Two Steps Backward, One Step Forward

Thanksgiving was less than two weeks ago, but it seems a lot longer.

Wendy, Misha and Simon came to spend the holiday with us. They got to visit Fay twice during their short stay. You can see Fay holding Wendy's hand above. Of note is the encouraging use of her right hand, which had been giving her some trouble. We visited the bird cage and Simon had a good time looking at pictures and taking in the sites at Courtland Gardens.

It would be a mistake to say that Fay was "ok" during these visits. She often seemed drowsy and confused, but that's nothing new. When Wendy and family saw her on Saturday morning, they reported that she was not very responsive. A few hours later, after lunch, I went to the nursing home and Fay was eating ice cream, getting ready for the Shabbat afternoon trivia contest. It goes like that; up and down in the same day.

The following Wednesday I was in Norfolk, VA on business when Fay's doctor called me. He found her completely unresponsive; it was difficult to wake her. He didn't think she had a stroke. A UTI was the most likely cause based on a blood test and urinalysis. So he started her on IV antibiotics.

I was back in town on Thursday and visited Fay that day and subsequent days. Evan came down for the day on Saturday. We were very worried about her condition, which didn't seem to be improving. She was eating nothing. She was extremely hard to rouse. When she was awake, we couldn't tell if she knew we were there. Saturday was a pretty good day. She smiled and even laughed when Evan was with her. I got her to drink some liquid diet supplement. On Sunday, she was back to being completely out of it.

Monday was a better day. Fay was up a little and looked around the room at us and the nursing aids. She even found the will to glower and snarl at her room mate. We'll never understand why Fay sometimes reacts that way to Rebeca, but at least it was some awareness.

The latest diagnosis is pneumonia, which is being treated by a different antibiotic that also covers the UTI. Fay has delirium, which sometimes happens to Alzheimer's patients that get infections. She can't talk. When she wants to say something she just mumbles gibberish. As of today, she isn't eating anything. The infection has taken away her appetite. Moreover, patients with dementia often either refuse to eat or forget to eat.

Mom's doctor and the nurse practitioner who treats her think that the appetite may come back after the infection clears. They doubt that she will come back to the baseline she was at before she got sick.

In the meantime, we'll take one day at a time.

Roots

My cousin Harry is quite a researcher into family history. From time to time he sends me photos and descriptions of material that he has uncovered about our common ancestors. His mother is my father's sister.

Last week Harry sent me a 20 page history of our common ancestry. The timing was actually pretty interesting. Thanksgiving was the holiday that we usually shared with Harry's family, including our grandmother. Fay was very fond of Lydia Rapport, her mother-in-law. When they were courting, my father would take Fay to his house on Virginia Avenue in south St. Louis. My mom used to tell me how civilized she thought the Rapports were. They actually set the table with knives and forks at each place instead of piling them in the middle of the table like her mother did.

I think Lydia taught my mother to cook. Since Fay was the youngest in a family that included four daughters, her jobs around the house were mostly cleaning up; certainly not cooking. My mom made delicious fried chicken and great fruit pies (I liked cherry best), skills she learned from Lydia.

I brought Harry's family history with me this weekend and read Fay some of the parts I thought she'd be most interested in. Fay was pretty sleepy both Saturday and Sunday this week. But when I asked her if she remembered Virginia Avenue, she said "yes" and smiled. I reminder her about the pies, and she smiled at that too.

On Thanksgiving Day, Wendy, Misha, and Simon will come to us for a few days. We told Fay that Wendy and her family would be coming to see her. She commented that Simon was cute, so I suspect that she understands that Wendy has a child. We're looking forward to the visit.

The Entertainer

"That's the way it's going to be now," Margie told me as we left the nursing home on Saturday. Fay was very sleepy on Saturday afternoon. I think she slept most of the time we were there. She had a lot of trouble with her ice cream (the usual Saturday afternoon ice cream party, sing-along and trivia contest). Since it was a warm fall day, we took Fay outside on the patio for some fresh air. We were also able to let her talk to Wendy on the phone, which was a reasonably successful conversation. But for most of our visit, Fay just drifted in and out of sleep.

The next day I went back to Courtland Gardens. It was a beautiful day and I thought maybe we could go into the courtyard for a longer stay. When I arrived, however, Fay was sitting front and center for a musical program. She didn't want to leave (who could blame her? see and hear for yourself). We sang along and had a pretty good time for about 45 minutes. Then Fay asked me to take her back to her room. We watched the Ravens struggle against the Bengals. Football seemed to really catch her attention. It was reassuring to see her a little more alert than the day before.

Where Did The Time Go?

We like to bring an activity with us when we visit Fay. This weekend we dropped by on both Saturday and Sunday. Saturday was ice cream and trivia. Fay and I went back to her room (it was nasty weather) and read through the Baltimore Jewish Times. There was an article on the most popular Jewish-themed mask for Halloween (it's a Bernie Madoff mask) and a long story about Topol, who at 72 is reprising his role as Tevya in a tour of "Fiddler on the Roof" that is coming to Baltimore. The Bernie Madoff story went over Fay's head, but I think she had some recollection of "Fiddler." My mom has a thing for older Jewish men with beards.

On Sunday we brought the album of photo proofs from Margie's and my wedding.


We (at least Margie and I) had quite a time looking back 41 years. To put things in perspective, Fay is 15 years younger than I am now in this picture. I was 45 pounds lighter than I am now. Margie looks pretty much the same.

We showed my mom photos of her nieces and nephews, her brother and sisters, and some others she seemed to remember. It's hard to know what Fay understood but she said that she knew who everyone was. It was the most responsive we have seen her in several weeks. Who knows? Maybe we'll bring my bar mitzvah album next week.

