Morphine: No Cure for Pain

Just before 6 a.m., my dad’s voice floats through my dreams, a distant call echoing through a warm, nighttime fog.

“Amanda, I can’t breathe.”

My eyes open and before I hear the second syllable of my name a second time, my feet are on the carpet, running, running, down, down, down toward my father who is standing with his walker at the bottom of the stairs, his oxygen cord a tangle at his feet.

“I’m sorry,” he says,  but I can’t breathe.”

He isn’t gasping. He isn’t blue. But he is upset, confused.

I shepherd him through the darkness toward his saggy, lopsided recliner, a green leather monster that moved into our house a few years ago when mom and dad did.

In the kitchen, a few feet away, I reach for morphine, a tiny square bottle packaged like it’s a precious cologne, Chanel No. 5  for the dying. A high school health teacher warned us so many times about the dangers of morphine that even now, 30 years later, it’s counter-intuitive to give this drug to someone I love.

The morphine is the same pine green of NyQuil and no thicker than water. I insert a syringe thinner than a pencil into the bottle and fill it about 1/4 full, only a few drops, less than an 1/8 of a teaspoon, the prescribed dose dad can take once each hour.

When I turn on the light by dad’s recliner, I’m startled. My father is there, but he seems to have turned into my grandfather, his own father who died in 1990.

Until this moment, dad never resembled my grandfather, a self-righteous, blue-eyed Irishman, red hair gone to frost.

We, my father and I, have always been Schneebergers, taller versions of my German grandmother, with hazel eyes, a dimple in our right cheeks, almost always harder on ourselves than we are on others.

“Dad, I’ve got something that is going to help,” I say, holding the syringe where he can see it.

Until now, I’ve only given dad morphine twice a day — once at breakfast and once before bed. Hospice prescribed the opiate after his esophageal cancer and chemotherapy combined to cause weeks of diarrhea, leaving him so weak he couldn’t stand.

Morphine causes constipation, so the diarrhea ended. And I know it can also slow the respiratory system so dad, whose cancer has spread to his lungs, won’t feel like he’s gasping for air.

Dad tilts back his head and opens his mouth, his gums pink and wet, naked without his dentures. And like a mama bird feeding a hatchling, I insert the syringe and plunge the morphine down his throat.

This change, this sudden morphing from Schneeberger to Garrett unnerves me. So does this increasingly unfamiliar and traumatic family drama.

A room away, my mother sleeps, oblivious to her husband’s struggles. More and more she’s living in her own bizarre  dementialand.

Most days she insists she can’t go to the bathroom without eating cheesecake and smoking cigarettes. Other days she says she can’t stop going to the bathroom unless she eats cheesecake and smokes cigarettes.

The television remote control, for her, might as well be a martian spaceship.

She’s can’t figure it out.

Fifteen minutes after I give dad the morphine, he’s still having a tough time breathing.

I worry this is the first of many such episodes to come. No one from Hospice has yet told me what to do.

Maybe dad is having a panic attack, I wonder.

The day before, when I was taking a shower, my dad sobbed to the aide who visited for an hour to give him a bath. Stacie, who’s helped mom bathe for nearly four years and who took care of my aunt with Alzheimer’s before that, is part of our family now and dad trusts her.

He’s been unwaveringly brave in front of me, but he confided his deepest fear to Stacie — suffocation — and she wisely passed that on to me.

I go back to the kitchen and reach for dad’s other new prescription — a generic form of the anti-anxiety drug Xanax.

For a moment, I think about popping one of the tiny yellow pills myself, but I have never taken anything like that and decide it’s too big of a risk. If I have some sort of weird reaction, my husband is saddled with this mess.

So I half-fill a glass — well, really a plastic tumbler with textured sides that old, feeble hands can easily grip — with water and carry the Xanax in to dad. He swallows it, thanks me and closes his eyes.

Eleven days before, dad entered Hospice, both the program and the facility. It happened on a Saturday after he wouldn’t get out of bed.

A nurse practitioner who had visited the day before as part of dad’s palliative care had noticed the decline in his health. She said it was best for him to decide whether he wanted to give up on chemo and opt for Hospice. But she changed her mind on that Saturday when I called and told her about the situation.

