Two Story Reality Check

concerned_sister

As I see it, DB is in Stage 4 per Tam Cummings. Though, "begins to have stumbles or falls", is one of the behaviors, DB has not shown that yet. Although YMMV, the guidance is the phase is 1 - 4 years, and let's say he's in his 2nd year. Also he is EO, and I have read this often progresses faster.

DB and his wife live in a 2 story home. I'd like to ask this group, have you been able to successfully stay in a 2 story home (Bedrooms and bath/showers upstairs) as your PWD progresses through stage 5?

Someone in this forum recently pointed out that AD is more difficult to talk about/deal with than brand x horrible disease. Thus far DB and wife have been appreciative of any help and advice I can offer. I'm looking to see if I'm overly concerned about the feasibility of them staying in a two story home. Let's say it's a given that in stage 5 DB would not be able to be alone by himself while his wife is working, and that would be true for 1 story or 2. But I'm wondering, if leaving a 2 story is inevitable, is it better to factor that in to any financial planning. Rather than paying x for 10 hours of in home care 5 days a week, plan on paying Y for a two person apt in an AL community.

FYI, I speak with a finacial consultant on their behalf today regarding their investments, there is a meeting with a CELA (with DB and SIL) mid month, and follow-up neurologist appointment (with DB and SIL) at the end of the month. I will be present for those meetings. I'm trying to do as much mental prep work as I can to ask good questions and play through the likely scenarios.

MN Chickadee

Two stories may be fine for a while, but it eventually will probably not work.. PWD have a point where their gait becomes affected. It happened really suddenly for my mother with Alz. She had been in great physical shape but one day she started shuffling and requiring someone holding on to her to walk. Falls started happening more and more. Probably was early stage 6. I would talk with your SIL about what her plans are for later stages. If she intends to care for him at home until the end or close to it, then the bathroom being upstairs may be totally impossible. If she thinks she may move him to memory care facility when he can't be left alone or when his mobility is affected then perhaps they can stay put. As incontinence sets in, having a flight of stairs to climb will be a real problem with toileting. Eventually PWD become all or mostly unable to ambulate and are in a wheelchair and bed all the time. The home has to be ready for that. He would essentially be confined to upstairs for the rest of his days once he couldn't walk the stairs, and he could be in that phase of limited mobility a long time. This could be many years away, or not. There is no crystal ball and all PWD progress differently. Some people live 10 years after diagnosis, others speed through the phases in a year or two. An illness like the flu or covid or urinary tract infection can notoriously jump start progression when you're least expecting it. So while not something she has to decide today, I would still get on it in the next few months.

M1

I would humbly suggest that you and your SIL meet with the CELA first, without your brother. You need to be able to have frank discussion with the attorney without worrying about your brother getting defensive.

concerned_sister

MN Chickadee,

Thanks for sharing your experiences. I appreciate you sharing how you would think through the situation. That helps me be better prepared for a conversation. There is a toilet and sink downstairs, but re experiences of others, it seems a shower needs to be available for toileting mishaps. Thank you so much for helping me think through how such a conversation with SIL might go.

concerned_sister

M1,

Thanks for your valuable input. I'm in the akward position that youngest brother had been tasked with taking PWD to the notary next to where they work to get DPOA etc signed. He got the blank forms late last year. As of early this week (after asking last week etc) youngest brother forgot to get this done. I started to wonder if he was having memory issues also - but it could just be his don't worry be happy approach to everything.

Anyways, without such in place I'm not sure we could have the CELA conversation without him. And I am torn as to whether if we could get the forms signed, would I push to do it then. The worrying about him getting defensive is a factor. But, he's still early enough, and wife timid enough, I'm not sure how it would go without him. Gosh this whole thing is so complicated. As much as I've gotten positive feedback for all the steps along the way, I'm still afraid of being seen as crossing a line in to things that DB and SIL should be deciding without me getting a vote. Yet, I'm best prepared to help them think this through. I think if I were wife not sister, I'd do this without DB; but in sister role, I still have to keep an eye out for my boundaries.

concerned_sister

FYI - I had the call with the financial consultant this morning. I needed DB on the line to consent to me talking about his account. The understanding was DB would drop off after that, but he stayed on the line. There were times he contributed information. Other times he got tongue tied and I carried the ball. I have no doubt he could not have held this conversation solo, do I think he got what we were discussing.