Communication

It's been some time since I've made a report. Actually, there's not much to say these days. Our visits with Fay are falling into a routine of sorts. Fay is usually at an activity when we arrive. If it's Saturday, she's at the trivia and ice cream social. The volunteers seem to understand that Fay needs sugar free ice cream. Most of the time Fay is feeding herself, although when she sees us she wants us to help, even feed her. Some days she seems very drowsy. Other times she is fairly alert.

The biggest change is that Fay can no longer have a conversation. She is unable to complete a sentence, even when you try to prompt her for the words she seems to be searching for. I actually think the situation is more frustrating for us than for her. When Fay forgets what she starts to say (which is just about always) she just settles back and smiles. She can't really answer questions, except for "yes" or "no," and those responses often are random and inconsistent with the answer we are expecting.

So we bring pictures to look at or go over the photo albums she has in her cabinet. Reading the Baltimore Jewish Times is another good activity. It comes out weekly and there are sometimes funny stories. If we laugh, Fay laughs. Margie buys her new clothes - tops appropriate for the season and slacks to replace the ones that seem to vanish occasionally. Fay likes that and is happy about the presents.

I try to be thankful that Fay seems to be comfortable and not anxious. The changes we are seeing are inevitable, say the medical staff.

An Afternoon in the Sukkah

Saturday was the first day of Sukkot. Courtland Gardens (despite it's name change) still put their sukkah up on the patio. It was a lovely, sunny fall day so we got to spend some time in the sukkah. The decorations were pretty special. I think the plastic fruit industry has discovered the holiday because this sukkah was decorated with strings of fruit, including etrogim!

We tried to get Fay to remember if her father had built a sukkah when she was a little girl. First she said no; then she said yes. We guess there must have been a sukkah on Macmillan Avenue. At least one.

We think Fay must have gone to the kiddush in the sukkah after services on Saturday, but she couldn't remember. Fay's memory is pretty spotty lately. The biggest problem is that she has a hard time expressing herself, so we never really know what she's thinking or if she wants to tell us something.

But, despite all that, she remains in pretty good spirits. Wendy and Misha and Simon will be visiting us for Thanksgiving, so that will be another opportunity for Fay to connect,

Sounds of the Season

I made my usual Saturday visit, this one being the one between Rosh Hashana and Yom Kippur. Fay was in the dining room, waiting for the trivia contest to start. Since the normal Shabbat afternoon entertainer has been out recovering from knee replacement, there is a new crew. The joke lady (whom I mentioned earlier) does the contest and another couple serves the ice cream. Although Fay wears a bright orange bracelet that identifies her as having diabetes, she was sitting with a huge double-dip of strawberry and vanilla when I arrived. I switched it out for sugar free chocolate. I assume this was a rare slip. Peter, the nurse on the Saturday swing shift, seems prepared for the blood glucose spikes of the diabetic residents on Saturday evening.

I showed Fay the pictures we took when Margie and I were in New Jersey and New York for Rosh Hashana. She got a kick out of seeing Alice and Simon, who are growing up fast. The playground pictures were a big hit. I reminded Fay that Sarah is pregnant, expecting a little boy in February. Fay was mildly confused about that news, but we'll keep reinforcing it.

The one image that seemed to break through the fog was a short video of Evan blowing his shofar. Evan is the baal tekiyah at a new congregation starting in Jackson Heights. He brought his shofar to Wendy's to entertain Simon and Alice when Wendy had everyone over for a Holiday meal. If you look closely you can see Alice hiding behind Evan and Wendy's dog trying to escape.

Family Ties

Fay's condition continues to be fairly steady. In early September Margie and I took a vacation to Canada. We stopped by Courtland Gardens after we landed in Baltimore on September 8. Fay was getting her hair done when we arrived. The hair stylist at Courtland Gardens seems pretty good. Fay's hair looks more natural and is missing the trademark hairspray helmet that characterized her appearance for a long time. We had a couple of laughs with the hair lady and then went to Fay's room for a chat.

Since this was a weekday, we also got a visit from the nurse practitioner who takes care of Fay. She had some encouraging things to say. Fay was happy about the "good report."

We looked through the "Monthly Monitor," the monthly news letter of Courtland Gardens. One of the articles was about "Fun with Foods" on Rosh Hashanah.

There was a description of a custom to head symbolic foods that, often through puns, are connected to wishes that we have for the new year. The first time I had heard of this custom was when Misha's sister Julia brought a whole selection of foods to Wendy and Misha's house for a Rosh Hashana lunch. We had a good time sampling the foods and saying the customary petitions for our new year wishes. The article above gives a short explanation of this custom, as well as some modern, English-based, food wishes. For example, you can eat squash and say "may bad luck be squashed."

Another (maybe more) interesting family tie occurred on Saturday during my visit. There was a voice message on Fay's telephone from her great-niece Sherry Schucart, who lives in upstate New York. Sherry is Fay's sister's grand-daughter (yes, the same sister who shares the name of Fay's room mate, Rebecca Wolfe). I called Sherry back and let her talk to Fay. That was a rather unsatisfactory conversation. Fay said hello, Sherry said something, then Fay sat quietly for a few minutes and Sherry apparently hung up. I called her back. "Is Aunt Fay ok?" she asked. I explained the situation and Sherry and I caught up on some things. Sherry had heard that Fay had moved to Baltimore when my cousin Shelly (Rebecca Wolfe's son-in-law) called his niece Sherry to tell her that Fay's sister Mary had died. So Sherry called Fay to offer condolences. I think that message got lost in translation.

