Love's Labours

Shortly before I left on vacation, I sent a letter to my favorite Professor, Murph Swander. I knew he was getting up in years (he's in his 90s now), and I wanted to be sure to let him know the impact he made on my life.

I composed a letter, but realized that the blog post I had written a couple years ago was really a love letter to him, so I printed it out and sent it to him with my card. Remember my post? See it here.

I was thrilled to receive a card back from him last week.

  

It reads:

August 19, 2013

Dear Karen--

Thank you!! How thoughtful of you!!

I truly enjoyed your card and the "blog post." It is wonderful to know that the work we did together has remained important in your life. I do miss those good old days.

But my wife and I are living a pleasant, quiet life. We feel blessed that we've been together over 70 years.

Thanks again! With love,

Murph

P.S.-- The other actor in the picture with Patrick is Bernard Lloyd. The three of us have remained close friends. They are both splendid humans. 

Yay! I was moved. I love that he honored our experience by calling it "the work we did together." 

And I LOVE that he used multiple exclamation points!!  A man after my own heart!!

I'm glad I sent it. ♥ ♥

If music be the food of love, play on!

Wonderful stuff.

You are precious, Rachel.

I've been working with a sweet, sweet man. Mr. L had a stroke, and was quite impaired in both his language comprehension and his expression.  I had worked with him a couple weeks before he suffered a second stroke. While he was in the hospital, they discovered he has lung cancer. He's on Hospice now.

His wife, also a sweet, sweet person, wanted me to come back and work with him. Of course, a patient on Hospice isn't expected to be rehabilitatable, so my role will be limited. But I hope that I can offer some suggestions on communication to his family.

I saw him today for the first time since he came home from the hospital on Hospice. His expressive language is marked by both semantic and phonemic paraphasias. A semantic paraphasia is substituting a word that means something similar, like substituting "table" for "chair." Phonemic paraphasias are sound-alike words. For example, he named "coffee table" as "taco bell."  Some of the same sounds, a little mixed up.  He'll also use neologisms, where anything goes. His comprehension is even worse now, so communicating is very difficult. He'll say things that just don't make sense, but he doesn't understand that he doesn't make sense. Of course, question-and-answer to try to discern his meaning doesn't work well. Occasionally, he can say something "right."  His daughter said he can still tell his wife how beautiful she is. They recently celebrated their 65th anniversary!

He is depressed and quite discouraged, but still very sweet.

My favorite mix-up today was i showed him a line drawing of one of these:

I asked him to name it and he said, "Shoe Flight."  It touched my heart, and I shared the origin of my nickname with his daughter. I got the nickname "Shoe" when I was learning to say new words. When my dad tried to teach me the name of that thing, I said, "Shoe Ball!"

Anyway, one thing he was consistent about: he kept calling me Rachel!  At least three times he called me Rachel as plain as could be.  I asked his daughter, any Rachels in the family? Nope, no idea where he got that.

He was grateful for my attempts to help, but he kept calling himself "Stupid." I told him that I don't like that word and it isn't allowed.  At the end of the session as I said my goodbye and gave him a hug, he came out perfectly with, "You are precious."  I'll keep that in my heart. ♥

351st Bomb Group

One of the great things about my job is I get to talk (duh!) to my patients and get to know them and life and history!  I always ask where they were born, where they grew up, and I ask them what they did during the War.

One of my patients who currently lives really close to me grew up in Dayton, Ohio!  He didn't recognize the family name, and I guess he lived there later than our family members anyway.  I got to talking about the war, and I asked how he served.

"I was a navigator in a B-17," he asnwered.

"Really?  What bomb group were you in?" 

"The 351st."

Cool!  So, we talked a little about the 351st.  I told him about Jack.  "He must've been a little guy," he noted.  That's the comment I get every time! 

Again, he didn't recognize the family name, but as he said, "It was a long time ago."  I got curious and decided to do a little research and found this site:  The 351st bomb group website.  If you do a search, you won't find Jack.  Search instead for the common misspelling.  There, you'll find his missions.  I've already contacted the person in charge and asked him to correct the spelling.

My patient was in Polebrook a few months before Jack.  His last mission was in August, 1944 and Jack began in October of that year.

Hats off to the Veterans!

One hundred and what?!

I was at a patient's house the other day to check on her swallowing.  Mrs. W is a lovely lady.  She didn't say much, but she did answer questions and followed directions appropriately.  I asked her how many kids she has. "Two," she said, as she looked off in the distance to remember, "but I think my daughter died. Yes, she died."

Her swallowing was pretty good, and I chatted a bit with her husband and their caregiver.  One of the things I do during my evaluation is to see the person's mouth and teeth.  I routinely give a lecture about oral hygiene.  Mrs. W didn't need much of a lecture.  Her teeth were in great shape!  The caregiver said, "Ask Mr. W to see his teeth.... he keeps them in his shirt pocket!"  I had to laugh, and I told her about Jack.

