Reflections on a Sunset

We spent yesterday at Grandpa's house, cleaning and painting and preparing. The doctors wanted us to have a Plan in place last week, anticipating a possible release date of Friday. We're nowhere near ready, but we're making some headway against the decades of accumulated stuff.

The Plan has been that Grandpa would go home, but not be left alone, day or night. A rough schedule of who takes what shift is in the works. It won't necessarily be easy, but it's family, so it will happen. Somehow.

Grandpa had been doing better on Friday, according to my uncle. He ate most of his food. He was talkative. He even wanted to walk around before going to bed - an activity he hasn't volunteered to do for years. It looked like he'd bounced back again.

My aunt stopped by the house yesterday after visiting Grandpa. He slept through most of her visit - not a true and restful sleep, but an exhausted, lingering insensibility. Even when he opened his eyes, he wasn't there, foundered in his own fog.

He's also been having other setbacks. The pneumonia tried to return; apparently, it's caused by him being unable to swallow properly and inhaling bits of food or water. The rehab center was supposed to be giving him thickened liquid to help, but not every order at this place is necessarily carried out with due efficiency or follow-through (as we discovered during the catheter/renal shutdown incident.)

It's starting to look like he might not come home after all. The balance of good days, days when he could be at home with a little supervision, and his bad days, days when he needs specialized eyes and hands nearby constantly, seems to be tilting towards the latter. All of our preparations may be not to bring him home, but to make Grandpa's home sellable.

He's bounced back before, but as days stretch to weeks, as nearly a full month has elapsed, those bounces look shorter and smaller, a ball running out of energy to rebound as it settles slowly towards a standstill. He's 92 years old - eight years shy of a full century - but watching those years catch up, his life wear thin, down to this last threadbare stretch... it may be inevitable, but it's still unpleasant.

We drove home under one of the strangest sunsets we've seen in years. The slanting sun painted the world in bright golden light, while a flat blue-gray sky framed the scenery. It looked more like a sunrise. It was oddly beautiful, enough so that we pulled over on the way home twice to snap pictures, to try to capture the peculiarity of it before it vanished to a memory.

On camera, at least, sunsets - and people - can last.

The Bumblebee

Today, we went over to Grandpa's house to continue cleaning up spare rooms; if he comes home, he'll need live-in help of some sort, and if he doesn't come home the house needs cleaning anyway. When we got there, I saw a bumblebee of significant size - not the largest I'd seen, but decently big - lying on the windowsill next to a vase of silk tulips. Nobody had been in the house for a day; it must have come in then and, having failed to find nectar in the artificial flowers, succumbed after beating itself against the glass.

Not a great sign, given Grandpa's continued downward slide.

He hasn't eaten voluntarily in three days. He rocks with nausea and stomach pain. Yet the staff still declares he's eating well. They even asked him if he was fine; he said yes, as he often does to any question put to him, especially questions he doesn't want to answer. So he must be fine. Never mind that he's shaking with hypoglycemia, that he can barely swallow what food my uncle coaxes him to try. Never mind that everyone who sits near him at meals knows he's falling asleep in his food and hasn't eaten. Never mind that one glance can tell you he's sick.

The whole family is getting exceptionally hacked off by the way the staff keeps brushing us off. Something's clearly wrong. He probably needs to go back to the hospital. At the very least, he needs someone to pay attention. This is not the same man who was doing so well in therapy. This isn't even the same man who left the hospital to begin with. This is a sick man, maybe even a dying man.

We'd been cleaning for a few hours when I heard something buzzing in the living room window. It was a bumblebee of significant size. A look at the windowsill revealed that the immobile, seemingly dead bee was no longer there. It had sprung back to life, and was now doing its best to escape the flowerless confines of Grandpa's house. I helped it out the door, where it buzzed about angrily for a moment before taking off.

I can only hope Grandpa will be as lucky as that bumblebee...

