CrossCast! OldBodies Family Practice

Gram: Family Practice is a new multi-part occasional series featuring Gram's family. This episode is a little heavier than the others, so if you're feeling a bit sensitive or have issues dealing with death and dying, maybe skip this one. If you're into it, welcome aboard.

Lydia: …Okay, yeah, yeah, and that was my first experience with the entire health system and how everything worked, and it was absolutely fascinating from an observer's perspective versus from a participant. I learned a lot.
I learned that perhaps I should consider a career in the health industry, such as a nurse, but I had already established myself at the top— pretty much at the top of my business career, if you will, as a female being hired as a top-notch secretary, and that had already been put in place. I would have had to get rid of all that and start all over again, and I thought I was too old, at the age of almost 20, of starting all over again.
And that is society's… the societal restrictions put upon a woman in those days. Because if, I mean, I had already spent a year and a half in school getting a degree in one area, and perfecting my career abilities in that area. And before I could reap the rewards of excelling in one area, I would throw it all away to start all over again in another area; starting all over again in education; having to get a degree in nursing and whatever all was entailed.
And at that time, almost 20 years old, I knew I was going to marry Chuck at that time, and I wanted to start to have children, so I knew that for the future of our family, my goal was to make as much money as possible by the time I would marry and have children, to have a really good nest egg with a home in the suburbs. That was my goal, and so I forgot about the career that I would have chosen in nursing or in the medical field.

Gram: Do you think that that's why you got into home care later in life? It's not so often that people go, I'll do it when somebody needs their mother taken care of, you know what I mean?

Lydia: Well, yes, I think that a permanent seed was established and not given the soil to nurture and grow, but it was there, lying dormant. And so, yes, I think that's exactly what got touched later in life. Actually when Jerry's mother needed assistance, and then that's when the seed got watered.

Gram: Bertha was your first home care patient?

Lydia: Yeah, Bertha was.

Gram: Yeah, and what is, tell me your story with her, anything you remember, tell me how it started, tell me how it ended.

Lydia: Well, it started because— I had, by then, I had exhausted my career in the floral industry and had reached my peak in that area, and had to find another venue of working. You know, I couldn't, I didn't want to stop working, but it wasn't working out that I would work for other florists after I gave up my business. It was not really working out. In fact, it made me realize what a wonderful boss I had been because I was working for other bosses that were really, really not that good, and—
Anyway, so I was working part-time or full-time here and there at other flower shops when Diana and Jerry realized that Jerry's mother could no longer live alone, or I think she might have been living with Esther, her daughter, but was not getting on well. I believe it was at the time when Bertha attempted suicide—

Gram: What?

Lydia: Yes, yes.

Gram: How did she try, what did she do?

Lydia: She attempted suicide because she couldn't stand living with Esther.

Gram: Oh my goodness, how old was she at the time?

Lydia: Oh, [to Vida] how old, how old, Vida, was I when I moved down to take care of Bertha? Yeah, late 80s.

Gram: Wow.

Lydia: We don't, yeah, so Diana and Jerry decided that obviously it was not, there was a problem there. They had to get Bertha away from Esther, and they decided they had two extra bedrooms, so they moved Esther— I mean Bertha, in with them. And I believe this was at a time— [to Vida] was Esther getting her divorce?

Vida: I think so.

Lydia: Yeah, Esther was going through a really bad time in her life because she and Herb were getting a divorce, and so she moved in with her mother. Herb, she and her husband lived in Pittsburgh, and Esther moved in with her mother in Miami when she was getting a divorce from her husband. And I think that's when the trials and tribulations started with Bertha, who attempted suicide by overdosing on Tylenol.

Gram: Oh, no.

