Caring for elderly parent

[Marilyn Michetti]

Hi, y'all

I just finished, or will tomorrow, moving my 82 year old mother into our home. She's been hospitalized three times since Dec. 28th. We just brought her home, here last Tues. Mom is a terminal renal patient, and now has gout in her left hand and right knee. We go to dialysis three days a week, (and yes, I mean WE, because it's six hours out of her day, and mine).

Moving her was physically hard - DH and I did it all - but I think, when it sinks in, it will probably kill mom. She's lost almost everything she owned, she's totally dependent on us to cook, bathe, and get around, and we're not getting ANY help from her insurance for ANYTHING ! Hospice won't help until she decides to give up dialysis, and her Secure Horizons doesn't cover an aide or PT. They'll send a nurse three times a week, but DH is an RN, and they check her vital's and blood at dialysis, so I don't need the nurse.

I'm in over my head, physically, (I have M.S.), and am scared that she will just decide to die rather than "be a burden".

How do you walk this line? I'll help her like she would help me, but I don't know how to be my mother's parent. Her mind is sharp, but she's sinking into a depression, or giving up. Putting her into a home would be the end, and I just won't.

Anyone been there? I'd sure appreciate any thoughts.

Thanks.:(

[bleukarma]

I can certainly understand what you're going through, although my situation is a little different then yours. When I was 9 my great aunt and great uncle became my legal gaurdian. In 1999 we lost my uncle which just left me and my aunt. Back in 1992 my aunt was in a very bad car accident and we almost lost her but she survived. As a result she has had lots of trouble with everything from eating (she can only eat soft foods), to her heart (she's on her second pace maker) and more recently she has had the "normal" side-effects of aging with her eyes and her general health. She is 73 years old and all things considering she is doing good.

We share a house together and since me and her are the only family down here in Florida then all the care-giving duties are my responsibilty. For the most part she can take care of herself but there are times that she needs to go to the doctor or the hospital and I have to take her. She feels like its a burden because I have to take time off work to do these things. Just two weeks ago I sat in the ER with her for 10 hours and I had to call into work since we didn't get home till 4am and I still hadn't slept. All night she kept making references of how much of a burden she is on me. She really isn't, I feel that its my job to take care of her and even though I need my other job to pay my bills I think that she is more important then anything else. She raised me, so I am going to be here for her when she needs it.

With that being said I'm not going to deny that it isn't a little over-whelming sometimes. I am a 27 year old single woman with no kids and two jobs. Sometimes I wish I had help. A few days ago she asked me if I could take her to the doctor the next day, but I can't really walk into my office and tell them that I have to leave in a few hours to take her to the doctor, my office needs notice. I started feeling stressed out. When you get into those moods you just have to take some time to yourself, take a deep breath, cry, and move on with your day. There ARE going to be times that it gets too much for you. But just remember that not taking care of her would probably make you feel worse then you do at that moment.

When she starts in with the "I'm sorry I'm such a burden on you" (I hear it all the time) then just reassure her that she isn't, that you love her, that you don't mind everything that do for her, that you love her, and that you couldn't imagine it any other way.

Good luck! And if you need to talk, have some questions, or need to vent then feel free to PM me anytime! :mickey:

[Dakota Rose]

When I was 18, my grandmother had a series of strokes which left her unable to walk or use her left hand. After the doctors said there was nothing left to do for her, we brought her home. My mom, sister and I cared for her until she died in my arms some months later.

I will say this, it was the hardest time of my life. But it was also a time of immense blessing. I learned things about my grandmother -- and about my mom and myself -- that I would have never known any other way. Though many days left me exhausted physicaly and emotionally (I have a spinal cord injury, was in college and working part-time during those months) I would do it all over again.

All that said, here's my advice:

Get whatever help insurance will provide or you can afford. If her traditional insurance won't cover anything, you may want to check into Medicare or with the social workers at the hospital. Often there are programs that are easy on the pocket book but you have to ask. You might even check with the local career schools. CNAs, medical assitants and therapists all have to do internships and might be an excellent source of help for you.

Carve out time for you to care for you. There are caregiver support groups you can join. My mom was in one and it helped her immensely. Even an hour or two a week of mindless shopping or quiet reading at a coffee shop can rejuvenate you. Invite a friend of hers, a church group, etc over and leave them to visit while you have alone time in another room.