Sherry and her sisters are best remembered in our family for their visit to Wendy's bat mitzvah, 24 years ago. My cousin Evelyn and her husband and their 4 daughters and two sons-in-law all came to celebrate with us. Our recollection, confirmed by the photos, is that they topped the list of celebrants, dancing, laughing and having a good old time. Evelyn and her husband have sadly passed away and we have only very infrequent contact with their children. But we have that one event to remember sharing family celebrations.

Finally Setting In? We Can Hope.

It's been 5 1/2 months since Fay moved to Baltimore and Courland Gardens. We expected some difficulties with the transition, and there were more than a few. As I mentioned earlier in this blog, Fay was abusive at times to the staff and some of the residents. She had her share of infections and other acute illnesses. I used to get called once or twice a week with a report about her behavior, blood sugar, bruise, or other problem.

But lately things have been more stable. Fay has settled in to her new environment and seem less anxious about her new surroundings. Wendy thinks it's to her advantage that her default operating condition is to be pleasant and outgoing. So even though Fay doesn't recognize her caregivers or the residents she is around every day, she still calls them "honey" or "my dear friend" and tells each of the staff that she loves them and how pretty they look. Much more Fay-like.

I have been thinking a lot lately about what it must be like to live without memory. I was visiting Fay on Thursday, the day that Ted Kennedy died. Fay didn't know who Ted was, nor did she remember JFK or RFK. The pictures on the TV spurred no memory. So she lives her life almost completely context free. Nothing that happens in the world at large makes any difference to her. Imagine what it must be like not to be able to anticipate a visit or special occasion. If you can't remember that someone is coming to visit, you can't be excited about the prospect. Of course, you also aren't alarmed when you hear that something is going to change for a short period of time, because you don't remember the details of the change ten minutes after you're told.

Maybe this is what people mean when they compare people with dementia to small children. Each day is the same because you don't know what's going to happen and someone else makes all the decisions for what you do and when. For example, on Thursday I stayed until someone came to take Fay to dinner. "You must be hungry, Fay. I know I am," the aid said. "I sure am, honey," said Fay. "Well then let's get you up and into the dining room." I kissed Fay goodbye and the three of us left her room. "Are you going to tell me where we're going?" said Fay to the aid.

It's Hot In the Mid-Atlantic

It's been a very had week here. We also have had our share of thunderstorms and other weather, some from Hurricane Bill.

Fay was looking pretty good this week. She's been having trouble expressing herself and communicating, but we heard a few complete thoughts on Saturday. Some were right out of her usual play-book. She introduced us, for the nth time, to Arthur a resident who often sits near her at activities. "This is my family," she said as she poked him to get his attention. Fay doesn't know Arthur's name. She also proclaimed to her roommate, "I'm having such a good time with them here!" Since Rebecca doesn't hear very well, there was no response. The expected and proper answer would have been to gush about how lucky Fay is to have such a wonderful family. We think some of the tension between Fay and Rebecca stems from Rebecca's lack of dramatic and outwardly expressed appreciation for Fay's family.



One of the activities on Saturday was picking which of the pictures from Wendy and Simon's visits to put on Fay's bulletin board. We think she picked two good ones.

Wendy and Simon Visit

Simon enjoys great-grandma Fay's bracelet. It used to be a charm bracelet. Now the only charm left says Wendy, 6-29-72.


Simon chats it up with great grandma while sitting on Saba's lap. Fay seems to be trying to interpret the toddler babble.


Simon's not getting away so easily from great-grandma Fay.


Smelling flowers in the courtyard.


Wendy and Simon watch great-grandma Fay take a drink in her room.



Fay's great-grandson Simon usually goes to a day care a couple days a week while his mom Wendy works from home. This week was the day care lady's vacation, so Wendy and Simon took the train from New Jersey to Baltimore to spend some time with us. Wendy and Simon were able to fit in three visits to Fay this week. The first visit was Margie, Wendy and Simon on Monday. Then on Thursday I took off in the morning and the three of us went back for a second visit. Because Wendy's train didn't leave until later in the day on Saturday, we fit in a visit on Saturday morning, too. You can see some pictures of these visits (in no particular order) above.

We were lucky that the weather was not too hot. Simon enjoyed running around the courtyard and smelling the flowers. He also got a big kick out of the bird cage, featuring very noisy and active exotic birds.

Fay really enjoyed these visits. Simon gave her kisses on her hand and liked stroking her hand and leg. At one point Simon sat on Fay;s lap. She found some unexpected strength holding him; we had to pry Simon out of her vice-like grip when it was time to put him down.

Fay seems pretty tired lately. We found her sleeping in her wheel chair at each visit. Usually she perks right up when we wake her, but sometimes she seems pretty out of it for a while. On Saturday she was at shabbat services, dressed in a skirt (but sleeping). I think she goes to services every Saturday, but she doesn't remember and says not. I'm a little worried about her right hand, which continues to get weaker. She almost never uses it now.

A Weekend in the Heartland

It was a busy week for us. I was in Omaha on business so Margie stopped by to see Fay in the middle of the week. It was the day that Fay had her hair done; Margie said she looked great. She seemed to understand a lot of the conversation, which centered on Margie's and my rendezvous in St. Louis. On Friday I flew (with some difficulty) from Omaha to St. Louis where Margie joined me. We wanted to take the opportunity to see our St. Louis family and friends.

Fay understood who we were going to visit and said how much she missed her family. As I have noted earlier in this blog, her family is everything to her.

The central part of the weekend was a 35th anniversary party for Jessica and Harold Fadem. It was a wonderful party. At the beginning of the festivities, Harold's sister Anita Wallach told the story of how the couple were introduced. It turns out that Fay ran into Anita in the grocery store. Jessica had been recently divorced and Fay asked Anita if she knew anyone who would be interested in dating a lovely woman. Anita suggested Harold, who was also divorced. The rest is history.

