Life at Timbercrest

(Note: Doreen got moved into Timbercrest back in December and continues to make great progress. We'll post updates and pictures on the family gathering at Christmas, but here are some more recent reflections from Judy.)
by Judy

On January 19, Judy went to North Manchester to visit Carl and Doreen and to take Doreen to an appointment with Dr. Kachmann, her neurosurgeon. She hadn’t seen him for a long time, and Lori Zimmerman, Carl and Doreen’s new physician, thought it would be good to check with him and see if he could make sure that the continuing dizziness was not related to the shunt or any other treatable brain conditions.

[By the way, Lori Zimmerman is the daughter of Gary Zimmerman, who was the academic advisor and mentor for Judy, Karen, and Amanda when each of them was at Manchester. In fact, Lori was the baby on the blanket in the child psychology course that Judy took from Gary. Lori, her sister, and her parents also took part in Karen’s wedding, so it seems natural at the same time it seems strange. I wonder how that baby could be her parents’ physician!]

The appointment in Ft. Wayne went smoothly. Judy, Doreen, and Carl drove together and were able to use a wheelchair at the Neurology Clinic. Dr. Kachmann and his nurse Brian greeted us like old friends, and they were very pleased to see the progress Doreen has made. They pronounced the shunt as functional and seemed to feel that there was nothing unexpected in Doreen’s progress. We really did not learn much there, but we were glad to see that they were pleased and that things were functioning the way they should. And Doreen made a point to thank both Dr. Kachmann and Brian for saving her life. She also apologized if she insulted them with her joking before the last surgery they performed. She has heard (although she doesn’t remember doing it) that she asked if they were going to use a chain saw for the surgery. Of course, Dr. Kachmann and Brian both said that they appreciated the sense of humor.

A theme in Doreen’s thinking during that day and since then came from a message given by Joe Mason at chapel on January 18: “strength for today and bright hope for tomorrow.” She has been singing Great is Thy Faithfulness in her head since then, and she feels it has worked. She feels that she has gotten promising feedback from several sources since then, and feels she is getting strength for the days.

After returning to Timbercrest, Judy shared some birthday presents, although Doreen’s birthday was actually on January 25th.

The next day, Doreen saw Lori Zimmerman again, and this time she was diagnosed with a sinus infection. It could that this infection has been a factor in the dizziness. She is now being treated for that, and we all are counting for the treatment to be “bright hope for tomorrow.”

A few days after that, Doreen went to Grossnickle Eye Clinic in Warsaw to see if they could give her any information about her problems with her eyesight. What she was told is that she has some cataracts that should be removed. Actually, she was told the same thing by her eye doctor in Illinois earlier. That doctor had told her that she would tell him when it was time to remove them. She is now agreeing that it is time. After the cataracts are removed in February, her prescription for her glasses will be checked. Then they will see if anything else needs to be done. So some more “bright hope for tomorrow.”

A couple of weeks ago, Doreen also had her hearing checked. Not surprisingly to anyone in the family, she has a hearing loss. Next month, the hearing specialist will start working on finding the right hearing aids—and will check Carl’s hearing more closely. Having assistive devices could make a huge difference for both of them! All of these things were put on hold after the emergency last spring, but now it is time to get on with them!

Last week was the final week for therapy for the time being, because Doreen had reached a plateau and was not showing continuing progress. Some of the lack of progress could be blamed on the dizziness and perhaps on a brief bout of the flu the week before last. But Doreen’s response is that she isn’t sure if it is a success or a failure that the therapy is stopping. Is it because she has a accomplished so much or because she is accomplishing too little? In any case, she is hoping for continuing restorative therapy to keep strengthening her hands, arms, and legs and to keep moving ahead.

For her birthday today, Doreen and Carl were able to attend church with the Manchester congregation, the first time they had do so without their daughters. Kurt Borgmann, pastor in Manchester and son of Carl and Doreen’s first exchange student in the 1950s, picked her up. After church, Daniel (Karen’s son who is attending Manchester) and the Borgmanns went out to eat with Carl and Doreen at a local restaurant. It is wonderful to be able to do these more “normal” and familiar activities, even if there are many reminders that things have changed. We are all very grateful that Doreen has celebrated another birthday and look forward to many more!

In case you don’t know, Doreen now has a phone in her room. Let us know if you would like to have her number.

Finally!

The family just got confirmation on Tuesday that Doreen has been accepted and will be moving to Timbercrest on Monday, December 8th! Karen, Linda, and Judy will all be there to assist with the transition. I'm sure they will provide a much more detailed report next week.