I had been in a bit of a rush that day, and I had gone into the house without looking closely at my facesheet.  As I left the house, I thought to myself, "Gee, that lady seemed pretty old.  I wonder how old she is."  I picked up the facesheet.  Her year of birth:  1902.

"1902!" I thought.  "Wow, she is old.  She is 98!"  Wait a tick.  "1902?!  Wait.... Does that say 1902 or 1920?"  Hold on one minute....I had trouble processing this.   1902.  This lady is 108 years old!  One hundred and eight!  My oldest patient ever!

I'm always amazed at the centenarians.  They are always in great shape.  In the occasional instances that I am referred to visit one, I am very rarely needed to do any intervention.  Some people just have amazing genes. 

Knock on wood.

I'll take "Tarts" for three dollars, please, Alex.

per·sev·er·a·tion  (pr-sv-rshn) n. 1. Psychology a. Uncontrollable repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by brain injury or other organic disorder. b. The tendency to continue or repeat an act or activity after the cessation of the original stimulus. 2. The act or an instance of persevering; perseverance. Perseveration is a common occurrance after a stroke, and I often see it in speech therapy sessions. Today I was working with a 90-something-year-old retired physician who has expressive language difficulties after a stroke.  I was having him formulate sentences with a given word.  He was tending to perseverate despite my cues to try to vary his responses.  Some of his sentences were: using hummingbird:  "The hummingbird ate the cake." using camera:  "The camera photographs the bird." using basketball: "The basketball photographed the cake." At that point I stopped him and pointed out that he was using some of the same words and the last sentence didn't make sense. So we went along and sentences seemed to be better, until the following: Me:  "Make a sentence using dollar."   Dr. S: "It's only a three-dollar doll."  Me:  "How 'bout using tart."  Dr. S: "She's a three-dollar tart." Luckily, he has macular degeneration so he couldn't see the shuddering as I tried to stifle my giggles. I love my job!

Mr. Z

There is a lovely, pleasantly demented man at one of my nursing homes.  He was born in October of 1905.  Yep, that makes him 104 ½ years old!

I went in to check his swallowing (doing pretty well, all things considered) and got to chat with him a bit.  He proudly told me about his coaching years, being an All-American football star at USC, owning half the land in Santa Barbara ("I'm a very wealthy man!") and that he has a building named after him at USC.  I hope when I'm 104, I will have had such a wonderful life, at least in my own mind.... none of this is true! 

After hearing about his accolades, I asked him how old he is.  He dropped his voice to a conspiratorial tone.  "I'm not supposed to tell you," he whispered.  "I'm looking for a girlfriend."

He told me, though, that the doctors have said he has another ten good years left.

Yay for oldsters!

Weather or Not

Remember the lady I told you about who grew up wealthy and miserable? She was a weather observer during WWII.

When I went to see her today, she told me that she had gotten 3.6 inches of rain at her house during the storm this week. She said she enjoyed yesterday, sitting and watching the rain.

I told her how Jack was a weather nut, too.

When we went to the family reunion in Ohio a couple years ago, we visited the National Museum of the Air Force. It was a wonderful museum, full of airplanes! Lots of 'em! One of the exhibits was outside. We nearly missed it, but I'm glad we didn't. It was a recreation of a US Army Air Corps 8th Air Force control tower and some Nissen huts, which was what Jack lived in while stationed in England. Inside the control tower was the weather room.

When I walked in to that weather room and saw all the maps and pages of hand-written weather data, with windows overlooking the tarmac, I instantly understood Jack's weather jones. So much of his personality was shaped by the war, and this is one aspect.

His life and the lives of the crew depended on the weather. It isn't surprising he carried this with him for the rest of his life.

Another lovely lady

A little loony, but lovely!

I'm working with another sweet, sweet lady with dementia. She is, as we often say, "pleasantly confused." She is a happy 96-year-old, but doesn't know the doorjam from the donuts.

She is full of non-sequiters and oddities. Such as, when I asked her how her lunch was tasting, she said, "It's okay. It isn't complete, but it is arriving in degrees." As we made our way down the hall, she said, apropos of nothing, "I think she was more pleasant later in the day." And a few steps later, "I want you to confirm it because I don't think it is."

We've been doing mouth and throat exercises to strengthen her swallowing. She was dutifully following my model when I decided to take a break. I asked her, "When is your birthday?"

She very clearly and distinctly articulated, "When. is. your. friendship?"

Buy the shirt at Signals.

