Resource Utilization Groups (RUG) Levels

Woah, I have a lot going on in my head. I am so overwhelmed with thoughts, feelings and emotions. My grandpa died. But first my grandma died. They were soul mates, they were never apart for very long. They were married 69 years. My grandma had dementia, the end was really difficult to experience. She fell while my family was vacationing in Myrtle Beach. I just knew it was the beginning of the end, September 9, 2014. She fell in the foyer of their home and broke her hip. I feel bad because I kind of wished that God would take her during the surgery. I knew from experience working in the hospital and the nursing home that people with dementia, mild to severe, never really come back after a surgery like that. God had a different plan in mind, like always.

The surgery went well, she was fearful of falling and fearful of getting out of bed. She stayed in the hospital for about a week. There were complications with her lungs or heart. She wasn't eating, she didn't have the desire to eat. Grandma failed the video swallow study with the thickest liquid. Next up feeding tube. It almost felt like a familiar song that I hated hearing. They transferred her to a "rehab facility". Fuck you hospital staff for allowing my family to believe that it wasn't a nursing home.
Grandma participated in therapy, or rather she was put on a bike for her 95 minutes of physical therapy. Then the occupational therapist probably counted the time that he or she "helped" the CNA to bathe and dress my grandmother. Taking away her dignity. Grandma stopped eating, she wasn't getting stronger. She went to see the speech therapist, who happened to be a classmate of mine. We played in the band together.

My dad is worried about doing the right thing, caring for the weak and sick like Jesus called us to do. My uncle Thom yelled at the speech therapist because she wasn't working hard enough. Do you hear the notes of that all too familiar retched song? How do you tell you family that it is a nursing home? How do you tell your dad the research does not support placing a feeding tube to sustain/extend life? The chords of this song are hurting my ears.
Why can't this stop? Why is therapy in a nursing home so stupid? Why don't legislators understand that these are human being, not vehicles to get your company the most money by putting them on a stationary bike for the 113 minutes, just so you can reach your certain RUG level? Why? This is my grandma! My loving, kind, and compassionate GRANDMOTHER! I only wish that she tried to pinch these unethical therapists putting the "robots" on the stationary bike!
They move my grandmother home, on hospice. More stress, more fancy word play to make my family think they are signing up for something that it is not. I go home to see my grandmother the weekend they move her home. She is sleepier, she isn't herself, well not fully herself. She did still try to have a quick wit, and put her fingers up in a pinching motion to let me know that she was still the boss. This is November 20th. My grandmother has been away from home for over 2 months. My grandfather was without his beautiful bride. He was sad, he missed his companion.

My grandpa and grandma get 33 more days together, at home. They get into bed together. My grandpa mumbles sweet nothings that only a spouse of 69 years can understand. His job now becomes caring for his wife, or rather he is able to resume his role as caregiver, provider, husband. At 12:29am on December 23rd my grandma went home. She wanted to get to heaven before Christmas. She wanted to be with Jesus to help celebrate his birthday. She was a good Southern woman who loved Christmas, and loved gatherings, joyful gatherings.
I got the call early December 23rd from my mom, tearful. Saying, we lost grandma. I was in bed with my spouse. He held me, I cried. He cried. I was sad, but felt like I had to remain strong. Strong for my family, my dad, my grandpa, for Christmas.
We got home early December 24th around 12:29am. A mere 24 hours after my grandma went to heaven. I know that the Catholic church believes in purgatory, as do I. I believe if I were to die tomorrow, I would spend some time in purgatory. I should pray for my friends tonight, that they might pray for me and pray me to heaven. Grandma, probably spent a millisecond in purgatory. My dad, grandpa and uncles sat next to Grandma praying the rosary. They came together as a family, to send my grandmother off to heaven.
Growing up, my grandmother always had rosaries around the house. So when she would sit down in one room, she would be able to pray the rosary. She was frequently asking me if I was going to church. She was faithful, she gave me an example of a woman who was trusting in God. She had to be, she lost a son in a farming accident when he was 12. Despite the fact that she had 6 boys, all 6 of the boys were hers. They were hers to care for, to love, to comfort. Then God called home one of hers. One boy that she and my grandpa believed they were called to care for, bring up in the church, and develop into the wonderful men my uncles and father are today. Now my grandparents rarely talked about the death of Uncle Chris, but I can only imagine losing a child. The guilt, the pain. My grandma's faith was probably tried at this point, but she remained faithful. She knew in her heart, for as long as I can remember, that she was going to heaven. She was going to die and spend eternity with the Lord. Be renewed, whole. Reunited with her son Chris.
My grandpa, uncles, father and mother prayed the rosary over my grandmother. John and I prayed the rosary for grandma. I felt peace, immense peace. I knew she went straight to heaven. During this time, when my family was praying the rosary and we were praying the rosary, my sister heard her name being called, repeatedly. She knew in her heart that this was grandma calling out to her. She believes this was grandma ascending into heaven. Amy was frightened, but a peace came over her as she drove to my grandparents house. She knew grandma was safe, grandma was with our Lord. Now Amy has had some experiences with angels and other feels as the one described above, but that is for another time.
There is still so much more that I want to describe, remember, grieve and heal from. I will have to write about this tomorrow. I am growing weary. I have cried, ugly cried the past three days. I am wiped out emotionally. So I am going to treat the rest of this entry like a therapy note.
Plan:

Discuss the viewing-drawing a picture of the strength of my dad during this, Aunt Margaret and my Grandpa sitting together. Resolving difference and forgiving each other after 69 years.
The beauty of the church during the funeral. The cold during the service at the gravesite. The image of Chris' tombstone. Charles being present and looking at Chris' tombstone. The gathering of my family, putting aside difference to come together for the matriarch of the family. My grandfather's words about my grandmother, "she was a great lady".