Tuesday, April 24, 2012

Bainbridge Abbey

I never thought that in helping to care for my parents, I'd be managing a staff of dozens. Since I am, does this mean that I can wear the fabulous clothes of Countess Cora Crawley of Downton Abbey as I supervise the housekeepers, caretakers, groundskeeper, nurses and cook? It seems only fitting that I should.

When Mom (Dowager Countess) and Dad (Earl of Bainbridge) moved into their apartment at Bainbridge Abbey in February, there were certain repairs that had to be made: a malfunctioning shower head, broken refrigerator door handle, etc. There has been an intermittently balky clothes dryer (it seems that birds nest in the vent), the installation of grab-bars and temperamental wi-fi service to be dealt with. It seems that every other week there is another little item that needs repair and follow up. Paul, the groundskeeper, and I are on a first-name basis, but I am thinking this should be in Carson's realm. I'll have to speak with him about that.This week, it's the dryer again. Damn those birds! I'll have to suggest a hunt.

The rent (hefty) for the apartment is supposed to include daily bed-making, rubbish removal and weekly cleaning. So far, rubbish removal has gone very smoothly.   The art of proper bed-making has eluded the young staff members who cheerfully arrive some days of the week to perform this duty. They would most certainly benefit from some instruction by Aunts Peace and Plenty. The Earl has taken to coaching them when he feels up to it, because he is an egalitarian sort. I have demonstrated hospital corners on occasion, but really, shouldn't Mrs. Hughes be handling the day-to-day instruction of the staff?

The cleaning has been sporadic at best, so I have had to go to Mrs. Hughes' stand-in and have a few chats about both quality and quantity. Fortunately, the Dowager Countess keeps a sharp lookout and informs me when things are not up to snuff. The Earl is far too permissive to be relied upon for an accurate report of such things. He has a soft heart where the staff is concerned.

The nursing staff is mostly a dedicated set and my supervision of them involves the monitoring of symptoms and frequent adjustments in medication on behalf of the Earl and Dowager Countess. Near daily (and often more) communication is typical, so we have established a collegial relationship. Fortunately there are nurses in the family (Sybil Crawley?) to provide the necessary expertise which I lack.

Unfortunately, there has been a recent staff change in the kitchen of the Abbey. It seems that the previous cook, who produced palatable, if unexciting, meals has been succeeded by a less talented chef. Much less talented. So much so that I have had a request from the Earl to purchase a few Stouffers frozen entrees. Can you imagine? The Earl dining on frozen entrees? Unthinkable. Once again, I have had to step in where Mrs. Hughes should have been attentively handling the issue. I can only hope it improves.

There have been automotive issues requiring attention, as well. The Earl's vehicle lease concluded while he was (and remains) unable to drive, necessitating the inspection and turn-in of his Lincoln. Alas, Branson was nowhere to be found, so I had to attend to this myself. I must speak to Carson, once again!

The most troubling area of oversight has been with the caretakers. We began to utilize round the clock caretakers for the Dowager Countess when the Earl was hospitalized in early February. Once he was released from the hospital after having broken his leg, he spent three weeks in the Rehabilitation Wing of the Abbey before returning their apartment. A mere five days later, he was readmitted to the hospital with a severe case of  pneumonia. Another week's stay in the hospital was followed by ten days in the Rehabilitation Wing. The Earl has not regained his strength, so we have continued with the caretakers, around the clock.

The caretakers are to assist with meals (serving only, no preparation) and "personal care"; keep the apartment tidy (no heavy cleaning); do laundry and dishes; attend to the needs of the Dowager Countess and the Earl, and communicate any concerns or needs to me. By and large, they have been lovely women who care for the Dowager Countess and the Earl with compassion and kindness, but there have been a few exceptions.

The first troublesome caretaker was the Drinker. Every staff has one, I suppose, (Thomas Barrow?) but it simply is not acceptable to have several glasses of wine while you are caring for an elderly woman with dementia and poor balance. Completely unacceptable! Moreover, the Dowager Countess was not fond of her ("She never shuts up!"). She had to go.

