Aging

The older we get, the worse we look, feel, and - sometimes - act.  Pain is a factor, as is arthritis and loss of padding in the derriere.  Psychiatric problems can arise as a result of pain, making us cranky, irritable, and - sometimes - incoherent.  Recently, my 93-year-old father-in-law fell and hurt his lower left leg.  The emergency room physician who examined him looked at the x-ray, said nothing's broken, and sent him home.  Three days later, the leg was red and swollen.  Under duress, my father-in-law agreed to return to the emergency room where it was determined that he had a cellulitis infection - MRSA.  While in the medical wing of the hospital the doctors discovered that his kidneys function at 20% on a good day and that he has fairly advanced diabetes.  Tipping the scales at 120 pounds, my father-in-law had no appetite and seemed as if he was making a quick exit from this life.  The doctors ordered installation of a PICC line in order to medicate and nourish this increasingly frail elderly man.  Compounding his problems was the inability to pass urine, despite constantly feeling the urge to go.  So, a catheter was inserted into his penis to drain his bladder.

After a couple of days, his physical state seemed better but his mental state continued to deteriorate.  He asked repeatedly what was going on, who was in charge, why he was here, and why we thought he was sick.  On the day he was to be discharged from the hospital to a rehabilitation facility (next door), his nurse removed the PICC line and the catheter, to my dismay.  How, I wondered, was he going to receive his antibiotics, and did they really think that his appetite had magically returned?  Four hours later, after failing to pass urine (duh!), the catheter was reinstalled and he was transported to the rehab facility.

The first thing you see when entering this rehab facility is a large poster proclaiming their commitment to compassionate care for elderly clients.  My father-in-law saw very little of this compassion from the nursing staff.  We waited for hours before his nurse deigned to come into his room and meet him.  After we got him settled in for the night, or so we thought, my husband, mother-in-law, and I went home for some much needed sleep.  I arrived at ten the next morning to make sure he was OK and here's what I found:  a confused, depressed, distressed, lost soul who had been parked at the nurses' station so they "could keep an eye on him".   There wasn't a nurse in sight except for the occasional CNA who buzzed by on her way to do something other than acknowledge the existence of a clearly distressed and suffering gentleman.  The problem, they explained to me, was that he kept trying to get out of bed and walk around and they were afraid he was going to fall, so they had to put him in what amounts to a traffic island so that if he fell, someone might see him and put him back in the chair before any harm was done (i.e., a family member showed up and raised holy hell).  It took me two hours to calm him down but I failed to convince him that he was not being held prisoner.

Five hours later, the facility manager - intuiting that we were not happy with Dad's care - came and made nice with us.  Finally, we thought, he will get the attention he needs.  Nope.  The next morning I arrived and found him in a guest chair with his head banging into the glove dispenser and sharps disposal.  All someone had to do was move the chair five inches so his head wouldn't bang into those objects, but apparently this did not occur to anyone.  Again, it took me two hours to calm him down but he continued to insist that a nefarious plot was afoot and that I needed to be extremely careful lest I get caught in the web of deception.

I noticed that someone had left a stapled stack of papers on his table with a pencil.  It turned out to be a list of menus for the next two weeks which my distressed, depressed, demented father-in-law was expected to select from in order to plan his meals.  I did it for him because he was completely unable to do it for himself.  Again, I asked myself, has anyone here noticed that he is losing his mind?  Do they really think that he will be able to make food choices?  Have they not noticed that he eats nothing?  Moreover, we told everyone who would listen (and it seems we were talking to ourselves) that he was in extremely fragile shape and needed help with everything.  Their policy, we discovered, is to "get to know the patient" before intervening.  Excuse me?

Once I finished selecting his meals from the fourteen page menu I noticed that he was sliding off the chair and tried to lift him back up.  He told me that his testicles ("balls") were hurting and he was trying to find a position which was less uncomfortable.  I asked if he needed someone to help him adjust the position of his catheter and he said that he was in pain and that no one was paying attention.  To indicate how bad, he insisted that I, his daughter-in-law, look at his male parts!  Having no experience being a man, I could see that all parts were swollen and inflamed.  I called a nursing assistant in to look at the catheter.  She concluded that all he needed was a change of depends.  After an hour during which nothing happened, I sought out his nurse (who had not shown her face in the two hours I had been with him) and explained that he was in significant pain and that his penis and scrotum were inflamed.  A little while later, a nurse practitioner entered the room and examined my poor father-in-law's private parts.  She concluded that the catheter was "leaking" and someone needed to address that.  I explained that he was in increasing pain and needed to see a doctor.  She explained that she could make him an appointment but he wouldn't be seen for two or three days.  "Your other option," she said, "is to send him to the emergency room."