Lydia: Yeah, and by doing that, she had compromised her health to some degree. Previous to that, I believe she was pretty, pretty active and pretty capable and, you know, and taking care of herself. And I believe after that she became somewhat physically deteriorated. And so Diana and Jerry decided they had that extra room to move Bertha in with them. And I mean, nobody else was living with Diana and Jerry at the time, and they had three bedrooms and the one guest room, which was across the hall there, and with the twin beds, and they brought her down.
However, they also realized that Bertha was not really reliable to be left alone all day, and both Diana and Jerry worked. So I got presented with the idea— since I was no longer owning my business, I was freelancing all over the place— that I could come down to live there to take care of Bertha during the day, and Diana and Jerry would take care of her at night.
And I said, well, the only problem that I have with that is the money, that I was earning freelancing, I was buying my— paying for my health insurance, which at that time I believe was over $500 a month, because I was not yet 65, and individual, and I didn't, couldn't belong to any group, because I, you know— And the only group there would have been was the floral industry had a group. Their insurance was like $500 also, so, and I needed to have health insurance, because you never know what's going to happen when you're almost 60 years old.
And so we made an agreement that I would go down there and stay with them, and they would get, pay my— I would work for them, if you want to call it that, and they would pay my health insurance. So I was getting, yeah, like over a hundred a week to pay for my health insurance.
And when Bertha was moved in, it wasn't like she was just thrown into the house. Since she ended up in the hospital from her attempted suicide— When you're, when you go to the hospital, and you're discharged, and you're elderly, there is a whole system of health care that you are entitled to when you're on Social Security. And that, that is provided through, you know, different local, state, and federal systems; health care at home.
And the purpose of that is so, to keep you out of a nursing home, because it works better for the patient, as well as the government, to keep an elderly person at home for as long as possible before they have to go into a nursing home, because nursing home care is extremely expensive. Home health care is affordable.
However, it's not affordable if you don't have any money, so she was on what you would call, well, I don't know if it was Medicaid, because she, home health care, and home nursing care, and— I don't know about doctor, I think we had to take her to the doctor. So all of this was put in place, a social worker, physical therapy, evaluations, medical, drugs, medical, whatever it is, a whole system set up for the home, this happened while I was there.
The Cuban culture, this was all under the Cuban culture. The Cuban culture is not like the American culture, they admire, revere, and extremely respect their elders. There's none of this elder— I don't know the word, elder disparagement, or anything like that. They love their elderly, they have an admiration for their elders. All of these programs were set up, and I think Diana set everything up, because she was part of the medical system, so she knew all of the right procedures, you know, being in the health field. And she set everything up.
So Bertha had a home health person two or three times a week, a nurse once a week, and I forget, maybe a physical therapist a couple times a week. All this was occurring while I was there, and they taught me everything that they knew, and they were— Yeah, it was like, it was like I was thrown into a hands-on medical school, and everything they did, I mean— and I was interested, you know, it wasn't like I was like, oh, do I have to really know that, you know? I said, no, I want to know how you're doing this, why are you doing this, what is she needing, and you know, all this. One of the side effects of the Tylenol thing is she could no longer eat solid food.

Gram: Oh, really?

Lydia: Yeah, yeah.

Gram: Oh, I had no idea.

Lydia: Oh, it was tragic, absolutely tragic. And so all of her food, she could, like— Okay, if there was, if you made roast beef, it had to be put in a emulsifier, a grinder, like you would do for maybe a baby, you know, a toddler.

Gram: Sure, make a soup out of it.

Lydia: Not a soup, but a—

Vida: Puree.

Lydia: Yeah, a puree, you had to make it, you know, like you would for, you know, a toddler.

Gram: Okay.

Lydia: And, you know, like, yeah, like, if you had fruit, it would have to be pureed; if you, you know, if you had cereal, it would have to be something like a very milky oatmeal, you know. I can remember times when she said, Lydia, please, can I have a piece of toast, just one piece, one piece of toast. And I said, Bertha, no, I can't give you a piece of toast.

Gram: Did she have an abdominal, did she have an abdominal resectioning or something?

Lydia: No.

Gram: Why was she prevented from eating solids? What happened to her organs that she couldn't do it?

Lydia: It's something that happened with her esophagus. Now, maybe nowadays they might do something with surgery, because I remember part of her physical therapy that, to this day, I know about, is like: I would have to sit with her and tilt her head back, and then she would lower her jaw, you know, and stretch that, and then bring up her jaw, you know; And like grin, and then lower her jaw and swallow, then bring up her jaw and swallow, you know; And do all these swallowing exercises. But I don't remember it ever not being where she could have anything solid. Now, she could have like a piece of cake, but it would have to be mushed. So, everything was mushed.

