Description of Exercises [For prologue to this section of The Mom & Me Journals dot Net, click here.]
As of 9/04/04:
As of 9/04/04:
- In Side Lift [ISL]: Standing, with weights; Holding arms at sides, weights parallel to floor, lift weights up along sides as high as possible while holding elbows as close to body as possible; lower weights to starting position.
- Kick It [KI]: Sitting, independent alternate leg reps; start with foot flat on floor, kick to touch trainer's hand with toes, return foot flat to floor.
- Lift Up [LU]: Standing, with weights; Holding weights above shoulders, elbows out to sides, weights parallel to floor, extend arms completely above head, return to starting position.
- Knee It [KNI]: Sitting, independent alternate leg reps; start with foot flat on floor, raise knee up to touch trainer's hand, return foot flat to floor.
- Forward Out 1 [FO1]: Standing, with weights; Holding weights to upper chest perpendicular to ground, elbows close to sides, extend arms straight out, return to starting position.
- Separate Demitoe Sitting [SDS]: Sitting, independent alternate leg reps; start with foot flat on floor, raise heel until foot is resting on ball and toes, return to starting position.
- Forward Out 2 [FO2]: Standing, with weights; Holding weights to upper chest parallel to ground, elbows perpendicular to body, extend arms straight out, return to starting position.
- Together Demitoe Sitting [TDS]: Sitting, both feet reps together; start with feet flat on floor, raise heels until feet are resting on balls and toes, return to starting position.
- Forward 2 Side [F2S]: Standing, with weights; Holding weights straight out in front at shoulder height perpendicular to ground, open arms out until they are perpendicular to front of body, return to starting position.
- Side Step Sitting [SSS]: Sitting, independent alternate leg reps; start with foot flat on floor, step smartly to side and back, lifting knee up and down with thigh action.
- Arm Circles [AC]: Sitting, with weights; Holding weights straight out to sides at shoulder height perpendicular to ground, circle arms forward for prescribed reps, then backward.
- Marching In Place [MIP]: Standing, holding on to back of chair with both hands for support; march in place smartly, lifting knees high. On 9/6/04, changed exercise so that she stands between two chair backs facing forward and supports self on either side.
- Forward Curls [FC]: Standing, with weights; Holding weights parallel to ground, arms close to sides, bend arm at elbow and raise weights to shoulders, keeping elbows close to sides.
- Separate Demitoe Standing [SDST]: Standing, holding on to back of chair with both hands for support, independent alternate leg reps; with foot flat on floor lift heel until foot is resting on ball and toes, lower foot flat to floor.
- Independent Arm Circles Right [IACR]: Standing perpendicular to chair back holding onto chair with left hand, without weights; with right arm hanging down at side, circle arm from shoulder and upper arm, forearm hanging loose and elbow slightly bent, around across body and face, up, then out to side and down.
- Together Demitoe Standing [TDST]: Standing, holding on to back of chair with both hands, both feet reps together; start with feet flat on floor, raise heels until feet are resting on balls and toes, return to starting position.
- Independent Arm Circles Left [IACL]: Standing perpendicular to chair back holding onto chair with right hand, without weights; with left arm hanging down at side, circle arm from shoulder and upper arm, forearm hanging loose and elbow slightly bent, around across body and face, up, then out to side and down.
- Side to Side [STS]: Standing, hands on hips, without weights; begin facing forward, twist torso to left, then to right, as far as you can go.
- Side Step Standing [SSST]: Standing, holding on to back of chair with both hands for support, independent alternate leg reps; start with foot flat on floor, step smartly to side and back, lifting knee up and down with thigh action.
- Back Drop [BD]: Standing or sitting, independent alternate arm reps, with weights; Turning arm out so palm faces away from body, grip top of weight between thumb and forefinger, lift a arm straight above head so weight is parallel to ground, keeping upper arm straight, bend elbow and lower weight behind head and neck and lift to starting position.
- Not So Grand Plie [NSGP]: Standing supporting self with arms between two chair backs, toes turned outward, feet about shoulder's length apart, bend just a touch at the knees, keeping back straight and buttocks held in, then rise.
