eldercare – Susan J Tweit

Mom posing on her honeymoon at Mt. Lassen, 1952

The Dangerous Power of Thin

Posted on February 9, 2014 | by Susan Tweit | Leave a Comment

Last week, when 24-year-old Rachel Fredrickson walked on stage as the winner of season 15 of “The Biggest Loser,” many viewers gasped. Fredrickson started the show at 260 pounds; she ended up 105, losing 155 pounds, more than half her body weight. She looked anorexic.

Mom posing on her honeymoon at Mt. Lassen, June 1952.

I thought immediately of my mom, who died three years ago at age 79. Her death certificate lists “severe rheumatoid arthritis” as the cause, and it’s clear that her RA contributed, as did early Alzheimer’s.

But what sent my bright, quick, funny, and intensely loving mother on her final slide was an obsession with thin.

Joan Cannon (later Tweit) in the Sierras in her teens

Mom in the Sierras in her teens

Mom, a California girl who grew up hiking and camping in the Sierra Nevadas, and who was always happiest outside with mountains in sight, was a healthy weight until one summer in her late 50s when a combination of rheumatoid arthritis drugs robbed her of her appetite. In three months, she lost 20 pounds from her 135-pound, 5″6″ frame.

Mom and Dad in Tucson, Arizona, in about 1990

She never regained that weight. By her sixtieth birthday, I realized with a shock that Mom was no longer taller than I. I commented and she denied it–until we measured each of us. She had lost 3/4 of an inch in height.

“How much do you weigh?” I asked, suddenly worried.

“I’m healthy; I don’t weigh myself.” Her tone was both lofty and evasive.

Perhaps I should have clued in, but I didn’t. She and Dad continued hiking, birdwatching, and traveling the world.

Mom and Dad with my brother Bill in Norway

And Mom continued to shrink. By the time they took their last trip overseas, she stood 5’2″ and weighed (she claimed), “around 100 pounds.”

By then, I was on a campaign to help her gain weight. Only it was already too late. Mom understood intellectually that she needed to stop losing, but she simply couldn’t.

Mom in the Never Summer Mountains on her last camping trip.

Her weight continued to slip, her bones continued to thin and her health deteriorated until one January morning in 2011, when she stepped out of bed and one hip shattered. It was unrepairable.

We brought Mom home. She lived another three weeks, long enough for all of us to be able to spend time with her, and to say goodbye.

Months later, I asked Dad if he knew where things went wrong.

“Thinking back, I guess when some boys called her ‘piano legs’ in high school. It stung so much that she never forgot.”

As he said the words, a childhood memory surfaced: My blue-eyed, curvy mom with the English-rose complexion and wavy brown hair eyed herself in the mirror and vowed to fit into a size 8 dress again. I had forgotten that part of Mom.

“That summer when she lost those 20 pounds must have triggered it. Losing weight was something she could control when she couldn’t control the arthritis. It was power.”

Dad nodded. “Something like that.”

I shivered. I know precisely the power of numbers on the scale dropping.

I inherited Dad’s slender build (and his Scots-Norwegian freckles and reddish hair too), and, I realize now, I learned Mom’s unhealthy fixation with weight.

Hiking with Mom and Dad.

No matter how thin my reflection in the mirror, it always looks just a little fat to me. When times are tough, it is comforting in a way I can’t explain logically to watch the numbers on the scale drop, pound by pound. I’ll stop when I get to this number, I say to myself, meaning it.

Except at that number, the idea of going lower is awfully appealing. Only the memory of caring for Mom as her body consumed itself, skin eroding from within, bones poking through, keeps me from sliding farther.

Which is why the photos of Rachel Fredrickson made me sad. Losing weight, she said, helped her find herself again. I hope so, and I hope she can find a healthy weight too.

The power of being thin is dangerously addictive. I know. So did my smart, funny and beautiful Mom.

Giving Thanks for Hospice

Posted on November 21, 2012 | by Susan Tweit | Leave a Comment

Molly Cabe and Carol Ley, harpist for Angel of Shavano Hospice, play a duet in our living room, November, 2011

A year ago, this house was filled with people. Molly and her sweetie Mark were staying in the guest cottage, Richard was ensconced in the hospital bed in our bedroom; friends and family came and went along with nurses, home health care aides and others from his hospice team. Even while I appreciated their support and love, the parade of people often overwhelmed me. I craved peace and quiet.

Today, it’s just me. I have peace and quiet in spades, and of course, I would trade it to bring Richard back, his smile beaming like sunshine. (Ttechnically it’s not just me here: Buffy Noble, an English poet, is staying in the guest cottage with the Terraphilia Residency Program. She’s very quiet though.)

My late love and his incandescent smile….

The approach of Thanksgiving has me thinking about what I’m thankful for. The list is long, beginning with the love and support of my wonderful family, the generous community of this small town, and the rich fellowship of friends and readers and colleagues.