TUESDAY UPDATE: Mom went to see Grandpa today. The other day, my uncle got in touch with a social worker who would see to it that Something Was Done, so she wanted to see if they were following through. She called from the rehab center a while ago. Grandpa's on his way back to the hospital proper for a urology problem. So, maybe they'll figure out what the heck's wrong with him and actually Do Something About It. (Seriously, one of the chief reasons we went with this rehab center was the fact that they had a hospital right below them if something went wrong... why did it take something this bad to make them actually take advantage of that proximity?)
UPDATE OF THE UPDATE: Grandpa's back in the rehab center after an excursion to the ER at the original hospital. (Turns out they don't have a urologist at the ER in the rehab building basement. I thought urology issues were pretty common problems, especially when you're dealing with older men, but whatever...) Anyway, they finally got a catheter in and drained him; it'll be a couple weeks before they can figure out if he'll need one permanently, or if there's any permanent kidney damage from the backup. Yes, this has been coming on for at least 24 hours, probably since he went off his food to begin with. Grandpa was apparently in so much pain he was crying last night - and this is a man who used to calmly sew up his own fingers if he cut them too deeply. Evidently the rehab staff was much more helpful today after complaints were made over their heads... guess you really do have to be the squeaky wheel, after all. So, it's been a long and stressful day, but it's over now. I hope.

Intermission with Moon

Just because it's been danged depressing around here lately...

Setbacks

When last I posted, Grandpa was doing pretty good in rehab.

On Monday, he started coming down with a bug.

Tuesday, he seemed worse; his mind was wandering between dream and reality, and he was coughing stuff up. But he still seemed decently upbeat overall.

On Wednesday, he complained to my uncle about an ache in his lung.

Fast-forward over Thursday, and Friday an X-ray showed fluid in his lung. Probably pneumonia. He's back to sleeping almost all day and showing no interest in food.

The rehab center he's in has an ER on the first floor, so he's in the right place. I'm hoping this is just a minor setback. So is the rest of the family.

Dang it...

SATURDAY UPDATE: The news continues to be Not Good. Apparently, the rehab center now claims that he's going to need 24/7 care regardless, and that further therapy probably won't help. This, after telling us all week how well he's been doing in therapy... Either they've decided that the lingering mental issues are insurmountable, or someone's been bald-face lying to us.
And the X-rays continue to show Not Good Things. Something about a mass, likely fluid, nearish the heart and lungs... They'll do another X-ray on Monday.
On the plus side, even though he still had to be coaxed into eating, he was evidently more lucid today.
I really wish we'd get a straight story out of these people, so we know what the heck is going on.

What a Difference a Day Makes

Yesterday was Grandpa's first full day at the rehabilitation center. My uncle spent most of it with him, seeing how he settled in. Grandpa kept wanting to go home. He didn't like the food. He didn't think the therapy was going to help. He started fishing around for the answers they wanted to hear, in an effort to secure his release. (I'm sure they've heard every trick in the book, at this place - the proof's still in the pudding, and you can't fake whether or not you can walk on your own two feet.)

Today, Mom and Dad visited him during lunch. He was smiling. He was happy. He liked the food now. He'd started talking to people, and he was doing so many things. He stayed awake for his entire meal - which he hasn't done reliably since before Xmas. He still has some short-term memory issues, but he had them before the Killer Furnace Incident. (To be perfectly honest, I'm not seeing a real difference between the Before and After Grandpas at this point - which is really amazing, considering how close to death he was, and how "off" he was when I saw him in the hospital.)

Maybe it's because he knows he's going home eventually - it's a "when" not an "if." Maybe it's being made to do something other than sit and rot in a recliner all day while other people did everything for him. Maybe it's being around people, in a new place. But he's starting to act more like the older Grandpa, the one who had some age-relating fuzzing of the brain but who still enjoyed doing things, who still thought, who still wanted to be more than deadweight in his own living room.

So, maybe he needed this all along... or something like this, without the nearly-dead part.

The Great Library Sorter Race

For many years (well, four), I worked at the only library system in the country with a complete AMH setup. Then the Queens library in New York City got one, too.

It's been unofficial war ever since.

We'd set a record hour for items processed. They'd set a record hour. We'd pull ahead. They'd get further ahead.