Take every opportunity to get to know your mom better. Get her talking about her childhood, etc. Not only will this strengthen your bond but it will also alleviate her depression.

Take field trips. Even though my grandmother was basically immobile, once a week we'd go for a drive. Sometimes we'd stop and have a picnic either in the car or at the park. Stop for ice cream after a doctor's appointment, etc. The change of scenery will be good for both of you and it can make the mundane tasks more tolerable.

Try to keep her schedule as close to the same as it was before she moved in. If she's always gone to church, see if she can somehow still get there even if you can't take her. If there are things she can still do for herself, encourage her to do them.


But, most importantly, remember to rest whenever you can. It's like having a small child again. Sleep when she sleeps and all that. Find support.

You are doing a noble thing. May you be richly blessed.

[Pirate Granny]

My dad lived with us for three years...at first we thought it was temporary until he got on his feet again, but after a while it was apparent that he would be better off living with us...Luckily, we had the room, and the financial ability that there weren't those type of issues...My DH was WONDERFUL and he took time off to take Dad to the doctors or help him with 'male type things'...It was hard some days and down right stressful on others, but hang in there...contact a local church group, sometimes they will help out an hour or two a week to give relief and a new face around the house, even once in a while makes a great change...Dad is gone now, but we never regret having him live with us...You and your family will be in my prayers and I hope that you can remain strong.
:pirate:

[DisneyDudet]

I don't know about taking care of my own elderly parent, but I do know what its like to have them in the hospital. It is difficult doing everything for them, and yourself as well.

Some of our staff also contract out as a personal home health aide. It is more like someone who can come to the home, take care of the family member, while errands are run and other things of the sort.

Also, do you stay with her at hemodialysis (HD)? That is a lot of time that you can have to yourself, to do things for yourself and for your family. While I'm sure you would like to, you don't have to stay with her every day and the entire time. You can run to the store or even go back home and pick up the house.

Is there a senior center near your house? If there is, see if there's any activities that your mother would like to do. They have all sorts of things there for older people to do, plus it helps them be social.

You said that she is sinking into depression. Have you discussed this with her doctor? There may be some medications she can take to help her with this. A lot of times, the elderly with a chronic or life-threatening illness will be depressed, so her mental health is just as important as her physical health, as they go hand in hand.

I would also sit down and discuss with your mother her wishes. Ask her what she wants if she goes into the hospital and other things like that. Also, I would also ask her to tell you when she's had enough. End of life issues are hard to talk about, and I know you don't want to lose her. If she tells you that she's had enough with the treatments, I would listen, see what other options you have, discuss it with the doctor, but be supportive of her. It hurts to let go, but one must honor her wishes. Let her know that she will NEVER be a burden, much like when you were a child. I would assume she never thought you were a burden to her. Let her know that caring for her makes you a busier and may stress you out at times, but you wouldn't do it if you didn't love her.

In this time she is living with you, you need to look after yourself. You becoming tired or ill will not help her, or your family, at all. If you ever feel like you can't do it, you need to let someone know, so that both of you can get the help you need.

I will be sending pixie dust to you and your family. I hope that everything turns out well for all of you.

[daparish]

I am so sorry you and your mom are going through this. I was 15 when my dad died and my grandmother moved in with us. She lived with us for the next 7 years. She developed Alzheimer's and kept falling and broke several bones. It got to the point that my mom had to put her in a nursing home because my mom's health was falling and no one other then my sister was there to help. She actually passed away in the hospital after being hospitalised for three weeks. My mom stayed with her during the day, my sisters at night and me during the weekends (night and day). I know putting her in a home was one of the hardest things my mom ever did but she really did not have a choice. I truly feel for anyone caring for a parent. My mil lived with dh and I since the day we were married. She had a stroke in October and passed away a week later and I truly feel honored to have had her live with us all those years. She use to always say she never wanted to be a burden but she was anything but. I truly treasure all the nights we spent staying up late and her telling me stories from her childhood. The week she was in the hospital she was pretty much in a coma. DH's brother and sister insisted we did not have to sleep at the hospital because she was unaware but there was no way I would let her pass away alone. DH was able to take off of work but I worked all day and slept at the hospital at night and we were both there when it happened. I am not sure where you find the strenght to keep going but you do but blease take time to take care of yourself. I will be praying for you, your dh, and your mom. God bless.

