Cancer and Chemotherapy during COVID

As far as my life-defining experiences are concerned, caregiving ranks right up at the top, along with the illness and death of my father, and with parenting.

After living through difficult caregiving situations, I think it’s safe to say that most people do not want to burden their children. However, from what I observed when I worked as an Assessor at the Area Agency on Aging and what I experienced as a caregiver, I discovered that in the attempt to not be burdensome, parents become exactly that. Ironic, isn’t it?

It is my theory that young people think they don’t need to give caregiving much thought; current caregivers are too darn busy; and past caregivers want to put it all behind them.

In my opinion, the primary reason for this is the lack of communication about the topic. Talking with your children, and even grandchildren, about lifestyle choices and end-of-life care is extremely important.

But because we as a society generally practice avoidance and denial about the topic of caregiving, we delay our response until there are rapidly escalating needs or episodes of crisis with which to deal. Discussion and planning are not usually done “ahead of time”, but as an evolutionary process.

If you look back through my blog posts over the years you will find that I revisit this topic with frequency, as I do likewise with friends and acquaintances who are either embroiled in in caregiving or on the precipice of a cliff and ready to fall off.

A number of my friends contributed caregiver stories for my book What to Do about Mama? One of those was “Patricia” (See Patricia’s Story in What to Do about Mama? pp. 118-120).

Patricia had a sudden onset of cancer during the COVID pandemic. If you want to follow the complete story, go to the Newsletters tab above and sign up—either through my email address or one of the two videos. For the past six months I have been documenting Patricia’s experience with cancer and I will be glad to send you the back editions.

Another friend who contributed a story was Katie. She had two starkly different caregiving situations, one for her mother, the other her mother-in-law. (See Katie’s Story pp 122-126). Together, Katie, Judene, and I, along with our spouses who worked together in the steel making business, were friends. We have witnessed first-hand how life can change dramatically in an instant when a surgeon makes a mistake. Most notable is Katie’s personal experience when, at the age of 64, she suddenly became a poster child for the fragility of life, and she found herself in need of fulltime caregiving. (See Katie’s Update in What to Do about Mama? pp. 308-319.)

This friend, by the way, is one of those individuals who downsized her home and “got organized” proactively—and is now glad that she did. (See Patricia’s Update in What to Do about Mama? pp. 294-296).

“Judene’s ” had an extreme experience as a long-distance caregiving. (See Judene’s Story, What to Do about Mama? pp. 118-120). She also contributed an update where she expressed: 

The problems and difficulties of caregiving tend to be repeated to some degree. It’s like anything else that is unpleasant that happens to you or a loved one. You don’t dig in to learn about what avenues are out there to assist you until you have a need for them. And we tend not to trouble our children or friends with unpleasant things, so they don’t have an opportunity to learn from our experiences, such as caregiving. Also, until faced with the problems directly, we often don’t learn even if someone tries to share their experiences. My husband and I have taken steps to prepare for our future; we have long-term health-care coverage. But I acknowledge there are additional things we should do, such as clean out the house; designate recipients of items; pre-plan our funerals; and make sure our will is in order. I guess we avoid said things because it’s just too much of a downer.

What to Do about Mama? pp. 288-289

And it is at this point I begin to feel like I’m beating a dead horse. I agree with Judene’s assessment about avoidance. She and her husband live in a beautiful home high on a hill with a long steep driveway and a yard that requires a lot of care and upkeep. Her husband cannot imagine not living in their home, nor do they believe in hiring anyone to clear the snow from their drive and to do the landscaping. A couple of years ago he participated in a senior triathlon and is proud of his physical condition—as well he should be. But as inevitable, he is now experiencing respiratory problems—and I am concerned that life is coming at them fast.

The following article, Caring and Grieving in the Shadow of COVID September 9, 2021, by Annika Vera brought me to tears.  It also made me think of my friend Patricia. 

Caring and Grieving in the Shadow of COVID | The Caregiver Space

Such a young woman with so much on her plate. When her mother had brain surgery to remove a tumor in May 2020—

  • She thought that was the most difficult thing that could happen during the pandemic.
  • She thought once her mother recovered, her caregiving role would end.
  • She thought she would go back to her life as a “normal” 20-year-old woman.