A Hospice intake nurse came to our house and, by then, dad was sitting in his recliner. I was ready, as his power of attorney, to  sign the Hospice forms. But dad rallied enough to do make this decision himself and, for this, I will be forever grateful.

Although Hospice would almost certainly argue otherwise, signing up for comfort care is surrendering to your disease. I didn’t want to wave the white flag for dad. It was good for him and for me that he made that choice.

My husband drove dad a mile away to the Hospice care center, a nearly new facility with several indoor fireplaces and rooms that overlook an equally new park where people jog with dogs and push strollers around a blacktop path.

I followed in a separate car with my mother, her wheelchair, three one-gallon Ziplock bags of dad’s medication, dad’s living will, my power of attorney and a pack of dad’s Pall Mall cigarettes, a red Bic lighter stuffed inside.

Three days later, after Hospice got his diarrhea under control, dad came back to our house to celebrate his 58th wedding anniversary with my mom and told me he never wanted to go back to Hospice.

I worry now, watching him in his recliner, that he will end up back in Hospice, that I might not be able to handle this.

It’s been almost an hour since he woke me and I give him another dose of morphine.

This squirt of green, in combination with the Xanax, works.

He nods off.

Later, when I call Hospice, a nurse named Ginger reassures me I did the right thing with the morphine and the Xanax.

She gets permission from a doctor to double dad’s morphine and his Trazadone, a pill he takes before bed that helps the mind relax.

Then she ask me if I know what do when someone dies.

My first thought is “run,” but I don’t say it. I don’t say anything.

Ginger fills the silence with a “What To Do When Someone Dies — For Dummies” talk.

The person will stop breathing. Their eyes may be closed or may still be open.

Don’t panic. Don’t call 9-1-1. Go slow. Take your time. Call Hospice immediately or whenever you’re ready.

Once Hospice arrives, staff will verify the person’s dead. And then, whenever you’re ready — remember, there’s no rush — Hospice will call the funeral home.

As she’s explaining this, my mother hollers from somewhere in the house demanding a cigarette. I seek refuge in the pantry overlooking our wooded backyard and notice for the first time that spring green has started coloring the tips of the trees.

Once Hospice calls the funeral home, Ginger tells me, it usually takes about an hour for the staff to arrive.

The only decision to make then, she says, is whether you want the dead person’s face covered or uncovered as he’s taken from the home.

Who cares, covered or uncovered, I think to myself. Ginger’s already told me my dad’s going to by lying there for hours in my house dead, his eyes possibly open.

By the time I hang up the phone, my husband has taken my mother out for a cigarette and helped my father back to bed.

I reach for the tiny bottle of morphine again to soothe my father’s breathing and wish that Hospice offered something just as powerful to cure my pain.

This happened two days ago. My father is sleeping more, eating less and, for the first time since he was in the Army during the Korean War, passing up cigarettes. Although I  know his final chapter is closing, no one knows when that will be. For now, I stand guard with the morphine and Xanax, trying to make him comfortable. Morphine was one of my favorite bands of the 1990s and a half-dozen of their songs still occupy my favorites list, including “Cure for Pain.”

Life can be ugly and unpredictable: Pick a husband who will last — and laugh with you — a lifetime

The first time I introduced Skip to my parents, I knew I wanted to marry him.

It was October 1998 and my future husband was not in peak form.

He — like his mother and most everyone on her Hungarian side of the family — had developed a painful cyst at the base of his spine. A few days earlier, a doctor carved a 4-inch zig-zag incision, scooped out the culprit and sewed Skip back up with what looked like an embroidered lightning bolt emerging from the top of his butt crack.

It wasn’t pretty.

And Skip was in pain. By the time we pulled into my parents’ driveway, he was ashen and sitting side-saddle because leaning against the driver’s seat hurt too much.

My mom, I had warned Skip, had no social boundaries. None. She was nosy, touchy and, at times, a wee bit raunchy. But she could also be witty and disarmingly charming.

When mom saw Skip limping up the back stairs, she greeted him with a smile and an innocuous question: “What’s the matter?”

Skip explained about the cyst.

And before Skip could shake my father’s hand, mom walloped him with round two — the inappropriate question, the one I was certain would come even though I couldn’t predict the circumstances or the timing — “Can I see it?”

Skip, without hesitation, unbuckled his belt, dropped his jeans and let mom peel down the dressing so she could marvel at his wounded anatomy.