However, Karen has still not been able to get in touch with Carl to tell him of the news. She's continuing to try and call this morning.

Thanks for all you thoughts and prayers over the past 6 months. Doreen has made wonderful progress since her move to the Rehab Hospital and while she will be sad to leave the kind people there, she is very much looking forward to being in North Manchester.

Dear Carl Myers Travelers

by Jim Garber

After this week we will have been at the task of providing rides for Carl to Ft Wayne for 16 weeks. I hope you know how thankful Carl, Doreen, and the whole family are for your generous rides.

Now, in consultation with the family, we believe it is time change our strategy. It is our plan to move from a style which demands special trips to a plan which, hopefully, can take advantage of occasional journeys that can combine your needs to be in Fort Wayne when Carl can ride along.

Here’s what we are suggesting: When any of you find yourselves heading for Ft Wayne for shopping, medical visits, or whatever, we encourage you to invite Carl to be a passenger. He can be dropped off at the hospital (he no longer needs someone to stay with him), where he can visit with Doreen and then return with you to Timbercrest on your schedule.

I expect I will remind you each week to include Carl in your travel plans when it makes sense to you. You can simple call or email me or phone Carl to set up the trip. My observation is that we are traveling often enough to provide a fairly regular ride for Carl.

If this raises any questions or reactions , please let me know. In the meantime I will look forward to our continuing serving Carl and Doreen in this more informal way.

Right of Passage

by Clay
You may remember the first time you got to mow the yard, at least I do. It was a highly anticipated and memorable moment when grandpa trusted me enough to let me MOW! And he allowed me to help years before my dad did.

Here's a video of Cameron's first experience mowing this past weekend. He's quite excited about it.



(That high pitched whine is me using the leaf blower in the garage.)

Planning for the Future

by Judy

Judy picked up Carl in North Manchester, and the two of them visited with Doreen today. After getting help with a kind family driving who helped Judy change a flat tire, she stopped at Timbercrest and helped to set up some new telephone and clock equipment for Carl. Then they surprised Doreen, who didn’t know they were coming.

The reports had been that Doreen was making great progress at the Rehab Hospital, and Judy felt that was accurate. Therapy sessions were done for the day, but Doreen was choosing TV channels and resting. The things that Judy noticed were that she smiled spontaneously more often than before, that she seemed more aware of what was happening and when, and she seemed to have a broader picture. Judy and Doreen worked on filling out a survey form related to Covington Manor (the place she was in for two months, lasting until two weeks ago), and Doreen seemed to be able to separate the experience there from the current experience and reflected very realistically on her reactions.

An exciting advancement is that the stomach tube has finally been removed! Doreen said that the doctor just “pulled it out.” She said there was some pain for about one minute, but then it was fine. So now she has two belly buttons, but the tube is gone!

One clarification involved the broken bone from the fall a couple of weeks ago. Apparently the broken bone was the bottom knuckle on the index finger of the right hand. The knuckle is still somewhat swollen and sore, but everyone hopes that the splint will be removed on Dec. 1 when she sees the orthopedist again. Doreen said that, if the splint is not taken away, she will ask if it can be taken off at least when she eats. That planning and suggestion is a great indication of Doreen taking charge of some of her care.

Crosswords are very important to Doreen at this point. She wants to do them as often as possible, and she continues to improve her abilities. She has been able to give answers to the puzzles at times throughout the last six months, but she is now able to remember recent clues and anticipate how the words may cross each other. And she still does it almost entirely in her head, because it is hard to her to see the grid and the clues. Her eyes are improving, though. She read most of a card that Judy brought, but after reading a couple of paragraphs, she seemed to lose her place or find it difficult to focus.

Doreen also continues to talk about going home and wanting to do things related to her old life, but that reflection is no longer as unrealistic and impractical as before. She no longer thinks she slept in people’s homes, that she will be going to the National Older Adults Conference when she has not yet slept anywhere besides a hospital or treatments center, or asking where she should get gas tomorrow so she can drive home. Now when she talks about going home, she says she would like to be in her home again for a little while, but she realizes it wouldn’t be like before. She wants to talk about Christmas plans, but she is planning for events at Timbercrest rather than Elgin or Camp Emmaus.

There was quite a bit of discussion about the progress she is making. There was clearly a smile when she heard about what others thought she had achieved, but she also talked about how she wished it were faster. She has come a long way, but she adds that she has a long way to go.

