To Recap: The topic of Senior/Elder care is addressed within the framework of an article I wrote for hire. In Part One, my husband’s mother’s experience living in a step-down facility is detailed. Part Two tells my mother’s story, which involved being in several institutions. The highlighted parts were not in the original article.

My mother, on the other hand, was as sharp as the proverbial tack, mentally. Her problems were physical ones. Over the years, she had been in and out of the hospital many times, both emergency visits to the ER and hospital stays for surgeries. She lived with us for 22 years in two different houses. We built an apartment in each house for her, at her request. Mother managed her own affairs, including driving, well into her late 80s. My husband and I both worked full-time, and it was a great help that Mother was able to drive herself to her numerous doctor visits, her hair appointments, her grocery buying, her church activities, and visiting with friends.

At age 88, she was diagnosed with bladder cancer, her second cancer diagnosis, and within a week, surgery was scheduled. At Vanderbilt. In Nashville.  Suddenly, I was faced with balancing my work schedule in Murfreesboro with driving two hours round trip to stay with Mother for 4-6 hours a day while she recuperated at Vanderbilt.

Mother came away from that surgery with a urostomy bag that I was taught how to put on and take care of every day until the day she died years later. Not a pleasant task, I assure you. The loss of privacy for my mother and myself was embarrassing, to say the least, but necessary. I found that not a lot of health care professionals know how to take care of a urostomy patient. I had to teach more than one person what to do as a back up in case I wasn’t there to handle any emergencies.

Be careful what you pray for. The daily travel, constant worry, my work, my family obligations – all combined to make my doctor double my two low-dose medications “for protection.” She thought I was a candidate for a heart attack or a stroke, she told me! So when a nurse friend of Mother’s recommended a convalescent center close to home, we thought it would be helpful to all of us. Mother would have round-the-clock-care, and I would finally have some rest.

What a nightmare that turned out to be!

Mother arrived at the facility with a potassium drip, but due to a “communication mixup”, the nursing staff never took it out. We got her a wheelchair so that she could have some mobility, but she quickly began to decline and assumed the fetal position in bed, semi-conscious. She was there for 5 days. The doctor assigned to the facility refused to see her during this time, saying he would drop in on his regularly scheduled weekly visit. On the fourth night, I walked away from her bedside and went to the kitchen where I was joined by a nurse in green scrubs. My first impression of her was that she was so pretty, it was just a joy to look at her! She said, “You look so unhappy.  What’s wrong?” “Everything”, I said, and I told her about Mother’s situation. “Have you talked with the person who is in charge here?” “Yes, I have, when I went in to complain that the only food Mother will eat is yogurt and ALL of their yogurts were over 6 month’s out of date. She didn’t believe me until I took her to the refrigerator and she saw for herself. To her credit, she threw them out.”

“M’am, I don’t want to tell you what to do, but if that sweet lady were my mother, I would take her back to Vanderbilt as soon as you possibly can – or else she will die.” The nurse hugged me gently and I felt a calmness I hadn’t experienced in a long time. I was used to running on FRANTIC! I thanked her as she went out the door.

It was morning a few hours later, and I called my husband, telling him we were going to take Mother out of the facility. When he got there, the morning shift was coming in and the night shift was going out. Both shifts of nurses were horrified that I was taking Mother out of the bed and putting her into her new wheelchair, and into our car. I was told I couldn’t leave without doctor’s orders. As usual, he didn’t answer his page. Once again, they called the doctor. Finally, I said “I need someone to take this drip out of her arm. How hard can it be? If you all don’t help me, I will take it out myself!” Thankfully, a nurse stepped forward and took the drip out. Looking over the assembled group, I asked to see the nurse who had been so kind to me during the night. They told me they had no nurses other than the ones there, and their scrubs were not green, anyway. I never knew who she was, but I’m pretty sure I know where she came from…

As we left the facility, we decided to take her back to Vanderbilt where the doctor who had operated on Mother said she was within a few hours of dying, from “potassium overdose”. 

Mother was ultimately released to our home with Home Health Care provided. That service was great and Mother became quite attached to the workers who helped her recover. Six months later, she was told she could resume normal activities, which included driving. She even felt well enough to go visit her sister in another state, but on the very day we were leaving, she opened her patio door, ignoring the handhold my husband had installed for her, and fell onto the concrete patio, breaking her left arm at the shoulder (ending her driving ability). We had been on our way to work on my husband’s mother’s house and had planned to drop Mother off at her sister’s for a visit. Mother had a nurse friend who offered to take care of her for the week we would be gone. We paid her $100 a day for a week’s care. Little did we know that that “care” consisted of keeping Mother in a recliner with her arm immobilized, which caused her arm to heal with a permanent gap at the shoulder.

Once again, we made the round of doctors, therapists and specialists, whose various, uncoordinated treatments produced a badly healed arm which became chronically painful. The home health care provider had ceased business operations in our area. Through a neighbor, we located a Nashville-based provider, and Mother regained a certain level of mobility, even though she had to use a walker.

Then, Mother’s heart began functioning erratically, causing temporary loss of consciousness and several falls, and it was determined that she needed a pacemaker, even though she was past 90. We went back to Nashville for that operation. When she was being wheeled back into her post-op room, the doctor came in. I thought to came to tell me how the operation went. He was just furious – with Mother! He apparently only took patients that could enhance his reputation and her crushed shoulder left bone shards in the very place he was going to house the pacemaker! He had to put the pacemaker in a less desirable place. My first thought was how painful that must be for mother – excruciating pain that painkillers couldn’t touch – but he continued to yell at her. I asked him if the operation had been a success, and he said it had. Then I asked him to leave Mother’s room and not come back. I later filed a complaint with the Medical Board, my mother’s heart doctor and her GP. I never heard anything about it.

It took about six months for some of her strength to return, but now there were three specialists in two towns to see, plus juggling side effects of multiple, uncoordinated medications, plus the dentist (ill-fitting dentures), plus the eye doctor (macular degeneration), plus dealing with her loss of sleep, and depression (due to chronic severe pain.)

On the positive side, Mother began to walk without a walker, and she “exercised” by walking from her patio to the driveway and back five times a day.  She still did her own cooking, medications, dressing, personal hygiene, bed making, paid her bills, read  books, magazines and newspapers, and kept up with the world through TV. And she had an opinion on everything! She was 91.

I will wrap up my mother’s final few years, in and out of institutions, until her death at age 96 in 2008.

So much for our family. Your family situation will pose different questions. How do you decide when it is time to entrust your loved one’s care to another? Some indicators may include a parent’s inability to maintain the activities of the home, such as paying bills, yard work, cooking, steps, frequent falls or suffering the isolation of living alone. Health problems to be considered include memory loss, confusion about taking medication, forgetting to eat or overeating, and safety concerns such as heaters and stoves left on “by accident.” Should you bring assistance into the home? Or look at assisted living or nursing home care?

Much will depend on how open your family member is to receiving help. And on the caregiver’s part, there are the emotional issues involved in making decisions for your parents, and the guilt one feels when we are unsure that we are doing the right thing. We have to be loving but firm when we find conditions that seem unsafe or unsanitary. And we have to question our motives as well.

Nashville is fortunate to have many wonderful senior care providers, and housing options from in-home care to assisted living and nursing home care.

It was at this point in the article that I addressed each real-life problem of our mothers and matched them with specific organizations and their contact information as to possible solutions. 

Senior/Elder Care – Part Three. Next week, I will conclude this series with the story of my aunt (mother’s sister), who is in a nursing home in her home town and she loves it! She is 96.