“Herm,” mom said to my father, “come here, you have to see this.”

My dad, politely averting his eyes, declined and asked Skip — in manly solidarity — if he wanted a beer.

Skip and I were in our early 30s then. My parents were in their late 60s. None of us could have imagined what the future held. But that moment — and the hours that followed — set the tone for all the years that followed, including the past three since my parents moved in with us.

Many readers of this blog have left messages and sent emails of encouragement to me. They say I am brave to help my parents and that my parents are lucky to have me.

But the truth is, my parents are lucky to have my husband.

If Skip didn’t support me — financially and emotionally — I couldn’t help my parents. He also pitches in daily to get things done. Today, on his day off, he took mom on a field trip to the library and listened patiently as she yammered on with two people she knew — even after those people seemed to lose interest.

How many books and movies — both comic and tragic – have been penned about Romeo and Juliet relationships doomed by quarreling or misfit Meet the Focker families? There’s a reason.

Even if you find a soul mate, a lover, a best friend, you’re destined for trouble if your match doesn’t fit with your family. Yes, couples can muddle through. And, for some, family isn’t as important. But I knew, particularly as an only child, that my husband would need both the right mindset and sense of humor to not only cope with my family, but to be happy with me.

I was already in love with Skip before I took him home to meet my parents. But as that day wore on — without tension, only laughter — I knew I would be his wife.

After mom re-bandaged his incision and Skip hoisted up his jeans, mom, who has no science or medical training, told Skip that his cyst wasn’t hereditary.

It was, she declared, his unborn twin.

Mom, now with dad on her side, told the story of a man they knew in Florida who had the same sort of cyst. When doctors operated, they found hair, tiny teeth and bones. Doctors concluded that the man’s body formed the cyst to expel the remains of a twin he had unknowingly carried with him for decades since birth.

Skip didn’t argue. He didn’t talk about all of his family members with the same issue. Or that, thankfully, his doctors did not report finding any teeth lodged above his butt crack.

Only later, when we were alone, did we laugh, not realizing at the time that his lightning-bolt scar would forever be known in our family as “twin.”

Would grandma and grandpa trade their driving privileges for private car service to the grocery, the doc?

Almost every day I take my dad to radiation, I spy an old person behind the wheel of a car or SUV who I suspect shouldn’t be driving.

I see men and women in their 80s and 90s emerge slowly from their driver-side doors, unfolding themselves and their walkers for agonizing and unsteady walks inside. Other older drivers unknowingly block the entrance to the medical building, parking at weird angles while waiting for another old person — usually even more feeble — to crawl into the passenger side.

I’ve also witnessed elderly drivers cut off semi-trucks when they pull out of the medical center onto the road. And I once saw an old man with wrap-around, goggle-type sunglasses turn left onto the highway like he was in London, staying on the wrong side of the road until a blaring horn prompted him to steer right.

Many old people have no options to get where they’re going. Others shun the options they do have (my parents, for instance, would rather independently ride a pogo stick through the snow than take a prescheduled public transport bus with strangers).

Today, Cleveland’s newspaper and Plain Dealer reporter Karen Farkas offer a different option that could work for some (here’s a link to the story: http://tinyurl.com/mjuqdjl).

The University of Cincinnati has partnered with a nonprofit group to pair its students with older people who don’t drive.

The students can bank credits for driving the oldsters to doctors’ appointments and groceries and anywhere else they need to go. And the old people get private, door-to-door transport by paying dues to a nonprofit for the service — dues that can often be paid in full when the old person sells his/her car.

The program, Driving Community Connections, is supported by the Ohio Department of Aging and the Ohio Board of Regents.

It’s only a pilot program at one university.

And the story doesn’t answer some important questions — like whether the student drivers are vetted or insured.

But it does raise the possibility of a new way of caring for the aged when people get creative.

Is it better to be tied to a tree than squashed on the freeway? Caregiver angst

Baby Walter — that’s what everyone called him since his dad was also named Walter and no one much liked the sound of “junior” — spent most of his single-digit years tethered to one heavy object or another.

His older sister Tina was one of my closest friends. We grew up in the 1970s and 1980s at different ends of the same rural road in Ohio, an unlined swath of blacktop connecting old farmhouses to the fields of green soybeans and sweet corn planted in between.

