In yesterday’s post I talked about my mother’s aneurysm rupture and eventual placement in a skilled nursing facility.  Before I delve into today’s topic I want to mention that my mother has progressed so well during her time at the skilled nursing facility that she is one of the highest functioning residents there. At this point in time she would be more well suited for an assisted living environment which would encourage her to develop some level of independence.  We are currently in the process of applying for placement in assisted living and hope that she qualifies very soon.

It has been exceedingly difficult being the only child to an elderly parent who is unable to care for herself.  Granted, my mother is in a facility which provides 24-hour care.  However, before she was placed in skilled nursing, I took on the role of caregiver and did my best to help her hold onto the independent lifestyle to which she had become so accustomed.  I purchased her groceries, cleaned her apartment, did her laundry, cleaned out the cat box, set her hair and nail appointments, and spoke with her employer when her behavior became erratic.

One day, several months before her fall, she got into a car accident and totaled her car.  Her report was that she hit a car, but I discovered that she had hit FOUR cars.  Despite my queries, my mother insisted that she had only hit one car.  She was taken by police escort home and neglected to call her employer, so I had to deal with her boss when she called asking where the hell my mom was.  My mom also stated that she did not know where the car was, so I had to track it down, pay the impound fees, contact the insurance company and file a report.  I also had to tell her employer that I saw no way that my mother could continue to work.

My mother fell into such a depression that when her friends would call her to ask how she was doing, she would ask them to bring her a gun so she could kill herself.  Naturally this prompted a call from Adult Protective Services which I had to deal with as well.  In some sense my mother’s eventual fall was a blessing because it prompted her placement into an environment which would be able to assist her with everything from meals to bathing, dressing, toileting, medication management and physical therapy.    With this placement, however, came the responsibility of taking over her financial affairs, closing accounts, making pre-need burial arrangements, applying for Medicaid assistance, and coordinating her care with the physician on staff at the skilled nursing facility.

The task of emptying out my mother’s apartment also fell upon me.  I cannot tell you how wracked with guilt I was while going through all of my mother’s belongings and determining what could be kept, as I knew full well that whatever was kept would be stored at my place.  It was such an overwhelming task that if I did not have my dear friend Dana and a professional estate liquidating team assisting me, I would have lost my mind during the process.  It was also an extremely emotional experience sorting through items that chronicled my mother’s entire existence and one which I would never want to repeat.

For the past six years my mother has been very stable and I am very thankful for this.  However, I write the checks for all the bills she receives, and I submit all applications on her behalf for aid.  I visit her weekly, bringing prunes for her constipation, fresh fruit if I get a chance to pick some  up, snacks and treats, magazines, and our trusty chinese checkers set which we use every week.  Lest you think I beat her at chinese checkers, she actually beats me more than half the time, which is something I find amusing and encouraging.  I listen to my mother’s complaints about the other residents and the staff, and do my best to keep her updated on my life with pictures and stories.  Honestly, though, I never feel like I do enough, and I think this has everything to do with my desire to always be a good daughter in my mother’s eyes.  I can never be entirely sure.

There are moments when I look into my mom’s eyes  and can detect the feisty spirit that she used to exude on a consistent and daily basis.  For a moment I forget that my now eighty-year old mom spends most of her days in a wheelchair, her body run down by arthritis and failing eyesight, a mere shadow of the beautiful, willful, strong woman who raised me.  And in that moment I am truly happy.

I love my mom dearly and never believed that the determined, independent, fashionable lady who raised me would at some point become so ill that she would become unable to care for herself.  As her only child I wish I had the foresight to anticipate such a thing, but it is very true that you can never be fully prepared for the time that your parent becomes sick.

In August of 2004 my mother had a brain aneurysm rupture from which she almost died.  It was a terrifying experience which forced me to see my mother completely incapacitated, head partially shaven, tubes and wires from the ventriculostomy tube and EEG surrounding her head, and her awareness of what was occurring wavering between minimal recognition to absolutely no clue as to what had occurred.  I spent three weeks in the Neurosurgical ICU at UCLA Medical Center essentially living there, wondering if my mom would pull through this monstrous event.  It was almost worse processing this as a physician, because I was well aware of the severity of the incident and how it would impact her if she were to survive.

My mother had two coil embolization procedures which stabilized the weak blood vessel in her brain and she was discharged to my home, where I spent the next month providing 24 hour care for her.  It was exhausting and I was overwhelmed with emotion.  After a month with me, my mother stubbornly insisted on going back to her apartment and returning to work.  At work, she was no longer the detail-oriented fact checker she used to be.  She forgot phone numbers that she used to take pride in rattling off with no hesitation.  Her behavior became extremely erratic and unpredictable, and she would fly into rages which were in complete opposition to the calm, reserved woman I knew as my mother.  I began to lose my cool as my anger over what had occurred and the realization that my mother would never, ever be the same fully set in.

My mother’s behavior continued to meander all over the place and she began to neglect the cat that she loved so much and was unable to clean up after herself.  I would purchase groceries which she would binge on, then call me in a rage later that day insisting that I buy more immediately.  She hoarded toilet paper and boxes of tissue.  One time I discovered pants in the garbage and when I asked her why on earth she would throw away a pair of pants, she admitted ashamedly that she had soiled them.

Finally, one day in January of 2006 I had gone to pick my mother up for her hair appointment.  She was not in the living room, but the bathroom light was on and the door was open a crack.  I called out to her to let her know I was there, but heard nothing.  I waited for a few minutes, then opened the door.  She was not in the bathroom.  Puzzled, I walked into her bedroom, looked to the floor, and saw her crumpled on the floor.  When I rushed over to pick her up, she cried out in pain.  I immediately called 911 and waited for the paramedics to arrive.

Once my mother was in the hospital, we determined from the BUN and creatinine levels that she had been lying there for two days.  She told me she was getting out of bed and simply did not have the strength to stand and slumped to the floor, where she remained until I had found her.  She had soiled herself and because she had been lying on her shoulder the entire time, she sustained a rotator cuff tear that had caused the pain which made her cry out.

By February of 2006 my mother was placed in the skilled nursing facility where she now resides.  I am so thankful that the majority of her memory and personality have been restored over the years, but she has absolutely no concern over her physical appearance which is such a bizarre thing for me to grasp.  This woman used to insist on putting on earrings and heels when she visited the grocery store, so to see her in sweatpants, a zipped up hooded sweatshirt and no makeup still breaks my heart.

All in all, though, I still have my mother and I hope that the experience which changed her life is one she doesn’t remember.