To determine once and for all who was the fastest sorter, us or them, a contest was proposed, to be held today. It started, evidently, as a little informal contest between bosses. Somehow, the stakes were raised. The AMH system manufacturer offered a trophy. The losers had to send the winners a prize. Soon, it seemed like everyone and their brother was leaning over our shoulders.

Normally, I don't work Tuesdays, but there was an opening, so I took it. So I found myself in on the big event.

How did we do?

We set a new hourly record for our facility, north of 12,000 items in a single hour.

We also set a new hourly record for the NYC facility... by fewer than 150 items.

In other words: we won, if by the proverbial skin of our teeth.

And not only did we win (in spite of snarky sorter software that fouled up our second hour), but we finished over an hour early. Even with an hour-plus lunch break. And we got celebratory cupcakes before we left.

Considering how cruddy the past week has been, that cupcake tasted especially sweet.

--

Okay, for all none of you following along on the Grandpa Saga, he was discharged from the hospital this afternoon. The people at the hospital are all amazed at how far he's come; he's still not 100%, but he's surprisingly close to his mental state before the Killer Furnace Incident. Now, he's at a rehab facility. I was at work during the transfer, but apparently he was excited: the facility is much closer to home, and he seems to understand that it's not a permanent, nursing-home situation. We don't know how much care he'll need long-term, but this place will assess where he is mentally and physically, and do its level best to get him as independent as possible again. I think the family's pretty much agreed that he can't be left alone all day anymore, though. We were pushing our luck before this, to be perfectly honest. Hopefully he'll just need someone to be with him during the day instead of 24-hour care... and hopefully he'll be able to go back home. But all we can do is take it one day at a time. The ball's really in his court now...

Field Report

I'm sitting in a designated "Family Waiting Area" at the hospital where Grandpa is staying. Since I am family, and I am waiting, it seems like the appropriate place to be. There's a fireplace in the corner, currently dark, and a small collection of chairs around a cheap-looking coffee table on a greenish carpet, the kind of bland, institutional pattern one only sees in hospital waiting rooms and generic offices.

The Little Black Critter sits on a fake wood end table next to a gold-washed metal lamp. Behind me, smocked employees of indeterminate rank push large, rattling carts full of linens and unlabeled medical supplies. The occasional visitor or white-coated doctor wanders past, but otherwise the waiting area is empty save myself and my sister.

Guess there aren't any other families waiting around in this wing of the hospital.

Down a hallway and to the right, Grandpa sits in his new room. No longer considered a critical care patient, he was upgraded this morning to somewhat more pleasant accomodations, without the oxygen mask and other tangle of monitoring cords tethering him into bed. The man whom we met sitting in the chair looking out the window, however, is not Grandpa.

Not entirely.

He remembers family. He knows he's in a hospital, if prompted to tell a body where he is. But there's a glaze, a vagueness in his eyes, that can no longer be blamed on sedatives. His gaze roves the room, looking over familiar faces, and wanders back to his hands, where he picks at his bracelet, the bandage over an old IV line, the fringe of his gown or his hospital-issue blanket. The effort of thought, of focus, of stringing together meanings from words, tells in the prolonged delays between question and answer, the faint crease of his brow. He'll be better, he says, when he goes home. Is he going home today?

Not just yet, Grandpa.

But already his thoughts and his eyes wander elsewhere. To the past, to some distant cloudy place, where he watches the world float by from a chair, a source of only occasional interest. He still isn't clear on why he's here. At one time, he thought he'd had typhoid (likely connecting the word "heatstroke" to "fever.") At another, he thought his house had almost burned down... which didn't stop him from professing an interest to go back home. The home he wants to go back to, I'm afraid, no longer exists. It's the home of years gone past, a home where he was still the man he used to be, the deviser of ingenious solutions, the tinkerer, the instrument builder and lapidary hobbyist. That home was fading even before his furnace malfunctioned and landed him here. Now, it's gone forever, burned up by a 109 core temperature, total dehydration, and near death.

While he took a nap, we went to the cafeteria to grab some lunch. Thin-cut chicken fried steak with a country gravy full of more pepper than flavor, over a bland white lump of potato with a side of carrots and peas. There was talk about what to do next - where we should put him, how much needs cleaning out if we opt for the in-home care option, what the best source of reliable information would be.

