keenchick

Stories and thoughts about family and life

I’m not a caretaker

 

The trips to the nursing home usually have some degree of interesting activity along with them.  Seldom is it simply a drop off of supplies or a check-in.  It might start out that way, but it seldom ends with simply that.  With each passing year I realize how woefully ill-equipped I am for caretaking of my elders.

My mother-in-law has advanced Alzheimer’s Disease.  This makes conversations around and involving her take on a new level of complexity.  She upsets easily and she fixates on details which are hard to overcome.  Add to that a roommate in her room who is bedridden and demonstrating her needs as we try to visit and you’ve got the makings for quite an eventful visit.

My father-in-law accompanied my husband and me to my mother-in-law’s room.  They no longer room together, and we have to change floors to find my mother-in-law has just finished lunch.  My father-in-law unceremoniously removes her from the dining facility and wheels her back to her room.  She looks at my husband and me as she passes by and says hello.  When dealing with someone with such an advanced disease, you want to believe that it’s recognition in her eyes, but it’s honestly just politeness.  She never knows me anymore, and she seldom recognizes my husband (which breaks my heart for him).

We follow them into her room and he helps her transfer from the wheelchair to the chair. She had been mumbling something to Louis just before us entering the room.  As she was moving into the chair, she said it again “I’m going to have to find some place to live.  I can’t stay here.”  My sweet husband, unlike me, has the patience of Job in situations like this.  He is amazing with our Boy Scouts and can talk them through things long after I would have had to leave the room and catch my breath.  He has been enormously patient with his parents and their questions, needs, and demands.  He and his sister are a united front on their cause and it’s a site to behold, especially after so many stories I’ve heard about other siblings.

He thoughtfully considers his response and says “you are living here.  You need to be here to get the help you need.”  Now, I should mention as well that my mother-in-law cannot hear and no longer has a functioning hearing aid.  She’s destroyed each one she has because she can’t remember having them in her ear and ends up pulling them out, stepping on and crushing them.   She cannot hear much at all, which I’m sure adds to the almost sickeningly comical tones our conversations must take on.  He has to repeat this sentence a couple of times, as does my father-in-law.  She continues to persist, “I can live with you,” motioning toward Louis, “or I can live with my sister and her husband but I can’t stay here, and I can’t live with him” as she gestures toward my father-in-law.   Again they try to reason with her.  We can see she’s getting upset, which is a key that it’s time to change the subject.  I pull up my phone and show her a picture from Brennan’s most recent 7th grade basketball game.  “Oh, my he’s grown!” she exclaims.  My husband and I beam that she seems to recognize him.  “Is he enjoying college?”

My husband tries to gently, although very loudly, explain that Brennan is in high school, and has a way to go before college.  She remarks about the cost of college and how we’ll pay for that and then she’s moved on to something else.  “I need to go to the bathroom,” she says.  I decide this is an excellent job for me: “I’ll go get the nurse.”  I run out to the nurses station and bring back her nurse.  My husband and I decide we should step into the hall to be polite and give her some privacy.

As we stand in the hall, one of the residents comes walking down the hall, with a big smile on her face.  “You’ve lost your hall pass, huh?” I chuckled, thinking that was pretty clever.  We’re in the hall, and we’re not moving.  Hall pass–yeah, that’s pretty funny.  Like how we used to have hall passes in school.  “Yes,” I remark.  “I don’t know what on Earth we did with them!”   I laugh at my wit, and she responds “I’ve lost mine too.  The nurses won’t give me another.”  I search her face for a second to determine if this is a continuation of the joke.  Sadly, it is not.  Now I feel like a heel for laughing.

Thankfully, the restroom break is over and we can return to the room.  My mother-in-law never missed a beat, asking about various financials, and remarking that she needs a place to live, but now that she won’t live with him (gesturing toward Louis).  “Where are my credit cards?”  she inquires.  “I used to have credit cards in my wallet.  Where is my wallet?”  I announce that I have her wallet, but that there are no credit cards left.  My father-in-law tries to explain that we had to close all their accounts and destroy their cards when they came to the nursing home.  She’s not having that.  She keeps asking and he finally makes a ripping gesture to demonstrate the cards have been destroyed.

