Penny for My Thoughts

Knowing something’s coming doesn’t mean you’re ready for it.

From the day I brought Penny home, I knew she was a short-term gift. She was just turning 12. Yorkies are supposed to live longer than bigger breeds, but anything past 15 is a stretch.

So much of our time with Penny was joyous. Her fierce intelligence, confident willfulness, stunning courage and obvious sense of humor instantly cemented her place in our lives. She was a glorious cartoon character come to life. And she loved us for loving her.

Her age presented challenges which we overcame: we walked her frequently to build her stamina, enabling her, at her best time with us, to walk a full mile on her own little legs. Both of her knees had luxating patellas, so they would dislocate and she would limp. I took her to a holistic vet who taught us physical therapy exercises and prescribed supplements that gave her mobility back. She peed in her sleep, and I found homeopathic drops that stopped it, so she could sleep on and with me in comfort.

Penny was also a wonderful traveler. She loved the car. She enjoyed meeting new people who would tell her how pretty she was. She enjoyed frolicking in grass and sniffing trees where other dogs had left their impressions. We had a sling to carry her into stores with us, so we wouldn’t be faced with having to leave her in the car unattended. And people loved to see her riding in her pink carrier with her little smiling face poking out.

Play could be consuming for her, particularly when I’d buy her a new toy. If it had a squeaker (and most did), she would rip at her quarry with her perfect sharp white teeth until it no longer squeaked. Depending on the object, this could take days. If you tried to take the toy from her, the fierce growl that came from her let you know she meant business. But she would let go so you could grab, throw or play tug of war with her. Playing is more fun with humans to keep things lively.

And humans were her favorite creatures by far. She tolerated other dogs until they would sniff her butt, an offense that would earned a snarl and snap.

Fletcher, our insanely friendly cat, was nuts about her. He’d keep a respectful distance, but waiting for her to sleep, he would creep in for a cuddle at every opportunity. And when she woke, she’d recognize the benign nature of their position and throw her head back down in surrender to his embrace. If he got too overbearing or invaded her space too brazenly, he’d lose a chunk of fur for his transgression.

During the time we spent together, I never took Penny for granted. I would observe her, sitting in her bed in my office, snoring contentedly; frantically alerting me to her need to go out; ferociously engaging me in play; begging relentlessly for her favorite biscuits (or whatever we might be eating); or simply looking at me with love and anticipation. My heart would fill, almost to bursting, with love and gratitude for this adorable little dog. I just loved having her, knowing her, caring for her and watching her enjoy the life we provided her. I am forever changed by this relationship. I will always miss her, but I will never regret the pain of losing her, because our time together was so amazing and rich.

Tuesday, October 23rd, 2018, was the day we took Penny for her last visit to the vet. She was ravaged by kidney failure. I was grateful we could help her cross over.

Nothing could have adequately prepared me for this. And yet, everything up to this point in my life has. I am so sad she is gone, but so glad she was able to stay for a bit. Thank you, Penny. I know I’ll see you on the other side.

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Posted in aging, caregiving, cats, death, dog, dying, Family, incontinence, life changes, pets, physical therapy | Leave a comment

Sanity Snack Guest Blog

I was invited to share caregiving advice as a guest blogger. You might want to take a peek. It’s short and sweet.

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Life Is But A Dream

When I was little, I had intense and frightening nightmares. A repeated scenario placed me behind the wheel of a car, forced to drive when I could not yet see over the dash or reach the pedals, ultimately driving off the road into a body of water before I’d wake.

(Strangely enough, when I first moved to Ringwood, NJ in my forties, I recognized some of the local roads from those nightmares. Fortunately, the worst one, the Westbrook Road Bridge, has been recently replaced with a new bridge, so I feel pretty confident that the dreams were metaphorical rather than prescient).

I was a fan of “Dark Shadows,” a daytime serial that featured vampires, witches, ghosts and other preternatural creatures. Characters from this show would occasionally appear in my nighttime excursions.

And there were a lot of anxiety dreams: getting to school too late for an important test, being observed, naked, by other people in odd situations, being walked in on when using the bathroom, and other embarrassing sequences.

The worst was the feeling of falling, followed by sheer terror, unable to move or open my eyes. I’d scream silently for someone to please wake me up. Eventually, I’d shudder awake, breathing hard and feeling grateful to have finally broken the grasp of the demon that held me in that blank purgatory between dream and waking life.

These frightening night sojourns made it hard for me to look forward to sleeping. I would try to control what I would dream about by thinking of every horrible, scary idea I could possibly conjure to inoculate myself before the sandman came. Sometimes, my dreams would be benign or forgettable. Other times, they’d be at least as horrifying as the pre-dream ritual images I’d run through my tortured mind.