- Standing Up/Sitting Down [SUSD]: That's right, standing up and sitting down, with coaching and support. Not surprisingly, she is currently having difficulty standing up and sitting down, so I decided we should practice this. She scoots to the edge of the chair, readies her muscles, braces herself with her hands on my very steady arms, I coach her to "lean forward from the hips" and she stands up, then sits down, while I coach her to "sit with control, don't plop yourself in the chair."
- Belly Grip [BG]: This is simply tightening the abdominal muscles, holding for a count of five and relaxing for a count of five. Performed standing up. It occurred to me that this might help strengthen her lower back and help her body "remember" how to stand correctly when using her walker so that she stands closer to it and pushes it with the momentum of her legs instead of with her arms.
Wednesday, June 15, 2005
Today's Walkering Session:
Well, we went to the mall today. It began well and ended badly. At first, I repeated my word, that I wouldn't coach her in public, only previous to and after each walkering stint; that I wouldn't push her further than she thought she could go; and that, if her back began to hurt, I wasn't going to baby her, I was going to encourage her, lightly, to correct her stance so that her back wouldn't hurt as she walked.
There were some surprises, though. First, she figured she could go further than she was actually able. I had planned a very short trek, to one store, close the the exit I chose, then out. She was fine all the way to Claire's. She sat out, on her walker, the buying of the gift certificate. We started out the door and she was beguiled by the store windows, the people, and wanted to explore, "a little". I asked her if her back was hurting. She said no. I should have known better, but, in view of her high spirits and no back aches, I let her lead the way. I reminded her that however far we went, she'd have to walker back. We had the wheelchair in the car, but I didn't want to have to use it. She agreed. She walkered about once again as far as our trek from the mall entrance to the first store. She stopped momentarily several times to watch children cavorting, speak to a toddler who was fascinated with her walker...and decided she wanted to wander through Bath and Body Works, which was having a seasonal sale featuring glimmering tubs of provocative merchandise. A few times between the two stores she looked as though she might be struggling, so I cautioned her, quietly, to stand a little straighter, which would bring her closer to the walker, in order to avoid her back aching, which she continued to insist was fine. At the sale store, though, she seemed to give out. I bought some fragrant soaps for bathing her, some that we'd used before and she liked. When it was time to go we made it about halfway back to the location of the first store and she wanted to sit.
"Mom," I said, "remember, I said I wasn't going to baby you. I know it seems like a long way, but we're barely into the mall, if you strand straighter, you can do this, it'll bring you closer to the walker and your back won't ache."
From that moment on each of us became more and more tense. I didn't have much choice...she sat, anyway. I told her, in a terse, low voice, that I was going to break my word. When she was finished resting, I was going to coach her out. In addition, she was mouth breathing, thus, having trouble catching her breath. I coached her, in the same terse voice, to keep her mouth closed and breathe through her nose, in order to get oxygen. I enforced this by putting a finger to her chin to keep her mouth closed. This worked, despite it seeming like a harsh measure. Her breathing settled down almost immediately.
Once we continued our exit, I coached her like a drill sergeant. It didn't help much. She just wanted to get to the car.
When we arrived at the car I ordered (yes, ordered) her to stand, with her walker, on the sidewalk at the front of the car and wait while I removed the wheelchair from inside the cab of the truck, where I'd locked it so it wouldn't be stolen. I explained to her that she needed to stand because her walker didn't have breaks and if she tried to sit on it she risked it going over the edge of the sidewalk. I counseled her to hand on to the sign if she had trouble standing with just the walker. I turned my back for less than a minute to hoist the chair out of the cab. When I turned back, she was hanging onto the sign for dear life, sagging to the ground.
I rushed to get her up. "Are you collapsing? I said, thinking she might be stroking out or something."
She was scared and aggravated. "I tried to sit down on the walker."
I was confused, tense and a little scared when we righted her. "Did you not understand me? Did you think I said, 'Sit down on your walker'? Did you not hear me say 'Don't'? Did you not see me point out the curb?"
"I heard you," she said, equally terse.
"You're saying you didn't believe me, then."
Silence.
I leaped over the edge, with abandon. "In the car. Now."
She did as she was told.