Three weeks before her 21st birthday, less than two months after her mother’s surgery—

  • Her mother was diagnosed with breast cancer.
  • (“My role as caregiver had only just begun.”)
  • The COVID-19 pandemic—a another layer of stress and anxiety on top of the “cancer stuff.”
  • I was now living with an immunocompromised person
  • From July 2020 to March 2021, we were isolated—no work, school, family, or friends. 
  • We only saw doctors and nurses at the hospital.
  • The fear of COVID was so intense that it almost became a distraction from the cancer.
  • Her focus changed from curing an illness to not contracting a virus.
  • Cancer brought uncertainty about life and death—
  • Contracting COVID ascertained the outcome would be bad.
  • Chemotherapy was a game of “Will they let me in with her not?”
  • Often she would be left to wait outside the glass doors for hours.
  • Every day she watched as the drugs made her mother sicker and sicker.
  • Then the cycle would repeat.
  • But another tragedy began to unfold.
  • Her grandfather had cancer, too and was declining quickly.
  • He was overseas so they were unable to visit.
  • Watching him die over a video call—a surreal nightmare.
  • He passed away without our seeing him one last time.
  • Being a caregiver to someone very ill—helpless.
  • Watching a loved in another country pass away over a video call—powerless.
  • We have very little control of our lives, but…
  • I got through the last many months of hell.
  • I continue to wake up to whatever the next day brings.
  • The strength comes when you think you can’t go on, but you do.
  • Although we are weak, sick, and grieving—we are at the same time—stronger.


Delusional Thinking and Dementia

See the The Imperfect Caregiver website: for discussion and an audiobook excerpt. Love this website!

https://theimperfectcaregiver.com/2020/08/01/caregiver-you-are-not-alone-anns-story/

My comment:
My friend suffered from a brain injury during surgery in December 2012. She was impacted physically (with the use of only 3 limbs), mentally (hard to determine since she maintains many thinking skills and abilities), and emotionally (personality has changed in significant ways). It’s confusing because despite the losses, when it comes to her mind, there is much that has been maintained. So it is particularly frustrating for her spouse when my friend expresses one particular delusion that she insists is true, when obviously to everyone else, it’s false. The delusion: she walks. I usually hear her husband say something about it is common sense she cannot walk and she should know that. My response to her is that her desire to walk, her dreams and recollections so strong, that it is easy for her to believe she walks–and then I add that I think it is delightful that she is able to enjoy that memory so realistically. I’m not sure what the experts would say about this but to me, it seems a workable compromise between the two extremes of believing and disbelieving. Read the whole story in “What to Do about Mama?” by Barbara G. Matthews and Barbara Trainin Blank.

Katie’s Story in Twenty-five Episodes:
Part One (October 2014)

Shifting Gears: Katie’s Story, Part One.

through
Part Twenty-five (April 2015)

Where Do We Go from Here?: Katie’s Story, Part Twenty-Five


Mom’s moving in

It is important to consider the living environment you can provide when you are considering moving a parent into your home, according to the Caregiving Support Services article How to Prepare your Home When a Senior Loved One is Moving in: http://mycaregiversupportservices.blogspot.com/
http://www.feedspot.com/?dadi=1#feed/fof_fo_1345863__f_4802513/article/6148894682?dd=4311523100447633

The article discusses the following factors:

  • Financing
  • Storage space
  • Bedroom with single floor living capability
  • Handicapped accessible bathroom near bedroom
  • Look for Ways to Make Mealtime Easy
  • Make way for mobility devices
  • Consider outside spaces

As detailed in What to Do about Mama? my husband and I felt good that we were able to provide his mother with a great living environment when she moved into our home. Very little preparation was needed.

David and I gave Mom our first-floor master bedroom suite—bedroom, bathroom, and sitting room—and filled the rooms with her
furniture and doll collection.

What to Do about Mama? p. 12

Another caregiver reported the following:

My husband and mother-in-law discussed the options. She had
the choice to move to assisted living, or to utilize her finances to
add a handicapped-accessible living area onto our home, which
was what she opted to do. We built a large living area with a
handicapped-accessible bathroom that extended off our existing
family room so we could provide the assistance she needed.

What to Do about Mama? p. 125

Ironically, some years later that caregiver was able to return home to live after a traumatic brain injury because she had that living area and a a 24-hour caregiver.

There are many factors to consider when moving a parent into your home, but having a safe personal space to live is certainly important.