By the time we'd returned to the room, Grandpa had woken. He had pulled out his IV, and was bleeding. Nurses were summoned to deal with the problem. Why had he pulled it out? No answer, save a puzzled glance at the people fluttering about him, for no reason he could readily recall.

And so my sister and I sit in the family waiting area while Mom and Dad sit with Grandpa. He's resting again, I'm told, his IV back in place. The nurses claim it's not uncommon for patients to pull lines out. Nothing to worry about.

Except the Grandpa I used to know wouldn't have done it.

In the corner of the cafe stands a large fountain, an indoor waterfall spilling into a rock pool. Beneath the rippling water, bright coins gleam against the stones, wishes cast in by patients, by family, perhaps even by staff. I should've tossed my own coin in to join them, but what I'm wishing for is beyond a penny's power to buy.

Bad Call

There's never a good time for a bad call.

Round about 6:40 this evening, the phone rang. This is not unusual; there seems to be an autodialer that enjoys annoying us in the evenings, no matter how many times it gets our answering machine. But this was not an autodialer. It was my uncle.

He was at Grandpa's house.

Sometime during the day, his old thermostat malfunctioned. Did he know it was malfunctioning? Had he felt chilled and turned the gauge up? Had he tried to call? We will probably never know; he's been losing his words, over the years, losing the focus needed to pick up a telephone and dial for help... if indeed he recognized that he needed help.

By the time my uncle stopped in after work, the entire house - including the basement - was about 100 degrees. Grandpa was lying in bed, panting, hardly coherent.

Heatstroke, the EMTs confirmed.

He's in the hospital now, being cooled down from a high core temp of 105 (CORRECTION: Evidently, we misheard. It wasn't 105. It was 109.) It's too soon to tell if there will be lasting brain damage, if he might develop pneumonia... if he has spent his last night in his own home.

Since they only want one relative at a time to see him, and since my uncle and aunt (and her husband) were already there, Mom opted to stay home unless called for now.

He's proven remarkably hardy in the past, so we're all hopeful that this isn't the end. Not yet. He was apparently twitching his feet and toes when they got him into the ER, which is a "good sign" according to the doctors. In the meantime, there's not much to do except keep an ear cocked for the phone to ring.

And hope that it's not another bad call.

WEDNESDAY UPDATE: This afternoon, right after work, I headed over with the family to see Grandpa in the hospital. He's still pretty out of it, but he opened his eyes now and again and was determined to get his oxygen mask off. Looks like he can move on both sides of his body, but it's still too soon to tell if he's lost anything else to heatstroke. He's doing much, much better than yesterday, though... evidently, he was down to brain-stem functioning. Probably less than an hour from actual death. In any event, it'll be a few days before he can go home, if it's determined that he can head home at all. We'll be inspecting the furnace and replacing the controller thermostat before then. (I proposed subjecting the faulty equipment to a sledgehammer retirement, but I expect my uncle will opt for more traditional removal methods.)

FRIDAY UPDATE: First, the Killer Furnace update. Evidently, the older model of thermostat in Grandpa's house had a little glitch: if the thermostat died, the furnace would run indefinitely. (Ours has died and our furnace just wouldn't kick on, but ours is newer.) So, even though the max thermostat setting was 99, the place actually got significantly warmer. Hence, the near-death. But it's Being Dealt With.
Now, the other update...
After a bad night, the hospital was forced to sedate him to keep him calm enough to stay in bed. Today, Grandpa was evidently doing Not So Great (TM). The drugs might explain some of it, but the doctors believe there is actual brain damage from the heatstroke. The upshot is that he can't live alone, possibly not ever again.
This will have to be Dealt With Soon...
Dang it...

SATURDAY UPDATE: According to relatives, he was doing better today, but still needs rehab at the least and alternate permanent housing at the worst. His short-term memory, never his strong suit these days, seems to be worse, and he's confused about why he's at the hospital, or if he's at the hospital at times. He's also being treated for pneumonia.