Baby Walter and Tina lived in the last house on the right before our road crossed over Interstate 71, the busy freeway connecting Cleveland to Columbus to Cincinnati.

And Tina’s mom — not overly protective of Tina or her older brother — worried constantly that Baby Walter would run down the slope of their side yard and onto I-71 where he would almost certainly be smashed by a semi-truck hauling automobiles or steel or some other heavy thing manufactured in Cleveland and destined for points south unknown.

Today, a doctor would likely diagnose Baby Walter with ADD and scribble out a prescription for a medication to calm him. But at that time, our patch of Ohio was stuck somewhere between “Hee Haw” and “Jesus Christ Superstar.”

We rarely questioned our fate and, if we did, we asked God via Jesus to help us, not some stranger in a lab coat. On rare occasions — like those Sundays when our preacher wrapped up his sermon in time to catch Browns kickoff — we knew God kicked in. But mostly, we fended for ourselves and worked with what we had.

That meant it was Tina’s job — and my job, too, when I was at her house — to keep Baby Walter safe by following instructions from Tina’s mom:

Tie Baby Walter to his bed for his nap.

Tie Baby Walter to the barn ladder while you’re in the loft so he doesn’t fall.

Tie Baby Walter to the tree so you all can play outside.

I know it sounds wretched now and certainly there were many what-ifs — like what if the house caught fire and Baby Walter was trapped, unable to leave his bed. But nothing bad ever happened.

Baby Walter would inevitably wrap himself around the tree like a tether ball to a pole, but it was fun — for him and for us — to unwind him until he wrapped himself around again.

He was happy, well-loved and well-fed and seemed to grow accustomed to the ritual, often waiting for someone to tie him, as if he, too, didn’t trust himself not to run into I-71’s siren song.

I’ve been thinking about Baby Walter — who must be 40 by now — all day.

This morning, before sunrise, before anyone else in our house was awake, when the temperature hovered at -16 degrees, my 83-year-old mother crept outside with her walker — wearing only a t-shirt, tennis shoes and a coat — and smoked a cigarette.

She made it back to the couch safely and we only discovered her crime when my father, who has cancer, went out for his first cigarette of the day and found an overturned coffee cup and a half pack of red Pall Malls scattered on the snow.

It frightened me, but it enraged me just as much.

How long does it take a 104-pound woman to freeze to death if she falls in the snow when its 16-below? Or how about our dog or two cats that always hover around the front door?

My mother has a combination of Alzheimer’s and vascular dementia (caused by smoking). She also has spinal stenosis and scoliosis that leaves her bent at a 50-degree angle, unable to straighten, unsteady on her feet and challenged to hobble on a walker more than a dozen feet without sitting down.

Her physical frailty has in some ways made her mental frailty easier to deal with. I can almost always catch her before she runs amok. But it’s done nothing to temper her bullheadedness or nicotine craving (yes, I’ve tried and failed to convert her to patches and gum and e-cigarettes).

From the first week mom and dad moved in, there has been a single rule that has dominated our lives: Mom must never go outside — or even open the door — unless someone is at her side.

Her dementia has stolen much of her left brain, always her weakest side. She doesn’t know $5,000 from $5. But even now she knows the door rule and knowingly broke it for a cigarette.

Nursing home was my first thought. I’m nearing the end of my caregiver rope.

Standing by my dad as he negotiates cancer — an oncologist today decided to end his radiation a week early so he can go on chemo because the tumors in his lungs are leaving him short of breath — is exhausting. And it’s sad.

Lassoing my mother’s wants and needs at the same time is nearly impossible.

But here’s the thing: My dad’s final chapter is closing.

And even though my mom isn’t the woman she was — and both OG mom and dementia mom make dad bats — I know he’d rather have her close as he fades away.

So I’ve got myself a Baby Walter dilemma: How do you prevent someone you love from running into traffic and getting killed?

I have a tree, but I’m unwilling to use a tether.

Please remember: © Amanda Garrett and Mom and Dad Move In — from 2015 until present: Unauthorized use and/or duplication of this written material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Amanda Garrett and Mom and Dad Move In with appropriate and specific direction to the original content. Feel free to re-blog on WordPress.