Birthday with Daniel

by Daniel Myers-Bowman (freshman at Manchester College)

On Sunday, I helped Grandpa Carl celebrate his birthday by taking him to visit Doreen in Ft. Wayne. A friend of mine was kind enough to lend us a car. We spent much of the day doing crosswords, which seem to be getting much easier for her. For Carl's birthday dinner, we brought in some Chinese food, which we all enjoyed very much. Doreen's condition gets better every time I see her. The Rehab hospital is able to meet all of her needs quite well, from what I could tell. The nurses responded very quickly whenever she needed help, and treat her with great care. I think she is in a good place for now, while we wait for her to be able to move to Timbercrest.

Birthday Greetings

(The photo at right was taken during Carl and Doreen's 60th anniversary celebration during the summer of 2007.)

Tomorrow, Sunday, November 16, is Carl's birthday. If you get the chance, you can post a message here for him to read. My guess is that he'll be in church in the morning then headed to Fort Wayne to visit Doreen. All of us want to express our appreciation for all the support and encouragement you've given dad over the past 5 1/2 months.

Progress and Patience

November 9 & 10, 2008
by Judy

(Doreen is pictured here with her roommate for the past several weeks.)
Another move! As of yesterday, Monday November 10, Doreen has moved to Lutheran Rehabilitation Hospital of Fort Wayne. We saw this as an exciting move ahead, but Doreen was not so sure. (This blog entry focuses on Judy’s experience with Doreen on Sunday and Monday morning.)

On Sunday Judy drove from Lafayette to see Doreen and help her pack. She arrived a little while before supper and found Doreen alert and visiting with fellow residents. Doreen was concerned about getting food for Judy and asked the staff to order a tray. Although the food was less than special, it was good to share the meal, and nice to see Doreen interested in taking care of other people’s needs. Doreen did well with feeding herself much of the time, although her movements were somewhat spastic and jerky. She was pleased that she didn’t spill anything! The splint on her right hand (from the fall and break from a couple of weeks ago) was largely responsible for the awkwardness.

Judy had not seen her mother for two weeks, and the change was remarkable! She moved around much more accurately and comfortably, she was talking well and sitting a bit more calmly, and she seemed to be much closer to the old Doreen. But she still has a long way to go!

Judy packed things and helped Doreen with crossword puzzles. She did very well with medium-level puzzles and wanted to keep working on them. She also asked to look at greeting cards as they were taken off the wall.

When Judy first called to say that she was coming, Doreen asked some questions about the move to the Rehab Hospital. She had talked with some former residents who said that they had been at the rehab hospital and that the staff make the residents work really hard. So Doreen asked if they would make her go to the bathroom alone and get herself in and out of bed alone. She was worried that she would be expected to do things she didn’t feel she was capable of doing. That nervousness was also an issue when she asked if she would get any help with eating. It seems that she doesn’t remember much of anything from her earlier stay at the Rehab Hospital, except maybe that she wasn’t ready to be there and felt pushed beyond her limits.

On Monday morning, Judy and Carl arrived at Covington Manor to get ready for the move. After packing up last-minute items, having an exit interview with someone from social services, getting discharge papers from the nurses, and taking one more trip to the “lost clothing room” (where we found none of her missing items), Doreen and Carl were picked up by the Rehab Hospital van, and Judy drove behind. We arrived at the hospital at the same time as Linda, who was coming from Illinois. Items were stored in drawers and the admissions and nursing staff asked questions. Then it was time for lunch and a very different dining room. Then the baton was passed to Linda.

November 1 update

November 1
by Judy, Karen, & Linda

DOREEN’S RECENT “ADVENTURE”
On Monday, October 27, Judy got a call from Covington Manor that Mom had fallen out of her wheelchair. The report was that she hit her head and had a bump on her arm. They were taking her to the ER at Lutheran Hospital to be checked out, since a bump on the head was not something to ignore following 4 brain surgeries.

Judy headed to Ft. Wayne, picked up Dad in North Manchester, and the two of them traveled on to Covington Manor. When they arrived, they noticed that she had a splint on her arm. There was a bruise on her left temple, but the more significant outcome of the fall was that she caught herself with her right hand and broke a bone—the thumb bone closest to the wrist. The splint goes all the way up to her elbow, so it is rather awkward. But neither the head nor the arm was causing her a significant amount of pain.