After the call he said something to me along the lines he used to be smart and could do these things. I complemented him that he kept up with the conversation. But, as discussed before, and as is common, he doesn't appreciate his deficits.

I'll be over to his house later today to help him resolve another problem he's having.

harshedbuzz

There are a lot of moving pieces here. This is certainly a topic to bring up with a CELA and without a PWD in attendance.

1. I feel like the biggest factor here is going to be what's best for your SIL going forward. The decisions being made are going to impact her to a far greater degree than they are her DH given her age. She needs to make choices that will fund her retirement and care needs in old age especially if she has no children.

2. I always suggest spouses think about where they want to be in stage 7.

3. Stairs can make care difficult but can be mitigated with planning. TBH, in most housing markets the addition of a bathroom or expansion of a powder room would be cheaper than selling a house when you figure in prepping for sale, broker commissions, transfer taxes and moving expenses. My aunt (cancer, not dementia) did hospice in the old Victorian in which she was born using a bedside commode and getting bed baths for 8 months.

4. FWIW, my mom's house has a first-floor owners' suite and a 2nd floor where dad used to play his versions of hide and seek— rummaging through boxes looking for proof we were stealing and hiding random things he deemed valuable. He did this well into stage 6— he was 84, blind in one eye and had COPD. It can be hard to predict when this will no longer be doable.

5. Moving to a hospitality-model AL is probably not sufficient for the needs your DB will need sooner rather than later. Most ALs provide well checks, optional meals and maybe some mobility assistance around dressing. An AL isn't going to provide 10 hours of caregiving daily as part of their monthly fee. In AL SIL would still be primary caregiver and would be adding on private caregivers in order to work at a certain point.

6. At some point, his care needs will require a MC placement which means SIL will be funding an apartment for her and a unit for him. Depending on the going rate, after taxes, it may be less expensive for her to stay where she is.

7. Many of the nicer places that have a continuum of care options near me have entrance evaluations for prospective residents to avoid offering places to those who already have signs of dementia. This is partly because their business model is based on a minimal level of care for a period of a couple years. Many also do this to promote themselves as an "active adult community" which means your DB might not be welcome.

8. Related to #7, not all areas in many of these places are of equal quality. Often the IL and AL are wonderful, but the MC and even SNF is more of an afterthought. Since these aren't selling features, they aren't as likely to be updated.

9. If Medicaid will be their safety net, she may need to downsize if their home is over the asset level established by their state. These can vary wildly. I live in a modest 1800 sqft home that is a bit above my state's housing value. If they're in a single, moving to a condo might make sense especially if your brother did a lot of the outdoor maintenance or they hired it out.

10. Once DB gets to a point where he needs supervision, a MCF could be the cheaper option. Six years ago, we paid $32/hr for in-home caregivers for dad which would be $1600/week through an agency. Figure SIL might need another 5 hours a week to take care of shopping, medical appointments, the dentist, oil change and an occasional salon visit and you're up to about $7700 a month. Dad's MCF was $7200/month. At home isn't always cheaper.

11. It's important to remember that many PWD suffer a loss of empathy and reasoning skills, so your DB might have a hard time with not insisting on what he wants at the expense of his wife.

HB

concerned_sister

HB,

Thank you. You've given me a lot to think about. I guess my other background reasoning is that DB lives in Southern Calif and a home sale (north of 800K) could translate to a lot of months of care bills. A couple of years ago I looked at AL for MIL. She was 90ish could live in AL for 20 years and still leave quite an inheritance. But I have to realize that is apples and oranges. The level of care DB will need far exceeds what her needs were when I looked in to this. I figured SIL would still have the proceeds to finance her retirement, but it's likely I've built in some false assumptions. I still need to process the information regarding Veterans and "Catastrophic". I was afraid there were going to be too many if/thens to handle, so I wanted to clear my head a couple of days. But knowing that is essential when trying to be realistic about how much of their care needs will they need to fund. Is keeping the home in the long term best interests of SIL. Note, the live in a condo with a homeowners association so my instincts tell me it's likely to be hard to impossible to get approvals for a downstairs shower. Maybe getting the modification to the staircase to include the automated chair to take him up and down is something to be explored. At least through stage 5. I'm encouraged that your dad was able to wander the upper story. As long as we can address the saftey issues of the stairs that sounds doable for him as he progresses. All of the points you make are really worth pondering. Thank you so much for offering your insights.

