Grandma H's First Week With Us

We are finally home! Arrived last Wednesday evening to be exact. And let me tell you, for me to say “home sweet home” is an understatement. While waiting for Mom (aka Grandma H) to get better, I literally lived out of a suitcase for almost a month. Furthermore, I slept on a hospital cot for about two and a half weeks. Needless to say, I am thrilled that all of the unpleasant events are in the past!

Now, there’s a new adventure in the mix. My family size increased by one. We are happy that Grandma H is here with us. But we’re also still trying to figure out what her likes and dislikes are. It’s been difficult because her speech is still impaired and her brain is still healing.

In a nutshell, here’s what our new adventure has been like since Grandma H has been with us:

Wednesday, January 1^st~ Got home late, had a quick meal and tried to get everyone ready for bed. My husband brought a bed-set downstairs to the living room for Grandma H so she could have something soft and comfortable to sleep in. Well, neither she nor I got any sleep the entire night. She refused to lie down and sat there in bed until she dozed off. When awakened, she yelled for assistance to the bathroom. A majority of the time, she really didn’t need to go; she just sat there. When back in bed, she didn’t sleep. Just sat there and yelled every hour or so. I’m surprised there weren’t any cops at our door during the wee hours of the night from all that yelling and screaming.

Thursday, January 2^nd~ Around 8 a.m. I went downstairs and found Grandma H sitting on the floor near the kitchen. Somehow she had manage to utilize her good side (left arm and leg) to get off the bed and maneuvered her way to the kitchen. When I asked what she was doing out of bed, her response—“I was hungry.” Immediately I checked to see if she was injured or sustained any broken body parts. She said she wasn’t hurt from the event. Thank goodness!

During the day Grandma H took catnaps. However, at night she would stay up entire yelling and screaming. Frequent trips to the bathroom were pretty much similar to the first night (January 1^st); she just sat there.

Friday, Saturday and Sunday were almost identical to the events that took place on January 2^nd.  Even with an over-the-counter sleep aid pill, Grandma H refused to rest. It’s like she's immune to the sleeping pill. It was obvious that by the end of the week I was feeling pretty much like a walking zombie. I’m so glad that my husband was able to pick up the pieces, such as made dinner and cared for M (our daughter). On a side note, I did try to squeeze in some speech therapy by helping her identify kitchen items, such as cup, spoon, fork, ect. Grandma H tried her best to pronounce them correctly. However, we have a long way to go.

As some of you may already know, taking care of an elderly (and physically disabled) family member is HARD WORK! Especially when you’re not sure what they want, and they themselves don’t really know what they want. So, at this point, I’m just trying to figure out what makes Grandma H comfortable and for her to sleep thru the night. We love her and want to see her happy. In addition, we'd like to see Grandma H get back to her normal self again. That's our ultimate goal.

Mom's Rehab Update, Week Four

Last week, each of the therapists wanted me to get more involved with Mom's rehab care. Getting hands on training will help me know what I need to do when we're at home. In other words, I've been working with Mom on her speech, occupational and physical developments. And will continue to do so until Mom can completely do things on her own; which in this case, will take awhile for complete rehab, if that.

Here's what I've been assigned to do:

Speech Therapy-- Decide what Mom need to work on the most. For example, should we start the session with counting numerically, or would looking at pictures of household items (and try to trigger her memory) be more productive?

Occupational Therapy-- Assist Mom with grooming and with each of her meals. She is able to feed herself. All I would need to do is place food items and plate/bowl in front of her so she can reach them. Remember not to do everything for her, but help her when she needs it.The goal is to continue to get Mom to some level of independence so she doesn't feel helpless. 

Physical Therapy-- Do arm and leg stretches several times a day. Help Mom get in/out of bed, as well as get in/out of wheelchair. I would also need to assist Mom when she needs to go "potty."

I will admit that some of these tasks are tough. What makes it even more difficult is the "language barrier." Meaning, I can understand maybe 60% of what Mom says. Even then, there have been times when I had to really listen and think about what she had said. Furthermore, I'm not sure how much Mom truly understands me (or anyone else) when she is given directions. So for now, its more of a guessing game (including body language and hand gestures) until Mom can understand and speak clearly. Tough days ahead for sure!