I have to say that I was incredulous.  Here we have a frail, infirm, very elderly man who has a history of infection and whose penis is looking severely infected and the nurse practitioner is acting like it was OK for him to wait until a doctor had an opening in his schedule instead of saying "get him to the emergency room, STAT!". If I were passive or stupid, my father-in-law would probably still be sitting in that room, dying from pain or infection.

This facility, "The Pavilion at Jupiter Medical Center" is considered one of the best.  One of my good friends who suffered severe head and body trauma from a car accident spent several months there and has almost completely recovered.  So why was my frail, demented, very ill, father-in-law neglected to the point that we had to have him readmitted to the hospital?  [Sidebar: he is not on the dole, so no one could claim he was a charity case.]  The answers point to a shocking attitude toward frail elderly people in America, that because they are at the end of their lives they do not need the same attention as a younger patient with a longer life expectancy.  It upset me tremendously because we are not trying to keep a dying man alive at any cost;  all we wanted was for him to be cared for with compassion and to have his discomforts addressed immediately, because he is old and fragile and he matters to us.

Long ago and far away, I worked for AARP when the headquarters building was on K Street in northwest Washington, DC.  In the 23 years since I worked there, in spite of tons of rhetoric and lobbying on the part of this mammoth organization, care for the elderly is still grossly inadequate.  My father-in-law has a wife, son, and daughter-in-law nearby who can advocate for him and still he received lousy treatment at a so-called rehabilitation facility.  All he needed was for someone in that facility to sit with him and hold his hand until a family member arrived.  Instead, he was left isolated in a strange place being "cared for" by people who couldn't have cared less.

AARP should get its priorities in order:  instead of selling insurance, they should be developing care standards for people who move from hospital to rehabilitation so that no one gets parked in the nurses' station or left with his head banging into the sharp's disposal container. There is no excuse for the shabby treatment this World War II veteran, entrepreneur, job-creator, philanthropist, husband and father received when he was at his most vulnerable.

Inertia

A body at rest tends to stay at rest.  The same applies to a brain, my brain anyway.  I go through these incredibly productive periods and then some force acts upon me and inertia sets in.  The force acting on me today is the horror of a massacre in an elementary school in a small town, far removed from the dangers of the big city.  As I try to wrap my head around what happened, I find myself in a state of paralysis because I see no end to the violence.

Crazy people do things like shoot up innocent children.  Why did the Newtown, Connecticut, shooter have access to so many powerful guns?  Because his mother owned them and apparently didn't keep them locked up even though her son who lived with her was mentally disturbed.  She supposedly kept the guns for her own protection.  Fat lot of good they did her.

The real problem, as I see it, is that we have an epidemic of mental illness in the United States of America.  Why is that?  The long answer is, it's complicated.  The short answer is that we are a fearful people and becoming more so.  We no longer have confidence that our law enforcement officers can protect us from the growing dangers threatening our well-being.  Lots of people, perfectly sane people, purchase guns to protect themselves.  The way they see it is that danger lurks around every corner, behind every door, up every tree, and so they keep a gun at the ready. I doubt that most of these guns are effective in preventing crimes, but I guess having them makes people feel better.

I do not advocate banning guns because that would just push the market for guns and ammo underground and create a whole new world of problems.  As far as I am concerned, people can have as many guns as they want AS LONG AS NOBODY GETS HURT.  So, how do we keep guns out of the wrong hands while allowing Americans to exercise their Second Amendment rights?  This may be the most important philosophical conversation we as a nation ever have because until something changes, more innocent people will be mowed down as they go about their lives, and it will happen with increasing frequency because the mental health crisis in our country gets worse every time a shooting occurs.

Adam Lanza was diagnosed with a form of autism called Asperger's Syndrom.  This did not cause his violent behavior per se.   It is quite likely that he was depressed, perhaps because of being bullied as a child at the school where he acted out his inner rage.  Lanza needed treatment -- medicine, therapy, a residential program, something -- but did not get it.  The responsibility for this likely rests with his mother who, given her own fondness for assault weapons, was probably not aware of the message that her hobby communicated to her disturbed son.