Iris L.

Regarding boundaries: I am concerned. Your DYB is unreliable. DSIL, although college educated, seems to be a bit slow on the uptake on understanding the reality of Alzheimer's Disease. I would ask myself why? It would be nice if she were making plans for herself and her DH, and asking you for advice. But this is going the opposite way, you are making plans and asking her about her opinion. It makes no difference to me. But if you are wondering about overstepping your boundaries, IMO, you might think about where the boundary truly lies. Perhaps she does need quite a lot of direction. In that case, go forth, and don't worry about boundaries.

I am mentioning this to avoid guilt. Family caregivers often seem to have (unnecessary IMO) guilt.

Iris

trottingalong

I live in a two story with a half bath downstairs. I will not sell my home to care for DH. I helped care for his mother with alz. There reached a point long before her death that she could not shower or even use the bathroom. I would clean her up in her bed or when we got her up to move to a wheelchair. For me not having a full bath downstairs is not a problem. But the idea of losing the home I love in an area I love is one step too far. I would definitely be getting the opinion of your SIL on this and hopefully there can be an understanding that your brother may one day be relegated to a downstairs area. We had a bed for my MIL in the living room. Selling a home you live in with your spouse is such a personal decision.

concerned_sister

Thanks, Iris. I've often seen references to "scaffolding" so that the person with dementia seems to function better than is real as the spouse/caregiver etc is right there. I guess I kind of wonder about the scaffolding I'm providing to my SIL. Maybe she'd rise to the occasion, but I fear not, so I find myself in this role. The scary part is, my significant other has a scary diagnosis and surgery is pending. I'll be stepping away for a bit in the coming months (to aid him). I guess like it or not, we'll see what my scaffolding has been supporting.

concerned_sister

Thank you trottingalong, perhaps I've been too preoccupied with my fear of the stairs. Your points are well taken. I'm glad you could make it work.

Belle

Gosh, I apologize for jumping into the middle of this thread but I have been reading along for a while about your DB with EOAD. I applaud you for wanting to help the family out but I wanted to gently echo what another poster mentioned already. If your SIL is still working, is young-ish, healthy and able to live independently then suggesting that she move to an AL is really a non-starter in my opinion.

My DH is beginning to have mobility issues due to his other medical conditions and I would consider a chair lift (until he can no longer cooperate to get himself into the chair), then placement in a facility before I would consider giving up my pets and the majority of my belongings so I could move to AL with him. I am not even 60 and healthy so it would not benefit me to be there. If we anticipated issues paying for it I would ask my CELA for advice on how to get him on Medicaid.

Sorry your SO is also experiencing health issues at this stressful time for your extended family. Your help to your brother is to be commended but maybe after getting the CELA involved you could take a step back and focus on your SO and yourself. Once your SIL processes and accepts the situation they are dealing with you may be surprised at what she can manage on her own when given the chance.

concerned_sister

Belle,

Thanks for jumping in. I appreciate your input. And I don't disagree with your perspective. As background, late last year, another brother came to visit from out of state. When SIL had him alone, she discussed what she had been seeing with DB (and what older brother was starting to see for himself). She asked for help, and the other family members asked me to fill this role. I agree stepping back may be a good thing. Assisting up until now is what I was asked to do.

We'll see what the CELA suggests for their estate planning.

H1235

The lawyer we went to refused to meet with us without our lo present. She was not an CELA. She was horrible. So maybe that should have been a warning. But mom did sign everything. I thing the bar was pretty low for competency.

Iris L.

I don't know why anyone over age 65 would want to deal with stairs on a daily basis.