It's great to remember how involved Fay was in the lives of her nieces and nephews. Over the weekend we had some good laughs about Fay's golfing lessons and other shared experiences with my cousins.

On Sunday, before we left for home, Margie and I stopped by the cemetery to check on my father's grave. An irony (or coincident at least) is that Fay's sister Mary had just been buried nearby, so there was lot's of evidence of visitors to my dad's grave as well as others in Fay's family. We gave my dad an update on Fay as well as his grandchildren and great-grandchildren, of whom he would be extremely proud.

Money Plants - You Reap What You Sew

It must have been 25 years ago, or so, when Fay was living on Briarwood, in the house that she and Charlie Rosen lived in. Charlie had lots of hobbies and interests, gardening among them. There was a rhubarb patch in their yard, a grape arbor, and other interesting plantings. Fay didn't think much of the grape arbor. That was one of the first changes after they got married. The grapes attracted birds and basically created a mess that Fay wasn't interested in keeping up with.

Among the plants in their yard were "money plants." These plants are so named because the seed pods contain shiny, cellophane-like disks that look like coins. When the plants dry out, you can rub the seed pods, remove the outer material, and expose the seeds and the inner "coins." Before one of Fay's visits to us, after Charlie had died, she picked a whole bunch of money plants and harvested the seeds. She brought them with her to Maryland and surprised us by planting these seeds all over our yard. I should point out that she planted these seeds before telling us about the project.

Money plants yield their seeds every other year. On the in-between years, there are purple flowers (that frankly look like weeds). On the year that the plants produce seeds, they scatter on their own so that we find a random money plant growing around our yard even now.

Last week Margie decided to pick some plants and fix them up to decorate Fay's room. See the photos above. Fay seemed interested in the story about the plants. We had some good laughs, but I'm not sure she remembers that she is the Johnny Appleseed of money plants in Columbia, MD.

Overall status: Looked good on Saturday. Not as drowsy as the week before. Staff report that she engages them and is in a pretty good mood overall.

Alice Visits Great-Grandma

It was a mixed weekend. When Margie and I visited Fay on Saturday she was sleeping soundly in her wheel chair. We had a hard time waking her, but we took her to the garden for a chat. Fay was very tired and kept falling asleep. We finally took her back to her room, had her put in bed and went for a coffee and snack at a nearby coffee shop. When we returned about an hour later, she was still very groggy and not too coherent. We stayed and talked for a short time, and then left.

The next day when Evan, Sarah, Alice and I returned, Fay was still in bed (it was about 10:00). An aid got her dressed and we went back to the garden. Alice had brought a watering can, so that she could water plants - a favorite activity of hers.


Fay seemed to enjoy the visit from her family. Evan and Sarah held her hand and talked to her. Fay loved the attention and enjoyed seeing Alice play. Alice also got to see the birds in the bird cage and the fish in the fish tank. Courtland Gardens has everything a curious 2 1/2 year old could want. Alice commented that visiting great-grandma Fay reminder her of Evan and Sarah's neighbor Nancy, who was a 90+ year old woman. Funny how kids make these associations.



In a couple of weeks Wendy will be visiting with Fay's great grandson Simon. It will be fun for Fay to get to see Simon who is now walking around and chattering.

The Transition to Courtland Gardens Continues

The sign on the building and the sign by the road now say Courtland Gardens Nursing and Rehabilitation Center rather than Jewish Convalescent and Nursing Home. The updated name will signal the community that this facility is open to all (although the Jewish atmosphere will still be honored, so they say). As part of the Jewish atmosphere, while we were sitting in the garden with Fay this afternoon we saw about five young Jewish men, a young girl and two adult women climb over the fence to enter the facility. The boys, complete with tzitzit and payes, had no trouble scaling the fence, but their mother in her long skirt had some difficulty. We figure the dramatic entrance was to avoid going in the front door which opens automatically when you approach. So rather than activating an electrical device on Shabbat, the family jumped the wrought iron fence.

Fay had a good time with her ice cream (we got there in time to get her sugar free today) and looking at a new picture of Evan and Alice fishing in Maine. We chatted about the All Star Game which will be in St. Louis this year. Fay was a little disappointed that the game is at night now, past her bed time.

We found signs of visitors in Fay's room. A young person named Chaya Yehud left a hand made greeting card that said "glad you are feeling better." Fay was pretty alert, but tired. Her hair had been fixed and she had a fresh manicure.

Independence Day Visit

There was some discussion over the past week or two as to whether or not Fay was at the picnic where she apparently got a little sunburn. Nadine, the nurse on the floor, was certain that Fay was at the picnic, but Fay didn't think so. However, the evidence is now clear. In the July issue of the "Monthly Monitor, A Publication for the Residents and Families of Courtland Gardens," there are some photos of the June picnic. You can see Fay enjoying a snack and a drink with an unidentified resident.

Back to July 4. It was a beautiful day in Baltimore, not too hot and dry. Fay was eating ice cream when we arrived (the Saturday special) and we took her into the garden. She was alert and fairly with it. We had a good time watching the birds feed out of a tray with bird seed that is set among the flowers and bushes. There were two breeds of birds that seemed to take turns at the feeder. This strange inter-breed harmony was only interrupted when the resident chipmunk invaded their space and took his turn at the feeder. Then the birds pecked at him and chased him into his hole.