She escalates the conversation and announces that she should have social security money (which she does), but she knows she doesn’t.  She knows that my father-in-law is getting his money and her money too.  Louis tries to explain.  She’s not hearing it.  She wants someone to take her to the social security office and fix this.  She reiterates, pointing a finger at my father-in-law, that she knows he’s getting her social security AND his, and then proclaims “you’re a BAD BOY.”

It’s almost like when your toddler has done something which really shouldn’t be funny, but at the same time is almost adorable and sweet and innocent.   I was watching my husband’s reaction, unsure what to do.   My mother-in-law now changed the subject a bit and said that she knew she had HIM (pointing at Louis) to blame for not being able to leave, and not being able to ride the elevator, and not having anything.  He was staring at my father-in-law, who finally shrugged, and tried to change the subject again.   I was grateful in that moment that she didn’t recognize me.  There’s no telling what thing I would have done to her.

Meanwhile, in the next bed is her new roommate, who is bedridden.  She is having quite the conversation with herself, although we can’t quite make out what she says until she yells across the room “I need help.  I need to go to the bathroom.”  I jump up and announce that I’ll get the nurse (remember the part where I don’t need to take care of people?), and I march out to the nurses station.  The nurse says she’ll be right in, but that the patient has a Foley, so she doesn’t need to get up.  I decide I can handle this, and I tell the nurse (who is right in the middle of something) that I’ve got this.

I go back into room, feeling confident that I’m going to solve this lady’s issue, even if I can’t make my mother-in-law feel any better or be any more settled.  I walk over to the bed and say to the lady that she has a catheter and she can just go.  She doesn’t have to actually get up and go to the bathroom.  I’m about to turn and walk away, exceptionally proud that I’ve handled this, when she holds up two bony fingers and says “but. . .”  Oh, no!  I am NOT the one to deal with this!   Nothing beyond number 1 for me!

Another trip to the nurses station and an announcement to the nurse that she’s going to have to come and handle this.  I’m not equipped for this kind of assistance.  She and her coworker half-giggled at me as she thanked me for trying.

There’s no telling what those people see day in and day out.  I tell her nurse every time we’re there that I have such a great appreciation for them.  Being a nurse is hard enough, but having a patient who can’t remember what you told them two minutes ago has to be ridiculously difficult.  I know it is for the family.  Her nurse keeps telling me that it’s no big deal, and that she’s called to do this.  She says that it’s okay for us to be unsure what to do, and not know how to respond.  I’m glad to hear this every time she says it, because I seriously don’t know what to say or do most of the time.

We try to simply find a little humor in each visit.  I think that’s the only thing that gets us through sometimes.  Like my Daddy says “just as soon laugh as cry about it.”  So I’ll choose to laugh, until it’s time to cry.

 