Soon after, she was replaced by the Emotional Basket Case. Overbearing in every possible way, she in turns browbeat me (The Countess!) about potentially dangerous conditions such as mold in the garbage disposal (horrors!), lint in the dryer vent (shocking!) and a wobbly table leg. I actually resorted to upending the dining room table, removing and reattaching each leg in turn just to silence her. She berated Lady Sybil about calling more often and burst into tears frequently and without warning. The Dowager Countess was not positively disposed toward her, either. She had to go.

Most recently I have had to terminate the services of the Lump. She schlumped into the apartment in a cloud of stale cigarette smoke (the Earl has lung cancer!), dropped her coat and bag onto any nearby chair (has she not heard of closets?) and immediately sank into the sofa and watched television. She was utterly devoid of initiative or energy and performed no task unrequested. I arrived one afternoon to see the Dowager Countess emerging from bathroom, unclothed, having both showered and cleaned the entire bathroom whilst the Lump remained immersed in TV watching. The Lump did not even notice the arrival of  "guests" despite my loud knock at the door before entering. The Dowager Countess found her tiresome ("All she does is sit there and watch TV!"). Without question, she had to go. Hopefully her replacement will be better suited to the position.

Managing an estate like Bainbridge Abbey would not be possible without sufficient staff and good people are so hard to find. Handling the financial affairs of the estate is one responsibility I simply cannot delegate to staff, no matter how trustworthy and loyal. Merely describing the goings-on of the Abbey makes me tired! I hope O'Brien has drawn a bath for me. I simply must have a good soak.

Thursday, April 19, 2012

Mr. Hollister

Spring break around these parts was a couple of weeks ago. Because of a long-planned for, much anticipated, three-week camping trip "out west" this coming summer, we had no travel plans. My children lamented this fact, as we live in an area of affluence. Most of their friends had exotic trips plannned: skiing, cruises and the like. We went to the Natural History Museum.

Oh, and the mall. Did I mention the mall? My 12 year old, who rates shopping right up there with a visit to the allergist, announced that she and her friend would like to go to the mall during spring break. B has not yet developed much of an interest in boys and while she takes care with her appearance (usually), she is more into tailored than ruffles, blues over pinks and absolutely nothing too "girly". Moreover, she hates perfume ("It maks my nose itch!") and loud music ("It gives me a headache.") and crowds ("They make me feel claustrophobic!"). I was shocked.

As a family, we are not big shoppers, other than a monthly Costco excursion. I spend as little time in malls as I can. I find them exhausting.  Now, that is. I used to looove malls. I used to shop as a competitive sport, but those days are long gone.

Still, I was surprised at her request.

"Sure, I'll take you and Emma to the mall. Any place in particular that you want to go?"

"No, just wherever. I thought you could drop us off and come back and get us."

We live about half an hour from said mall, so that was unlikely.

"Well, I am happy to take you, but I'll probably just take A shopping and let you two go your own way. Will that work?"

"Sure. As long as A doesn't have to come with us."

(Of course. Goes without saying. Having your 10 year old sister with you would totally, I mean totally cramp your style.)

On the appointed day, at the appointed hour, we picked up the friend. B had her purse, which she never carries, bulging with cash she had been hoarding since her birthday in late December. I parked outside Nordstrom and we synchronized our watches. We would meet up in about 3 hours.

As much as B hates to shop, A relishes it. We took off immediately for the food court. She had to have an Auntie Anne's pretzel. Then we hit Claire's, which ate up a good hour and 15 minutes, since she had to examine each and every earring in the place. On to Bath and Body Works. Another hour went by as she smelled and tested all the lotions. A spends her money as fast as she gets it, so her bags were accumulating. As we trolled the mall, we passed by a store I had never been in: Hollister. I had heard of it, of course. I understood it to be a teen mecca of a similar ilk to Abercrombie.

"Mama, looook!" (She pointed.)

"At what, honey?"

"Over there. There's a giant picture of a naked dude at that store!"

(Damn straight there was. Holy moly!)


(Well, I wouldn't go that far.)

"I would never go in there! It's too creepy!"

(Hey, lifeguard, I need a little mouth-to-mouth over here.)