Some of my neighbors feel that there should be more guns, not fewer.  These same people are devout Christians of the born-again variety who spend countless hours in Bible-study and prayer.  I don't get it.  Jesus was supposed to have said that we should turn the other cheek rather than hit back.  Unless I am misinterpreting everything I ever heard in church and Sunday school, Jesus would probably be distressed that his followers brought their pistols to church, just in case. 

In the words of the great Pogo Possum, "we have met the enemy and he is us."

I Forget

When my children were little, they named me "Miss Forget" because they noticed that I had a hard time remembering things.  Like the saintly mother than I am, I laughed when they called me this because I was in no position to argue with them.  I frequently forgot lunches, appointments, playdates, essential items from the grocery store, and where I had put things during my occasional cleaning binges.  I would also forget things like Hubby's lifelong aversion to onions and follow a recipe to the letter only to have him eat a peanut butter and jelly sandwich for dinner.  I have come to realize that "forgetting" the onion problem was passive aggression on my part.  Those early years had their rocky moments.

The Operating Principal in our home was that anytime something went missing, Hubby and Daughters 1 & 2 would accuse me of throwing it away because to them cleaning meant tossing even though I was always extremely careful not to toss anything important, like a report card or math binder.  Cleaning binges being binges, after all, I goofed once in a while and threw the proverbial baby out with the bathwater.  Of all the things I inadvertently threw away, none was of particular importance or monetary value in the grand scheme of things, they were instead bits of clutter that had special meaning to their owners which I had failed to appreciate.  Every time this would happen, I would beat myself up for being an insensitive and overbearing matriarch, and proceed to empty out the trash bins while vainly searching for the missing objects, praying for God's mercy so that I could get out of the doghouse.  On a couple of occasions I did find the items in the trash, but most often they would be long gone.  My sins, however, were never thrown away:  they resided on a list which Hubby and Daughters 1 & 2 would recite from memory as proof that what they could not find I had obviously disposed of.  Unfortunately, I could never remember any of the times that I found the items they had accused me of throwing away, so for years I felt quite defenseless.

The other thing I did during my cleaning binges was to Organize the House and this involved finding a place for everything and putting everything in its place.  My three nearest and dearest compete with each other to be in the Packrat Hall of Fame to the point where they sometimes border on hoarding.  This upsets me because it is impossible to clean a cluttered house and when I am in a mood to clean, I let nothing stand in my way.  I have tried various methods of corralling the clutter such as boxing stuff up and storing it in the attic, basement, or garage to see how long it will be before anyone asks for their most precious scrap of paper or Pokemon eraser.  Once, after a box had sat undisturbed for three years, I looked through the contents and tossed it.  The very next day, Daughter #1 asked about that little rubber chicken she had gotten as a party favor in kindergarten which I had just found inside the box which the trash collectors had just picked up.  Of course I lied about it because if I hadn't looked in the box, I wouldn't have known the little rubber chicken was inside.  My penance for telling this lie was that Daughter #1 was hysterical and demanded that I turn the house inside out to help her find the damn thing.  For those things which I assumed had some value to their owners, i.e., they were in the top layer of clutter, I would attempt to stow away in a logical place with the hope that I would remember where to look when asked.  Unfortunately, I could never remember which Organizing Principal I was operating off on the day when I did the stowing and so the item would remain lost until months or years later when I found it while de-cluttering, re-organizing, or moving.

Why is my life so much more complicated than everybody else's?

Copyright 2012 Teresa Friedlander all rights reserved

Weed (s)

The Red Dog

I am not sure why I bother to weed my garden beds because the weeds grow in much more quickly than I can pull them or kill them with Roundup.  I even have help of the canine variety.  The Red Dog loves only one thing more than the swimming pool, and that is helping in the garden.  He is the reason why my house is not and never will be clean (another of my opportunities to practice being Sisyphus).  He is also the reason why my white jeans are permanently stained with large paw marks.  I used to go right around the twist when The Red Dog "decorated" my clean white jeans but now, I no longer care.  The reason I no longer care is that I no longer go anywhere that requires my looking clean and put together, so when The Red Dog comes at me wearing his mud suit and boots, my cammo pants hide the evidence.

Sometimes I use weed-pulling as an excuse to avoid doing things I do not want to do, like cooking dinner, going to the grocery store, cleaning the house, or working in my office.  When Hubby comes home and there is no dinner on the table, I tell him I am saving us tons of money by doing manual labor rather than hiring someone (who really needs the money) and suggest that he get us a pizza from Enzo's.  When the overdue notices start showing up in the mailbox because I have been "too busy" to sit down and write checks, I hide them and then have to spend two solid days in purgatory (my office). It is a good thing that Hubby doesn't get involved with the household accounts otherwise I might have to get a "real" job.