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Nursing Home Know-How

I’ve toyed very seriously with the idea of writing a couple of books. One of those is for people dealing with elderly parents at varying stages, and I keep telling myself that when I feel like I have “enough” knowledge I’m going to get right on that. The problem is that there is never “enough.” You think you know how things are going to go, and you think you’ve gotten into some type of rhythm, but that only lasts about two weeks before a whole new situation has put you right back into the confusion chair.
Some of the things that happen with my in-laws have become humorous. Honestly, they have to be, or we’d all go insane. My husband and I share with his sister and her family the daily goings-on of my in-laws and we all just have to shake our heads and smile. Some of the things are really funny, and some are so terribly sad that you just can’t find humor or that the things you do find humor in seem morbid to someone on the outside.
Just like enduring a bad relationship and finally realizing why the divorce rate is so high, you find yourself in uncharted waters here, and you endure the best way you can. The really sad times come when you have to treat your parents like children, denying them things you dearly would love to give them because it’s not “good for them.” We’ve had one than one conversation about just throwing caution to the wind and letting them really enjoy their remaining time here, but that is quickly reversed by the seriousness of the $1,000 pharmacy bill because of additional insulin, or the $250 bill each month for pull-ups, or the reality that I can’t get Medicaid approved for them quickly enough, and struggle constantly to try to get that in place to assure they will have care going forward. The see-saw is getting really old. Plus, it’s hard to reason with an 80 year old woman who doesn’t realize where she is half the time about why she can’t just have ice cream any time she wants it, or taking the administrative rights away from a 75 year old’s computer because he can’t comprehend what he’s clicking on well enough to stop downloading viruses. I don’t appreciate this juxtaposition of give and take that it seems we’re always evaluating.
It makes me sad on levels I can barely comprehend, let along articulate. My mother-in-law and I have certainly had our spells where we’ve not gotten along over the years, but I still recognize her as part of my family and as my husband and I were married so young, I view both of his parents as my parents as well (as does he). We’re blessed to still have all four of them at this point in our lives, and that our children have been able to know all of their grandparents (as I didn’t). My father-in-law and I have always been relatively close, and I’ve enjoyed his company. They both do things which drive me crazy, but I’m sure I do things that make them crazy too.
The moments of exceptional frustration intertwine with the blah humdrum of routine which intertwines even further with sadness or the occasional comedic episode. The comedy is becoming less and less, as the frustration is more and more. The routine gets lost in the middle somewhere, and the sadness takes a passenger seat to the frustration. The emotional roller coaster one is on when caring for elderly parents is nothing short of terrifying and long. Your own life gets lost in theirs, and you feel like you’re not allowed to feel your own emotions anymore for stopping to deal with theirs.
I’m ashamed to say that I awoke in the middle of the night a few nights ago, thinking about a trip we have planned to Disney in December with our kids (we try to go every couple of years) and thinking that I should be prepared for the fact that one of them might die just before we leave, or even while we were gone. I need to have a plan for all of that. I say ashamed not because I think we shouldn’t get to go to Disney with our kids, but that I feel a bit of resentment at the time we’ve lost with our children in the past five years. I can’t even count the Sunday afternoons they have entertained themselves on the couch watching television while my husband and I did ‘bills and pills’ where he would shower his dad or help with his mom and I would handle the finances. We had realized even then that we had to count out their meds, because they would over or under medicate if left to their own devices. We sat in a teary-eyed conversation one night, promising them we would keep them in their house as long as possible, and we kept our promise, but I don’t know if it was more beneficial or hurtful.
I’ve pretty much stopped going to visit them in the nursing home. My mother-in-law usually doesn’t know who I am, and it’s upsetting to the kids to go. We take them when they are interested, and we don’t push it when they’re not. They’ve sat quietly in the room and tried to engage in conversations, only to find that neither one of my in-laws have much of an attention span anymore. My mother-in-law doesn’t know who we are half the time, and it seems to upset her when I’m there. She’s always tolerated me in my relationship with her son, and I sense some of that anxiety comes through when she’s confronted with me. Maybe I’m just projecting. Maybe it’s me who is uncomfortable. Maybe I’m imagining the whole thing. My father-in-law will only visit in short spurts now as well. I wonder if that’s a subconscious decision on his part to let us “off the hook” now that they’re in the nursing home. I wonder if we’re just another random occurrence throughout their day. He fixates on things that would never have bothered him before, and he’s taken to calling me 10 times over the same thing when he decides he needs something. Louis is the one who actually goes by and interacts. He has to anyway–he’s the only one to whom his mother responds positively, and his dad only has requests of things he wants brought to him. This is more annoying than anything for Louis, I think. There is not much general “how are you” conversation. They ask the same three or four questions, don’t really comment on the answers, and then issue their list of requests. These trips aren’t much fun for Louis, I’d wager.