The story of the fall is that Mom wanted to watch TV, but she dropped the list of channels. She bent over in her wheelchair to pick it up off the floor, and she fell out, hitting her head against the open bathroom door and catching herself with her hand. Like the last time she fell, she said, “I did a dumb thing.” Her roommate was gone when she fell, and there were no staff members in the room, so she scooted on the floor on her back up to the door to let someone know she needed help. Her chair alarm was going off, too, so she did get help. The fact that she could respond that quickly to ask for help is a very good sign!

Mom saw an orthopedic doctor on Wednesday and was told she will have to wear the splint for several weeks while the bone heals. We are pleased that it is a splint rather than a cast. It is removable for showering, etc. It makes it difficult to feed herself, but they have made special utensils available to her and she is able to feed herself.

During the rest of that day (Monday), much time was spent with crossword puzzles. We had hoped that therapists and activity staff would do puzzles with Mom regularly since we brought up that activity at the last Care Plan conference, but that has happened only twice. On Monday, Judy and Mom (with some contributions from Dad) completed 3—one easy, one medium, and one hard. Mom is still having difficulties with double vision, so all of her contributions to the puzzle completion were done verbally, but she is still capable of “seeing” the puzzles in her mind!

Monday evening Judy and Dad stayed until Mom got in bed. She was given two Tylenol PM, so she should have slept well that night, and we hope that the awkward splint was not too annoying. She would like to always have someone there when she goes to sleep. The family wishes we could fulfill that request.

NEXT STEP: TIMBERCREST?
On Tuesday morning, Judy joined 5 members of the Timbercrest staff/administration to discuss their current thinking regarding admitting Mom and to talk about Dad’s living situation. Karen and Linda joined the meeting by telephone conference call. Although we were hoping for a final decision, Timbercrest was not ready for that yet, but they did say are willing to admit Mom—just not quite yet. They generally do not admit residents directly to health care, but their census there is down right now. However, they have a few long-term residents who may need the open beds because they are facing health care issues. They said that they will be in touch with us in two weeks, if not before. And they still did not guarantee that we would know for sure in two weeks.

There was also discussion about Dad. The family reported that they think he is doing very well there and that his functioning has improved along with his sense of well-being since he has been a resident. Timbercrest is ready to admit him as a permanent resident, but we will not take that step until it is sure that Mom can join him at Timbercrest.

We are all hopeful that we are getting closer to finding a permanent, shared home for Mom and Dad. The support and positive thoughts sent that direction are very much appreciated!

Family Fun Time (with video!)

It's been a long time since we posted an update: sorry for the delay. Karen, Linda and Judy are all back to work and don't see Mom and Dad very often. Plus, their situations have stabilized somewhat so there are fewer changes to report. However, this makes for a L-O-N-G entry this time.
by Linda, Judy, Karen

DOREEN’S FIRST FIELD TRIPS – OCT. 10 & 12
Last weekend was homecoming weekend for Manchester College and much of the family was able to gather in North Manchester. Karen, Clay and Cameron drove in from Kansas. Amanda and Aaron flew in from New York. Linda and Lee drove in from Elgin and picked up Parker in Chicago on their way. Judy and Dick drove in from Lafayette. Daniel is living in North Manchester as a student at the college. (Unfortunately, Kelsey, living in New Jersey, was not able to take time off from her new job and Stephen and Cosmo were not able to join us from California.)

For the first time since her brain hemorrhage, Mom got to go on a field trip! On Friday afternoon Karen and Clay took her from Ft. Wayne to North Manchester and she was able to see Carl’s apartment at Timbercrest Retirement Community for the first time. She enjoyed being there and immediately (within a few minutes) asked to sit in her recliner that had been brought from home, falling asleep within minutes (or so we thought: see video at end of post). Dad, Mom, Karen, and Clay had supper in a Timbercrest dining room, and then joined the rest of the family at a concert at Manchester College. The MC choir and band were joined by alumni. The choir included Daniel—a current choir member, Amanda—a 2003 alum, and Judy—a 1975 alum. It was a fun experience and Dad loved being able to show off his "date" to the many, many friends who greeted Mom.