Many a night, I’d lie awake, listening to late night talk radio. I’d sit by my window and watch the neon sign from the amusement park two blocks away flash its upward laddering pattern over the top of the row houses across the street. I’d listen to the cars on Flatbush Avenue. Hearing sounds of life outside made me feel better, less alone.

I chose to become a psychology major half way through my undergraduate studies. I learned a lot of valuable things about human nature, including my own.

And I’ve gone for therapy from time to time. I believe we all need periodic “tune ups” to lead happy lives, and I’ve sought help whenever I’ve felt the need.

Over time, I came to understand the meaning of some of my dreams. I believe they are messages my unconscious mind serves up because I tend to ignore certain information during my waking life in order to get through the day. These messages are important. That’s why they’re intense, so I’ll pay attention.

The driving dreams came from my feeling of “being in over my head” as a child. I worried about my parents. I was very sensitive to their anxieties and stresses. My mother was reliant on me for emotional support from a very early age.

Anxiety dreams are pretty common, and they allow us to express our deepest fears without direct consequence.

In the last several years, I have learned some very important lessons about the things we tell ourselves and how these messages impact our lives. The bedtime ritual I implemented as a child to ward off bad dreams, thinking of every terrible thing I could come up with, was actually counterproductive. It was “superstitious” behavior, believing that dreams came from somewhere else. I didn’t understand that everything I dreamed came from ME. I was trying to control the growth of a monster by over-feeding it.

A better idea, and one that I have come to embrace, is to think of beautiful, wonderful, delightful things; things that bring me joy; things that I WANT to happen.

Consequently, now I LOVE to sleep. It’s rejuvenating. It’s a time to rest, and a time to process information and solve problems. It’s mighty interesting, and a lot more satisfying.

What I have come to realize through so much information I have ingested, is that our lives are what we BELIEVE they are. Our original beliefs are based on those espoused by well-meaning adults (parents, grandparents, family, neighbors) that were passed on to them. These ideas have no basis in fact. They are simply ideas that were accepted by the previous generation, adapted and insinuated through teaching and parenting. And mostly, what’s at the basis of every BELIEF is a LIE.

Everything my parents taught me was aimed at protecting me. Don’t go to that school you want to attend; it’s too expensive, in a terrible neighborhood, you aren’t old enough to go there by yourself and we aren’t taking you. Expect the guy driving the car closest to you to do the stupidest possible thing. You can’t go to Europe by yourself! You’ll be kidnapped! Always expect the worst outcome. Fear will keep you safe.

Many people suffer from these fear-driven belief systems. And they tell themselves things like “this is too good to be true.” “If they want me, they can’t be that great.” “Rich people are all greedy and I’m not greedy so I’m glad I’m not rich.”

Here’s the thing: fear is all in your mind. FEAR = False Evidence Appearing Real. When you live your life in fear, you die a thousand deaths.

This isn’t magic, and I don’t pretend to have all the answers. But I will tell you that my life is much bigger, happier and fun since I decided not to be afraid. I allow myself to embrace beauty and prosperity. I am on a journey to become the best version of myself. And I deserve all the happiness and satisfaction that comes with that pursuit.

Is my life perfect and completely awesome? Of course not. But no matter what happens, I find reasons to feel gratitude every day. I enjoy the time I spend with others. I choose to focus on the positive aspects of every relationship I have. And I look forward to getting up every morning, refreshed and ready to take on the world.

I have no need for sleeping pills. Most of my dreams are pleasant, benign or forgettable. I haven’t driven into water in a very long time. And I’m happy to be who I am, where I am, in a very big, unconstrained universe.

I wish you the gift of believing in yourself and very pleasant dreams.

Posted in aging, beliefs, dreams, driving, life changes | Leave a comment

Absorb This

My little old dog, Penny, is a teacher. One of my dog sitters, who admits to having issues with assertiveness, has credited Penny with showing her how to be more firm and clear about her own needs. And today, Penny reminded me of another pending lesson.

My girl HATES being left alone. When she sees me sling my handbag over my shoulder, she knows I’m leaving the house. That’s when the barking starts, and I swear she sounds like she’s screaming “YOU SUCK!”

Since she’s become ill, Penny’s ability to hold her water has been compromised. Once upon a time, she could hold her bladder for four hours or so without too much trouble. Now, it’s definitely harder. She likes to go out every hour or so. And I keep a diaper on her when she’s in the house.

I know she doesn’t like going in the diaper. If she dribbles, it’s one thing. But an all-out whiz can’t be contained by her puppy pull ups, and she will leak on her bed and on herself. Physical discomfort aside, when she pees in the house, she looks mortified. She’s a proud little dog. I respect that.