I can imagine how demeaning this life is for them. I went out of my way to make it as comfortable and “home-like” for them as possible, rearranging the room and creating a small living area where they could sit side by side in their chairs and watch television. Still, they never leave the room anymore, save the occasional walk to the courtyard. They have their meals delivered to their room, and they sit there hour after hour, day after day, week after week. They have a few regular visitors, and they seem pleased with that, although one of the visitors told me recently that Helen seems to not recognize anyone anymore–she acts as if the visitor is a stranger who just wandered in from the hall. This is exceptionally difficult for Louis, too. The last time he had to take them to an appointment, his mother kept calling him by his father’s name, and kept insisting that it was time to go “home.” We agonized for a long time over moving them from their house to their apartment. We even had entertained the idea of selling both houses and getting something with an inlaws quarters. A good friend of mine advised me against it, and I’m grateful she did. I don’t think we’re physically, not to mention emotionally, equipped for the things we’re seeing now. Helen is essentially dead weight, and needs to be lifted in and out of bed or the chair. She simply sits on the side of her mattress, much as a toddler would, waiting for you to dress or undress her, but not even offering to lift her arm or leg anymore. I can’t imagine what must be occurring in her mind, and we’ve seen the occasional manipulation she used to create now give way to complete and total confusion and loss. She literally has no idea where she is or what’s going on most of the time. She gets very excited when we bring her a treat, and very upset when she asks for one and is denied. Other than that, she doesn’t engage much.
My father-in-law called me this morning as I was running some errands. He told me that she’s started asking for her mother, and she becomes very upset when he tries to explain. I don’t know why, but this really has sent a chill through me today. She’s engaged in similar behavior before, but she’s usually not quite this adamant. I’m hopeful that when my husband gets home from his campout and can go see her, he can help calm her down; but honestly something about this feels different than the previous times. I have a strange sense of foreboding. And I feel the fear my father-in-law feels–the fear he projected in his voice when he called me. I debated going to see them myself this morning, but I’m trying to decide if I will cause more harm than good, and I certainly don’t want to make the situation worse. It really is something to watch how soothing it is for her to have Louis close-by.
I remember when my dad put his mother in a nursing home in town, as well as a neighbor of ours going into the nursing home. Both were good experiences. They enjoyed it, and made friends. They had people to look after them and ensure they had a good meal. They could socialize when they wanted and rest when they wanted. I think that’s the idyllic picture, and I wish very much they could have had that experience. Unfortunately, it doesn’t appear it’s going to work out that way. My sister-in-law had pointed out one night that they’ve become quite co-dependent, and they each need to have the other one close-by, but it’s also meant that they don’t try to engage anyone else. I often wonder what we might have changed if we had it to do over again.
I’ve had several conversations with my husband about whether we would have pushed for assisted living right out of the gate when we moved them out of their homes. If we had done that, would they still be able to live there? What if we had left them in the house? Maybe we should have just hired a private duty nurse? The realities always come back, though. There wasn’t enough money to do any of that. We probably waited too long to move them out as it was. Paul nearly died last October and November, which is what brought into sharp focus how bad Helen’s condition really was. We had no idea the amount of covering for her he had been doing. My husband assures me that this all means they’re in the right place, and they probably should have been there sooner. This was confirmed when we found his mom’s medical records from over a year ago that said she already needed nursing home care. Why didnt’ he tell us? I’m sure he was afraid we would separate them. We’ve been concerned for quite some time that she was weighing too heavily on him and bringing him down too.
I have to admire Louis’ sister, who can take a much more clinical, hands-off approach. She understands the physiology of it all, and she can appreciate that this is a simple process of deterioration. While it’s sad, it just is how it is and we have to deal the best way we can. Leave it to me to second-guess and wonder whether I’ve done everything appropriately.
So, back to the book idea. You can appreciate why I feel like I don’t have the knowledge-base to be a subject matter expert, huh? I can’t decide if that’s a good thing or a bad thing. I’d like to say that you handle a situation and you know better how to handle the next one, but I think in the case of elderly care, that’s very difficult. No two cases seem to be alike.

