Thursday, January 5, 2012

The Event! (Unfortunately It Took “An Event” Before We Could Get Our Elderly Parent The Help She Thought She Didn't Need)

As many of you know and as I have wrote about in the past I have an 89 year old mother.  Over the last two years my brother, John and I have spent countless hours trying to convince our mother to move to an assisted living facility.  Why an assisted living facility and not one of our homes you may ask, because she would still be able to have her independence.  Living with a child would mean her giving up her independence something she was in no way was willing to give up.  However, due to her declining health it was becoming more and more obvious that her staying in her home was soon not going to be an option.

Over the last two years I conducted countless searches on my computer looking for advice on how to convince a stubborn parent that moving to a place that would provide her assistance was a good move. While many of the searches provided me with good suggestions on how to approach an elder about moving, most ended with a statement that if none of those suggestions worked it would take “an event” to actually change a situation.  I can’t tell you how many times I got to the end of those articles and thought you have to be kidding.  Seriously, we have to wait for something bad to happen before we can get her some place safe?

But that is exactly what ended up happening.  Despite taking her on visits to four assisted living facilities, talking with her doctor about memory issues (amazing how someone who couldn’t remember anything on a daily basis could answer all the doctor’s questions accurately enough to avoid intervention when backed against a wall) and countless conversations in various ways to make it appear it was her idea, she continued to fight moving.

However, in June 2011 while on a visit to our fourth assisted living place in two years (she would go to visit to shut me up but shoot them down as soon as we left) my mother stated she liked the place and when pushed said she could see herself living there.  Well trust me that was all I needed. I immediately filled out all the forms and got her on that facilities waiting list.  She had no idea I would act that fast on her statement. It was a move that five months later turned out to be the smartest thing I had done throughout the two year period, because on November 7, 2011 the event happened.

The three months leading up to the event had been the hardest months of John and my life.  Mom fell in August just a couple hours after we had left her and after a quick trip to the ER was sent home with a report of no injuries.  September brought about another fall, although I still have my doubts about that one and believe that was a call for attention, but thankfully no ER due to no injuries. But by that time I decided it was time to make a push for in home care.  I am associated with an in-home care group through my temping so I asked my colleague to speak with mom.  Well that too fell on deaf ears.  Mom’s response was “you have given me something to think about” (translation I don’t want to be rude but there is no way this is going to happen) and “my family takes care of me’.  The problem with that second statement was her “family” that she was relying on has no medical training and her health status was declining to a point where it was more than we were capable of handling.  I can’t put into words how scary and frustrating it was for John and me. Knowing she needed more than we could give her and her as I put it “not getting out of her own way”.  It is a tough thing to watch your mother, who cared for you, not allow herself the opportunity to get the help she needed, but we were the “kids” and we didn’t know what we were talking about.

In September I made the decision to not put my life on hold anymore and to head back out with Vince.  But despite knowing I had done everything to get her some help, I still left with an incredible amount of guilt. Guilt that I was leaving my mother but more that I was leaving John to deal with her alone.  Well she showed me, because after I left she took her acting out to a whole new level.  She just flat out didn’t get up until John would show up daily to get her up and refused to answer the phone when I called.   I think John would agree it was without a doubt the longest and most frustrating five weeks of our lives.

However, the week after I returned light appeared at the end of our long dark tunnel.  The facility called to tell me there was an opening. I immediately made an appointment for the three of us to go look at it.  Now you must understand that in my Mom’s mind she believed she would be dead before the apartment would become available.  Many times over the past three months all we had heard from her was why won’t you just let me just die.  As a side note we worked with the doctor on her depression issues it was not something we ignored and her physical health while declining was still good. Her heart and lungs are very good for her age. So when I told her about her appointment to go see the place that threw her into full blown defiance and on the day of the appointment she told us she wasn’t feeling good so she wasn’t going and for us not to make any commitment.  Well on that day we did the second smartest thing of the year by putting a deposit down on the apartment and made a follow up appointment for the next Monday to pick out colors.  On that Friday John and I made a pact that we would do everything we could to make sure she moved into that apartment.

But little did we know that the pact was not needed, because the “event” would preempt everything. When John and I arrived at our childhood home on that Monday we found our Mom on the floor dehydrated and hallucinating but shockingly as I accessed her, she had no other injuries.  From reviewing her pills we believed she had been down about 24 hours but the most frustrating part was she was lying on the floor with her medic alert button sitting directly on her chest.  She once again had refused to push the button. In her previous falls she hadn’t pushed it but rather made it to the phone to call someone for help.  We believe she had just hoped she would get her wish and die, but as the saying goes, “if you want to make God laugh, tell him your plans”, because it was definitely not his plan to take her that day.