"I hope B doesn't go in there."

(Me, too!)

"She won't. The music is too loud."

"Yeah, you're right, Mom. B hates loud music."

We strolled and chatted happily until it was time to rendezvous.

I saw the tweens before they saw me. I saw only one bag.

"Hey girls! Did you have fun? Did anybody buy anything?"

B produced a bag, adorned with none other than Mr. Hollister.

"You went to Hollister?"

"Yeah. I didn't want to go in there at first because of that creepy picture, but Emma convinced me."

"So how bad was it?"

"Not bad once you got inside. Just LOUD."

"Show me what you got."

She pulled out a vivid turquoise zip-front hoodie with Hollister emblazoned down one sleeve in white letters. It was cute and a perfect color for her.

"Feel how soft it is! And it was on sale!"

"Good for you. I'm glad you found something you liked."

We headed for home, chatter and giggles filling the car. We dropped off the friend, pulled in the garage and got out.

"Where's your bag, B?"

"I'm not taking that thing inside. I threw it in the back of the minivan. That thing scares me!"

I shook my head and laughed as she ran inside, already wearing her new sweatshirt.

A couple of days later, the temperature dropped and someone needed a jacket to wear to school. A jacket that, it seems, had been carelessly tossed in the back of the minivan. As I retrieved it, I saw Mr. Hollister looking up at me. Smiling. On impulse, I rolled him up and shoved him in the jacket sleeve. As B came running out the door, heading for the bus which was pulling up out front, I tossed her the jacket.

"Here you go, honey. Have a great day!"

"Bye Mom!"

When she came home from school, she headed right upstairs to do homework. I didn't see her until dinner. She never mentioned my "surprise".

I couldn't help myself:

"How was your day?"


"Did you end up needing your jacket?"



"Was there anything unusual about it?"



(Oh, man, I hope he didn't fall out and get lost on the bus!)

"Yes, Mom. That was lovely, what you put in there."

I cracked up.

"I hope I didn't embarrass you too much."

I was howling.

"What did you do, Mom? How did you embarrass her?" A asked.

"I left a little reminder of our fun spring break in her jacket this morning."

I was laughing so hard.

"She put that Hollister bag in my coat! I went to put it on and I felt something in there. I had to hide it in my book bag!"

Tears ran down my face.

"Where is it now?"

"I threw it away! That thing creeps me out."

I wiped my eyes.

"You aren't mad at me, are you?"

"No, Mom."

That evening, after a late Pinterest session, I went up to bed. Hombre was sawing logs on his side of the bed. I pulled down the covers and took off the decorative pillow sham, only to see a smiling face.

Now it's war, baby!

Wednesday, April 11, 2012

What Happens When Kids Don't Have iPods

I resisted getting iPods for my children for as long as I could. I just hated seeing other peoples' kids with their faces looking down at the gadget in their hands. I hated how it isolated them from the real, live people sitting next to them. I hated the way it took them to a manufactured place; an imaginary place created by someone other than themselves. I remembered all the fun I had creating my own imaginary worlds with my Barbies and my sketchbook and I wanted them to have the satisfaction and fun of doing that. For years they did just that, with their dollhouse and legos and blocks.

Under pressure, I gave in. I'm sorry I did. They have hardly touched the dollhouse or the blocks or the legos since Christmas.

Then I saw the video below. It restored my convictions. I'll be showing it to my kids as soon as they get home from school. And then I'll put some limits on the iPod usage, because things like this don't happen when you are busy playing Angry Birds or Fruit Ninja or Words With Friends.

What the imagination can do: Caine's Arcade.

Wednesday, April 4, 2012

The Other Shoe

Mom and Dad had been getting settled in to their new place. Dad had been futzing around, finding the bank and checking out the wine department at the grocery store across the street. They were enjoying meals cooked by someone else, hanging pictures and generally relaxing. My girls made themselves at home there, even meeting some of the other residents over the puzzle table in the library. Me? I enjoyed driving 3 miles each way to see them, instead of 98!

