Hospice Care for Betty

On September 1, Jean and I went to a Care Conference for Betty and noticed that there were some significant changes in her.  She no longer recognized me, she favored her left side, and then she started having falls.

On October 13, I went to a Care Conference for Grandma at Evergreen.  Jean was out of town at a veterinary conference in Reno, Nevada and couldn't attend.  While I was at the Care Conference, the staff discussed with me their concern about Betty because she'd been making a rapid decline.  Most of this was because of her falls; she'd been having about two a week.  As a matter of fact, she just had one Oct. 21.  On one of her falls, she broke her bottom dentures.  I asked the resident social worker Roger if he thought that there would be any benefit to Betty's way of living if we got new dentures for her.  He didn't even hesitate to say no.  The staff has moved Betty to a new room where she can be better monitored, but that doesn't stop Betty from trying to get out of bed when she wakes up.  The staff recommended that I put her on hospice care.

To me this was not shocking news.  Having studied a bit about Alzheimer's Disease, I recognized that once she started falling, she would probably make a rapid decline and then pass away.  Alzheimer's patients can be obsessive walkers, which Betty is, and at some point, they forget how to walk.  The combination can become fatal.  It seemed that this was coming true for Betty.  Based on what Evergreen was telling me and how fast someone can decline, I guessed that she only had another month to live.

I tried to get an appointment with Betty's doctor because he wanted to talk to Jean and me about some test results on Betty, but I was unable to that day because it was Wednesday and neither the doctor nor his nurse were in.

Thursday, Oct. 14, I called both Hospice Care and Rocky Mountain Hospice.  Wow!  There is certainly a difference in the companies!  If anyone in the Livingston/Bozeman area wants a recommendation for a hospice company, I can easily recommend Rocky Moutain Hospice.  We set up a meeting at Evergreen that day and talked about Betty's care for an hour and a half and then I signed their paperwork.  We still needed Betty's doctor's orders to put Betty on hospice though.

I went back to Park Clinic and tried to make an appointment to see Betty's doctor.  I had two errands now: Betty's test results and hospice care.  His nurse, told me that he was "booked for the rest of the day and can't see you, and he's going out of town tomorrow and won't be back until next Thursday.  Is that too late?"  That was just about the stupidest question I had heard.

"I don't know," I replied, "Betty's going into hospice.  When is too late?"  Nothing was accomplished by talking to that nurse.

Rocky Mountain Hospice went to bat for me and found out that Betty's doctor was actually going to be back in town before he was actually supposed to be at work, so they were able to get the ball rolling.  Betty was officially on hospice October 20, six days after we tried to get this done.  Thank you Rocky Mountain Hospice!

Yesterday, October 21, Jean got a call at 2:30 pm asking us where we were because we were late for an appointment with Betty's doctor.  I kid you not:  I flew off the handle, especially at the Park Clinic employees, because Jean and I knew nothing about this appointment with her doctor, for which we would have gone to had we known about it.  For real!  I tried twice last week to make an appointment, in person!  (Living in Gardiner means that we need to know at least an hour before an appointment so that we can drive to Livingston.)

I did get to talk to Betty's doctor, and explain all the road blocks I had been having trying to get in touch with him concerning both Betty's test results and hospice care.  Her doctor is a good one, and he's always tried to help us out when he could, but I recently kept having obstacles in arranging an appointment to meet with him, and this was really the third strike.

Betty's test results showed that she had scarring in an aortic artery.  That may or may not have any affect on her falling.

Also, tests were done on her vocal cords because she doesn't talk anymore.  The doctor doesn't believe that the paralysis of her vocal cords is because of Alzheimer's; he believes there may be a tumor or other malady near her throat.  All her life she's had thyroid problems, and I consider that this could be a result of that.  The doctor doesn't believe that treating it would be in Betty's best interest, and I agree; one of the reasons I wanted to put Betty into hospice is because of problems that we can't fix without life-threatening solutions.

The doctor agreed to sign the orders for hospice because of our wishes, but doesn't necessarily believe that Betty is terminally ill.  On the other hand, the nurse who did an exam of Betty for Rocky Mountain did believe that she qualified.  Evergreen staff and Betty's social worker at Evergreen recommended hospice.  I see Betty's rapid decline myself and know it's a really bad sign.

I hope that Betty gets better with the extra comfort-level attention that hospice can provide.  Maybe she'll get out of this scenario.  But if she does, I don't think she will live very long anyway because of the possible tumor and because after losing the ability to walk, Alzheimer's patients lose the ability to swallow.

