=>Moving =>Mom

    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...

Time Session Began:  1905 Duration of Session:  49 min
Exercise	Reps	Sets	Comments
ISL	12	1	Very good.
KI	12	1	Upped reps. She's finally keeping her thighs down; I can see her thigh working.
LU	12	1	Upped reps. Lots of Correction: "Elbows up and out. That'll keep your wrists from breaking."
KNI	10	1	Stopped at 10 because her thighs were complaining a bit about all the exercise of late.
FO1	12	1	Upped reps. Her main problem when she works the upper areas is maintaining her grip on the weights.
SDS	12	1	Good! "Sit at attention! Forward in chair!" She did.
FO2	12	1	Drop in reps but continuation was smooth. I discovered that she wasn't "feeling it" in the right place and showed her where she should be feeling it. We'll work on that on the 16th.
TDS	12	1	Upped reps. Good.
BG	5	1	She did well with this. I could see her holding the grip in her belly. I explained to her, again, the value of this exercise. She couldn't do any more than 5, but she did 5 well.
MIP	8	1	Excellent! I added this one on the fly, today, when I noticed how well she was keeping her balance during the previous exercise. I figure this one will benefit her walkering, as well.
F2S	10	1	Needs to feel it through chest and shoulders. Working on it.
SSS	10	1	Worked on keeping legs in alignment. Better on right side than left.
AC	5	1	Still having problems moving from her shoulders. I explained that this exercise was primarily to benefit upper arm strength and shoulder and strength and flexibility.
FC	10	1	Again, better. Becoming very smooth and controlled.
SDST			Did not repeat.
IACR			Not yet.
TDST			Not yet.
IACL			Not yet.
STS			Not yet.
SSST			Not yet.
BD	10	1	Improving dramatically! Can almost hold arms straight above head. Better right than left.
NSGP			Not yet.
SUSD	5	1	Lots of difficulty, more than I expected. I changed the exercise a bit, though. Instead of having her seek support from my entire arm, I only allowed her to use my hands. She was game but it was difficult for her to stand and sit with strength, fluidity and control.

    I reminded her, today, during our session, of how far she'd gotten in the fall. She had a hard time believing that she was doing most of the exercises standing, and standing up and sitting down on her own. She expressed doubts about reaching that level of physical acuity again. I reassured her that she achieved what she did after she'd suffered an almost complete physical collapse from the low sodium episode. She was as weak as a kitten when she entered the SNF. "You're much better off now, Mom, even after spending the winter in bed and in your rocking chair, than you were when you went into therapy there." She took comfort in and inspiration from this.
    I rearranged the order of the exercises, today, in order to perform the BG standing. Since she was doing well standing while supporting herself between the backs of two chairs, I added the MIP, as well. I will probably keep this order for awhile, until we incorporate more standing exercises.
    We talked, today, too, about holding her shoulders back and standing as straight as possible in order to maximize the benefit of the weight exercises in the right places. She wanted to insist that she can't sit up straight, but I showed her that, despite her upper back slump, she was capable of holding herself straight enough to benefit in the right places.
    Our session was longer than usual, today. We did a lot of correction. As it turns out, I corrected myself, as well, on some of the arm weight exercises. I realized that the reason I was experiencing pain around my elbows is that I wasn't positioned to allow my upper back and chest muscles to take the hit. I exaggerated my own 'shoulders back' stance. What a difference this made, both in value of the workout and decreased pain spikes in my elbows! This is what led me to ask Mom repeatedly where she was "feeling it", check her shoulder work and posture and start correcting it.
    The plan for tomorrow is walkering at the mall. Malls are always built to maximize walking and the one here is no exception. We need to pick up a gift certificate for a birthday. I've mentioned the trip several times tonight and she is excited about it. It'll be interesting to see how it goes.

