I have experienced post-acute and long-term care through the eyes of a child. I say that because at any age, you are still a child and aim to please your mother. When I chose to summon a geriatrician to help my mother, I realized that pleasing her was not my role. All of a sudden, I was her caregiver and I needed to adjust my thinking so that I could make the best decisions for her. And, as I became the decision maker, I still had to deal with the child-like need to please my mother. Our story follows.
A few years ago, my mother called and begged me to help her. She had struggled for years with anxiety, arthritis, and other complex medical issues. She seldom left her house for any reason. Because of her anxiety, she had untreated shortness of breath, difficulty swallowing, loss of vision, and painful digestive issues. Despite having my sisters and I having worked hard to keep her functioning in her home, my mother ended up in the hospital. Her challenges in daily life were too great for her to return to her home, so she transitioned to a nursing home
After a short stay in the nursing facility’s rehab, my mother was transferred to long-term care. In long-term care she was safe; my sisters were not awakened by distress calls during snowstorms; they didn't feel guilty if they were out or unreachable on the phone. Meanwhile, the staff at the facility was very compassionate. They understood her severe anxiety and adjusted their routine to make her less anxious. An ophthalmologist prescribed glasses to help her vision; a geriatric psychiatrist adjusted medications to help reduce her anxiety. The nursing home doctor gently adjusted her many medications into an easier to swallow regimen. Recreation therapy helped her e-mail her grandchildren on the computer her granddaughter installed in her room.
Despite this, during the weeks in long-term care, my Mom continued to slowly struggle. She was not going to try to read (her favorite pastime); she was not willing to use oxygen for her breathing problems. She then experienced a sudden cardiac episode precipitated by difficult to manage atrial fibrillation. With the help of family, caregivers, and the nursing home’s medical doctor, my sisters and I made the decision not to transfer her to the hospital. It was perfectly clear, that it was time to do as my mother wished. It was time to give her peace. I knew that medicine could stop the fibrillation but not make my mother better. No therapy was going to make it possible for her to live in peace in her home.
Mom passed peacefully shortly after the incident. Because of the rehab/long-term care, my mother died in peace. Though, I had hoped that my Mom would return to her books and her rocking chair, I realized that my Mom did not want that. She was done with her struggle. Her death was peaceful; long-term care had helped her and my sisters transition through the challenges of the end of life.
My mother lived a long life and made a lasting impact on her grandchildren and great-grandchildren during her final months. She kept her visitors and caregivers busy checking email. The children saw long-term care facilities as "homes" with party rooms, entertainment. They enjoyed attention from other 'grannies.' The staff of her nursing facility helped her to live with dignity through change, the challenges of multiple medical problems and in her death.
I often revisit the last months of my mother's life. I am grateful that she trusted me. I am grateful that my sisters did not second-guess me. But most of all, I am grateful for the caretakers who treated my mom with skill and compassion. They gave her peace. I will never mouth the words, "Do not put me in a nursing home" or “I will never leave my home." I know beautiful care happens in the nursing home, and I am confident that my children will help me find high quality long-term care if and when I need it. God bless all the caregivers who recognize and cherish their patients, veterans of all different kinds of precious lived lives. I trust they will be there for me when my family and I need them.
Mary Ann Perks