[kakn7294]

Marilyn, the only advice I can offer is to not forget to look after yourself during this difficult time - DH as well. It's so easy to let yourself get run down because you ignore your own needs for those who are dependent on you. Best of luck to you - you'll be in my prayers!

[merlinmagic4]

Marilyn,

You've gotten some good advice from people who have been there. I wish I had some but wanted to send my good wishes and :pixie: dust for all of you.

Is it possible to consider home dialysis? I mainly know children who are on it but I do know of one elderly person who does it. It would save you the trip out to hemodialysis and I think people feel better on it because it is daily as opposed to three times a week. Just a thought...........probably one you have considered but thought I'd throw it out there anyway.

[Marilyn Michetti]

You've all given wonderful advice. My mother is on an anti-depressant, and home dialysis has been ruled out because she's incontinent. I know she wants to "go home", and when she decided she's had enough, hospice will come in and make her comfortable.

Right now, it's just day to day.

THANKS ALL !!!!!!!!!!

[sorarail]

My mom and I always had a very good relationship, so there was no question that I, being the only daughter, would be the family member who would take care of her, if and when the time came.
My mother lived with DH and me for two years exactly. She moved in shortly after my father died because she was not capable of living on her own and, in spite of my brother telling us to "put her in a nursing home," we brought her home. Because we don't have children, DH and I laughed that we waited 23 years to have a parent.
We had the room for her. One of our extra bedrooms became her bedroom, the other became her sewing room/library. We also put her piano in that room. We incorporated some of her furniture and art into the common living areas so that our home would be more familiar to her and seem more like home. No where in the house was "off-limits" and she respected our privacy.
We also built a couple of raised-bed gardens for her because she liked to grow vegetables.
Mom was frail. She had a form of schleroderma that caused havoc with her breathing, swallowing, and circulation. Luckily, I have an excellent employer who would let me take the time when I had to run Mom to Dr.'s appt or to the emergency room. We had a dream team of doctors to take care of her.
We had a lot of fun with Mom, in spite of her health. She loved to bake - DH and I both put on about 15 pounds as a result. We would take her places, she would go shopping with us, we took her on a couple of trips. We took her to church.
She died two years to the day from moving in with us. I think she was tired. Right before I took her to the emergency room the last time, she said "I think I'm going to die today." She knew.
What I miss most is the good night hug ritual we had. In spite of her bad health, she had a strong hug.
Taking care of mom was a lot of work (I won't go into all of the personal hygiene issues) but I would do it all over again if I had to.
That was our experience.
I miss her.

[KEYONNAH]

Does your state have services through the Department on Aging? I work for the Dept on Aging in Illinois as a case manager. I'm able to get homemakers to come into homes to help with caring for elderly clients as well as doing cleaning, errands, doctor appts, etc. This might help lower your stress level. It would also give her someone to visit with.

[Cinderelley]

Have you looked into ALTCS? I don't know too much about it, but they provide in home respite care. Have you talked with the social worker at the hospital she was discharged from? I don't have a lot of time right at the moment, but if you want to PM me some more info, I can ask our social worker at the hospital.

[MsMin]

Marilyn, I was thinking about you today b/c I haven't seen your posts in a while.
I hear you b/c I spent most of the day arguing w/ the hospital for my dad. It's a fight every step of the way.
I'm pulling my hair out down here b/c I can't get the support I need. I don't claim to be an expert w/ insurance or start and insurance feud BUT from my experience I've seen many patients receive better care on medicare alone than with a medicare supplement. When my grandmother was sick we ended up canceling her policy b/c I couldn't get the same care that we could w/ medicare only. It's unfortunate but sometimes the elderly are actually paying more for less :(