Update: Nursing home transport aides who not only drive residents to medical appointments, but handle their insurance and questions once they get there

Earlier this week, I wrote about the best nursing home in our county — and one of the best in Greater Cleveland — using its transportation aides to not only drive residents to doctors’ appointments, but to manage the residents’  insurance and medical questions once they get there.

Today, I saw this in action. The same nursing home resident I wrote about this week was back in the waiting room of the oncology center. She is having radiation to her brain and already, during her first week, has developed a bright red, raw-looking splotch on her temple.

A different transportation aide from the nursing home — it only has two — was with the woman today. He disappeared and came back a few minutes later, saying he had spoken with the oncology nurses, trying of figure out where he could buy a cream the resident was supposed to have to soothe the burned skin.

The pharmacy at the nursing home where the woman lived didn’t have it, the driver said. So the oncology nurses in radiation gave him some samples of the cream for the woman until he could track down a tub, he said. But he didn’t know where to go.

I bought the same cream for my father a few days before, so I shared the name of the drug store with the driver and the woman. The driver dutifully jotted down the information on his clipboard and both he and the nursing home resident seemed pleased there was a solution.

But again, I ask: Why are nursing home drivers tasked with medical duties? This is bizarre.

This driver was every bit as helpful and respectful to the nursing home resident as the other nursing home driver I met with her this week. When dad was through with his radiation today and I drove up and parked at the entrance to run in and get him, the nursing home driver even wheeled dad outside and helped me get him into the car.

But what kind of nursing home care system do we have when drivers are handing the needs of a radiation patient?

Suicide is painless: Damn you, Hawkeye Pierce!

“Suicide is painless” — I wake up humming — “it brings on many changes.”

“And I can take or leave it as I please.”

Cue helicopters.

No worries. I’m not offing myself. I’d have a much angrier theme song if suicide was my plan.

It’s just that song, that horrible TV theme song, is nibbling at my brain, sucking out my soul.

I’ve  been trapped in a 1970s, olive-drab time warp for weeks after Netflix released five years worth of M*A*S*H episodes.

Every night after dinner, my parents tune into Hawkeye, Hot Lips and Frank Burns (well, now Charles Winchester III).

And I’m suddenly thrust into this bizarro world where I’m doing dishes and waiting, hoping for them to go to bed….while my mom and dad are eating Oreos and giggling at the TV.

When M*A*S*H first aired, I was 6-years-old and the roles were most assuredly reversed. I prefer the role of couch-dweller.

Caregiving — a term I despise for myriad reasons, but have no word yet to put in its place — is slowly ruining swaths of pop culture and other joys for me.

When mom and dad first moved in, mom would often fall when she got out of bed. I had to come up with something to alert me before her feet touched the ground so I could help her.

There are a lot of devices on the market, but almost all depend on weight. They don’t sound an alert until the person is standing.

My solution? A driveway alarm that sounds if something (presumably a car) breaks a beam.

My husband mounted the part of the device that shoots the beam on mom’s bedside table. And every time mom swung her feet across the beam, the alarm — which I programmed to play my favorite song at the time, Rickie Lee Jones’ “The Moon is Made of Gold” — would play from a device on my bedside table.

“Don’t feel bad because the sun went down, the night has wealth untold,” Rickie Lee crooned, gently waking me for the first time each night mom was getting up.

“You just keep watching, and you soon will see,” Rickie Lee poked me awake the second time mom stirred.

“The moon is made of gold,” Rickie Lee’s chorus only arrived on my third wake-up of the night, usually drawing an exhausted single-word response from me: “Bullshit!”

This continued for months.

And now, I’m probably the only person in the world who gets visibly angry when she hears happy-go-lucky Rickie Lee Jones sing anything.

I’ve since learned to be careful mixing my favorites with anything caregiver related.

Can’t go to flea markets or antique shops because they all seem to have the same musty odor, however, faint, as my parents’ house when we cleaned it out.

Can’t stand the smell of gravy, a standard in dinners I cook for mom and dad. It makes me nauseous. My husband and I have gone vegan.

Can’t love my own, lovely front stoop — carefully painted and planted to be inviting — as my parents have seized it with outdoor furniture as smoking central.

Luckily, M*A*S*H was never a favorite.

I was a little nostalgic when mom and dad first started binge watching, but any sentimentality  evaporated by Season 3.