Gram: Right.

Lydia: So, that's why she said I would do anything for a piece of toast.

Gram: Wow.

Lydia: Yeah. So, that, you know, that's part of it. And I forget how long I was— how long was I there, Vida? Do you remember? Five months or something?

Vida: I was going to say like six.

Lydia: Six months?

Vida: Yeah. Maybe five.

Lydia: And then why did I leave?

Vida: I don't remember now, either.

Gram: What was your day-to-day like with her?

Lydia: Up, you know, whenever she would want to get up. I think she had to have help getting up. I know I had no bathroom issues, she used the toilet. For bathing, I was taught how to do toilet bathing. To this day, I know how to bathe a person sitting on a toilet. And so, I guess she couldn't shower. And I don't remember how did we wash her hair?

Gram: Was that because she had fallen and broken her hip at the time?

Lydia: That happened later. Did she ever fall and break her hip, Vida?

Vida: Yep.

Lydia: When was that? Was that under my care?

Vida: Well, no. You weren't there, but you had to go back down.

Lydia: Oh, so initially, probably when I was there, she was able to bathe?

Vida: Yeah.

Lydia: All the other stuff happened later?

Gram: Sure.

Vida: You were not there when she fell and broke her hip. She was, it was, she went to the bathroom and she wasn't supposed to do, whatever it was.

Lydia: She got up, they weren't in the room. She got up to go to the bathroom, didn’t tell them, and she fell.

Vida: Right.

Lydia: Didn't tell them and she fell.

Vida: Right.

Lydia: I know that by the time I was 60, I was back home here because I had my 60th birthday party here. I was here for your 50th as well.

Vida: Yeah. You were only there like six months. I think you went back down for a month or two after she came out of the hospital, but then she died shortly after that or something.

Lydia: She didn't die on my watch either.

Gram: How did she die?

Lydia: I don't remember. We don't remember.

Gram: Okay. Well, that's okay. If you remember later, I'll edit it in. Let's move on to your next client.

Lydia: Okay. Now, before that, I took care of my mother. First off— I guess we jumped straight to Bertha. How did I pass up on my mother? I broke my leg, my ankle in September of 88. In the meantime now, I had been taking turns with Vida, regularly going to visit our mother who was at that time pretty severely dying of cancer. Did she have any health aides?

Vida: No.

Lydia: She had no health aides?

Vida: That was it.

Lydia: I think she did have one and she fired her.

Vida: I don't know. She may have.

Lydia: Yeah. I'm not sure how it was that she had nobody coming except, I guess, Vida and me. And I don't know. You weren't living with me then?

Vida: No.

Lydia: Were you going over there every day or I was there?

Vida: No. You must have been going every day or every other day. Dad was there.

Lydia: Yeah. I was going every afternoon, I think, to help take care of her. And it reached the point where she said that Lad, her husband, could no longer take care of her. And she requested that she be moved into my apartment. I believe she requested it.
And I made arrangements to have her move into my bed, my bedroom, and I would sleep on the couch, which was comfortable. It was not a problem. And then I arranged for home health care. A nurse would come, I think, every day, if not, because I think she required pain shots. Oh, she had an IV drip. So she required a nurse to come every day.
And until eventually she got bad enough that she wanted to go to what she called the hospital, which in our case, we knew it was not the hospital. It was to hospice. And because by then— between Vida and me, I'm not sure who did what, we were making arrangements for hospice care. Oh, Diana was making arrangements? Yeah, for hospice care at Illinois Masonic. And so when she decided to, that she needed to go to the hospital, she had a lot of close calls, terrifying things happening to her. And of course, I was emotionally undone and not capable, not as good as I thought I was—Don't forget, this was before my nurse's training— in which she would be terrified that she's dying and stuff.
I remember one time calling Jean and calling her and crying and saying, my mother is yelling, she's screaming that she's dying. I don't know what to do. She sent over her priest and he came— He was the one at the funeral. And he came and he administered to her. And that seemed to soothe her. I mean, because she had lost her religion a while back, but it seemed to comfort her.
What I have since learned is when someone— is you go in there and you hold their hand, brush their cheek, their head, their face, that kind of thing. You soothe. So I didn't do very, very, very good by her. Finally, I couldn't take it anymore. And when she was screaming to be taken to the hospital, I guess I called hospice, and they sent an ambulance. And she was screaming, I can't breathe, as they were carrying her out in a gurney. And then she was admitted.
And I couldn't help wondering if psychologically or spiritually or precipitously, or did I break my ankle subconsciously in order to be able to take care of my mother? Because since my ankle was broken, I could no longer work. But I could do my work from home, the work we had, like paperwork, payroll. I didn't do much at the shop anyway, because everybody that I had hired had the creative talent. And then I could be home, and I was able to take care of my mother.
Now, I was, I'm still on crutches and a hard cast when I would go to hobble in to go visit my mother at the hospice care. But I must have very quickly got into a soft cast and was able to walk over there. And I think I might have still been in a soft cast at her funeral.