Then there are those opportune times, during tropical storms and 100% humidity, when I voluntarily go to the office with every intention of paying the bills and filing everything away that needs filing and shredding everything else, but decide to check FaceBook instead.  This takes an inordinate amount of time (all wasted!) and makes me want to do some writing in order to get my focus back so I can attend to the high priority tasks languishing on my my desk.  The unfortunate thing about writing is that once I start, I can't do anything else until I am finished -- no matter how long it takes.  It is a little bit like weeding in that way, which leads me to wonder whether writing is a form of procrastination.  (Better not go there.)

As soon as the sun comes out, a whole new crop of weeds will spring forth and I will have to get back to my futile attempt to get my gardens in shape.  My Highly Effective Sister and her Mister do not seem to have these problems.  They keep their garden in shape, get their bills paid on time, host frequent dinner parties, own numerous rental properties, travel constantly (for fun), and hold down Important Jobs!  And they each have graduate degrees.  It's enough to make me want to get out of the gene pool, except it is too late:  Hubby and I have already reproduced, ensuring that the next generation of Highly Ineffective People, like weeds, will keep the entropy going.

Copyright 2012 Teresa Friedlander, all rights reserved

When Highly Ineffective People Go Rogue

Highly Ineffective Person's Dwelling (when it was on the market)

I am coming off a month-long period of being Highly Effective.  This happens about once a year and catches me totally off guard.  To recap, in the past month, I packed Daughter #2 off to her sophomore year of college; removed every dust mote and mold spore, virus and bacterium, from the 1600 square foot apartment occupied by Daughter # 1 so that she will be able to breathe; helped my in-laws empty their family home of 40+ years; organized my husband's half of the home office; and re-organized my entire filing and bill-paying system.  And, I got my garden beds weeded, trimmed, and mulched while I was on the road!  I even managed to do some writing when I wasn't driving or slaving away.

My Office:  AFTER (family photo)

When I enter these (temporary) Highly Effective phases, it feels like a kind of mania.  I talk faster, write more, don't sleep (much), and feel like I can do anything.  I make lists and actually use them! I create strategies for how to manage my day and do the work that ten of me couldn't accomplish under normal circumstances.  And then, it all ends just as quickly and mysteriously as it began.  Suddenly, the kitchen is grimy, the floors are gritty, and the laundry has piled up into a three-day affair.

One thing I have learned in recent years is to make the most of these brief and rare periods of productivity because it is the only time I actually get anything done.  The rest of the time I feel like I am shuffling piles of papers, living in the laundry room, and panicking over what to fix for dinner for my husband who is "absolutely starving" and has to eat the minute he comes through the door.

The garage will have to wait until next year, I'm afraid.  Unless it "accidentally" burns down.

Copyright 2012 Teresa Friedlander, all rights reserved

Dogs

Today got off to a good start:  I was up early and got the housekeeping out of the way in record time.  There was even a hint of the cooler, drier air which is why people live in south Florida, so I decided to take the dogs for a walk.  Part of my rationale for doing this was to make Ringo so happy he wouldn't feel the need to escape our fully-fenced 3 1/3 acre property.  Alfie is a good dog and won't leave when the gates are open because he's a homeboy who knows that his life is good.  Ringo knows his life is good, too, but there's always room for improvement.

Ringo is also known as Mr. Fun because he can't seem to get enough of it.  At first, he was content to torment Alfie into play fighting with him for several hours a day, but then Alfie stopped taking the bait and the fun was over.  Luckily for Ringo, and unluckily for us, Doug, the dog next door, is 65 pounds of solid muscle and has boundless fun capacity!  Our wildlife fence was a serious problem for these two fun-boys until Ringo discovered a hole in the one place we could not get to without serious bodily harm.  Somehow, he slid through the impenetrable net of vines, palmettos, and thorn bushes in the southwest corner of our lot where he somehow knew a narrow gap existed.  Getting from the canal into Doug's yard involved some serious problem-solving and geographical aptitude.  It turns out that our big red dog is a canine genius.