Right up near the top of that list is hospice. Last year I got to know two hospice organizations: Visiting Nurses Association of Denver cared for my mom until her death in early February. Seven months later to the day, Richard’s oncologist told us it was time to refer him for hospice care. So the day after we returned from The Big Trip, our three-week, nearly 4,000-mile-long drive across the interior West and down the Pacific Coast from Washington state to southern California, his team from Angel of Shavano Hospice made their first visit.

What is hospice? Simply put, it is team-oriented, compassionate care for people with a terminal illness or injury, and their families. Hospice care focuses on combining therapeutic medical care, pain management, and emotional and spiritual support to allow people to live the end of their lives in dignity and comfort, whether in a hospice facility or at home. The word originated with shelters for travelers on pilgrimages in the Middle Ages; the first modern facility to employ hospice principles in caring for the terminally ill was established 1967 by Dame Cicely Saunders, a British physician.

None of us want to think about death. But if we do, most of us would prefer to die at home or in a comfortable facility with expert care. Why wouldn’t we?

Mom, celebrating her 79th birthday with high tea at Denver’s Brown Palace Hotel

That’s where hospice comes in. When my bright and tenacious 79-year-old mother’s body began to fail, stressed by decades of living with what her doctor said was the most severe case of rheumatoid arthritis she had ever seen, and aggravated by the early stages of Alzheimer’s Disease, Mom was sure she would be “fine” soon. But after she stepped out of bed one night (having forgotten she could no longer walk) and her brittle right hip shattered, she was sent to a rehab center. All she wanted was to go home with Dad, and the Denver Visiting Nurses Association made that possible. By the time Mom drew her last breath, holding Dad’s hand as she had for more than 58 years, she had come to look forward to visits from her hospice team, and her sparkling smile bloomed.

Then in September, it was my love’s turn. The two months between when we got home from The Big Trip and his death on November 27th could have been dominated by fear and grief. Instead, thanks to the warm and skilled support of his team from Angel of Shavano Hospice, especially his nurse, Will Archuletta, and the presence of Molly, who spent the last five weeks of his life with us, love and laughter and sweetness prevailed. We were blessed, and hospice was a big part of that.

Thanksgiving 2009: Richard, Dad, Mom, and my sister-in-law, Lucy Winter

So in this time of giving thanks, I am thankful for Dame Cicely Saunders for her vision and courage, for the Veteran’s Administration for embracing hospice and palliative care, and for hospice caregivers and organizations everywhere.

I encourage you to learn about and support your local hospice organization. Because much as we hate to think about it, they’ll likely support you or those you love one of these days.

(Two other outstanding hospice organizations in Colorado are Pikes Peak Hospice and Palliative Care in Colorado Springs, and The Denver Hospice.)

Adventures in Caregiving: Dad’s off

Posted on September 30, 2012 | by Susan Tweit | Leave a Comment

Dad at Highlands Garden Village in the public garden he and Mom helped maintain.

On Friday afternoon at two-thirty, I parted with my 84-year-old Dad at security in Denver International Airport. I reminded Dad, ensconced comfortably in a wheelchair for the ride through the airport, to call me when he got to SeaTac Airport in Washington.

“I love you Dad,” I said, and bent over to kiss his cheek. “Thanks for everything you’ve done,” he said. I slipped the wheelchair attendant a five dollar bill, thanked him for escorting Dad, and they were off.

I turned and walked the other way, toward the parking garage and the mountains I would drive over on my way home.

I’d like to say that as I made my way out of the airport and drove west toward the shimmering line of peaks of Colorado’s Front Range of the Rockies the weight of a decade of care-giving dropped from my shoulders. That’ll take time, I think.

Dad and Mom at our house on a Christmas visit

I did think back on the day, my Dad’s last in Denver. That morning at the Westland Meridian where Dad (and Mom, before her death a year ago February) lived, I prompted Dad to say goodbye to his favorite staffers and residents. Everyone we met offered good wishes, and told him how much they would miss him. “Don’t forget you can always come back,” said one. Dad smiled broadly, excited about heading to Washington to live near my brother and his family, including five great-grandchildren.

“It’s nice to be loved,” I commented as we drove away with his suitcases tucked in my Subaru. Dad nodded. “Thanks for reminding me to say goodbye.”

The carousel building with colorful fall native grasses in the Plant Select Garden, Highlands Garden Village, Denver

We took a farewell tour of some of Dad’s favorite places on our way to the airport. First stop, the public gardens at Highlands Garden Village, the first place he and Mom lived in Denver. They joined the volunteer group maintaining the gardens there and continued even after they moved to another senior apartment building. As we rambled through, admiring the bright fall colors, Dad reminisced about the gardens’ evolution. (Thank you, Erica Holtzinger, for making the garden and the group so welcoming!)

The prairie at Denver Botanic Garden, a mosaic of grasses and wildflowers

From there we headed across the city to Denver Botanic Gardens, where we wandered the wilder edges, including Dad’s and my favorite dryland mesa and prairie gardens. We stopped to sit in the warm sunshine, bent close to look at the intricate details of fall flowers and grasses, listened for birds above the chatter of schoolchildren, and ate lunch at Offshoots, the gardens’ cafe.