Vida: Yes.

Lydia: So she was in hospice care for a couple of weeks. Now, while in hospice care, I thought about changing my career to hospice care, because I had seen what they do there. And I was going to become a volunteer. But it was too hard to do my job and be a volunteer. So that never came up. So that was before I went— I think what I learned, the little bit I learned in taking care of my mother, is what made Diana and Jerry realize that I could take care of Bertha.
And so there, okay. And then one thing, and then I became an actual professional, if you want, after Bertha. But even that, I didn't do it correctly.

Gram: Oh, what do you mean?

Lydia: When I look, well, when I look back on it, I had another glitch, which I never resolved, because I hadn't been confronted with it. But one of my first realizations after taking care of family is that it isn't just taking care of the patient. It's knowing how to take care of the children of the patient. Because I would have confrontations with people not following my instructions. And it's not the patient, but I would butt heads with other people in charge that I didn't realize I was condescending to, because I thought I was the cat's meow.

Gram: Right, okay.

Lydia: Yeah. Yeah. I thought I had the knowledge, the education, and the expertise. So therefore, you listen to me. What helped me through that was my friendships with [Nursemaster] Janet and with [Nursemaster] Margo, that I would then, you know, if I had butt heads with the son of a patient, I would say, well, this is what he wants me to do, and what should I tell him why I can't do it that way? And then they would educate me that way. But I never, I always, you know, my temperament didn't— wasn't always the best. I mean, to do it, I would do it so differently if I were to do it over. And also, I would be a lot more kind, I would be much, much kinder to the patients, and more forgiving of their circumstances than I was.

Gram: Okay.

Lydia: So I, yeah, I learned, I learned that.

Gram: Well, that's, that's a nice, I mean, yeah, yeah. Okay, awesome.

Lydia: And then I didn't have anyone die on my watch until it came to, eventually I ended up taking care of Jean, the woman that called the priest for me. And I, to this day, I'm troubled about what I did and did not do with her, because she was a friend. And, and I couldn't, I became a hysterical— internally hysterical, I wasn't, you know, running around screaming hysterically, physically— but internally, I shut down, my brain shut off. And I didn't know what to do. It was kind of like my mother again. Only this time, I didn't have Jean to call, because it was Jean. And as she was dying, I didn't know what to do. And all I, in my head, I was just screaming, I don't know what to do.I don't know what to do. And I did know what to do. I just didn't know what to do. You know what I mean? I wasn't capable, I wasn't capable of, of, of— I needed somebody to slap me and say, get over it. Like, you know, that movie, right? It's with Cher.

Vida: Moonstruck.

Lydia: Moonstruck. I needed somebody to slap me and say, get over it. And you know, and, and so as a result, when she, as she was dying, I didn't, I didn't do right by her. And to this day, I regret it. And, and, and you want to know what I should have done?

Gram: Okay. Yeah, we can do another time. No problem. This is great so far. You'll just have to be a multi-parter, I think. This is great. Um, you'll be the most popular person on this show, I'm sure.

Join us on Excisions for a Eulogy to Jean.