We talked about a lot of things, and Fay seemed to know what we were talking about. I mentioned Harold and Jessica's wedding anniversary, Shelly and Deanna's birthdays, Jessica's birthday, Mike Rubin's barbershop chorus (first place international competition), and a phone call I had with college friend Cary Berkowitz, whom I haven't contacted in well over 30 years. Fay seemed to know what I was talking about. You never know for sure.

Health Update

Fay has had a rough couple of weeks, health-wise. The good thing about memory issues is that she doesn't remember.

It started when I noticed that she was coughing a little more than usual. She often coughs because of her chronic obstructive pulmonary disease, but this seemed worse to me. I mentioned this to the nurse practitioner who ordered a chest x-ray. The test came back positive for an "intrusion" in her lower lobe, which was treated like pneumonia. The antibiotics for the pneumonia apparently caused a flourishing of the c-diff. bacterium (Clostridium difficile, for those interested). C-diff causes antibiotic-associated colitis, symptoms of which are bloody diarrhea. New antibiotic, slight change in other medicines that can irritate the digestive tract. Cleared up the C-diff, but a UTI followed, most likely from contamination from the diarrhea. Currently, all infections are under control.

Last time we saw Fay she was more tired than usual. Not too surprising. The nurse practitioner was not too concerned, nor was the doctor or nursing staff. It takes time to recover and they wake Fay up early to start the day. Sitting all day, even with activities, can be tiring.

Margie had just returned from a visit with Evan, Sarah, Alice, Misha, Wendy and Simon at Sarah's parents' vacation home in Maine when we visited last. Fay had a good time looking at Margie's pictures, particularly the ones of Alice and Simon. Alice busy digging in her garden and Simon displaying his new-found skill walking upright on two feet.

More On the Birth Certificate

One other oddity on the birth certificate below. The number of living children listed for my grandmother is 10. I wonder where that number came from?

What's In A Name?

I had to complete some paper work for Fay the other day, and needed to include her birth certificate. I was surprised as anyone that I was able to find it among the records I have been collecting recently, but I did. I also learned some things.

Most of us know that her given name was Fannie, not Fay. I asked her today when she started using Fay, but I don't think she remembers. I asked her if it was in high school. She said, "Yes," so we'll go with that. The other interesting things I learned are:

• Her birthday is April 9, not April 8 as most of her records show. That's actually old news. The story is that my grandmother went into labor on the 8th and assumed that her baby was born on the 8th, even though the actual birth was on the 9th. Since the time of birth is 1:45 AM, this story is certainly feasible.
  
• The names are spelled wrong. The family name is shown as Fader, not Feder as everyone spelled it. My grandmother's name is listed as Sabra, not Sarah.
  
• I had thought that my mother's childhood address was on MacMillan Avenue, but the address recorded is on N 14th or N 19th Street. I guess the family moved to MacMillan some time later.

I'm guessing that inconsistencies like those happen from time to time, particularly in the immigrant communities where English is not the primary language. I can't wait to see what problems this causes down the road.

For those of you following general progress... Fay was treated for pneumonia earlier this week (a condition she has had before, usually reported as "infiltration of the left lobe.") The antibiotic knocked the pneumonia out, but caused an intestinal infection that needs to be treated with yet another antibiotic. Fay is a little weak from all of this. On Thursday she was tired but not too disoriented. Not so with it on Saturday.

The Family Circle Club

Fay is always saying, "I love my family." This is not just idle talk. It is hard to overstate how important family has been to her all her life. In her extended family, the distinction between cousins and brothers and sisters, or parents and aunts and uncles often blurred.

I came across a tattered old notebook the other day that contained minutes and other artifacts from the Family Circle Club of the Tepper and Feder families. "The welfare of the family first" was the motto on the club's official stationery. The minute cover the period from 1956 to 1961, more heavily weighted towards the earlier days in this time frame. We took the book to Fay yesterday and read through some of the papers. We had a great time thinking back to the time when you could throw a banquet for 25 people, including flowers, favors, liquor, and food for less than $150.

The Family Circle Club had about 25 active members. They met monthly at the home of one of the members, usually starting late often after 8:30. Margie and I speculate that people in those days worked long hours, even on the weekend. I know, for example, that my father, who was a pharmacist, often worked weekends and late into the evening.

The business of the club included how to spend the money they collected (usually donated to a yeshiva in Israel to commemorate a yahrtzeit). Most of the time, as dutifully recorded by Fay in typed minutes, was spent on procedural issues and planning the next social activity. One exchange is particularly illustrative of the personalities involved. The montly dues were $1.50 per family. Fay's sister Mary that amount was too high and moved that the dues be lowered to $1/mo. A large debate ensued until my father, Phil, moved to table the motion. My dad was not big on rancor or pointless argument. Phil's motion passed with the provision added by my Uncle Hy that this issue be the first order of business at the next meeting. Hy was big on organizational dynamics and would have loved the debate (unless it moved in a direction that he opposed). Fay's brother-in-law Nat Solomon, apparently worried that the treasury could take a large hit in the future, made his own motion that they collect three months' dues at this meeting, thereby nullifying Mary's motion. The members saw through this trick, apparently, because the motion died for want of a second.

The club ran out of steam in the late '50s. In an attempt to attract the next generation, my cousin Irwin was elected the next president. My sense from reading the minutes and looking at the flyers (see above) is that Irwin was the connector who kept the club together and his wife Roz planned or herself catered most of the activities. So it is with organizations; the work is rarely shared uniformly.

A Digression - The Recipe File

Our son Evan suggested that we share some stories about Fay from her younger days. Here's a short vignette that reaches back to ancient history, before e-mail and cell phones, when people communicated mostly by mail and once in a while (on special occasion) by long distance telephone.