You've received some great advice, here are my rules. Consider your future.... think about what you need to feel that you did everything you could so that you don't feel guilty when she is gone. Use that as your base and trim the expectations within budget and your physical limitations. My grandmother died a year ago and I don't have any regret on the treatment that we were able to give or not give. Point is resolve this issues now b/c those ghosts can and will come back to haunt you. If you feel guilty now about what you can not provide then work this out now for your own mental health and grief later.
Next make her feel useful. Give her a job even if it's chief napkin folder, to remind you to remove the lint from the dryer or to remind you to watch a tv program. People need to feel needed and useful so find some tasks or role she can play in your home. No matter how bogus the job it helps a senior to feel that they are contributing in some way so GIVE HER JOB ;)
Also as mentioned try to get her involved in some activity whether it be outside if that's possible or at home. You say she has a sharp mind maybe you can have her recall some old family stories or compile recipes or ID ppl in old photos. These will help with the depression too.
The struggles that I face right now is it's easy to tell someone else what to do but to tell your own parent gets a little tougher-- if not impossible. As I have mentioned before my dad has had 3 strokes and one has affected his personality and he just rages for little things and the dr's don't want to help w/ meds b/c it can compromise his health but it's so hard on my mom. The other problem is the incontinence and the denial that accompanies it. He doesn't want to help us to help him and it's wearing us all down. He's refusing to use any aids for incontinence and I am having trouble handling that. I've asked the docs to help w/ a therapist and they just tell me I could do as much or better w/ my own parent. He says it's not a problem but it is a big problem. He loves to go to lunch but I need him to improve his hygiene. He gets outraged if I talk about it but it's becoming a serious problem. Then he weighs 275 and I can't physically help him with everything b/c I'm not strong enough and he tells the dr. everything is fine and I look like the crazy one. :confused:
Marilyn, you're welcome to PM me too and any help is appreciated here too.

[Cinderelley]

MsMin & Marilyn, have either of you considered an assisted living atmosphere? It's not a nursing home, but the individual (your parents) would live in a condo, apartment, etc, where people would come in and help them. A lot of times, it's easier for a stranger to assist someone than a family member. Also, the staff that comes in to help may be able to give the doctor a 3rd party opinion instead of just he said/she said.

Or have you considered a day program? I know it sounds terrible at first - like you're sticking your parent in a day care, but they can actually do wonderful things for them with physical therapy, occupational therapy, etc. A lot of programs have transportation to and from their site, so you don't have to physically move them.

Obviously, I don't know the whole story for you two, but maybe one of these options will work out well.

[Marilyn Michetti]

Thanks for all the support. MsMin, mother DOES have a job - she washes her teeth. I can do all the really bad bathroom stuff, but cleaning her teeth is just UGH ! :ill: I'll never be a nurse. I also have her fold the washclothes we go through - many, many, washclothes.

I'm getting some of it down to a science, and my mom and I both have a sense of humor, so we're going to make it. I'm waiting for a couple of calls prompted by suggestions from Intercot friends. Keyonnah put me onto the Department of Aging.- THANKS!!! Lots of forms coming in the mail, but some good information.

I've never loved a bunch of strangers more than you guys. We get through some tough stuff together. Thanks, and keep the tips coming.;)

[MsMin]

We took my dad home from the hospital yesterday. I did threaten to change dr's if we didn't get some help. One good thing is my dad had one of his fits in front of the dr. so now the doc has agreed to prescribe him something for his rages, an anti-psychotic. (there are many that help calm ppl in subclinical doses). We are hoping this helps.
Cinderelley, I love assisted living. I had put my grandmother in assisted living in 03 before she became too sick and had to move up to full care (she had a mean streak too and would hit ppl and ended up very happy in a nursing home b/c she thought it was a hotel/casino and she owned it) But my mom wouldn't let my dad go in assisted living w/o her. He is so so dependent on her. My brother was at the hospital w/ him and he wouldn't eat his lunch b/c he needed my mom to come cut his meat.
The doctor did agree to help w/ anything we need, he is sending homehealth. I think he scared my father a little into behaving for a while.

[Cinderelley]

We took my dad home from the hospital yesterday. I did threaten to change dr's if we didn't get some help. One good thing is my dad had one of his fits in front of the dr. so now the doc has agreed to prescribe him something for his rages, an anti-psychotic. (there are many that help calm ppl in subclinical doses). We are hoping this helps.
Cinderelley, I love assisted living. I had put my grandmother in assisted living in 03 before she became too sick and had to move up to full care (she had a mean streak too and would hit ppl and ended up very happy in a nursing home b/c she thought it was a hotel/casino and she owned it) But my mom wouldn't let my dad go in assisted living w/o her. He is so so dependent on her. My brother was at the hospital w/ him and he wouldn't eat his lunch b/c he needed my mom to come cut his meat.
The doctor did agree to help w/ anything we need, he is sending homehealth. I think he scared my father a little into behaving for a while.