I haven't been too close to Betty myself, so I hope I don't sound heartless in writing so dispassionately about her circumstances.  Her decline is sad, but it doesn't affect me very personally.

My biggest goal in her care at the moment is making sure her immediate needs are taken care of.  I think it's especially important now because of the possibility that she will soon die.  Montanans want to die with dignity; it's even written in our constitution.  I won't deny her that.

The Bear's Tooth

September 29 Jean and I decided to drive along Beartooth Pass.  She had been dealing with pressures from her work, and we hadn't done something together since we went to the Montana Fair in August.

We drove in a loop, starting in Gardiner, then going to Mammoth, Cooke City, Red Lodge, Laurel, Livingston, and then back to Gardiner.  It was definitely an all-day trek since we wanted to take pictures and enjoy the day as much as we could.  I'm not complaining about my work schedule, but my night shift obviously keeps me up all night so we had to hoof it a little bit because sunset is now around 7 pm.  I get up late in the morning or early in the afternoon, so I had to get up "early."

We enjoyed viewing the bridge on US Highway 212 at Lake Creek.  There is also a waterfall there for those who are willing to walk one or two hundred feet.  From there we made a couple stops near Beartooth Butte.  We could easily see the fire watch tower on Clay Butte.  There is still some construction at Beartooth Lake, but it's limited.  We hardly had to wait at all.  From there we drove to the top, about 11,000 feet above sea level.  I noticed that the sign that used to say that we were at the 11,000 mark is painted over.

Beartooth Lake

Near the top we could clearly see Quintuple Peaks, also known as the Bear's Tooth.  I am truly a geek because I have the USGS data for Montana and Wyoming on my computer.  Apparently, even though the sign says The Bear's Tooth, that is actually not the mountain's name.  In fact, the official name is Quintuple Peaks.  It certainly is a geologic quandary.

It's me!  I'm in front of Quintuple Peaks on the Montana and Wyoming border.

Probably Jean's favorite spot was at Twin Lakes.  There are so many lakes in that basin, but only the two lakes are named.  The basin isn't named, and neither is the ridge on the edge of the basin.  I am absolutely amazed at the lack of identification for a place which is so popular and beautiful.

Twin Lakes; Hellroaring Plateau is in the background.

On the Montana side of the pass, we stopped at a roadside park.  There were several least chipmunks in the area, and they looked to be well fed.  We took some pictures of them for a little while and then walked on the short trail to the edge of a cliff.  From that vantage point we were able to see a good portion of Rock Creek Canyon.  There was a little bit of smoke in the air from the Antelope Fire in Yellowstone National Park, and it gave the mountains extra character.

Autumn Blaze

Once we reached Red Lodge, we saw a red fox on Shadow Lane.  It must have had fleas or something because it was constantly itching itself.  It was nearing some people's chickens, but didn't actually pay a lot of attention to the chickens.  I think the fox was more worried about my presence than anything else.

Jean and I ate dinner in Red Lodge at Bogart's.  It's a good Mexican restaurant that we can both recommend for anyone traveling in the area.

From there, we drove to Laurel and got some gas, and then headed back home along Interstate 90.  We had a really great time.  The last time I went on Beartooth Pass was with my ex-girlfriend back in 2007.  Jean hadn't been there since she was a child.  It was about time that we saw it again.  We really had a great time, and we got the relaxation that we needed.

The Gardiner Bruins Isn't Just a Team...

I know I still have to write about Jean's and my trip on Beartooth Pass last week, but before I do, I wanted to tell you about a newspaper story that occurred near my home.

Coop-raiding grizzlies back in Yellowstone

BOZEMAN (AP) -- Three grizzly bears that raided chicken coops near Gardiner have been relocated into Yellowstone National Park, but a male bear that had been hanging out near the school in West Yellowstone was not so fortunate....

Also Tuesday, FWP [Fish, Wildlife and Parks] officials captured a female grizzly and two cubs that raided two separate chicken coops in the Gardiner area.

The sow was in fair condition and the cubs were thin and biologists are uncertain if they will survive the winter.

Yes, the sow and two cubs killed about 14 chickens across the road from me about a quarter-mile away.  When I went to work, I saw the bear cage in their yard, but I couldn't see the grizzly if it was there.  I was sorry to hear about the chickens.  I saw them on a regular basis on my way to Gardiner.

It's kind of interesting when the news reports something that's close to you.

I've been having a grizzly boar in my yard lately, and he's messed up a couple trees.

Also one of our neighbors' cats is missing.  I still haven't seen that cat, and I hope that Puff hasn't turned into a grizzly snack.