When I Was an Interpreter

Communication can be very difficult and frustrating for foreigners who immigrates to the United States later in life, and unable to grasp the ability to learn the English language.  My mother is a prime example.  She came to the United States while in her mid-forties. No matter how hard she tried, she just could not hone down the English language. During my youth (which took place after I was educated enough to be bilingual in both the Khmer and English language), I remember I had to translate for my mother pretty much everywhere we went. At the time, I thought the task was unpleasant and would try to get out of it whenever possible. As luck would have it, I was not very successful.

I remember I had a strong aversion to being the interpreter for my mother. I remember how I absolutely hated it when I couldn't find the right word-for-word translation. Anyone who speaks more than one language knows what I'm talking about; there's rarely an exact word-for-word translation. I remember being totally irritated by the daunting task because all I wanted to do was be a kid and hang out with my friends. In retrospect, I'm not sure how my mother would have gotten by without an interpreter. She knew only a few basic words of English (and still does to this day). One can only say, "Hello. I'm fine," and "thank you"  so many times in a conversation.

Looking back, I'm glad that I was able to be my mother's interpreter even when I drudged the task. I can't imagine being in a foreign country and not able to communicate. Now, as an adult, I won't hesitate to help others who are in similar situation as my mother.  However, with that being said, I will always be glad to see a professional interpreter because more likely than not, I will end up adding new words to my ever growing word bank. In my opinion, it never hurts to increase one's vocabulary, especially when translating from one language to another.

(Read my other post, The Importance of Adequate Translation, and watch a short comedy video).

Mom's Rehab Update, Week Three

Good news! Mom's discharge date is set for January 1, 2014. Yay! We are excited and hope things will work out smoothly for everyone involved.

This week's therapies are pretty much similar to last week's. So, I'm going to just include short notes of activities during each session.

Speech Therapy-- Worked one syllable words, identified objects from a flashcard, practiced counting numerically, practiced days of the week, practiced moving her tongue up and down.

Occupational Therapy-- Worked on tasks that she will eventually do daily, such as get dressed, shower (with assistance), comb hair, etc. Also worked on releasing muscle tension in her right arm and stretching/straightening the fingers. OT also did a short session that involved electro convulsion therapy on the right arm ( there were some muscle movements in knuckle joints but not so much in the upper arm).

Physical Therapy-- Worked on transferring from bed to wheelchair, and vice versa. Did strengthening of the leg exercises (leg lifts and bicycling), scooting left and right, standing for about a minute at a time, walking across the parallel bars with assistance, and practiced standing up on her own.

 Along with working on her movements and speech, learning to move around in her wheelchair is another task. So, during her free time, we would go out into the hallways and have her practice "driving" her wheelchair. 

Overall, things are looking good for Mom. Just a little less than two weeks and we can head home!

Mom's Rehab Update, Week Two

Mom is continuing to improve on a daily basis.  With practice and encouragement, she has become more independent.  For instance, she's been able to get most of the food onto the spoon and into her mouth, reach longer to grab something, and push the "call" button when she needs assistance from the RN and CNAs.

Mom have also been able to maneuver her working arm (left arm) and get herself partially dressed, hold onto a bedrail so she could push herself from side to side with ease, and move her wheelchair backward and forward (even though right now all she's been able to do is go in circles with it). In addition, she is able to sit up in bed for longer period of time without any assistance. Also, by just looking into the mirror in front of her, she knows when to wipe away any food particle that land on her chin. And she does a pretty good job at it the first time around.

The therapists suggest we continue to work with Mom on self-care, such as getting dressed, combing her hair, feeding herself, etc. Also, we should continue with helping her identify objects and improve her speech.  A method that the Speech Therapist suggested was to have only one person speak slowly to Mom, as well as have Mom speak slowly to us.  Furthermore, when having a conversation with Mom, try having her finish the sentence.  For example, say something like "My name is ..." or " His name is...".

Reflecting back on therapy sessions and whatnot this past week, I believe Mom have made great improvement. Not only has she been able to pronounce some words clearer than last week, but she is more aware of what is expected of her, in terms of feeding herself and taking medications.  In short, she is getting the hang of things. I think consistency in daily routine is key to her moving one step closer to a quick recovery

Mom's First Three Days at Rehab

Last Friday (December 6) was Mom's first day at the rehab center.  She let it be known that she's going to be difficult to work with; stubborn and opinionated. But I have been told that stroke victims tend to be difficult and grumpy.

The first night an RN placed Mom's legs in compression cuffs to prevent clogged arteries in the leg.  An hour later, she took them off, with only one hand. Then she demanded that her ankle sock and support hose be taken off.