Margie was cleaning up her recipes the other day. The recipes she had collected after 40 years of marriage were stored in a ragged three ring binder that used to be organized by type of food. Lately the material was just tucked away with less attention to the type of recipe or food group. In a burst of creativity and energy, Margie bought a new binder, some file separators, and some pocket dividers. Then she organized her recipes, throwing out the ones that she didn't like or didn't plan on making. In the pile of recipes to keep were several 3 x 5 index cards from the mid '70s that Fay had sent her. The one above is for Passover cookies that Margie has made from time to time. Some of the recipes came with letters, handwritten early in the morning from Fay's office at St. Louis Shower Door, or perhaps Cooper Window Replacement Company.

The notes accompanying the recipes usually had a comment about how Fay was tired (the more things change, the more they stay the same) and some news about her life. These recipes were sent a few years after my dad had passed away and before she married her second husband, Charlie. Fay was involved with her friends and club work at the time, including taking a Dale Carnegie course. We kept in touch mainly through letters and a weekly phone call. It's hard to appreciate the importance of taking the time to write out recipes and mail them in these days of instant communication and feedback.

We shared some of these recipes and letters with Fay the other day. She was happy to see them and was proud of her handwriting (which is pretty good, you must admit).

More stories as I think of them.

A Little Ferblunged

I think we may have woken Fay when we arrived on Saturday afternoon. She was sitting in the dining room, waiting for the ice cream social and trivia quiz, but she was probably asleep. She was happy to see us because she "needed to discuss some things with us." We went to her room and Fay seemed disturbed. She had a lot of trouble verbalizing what was on her mind - we think it may have been the continuing saga of room-mate Rebecca's frequent trips to the bathroom.

We went to the sun room to chat and have ice cream. Fay asked us if she had left anything that she needed on Macmillan Avenue (where she lived as a child and teenager). Her conversation was definitely garbled today. Maybe because she was sleeping when we arrived.

We skipped fingernail polishing because the manicurist at the nursing home had already fixed her nails with a bright red-orange polish. Margie showed Fay some pictures (duplicates of the ones on her wall) and Fay was very excited to see great-grandson Simon's picture as well as some of great-granddaughter Alice. Fay gave Simon one of her highest compliments: "he looks like a schaigetz."

Since we are going to see Wendy over the Memorial Day holiday, I'll try to stop by on one or two afternoons this coming week.

Mother's Day Part II

Since today was the real Mother's Day, I decided to drop by Courtland Gardens and see what was up. I got to the nursing home about 10:00, and Fay was still getting ready. It turns out that the staff were setting up for a Mother's Day brunch. So Fay and I got to have a good visit as well as brunch set up in the dining room, the sun room, and on the patio. We ate on the patio.

Made to order omelets, fruit, cheese, bagels, coffee and tea. The process was supposed to be that guests got their own food and the staff brought food for the residents. That process was supposed to ensure that the residents got food appropriate for their special, individualized diets. I as well as most other guests failed to follow directions and brought our mothers their own food. Staff came by and inspected our choices. I think I passed.

Each mother also got a carnation. I put Fay's and room-mate Rebecca's flowers in vases in their room. Rebecca is eating next to Fay in the picture above.

It was a beautiful day, and eating on the patio was pleasant. We also got phone calls from Margie (who was enjoying her morning walking with friends and dogs around the lake near our house) and Wendy.

Other features of the brunch were special music (I think it was Rudy Valee recordings) special flowers on the tables, and festive decorations that would have been more appropriate for Cinco de Mayo.

Mother's Day, Part I

It was a little longer between visits this week. We stopped by on Friday, May 1 on our way to New Jersey to visit our kids and see a play by good friend Mike Goldfinger's daughter-in-law Jackie. Mike describes the play as "off Broadway," but "off off-Broadway" may be more accurate. Anyway, the play was very, very good and we had a fun (if short and rainy) weekend.

On that Friday, Fay was in a particularly cranky mood. We tried to reassure her and calm her down. Since they keep unplugging her phone to hook up her nebulizer, we couldn't check on her directly until our visit on Saturday, May 8. We found her in a good mood, laughing at everything, telling all the staff and care-givers who we are and that she loves them. We brought some presents, including an extra plug so that the phone can stay plugged in.

Fay had received some Mother's Day cards. The clip above is her public "thank you." Jessica Fadem's was the most original. It was supposed to be a recording of her voice, but unfortunately the electronics were damaged in the mail and all we heard was a male voice giving instructions for recording. We had a good laugh and it was a good opportunity to remember Jess and Harold, Sarah, Michael and Justin as well as the other neices and nephews.

We have our regular cadre of other visitors on Saturday. There is the religious woman who comes with her children for the mitzvah of bikkur cholim, visiting the sick. I think I mentioned that her grandmother owned the Evergreen nursing home in St. Louis where Fay's sister Beckie lived. We chatted about St. Louis. She wondered if I knew her grandfather, Rabbi Kelner (sp?) and I asked her to check with her family about Fay's sister Ann Rose who was a kosher caterer in St. Louis for years.

There is also the elderly lady (very elderly) with the Cleopatra eye make-up. Her husband is a resident and she comes every day to volunteer. She also has an inexhaustible supply of jokes, most of which are shockingly off-color. Yesterday's topper (which I won't repeat) involves a Jewish woman, deviant sexual practices, and an Arab husband. Fay laughed like crazy, and Margie and I laughed at the bizarro situation.

The Care Plan Meeting

Because of the apparent, sudden personality changes that the staff at "Courtland" observed in Fay, I asked them to hold an early care plan meeting which I could attend. They squeezed me in at 10:00 today, 15 minutes earlier than the normal start times for these meetings.

