the difficulties because he got copies of the letters I wrote to Medicaid.

I also got from Medicaid the prescription which is also the billing for the power chair. I was surprised to find the order was for a different brand than the brand I got. In fact, it was the same brand and model as my previous power chair. The transition to that chair may have been easier for me, since I had used that brand of chair since 1998.

I have no idea why the wrong brand of chair was in the order. It's confusing. Maybe it was a clerical error. Maybe the wrong paperwork got sent. Maybe it got switched with another order. I do have to admit that the order process paperwork is very convoluted. And it was 37 pages long. Some of the documentation about my medical condition is on the paperwork several times. The whole form I know is computerized. Did they think everyone would write something different to put it in each individual section?

I have no idea. I just know the whole thing has me a little bit scared. Have I uncovered something? All I wanted was a power chair that worked for me and was newer than what I had. In my research I have discovered that Medicaid law says a vendor cannot substitute a different power chair from what was ordered. So, if that's what happened, there is a problem.

I also was told from a Medicaid representative that Medicaid does not check power chair purchases on a case-by-case basis. She told me there's no way they could do that. That just mystified me. Medicaid needs to know it's not their money it's the taxpayer's money. They need to use all due diligence to make sure the power chair that is prescribed is ordered and delivered.

I also wondered if Medicaid made the error. Since my first and only Medicaid power chair was the same brand as what is on this paperwork, I wonder if when they went through the data, they printed the wrong file. Some of the prescription for the chair looks like it's on old forms. But, it has been copied. I just wonder if it was pulled out of a notebook of regulations. Perhaps order paperwork is not always in the correct order.

The vendor has suggested a meeting towards the middle of the month. I would like the regional long-term care ombudsman to be there. I also want a friend to attend with me, or call-in via conference call. I would like someone to hear what goes on.

The vendor also wants to meet late in the day – 3 PM. I wake early in the morning and will be winding down and getting tired by then. So I asked if it could be changed to a different time, or maybe a different day, if necessary. I also said I wanted a friend to attend and if they could not make it on the day he suggests, we may have to negotiate a different day.

So, my life is getting stranger than I thought. It's too bad there is no Medicaid forum online where I could have posted my complaint months ago. Then maybe we would all have been saved a lot of trouble and time.

How death starts

It's really hard to write about the decline of resident's health. But that's what I'm doing. I'm writing about a resident I've known since I came here more than six years ago. I knew she was a little eccentric then. I also wondered if all her stories were true. Nevertheless, she was past 65 and I was sure that she had experienced many things in life, some of which were probably not pleasant.

I will call her Esther for the purposes of this blog and it's reading. I knew Esther was not that educated. She told me she had lost her child (a daughter) who was taken from her by the County Department of Children's Services. That had to be a horrible thing for a mother, despite whatever reasons there were for it happening. Esther used to say she hasn't seen her daughter in a very long time. Over the last few years, she said she has 14 grandchildren. That would be a hard thing for a single daughter to do. But, I haven't heard Esther say that lately.

Esther has made the rounds of different rooms in this nursing home. She was on the front hall which is close to the nurses' station and the dining room. Then she was moved back on the hall where I am a few years ago. This part of the building is far away from the activity centers. Even though this building is not that large, only 50 residents max can live here, it still is a walk for someone who has difficulty doing it. Esther told me she had polio as a child and has had difficulty walking ever since.

When Esther walked she did it in nonslip socks instead of shoes. She did have a hard time walking and sort of dragged one foot a bit. I can see where wearing shoes may have tripped her up at times. Walking for her was a struggle. But she made it. Most of the time the incentive was meals and snacks. Esther is overweight so I guess you can say that food motivates her. She never complained much about the food. Although at times, she did ask for the backup for some things. She doesn't like tomato soup and always requests chicken noodle.

Esther has a birthday in late November. She always reminded everyone here that she was born a few days before Pearl Harbor was bombed in December 1941. That means Esther is 75 years old. But she seems to be caught in a time warp. For the last three years, she has continued to say she is 72. She apparently doesn't realize what year it is. When I tried to remind her a few days after her birthday, I could tell my suggestion of a correction was not going anywhere. Maybe it wasn't registering that she was misremembering her age. I didn't pursue the subject further. It was a little disheartening realizing that she's lost her sense of time and date.

Everyone wants to know what death looks like. Maybe we're watching it catching up to Esther. That's not a happy thought, but it may be the truth. She no longer walks. Soon after  her November birthday she had greater difficulty making it to the dining room. Sometimes she was incontinent and had to be pushed to her room for a quick change to return to a meal. I think she realized life would be easier in a wheelchair.