Iris

concerned_sister

Iris

Me too. But I'm so glad I solicited input that emphasized my preferences and fear of stairs is beside the point. I'll have to do my best not to offer opinions on this issue and let DB and SIL sort this out with the CELA

While typing this out, I had a flash of memory that I've fallen down stairs twice in my life.

sunnydove

I am caring for my mom in her 2 story townhouse. She is now entering stage 7. I stopped working 3 years ago to take care of her 24/7 so our experience is one of her having a constant companion. We go for a walk around the neighborhood (typically around one square city block, so 4 lengths) 2-3 times daily. There are stairs to get in and out of house (I think about 10 total) and stairs inside as well. The house is 100 years old so only 1 bathroom on upper floor. While my mom is clearly in stage 7 in every other way (incontinent both ways, very few words, needs to be reminded to swallow, etc) she is still amazingly ambulatory. I think that is in large part to it being a big part of her life. Both her primary care and her cardiologist are thrilled with how strong and robust her health is. Her primary care said 2 weeks ago that if she was in a home she would not still be alive at this point. In some ways that makes me so happy that I am caring for her so well. But in other ways I wonder if I am not just extending her life beyond her ability to enjoy it. At this point, despite her advanced disease, she still is happy to be alive. She smiles and points at funny animal videos on tv, loves the birds, squirrels, bunnies and flowers we see on our walks and ALWAYS loves her nightly bowl of ice cream. but I digress…..

I have long since been dreading the day where we are going to be stuck on one floor. Will it be upstairs where the bathroom and bedrooms are or downstairs where the kitchen and brighter rooms are? How will I walk her around the neighborhood even in a wheelchair with there being stairs to even get in the house? I thought the day would have come already but right now we are still managing. My hope is she passes in her sleep before she gets to the later stages and those harder decisions, but that's unlikely.

One thing I am incredibly grateful for is my mom had a second railing installed on the wall side of the stairs inside the house over a decade ago. We go up and down VERY slowly but having her hold on to the railing on both sides helps stabilize her and keep her safer. So if your stairs only have a railing on one side, you might consider having a railing installed on the other side. We also go up and down many times per day for potty breaks which keeps her active and keeps her in practice. I haven't had 5 minutes off in over 3 years, but I have a feeling if she was away for even a few days, she'd have a hard time acclimating back to stairs all day every day.

ButterflyWings

https://alzconnected.org/discussion/comment/204509#Comment_204509

Just a heads up - all this may unfold in a totally different way as well. We say here, when you've met 1 PWD, you've met 1 PWD. I think flexibility is the main skill and mindset to cultivate. These are excellent scenarios and recommendations…IF…your LOs situation mirrors my family's experiences or another forum mates. YMMV, so my examples could be totally off.

One thing to note: many PWDs balk at showering or bathing sooner rather than later. The mention that a 2nd floor shower could be a deal-breaker…well if they are like my DH it is totally irrelevant. He has not showered in several years, and will not. We are 100% "bird bath" and with the right hygiene products and me shifting my brain about showers and baths being a necessity, he is clean, with no BO, and no skin breakdown. It was not my plan to go fully sponge bath for the last 2+ stages, but I had no idea the resistance that would arise from a man who LOVED his daily showers for as long as he can remember.

So. My 2 cents worth. We plan, and then we adapt to what dementia throws our way. I would consider what ground floor options might exist to temporarily serve as bedroom and powder room rather than assume a move is required. In reality, this is sad but necessary to consider: If his spouse outlives your DB, you all need to look ahead to that timeframe too…not just getting through dementia. What does she feel will be best for her future life, in Stage 8? Would she miss their home and current community? I hope you all can continue to work well together. It is a blessing and a gift to your DB. Dementia is hard enough without family or in-law conflict, I can tell you. Enjoy your DB while you can.

concerned_sister

Sunnydove,

" She smiles and points at funny animal videos on tv, loves the birds, squirrels, bunnies and flowers we see on our walks and ALWAYS loves her nightly bowl of ice cream. but I digress…..", thank you for your digression. It brought a smile to my face that despite it all you and your mother are finding the moments of joy. After doing so much research on Veteran's benefits recently, I'm optomistic that any modifications to the stairs, should they decide to stay, will be covered. Thanks for your example of this being doable in their current home.

FYI, my brother's routine has included walking about 6 miles per week. He's cut back on that a bit. Some evenings he and SIL will walk (she has only recently joined in). He has about a short walk each Saturday with friends, and a bit of a longer walk each Sunday with friends. I hope he sees the long term benefits your mom has of this being an intregal part of his life.