It took more than a week to hack away at the jungle so that we could close the hole in the fence and for three whole days, Ringo sulked around like we were punishing him.  But then, Doug taught him how to dig under the shared fenceline and an escape artist was born.  So began an endless cycle of digging, escaping, and patching.  I no longer feel sorry for Sisyphus.  Whatever he did to irritate the gods, he likely deserved.  At some point I will put in a sheep fence or hot wire, but that takes measuring and multiplying and problem-solving, three things which I have little talent for.  My brain hurts just thinking about the thinking involved.  And then there is the cost of putting in the fence because if I do it not only will I electrocute myself but the wire won't work and then my husband will left alone with Houdini's heir.

In south Florida, wildlife fencing is a necessity if your property backs up to a canal where alligators have been known to flourish, not to mention snakes, boars, and who knows what else.  If a dog goes missing for a couple of days, chances are it fought an alligator and the gator won.  When (not if) Ringo goes mandible a mandible with a gator I expect he will go out in an explosion of ecstasy because, after all, the flip side of pain is pleasure!  And that brings me to my own pain (aka Ringo, aka Houdini, aka Mr. Fun).  If I were a Highly Effective Person, first of all I would NEVER have adopted this dog.  Highly Effective People purchase pedigreed dogs, guaranteed to be brain dead.  They have much better sense than to "rescue" someone else's problem.  My husband and I, two of the most Highly Ineffective People you are likely to meet, have now "rescued" four dogs, not one of which could be considered brain dead.

What we have that our Highly Effective brethren do not, is a collection of hilarious stories of dogs from hell who captured our hearts and taught us that there is always something to look forward to.

Copyright 2012 Teresa Friedlander all rights reserved

Habit #11 – Putting Others First

Everybody knows somebody who juggles childcare, eldercare, social activities, and a full-time job, with every hair in place and no wrinkles in her linen suit.  We Highly Ineffective People talk about them behind their backs, admiring them while secretly tearing them down because we are consumed with High Effectiveness Envy (HEE).  I have been in a care-giving role for 22 years and never – not once – have I managed to look put together.  The hair is always frizzy, the blouse rumpled, and the pants a little too long in the rise or baggy in the seat.  Until recently, my main responsibility was for school-age children, but suddenly I find that in addition to managing children in two remote locations, I have aging parents, with increasingly complex needs, demanding my attention.  And two birds, two dogs, a horse, and a husband.  And a large house and 3 acre garden.

Even with some household help, I am never caught up and most of the time am not looking my best.  It would be easy to blame the south Florida climate for my rumpled appearance except I had the same problem when I lived up north in much less humidity.  It would be equally easy to blame my complicated family for my constantly disorganized household, except that I know women with much more complicated families who keep it together AND work full time.  Why does their hair look neat, their manicure fresh, and their clothing brand new?  Who has time to get her hair done (two hours), nails manicured (one hour) and buy new clothes (hours and hours) every week?  Not me.  I barely have time to go to the grocery store and fix a no frills dinner on days when I have to pay the bills which I have neglected until the last possible moment.

What is it that differentiates Highly Effective People from their Highly Ineffective counterparts?  My latest theory can be summed up in one word:  Caring.  These two types of people care about the same things but in very different ways.  Highly Effective People care about efficiency and effectiveness, their appearance, and what others think about them.  Highly Ineffective People care about these same things, but cannot do anything about it.  Marshaling our energies takes so much effort that we should never do more than one thing at a time.  Highly Ineffective People are incapable of multi-tasking, and yet we do it anyway.  And the reason:  because we cannot say no to the people (and animals) we care about.  When the children need something, they need it NOW.  When Hubby needs something, he needs it YESTERDAY.  When the dogs need something, they knock me over.  When the horse needs something, he kicks out his stall door and then I have to call the vet to stitch him up.  Usually, EVERYONE needs something URGENTLY at the SAME TIME, which is exactly the time during which I had planned to clean the kitchen or pay the bills or weed one of the garden beds or do a load of laundry or go to the grocery store or cook dinner or backwash the water softening system or make the bed or dust the plantation shutters or clean the pool deck or change the air conditioner filters or take the car for service etc.  So I do what any other Highly Ineffective Person would do and try to do everything at once and when, predictably, I accomplish nothing, I am tempted to sell my soul to the Devil in exchange for becoming a Highly Effective Person.  The only problem I can see with this is that I might not like my Highly Effective Self and the Devil would say “Didn’t your mother ever tell you to be careful of what you wish for?  Because you might get it.”

Maybe I should tell my loved ones to be independent for a change, but then they might do it and then they would figure out that they don't need me and then what would I do?

Copyright 2012 Teresa Friedlander, all rights reserved