Dad's leg had been bothering him for the past few weeks. He had picked up a knee brace, but it didn't seem to help much. It wasn't bad enough to keep him and Mom from enjoying a concert, happy hour or a little drama production, but enough that he resorted to using a cane. He mentioned it to his new doctor on his first visit, about a week after they had moved. She looked it over and prescribed total rest, alternating ice and heat and some Tylenol. If it didn't improve quickly, he was to call her back. It got bad enough over the next couple of days that he made another appointment for the upcoming Saturday morning, February 11. She planned to do an x-ray and maybe an ultrasound.

Like many men of his generation (my Dad's a WWII vet), Dad is pretty tough. He doesn't complain much and even when he does, it is tempered by his glass-half-full outlook on life. He was so happy to be done with his cancer treatment. He was proud of the glowing reports from his doctors about how well he had done. The next PET scan was scheduled for April. He wanted to get his leg fixed up so he could get back to the cardiac rehab/workout routine he had done so faithfully since his triple by-pass in 2000. Once he could do that again, life would be back to normal. Or at least his "new" normal.

At 5:19 a.m. that Saturday, I got the call.

"Hello? Ms. Pauken? This is Nancy at The Weils. I'm calling about your father. He's had a fall. It looks like he may have broken something."

"We have called the ambulance to take him to the hospital. They should be here in a few minutes."

"Okay", I mumbled, "thanks for calling. Which hospital?"

I jumped out of bed, brushed my teeth and as I was brushing, the phone rang again.

"This is Nancy again. Your mother wants to go in the ambulance with your dad, but she can't because of her walker."

Of course. The medics need to be taking care of him, not her.

"Okay, we'll get someone over to stay with her. Please tell her to sit tight."

I called my brother,who's about 45 minutes away. I filled him in and since I was already up and dressed, I told him I'd head to the hospital. Would he please go to the apartment and stay with Mom until we knew what Dad's status was?

"Of course."

In the meantime, my sweet Hombre got up, dressed and headed out shortly after I did, to stay with Mom until my brother got there. The girls were still sleeping. There was leftover coffee in the pot that I microwaved and poured into a travel mug. I grabbed a banana and a granola bar and hit the road. It was snowing; big, feathery flakes.

The emergency room was deserted when I arrived. There were two young nurses behind the reception window, chatting, and a lone hooded woman slumped in a chair.

"No, he hasn't arrived yet.Once he is in and settled, we'll let you go back and be with him."

They went back to their magazine or whatever it was they were poring over together, without a second glance at me.

I walked to the outside window, watching for the ambulance. Something that looked like dried vomit crusted the floor near a row of chairs. It was at odds with the new-ish, sleek room.  The slumped woman looked miserable. She was called back. While I waited, I called my other siblings and told them (or their answering machines) what had happened and where I was. I paced, watching out the window for the flashing lights of an arriving squad. All I could think of was the pain my father must be in and my mother's confusion.

Another woman arrived. She looked to be in her late twenties. Heavy-set with badly dyed hair, she took an aggressive stance at the window before the two cute young nurses.

"I have a scratched cornea. I got in a fight with my mother last night."

Of course she sat down right near where I stood. I didn't want to talk to a stranger. I was in no mood for small talk, yet she began to babble about the weather: too energetically, too enthusiastically. I wondered what she was on. Red flashing lights caught my eye. An ambulance pulled up outside. Through the frosted glass, I could not see who was brought out of it, yet I knew it was my Dad.

I turned back to the intake window. A man was there, telling his tale of woe. When he stepped away, I told the now lone nurse that I thought my Dad was here. Could I go back?

"We'll get you when you can come back," she said.

"He's really hard of hearing. I'm sure he probably doesn't have his hearing aids in."

"We'll let you know when you can go back."

I retreated back into the room, the rows of chairs empty except for the new man and Crazy Hair Woman. I paced. Another woman came in; in obvious discomfort. "UTI," I thought to myself, based upon how she walked and sat so gingerly.

The minutes dripped by. I paced. I tried again to catch the eye of the nurses at the window, who were decisively ignoring me, like Queen Bees at the "popular" table in a high school cafeteria. I considered going back into the examination area without permission but realized that my being escorted from the ER by the police would not help anyone. I hate feeling powerless more than just about anything.