Maybe things will level out and Esther will learn to thrive in that wheelchair. She's been encouraged to motivate it herself. But she's not doing a very good job. Lately, I see aides and nurses pushing her in her wheelchair more than they used to. I wonder if she beats herself up because she no longer walks. I would think that would be very self-defeating. She was offered therapy, got it for a while, and then refused. But, as everyone knows, no resident can get therapy continuously while living in a nursing home. There has to be a goal. Esther is not going to leave here so her goals will be limited and so will therapy.

Esther told me she hurts and I'm sure that's true. Sometimes I think the depression is hurting her more than her physical ailments. But I'm not in her body, so I don't know.

But if I want to know what death looks like, I think all I have to do is keep watching Esther. If I can get close enough, maybe I will find out.

Naturally colored hair

My hair was last colored the first week of June. Since then, I had a difficult time talking anyone into coloring it. This nursing home does not have a cosmetologist. For a while one of the activity aides was a licensed cosmetologist and she could color, cut, and perm hair. But, most of the residents, even the females, just have their hair cut.. I sort of felt like I was asking for too much to get more done to mine.

I offered to pay her something for doing my hair, but I was told she could not take anything. I had to buy the perm or the haircolor that she used. But, that was not that bad.

But there were times when she could not do my hair. That's when I felt I would rather pay someone. At least I knew if I went to the salon, I would get something done to my hair.  Living in this nursing home, I was never sure when my hair would be cut, colored, or permed. I also could not be spontaneous about my hair. If you can't be spontaneous about a hair decision, what can you be spontaneous about? But here, anything done to my hair, was planned to an extent. No one here could just drop everything and do my hair.

So, by the time of my birthday in September, my hair had not been colored – even though I asked. I decided to just let it be natural. The worst part of regrowth is when there is 1 inch or less of hair that is different. I realized I don't even know what color my natural hair is. The longest I've gone without haircolor in the past 20 years has been three months. I know my hair is 50% gray – which isn't all that gray.

So the journey of letting it grow out has been interesting. One good thing is the only mirrors here are in the bathrooms. Since I can't stand and walk, I can seldom see in the mirror. The only place I can look at my hair is at the nurses' station through the glass around it. And that is always a distorted view. So, unless I intentionally look at my hair in my hand mirror, I have no idea how gray it looks.

Last week one of the aides did my shower. She told me I really needed to color my hair. I told her I actually don't and I'm not going to. I told her I'm letting it grow out to see what color it is.

The last time I saw the color was a couple of weeks ago when my sister visited. We went to the salon inside Walmart and I got my hair trimmed. It looks like my hair is coming in a silver color. I was hoping it would be more white. But it is not. I still have blonde on the ends because I started having it colored blonde two years ago, before I stopped coloring it. I guess that was the transitional phase.

It looks like it's going to be a while before all the colored hair is grown out. I thought maybe by June all my hair would be back to the "natural for me" color. But it may be more like the end of summer or the fall.

Since I have read that gray hair curls easier than colored hair, I'm hoping mine might curl up naturally just a bit. If I no longer need to get perms, I would be almost salon free.

When the heat is gone

I've lived in this nursing home for over six years. And the heating is really strange. It is either really hot or way to cold. There seems to be no in between.

In March the weather in this part of the state gets warmer quicker than the southeastern part where I used to live. When the temperature gets up in the 50s and 60s, any heat that comes out of the ceiling vents here makes it feel sweltering in this building.

Last Friday it was 77°. The nursing home staff looked wilted. We residents did as well. I know I had to put my air conditioning on. I felt kind of stupid doing that when I felt the heat coming down from the ceiling vent. But there is little I can do about the heat. I just know it's too hot and I need to be more comfortable.

At some point this week, the heat in here seemed less impressive. The weather was in the 50s and then got much cooler. This morning temperature was 16°. This building was frigid. The back dining room was so cold, I had a blanket on my lap and a shawl around my shoulders.

I realize turning the heat off and back on may not be possible into building this size. Once the maintenance man turns it down, or off, we live with that setting. Today most of the residents were complaining that they were too cold. After breakfast many went to their rooms and curled up in bed to get warm.

It is not too bad for me since I have a desktop PC for daytime warmth, and on chilly days my laptop, I use in the afternoons and evenings, provides needed warmth on chilly days. But they also can provide too much warmth on a hot day. Maybe this year I will get one of those cooling fans to see if it will make a difference during the warm summer months..

Tomorrow it is supposed to be in the 50s. With the heat in the building right now, tomorrow should be much more comfortable inside for everyone. The outdoors will also seem more inviting.

It's hard to believe we are getting close to spring. They heat is turned down our off similarly each and fall. Like I said in an earlier blog, I got used to a heater/air conditioner under the window in my previous nursing home. That made it more like a motel where you can easily change between heat and air conditioning.