When we left the botanic gardens, we headed east across the city and along the edge of the Stapleton Neighborhood, the redeveloped site of the old airport, to Bluff Lake Nature Center with its long views of downtown’s tall buildings and the Front Range, dusted white with the first fall snow. Dad and I walked the path down the bluff and turned upstream on Sand Creek to find seats on sun-warmed granite boulders by the stream with its line of short, fat Plains cottonwoods.

Dad “birdwatching” with my brother, Bill, and the five great-grands, Liam, Fiona, Porter, Colin, and Connor

We talked about how he and Mom explored Denver by bus and light rail (Dad’s worsening vision had made him legally blind before the move to Denver; Mom, colorblind from birth, had never driven), the places they found to watch birds, their trips to the mountains and Plains with Richard and me, and how much they had enjoyed their years in Denver.

Then we climbed the bluff to the car and headed for the airport.

Later, as I drove west toward the mountains, I thought about Dad’s next phase in Washington State, and blessed his spirit of adventure, and my family there for being excited about Dad’s arrival. As I turned off the interstate and onto the winding two-lane highway, headed uphill to cross the first mountain pass, I exhaled one large breath, feeling very fortunate to be headed home again–by myself.

Adventures in caregiving: moving Dad

Posted on September 8, 2012 | by Susan Tweit | Leave a Comment

Dad with his two youngest great-grandkids, Liam and Colin Roland, at my brother’s house in Olympia, Washington

Last Wednesday, I wrapped up my writing day early so that I could drive to Denver and pick up my Dad at the airport. He’s 84 years old and legally blind–not that his limited vision slows him down much.

The airline had arranged for Dad to be escorted from the plane to the main terminal. I had reminded him to turn his cellphone on when the plane landed, so he could call me if anything went wrong.

Of course, Dad can’t see the buttons on his cellphone very well, which means the voice-dial feature doesn’t always work.

It’s a three-hour drive from my house over the mountains and across the Denver Metro Area to the airport. In good weather like last week, the first two hours are beautiful, with sweeping views across high grasslands toward distant peaks, and dramatic canyons winding through forests splashed with aspen groves. Beautiful or not, the drive always wears me out.

Buffalo Peaks across High Creek in South Park, on my route to Denver.

So by the time I got to the airport on Wednesday evening, parked, and figured out where I needed to meet Dad and the escort, I was whipped. But Dad wasn’t: he smiled when I hailed him, and talked non-stop from that moment until bedtime. (For all I know, he continued talking, but I couldn’t hear him!)

Dad’s excited, with good reason. After ten years in the Denver area (we moved my folks there in 2002 from Tucson, where they had lived for 23 years; my mom died last year, in February), Dad is making one more move, to western Washington. There, he’ll be close to the remainder of the Tweit clan: my brother, Bill, and his wife, Lucy Winter; their girls, Heather Roland, Sienna Bryant, Alice Tweit; and the big girl’s kids, my dad’s five great-grandchildren. (Four of the latter are pre-schoolers, one just hit his teen years.)

Dad and my brother, Bill, with the great-grands, binoculars raised, “birdwatching.” (Thanks to Heather and Sienna for arranging the photo!)

Once Dad decided that my suggestion of moving was a good idea, he was ready to go. He toured Panorama, the a retirement community I suggested near my brother and Lucy, picked an apartment there, and put down a deposit.

Hence my week-day trip to Denver. Dad, who has been away in Washington state for two months at an excellent Department of Veteran’s Affairs training for the blind and visually-impaired, was returning to get ready for the move. Which meant I would be doing the getting ready, and he would be cooperating good-naturedly (talking all the while).

Thursday morning I set to work, helping Dad fill out the forms involved in leaving his current place; calling moving companies to set up appointments for estimates on packing and moving his one-bedroom-apartment-sized household; sorting through and boxing up things like cookware he no longer uses with his limited vision; transferring computer files and helping him get set up on his Macintosh after a summer of using a customized PC….

By the time I climbed into my Subaru for the drive back home yesterday afternoon, we had picked a mover, signed a contract and gotten dates for packing, loading, and delivery; arranged for pickup of the things he isn’t taking with; and made a detailed check-list for what else needs to be done before moving day–in three weeks.

Aspen gold on the approach to Kenosha Pass, 10,000 feet above sea level, between Denver and Salida, Colorado.

And I was beyond exhausted. As the highway curved to climb the first of the three mountain passes, I spotted the season’s first brilliant gold patch of aspens, and pulled off on the shoulder, laid my head on the steering wheel and cried.

Last fall, Richard and I shared his final Rocky Mountain autumn on our way home from The Big Trip, our 29-year-delayed honeymoon. He died two months later.

After a while, I dried my eyes and pulled out my camera. I got out of the car and shot a photo, and then another, and another. The sun was shining, the aspen vivid gold, the peaks bare against a bluebird-blue sky.

When I had looked my fill, I got back into the car and drove home.