Your mother could move in with him if she wanted. But, my big concern is his "fit" as you called it. Would he take it out on your mother? I see it happen sometimes esp with stroke patients since it can affect their personalities.

[Marilyn Michetti]

My mother had some psychotic episodes after being in ICU - none with mean behavior, but one was really scary. She was sitting on her night-table when I went in, clutching her cat, terrified out of her mind. She said she had been kidnapped, and the men in the boats wouldn't take her kitty, and tried to drown them both. It was very real to her, and evidently, it's a common thing. Scared me half to death.

My mom is funny, and sweet most of the time. I was getting her dressed for dialysis, and she finally said, "Is there some reason you're trying to put my pants over my pajama bottoms"? Well, DAH ! I don't think I could hold it together if she was mean or agressive.

[laughingplace<3]

My grandmother has been in and out of hospitals due to a staph infection in her hip. She had fallen and needed a new hip, but the new hip caused a staph infection. She has since had about 5 surgeries to give her a new hip (the one that caused the infection was immediately taken out) and she has been feeling down. She missed her home and obviously didn't like having to keep on getting surgeries. We were afraid that she would begin to think that it wasn't worth it.

To make matters worse, she lives in a house that has another part to it where my aunt and uncle live. They are both nurses and were supposed to care for her, but it is impossible for them to help her all day because they both work a lot and have an older son going off to college. We feared we'd have to put her in a nursing home; my grandmother had always said she'd rather die than going there and the joy of her still living was that she'd be able to go back to her home and live an independent lifestyle.

She is now officially back home since three weeks and it has now sunk in that she can't take care of herself. She can't drive and she can't cook, and doesn't want to eat unless we put food infront of her. Fortunatley we found someone to go there everyday for a couple of hours to keep her company and make her food. We even got her a huge flatscreen TV (since all she does basically is watch TV) and she LOVES it. We visit all the time and when she is in better condition plan on taking her to my aunt's house in FL where she has been once and loved it. Sorry for rambling on, but that's the advice I can give you- give her thinks she likes to do and things to look forward to. My grandmother always mumbled about being a burden so the best way to do it is care for her not in a way that is 24/7 and seems like you are using all your energy. My grandmother is very happy now at her own home.

We also faced something similar in terms of cost- medicare wouldn't pay for hardly any of her bills she has accumulated in the past 5 months. We hired an excellent lawyer and got medicare to pay for it, and to extent the contract that she has. All I can say to you is hope and you WILL get through everything! I'm sending loads of pixie dust your way. Oh and- you're not alone. :mickey:

[Marilyn Michetti]

One of the nurse's DD works with explained the eating thing. Our loved ones are in a home that they don't own, and have had all important decisions taken out of their control. That includes "what to have for dinner".

My mom won't know what she wants if I just ask her, so I fix her dinner on a smaller plate, and make it as pretty as possible, then ask her if she wants peaches or applesauce or does she feel like rice or a potato. I guess that made a difference, because she's eating a little better now. It's hard ! DD and DH went to college and nursing school to learn this stuff. Unfortunately, they're at work, so ??? She gets her afternoon O'Doul's and really looks forward to it. (I'm not sure she knows it's non-alcholic).

I'm surprised that so many of us are dealing with this, and touched that you're taking the time to help me.:)

[sorarail]

My mom looked forward to her daily O'Doul's too!:beer:
The trick is to keep some of your mom's favorite healthful items handy in case she doesn't want a regular meal. In our house, that meant yogurt, fresh fruit, cheese & crackers, and she liked a glass of hot milk w/ buttery toast before bedtime.
Taking care of mom was a major learning curve for DH and me, but at least we know mom ate healthfully, for the most part, up until the end.

[offwego]

On the same vein Marilyn have you thought of getting your mom to help plan the menu a little?

Like saying I'm "stuck for what to make next tues..do you think chicken or fish or what have Mom?" might that help a little?

I'm sorry your going through all this and hope that the advice, support and info keeps helping.