I wonder they will ever retrofit these older nursing homes with more modern under the window/through the wall heating and air conditioning units. To me, it cannot come soon enough.

We could probably live with cooler common areas if we knew our rooms would be warm enough.

The foot doctor

At my first nursing home, when the foot doctor came, I was told I had to get on my bed. They took my shoes and socks off, put a towel under my feet, covered me, and I waited until the foot doctor came by and either cut or checked my toenails. I hated this practice. I'm not diabetic and I did not think I needed to have a podiatrist cut my toenails. I thought a nurse or an aide could do it.

I talked to the nursing home management and they agreed. So for years I did not have to go to the foot doctor.

When I came to this nursing home, I was told to go to the foot doctor. But here he does not come to my room. I have to go to where he is seeing patients and wait outside. Sometimes there are 20 residents waiting there for him. To me, I think it would be better if he came to the rooms. That way the mess would be contained, and a common area would not be soiled .

I usually only saw the foot doctor when my toenails needed shortened. Some aides shortened them with my small, battery-operated, nail drill, or an emery board. To me using an emery board is safer than using clippers. But if the aides did not get to it, sometimes I could get in to see the foot doctor. However, I would rather have the aides shorten them.

Earlier this year I started to get a lot of pushback about any of the aides shortening them with an emery board. Maybe they thought the aides were spending too much time with me doing toenails.

Since then, a nurse has been cutting my toenails once a month. That is she was, until the beginning of February. The day she was to cut them, the podiatrist showed up. Then, she said I should have him do it. I had already asked and the aide in charge told me I was not on the list. So I went back to my room and worked on my PC.

I headed towards the room where the psychiatrist was. I somehow thought going there would not turn out well. I'm not always able to get on the list after the foot doctor arrives. When I got to the front lobby, the last four people were waiting. I was at the end of the line. When I got up to the doorway, the foot doctor said it was 3 PM, and he was finished.

When the aide heard the podiatrist, she went into the nurse manager's office. The nurse manager came out and said, "You will cut her toenails. We have a contract." Then she walked away and I wondered how the foot doctor felt about being challenged within earshot of his last patient.

I went and offered a sort of apology for causing him to stay longer. Even though, he seemed to shake it off, the situation was uncomfortable.

Then, he took his clippers and gave my toenails a cursory shortening. Since I had not seen this foot doctor before, I asked if he could smooth the sharp edges with a drill. He said he had no drill, and picked up a well-worn, thicker cardboard file. As he moved it towards my toes, I cringed. Afterwards, I said, "Is that all you're going to cut them?" He told me that was as short as they should be. I wondered why he could not just make them a bit shorter, which is the length I like.

When I asked how often he visits, he told me every nine weeks. I said I had never let my toenails grow for nine weeks. He said, "Well, you will if I'm cutting them. If I do them sooner than that, Medicaid will not pay and you will have to."

He's right I will not be having him shorten them sooner. I do not want to have to pay for that service. If I am not able to get an aide or nurse to shorten my toenails, then I may HAVE to wait.

To me, it's amazing how choices are taken away willy-nilly after moving to a nursing home. I just think I should have some choice in it. I cannot just shorten my own toenails. I have to ask someone to do it. Being told when it will happen makes me feel like an Army grunt who has no choice but to follow orders.

I have no idea how long my toenails will grow in nine weeks. But, they will probably be an exotic length, long enough for sandals or flip-flops. That's way too long when you wear sensible shoes like mine.

Power chair saga – Update 01

Well, it's over a month since the January letter was mailed. But it looks like the letters I wrote had an impact. It's not like a million hits on YouTube… But it's close.

From a letter I wrote and sent in mid-January, I was contacted two days ago by Medicaid here in my state. I was asked several questions. Then I was asked if I had contacted the vendor since I wrote the letters. Medicaid wanted to know what's been going on with my chair. I said it's in my letters. I have been having periodic problems with the power chair's joystick bracket. Maybe it's a good thing I wrote those letters. I knew I would probably have trouble with this newer power chair again.

I got another call from Medicaid today asking me if the vendor had contacted me. I said he had not. A little while ago I got an email from him. It was only about two sentences long and it didn't say very much. I'm trying to read between the lines to see what he means by what he is saying.

He wants to know if this is an old problem or a new problem. Maybe I should just say it's an ongoing problem. Anytime you have equipment it needs to be maintained. That means you need another person or persons to help you.

So far I have written three different drafts of an email to him. I'm trying to strike just the right tone. It's kind of hard. I suppose it's possible he knows nothing about me or the power chair I received. I don't know quite how that could be. But I suppose it is possible.

I was going to try to email him back right away. But I kind of decided not to. I'm going to wait a bit. I want to sleep on it and see what I think in the morning.