A door opened and one of the nurses summoned me.

"He's in exam room number 10. You can go back."

I entered cautiously, not sure what to expect. My dad was lying there, in his shorty pajamas, on a bunched-up yellow towel,  gripping the side rails of the gurney tightly, his face pale, left leg bent and his right leg splayed at such an unnatural angle that it made my stomach tighten just to look at it.


"Hi, Dad. How are you doing?"

He grabbed my hand.

"I've never had pain like this. I don't mean to complain. I got up to use the restroom and my leg just buckled underneath me. I could tell right away it was broken. It hurt so bad when I was laying there, I prayed I could just pass out."

"Oh, Dad. Have they given you anything?"

"I don't know. I think so."

"Let me get a nurse and see if they can't give you something for pain."

He gripped my hand harder. "Don't leave me."

"I won't; let's find the call button."

Just then, he was seized by a spasm that caused him to lift up off the bed and cry out.  My stomach lurched again.

A voice came out of the handset, "This is the nurse, what do you need?"

"My Dad is in severe pain. Can you give him something for it?"

"I'll see if I can give him anything."

A few minutes later, a nurse came in with a syringe.

"I gave him half a dose of dilaudid when he got here; I'll give him the other half now."

She turned to Dad,

"Sir, are you in pain?"

"Yes. Terrible pain," he said.

"How would you rate it on a scale of one to ten, one being the least and ten being the worst?"

He grimaced. "Fifteen."

She depressed the plunger. I prayed silently, to whom I am not sure, for relief for him. I had never seen such agony.

His whole body remained clenched, waiting for the next muscle spasm to occur.

"Is anyone with Mom?" he asked.

"Got it covered, Dad. Kevin is there now and Pat is on his way over."

"I hate that I had to get you out of bed on a Saturday morning like this. Where are your girls?"

"In bed. They are fine. They know where we are."

"I hate doing this to you."

"You are not doing anything to me. This is what family is for. I'm glad I am able to be here. Don't worry about that, okay?"

"Well, I do worry about it."

"Well, don't," I smiled.

He gripped my hand, and then another of the muscle spasms took over.

We waited, together, through many of these episodes, wondering what was coming next and seeing almost no one. It was eerily quiet in the tiny room. He said they had drawn blood right after he got there, but that was all. He had not seen a doctor.

A frail looking woman came in and announced that she would be taking him for x-rays. Dad looked visibly concerned.

"I don't think I can move."

I cautioned her, "He is in a tremendous amount of pain. Please be careful with him, okay?"

She nodded, released the brakes on the gurney, grabbed onto the IV pole and wheeled him away.

"I'll be here waiting for you, Dad."

My younger sister called; she was on her way from Columbus. An older sister called. She and a brother were driving together from West Virginia. I got a cup of coffee from the nurses' station. I played Words With Friends. My brother called from Mom and Dad's apartment. She was okay, just worried and confused. They would stay there until Dad was moved to a room; the emergency room was no place for Mom.

I called my girls. Yesterday was Anna's birthday and we were supposed to go get her ears pierced today. It would have to wait, I explained.

"We will go, honey, just not today. I love you. Papa will be okay."

Finally, Dad was back, looking ashen.

"Dad, are you hurting?"

He nodded, not able to speak.

I pressed the call button. A different nurse appeared.

"He is still in very bad pain. Is there anything you can give him?"

She returned with a syringe.

"This should help."

"I hope so, " I said. "Thank you. Do you have any idea when we might see a doctor or have some kind of plan?"

"The x-rays have to be read and then they will let you know."

She disappeared and we were left, again, to ourselves.

Dad gripped my hand. "I am so glad you are here with me."

"Me, too. This is not the kind of thing you want to have to go through alone, that's for sure."

Some time later, a man came in, dressed in scrubs.

"I'm Dr. S_____, the orthopedic surgeon. His leg is broken. It's a clean break, but we will need to put in a rod and hold it in place with pins. We have scheduled surgery for tomorrow morning, because he has to be cleared by medical."