I arrived at the nursing home at 9:50 and was directed to conference room 1A. I assumed that if they had numbered conference rooms there would be several to choose from. In fact, there seems to be only one conference room. So 1A is a better room number than, say, 5B, or 207.

At about 10:00, the team arrived. Glenora, the social worker, conducted the meeting. She started by asking Bonita, the nurse in charge of this unit, for her observations and assessments. It seems that Fay does sometimes act abusively to staff and residents. But the behavior is transient and she usually becomes pleasant again quickly. All the staff are trained in dealing with patients with dementia, so they know not to associate this behavior with the patient, but with the disease. Bonita reported that the psychiatric nurse feels that reducing the dosage of the Alzheimer's drug (Nimenda??) may not be a good idea. I am to check with the nurse practitioner to see if she agrees.

Rachel, the activities director, said that Fay likes to go to activities, although she doesn't participate actively in those that require cognitive activity (like the daily trivia quiz). (Who is surprised by that?) Fay particularly likes the intergenerational programs (which I think means kids singing songs).

Christine, the dietitian, says that Fay's appetite is good. She eats 75% to 100% of each meal. I asked how she feeds herself since she doesn't use her right hand. That fact seemed to surprise everyone. Hmm.

All in all, it was a reassuring meeting. The team seemed to understand the situation well and was prepared to handle Fay's needs.

After the meeting I found Fay waiting with Rebecca for the trivia contest. We left the contest and went back to her room. Fay had her hair done the night before and still had the baloon on her wheel chair from the April birthday party yesterday afternoon.

Sign Of The Times

One of the things that attracted us to the Jewish Convalescent and Nursing Home was the haimish feel of the place. Kosher food, some men wearing kippot, a bima and prayer books set out in the dining room, etc. But times are changing.

Just like the Cedars in St. Louis is losing its Jewish identity (are there a dozen people using the kosher dining room?) so is the Jewish nursing home in Baltimore. We learned this weekend that the home has been renamed Courtland Gardens to reflect the fact that "the demand for long-term care services within the Baltimore-area Jewish community was not sufficient" to support a Jewish-only residency. But, says the notification letter, Jewish residents "will continue to share in the traditions of living a Jewish lifestyle." "One thing is certain," the letter goes on to say, Courtland "will continue to maintain the hightest standards" of care.

Thank goodness for that.

Closer to Her Old Self

Today Fay was finishing lunch when we arrived. On Shabbat, all the meals are cold. It looked like Fay had done a pretty good job on the white fish salad and veggies, but left the potato salad. She was drinking milk from the carton, sitting next to Rebecca.

We brought the old phone from the Cedars, programmed with my home, cell, and work phone numbers. It's one touch dialing; we'll see if it works. We were about 1 for 3 in the experiments we tried. Not too good for phone dialing, but it will get you into the Hall of Fame if you play baseball. The other advantage is the answering machine. We can check to see if anyone calls during the week and get back to callers who leave a message.

It was hot in Baltimore today. We went outside and sat in the gazebo, read the Baltimore Jewish Times and looked at some pictures. Then we went inside for the ice cream social. Some of Fay's old personality shone through the confusion today.

She asked me if she could pay for the phone.

She told us not to spend our money at the hardware store (we told her we were getting some stuff for our deck-garden).

She reminded us to say goodbye to Rebecca (after all, she has to live with her).

The Problem With Blogging

I can see that blogging has its sinister side. Once you start, you feel like you need to keep going, like a diary. Then you worry that, unlike a diary, what you post is available for anyone to read. It's like being an exhibitionist. You want to share, but somehow you worry that it's wrong.

Today the nursing home called to say that Fay was being verbally abusive to her caregivers. She has had outbreaks like this before, but I thought things were getting better. But today she hit her caregiver. The nurse practitioner will increase the medicine that is supposed to calm Fay down. I suggested that they check for a urinary tract infection, which sometimes makes her act strangely.

So here we go. My friends tell me what a good idea it was to move my mom to Maryland. "Now you won't have to feel guilty every time something happens and you can't be there," they say. So now I feel guilty that I have moved her from one situation, where she was apparently comfortable with her surroundings (albeit lonely for me and Margie and our kids) to one where she must feel threatened by her caregivers (and still lonely).

Go figure. Things will work out.

Spring Has Sprung

The weather in Baltimore is 72F with a few high, whispy clouds, and hardly a breeze. We took Fay out into the courtyard this afternoon for her sugar-free ice cream snack and manicure. Margie only wounded Fay once during the manicure, but Fay didn't seem to mind. Basecoat, polish and topcoat. Ready for another week.

You can see that the beauty shop has become a little more adept at styling Fay's hair. It has grown out some and the new set looks good. Not as much hairspray as Fay has used for the past, oh, 60 years, but attractive nonetheless.


Fay seemed a little confused today. She talked on the phone with Wendy and then with Sarah, but at times the conversations seemed to take strange twists. I think her ability to articulate her thoughts is lagging the thoughts themselves. Sometimes by the time she thinks of how to say what she had on her mind she has forgotten why she wanted to say it. The nurse practitioner and doctor are of the opinion that the memory and Alzheimer's drugs are not doing anything (and their efficacy is controversial anyway) so we have started to wean her off them. Maybe we need to re-think that strategy.

Birthday Cards, Etc

Today (Saturday during Pesach) only Denny came for a visit. Margie was with Fay yesterday when she brought Wendy and Simon for a visit.

Fay was all dressed up in a velvet skirt. I'm not sure if it was because of Shabbat or the staff just find the skirt easy to put on. Anyway, another visitor or volunteer said that he saw Fay at services this morning. That's a fine activity for a rainy Saturday morning.

