Wednesdays with Dorothy: "I’ve Got Myself in a Terrible Mess"

< Previous post              (This is part of a series. For Table of Contents go here)                  Next post >

The telephone rang at about 3:30 in the morning one Saturday. It was Dorothy calling.

“Charlie, can you come over here? I’ve got myself in a terrible mess.”

I asked Dorothy what was the matter, and she explained to me that she had been very ill throughout the night. She had called 911 and the EMTs were already on the scene.  Fortunately, I did not have to go to work that day, so I was able to get dressed and go on over to Dorothy’s apartment.

At this point in Dorothy’s life, she was using a cane to get about and had a bedside commode to use when she had to get up during the night to avoid having to make the trip to the bathroom. There was the danger of falling or soiling herself. Since her bout with colon cancer several years earlier, she had been managing her colostomy bag independently with the help of home health nursing which made visits to her home two or three days a week. Medicaid covered home assistance providing for healthcare needs as well as housekeeping and assistance with bathing.  On this night, she had had such gastric disturbance that her colostomy bag had burst loose, soiling her bed and leaving her too weak to help herself.

When I got there, I went up to hospital with Dorothy while they evaluated her in the ER. They administered IV fluids because she was dehydrated and gave her some medicine for her nausea and diarrhea.  I went back to her apartment to clean up for her. Dorothy was very fastidious about keeping her place neat and clean, and was embarrassed that she had left a mess as a result of her illness.  Since Dorothy had given us a spare key to her apartment, I was able to go back to her place to do some cleaning up. Later, Dorothy’s friend Lona came by to help.  The mattress was so soiled that she decided to replace it with a new one. Dorothy later reminded me that the mattress we had to replace was the one she had bought years before when I had taken her out shopping for a new one. 

They didn’t keep her for very long in the hospital. She was sent back home the same day after a few hours of observation and assurance that she could keep fluids and nourishment down without getting sick.  It was only a matter of days, however, before she had to be readmitted to the hospital. With her second visit, more attention was given to getting her stronger and adjusting her medications. When she left the hospital this time, her friend Nioka insisted that she come home with her for a few days until she got her strength back. 

Looking to the not-so-distant future

 

All of us were concerned that Dorothy would not be able to safely stay by herself in her apartment much longer. Since she had once been under the Department of Mental Health and Mental Retardation, I made my first call to them to see if they could help in transitioning Dorothy to another level of care. I recalled talking with Dorothy’s case manager a few years earlier right at the time her case was shifted out of the Department of MHMR. “In her most recent testing, Dorothy tested out of the Mental Retardation classification, so we are shifting her services so that Medicaid can provide more in-home services.”

I had done testing on our clients years before when I was with the St. Andrew’s Foundation. Part of our regulations was to provide testing on each client using the Adaptive Behavior Scale. I understood from this testing tool that our definition for mental retardation is not simply one’s IQ level – it is as much defined by social skills and adaptive behavior as it is intellect. For that reason, I could understand how Dorothy, at that point in her life had “tested out” of the mental retardation label. Dorothy herself spoke with me about it on more than one occasion, speaking with some pride that she was no longer under the MRDD classification. The good news was that it had allowed her to stay in her apartment with home services that the Department of Mental Health and Mental Retardation would not have provided for. The bad news was that her case had been closed with the State MHMR Department. The only way to even try to get services for her would be to re-apply and get on a waiting list. I was all too familiar with waiting lists and how long it would take to even get seen due to the unfortunate lack of services in the state.

Dorothy’s friend Lona had been very helpful in recent years, so she and I were both looking into what would need to happen in order to get Dorothy place in a nursing home, even though Dorothy herself remained adamant about not wanting to leave her home for a nursing facility. In the meantime, Dorothy’s health rallied.  After a few days at her friend Nioka’s house, she was stronger and was able to go back to her apartment. Her 82^nd birthday was coming up, and she was making plans, as she did every year for a big celebration.

A Grand Birthday Party

For many years, Dorothy had used her birthday as an occasion to celebrate with her friends. Sometimes she would order a cake, but for at least the past two years her friend Nioka had made the cake herself. This year the cake theme “Princess” and the party location was The Cracker Barrel.

Dorothy at 82

Years before, Dorothy had mentioned to me that one thing that she had always wanted to have was a tiara. It just so happened that my daughter, who was 11 or 12 at the time, had seen a tiara set with rhinestones in a department store and said she wanted it for her birthday (what Dad would not delight in getting his daughter a tiara?). Having had that experience, I knew exactly where to get Dorothy her own tiara. After I bought it, my wife decided to use her artistic skills to make the tiara even more beautiful and personal. She bought some jewelry paint and colored the clear rhinestones to look like amethyst, Dorothy’s birthstone. That tiara was presented to Dorothy on her birthday – she must have been a mere 75 at the time. Since that day, Dorothy would wear her tiara on special occasions, so it made sense now for her 82^nd birthday to be celebrated with a princess theme.

The party was a great success, Dorothy had a wonderful time with friends, and she was beginning to be open to alternate living arrangements.  The church she attended, Glen Iris Baptist Church, had a ministry at the Trade Towers apartment building which offers assisted living options for seniors.  Lona and Nioka had taken Dorothy over there to see the apartments, and Dorothy called me afterwards to tell me that she was thinking about making the move to assisted living. 

<Previous post                                                                                                                  Next post >

*

Wednesdays with Dorothy: Matters of Health

< Previous post              (This is part of a series. For Table of Contents go here)              Next post >

Dorothy standing
in front of her apartment

As I was walking up to Dorothy’s doorstep one afternoon for our  appointed time to sit and talk about her life, her neighbor who lived in the adjoining apartment greeted me and asked how Dorothy’s story was coming along.  Dorothy’s neighbor seemed like a nice lady, though admittedly a bit eccentric.  She collected plants, storage crates, and cats, all of which could be seen lining her porch and spilling out into the yard.  When I had asked Dorothy about her neighbor, Dorothy indicated that she didn’t want to have anything to do with her. “That lady can’t keep her place clean, she has all them cats, and you hear her wandering around talking to herself. She’ll wander out at night, too, collecting cans and stuff.”