He raised the sheet and took a very brief look. He removed a pen from his pocket and initialed Dad's leg, on the upper thigh, just above where the break looked to be. Dad winced as he did so.

"Any questions?"

Dad wanted to know where he went to medical school and how many of these types of surgeries he had done; I wanted to know what was involved in being "cleared by medical". He seemed to be annoyed that we asked anything at all.

He left and the nurse reappeared.

"You will be admitted as soon as a room is ready." It was about 10:30 a.m.

I texted the news to my family and sat back to wait. And wait. And wait. And wait.

Around 1:30, they moved him to a room. He was still in agonizing pain. I had to leave the room when they moved him from gurney to bed. My younger sister, a nurse, arrived. She spoke to the nurses about pain control, in their own language. The surgeon had ordered morphine, but it wasn't cutting it. They got the surgeon on the phone. Since I had already met him, I took the receiver. He was abrupt with me. Rude, even.

"I ordered morphine for him."

"Yes, I know, but it's not working. He is having these muscle spasms that are lifting him off the bed, they are so bad. He is miserable."

"Fractures are painful."

"Yes, but he's 84 years old and you aren't doing the surgery until morning; can't you give him something else?"

"I'll see what I can do, but I already ordered morphine."

I seethed. "I would appreciate it if you could try something else."

Hours went by and there was no contact by the "medical" that was supposed to clear him. My brother and sister from West Virginia arrived. My brother arrived with my Mom. We paced. We talked and ranted among ourselves as Dad continued to writhe in pain. The nurses made repeated calls to the "Hospitalist", the medical doctor who would manage his care. She kept saying she was on her way but she never arrived.

Two of us went to find an ombudsman.

"None on duty on the weekend," we were told.

(Must be because things run so smoothly then, huh?)

"I can put you through to the nursing supervisor," the information desk lady said.

"That would be helpful."

The nursing supervisor was familiar with the situation, she said. She had been in communication with the nurses and there was really nothing she could do. It was up to the medical doctor to evaluate him.

It was now close to 5 p.m. My mood had soured considerably and what little tact I possess was long since gone. We returned to the floor and asked the nurses to get the "hospitalist" on the phone. First my brother spoke to her, asking her to please come and evaluate our Dad. She was apparently pushing back, because he handed the phone to me in frustration.

A cadre of nurses gathered around as I raised my voice and said, "We have been at this god-forsaken hospital since 6 o'clock this morning and no doctor has examined him! He is in excruciating pain and if he weren't we would have been out of here hours ago! In the time you have been on the phone, you could have been up here already!"

Do you remember Terms of Endearment? When Aurora goes after the nurses to give her daughter, who is dying of leukemia, her pain medicine? That was me.

At 5:30, the doctor finally appeared, full of CYA prattle, which none of us wanted to hear.  She actually examined my Dad and took a history. We expressed our displeasure with Dr. S____, the orthopedic surgeon. She said we were entitled to a second opinion, if we wanted one. We did. She called in a favor from a friend, who said he would come down and talk with us. She got the pain management doc on the phone and he changed up the pain medications. At last, things seemed to be moving in the right direction, although Dad still lay upon the pajamas that had been cut off him and the wrinkled yellow towel that the medics had used to lift him from the floor at 5:30 that morning.

At 7:15, Dr. H____ came to the room for our second opinion. He spent some time talking to Dad, who was finally getting some relief from the pain. He fielded questions from all of us, although he couldn't tell us why the surgery had to wait until morning. No one could. He said Dr. S____ was a "technically excellent" surgeon, who got good results. If we switched surgeons at this time, Dad would be bumped from his time slot on the surgery schedule.

He offered to show us the x-rays and we eagerly crowded around the monitor. It was ugly. The femur was broken jaggedly, and had dislocated so that one section was alongside but at an angle to the other.

"It's clearly a pathological fracture, " he said.

"A what?"

"A pathological fracture. Cancer. His lung cancer metastasized to the bone and weakened it, which caused it to break. See? You can see it very clearly right here." He pointed to a shadowy area on the screen.

"It was probably broken before he fell. Didn't Dr. S____ share that with you?"

No; no, he had not.

At once, our loquacious group was silent.