Where Do We Go from Here?: Katie’s Story, Part Twenty-Five

Helping Others

Katie’s Motto

Katie’s life before her TBI was full of profoundly meaningful activity.  Katie was dedicated to helping others in a multitude of ways.  (See “The Plan” Katie’s Story Part Six.)

Katie’s life now revolves around her daily care.

Additionally, however, there has been significant improvement in her social interaction.  She is able to go to church.  Friends come to visit, and together they enjoy activities like dinner and movies and games.

But I’ve been thinking about ways to rekindle the element of altruism that was once integral to Katie’s objective in life.

I asked Katie if she would like have a pen pal, and suggested
Gabrielle Giffords http://en.wikipedia.org/wiki/Gabrielle_Giffords  or
Sharon Budd http://www.pennlive.com/midstate/index.ssf/2014/10/victim_of_i-80_rock-throwing_s.html
The idea did not pique her interest.

I talked to Sam about joining a support group so that he and Katie could have the opportunity to both give and receive encouragement by sharing common challenges with other brain injury patients.

Sam did not discount the idea entirely, so I think I will bring it up with Katie at our next visit.

Sam did say, however, that he is not personally under a lot of stress, and although that is probably not entirely true, I will say that his demeanor has improved greatly.  Sam appears to be doing better than I have seen him for more than two years.

When I asked Sam specifically if life has improved for him since Katie came home, he replied, “Yes.” This I was obviously pleased to hear.

NO BIG NEWS is a GOOD thing!

NO BIG NEWS
A GOOD thing!

I’ve been struggling somewhat over continuing to blog Katie’s Story.  There is no longer any “big” news to report—and that is a good thing.

So, although I will leave the door open for future posts about Katie, I would like to sum up Katie’s Story with the following observation.

Life is unpredictable and sometimes catastrophic.  What happened to Katie was tragic and overwhelming.  Although Katie’s life will never be the same as it was before her brain surgery, it is better.  Arriving at this place was improbable, but every effort has been worthwhile.

I would recommend to others in crisis to think creatively, to be optimistic, and to have perseverance.  Sometimes you can accomplish more than you ever thought possible.Success

 

And finally—

Don't Listen


A Movie for Katie: Katie’s Story, Part Twenty-Four

Movie

Judene and I couldn’t visit Katie last week.  Sam called and cancelled our date because they were having other company.  Sam was apologetic, but I told him that was great.  Re-establishing a social network is one of the objectives of bringing Katie home.

We were able, however, to visit Katie yesterday.  I brought the movie The Theory of Everything which is a biopic about quantum physicist and scientific genius Stephen Hawking, who was diagnosed with a devastating neuromuscular disease in 1962.  While he was given a life expectancy of two years—Hawking overcame all the odds and is still living more than fifty years later.

Biopic

Katie Identifies

In one poignant scene, Hawking fantasizes about getting out of his wheelchair, walking down the steps, and picking up a pen that a young woman has dropped.  Katie has, on a number of occasions, imagined that she, too, has walked.  We were able to talk about how intense desire can make such an illusion seem so real.

Popcorn

…and the popcorn, too!

At the end of the movie Stephen Hawking’s character states, “Where there is life there is hope.”  I think Katie enjoyed the movie and the message…


An Opportunity to Say THANKS: Katie’s Story, Part Twenty-Three

Thanks

In my  November 18th post:  The Plan, Katie’s Story Part Six, I recounted that when Sam decided to pursue the idea of bringing Katie home I e-mailed the social services director at Aging with the request that she facilitate the agency process.  She told me that she was retiring in a few months, and that the nurse (who I really wanted to do the assessment) was leaving the agency in a couple of weeks, but that she would do what she could to help.  Because she followed through with her commitment and got the ball rolling at the agency, everything fell into place as I have reported throughout Katie’s Story.

I recently invited this lady to join me for a visit to see Katie.  I wanted her to be able to witness how “The Plan” was working (which none of us expected to come to fruition) and how her efforts contributed to the dramatic improvement in Katie’s living condition and outlook on life.  She was duly impressed.

I’m betting that what she saw will be a highlight for her whenever she thinks about those last days winding up her career.

At the top of my TO DO list I have added:

Thank All

On Katie’s Team


Mundane is Magic: Katie’s Story, Part Twenty-Two

It’s been a cold snowy winter, but…

Change is in the air and

spring is just around the corner.

Spring

Sam took Katie to church.

Sam took Katie for a walk outdoors.

Judene and I took Katie out to sit on the deck.

A couple of neighbors stopped by.