Recently, she’s been voicing annoyance when I go to another floor of the house without her. My thought process at that time was “if I don’t get back up in time, she is wearing a diaper.”

And then I had a flashback to my mom.

When my mother resided in her last home, she had been incontinent for some time and routinely wore adult diapers. When I visited her, I could usually tell when she needed to go to the bathroom. She might not be able to articulate it verbally, but I could tell from her gestures and behaviors that she was uncomfortable, and if I asked her, she’d confirm my suspicions.

On one such occasion, I asked one of the aides if she could help my mother get to the bathroom. She responded “She’s wearing a diaper.” And I said, “Yes. And she needs to go to the bathroom.” The aide complied and took Mom to the bathroom where she could eliminate in a toilet like a real person.

The response, at the time, gave me pause. Was I supposed to say “Oh, OK, she can just pee in her pants?” If I wasn’t there to run interference, that’s most likely what would have happened. But when I could DO something about it, I did.

I will confess that I don’t always get Penny out in time to avoid wetting her diapers. Sometimes I don’t quite know what she wants. A lot of the time I follow her to where she leads me and “out” is NOT her goal. And I DO have to leave the house, attend meetings, run errands and go places dogs (particularly incontinent ones) are not welcomed.

However, I wanted to use this as a teaching moment for anyone caregiving someone who wears diapers. I personally have not worn a diaper since I was an infant, but I can only imagine the discomfort of having to wear a garment containing one’s own waste for any length of time. Whether it’s a pet, a baby, or a cognitively impaired adult, the condition can’t be enjoyable.

So, never let a diaper do the heavy lifting in waste removal. That’s not their purpose. They are designed as a temporary bridge, if you will, from a point in time when a body must unencumber itself to a near future that provides the opportunity to completely rid the wearer of all the unneeded materials and remnants so as to avoid any irritation or infection.

Don’t assume that because someone is wearing a diaper, they’re good to go. Put yourself in their place, and you’ll absorb my point.

Posted in aging, caregiving, diapers, dog, incontinence, life changes, pets | Leave a comment

The Hard Part

In 2015, a few months after mom died, I made a decision that caused the “Mom voice” in my head to scream “ARE YOU CRAZY?” I decided to adopt a 12 year old dog.

Penny is a Yorkshire terrier. Her previous home consisted of her original mom, plus a dad and two little children. Her parents worked a lot of hours, keeping the human kids in day care while the adults worked. Penny was kept in a crate when no one was around to care for her. No one should have to be in a cage 15 hours a day, let alone a creature who is genetically engineered for companionship. Penny’s life had evolved from being the center of her mistress’s world to being an inadvertent convict. I had the power to make that stop for her, so I did.

Bob and I adore this demanding little dog. Extremely bright, energetic and funny, we’ve enjoyed her immensely. A great traveler who is welcomed everywhere goes, she seeks the adoration of any human with whom she can engage, and usually succeeds. Not only is she pretty and courageous (she is the only dog I’ve ever met who barks at vacuum cleaners and fireworks), she makes unique noises. When content, she clucks like a hen. When absorbed in exploring during a walk, she grunts like a pig. And she snores like a sailor when she’s sleeping.

Shortly after we adopted her, some health issues arose. Her knees would displace (luxating patellas) and she’d limp. I found supplements to make her ligaments stronger and gave her physical therapy. Her leg strength improved and her knees stayed in place.

Then there was urination while sleeping. I discovered this when she had been napping in my lap, and upon disembarkation, found a wet spot on my jeans. Investigation revealed a homeopathic remedy that I could squirt down her throat twice a day. This worked beautifully for two years.

In the last couple of months, she began peeing in her sleep again. I took her to the vet to seek other remedies. He suggested urinalysis to see what was going on. The results were not good.

Blood work revealed kidney failure. It was early. We could give her low protein food and infuse subcutaneous fluids to keep her hydrated. We’ve been “poking the pup” nightly to pump 250 ml of Lactated Ringer’s Solution into our girl. She takes it well. But she’s clearly in a new, nearly final chapter, and it’s getting hard.

Last Wednesday, the vet examining Penny didn’t like the sound of her heart and lungs. An x-ray revealed enlargement of the heart and water where it shouldn’t be. Congestive heart failure is now on the menu. Lasix, a diuretic, is being prescribed. Guess what that does? It makes her pee more. Oh joy.

So, aside from the constant need to clean up her urine, wash her beds, change her diapers, let her out and walk her, we’re watching her lose ground. It’s awful seeing this happy little dog get tremors and have her legs buckle under her. She’s declining the biscuits she’s always gone crazy over. She won’t touch any of the prescription food, wet or dry. The only food she seems to like is wet cat food, and that’s high in protein, which isn’t good for her kidneys.