[thrillme]

I remember many years ago my grandmother became a very picky eater. Being a young mother during the depression and a farm girl, she HATED wasting food. She's get so upset when we'd go to one of her favorite local resturants because they'd give her servings larger than she could finish. One particular upsetting day she was suddenly stressing more than usual about having to eat ALL THAT FOOD. I looked her straight in her beautiful blue eyes and told her in a cheery voice..."Don't worry Grandma. The food NEVER goes to waste. They dump it all in a big plastic bag and sell it to local pig farmers as cheap slop. So everybody's benefitting here..." She sighed with COMPLETE relief as she finished only what she wanted to finish...I was so proud of my Mom for not killing me for the fib. Unfortunately as we were done Grandma snagged the waitress and handed her plate of uneaten portion and told her quite seriously..."Here ya go honey...you put this in the bin for the pigs OK"...Needless to say...my winker was winking it's fullest as my Mom turned beet red at the poor waitresses confused look. Fortunately the gal got a pretty good tip for going along with the scheme with nothing more than "oh yes ma'me...right away". Ahhh...Grandma...

I do sympathize with you tremendously. We put so much effort into so many other things rather than our care for our senior citizens which we will ALL be one day. Lots of prayers during this time. Remember you and your life is very important too.

In the meantime several "assisted living" homes provide great care for those that are at least somewhat mobile (wheelchair, walker, ecv) and they're paid for through social secuirty, nursing homes as well (not all nursing homes are evil...some are quite lovely you just have to investigate). My grandmother eventually went to a retirement home that she resisted at first then she totally LOVED it. They had church services of EVERY kind all week long, Bingo, music, games, arts and crafts, field trips...she was too busy for us sometimes. Eventually she needed more care and went to a nursing home. It was quite nice. Still lots of activities. All tenants were dressed each morning ready for daily activities. One gentleman even had a nice vegetable garden in the courtyard.

[kakn7294]

Marilyn, I'm glad to hear that things are going a bit better for you. There's plenty of things that your Mom can do that will keep her mind busy even if her physical body can't work as hard as she used to. Having her help plan menus and look through ads and coupons to compile a grocery list is great (if you guys get along in your food choices). She can also help with laundry other than washcloths - she can fold underwear, match and roll socks, etc. She can also help with the dog if your pup likes to be brushed - even if it's not really doing anything for his grooming, they both may really enjoy it. My cat hates to be brushed but will let the 8 yo do it - probably because she's not really doing any more than running the brush lightly over his fur. When it comes to her own hygiene, let her do as much as she can for herself. My grandma used to joke that she would "wash up as far as possible, then you can wash possible".

Beth, some of those anti-psychotic drugs are great - they don't dull the patient at all but really dull that aggressive edge. I'm glad the doc finally believes what your Dad is like - so many times we have that issue with inpatients too - the docs for some reason don't believe that normally nice, sweet people become uncontrollable in the hospital or with illnesses or even just at night.

Best of luck to you both - keep us updated.

[DisneyDudet]

Marilyn, I'm glad to hear that things are going a bit better for you. There's plenty of things that your Mom can do that will keep her mind busy even if her physical body can't work as hard as she used to. Having her help plan menus and look through ads and coupons to compile a grocery list is great (if you guys get along in your food choices). She can also help with laundry other than washcloths - she can fold underwear, match and roll socks, etc. She can also help with the dog if your pup likes to be brushed - even if it's not really doing anything for his grooming, they both may really enjoy it. My cat hates to be brushed but will let the 8 yo do it - probably because she's not really doing any more than running the brush lightly over his fur. When it comes to her own hygiene, let her do as much as she can for herself. My grandma used to joke that she would "wash up as far as possible, then you can wash possible".

Beth, some of those anti-psychotic drugs are great - they don't dull the patient at all but really dull that aggressive edge. I'm glad the doc finally believes what your Dad is like - so many times we have that issue with inpatients too - the docs for some reason don't believe that normally nice, sweet people become uncontrollable in the hospital or with illnesses or even just at night.

Best of luck to you both - keep us updated.

I love those ideas, Kathy! If our patients are confused and trying to get out of bed, we will put them in a wheelchair near the nurses station, and have them fold towels! They love that.

I agree about keeping older people busy. Letting them just sit there will make them think about the state they are in. Bring puzzles and board games like checkers to her and have her try that out. Somehow, they tend to keep their minds on puzzles and such, and less on other things.

Keep going strong, and work together! Sometimes, making you mom do things that you know she can do will help her out tremendously, much like you making her wash her teeth. You are doing very well! :pixie: to your whole family!