She was transported to the hospital.  While waiting in the ER for the test results I tried to remember that the hallucinations were due to the dehydration but it was scary none the less.  I found myself preparing for the worse.  But the worse was not to be, her test results showed no physical injuries and she was admitted to the hospital under observation.  The next day I met with the social worker to talk about rehab and after rehab living arrangements.  Her decision to not push the button gave me the opening I needed to impose the durable Power of Attorney (POA) Mom had signed many years ago, since she demonstrated she no longer could make appropriate decisions regarding her health.  I had taken over the finances under the POA long ago but her ability to answer the doctor’s questions appropriately had always blocked me in the past. It was agreed that if possible she would rehab at the same facility where her apartment was waiting.  A side note for all those looking at facilities for a family member, we only looked at facilities that had skilled nursing attached so that it would result in only one move.  In our case her entering through the skilled nursing ended up being the best case scenario, as any other way would have resulted in defiance.

Within a couple days we were informed she would be rehabbing at our chosen facility.  I can’t tell you what a relief it was to know that she would be able to move directly to her apartment after rehab.  While John started sleeping through the night for the first time in two years the night she was admitted into the hospital, I didn’t until I knew she was going to the same facility as her apartment.

By Thursday she was well enough to be transported to the facility for rehab and while the first weeks of the rehab didn’t exactly go smoothly.  There were still many conversations about why didn’t we let her die, but there also conversations where she acknowledged she didn’t realize she had gotten so bad.  The caregivers at the facility: nurses, physical therapists and aides could not have been kinder and more caring. On the day I saw my 89 year old mother peddling away on an exercise bike that works both legs and arms I knew that we had done the right on never giving up on getting her to move.

December 8th was a monumental day in all our lives because it was the day Mom moved into her AL apartment.  On that day I was filled with excitement but soon learned Mom was filled with fear and apprehension.  After signing the discharge papers for her and informing her it was time to go down the hall and over to the apartment, my mother decided to have a stand in, in the bathroom.  When I went to check on her after her going the bathroom, she informed me she didn’t think she could do the move or even go on anymore.  I said “ok” thus validating her feelings, then went on to tell her I was going to get her settled into the apartment before coming back for the rest of the stuff.  Initially she was quiet in the apartment but then the aides and nurses that had cared for her started stopping by to see the apartment.  As I was arranging her things I could hear them telling her how great all her stuff looked in the apartment and could tell their words were reassuring her that everything was going to be okay.

While the last month has not going smoothly, trust me she has had her bad days, but there have definitely been more good days then bad.  We know she is in a better place both mentally and physically.  She is no longer on antidepressants, can physically do more than she could in the last few years and still has a great deal of independence.

Finally, the reason I shared all of this very personal information is because I know there are hundreds of thousands of people out there caring for elderly family members and friends.  While our story had a happy ending we know we were lucky, our event could have ended much worse had Mom fallen and hit her head or broken her hip.  Please know that you are not alone and that I pray every night that you can get your family and friends to move whether it be in with someone or into a facility or at least allow someone in to check on them on a regularly basis, before “an event”.  I know well the frustration of trying to help and getting nowhere. But I also know you need to keep going and be prepared so I share this advice for what it is worth because I know how much it helped us. Before an event or at the time of event you will want to:

  • Make Sure You Have Papers in Order -We had her will, living will and Durable POA in place years ago
  • Read Everything You Can on How to Talk with Them – I tried everyone of the techniques many times, something obviously sunk in because she did go and look at places which ultimately got her where she wanted to be and not in one we picked out
  • Keep Talking to Them About Getting Help – Talk, drop it for a month or so then bring it up again
  • Not Give Up- Trust me we know how hard it is but you can’t give up, they really don’t understand how bad they are and need you to keep pushing.


COMMENT By Mary 1/5/12
I received this response from my niece, Mary that unfortunately was too long to fit in the comments section of the blog. I believe it is a very powerful story and one that many will relate to and be moved by.  My thanks to Mary for sharing it!