    Today involved walkering, a fair amount of it. I've just about decided that we will alternate exercise session days with walkering days. Perhaps, in the near future, some days will incorporate both.
    Our first walkering session involved a short trip to Costco to pick up some supplements I'd forgotten to replenish the previous day. It involved walkering from the car (we got a space as close to the entrance as the handicapped spaces, even though all the handicapped spaces were taken) into the store, through the front, all the way to the opposite side to the pharmacy area, to check-out, maneuvering through there, then back to the entrance, out the door and back to the car. She did well. When we got to the supplement aisle I allowed her to rest, a bit, although she didn't sit on the walker. Before we left the car, I told her I was going to "drill sergeant" her through the store but, I reminded her, if she didn't stay close to her walker, straighten her back and allow the momentum of her legs to move the walker forward, her back would probably bother her. Sure enough, on our way to the car she complained that her back was hurting. I reminded her, again, why this was so. I, once again, encouraged her to take this into consideration when we went to New Frontiers and make an effort to ease some of the stress on her back with my technical suggestions.
    Upon arriving at New Frontiers I once again reminded her of the techniques that would allow her to walker through New Frontiers with ease, and again told her that I would not correct her in public but leave her to her own devices. I don't know if her back bothered her this time. It was a very short trip and her attention was caught by the color and variety in the store. These aspects of New Frontiers capture me, as well, and we did a bit of perusing on our way to and from our intended items. She wanted to google their deli case, as well, which we did.
    Once we arrived home I reviewed, again, stress-free walkering technique.
    In response, she hit me with a conundrum, what she considered her primary walkering disability: "I can't walk that way; my body isn't built like that."
    I knew that she was referring to the humping of her upper back. I also knew that this was a psychosomatic problem for her and immediately thought of two ways to dispel this problem: "Mom," I said, "your hump is just below your shoulders, and is, all humps considered, fairly slight. Are you telling me that when you complain of your back hurting from walkering, it's hurting in this area?"
    "No," she said, as I guessed she would, "it hurts down here," and rubbed her lower back, just below her waist."
    "Okay, then, the problem isn't your slumping. You're built just fine for walker use. I think the problem is that you are pushing the walker as though it is a lawn mower."
    "Well, yes!"
    "It's not a lawn mower. You don't have to push it with your arms. It will move forward as you walk; thus, the closer you are to it, the easier it will be to straighten up and move it forward. The walker isn't to be used as a shopping basket; it's in order to steady you when you walk, which it does, regardless of how you use it. It'll be easier on your back, though, if you let it do its work instead of trying to do its work for it."
    This is when I got a bright idea. "You know, Mom, it might be easier yet if we start doing belly grips to strengthen your abdominal muscles. That should help you naturally step up to the walker, because your back will want to straighten up. You know what I'm talking about: contracting your belly muscles, holding them for a count, then relaxing them for a count. I think we'll add that exercise to our routine."
    She rolled her eyes. "Uh-oh. I shouldn't have said anything."
    I laughed. "Trust me. In a couple of weeks, you'll be glad you did."
    "Me and my big mouth!"
    So, maybe we're on our way to a solution to my mother's walkering dilemma. It may take some time and she may have a few more back twinges in store for her before we've reached an accomodating 'perfection', but I think we're on our way, now.
    And, yes, I will be making an effort to report regularly on our walkering sessions, when it seems appropriate.

Time Session Began:  1700 Duration of Session:  40 min
Exercise	Reps	Sets	Comments
ISL	12	1	Very bad.
KI	10	1	She's finally getting the hang of this exercise, hallelujah.
LU	10	1	O.K.
KNI	10	1	Good.
FO1	10	1	O.K.
SDS	10	1	O.K.
FO2	14	1	Working on form.
TDS	10	1	Good.
F2S	10	1	Good.
SSS	10	1	Really worked on form.
AC	5	1	Corrected form.
MIP			Not done.
FC	10	1	Better, surprisingly.
SDST			Did not repeat.
IACR			Not yet.
TDST			Not yet.
IACL			Not yet.
STS			Not yet.
SSST			Not yet.
BD	10	1	O.K.
NSGP			Not yet.
SUSD	5	1	This time, I had her stand up and sit down in a way that was most comfortable for her. I am still offering her support with my arms, and she is still using it, but, it seems, she hasn't quite recovered the hang of rolling her upper body forward to gain momentum for standing, so I let her improvise and she seemed to stand up more easily doing it "her way". We'll work on this.
BG			Plan to begin this one on June 14th.

    Since it's been 11 days since we last had an exercise session, I was prepared for some back sliding, but I was also particularly ornery. Although I should probably have back peddled the reps, for the most part I didn't. I was a bit more critical than usual, as well, although, overall, she performed well.
    I've never mentioned the following before, but there are certain stylistic corrections I repeat throughout the sessions that I want to cover here.

1. She relaxes into the chair, practically sitting where her tail bone used to be (she had it removed many years ago after breaking it). "Sit at attention, move forward in the chair so that you're sitting on the edge, push your butt(if I'm in a good mood>/ass(if I'm getting annoyed) back," I remind her before almost every exercise.
2. When using the weights she relaxes her muscles between reps, thus often breaking her grip, her wrists, and dropping the weights instead of lowering them. I am constantly reminding her to "keep the grip, raise and lower the weights, don't shove and drop them."
3. She tends to relax her legs into a modified splay when doing the leg exercises, rather than keeping them taut, knees over ankles, which compromises her ability to lift and move her legs with her thigh. We work on this throughout the sessions, as well.
4. She has an unfortunate tendency to relax her arms, thus, bending at the elbows when using the weights on straight arm exercises. Some of this is legitimate...her arms muscles just need more strengthening; some of it is not. I can tell the level of legitimacy by gauging whether she is throwing the weights around or lifting and lowering them.

    I am, as you can tell, a fairly fierce coach with her. She takes it well, even though she complains before every session. The truth is, I know that her reaction to "nice" is to relax. Her reaction to "stern" is to hop to, as I'm sure she used to do in the Navy when she was in boot camp and practicing drills. I have to say, I consider myself blessed that, although my beloved 87-going-on-88 year old Ancient One would prefer to spend most, if not all, of her time in bed or immobile in her rocker, she does pay attention to me when I make it clear that I am trying hard to benefit her. She appreciates focused attention and responds to it well. Especially stern focused attention. Praise the Gods of Moving and Flexibility!