A Tale of Two Ladies

It seems that often my clients come clumped. I'll have a streak of clients with a particular trait. Maybe over-100-year-olds, or several folks suffering from Parkinson's disease. Or, maybe a bunch live within a few blocks of each other in Goleta. Right now, it is Crazy Cat Ladies. Ok, so they aren't crazy, really; all three have dementia. But they are strikingly similar: about the same age, with memory and cognitive deficits. They all live in similarly modest homes. All of them are widowed (actually, one long-divorced), and they each live with a supportive daughter. They are open with many stories of their past. They all love cats. And they are all happy.

All three are in similar places now, at this time of their lives. But getting to know them, I see they traveled here on very different paths. I want to tell you about two of them.

Mrs. S was born in Oklahoma and grew up dirt-poor in Tennessee during the Depression. When she was in her early teens, her mother left her father. A cousin from California drove to Tennessee to get the family and moved them out West. Mrs. S had to quit school in the 8th grade to care for her baby brothers when her mom had to go to work. Though she can't remember if she ate breakfast this morning, she is full of stories of a large, warm, supportive family. For example, a cousin was orphaned and was sent to live with an "evil" aunt. Other relatives shuttled around the unfortunate little girl to shield her from the unhappy situation in that house. Though she grew up poor, it is obvious Mrs. S grew up happy and loved. Her extended family is important to her.

Mrs. W is another delightful lady. She grew up in a very wealthy home in the suburbs of Cleveland. During the Depression, in her words (she gave me a written brief biography), "While people were living out of garbage cans during those years, and the Oakies were struggling across the country, we had our sacrifices, too. Our household staff was reduced to a live-in cook and a live-in maid."

Mrs. W's stories of her childhood are heart-wrenching. Her mother was cold and abusive. There was no love in her house. Her higher education was in fits and starts, depending on if her mother would give her the needed money or not. She finally got a master's degree in library science at age 41.

She overcame a disastrous marriage, too, and eventually found her way to a fulfilling, happy life. She raised two kids as a single mother. She is an animal rescuer and currently has four cats. Lately one has died. She feels his loss deeply; her animals are extremely important to her. She is a laughing, happy, sweet lady that I have the real pleasure to know.

Getting to know these women really got me thinking. It isn't always about where you were, but where you are. Life can put up obstacles of many kinds. There are ways to knock down obstacles. You can decide to do that, or you can decide not to. Finding the path to Happiness is not always easy, but there is more than one way there. Go out and find it!




"Most folks are about as happy as they make up their minds to be." --Abraham Lincoln

"Happiness is nothing more than good health and a bad memory." --Albert Schweitzer

Sweet Jesus!

One of my fondest childhood memories is watching The Lawrence Welk Show. Every Saturday night, I'd join Gram in the living room. She'd sit in a comfy chair, and in the middle of the living room, I'd sit in my little rocking chair and dance.

"Dancing," in this case, consisted of rocking back and forth while making a series of third-base-coach-like moves. I'd dance to every number!

A few years ago, I was writing some documentation at a skilled nursing facility (nursing home). I was sitting in the day room, where the TV was showing The Lawrence Welk show. I sat, lost in my memories, and watched for a while. My trance was broken when someone in her office saw me and laughed, "I never knew you liked Lawrence Welk so much! You should see the grin on your face!"

When I saw this video recently, I could only think, "Oh, my." Wasn't there any one on the cast or crew who could warn them? Where the heck was Bobby?

May you see WHAT?!

Y'all know me; I am a 40-ish-year-old woman. I think just about anyone you ask would say I look around 40-45. I don’t look 30. I certainly don’t look 21!

Today I bought some Bacardi (remember my mojitos?) at our neighborhood drugstore, and I heard a question I hadn't heard in about 20 years.

"May I see your identification?"

I laughed, thinking she was joking, but she said no, she needed it; the policy was to card anyone who looked 40 or under.

What the heck?? What kind of policy is that??

I gave her my id, but instead of checking the date, she ran it through the card reader before I knew what she was doing. That really ticked me off! What an invasion of privacy!

And anyway! Just a quick look at the card would tell her I was over 21. It is slightly obvious! Photo on right=under 21; Photo on left=over 21. Big red bar across front = under 21.


My wrinkles may have given her another clue!

The whole thing is very weird. So I had to write a poison pen letter. {evil grin} I'll keep you posted!

Take Me Home!

I was at the nurses' station yesterday and I overheard:

"I want to go home! There is no one to take me home."
(pause)
"I'll take you home."
"OK."
(pause)
"When care you going to take me home?"
"Now."
"OK."


Ah, Mrs. B! I suppose it is good to be your own best friend.

Keep your thumb inside!

I was walking down the hall at one of the skilled nursing facilities that I work at, and I heard one of the elderly ladies sitting in a wheelchair talking to a gentlemen, sitting in his wheelchair.

"No, no! Keep your thumb inside! Keep it in!"

Curious, I turned to look. She held up her hand to demonstrate. "You tuck your thumb inside here, like this," she explained. "See, that way, when you punch someone in the face, you don't break your thumb!"