Elder Care Brings New Responsibilities

Friday, October 31, 2008

Page 15

AT THE SIDEBAR (Column)

Elder Care Brings New Responsibilities

By J’AMY PACHECO

When I became a parent, I was prepared for the responsibilities and demands that came with the job.

My daughter is now in middle school, and her greatest demands from me at this point involve my car and wallet. My “little girl” doesn’t need the same care she used to.

Whenever I do something extraordinarily nice for her, we joke that my motivation is to keep her from putting me in a nursing home someday. My husband and I can be considered “older” parents, and I sometimes worry about the effect our aging might have on her prime years.

These thoughts were magnified recently when my mother had to temporarily be placed in a senior care facility. My diabetic mother lives alone in a remote desert community almost 100 miles from my house. When a bad knee forced her to have surgery, I tried to arrange for her to recover at my house. Her health management company denied the request. They assured us that she would be placed in a rehabilitation facility to receive physical therapy, and that she would subsequently receive therapy and visits from nurses at her own home.

Distance related complications immediately arose. My mother needed a ride to the hospital, and planned to take a cab. In an ironic stroke of “good” luck, my sister got laid off and was free to drive our mother to the hospital and be there when she awoke.

After four days in the hospital, my mother wanted to go home. I strongly advocated for her to go to the rehabilitation facility, knowing the dangers of her being alone and barely able to walk. She was moved to what we were told was a rehab facility.

It turned out to be primarily a home for Alzheimer’s and dementia patients. My sister reported patients wandering the hallways and intrusions into my mother’s room. My mother, drugged with enough painkillers to think the ceiling sprinklers were moving, was terrified.

My own first impression of the facility was that it smelled of urine. I suspected a number of patients wore diapers, and could have overlooked the odor if not for the feeling I soon developed that a number of the staff just didn’t care.

My mother, for example, shared a room with an Alzheimer’s patient who was unable to get out of her own bed. Shortly after I arrived, she announced that she needed to use the restroom. The woman called out repeatedly, and nobody came. I pushed the “call” button on her bed, and still, nobody came. Finally, I went to the nurse’s station. Nobody responded.

My mother’s physical therapist ended up taking the woman to the bathroom. About 15 minutes after she was back in her bed, an aide came in to shut off the call light which was, she announced, driving her “crazy.” I couldn’t believe it.

I recognized that I was unfamiliar with the patient’s situation. For all I knew, she could have called for a potty escort every 15 minutes, and the staff might have known it was a false alarm. But when aides ignored my requests for clean pads for my mother’s bed and actually walked away from me, I started to worry about how much the people who worked there really cared about patient welfare.

My mother mentioned that two patients had died in the short time she’d been there. It occurred to me that if I knew I had to spend the rest of my life there, I would have lost my will to live.

My mother received physical therapy only after my sister demanded it. She had been placed in a bed that made it impossible for her to get up unassisted, which meant she spent the days she should have been trying to walk lying in bed, unable to move.

I spoke to the administrator, and within 15 minutes, she had a proper bed. She’s back home now, but a reported blow-up between her health management company and the physical therapy provider means she isn’t getting any physical therapy at home, and is unable to drive to appointments.

Fortunately, she recently closed escrow on a house near mine. She will be moved Monday, and my siblings and I will be in a better position to care for her. It means we will have take turns making sure she walks, takes the daily shots she now requires, and gets to all of her medical appointments.

After our experience, I can’t help wondering what happens to elderly patients who need care like my mother, and who don’t have children to intervene.

I was prepared for parenthood, but confess I’m ill-prepared to be a caregiver for my parent. Of course, I’d do anything for her. I just wasn’t prepared to have to prove it so soon.