Now, pity Alan Alda should our paths ever cross.

One of these days, Hawkeye. Pow! Right to the moon.

I know it’s not made of gold.

Would you let a nursing home kitchen assistant negotiate medical care for your mom and dad? Some are.

When my dad and I were waiting for his daily cancer radiation treatment yesterday, a gangly, good-natured kid wheeled a woman into the room and parked next to us.

He was in his early 20s and could have passed for the woman’s grandson the way he doted on her, tucking a hand-crocheted blanket around her shoulders, making sure she had enough water to drink because a medical condition dried out her mouth.

But he was an employee at the nursing home where the woman lived — the highest-rated facility in our county and one of the best in all of Greater Cleveland. Hopeful residents each fork over about $5,000 to get on the facility’s waiting list and often spend years elsewhere before a space opens in independent, assisted-living, nursing or memory care units.

After a nurse wheeled the woman away for radiation, the young man told us he started working in the nursing home’s kitchen in 2009. A few months ago, one of the nursing home’s two transportation jobs opened up and he landed it.

He figured it would be a simple job, driving the residents — about 300 — to places they needed to go. But it has turned out to be much more complicated.

All of residents have lots of medical appointments and besides the transport obstacles — safely getting people on walkers, canes and in wheelchairs into and out of offices through ice and snow — most need help handling their insurance and medical questions and answers with doctors and nurses.

What? My face froze.

So you not only drive them, you act as their representative at doctors’ appointments, I asked, just to make sure I understood.

Yes, he said, shaking his head. It’s a shame, he said, how so many families absolve themselves of all responsibilities once a loved one is ensconced at a nursing facility.

A few minutes later, dad and I were sitting in another room with his oncologist. Dad told her he had started having pain in his esophagus near where his tumor is. She said she would write a prescription for a soothing serum to coat his throat that contained Benadryl as one of its main ingredients.

Wait, I interrupted, dad already takes one Benadryl pill every night before bed to help him sleep. Couldn’t that be a problem?

Yes, she said. Dad should stop taking the nighttime Benadryl because taken together, the serum and the Benadryl, could cause him to fall.

A fall — even though dad’s cancer is at Stage 3 and only being treated palliatively — is more likely to kill dad than his cancer, another oncologist told us after dad asked him how he would likely die (the other most likely way is aspiration).

So this seemingly simply Benadryl mix-up couple have been an early death sentence.

Would the good-natured nursing home transport driver have caught this potential medical mistake if he took dad to this radiation appointment? Doubtful.

I’m a veteran newspaper reporter — trained in both reporting facts and asking tough questions — and I have a difficult time managing medical care for my parents, two people I love.

How would a kitchen assistant turned driver manage this for strangers? And why should anyone expect him to?

No matter how good his intentions are — and they seemed exceedingly good — the nursing home driver has no medical training and far too many residents to know each of their medical needs and vulnerabilities.

Later, on our drive home, I asked dad if he was surprised how that nursing home depended on its drivers. No, he said, but he thought it sad, especially considering how much people pay for their care.

The nursing home driver told us the woman he brought to radiation that day shells out more than $8,000 a month. More skilled nursing care or the memory unit — a separate, locked-down facility for dementia patients — costs residents much more, he said.

What do residents get for that money? Some were on a field trip to nearby Harry London Chocolates that day to see how bon bond and chocolate-covered pretzels are made. Tonight, a group of residents is putting on a stage show open to the public.

And one day a week — the day many residents live for — the lobby is filled with therapy dogs who wag and lick away loneliness and fear.

All of that is fantastic. It’s also a clean, well-run facility where many residents feel a kinship with staff. I know. My aunt was a resident and I’ve been a visitor.

Yet none of this makes up for a kitchen assistant being promoted to a driver whose job also includes negotiating residents’ off-site medical care.

Caregiver gripe of day: Other caregivers, delivery drivers and morons hogging drop-off zone

The suburban medical building where I take my father for daily radiation treatments needs a traffic cop.

Drivers are selfishly and needlessly clogging the large semi-circle drop-off zone.

Today’s traffic included: A white delivery van parked with its flashers on for at least 20 minutes; An old man in a mini-van with a Veterans license plate parked, engine off, waiting for his wife; And a couple of SUVs idling for reasons unknown.

