It was a sunny day in October and everything was going smoothly. The phone call came while I was at work. Mom fell and they were calling an ambulance. This was something quite unexpected because mom was very spry. She wore three inch high heels when she was eighty, she is 89 now. The accident happened while she was trying to wash a cup and the rubber sole of her shoe stuck to the floor, she went down full force. Mom broke her hip and opposite side foot. Previously, she was in the hospital for stage four breast cancer which has been in remission for nine years. As you can see, she is a real fighter, her only other ailments being macular degeneration in one eye, and high blood pressure. The high blood pressure was a concern for us because she refused to take her blood pressure medicine.
While she was in the emergency room, they did an EKG which showed that she might have had a small heart attack sometime in the past. Baring this in mind, the surgeons had to give her a local anesthetic to repair the hip with two metal bars. She was doing well after surgery; but the next day she had a heart attack, and they moved her to another floor to watch her more carefully. She seemed to be getting better, but then at 2:00AM, we received a call that she had another heart attack. This time they moved her into intensive care. The doctor did an angiogram which showed that she had 90% blockage in three arteries and 95% in two others, all going to her heart chamber. He said that surgery to correct the arteries was out of the question because of her age and the severe blockage. She would not agree to surgery anyway, so the doctor put her on medicine management for her heart. She stayed there for about a week, her condition going up and down, and during that time she experienced renal failure.
By the next week they took her out of intensive care and she started getting better. As a family, we asked the doctor about her prognosis. He told us that for a normal person he would tell the family about six months, but with our mom six months to 15 years. He thought when she had the breast cancer she would be gone by now. So, now we knew how to plan, and we needed to make sure mom was taken care of for quite a few years.
The hospital started talking to us (the family) about her care after she left the hospital. So amongst ourselves we tried to figure out a plan for mom's care. The hospital suggested that she go to the Rehabilitation Hospital across the street to learn to walk with the new bars inside her hip. They suggested a Skilled Nursing Home would be best after she finished at the Rehabilitation Hospital. So we spent a lot of time and effort finding the best Skilled Nursing Home for mom. However, mom was not happy about this turn of events. Here was someone who was controlling all her life and, suddenly, all control over her life was gone. She turned into someone none of us recognized. She accepted the Rehabilitation Hospital, but insisted she was not going to the Skilled Nursing Home under any circumstances. The hospital social worker suggested that we contact an Elder Care Attorney which we did, and we were given a few options for mom's care.
None of us expected what happened next. Mom went to the Rehab Hospital and did very well. It was almost time for her to be transferred to the Skilled Nursing Home. She flat out told us that she was not going to a Skilled Nursing home for any amount of time. Consequently, I called her rehabilitation doctor, who was not in agreement with us. He felt mom should go home if that was what she desired. He was not taking into account how we were going to take care of her. There was a Determination of Needs Report done on mom and she scored very low. Her capacity to take care of herself was only 30%. I called the Elder Care Attorney that the hospital suggested; and she said, Â“if we let her go home as she desires, even with a part-time caregiver, we could be prosecuted for elder care abuse.Â” Okay, that shocked us. So now the only problem we had was that we needed to convince mom and the doctor that Skilled Nursing was the way to go.
We contacted our attorney who set up a meeting with the doctor, the social worker on staff at the facility, mom, the rest of the family, and a social worker from the attorney's office. To say the least, things did not go well. It was the doctor, the staff social worker and mom versus the family and our attorney's social worker. For the life of me, I could not figure out the Doctor at the Rehabilitation HospitalÂ’s thought process. The only thing I could come up with was that mom might have mentioned that her sister-in-law lived downstairs. However, her sister in-law who is 86 lives in Florida 90% of the time. By this time, my nerves were on edge. When I came to work one day, Mike Holland, one of our Helping Hands Counselors happened to be sitting at the desk next to me, and we started talking about mom. He calmed me down to the point I was able to start making rational decisions. He explained to me that mom was losing all control over her life, which can be very difficult. After days of our nerves on end, it was settled that she would go to a Skilled Nursing Home for the duration of her Medicare days. It seems that Medicare would pay for Skilled Nursing Home for up to 100 days after she left the hospital.
Mom was at the Skilled Nursing Home for about one month, and she was doing great. She was eating well, and they were making sure she took her medicication. Now it was time to figure out what to do with mom after the Skilled Nursing Home. She wanted to go home, but the problem was she needed someone with her 24 hours day. To have someone stay with her 24 hours was at the very least $20 per hour, and she just did not have that kind of money. We contacted the elder care attorney again. They looked over her financial situation and suggested "supportive living.Â” They also suggested she apply for Medicaid, then sell her home and put the money in a Medicaid Exempt Trust. This way Medicaid would help pay a portion of her living expenses, but she would still have access to her money for everyday things. When we suggested this option to mom, she hit the roof.Â” Her thinking was, Â“she has never had to be on any type of Aid and she will not even consider it, after all she has a house that is paid in full.Â” What she did not take into account was that the house's proceeds could not cover her care for a long period of time.
My sister in-law, Peg, and I spent many days and nights trying to find solutions to make mom happy. I would call my son, Jim (always nice to have a counselor in the family) daily for advice and then, Jim helped me realized that no matter what I did, mom was still going to lose her independence. Therefore, she would not be happy with any decision I made for her. Dr. Susan Savage at VCC Counseling suggested I read the book The 36-Hour Day, which I am sorry to say that I did not read till after this was all over. It would have helped in my dealings with mom. I am thankful for the support I received from VCC Counseling. Drs. David & Debbie McFadden, Dr. and Mrs. Gursky, Sherry and Danielle were always there to lend an ear and offer supportive suggestions.
We spent night and day trying to find the right supportive living facility for mom. We wanted to make sure she got the best care. Finally, we found one, although, mom was really not happy about it. It was almost like she turned into a four year old child who did not get her way. We moved her in against her wishes, and every day she would call and tell us that, Â“she should not be there, and she did not need to take any medicine.Â” The fact is the medicine is what is keeping her alive. As of writing this she is now living there, and though she says that she is not happy, the staff tells us she seems to be doing quite well. I try to go there to take her shopping or to dinner and stop in at different times to see how she is progressing. Every time I show up, she is visiting with people or playing a game, and she even seems happy.
We as a family feel terribly guilty about having her in a supportive living arrangement. However, she was not happy in her home either. She was always complaining that she was alone too often, even though, we took her shopping every week, brought her dinner a couple times a week, and took her on outings. If she had any problems with plumbing, heating etc., we were there for her. I think it is just her stage in life that she does not like at this point. Her independence has been taken away; she has lost that control and is having a really hard time dealing with it. Thank you to my sister in-law, Peg, who was right there with me through this extremely hard time, to my daughter who is still helping me sort through 89 years of momÂ’s belongings, to my son, Jim and Village Counseling for helping me realize that it was not me she was mad at, just her circumstances. Now our roles are reversed; mom is more like the child and I am more like the parent.