Does this all sound:

Commonplace or

ordinary or

routine or

uneventful?

Well, maybe so…but in this case it is:

Exceptional and

extraordinary and

unusual and

exciting.

Mundane Magic


Dinner with Friends: Katie’s Story, Part Twenty-one

Indian Food

Last Sunday Manny, Judene, Dave and I joined Sam and Katie in their home for a dinner and game night.  We had done this a few times at the nursing home, but as you can imagine, this was SO much better.

Sam had set the table with the good china, silverware and crystal.

Dave had a hankering for Indian Curry, and I worried a bit because everyone had professed they didn’t like curry.  But this dish had always been a winner for us, so they all agreed to give it a try.  Curry is served over rice with condiments:  onions, tomatoes, bananas, coconut, peanuts and chutney.  Thankfully, it was a big hit, especially accompanied by a nice Riesling White Winefrom the Finger Lakes.  Judene brought Manny’s favorite spice cake with caramel icing for dessert.  Dinner together—like times gone by.

We played Sequence, one of Katie’s favorite games, and although she has a lot of limitations, she was able to do pretty well and had a good time.

Sam enjoyed talking to his buddies.  We were all happy to get together again in familiar surroundings.

When I visited Katie again later in the week I asked Sam, “How’s it going?”  He replied, “Pretty good!”  That’s his most positive response to date.  I am encouraged.

Encourage Empower


An Optimistic Update: Katie’s Story, Part Twenty

OptimismFor the first time, I am reporting to you with a sense of confidence.

The problem with funding has been rectified.  The only major item remaining to be acquired is the shower wheelchair.

The change of caregivers has taken place. “Faith” started last Sunday, and already she is a comfortable part of the family.  Faith is a take charge individual.  She sends Sam out of the room when she performs Katie’s personal care.  Moreover, she is a task-master with Katie’s exercises.  This is important since Katie has lost a lot of her inherent drive.

Faith Building BlocksThe experience with Grace was an opportunity to learn and a sturdy building block for a successful experience with Faith.   Sam has learned that he can step back and let Faith do her job—he is in fact, eager to do so.  It is obvious that Sam is relaxing as stress decreases.

Faith stones

With Faith, I hope to believe:

THIS PLAN WILL SUCCEED!

Success ahead


Ideas: Katie’s Story, Part Nineteen

Idea balloons

 

When Judene and I visit, we listen and observe.  Later we brainstorm to identify obstacles, needs, potential solutions, and how we can help.  But at this point, we have tabled our thoughts until the more immediate fundamentals are taken care of.  Sam doesn’t need more on his plate than he can handle at one time and right now his plate is full:

 

  • First of all, there has been some progress since funding has AGAIN been approved, but there is still no green light on the flow of funds.
  • Secondly, Gloria has decided that the physical aspects of providing care are too difficult for her to handle. She and Sam have made good progress at working together as a team. But the fact remains that it is essential that Gloria is able to work independently so that Sam has the ability to come and go more freely. Katie has gained 50 pounds since becoming disabled and has almost no ability to assist with her own movement. Gloria is not a young woman and she is small. The concern that she will lose her own health and well-being is undeniable.

Some ideas for Sam:  You are spending most of your time at home in the role of caregiver.  You need to learn to step back and try to reconnect with Katie as her husband.  I know that’s quite a challenge because Katie has changed.  It’s like forming a relationship all over again, and learning to do things differently the second time around.

  • Start with small things like: having breakfast together at the kitchen island; discussing the news of the day; planning for an outing or two each week.
  • Find free time to go off by yourself, especially when Katie is napping; reconnect for dinner and TV or a movie during the evenings you do not work.
  • Hire another caregiver to assist with getting Katie ready for bed.

Some ideas for Katie:  You would like to walk again and are frustrated that every day is the same as the day before.  You need to learn to take control over your life again by speaking up, taking responsibility, and making choices.  Work on developing the perseverance to do things that are difficult for you.

  • Set small / short-term goals.
  • Establish a routine to do cognitive and physical therapy, and then DO it.
  • Read on your Kindle.
  • Get help to work on picture books on the computer.
  • Write to Gabrielle Giffords to share your experience.

Some ideas for Sam and Katie:

  • Go to church services.
  • Join a Stroke Support Group so that Katie feels like she can make a contribution.
  • Try other community outings.
  • Attend the grandchildren’s sporting events.

Ideas