Thank you and Uncle John for caring for Grandma Dody all these years. Will and I have been going through many of the same issues with his mother. Grace's event happened this fall when she ended up needing emergency surgery to remove several large clots in her leg. She was unable to speak for almost a week after the surgery. Will and his brother Mark ended up taking on the responsibility of her welfare. The situation was extremely complicated. Grace was still legally married and living on the same property as Will's dad. They lived in separate residences and had for twenty years or so. She lived with one of Will's brothers who lets just say is not emotionally stable enough to take care of himself. The house where they lived was a nightmare of garbage and disrepair. A well person would have problems navigating through the rooms. The kitchen was so packed full of stuff that you could not walk into it. When Will and I started dating a decade a go it was messy. A few years ago I stopped going there if I could help it because she had started letting cats in and my allergies couldn't take it. When we went there after the surgery I could not even stay inside. It smelled like someone had already died. Just imagine the hoarder TV series and add another ton of garbage. There were places where leaks had caused piles of mildewed clothing. How she had made it this long living there was a mystery.

Grace is 73 much younger than Grandma, but she is very overweight and has had strokes. After she was well enough to leave the Hospital They arranged to have her sent to Bortz a nursing home. She could not walk and had to work with physical therapist on a daily basis. We knew we had a short window of time to figure out what to do. Will took many days off work going to different government agencies asking for help. Everywhere he went they pretty much kept telling him "Oh that's horrible good luck." finally weeks had passed he was in contact with a lawyer, an assisted living apartment complex, and Medicaid. One day in the middle of work all of these places called to give him bad news and the nursing home called to say they would be releasing Grace at the end of the week. Grace at this point could not make it to the bathroom with out assistance. Will broke down he left work and came home. It is hard to see your partner in full out despair.

I racked my brains trying to help find a solution. I finally thought of the Woman's Resource Center. Ten minutes after we entered there office we had a list of numbers and contacts. It was the most help we had had in weeks. We found a lawyer who would give Grace a free divorce so she could get the government help she desperately needed. Will's dad thought she should just come back home, and was unwilling to help in anyway. He said "If it was me I would just shoot myself." We photographed the home and went to adult protective services. That solved the problem of her being released too early. She was accepted at the apartment complex after we went there and explained her situation and again showed the photos. The manager is bending over backwards to get her in. Unfortunately we still have to wait until the divorce is final. She has been released from Bortz and is living with Mark the other sane brother. When we first took her to see the apartment we got the same "I'm never living there" upon leaving. I was trembling I was so mad. After all the grief and pain her son went through to find her this home. He eventually convinced her, and let her know most of all he wanted her to be safe. I’m sure we will get more dissatisfied comments from Grace. I just have to remember she is just scared and insecure. She has been living one way for so long she doesn't want to live any other way. Eventually I might have to give up my farm and gardens and move into an apartment, and that will be sad for me too.

We hope that she will be able to restart her life and maybe even begin to be social again. Most of all she will be safe. You don't expect to become a parent's caretaker in your thirties. It seems like we just started to build our nest and become real grown ups. I have gained a lot of respect for Will through all this. He could have ignored the problem like most of his other brothers were. Instead he fought and fought for one who he loves. So thank you for posting this it helps to read your story. I also have never had the chance to know Grandma Dody and it is nice to read about her too.


2 comments:

  1. I gathered from your Mom's Christmas card this year something was up. Please tell your Mom I love her and think of her often. It is so hard when they give up, or try to give up. It breaks our hearts. But we are only human and although we would love to move heaven and earth for them, we just can't. She is so lucky to have you and John in her life, and I am sorry you both had to go through this, but it only goes to show how much you love your Mom. I wish I had help with my Mom from my brother and sister, but I had to do it all on my own and it breaks my heart of the decisions I had to make by myself. I miss my Mom terribly, but I stayed by her side the whole way. Through it all though I know deep in my heart she really appreciated me being there.

    My love to you and your family Joan. Keep up the good work and your writings. I love following along. - Love Jen

    ReplyDelete
  2. Jen,
    Thank you for your love and kind words. While going through all of this, I honestly thought of you and some of my other friends who either were only children or had siblings who were not of much assistance. John and I made a promise to each other many years ago that we would hang in there together. As she got tougher and tougher to communicate with, as I stated in my post the guilt of leaving was not only about leaving Mom but more that I was leaving John to deal with things alone. He has been a great son/brother to Mom/me through all of this.

    As Mary shared, her being "safe" was so important to us. Just knowing that she is being checked on and able to get her meals without difficulty has brought us and we believe her a lot of peace and comfort. While accepting such a big change to her life right now is a day to day rollercoaster ride. She is socializing at meals with her table mates and cooperating with her physical therapist. So we are optimistic that she will find some happiness and enjoyment as time goes on.

    ReplyDelete