Dorothy had also told me about her upstairs neighbors with whom she had some occasional contact – and she was on friendly terms with them – but she kept some distance between herself and her next-door neighbor. So while Dorothy managed to maintain a circle of friends, like anyone else, she had some limits as to who she let into that circle.

In my conversations with Dorothy, matters of health would come up from time to time. I had been with Dorothy in the hospital a few years before when she underwent surgery for colon cancer.  Before that she has suffered a heart attack and had to have a stent placed in her coronary artery. There was another time that I visited her in the hospital when she was admitted for respiratory problems due to congestive heart failure. On that occasion she was just a just a couple of floors up from where I worked, so I was able to pop in on my lunch break and after work.  With her age and her history, it was only natural that we would talk about her health form time to time.

During one of our conversations, she talked about an emergency trip to the ER and then went from there to recollect another hospitalization when she had surgery:

When that fluid builds up in my lungs, that’s when I lose my breath. One night I went to bed, I couldn’t get to sleep. I couldn’t get my breath and I called 911. They come and I come out on the porch and flagged ‘em down and they come on in. I told ‘em I couldn’t hardly get my breath. They wound to taking me to the hospital at UAB. Well, Dr. Craig got that oxygen pump and put it on my mouth and they started with me down to the emergency room.  I was on the gurney. Somehow I could see Jesus – I couldn’t see him with my human eye, but I could see him with the eye of my heart, you know. He was standing there looking at me. I reached my hand out and he took me by the hand. I said Lord, I love you because you died for us all. And he looked at me and said, “I love you to, my child.” He was standing there with me. When I reached again he was standing there at the foot of my bed – they had already moved me to a bed and he was at my bedside. I looked up and smiled at him and he vanished.

It really made me feel good. They finally got me to breathing well. The first time I went to the hospital, it was a Sunday night. I had a room on the West side. I thought I could hear a revival going on – I mean it was a good Holy Ghost, Spirit-filled revival. The preacher preachin’ and people singin’ and shoutin’ and coming to the Lord to be saved, and everything. I thought they were singing so pretty, and the devil wasn’t nowhere around because Jesus wouldn’t let him in the picture. I could hear them preachin’ and singing’ and shoutin’ and I never did want it to end. I thought, God’s gonna do something. When I come to I was saying, “God’s gonna do something, God’s gonna turn something around, God’s gonna do something” I was saying it to myself, then I got pretty loud with it. I was really enjoying it – and I finally went to sleep.

When they gave me that shot of morphine when I had my colostomy surgery, I was laying in the room that night. I seen a lady out in the hall, I didn’t know who she was. I said, “Hey lady come here.” She came in and said “What is it Miss Burdette?” and I said I would like for you to get my oxygen straightened out because my urine is going in to my oxygen.”

She said, “No it’s not,” and I said “Yes it is. My feet’s all twisted up and how about you fixing it so I can move my feet?” She did the best she could and said, “Now is that all right?” and I said “Yeah, I think it is,” and I finally went on to sleep. The next day, it must have been in the morning report, because the nurse came in and said, Miss Burdette, I’ll never give you another dose of morphine.”

*   *   *

Talking about hospitals prompted Dorothy to reach back further in her memory when she was younger and had to go to the hospital:

I had one surgery when I was down in Thomasville. Dr. Green had to take a piece of skin off my cervix to see if it was cancerous, but it weren’t.  Then I had to go back and work at the motel. Well I got sick and the lady I was working with had a fellow take me home, well she didn’t know he was dog drunk. We had a good little ways to go, and it was pouring down rain. He kept asking me did I want to go to Westbrook, or somewhere and I said no, just get me home or I’ll get out and walk. He finally got me there. I got out and slammed that car door and went in the house and shut the door. My blood pressure went way up and I had to go to the emergency room!

One of the workers at the center took me to the emergency room. They took my blood pressure. I was so sick I threw up what little bit I did eat. They kept me over night, then I went back to my house the next day.

*   *   *

On another visit I asked her how she managed her medical appointments and kept track of her medications:

Now I have a medicine nurse, comes on Wednesday, or either Friday.  She comes every two weeks. She puts all my pills in my pill box so I don’t get mixed up about what medicine to take when – I take so much now. My friend Lana arranged to have my medicine sent in the mail.

If I have to go to the doctor, different ones will take me. Lana, when she can, takes me, and another friend of mine when I can get her to come by. I hate to call a cab. One time my case manager had a cab come pick me up for my doctor’s appointment, and he didn’t know where he was going.  He took me way down the hill below Family Practice. I had to go back up the hill, and when I got up there, I completely lost my breath. I thought I’d never get my breath back. I used to could walk, but now I never can get up a high place without my legs giving way.

Another time I had a cab to take me to Dr. Hayes’s office, and he didn’t know where to go. I kept trying to tell him and he just went way on, I guess a couple of miles past Dr. Hayes’s office. He asked me, “Is this it?” and I said, “No! You done gone too far!” He turned around and found a guy driving a truck and he asked him where it was. I thought “You idiot, I told you where to go.” Then when we got there and I got out, I thought, “Dear God! I don’t never want to ride with him no more!” It was the same way when I used to go to the Food Stamp Office.  

Next week we will hear Dorothy talk more about how her day-to-day needs were met, and also see how much she loved having her own place that she could call home.

<Previous post                                                                                                         Next post >

*