The second day a CNA combed her hair, detangled it, and tied it in a ponytail. She looked great. Clean and refreshed. But that did not last very long. For as long as I could remember Mom have always preferred her hair down and untied.  So, off came the hair tie.  Now I see where my daughter gets it from.

Breakfast usually consist of cream of rice with brown sugar, pureed omelet, pureed banana, and applesauce. 

Lunch usually consist of mashed potatoes with gravy, pureed vegetable (peas or carrots), pureed fruit (banana or pear), and/or applesauce. Sometime pureed meat is included (which is usually beef or pork).

Dinner is very similar to lunch menu items. It usually consist of pureed beef, pork or turkey, and sometime paired with mashed potatoes and gravy, pureed vegetable ( peas or carrots), and pureed fruit (banana or pear), and/or applesauce. 

Drinks that accompanied each meal were usually water, orange juice and/or apple juice.  However,  a recent lab result showed low sodium in Mom's system. So, no more juices; only chicken and beef broth, and some water.

Saturday, December 7... Due to low sodium in her body, the doctor ordered an IV, thinking it would be the easiest method for increasing Mom's sodium level.  But, it turned out that she did not like it, so she made a HUGE fuss, to put it nicely.  After awhile the nurse called the doctor, and the IV got taken out.  Obviously, actions of "anger and non-contentment" is something that can be understood across all nationalities. In other words, you don't have to speak the same language to know when someone is upset.

REHABILITATION UPDATE ( for December 6-8 )

The Occupational Therapist (OT) did some movement evaluation, which included leg and arm stretches. Therapy exercises have included re-learning how to shower, get dress,  comb/brush hair, stand, and walk.

The Speech Therapist (SP) evaluated her eating, chewing, swallowing, communication, and of course, speaking abilities. SP also worked on counting, recognizing and identifying objects, as well as understanding what they are used for.  It took at least three tries before Mom could count numerically. She managed to count up to number five; did it once with a combination of both English and Khmer. And then once again in only Khmer.  For the most part Mom can perform the functions. 

SP recommendation: work with Mom on a daily basis by encouraging her to move her tongue around the mouth for increased muscle strength, encourage her to smile often to work on facial muscle, and lastly, when she feed herself, put a mirror in front of her so she could see the food in her mouth while "chewing" and know that she needs to work on the right side of her mouth.

The Physical Therapist (PT) worked on mobility.  She had Mom do ankle and leg movements, as well as stand up and use the parallel bars for support. The PT said "she's a hard worker."

Overall, Mom has made progress, considering it was only three days of rehabilitation therapy. This week will be a full six days of SP, OT, and PT. I am hoping for more progress. Despite her disability and condition, Mom can be cherry and upbeat most of the time. But just like anyone who has suffered from a stroke and unable to communicate effectively (with a language barrier at that), she does have her moments.

Tragic News

On Monday morning I received news that my mother had suffered from a stroke.

I thought I was prepared for any bad news. But that was not the case. I was actually in shock and it took a little while for everything to sink in. When it finally sunk in, I was in tears. I felt lost and could not focus on anything.  There were many tasks that day that I had left unfinished. When my husband got home from school that afternoon, I informed him of what happened. Minutes later, he was looking for airline flights for me, and I flew out the next day.

According to my older brother, the terrible event took place around 4 a.m. He was asleep but thought he heard a faint cry for help coming from my mother's room. He quickly got up to check, and found her body limp, but her hands held tight onto the door knob. Medics were immediately called, and they arrived soon after.

My brother and sister-in-law never left my mother's side. They stayed with her until I arrived. And have been back to visit everyday since. My nieces and nephews, and extended family members were also there, for support. They are awesome like that. 

According to the neurologist, my mother had an ischemic stroke. The right side of her body is paralyzed. Her speech is majorly impaired, thus making it difficult to understand her. However, for the most part, she is alert and aware of her surroundings.

Today is Thursday, December 5th. She is now at the inpatient rehab facility, which is part of the hospital. Physical therapy will start tomorrow. Right now, the goal is to have physical, occupational, and speech therapy one hour a day, six days a week for the next three or four weeks.

I am amazed at how fast my mother is progressing.  I believe this was made possible through the power of love and prayer from friends and family. On behalf of my family, especially my mother, I would like to thank everyone for thinking of us and remembering us in your thoughts and prayers. I will try to keep everyone updated on her progress.