I think Medicaid needs to change their process. It's not very consumer friendly. I'm sure they don't buy many power chairs for nursing home residents. I only know of less than 10 people getting one in the last few years. That's not very many. Medicaid already told me that they cannot check into every power chair purchased. I don't know why not. It's the people's money not Medicaid's.

One thing about the wheelchair users forum that I used was that they wanted to make sure that I followed up about what happened with the chair and how the vendor handled me and my difficulties. They said it was very important for other wheelchair users because they may be treated similarly and then end up feeling like I do.

I guess we cannot put down the written word. Yelling, chanting, and marching carrying a sign might get attention. But if you write down what you want and are not getting, I think it's easier to understand.

Even though I have needs that have not been met to my way of thinking. I'm trying to think about what this CEO might be thinking.



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Fluoride varnish and chewing gum do not mix

I am 68 and sometimes have tooth sensitivity issues. It's maddening. Since I turned 60, I learned to use fluoride varnish when the sensitivity gets to be too much. But sometimes the aides do not want to put it on. They say I have no dentist's order. In the past I have called and the dentist has written the order and supplied the varnish to a nursing home staffer. Then, the nurse applied it. But that nurse was leery and did not have a technique. I know training would be helpful but you really just need to be a detail person to do it.

Since I have two teeth that were filled 2 1/2 years ago and have ached quite a bit since, I thought maybe I might need some work done. The dentist had mentioned that one tooth might need a root canal. I am a tooth grinder and I have TMJ occasionally which is equally awful. So a dentist's appointment was made. I usually only see the dentist once a year for Medicaid paid for cleaning.

They made me an appointment and I went today. Two aides have to go with me if I need to get into the dentist's chair. It used to be that one person could take me and the dentist or one of his staff would help get me into the chair. Now, the nursing home must provide the assistance.

So we headed to a 2:30 p.m. appointment. It was getting rather windy on this March 1, 2017 as we arrived. We sat and waited for about 10 or 15 minutes. I really like it when people are on time and I think we were a bit late.

As I went to the little booth I told them I would stay in my chair until they decided what they needed to do. They took an x-ray. We waited a while. The dentist came in. He asked me where it was hurting. I told him which teeth it might be. He tapped around with something metal and when I did not jump out of my skin, I guess he figured I would live, but maybe have tooth pain. I told the aides they would not do anything significant today. They would make me wait because that's what happens with Medicaid and probably most other insurance.

I think we kind of determined it was sensitivity or maybe a virus infection, or possibly a sinus infection which will go away eventually. So I asked about a fluoride varnish treatment. I told him I know that will usually help some. So the dental technician applied the fluoride varnish. I also got the dentist to write a prescription so that I could use the fluoride varnish I always keep on hand – in case.

When I returned it seemed like I waited forever to get in bed for the rest of the afternoon. An afternoon shift aide called off and we were already shorthanded. A day shift aide had to stay over and so did the activity aide. I was told another second shifter was coming in after supper. But, since it's her day off, I doubted it.

After I was in bed the nurse gave me my medicine. Since it tastes really yucky, I asked for gum. I never thought about the fluoride varnish. I started chewing the gum and noticed the gum was getting very soft and moving with every chew on top of the fluoride varnish. I usually only get fluoride varnish in the morning and eat before I return to the facility. Perhaps I was told in the past, NOT TO chew gum, and I'm sure I didn't. But I don't remember that I was warned against gum chewing.

When the gum covered up the fluoride varnish and moved into the grooves between my teeth, it felt like this monster had gotten loose in my mouth. The citrus taste of the gum was mixing with the citrus taste of the fluoride varnish. I tried to move the gum with my tongue and it was stuck fast. I'm quadriplegic and cannot reach up there with my fingers to get the gum loose. I sort of did not know what to do.

I put my call light on. It was 15 minutes after supper started. I figured nobody would be able to come. They were already shortstaffed. I called the nurses station. The nurse answered like she had all day. I explained to her that gum was stuck to the fluoride varnish on my teeth, and I could not get it out. She said an aide was coming. The aide came in and pulled as much of the gum out as she could with her gloved fingers. She said they would get the rest later.

After that aide left I kept working on the gum with my tongue to loosen it. I was able to get a few pieces and spit them out on the tissues that were on the front of me.

When an aide came into feed me my snack, I asked her to get a facility toothbrush.. She tried using it and didn't have much luck. Instead, she got a floss stick and removed more of it. I ate some of my tortilla chips which loosened additional gum.

I googled fluoride varnish and I now know that it and chewing gum do not mix. But there was no answer about what you do to easily remove gum from fluoride varnish. I know this has to have happened to other people. But they probably just kept pulling it out with their fingers and maybe used a toothpick.

In the future, if possible, I will only have fluoride varnish applied after I brush my teeth before I go to sleep.