ButterflyWings,

Thanks for your words of wisdom. When I was with SIL earlier this week she talked through various scenarios. I don't think her feet are in cement as to what she would prefer. I think they'll be better able to frame their decisions after they talk to the CELA next week. Right now the family relationships are good. YDB has been a let down not handling some of his todos. The solution seems to be to lower my expectations of him. If I don't ask him to do X, I won't be disappointed when X doesn't get done. We adjust and go with the flow, as you point out preserving the relationships through all this is essential.

mommyandme (m&m)

sunnydove, “Will it be upstairs where the bathroom and bedrooms are or downstairs where the kitchen and brighter rooms are? How will I walk her around the neighborhood even in a wheelchair with there being stairs to even get in the house?”

I went on long wheelchair walks with my mom, I had to get exercise somehow. When mom couldn’t use the few stairs going out of the house, we installed a ramp that we purchased on Amazon. What a lifesaver it was for so many reasons, including her walking out of the house herself and for the wheelchair. It wasn’t cheap but after she passed I was able to sell it to another ‘caregiving at home’ family. When mom was no longer walking, due to fear mostly, we moved her hospital bed into the main living area. That was ideal for us, it was much brighter and warm. Mom was only being changed in bed by that time even though she could/would get up to the wheelchair or recliner. If you moved your mom downstairs and she was still able to get up to be toileted, maybe a bedside commode could work.

The adjustments/adaptations that must be made are difficult to accept as we watch our LOs decline, yet when put in place, I found them a huge relief when I’d finally surrender to the reality. Hopefully your momma will ‘keep on trucking’ for a long time.

Iris L.

Sunnydove, thank you for sharing about your mom and how you are making caregiving work for you.

Years ago, I attended a Disability Expo and one of the vendors presented a portable in-room shower that was basically a water-resistant box attached to a hose by which a wheelchair-bound disabled person could be showered in. One might search around the internet for this if interested.

CS, I still think your DYB needs to spend a weekend with DB. Then he will see with his own eyes what he is now imagining. Everyone has only a limited understanding of dementia until they are confronted with the reality.

Iris

wose

https://alzconnected.org/discussion/comment/204678#Comment_204678

I’m with you on this tonight @Iris L. , I have 28 steps from laundry room to upstairs bedrooms and boy am I feeling it. I’m considering spending down some of our savings on a one-level place.💜

concerned_sister

Iris,

Thanks for your input. "Years ago, I attended a Disability Expo and one of the vendors presented a portable in-room shower that was basically a water-resistant box attached to a hose by which a wheelchair-bound disabled person could be showered in. One might search around the internet for this if interested." Reminds me of my younger apartment dwelling days where I had a small washer that I could wheel up to the downstiars sink. I'm picturing the hose you speak of going to a sink with hot and cold water, and not just the out door hose.

DYB processes reality differently than I do. It's not that he doesn't see it. They spend a lot of time together. In other stressul situations in his life, he takes a don't worry be happy, everything is fine until it isn't attitude. I'll leave the details of my frustration with him out of this forum. But bottom line in my view he has made something we'll discuss with the CELA on the 16th more difficult. He was reassuring me it'll be fine this isn't a problem. I had to set him straight that he can't speak for the CELA, he can't state with certainty that not having things in order won't be an ostacle. His assurances of everything will be fine are frustrating in situations he's not participating in and has no control over. Anyways, a life rule I learned long ago is never to let someone else cause me to fail. I just have to not ask him to take care of certain things.

Quilting brings calm

==. I'm in the akward position that youngest brother had been tasked with taking PWD to the notary next to where they work to get DPOA etc signed. He got the blank forms late last year. As of early this week (after asking last week etc) youngest brother forgot to get this done.==

==His assurances of everything will be fine are frustrating in situations he's not participating in and has no control over. Anyways, a life rule I learned long ago is never to let someone else cause me to fail. I just have to not ask him to take care of certain things.==

The above statements concern me. If young brother was tasked with the DPOA form, that implies he’s going to be the DPOA. Yet he’s not involved in most of the decisions. That’s not going to work. The SIL needs to be the POA and decision maker for her spouse. She’s the one the legal and financial decisions affect. Presumably their finances are joint?
If she doesn’t want to be that, then it needs to go to the person who is most involved in those decisions and who will be handling their legal and financial activities. Not someone who isn’t involved in decisions. I think you’ve seen how dependable young brother is going to be.

harshedbuzz

@Quilting brings up a good point. Is DTB going to sign as a witness with you/DW as POAs?