Thursday morning, I got up and checked on her. She prefers to sleep in a bed in my office. I used to try to get her up and out to pee before she could wet the bed, but I can’t seem to time it right anymore. And she was sleeping so soundly, I didn’t want to wake her. I also thought she might have already passed. Unwilling to confront that possibility, I went back to bed.

An hour later, she lifted her head when I walked into the office. She was ready to go out. And her bed was ready for the washer.

Speaking with the vet that morning, I learned that Penny’s kidney values were worse, pretty much where they were when we first diagnosed the issue, before the infusions began. The vet told me we could do ultrasound tests to get more data.

I told her, firmly but gently, I was not interested in spending hundreds of dollars on diagnostics that would tell me what I already know: my 14 year old dog is dying. I want to keep her as comfortable and happy as possible until I can’t do anything more to comfort her. The vet understood and supported that goal.

Penny will be getting Lasix to keep her heart functioning better (and peeing more). I will look for fattier food with less protein that she might actually eat. She is a little overweight for a dog her size (she had maxed out at 12 pounds, being spoiled by my husband, the human Pez dispenser), and in recent months got down to 11 pounds (still a pound more than she was when we adopted her). So she has weight to lose. And I suspect she will be losing a lot more weight as her condition deteriorates.

When you adopt an old dog, you know, intellectually, they will not last for a long time. I’ve spoken to Yorkie owners who say these little dogs can live to be 20. And, being the optimist I am, I had hoped Penny might be one of those lucky freaks of nature.

We now know, that is not the case. Penny will not make 20. I’m not sure if she’ll make it to 15. Her birthday is in September.

Here’s what I do know: I love this little dog with all my heart. I have enjoyed our time together more than I can possibly express. I am grateful that her previous owner was loving enough to have sought a great home for her. I will use my resources to give her the highest quality of life I can while she’s here. And I will miss her like crazy when she finally goes.

Was I crazy to have taken her in and put myself in a position to lose her so soon after adopting her? Possibly. Does watching a creature you love get sick and die hurt like hell? Do I even have to answer that question?

But do I have any regrets? Not one.

Posted in aging, death, dog, dying, Family, life changes, pets, planning | Leave a comment

Explaining

Lately, I’ve been asked about how to reason with a demented person, and it makes me laugh. Maybe I’m a little perverse, but if you know me, or have read any of my stuff, you know that humor is my favorite defense mechanism.

Having lived with this knowledge of the evils of dementia for several years now, and because I UNDERSTAND THIS so very well, I take for granted that EVERYONE knows it already. I need to be reminded that there are millions of people who haven’t gotten the memo yet. Thank you for reminding me. This mission is important and there’s a lot of educating to do.

So here goes: YOU CANNOT REASON WITH A DEMENTED PERSON. Saying anything to someone who is in cognitive decline has extremely limited value. Why?

  1. Demented people can’t learn anymore, so they can’t retain what you tell them.
  2. They are often HALLUCINATING. They see all kinds of things that we cannot. And what they see in their minds is just as real, if not more so, than anything you could possibly tell, show, or be to them.
  3. Their ability to “reason,” apply “logic” or comprehend language is diminishing, because their condition is damaging their brains.
  4. The information they are receiving from inside and outside is terrifying, especially in the beginning, when they are still high-functioning. They are finding that they can no longer trust what they perceive, and that they are losing the ability to be the person they have valued being. They often suspect that someone else is doing things to trick them. They become paranoid, agitated, frustrated, angry and unpleasant. I dare say you would, too.
  5. They do a good job of acting as if they understand what you’re saying, especially in the early stages. They’re usually good at “covering.” Because those of us who love them are in denial that they are as sick as they are, and we want to BELIEVE they comprehend, the ruse is successful for a while.

The great author, Robert Heinlein, famously said: “Never try to teach a pig to sing; it wastes your time and it annoys the pig.” And so it is with the demented. Don’t waste your valuable time annoying people (including yourself) and getting nowhere. Spend the time learning more about what they’re going through (reading this will help) and sharing affectionate moments with them instead. They don’t need to be corrected or convinced. They do need care and love.

And unlike pigs, demented people often can sing (and may surprise you by recalling lyrics), and will find enjoyment in connecting with music from their past. The emotional centers of their brains survive longer than the other parts, so connect there. You and your loved one will both feel inexplicably better as a result.

Posted in aging, caregiving, delusions, dementia, Family, life changes, psychosis | Leave a comment

“Dementia Sucks” on the Whole Care Network

Read here about my wonderful interview with caregiver advocate and host of Healing Ties, Chris MacClellan.

Posted in aging, book, caregiving, death, dementia, dying, Family, podcast | Leave a comment