She enjoyed the concert, but got restless pretty quickly. She is dealing with a sort of “restless body syndrome.” She often “rocks” back and forth in the wheelchair and/or asks to be walked around. By the end of the evening, she was tired, but felt good about the visit and wished she didn’t have to go back to the rehab center. On the way back to Covington Manor with Clay and Judy, she asked Judy to work on a crossword puzzle with her. She said that would help her relax, but she wanted to be left with a challenging clue so she would have something to think about as she went to sleep! For the entire 40 minute drive, Judy would read a clue and indicate how many letters were in the answer. It was amazing how many times mom would know the answer almost immediately. (She would often beat me to the answer: Clay)

On Sunday, Judy and Karen picked up Mom early so that she could be in North Manchester in time for church. She sat in her wheelchair in the back because she needed to move her chair back and forth or be walked around, but she appreciated the sermon and was again greeted by a long line of friendly and supportive people. After leaving church we went to Timbercrest for lunch. 13 family members and the five members of the Borgmann family (Kurt is pastor at the Manchester church and the son of Egon, an exchange student who lived with the Myers family in the 1950s) shared lunch, fellowship, and stories in Dad’s apartment and the lounge on Dad’s wing. Mom could sit in her recliner, watch TV, laugh at grandchildren, or sleep. We just “hung out,” and it felt good. Mom did very well and hopes to be with her family more often, but it was very difficult for her to go back to Covington to be alone again.

MOM’S “CONDITION”
Mom is having some challenges keeping her spirits up. She says she gets lonely at Covington. She also has begun to realize that she will not be able to do all the things she used to do. She told Karen, “I miss my life – I really loved my life!” It will come as no surprise to anyone who knows her that she feels like she needs to plan something. And she misses Elgin. While we are sad that she feels sad, this is a step forward. Even a few weeks ago, she was not truly aware enough of the situation to be sad. This is a great indication that her brain is healing!

On Friday afternoon (Oct. 10), Karen, Clay, and Judy attended a Care Plan meeting at Covington Manor for Mom. Some helpful information was shared, but the meeting was also rather frustrating for us, because the information we receive can be inconsistent. While her swallow study came back with the “all clear,” she is still having some trouble with occasional gagging. She is eating a regular diet but is quite tired of the limited selection (especially because she does not eat red meat and often ends up with a micro-waved and rubbery piece of chicken).

As those of you who facilitate Carl’s visits with her know, she often asks for fast food as a treat. She will then eat with gusto and enthusiasm – quite entertaining to watch. She will now and then announce she is done in the middle of her meal and then suddenly attack her meal again with verve. They have no good explanation for any of this.

During the Care Plan meeting, the staff reported what they called “impulsive” actions in her behavior. While she is doing very well with moving herself in the wheelchair with her feet, she does not steer accurately nor look carefully to be sure she will not run over something or someone. Earlier in the week, when she had been left by herself in the bathroom, she got impatient and decided to stand up on her own. Unfortunately, she fell and hit her head. Another report was that some aspects of her behavior are inconsistent—she is sometimes eager for working during therapy and other times wants to slack off. These concerns seem to hinge on her inability to consider consequences of her actions. As a result of the damage to her brain, she exists so much in the moment.

Concerns that the family has are: 1) this rather “negative” assessment of Mom’s behavior, 2) the lack of understanding of brain injury this seems to show, and 3) inconsistency and a seeming lack of coordination in the treatment at Covington Manor. In addition to the situations we described above, at the Care Plan meeting, the staff said that the PEG tube was no longer being used for feeding. However, that evening, a nurse came in the room with a bag of the “food” for administering overnight. We questioned her, and she looked at the chart and said that there was no order to stop the feeding. Apparently she was being fed through the PEG tube every night. We brought this inconsistency to the attention of the administration. Since then they have suspended the feeding and we have declined any further use of the tube. We wonder why and how often there is miscommunication.

THE FUTURE?
Considering our concerns, we are anxious to move Mom into a situation that is more supportive and with which we feel more confident about the level of care. Therefore, on Friday, Oct. 10, Karen met with administrators at Timbercrest to make the formal request of moving Mom there. She will need skilled nursing care and rehabilitation, so it will not work to have Mom and Dad in the same room yet, but it will be great to have them in the same community. We were told that there are some openings in the healthcare unit there and that they would evaluate the situation to determine whether Mom can make the move. The Director of Nursing visited Covington Manor on Thursday to review and evaluate Mom’s condition and needs. The administrative staff will meet on Monday to discuss what she found.

We should hear by the beginning of this week whether Mom may move to Timbercrest. It would be wonderful for Mom and Dad. He would be able to walk down the hallway to visit her! We are counting on everyone to send your thoughts, prayers, suggestions, and support in that direction.


The video is of Carl reading mom a letter he had received from Howard Royer. Near the end, even though it appears that she is sleeping, she asks in a shallow voice: "Who wrote that?" Listen all the way to the end!)