Once the car started, so did I. "Okay. First, I'm glad that happened out there, you losing your balance because you didn't pay any attention to what I said. You thought I was just full of tyrannical shit. I wasn't, was I?"
"No." No meakness.
"I'm really, really angry with you. I'd be okay with what happened if you simply forgot, in 30 seconds, what I told you, but you didn't."
"No, I didn't."
"You just didn't fucking believe me." I only use that word when I really mean business.
She knows this and said nothing.
"Obviously, you think I'm worth absolutely nothing. Look, I appreciate your spirit, I honor it, I'm glad for it. But you can barely get around. I am not, I am never, trying to pull rank on you when I tell you to do things. I'm trying to keep you safe and alive. I don't know why you don't get that, but you don't."
"I get it."
"Look. Even if you wanted me to leave you to your own devices, I can't do that, now. Aside from the fact that you wouldn't be able to take care of yourself, and I wouldn't do that to you anyway, because I love you, I'm so far into this taking care of you that I'd be considered criminally negligent if I left you to your own devices."
Silence.
"Let's get a few things straight. You could live for another 20 years but I'm telling you, now, you are not ever going to be sturdy enough on your own, again, to walk without that walker. So get used to it. Make friends with it. See to it that allow yourself to realize what a miracle it is. If you don't, you're going to spend the rest of your life wasting away in your bed and your rocker. Is that what you want? If it is, I'll let you do it, but I can't guarantee how long I'll be able to take care of you on my own in our own home. But, if that's what you want, we'll do it. Is it?"
"No."
"O.K. I believe you. Now, take note of what I'm about to say. Your refusal to listen to me and to trust me makes it much, much harder for me to take care of you. You owe me an apology. You owe me an apology for not listening to me and not trusting me."
Long silence. Finally, "I apologize for not listening to you."
"And what else?"
Pause. "And not trusting you."
"I'm not accepting your apology yet. I won't accept it until I have proof that you are listening to me and are trusting me."
That was that for the rest of the ride.
None of the deterioration of our trip felt good to me. I'm sure it didn't to Mom, either. Once we arrived home we were allowed a brief respite. Mom had lunch. I gave her a couple of extra strength acetaminophen for her back. She laid down for a nap. I huddled on the couch and sobbed quietly.
When we were both rested and she arose, I thought it was over, but it wasn't.
She awoke with a playful gleam in her eye. In the bathroom, while we were changing her into fresh underwear, she said, "What do you think of Iowa?"
I knew where this was going, and my spirit tensed, but all I said was, "Why do you ask?"
"Well, I've got lots of relatives back there, you know, and I think we should move back to Iowa. We've lived there before, you know."
Normally I humor her until she gives up her ghosts, but, today, well, not today. My need to push for some room for myself and the life we've built here came flooding back. "I've never lived there, Mom, only you have."
"Well, that's okay. I know lots of people there. You'd like it."
"Almost everyone you know there is dead, Mom. You're 87. You have one cousin and two in-laws by cousins there and that's it. We're not moving there."
By this time we were out in the living room.
"I'm sure most of the people I know there are still around. I've written them.
"No, you haven't. Not for years. Verna's dead. Lucille's dead. Forrest is dead. Everyone is dead, Mom. Except for three."
"I think you're wrong. Do you like it here?" she asked in that accusing voice.
"Yes. I like it here. I didn't used to, but, when you decided 8 years ago that you just had to have this house and I couldn't talk you out of it, I decided to like it. And, it worked. But that's not the issue. The issue is, you want to move. I'm the one who conducts all business on your behalf and on mine. I'm the one who lives all of my life and quite a bit of yours. I'm also the one who, for years, has pulled my spirit to the limits trying to humor you and accomodate you and make everything you want come true. I finally exhausted myself and, when I did, this last September when I decided to sell that albatross of a mobiile home in Mesa, I realized, I have to make the decisions, now, so that our life doesn't continue to slip around the edges of chaos. We are not moving to Iowa. This is our home now. Get used to it, like I did. Learn to like it. Like I did. You are going to live the rest of your life here. That's it. No more discussions about moving. I'm not going to enter that chaos, again, on your behalf. No more chaos. You're on this endless search for excitement. You need to understand, now, at 87, that life is lived in the everyday moments. Excitement happens not by dint of the parties and the moves and the novelty, but because we chose to be excited about every moment of our lives. It's time for you to get excited about yours. Now. As I said earlier today, earlier today, you can chose to sleep and sit the rest of your life away or you can generate some excitement, stay awake, move around a little. Either way I'll support you. But we'll do it here. Right here. Our life is finally settling down and we're not moving again, unless it's absolutely necessary. That's the decision I'm making on behalf of both of us. You don't have a say in it, because I'm the one who's handling the business of our lives, both of our lives, and much of the other stuff for both of us, too, and I need to handle our lives in the sanest way possible, for our combined satisfaction. Do you understand?"