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The second move

My in-laws were moved into a nursing home the second week of November. We moved Helen on Wednesday, and transferred Paul from the rehab facility where he had been recovering into the nursing home on Thursday. He would be able to continue his rehab services and be with my mother-in-law, so it was the best of both worlds. My husband and I live in the same town as them, so it naturally falls to us when they have immediate needs. Louis and I had moved Helen’s lift chair, TV and three days of clothes, medicines, and anything else she managed to chunk into a trash bag that evening. I was amused when I was settling in her items that night at the choices she had made, from empty jewelry boxes to multiple boxes of Kleenex. Ultimately, though, the move-in went pretty smoothly and we reassured her several times that we would be back over the weekend with the remainder of her clothes and items.

We went by Thursday night to be sure Paul had settled in, and I took his clothes (which no one thought to pack Wednesday night), so he would have them when he was ready. He was bed-bound at that point, and wasn’t feeling well when we arrived. We were a little unnerved, but reminded ourselves that he had been through a lot, and the move that day was probably not helping. He seemed grateful to be with Helen, and as he drifted in and out of sleep, we told him we would be back over the weekend.

Kathryn, my sister-in-law, has made trips down every weekend to help us complete the move. Kathryn is only able to come after she gets off work on Saturday, so that really only left us Sunday morning to do anything we needed and get Kathryn back home in time for work on Monday. After we made a pass through the apartment, we decided the most logical approach was to divide the clothes into piles we knew we would/should take, things we would/should donate, and things we needed to take and ask about, knowing we were likely taking them back home with us. In addition, we had to label everything in the room, except their clothes. We were fortunate to have the laundry worker at the nursing home willing to do that for us. Regardless, there was a TON of other stuff to label, all the way down to their toothbrushes. Helen, being incapacitated somewhat (we haven’t officially diagnosed her, but suspect some onset of Alzheimer’s/Dementia, etc.), wants to know everything we’re doing. She asks us 50 questions about everything. She grows annoyed if she sees Kathryn and me talking and she can’t hear. She is obsessed with knowing every little detail, and wants to have input into every conversation. Then she gets irritated if you’re discussing something she doesn’t understand, and she huffs about not understanding.

Needless to say, conversations like that are long and very frustrating. It’s hard to make someone understand you’re not talking about them. It’s hard to make them understand that you’re following the rules and it has to be one way or another. It’s hard to sit and listen to remarks about how much they miss their home and how they wish they were still there. It’s hardest to remember that these people don’t mean to hurt your feelings (usually, anyway), and that it doesn’t occur to them all the effort you’ve put into placing them here and how hard you’ve worked to get them in the best facility which meets all their wishes.

As Kathryn and I exchange glances with each one of these comments, we set about trying to make it a little more entertaining. From remarks about what needed to go into the closet: “Here, let ME do that. I know you’re not even tall enough to see the shelf, let alone get anything up there.” to the shoe rack when I said “my shoes won’t both fit in each of those little slots–I have to put one shoe in each” to which my sister-in-law remarked “well, that’s because you’re a Sasquatch!” as we roared with laughter at our cleverness, we gradually lightened the mood in the room and were able to accomplish our task. By the end of the afternoon, Louis had set up both (yes, both) TVs for both of them and programmed everything electronic we had brought. Kathryn and I had everything put away and had even labeled the drawers to make it easier to follow when searching for clothes. We were pretty proud of ourselves.

As I watched Kathryn drive away that afternoon and prepared to head back to the facility to finish the last few items, I thought about how far we’ve come in this whole thing. We’ve gone from nearly losing Paul the first few days of November, to now having him at a facility where he could receive rehab and have them together. I’d started conversations with an Eldercare lawyer and trying to figure out what to do next, and we were preparing to move their things out of their apartment. A lot was finished. We still had several things to do, but I could start to see the light at the end of the tunnel. Now, the move out of the apartment was going to be an adventure all its own.

One of the nurses suggested that I write a book about this and the lessons learned and the stories. I watch her in complete amazement as she handles the elderly people in her charge. The compassion and patience she displays is truly inspiring. Nothing rocks her and she moves from issue to issue without irritation. She pats on a person’s arm and says sweetly but firmly what she needs. She says that someday soon we will be the same way–it just takes time. I have a hard time seeing that right now, but I sure hope she’s right.

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The second childhood

I remember a lady with whom I used to work, speaking about her mother-in-law who was living with them and had Alzheimer’s. She referred to it often as “her second childhood.” I was about 15 years younger at that point, and while I could sympathize with her situation I didn’t really get what she was saying. My perspective is rapidly changing.

I’ve come to see life as a mountain range. You spend the first few years of your life climbing the first hill, the middle years (hopefully a long period) traversing the top of the mountain range with a few ups and downs but generally at the same level, and then your senior years coming back down the mountain and regressing back to essentially the same state you were as a toddler. I had heard several stories of people dealing with this, but honestly had always thought it was a bit of an exaggeration. I mean, these are people who have a whole lifetime of experience–surely they don’t lose all of that. But they do, and that’s what makes the trip down the mountain so dangerous, and so unexpectedly painful.

I have also felt really guilty about thinking some of the things that are happening are funny, but I’ve had to realize that the same way I share funny and cute stories about my kids, that with in-laws who are now on many of the same levels, they are going to repeat many of the same things. Sometimes it’s really funny, and sometimes it’s just sad and miserable. The humorous parts help us through the ones which aren’t, though, and I’m trying to just see the humor when it’s there in everything.