Not today, but often, there’s any number of small buses from area assisted living facilities jockeying for positions there, too.

This isn’t a design problem.

This is a user problem.

Drivers: It Is common sense and common courtesy to park elsewhere until the person you’re picking up is ready to go.

It’s simple. The person you’re picking up (or his doctor’s office) should call you when they’re approaching the entrance. Don’t park at the entrance and wait.

It’s bad enough I have to cart my dad’s wheelchair to this place because there’s no guarantee a wheel chair will be available.

But please, fellow drivers, give a gal a break: Leave room at the entrance for me park, pop my hatch, wrestle out the wheelchair and get dad safely inside.

I always do the same for you.

Beer cans littering your digital grave: Who would you trust to manage your online afterlife?

Teeth in, glasses off, nightgown on, no shoes.

This, my mother told me no less than a thousand times, is how she wanted to be laid out in her casket.

I teased her, just as often, that she better treat me well or it would be teeth out, glasses on, scratchy wool suit, pantyhose and pointed-toe heels — her version of hell.

Mom ended up choosing cremation, no viewing, when she pre-planned her funeral.

Was it because she didn’t trust me? Not especially.

She didn’t trust anyone to get things right after she died.

I thought about that this week when The Washington Post uploaded this story to its Website: “Facebook will now let you manage what happens to your account after you die.”

When I first saw the headline, I thought this was the most definitive pronouncement of the afterlife I had ever read in a newspaper — that we will somehow live on in digital heaven (or, depending on your view of social media, hell), Tweeting and Facebooking our way through eternity.

Alas, the story beneath the headline disappoints. Facebook is most decidedly limited to the earthbound.

But there is a significant change — Facebook users can now designate an heir to manage some parts of their accounts posthumously.

Facebook calls that heir a “legacy contact.”

People with this power can pin farewell messages (or anything else they like) to profiles, respond to new friend requests and update profile pictures and cover photos.

This could ultimately turn Facebook into a living cemetery — an idea that both worries and intrigues.

Choose the wrong legacy contact and your Facebook page could be littered with empty Natty Light tall boys and knock-knock jokes. There is no digital groundskeeper to occasionally sweep that crap away.

But done right, Facebook memorial pages could offer so much more than a marble tombstone ever could.

Insight. Images. Genealogy. Comfort, even, for those grieving, no matter where they lived.

This makes me re-think what I have posted on Facebook and maybe what I should.

My mom, who is 83, doesn’t have a Facebook page.

If she did, it would be crammed with images of her artwork and poetry, the hundreds of houses she sold as a realtor and way too many re-posts of puppies.

Would she trust me to maintain it?

Doubtful.

But the powers behind Facebook clearly considered control freaks like mom with their new death policy because, if users designate no legacy contact, Facebook will delete their accounts after they die.

Mom, I know, would choose this option — digital cremation.

Finally, first generation of simple technology for the old (and everyone else): Amazon’s echo

Our Amazon echo arrived today — the voice-activated Wi-Fi personal assistant that can tell you everything from whether it’s going to snow tomorrow (in your area or anywhere else) to what you can swap out for baking soda in a recipe.

I’ve only had it connected to for a couple of hours and what’s surprised me most is my father’s immediate embrace of this oh-so-foreign gizmo.

As I was serving my parents dinner, I demonstrated with some simple commands and then let Alexa — the trigger word to turn the device on — slumber.

While I was in the kitchen, I heard my dad: “Alexa, play Dave Brubeck please…..louder….louder…louder…that’s good.”

My dad has always loved computers. But macular degeneration and Microsoft’s switch to an app-like desktop system–so radically different from anything he’s known–was finally too much. He stopped using the computer a month or two ago.

But echo puts him back in the game. And that’s fantastic. I’m truly thrilled about this.

And I don’t think echo’s likability would be limited to those seniors who like computers. If they can remember “Alexa,” almost anything is possible.

I’d suggest to Amazon that, if possible, users should be able to choose their own trigger word. Only “Alexa” and “Amazon” work now. Older folks would likely have a much easier time adjusting to a word or name they are familiar with.

I’ll update this as the days and weeks pass.

But I’m already bummed we don’t have two or three echoes — one for my folks, one for the kitchen and one for our bedroom.

FYI: echo is $99 for Amazon Prime members, $199 for everyone else.

I