A New Year? Really? Already?

In response to a diminishing number of requests, I'm pushing past whatever it is that has kept me from writing to post an update about Mom, starting where we left off.

September '08 was a difficult month for both of us. We'd settled into an acceptable routine of my part-time care giving coupled with my full-time job and help from Linda, when Mom suffered a fall that changed everything.

As was my custom on weekends, I'd checked to make sure that Mom was sleeping comfortably before going out to the den to watch CBS Sunday Morning. I enjoyed the show, as always, and decided to spend a little more time watching TV and drinking coffee before going back to her room to see if she was awake. When I finally tore myself away from my comfy nest on the couch, I walked back to our room and found Mom curled up on the floor at the end of her bed, resting her head on the step that separates her part of the room from mine. She'd managed to pull a blanket over herself but was clearly, not surprisingly, distraught.

"Mom! What happened?"

"I don't know. I'm not sure. I wanted to go out. Help me up. I don't like it here."

I felt confident that I could get her up as she weighs just a little over 100 pounds, but when I tried to move her, she gasped in pain. I sat down next to her while I decided what to do next. I was a bit shaken and feeling more than a little guilty to have discovered her lying there, fearing that she'd suffered a broken hip, or worse. She smiled and held my hand and waited for me to get my act together.

Any position seemed to be painful for her but I decided that getting her past it and into bed was the best course of action. I moved a padded foot stool close, rolled her onto her back, and had her try to sit up. Although it was painful, she gave it her best effort and I was able to lift her enough to get her on the stool, then into a standing position long enough to get her to grab the bars of her walker and take a few halting steps to her bed. I was very concerned but reluctant to call an ambulance if we could manage on our own. Past trips to the emergency room have left her so distraught and created so much pain for her, with uncomfortable exam tables and IVs and long waits, that I made the difficult decision to skip it unless she began to show clear signs of a catastrophic injury.

Once I got her settled under the covers she seemed to have forgotten that she'd fallen and was puzzled as to why she was in pain. She couldn't tell me what had happened, but it seemed clear that she'd been trying to get to the bathroom when she got out of bed and had walked in the wrong direction and fallen trying to maneuver up the step where I found her.

I called Linda, who stays with Mom for several hours during the day while I'm at work, and she came over to help me evaluate Mom's condition. There were no obvious bruises although there was some reddening around one hip. Mom could move her legs and arms enough to make it clear that nothing was broken, although we couldn't be sure about her hip at that point. As it turned out, we still don't know if she broke her hip.

We called Mom's doctor, who agreed with Linda's suggestion that we get a hospital bed to make it easier to care for Mom during what we hoped would be a speedy recovery while realizing that being confined to bed can lead to severe complications. Mom's doctor made a surprise house call within a few days (bless her) to try to determine what, if any, injuries had been incurred. She understood my reluctance to take Mom to the emergency room and reassured me that even if they had diagnosed a broken hip, the usual treatment is bed rest, which Mom was getting at home. The doctor also did an evaluation of Mom's overall health and concluded that Mom's advanced age and congestive heart failure qualified her for Hospice care. That changed everything in terms of obtaining help for Mom.

We enlisted a local agency--a fairly straight forward process--and began to work out schedules with aides to supplement what Linda was already doing, making it possible for me to return to work after a few days off to get things organized. The hospital bed turned out to be a significant improvement over the bed we had been using. We were able to raise the height of the bed to make it much easier to care for Mom and the side rails gave me an extra sense of security when we were away from Mom's bedside.

The fall and subsequent changes in Mom's routine left her disoriented and exhausted for the first couple of weeks, to the extent that I felt we were facing a rapid decline in her health. I contacted family members to let them know that it might be wise to schedule visits sooner rather than later and to prepare for the likelihood of Mom's death. In retrospect, I realize that I may have been over reacting, but at the time my caution seemed justified.

Family flew and drove in from distances reaching from Paris, France to Stuttgart, Arkansas. I had had a tearful conversation with my daughter, Alison, in Maryland and she, too, decided to fly home to spend time with Mom and me. Although everyone in the family was willing to drop what they were doing to fly to Mom's bedside, I encouraged some to wait a couple of weeks so that we wouldn't end up overwhelming Mom at a time when she needed rest as much as she (and I) needed the many expressions of love and concern.

The first to arrive was Mom's younger sister, Helen. Helen's daughter and son-in-law had driven her up from Stuttgart and Helen, thankfully, decided to stay for nearly a week. She was a tremendous help, both physically and emotionally and contributed to our well-being, in many ways, with her loving spirit and generous heart.

Next to arrive was my nephew, Brooke, who flew in from Paris along with his girlfriend, who was seeing the states for the first time. They were both very attentive to Mom and would sit for hours holding her hand and singing "Alouette" and other French melodies. All of Mom's visitors bolstered Mom's spirit considerably and gave me the support I needed to face what came next.

...to be continued...