I signed Fay up for a special Medicare program that provides an LPN and drug coverage (like Plan D) for nursing home residents. The LPN had given Fay an examination earlier in the week and gave me a report on what she observed, some things she was going to adjust, etc. I mentioned the visit to Fay and she said she was looking forward to meeting this lady. (Events an hour or two in the past or often lost to her now, much less something that happened three days ago.)

I also found birthday cards from my good friend Mike Goldfinger (see post below about A Friend in Need) and Fay's sisters-in-law Lydia and Rosie. Fay wants me to tell everyone how happy she is to get the cards.

Visit from the Grinbergs

Here are a few pictures from Wendy, Misha and Simon's visit over Passover. They were excited to wish Fay a happy 89th birthday. The great grandson and his great grandmother thought one another were, well, great!





Simon wasn't too interested in the birds or the fish, but he had lots of fun throwing the camera case and then picking it up.



He also appreciated the toddler-level microwave that reminded him of the play kitchen.


Everyone liked listening to stories.





Grandma Fay especially liked Simon's shoes.


A favorite comment overheard in the sun room--
Clue for "giant" crossword: I think, therefore...
Best guess: I think they're five!

Well, we think you're swell, Grandma!

Settling Into A Routine

Saturday afternoons are starting to take on a comfortable routine. After Denny has his workout and Margie does her morning activities, we go to the nursing home for a visit with Fay. By the time we get the home it's about 1:30, which is just in time to do a little schmoozing in the room before we go to the dining room for the start of the ice-cream lady's program. We discovered that she has sugar fee ice cream, which apparently was better for Fay than the two scoops of chocolate that sent her blood sugar through the roof last week.

We don't stay for the trivia contest and story telling. We go next door to the solarium and read stories. Fay gets a free copy of the Baltimore Jewish Times, so we read some of the more interesting features, like the resumption of a kosher food stand at Orioles' games. (A favorite of Evan, when he lived in Baltimore, were the gigantic knishes that they served.) Margie has become quite a manicurist. It's a nice touch to have someone fix your nails and Margie has gotten very good at this skill.

You can see Fay displaying her manicure above.

Another fun touch is that we have met a young Orthodox woman and her two little girls who walk to the home every week to visit the residents. Fay gets a kick out of chatting with this family (plus a young friend who usually comes too). An interesting note is that this woman's grandmother lived in St. Louis and owned the Evergreen Nursing Home, which I think is where my Aunt Beckie lived for a while. The other link to Aunt Beckie is that Fay's room mate's name is Rebecca Wolfe, which was this same Aunt Beckie's name. I've tried to explain this several times, but I don't think there is any comprehension.

An Up and Down Week

Last Saturday (March 21) was a rather worrisome start to the week. We found Fay lying in bed, rather disheveled, in a poor mood. We got an aid to get her dressed and into her wheelchair and took her to the sun room (see "Krabby's" post with a picture of the sun room). By the time we left Fay was in a pretty good mood.

On Monday, the LPN called me to say that Fay was being abusive to the staff and her room mate (a sweet 94 year old woman who is hard of hearing; it's hard to see how Rebecca could bother anyone, but that's another story). I went to the JCNH on Tuesday and Fay was indeed acting very strange, complaining loudly about people she was interacting with. The LPN had scheduled a psych evaluation for Friday to see if there was anything going on with the attitude shift.

By Friday, however, Fay was back to her old self. The psych eval was post-poned. When Margie and I visited on Saturday (March 28) we found Fay talking to Rebecca. We went to the ice cream social (note to self: a smaller portion will probable not send the blood sugar through the roof), looked at some photo albums and had a grand old time. Fay remembered lots of people in the pictures whom she hadn't seen in quite a while. "That's Margie's mother" was an unexpected comment when looking at Wendy's photo album.

We hope the early part of the week was just part of the transition process. Right now, Fay's OK.

A Friend In Need

With all of the information about Fay's move from St. Louis to Baltimore, I forgot one of the most important parts of the transition. When our very good friend Mike Goldfinger learned about our plans, he immediately asked what he could do to help. Mike didn't take no for an answer and volunteered to take off from work on arrival day and meet us at the airport.

What a wonderful site it was to see Mike waiting at the baggage claim for us to help get the stuff loaded in the wheelchair van and take Margie and her stuff to our house while Denny rode with Fay to her new home. On one hand it seemed so natural to have Mike part of this day. On the other hand it made us grateful to have such a committed friend to count on.

Visiting Grandma Fay

The blog's namesake. A friend embroidered this sign for Grandma years ago and it is now hanging above her bed.

We were fortunate enough to see Grandma twice on our trip over Evan's spring break. Alice showed Grandma one of her favorite books, "Four Little Bunnies."

After some time in Grandma's room we went to the sun room, right down the hall, past a dining room where a volunteer was holding a trivia game (the host of the game later approached us, asking what kinds of activities Mrs. Rosen might enjoy). The sun room is bright and warm with a sweet birdcage. Alice had fun running around. Sarah had fun, but maybe slightly less fun than Alice, chasing her all around.

A major highlight for Alice: two volunteers in the dining room gave Alice some cookies.

What a great visit we had. Lots of smiles all around. Grandma really seemed comfortable and well cared for in her new digs.

First Visitors

The week after we moved Fay into her new home in Baltimore, grandson Evan, granddaughter Sarah, and great granddaughter Alice came for a visit. It was Professor Rapport's spring break, so the family came south from New York City to spend some times with Margie and Denny and to see Fay in her new home.

Evan and Sarah report that Fay is doing well and seems to like her new home. There are sure to be some rough days - Fay's health and mental state are rather fragile - but we'll take all the good days we can.