"Yes. I understand."
"Good."
Although, well, not that good. I continue to feel shaky about asserting myself and my command over our lives. I continue to wonder if I "should'a'" figured out a gentler way to do it, simply because I know this will all come up again...the day will fade into that chasm that holds much of my mother's long and short term memory. It may be burped up, occasionally, but this is not the last time she'll decide we should move, with excitement and anticipation. It isn't the last time I'll have to deal with her strange reality by either breaking into it or humor it, while continuing to hold, together and secure, the life we have now. Conflict and resolution. That's what life is about. Even when you're a caregiver. Even when the unrealistic expectations of the society within which you are doing your caregiving prescribes the comportment of an angel (a being which doesn't exist, I might add) for every caregiver and judges each one based on how close one approximates much comportment. I'm lucky that my Ancient One continues to be capable of appreciating conflict and resolution. I'm haunted that I am now finding myself in the position of resolving conflict between us in favor of a reality that she only partially understands, and that her weakness in reality gives me the edge.
I can only continue to do the best of which I am capable, and continue to contemplate ways in which to make that best better, and gentler, for both of us.
Onward. One change I've decided to try to implement is to talk to the doctor about getting a prescription for a therapist to work with her for awhile to teach her proper walkering. I think we'll be able to do this. I know of a therapist up here who was recommended to me last fall, but to whom Mom refused to go, because she felt she was "doing well enough" on her own, who I think would be perfect for this. I'm going to give her a call before Saturday, explain what we need, and see if she would be willing to work with Mom. That way, I'll be able to tell the FNP on Tuesday exactly who will be handling this. I'm hoping that Mom will listen to and believe someone else, a certified expert. Of course, there's always the hitch that Mom doesn't have a lot of respect for professional health people. I'm hoping that she can suspend her doubt long enough to give this therapist a chance. I'll talk to her about it...
...here we go again...
There were some surprises, though. First, she figured she could go further than she was actually able. I had planned a very short trek, to one store, close the the exit I chose, then out. She was fine all the way to Claire's. She sat out, on her walker, the buying of the gift certificate. We started out the door and she was beguiled by the store windows, the people, and wanted to explore, "a little". I asked her if her back was hurting. She said no. I should have known better, but, in view of her high spirits and no back aches, I let her lead the way. I reminded her that however far we went, she'd have to walker back. We had the wheelchair in the car, but I didn't want to have to use it. She agreed. She walkered about once again as far as our trek from the mall entrance to the first store. She stopped momentarily several times to watch children cavorting, speak to a toddler who was fascinated with her walker...and decided she wanted to wander through Bath and Body Works, which was having a seasonal sale featuring glimmering tubs of provocative merchandise. A few times between the two stores she looked as though she might be struggling, so I cautioned her, quietly, to stand a little straighter, which would bring her closer to the walker, in order to avoid her back aching, which she continued to insist was fine. At the sale store, though, she seemed to give out. I bought some fragrant soaps for bathing her, some that we'd used before and she liked. When it was time to go we made it about halfway back to the location of the first store and she wanted to sit.
"Mom," I said, "remember, I said I wasn't going to baby you. I know it seems like a long way, but we're barely into the mall, if you strand straighter, you can do this, it'll bring you closer to the walker and your back won't ache."