Thus, we’ve learned the past couple of weeks that my father-in-law has been making bizarre phone calls while he has been in rehab (I’m learning that this is actually common for people in the hospital on pain killers). We suspect that he’s dreaming something and then wakes up and acts on it. For example, my husband received a frantic call from my father-in-law a couple of days ago, saying that my mother-in-law had “lost it” and had called him saying Frankenstein was in her apartment and she needed someone to come kill him. Now, if we had all stopped to think about it, my mother-in-law has been with a 24 hour caregiver for the past couple of weeks, so the likelihood of her making a call like that was exceptionally slim. But in the moment, you just react. My husband dropped everything and drove like Mario Andretti to the apartment to find my mother-in-law and her caregiver, joyfully watching “The View” on TV. We chalked that up to just a prank call until my father-in-law did it again, this time calling an uncle to come and get him out of the hospital. This has prompted several new conversations around the telephone, and that it never occurred to us that you might not want your loved one to have a phone too close at hand.

Paul was moved to the nursing home Thursday afternoon. Friday morning at 3 a.m., we received our first phone call from the nursing staff, saying Paul had fallen out of bed. He was fine, and they weren’t really sure what happened, except that they found him on the floor. When we questioned Paul Friday night, he had woken up at 2:30, decided he was tired of lying in bed, and that he wanted to stand next to the bed. He had been given orders not to get out of bed (his legs aren’t strong enough), but decided to anyway, without calling for help. We had to have a talk about following the rules, which was quite reminiscent of conversations with my 10 year old about consequences.

My mother-in-law was worked up about someone having come in during the night and “messed with” her CPAP, taking one of the straps off and replacing it with a string. She was so upset about it that we had to take the headset and show her that it was actually alright and looked like it always does. She decided that he must have come back and fixed it during the day. Although, she did remark that it worked better with the string.

Helen was also upset that when Paul fell, the ambulance was over three hours away! This elicited quite the excited response from both Louis and me, as we struggled to figure out why an ambulance was called if he was okay. Being new to the nursing home policies, we weren’t sure what order everything would happen, and maybe they had decided afterward that they needed to transport him somewhere for x-rays and then bring him back. After questioning her for several minutes, and explaining that we thought they had a portable x-ray unit, we discovered that’s exactly what happened. There was no ambulance, and they had to call someone in for the portable x-ray unit, which did take a couple of hours.

We’re having to learn to take everything with a grain of salt, and ask 10 additional questions with each story. We’re only at the beginning of this journey, and the nursing staff has been more than helpful explaining things, and helping calm us when we come out with some crazy question or trying to investigate the latest “happening” about which we’ve received information. The nurse was very gentle with us last night as we were trying to explain how upset Helen was that Paul’s oxygen mask was not replaced after they had taken him out of the room for the x-rays, and that we wanted to know what happened. We found out he was never removed from the room, and hadn’t even been out of bed except to be moved to a wheelchair to sit for a bit today, and they had ensured his oxygen was moved with him. Paul seemed to have no recollection of having his oxygen off either.

As we drove home last night, we discussed how anyone who has a loved one in a nursing home would ever know if anything was really not going on properly unless your loved one was not mentally impaired at all. Helen was increasingly agitated when we wouldn’t remove items that had been left in the room when they moved Paul in, despite us explaining those were his things and needed to stay with him. They have given him a sling to use in a portable lift they use for him (until he can walk again), and it took a rather terse 5 minute conversation to get her to understand that he needs those items and they belong in the room so they’re handy when they’re needed. We finally agreed to take one of the blankets with us so she would let the rest of it go. Life has become somewhat of a negotiation. In those moments it’s hard to see any humor at all. Those are the sad moments that just make you want to cry.

I think a lot of a conversation recently with my sister-in-law regarding advice from her preacher about how quickly people deteriorate when already slightly incapacitated and then their world is changed. I’m honestly a little nervous about the next few months. I’m thankful they’re no longer living on their own, but I think we’re still in for quite an interesting ride. Hopefully we’ll move to a point where it’s more humor and less sadness.

I have been so thankful for my own parents, who have endured this journey with us, and tried to offer kind advice and a listening ear whenever possible. I’ve been able to ask them several “how would you want to hear this” scenarios and it has given them pause to think about their own situations, and what might happen to them. I told my mother a couple of weeks ago that the hardest part has been parenting the parents, and that since Louis and I were married so young we both “grew up” with these two sets of parents. It’s heart-breaking to see this all happening, and it’s hard to suddenly take charge and have to say “this is how it’s going to be.” We’re in unfamiliar territory with no map. There is not a “Dr. Spock” or “What to Expect” book that can adequately prepare you for these kinds of situations. They vary as wildly as the individual, and their personality has a huge role to play in how they react to each thing.

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