Since you're seeing a CELA anyway, I would have that person handle the POA after talking with them instead of relying on some boilerplate off the internet. You want a solid, bullet-proof document that will allow the agents to do everything they may need going forward. Be aware that some institutions will vet this document and may reject it if it doesn't meet their standards.

I did do a quickie POA for mom when dad was initially diagnosed in mid-stages. Not long before she'd been critically ill, and he was unable to recognize how sick she was and was unable to advocate for her or follow advice given. She nearly died and wasn't out of the woods yet, so I had the neurology social worker procure a boiler plate which we replaced when we saw the CELA a couple weeks later.

Once you have the notarized document, you may want to submit copies of it them to banks and brokerage houses as soon as you get it. This process can take 2-3 weeks, so it's best to do this before you need to take action around something.

HB

concerned_sister

Thanks QBC, you pieced that together well. Let me throw in those last few details. Tuesday I drove about a half hour from my home to the office where DB and YDB work. They share this large room with another person who only comes in a few days a week. Her next day in would be Thursday. So I'm in the office, I work with DB (using the laptop I brought) to get the necessary money from point A to point B. This was the final step in a multi step process. Next, YDB printed off a blank DPOA form. We filled out the form so that SIL, Myself and YDB have POA and can act separately. We have all mutually agreed SIL is #1, if SIL can't or asks for help I'm #2, only if I'm unavailable (traveling out of state etc) does YDB act. This is to ensure we have back up. Ok, so the form is ready to be signed in front of the notary. We (3 sibs) discuss doing this Thurs so their officemate when she returns could act as witness. YDB was about the notary in the building. We agreed I could come back Thursday afternoon to oversee the process and make extra copies once notarized. So YDB was asked to arrange for the notary Thursday afternoon. Upon this request he leaves the room. I go home, come back Thursday. We have the health Directive and the DPOA to be signed. When in their office, I was introduced to the woman who was out earlier in the week After taking care of a task with DB. To make conversation I ask the woman if the brothers had mentioned to her they'd like her to act as witness. Well, no they hadn't, but that would be fine. (Not a good sign!) I have DB gather the papers to be signed and ask if the notary would be ready if we walk over? We go over and DB looks into the open office, A woman comes out and I introduce myself (she had worked with the sibs). She asked if we had an appointment. I replied that YDB had talked to someone Tuesday to see if we could come in Thursday afternoon. We come to learn that no he hadn't. Returning to the office of the sibs YDB admits he hadn't. Tuesday he left the office for a different reason when asked to set this up. And I get his don't worry be happy routine. I wanted everything lined up so that I had the power to speak on his behalf at the CELA in case DB gets tongue tied. Anyways, waste of my trip there, and the parking I paid for. But new resolve not to ask YDB for anything of consequence. Not joking, I start to wonder if YDB has issues. I'll have to watch him.

M1

Silver lining, it's probably good that it hasn't happened yet. Ask the CELA about POA both for finances/legal, and for healthcare. I'm totally with HB on this, I wouldn't go with anything boilerplate.

concerned_sister

Note a close family member by marriage to YDB provided the blank forms. He is a retired lawyer. Have I been wrong in thinking I'd be more empowered to speak for DB to the CELA if I had that document. DB would be their, but their are times he can not communicate effectively. SIL will be there, but with ESL, she's not always confident in her understanding of complex topics.

I start to laugh at myself when I realize I almost think of it as a legal "HIPPA". (But, yes, so much more than that as well.)

Iris L.

CS, I was not going to comment anymore about DYB. But he sounds flaky. Is he really this flaky, or does he really not understand the seriousness of what is involved and what you are trying to ensure? Every day members post about some problems that might have been avoided if handled beforehand. So far, all of this has been on you. But you have your own needs and your SO is ill. I am concerned about YOU. There are a lot of threads about self-care and not getting overwhelmed. Don't let this happen to you!

Iris

concerned_sister

Iris, thanks for your input. I think it's more, "or does he really not understand the seriousness of what is involved and what you are trying to ensure". I think he's a prime candidate for getting stuck in the trap of everything is good until it isn't. I've been the doer, but I'll give a shout out to older DB. We talk most days, he's a sympathetic ear when I need it, but also great at helping me think through the logistics of what needs to be accomplished. He's out of state so he can't be hands on. He had the tragedy of suddenly losing his wife a couple of years ago. He gets that things can change in a hurry. And so do I. Thanks for the reminder of self-care.