From that moment on each of us became more and more tense. I didn't have much choice...she sat, anyway. I told her, in a terse, low voice, that I was going to break my word. When she was finished resting, I was going to coach her out. In addition, she was mouth breathing, thus, having trouble catching her breath. I coached her, in the same terse voice, to keep her mouth closed and breathe through her nose, in order to get oxygen. I enforced this by putting a finger to her chin to keep her mouth closed. This worked, despite it seeming like a harsh measure. Her breathing settled down almost immediately.
Once we continued our exit, I coached her like a drill sergeant. It didn't help much. She just wanted to get to the car.
When we arrived at the car I ordered (yes, ordered) her to stand, with her walker, on the sidewalk at the front of the car and wait while I removed the wheelchair from inside the cab of the truck, where I'd locked it so it wouldn't be stolen. I explained to her that she needed to stand because her walker didn't have breaks and if she tried to sit on it she risked it going over the edge of the sidewalk. I counseled her to hand on to the sign if she had trouble standing with just the walker. I turned my back for less than a minute to hoist the chair out of the cab. When I turned back, she was hanging onto the sign for dear life, sagging to the ground.
I rushed to get her up. "Are you collapsing? I said, thinking she might be stroking out or something."
She was scared and aggravated. "I tried to sit down on the walker."
I was confused, tense and a little scared when we righted her. "Did you not understand me? Did you think I said, 'Sit down on your walker'? Did you not hear me say 'Don't'? Did you not see me point out the curb?"
"I heard you," she said, equally terse.
"You're saying you didn't believe me, then."
Silence.
I leaped over the edge, with abandon. "In the car. Now."
She did as she was told.
Once the car started, so did I. "Okay. First, I'm glad that happened out there, you losing your balance because you didn't pay any attention to what I said. You thought I was just full of tyrannical shit. I wasn't, was I?"
"No." No meakness.
"I'm really, really angry with you. I'd be okay with what happened if you simply forgot, in 30 seconds, what I told you, but you didn't."
"No, I didn't."
"You just didn't fucking believe me." I only use that word when I really mean business.
She knows this and said nothing.
"Obviously, you think I'm worth absolutely nothing. Look, I appreciate your spirit, I honor it, I'm glad for it. But you can barely get around. I am not, I am never, trying to pull rank on you when I tell you to do things. I'm trying to keep you safe and alive. I don't know why you don't get that, but you don't."
"I get it."
"Look. Even if you wanted me to leave you to your own devices, I can't do that, now. Aside from the fact that you wouldn't be able to take care of yourself, and I wouldn't do that to you anyway, because I love you, I'm so far into this taking care of you that I'd be considered criminally negligent if I left you to your own devices."
Silence.
"Let's get a few things straight. You could live for another 20 years but I'm telling you, now, you are not ever going to be sturdy enough on your own, again, to walk without that walker. So get used to it. Make friends with it. See to it that allow yourself to realize what a miracle it is. If you don't, you're going to spend the rest of your life wasting away in your bed and your rocker. Is that what you want? If it is, I'll let you do it, but I can't guarantee how long I'll be able to take care of you on my own in our own home. But, if that's what you want, we'll do it. Is it?"
"No."
"O.K. I believe you. Now, take note of what I'm about to say. Your refusal to listen to me and to trust me makes it much, much harder for me to take care of you. You owe me an apology. You owe me an apology for not listening to me and not trusting me."
Long silence. Finally, "I apologize for not listening to you."
"And what else?"
Pause. "And not trusting you."
"I'm not accepting your apology yet. I won't accept it until I have proof that you are listening to me and are trusting me."
That was that for the rest of the ride.
None of the deterioration of our trip felt good to me. I'm sure it didn't to Mom, either. Once we arrived home we were allowed a brief respite. Mom had lunch. I gave her a couple of extra strength acetaminophen for her back. She laid down for a nap. I huddled on the couch and sobbed quietly.
When we were both rested and she arose, I thought it was over, but it wasn't.
She awoke with a playful gleam in her eye. In the bathroom, while we were changing her into fresh underwear, she said, "What do you think of Iowa?"
I knew where this was going, and my spirit tensed, but all I said was, "Why do you ask?"
"Well, I've got lots of relatives back there, you know, and I think we should move back to Iowa. We've lived there before, you know."
Normally I humor her until she gives up her ghosts, but, today, well, not today. My need to push for some room for myself and the life we've built here came flooding back. "I've never lived there, Mom, only you have."
"Well, that's okay. I know lots of people there. You'd like it."
"Almost everyone you know there is dead, Mom. You're 87. You have one cousin and two in-laws by cousins there and that's it. We're not moving there."
By this time we were out in the living room.
"I'm sure most of the people I know there are still around. I've written them.
"No, you haven't. Not for years. Verna's dead. Lucille's dead. Forrest is dead. Everyone is dead, Mom. Except for three."
"I think you're wrong. Do you like it here?" she asked in that accusing voice.
"Yes. I like it here. I didn't used to, but, when you decided 8 years ago that you just had to have this house and I couldn't talk you out of it, I decided to like it. And, it worked. But that's not the issue. The issue is, you want to move. I'm the one who conducts all business on your behalf and on mine. I'm the one who lives all of my life and quite a bit of yours. I'm also the one who, for years, has pulled my spirit to the limits trying to humor you and accomodate you and make everything you want come true. I finally exhausted myself and, when I did, this last September when I decided to sell that albatross of a mobiile home in Mesa, I realized, I have to make the decisions, now, so that our life doesn't continue to slip around the edges of chaos. We are not moving to Iowa. This is our home now. Get used to it, like I did. Learn to like it. Like I did. You are going to live the rest of your life here. That's it. No more discussions about moving. I'm not going to enter that chaos, again, on your behalf. No more chaos. You're on this endless search for excitement. You need to understand, now, at 87, that life is lived in the everyday moments. Excitement happens not by dint of the parties and the moves and the novelty, but because we chose to be excited about every moment of our lives. It's time for you to get excited about yours. Now. As I said earlier today, earlier today, you can chose to sleep and sit the rest of your life away or you can generate some excitement, stay awake, move around a little. Either way I'll support you. But we'll do it here. Right here. Our life is finally settling down and we're not moving again, unless it's absolutely necessary. That's the decision I'm making on behalf of both of us. You don't have a say in it, because I'm the one who's handling the business of our lives, both of our lives, and much of the other stuff for both of us, too, and I need to handle our lives in the sanest way possible, for our combined satisfaction. Do you understand?"
"Yes. I understand."
"Good."
Although, well, not that good. I continue to feel shaky about asserting myself and my command over our lives. I continue to wonder if I "should'a'" figured out a gentler way to do it, simply because I know this will all come up again...the day will fade into that chasm that holds much of my mother's long and short term memory. It may be burped up, occasionally, but this is not the last time she'll decide we should move, with excitement and anticipation. It isn't the last time I'll have to deal with her strange reality by either breaking into it or humor it, while continuing to hold, together and secure, the life we have now. Conflict and resolution. That's what life is about. Even when you're a caregiver. Even when the unrealistic expectations of the society within which you are doing your caregiving prescribes the comportment of an angel (a being which doesn't exist, I might add) for every caregiver and judges each one based on how close one approximates much comportment. I'm lucky that my Ancient One continues to be capable of appreciating conflict and resolution. I'm haunted that I am now finding myself in the position of resolving conflict between us in favor of a reality that she only partially understands, and that her weakness in reality gives me the edge.
I can only continue to do the best of which I am capable, and continue to contemplate ways in which to make that best better, and gentler, for both of us.
Onward. One change I've decided to try to implement is to talk to the doctor about getting a prescription for a therapist to work with her for awhile to teach her proper walkering. I think we'll be able to do this. I know of a therapist up here who was recommended to me last fall, but to whom Mom refused to go, because she felt she was "doing well enough" on her own, who I think would be perfect for this. I'm going to give her a call before Saturday, explain what we need, and see if she would be willing to work with Mom. That way, I'll be able to tell the FNP on Tuesday exactly who will be handling this. I'm hoping that Mom will listen to and believe someone else, a certified expert. Of course, there's always the hitch that Mom doesn't have a lot of respect for professional health people. I'm hoping that she can suspend her doubt long enough to give this therapist a chance. I'll talk to her about it...
...here we go again...
