With all the turmoil and bustle and anguish and anxiety, I haven't had time to take care of myself. I've spent every evening after work with my mom, getting home around 9:00 pm-ish. That's too late to even think about any kind of exercise. It takes a couple of hours to unwind enough to go to bed, and even then my brain races along while my body tries to rest. With all the tossing and turning I'm too tired to get up and exercise before work; I'm afraid I'll be so uncoordinated with sleeplessness that I'll hurt myself. My system has keenly felt the lack of activity so this morning I dragged myself out of bed and headed for the treadmill.
Three miles later I was smiling, relaxed, breathing heavily, sweating heavily-er (sorry, I liked that word), ready to face the world. I was tired, but a good tired instead of a beat-up tired. For a short time I was thinking about running, thinking about the amusing program I was watching, thinking about everything except my family issues.
I'd forgotten how good that feels. Hmm. Maybe there is something to all the talk about how exercise is good for you ...
Thursday, July 16, 2009
Monday, July 13, 2009
It got worse again
"You BITCH!"
With those lovely words my mother greeted me a couple of days ago. "I can't believe that you, of all people, would do this" she continued. Since I hadn't taken her home, had let the hospital keep her in custody and care, I had become the enemy.
As a runner, "downhill" has always been a good thing to me. It means my path is easy, better, smoother. But "downhill" for the rest of life isn't as good. My mom's condition has has continued to go downhill quickly. Mentally, physically, emotionally. Despite our hopes and the actions of the medical staff my mom is almost certainly about to be put in a mental hospital.
A week ago it looked like changing her medications would calm her down, clear up the mental confusion, steady her moods. Even while giving her some of the most toxic drugs available she has only gotten worse. Suspicious, paranoid, still unable to string together any type of coherent conversation. Her only focus was going home, being by herself. She said she was in prison, locked up, out of her own control and being held against her will.
Unfortunately her physical strength continued to build as her mental state continued to deteriorate. She's able to get up and walk, almost run, even though she's still bent over and stumbling and unsteady. Her anger built day by day.
The hospital decided she was stable and healthy enough to be released. We found what seemed like the perfect, peaceful rehabilitation facility (aka rest home aka nursing home). Since she really couldn't be left alone we hired a sitter, someone who would watch her and make sure she didn't hurt herself.
Early this afternoon she was transported to the place I'll just call "Manor." She didn't want to get in the transport, was rude and vile to the ambulance attendants, ignored me when she saw me waiting at the door. She arrived at her room, continued ignoring me. I introduced the sitter and mom was quite clear in telling her to go away. I was just as clear in telling mom that the sitter was staying.
I had brought clothing and some personal possessions so she could feel more comfortable. I don't know if she didn't recognize them, or just didn't care. She was very cold to me, outright rude to the sitter and ignored the nurse who was trying to do intake. My mom kept asking for my sister's phone number so she could call "the daughter I love" and finally I told her that if she allowed the nurse to do a short exam, the nurse would call my sis for her. My mom cursed, told me to get out of there, so I left.
We had told the Administration, the admitting people and the nursing staff we met that she was not compliant and was very angry and could be very loud and horrible and mean with what she said. We also told the sitter and the sitter's boss the exact condition of my mom. We made it clear, and the hospital discharge papers made it clear, that giving her Haldol would calm her down. Either none of them listened, or they just didn't believe us, because it turned out to be more than they wanted to handle.
I got a call from the sitter about an hour after I left (while I was in the middle of Safeway, shopping). She was in tears and told me my mom had pulled her hair and yelled at her and threw her purse at her. I called the doc, he called the Manor and told them to give her the drug, they told him they would, I called the sitter back, she sounded relieved.
Five hours later I got a call from the Manor telling me that they had called the police twice because they couldn't handle my mom. I was shocked. The nurse told me that while a cop was standing there my mom finally agreed to let them give her the Haldol - 5 hours after I thought she had gotten it. Since my mom was a little quieter after that, it seemed everything would be ok.
I then received a call from a wonderful Walnut Creek Police Officer. She was the one who responded to the second call and was sitting outside the Manor waiting to make sure everything was ok. She just wanted to get the full story about what was going on. I explained the whole over-medicating, dementia/psychosis thing, told her the Manor was well aware of what they were getting. She said that they had called 911 wanting to get an ambulance to take away my mom.
The staff had told the cop that they had spoken with the family, but were unable to produce the staff member who had made the call. Probably since that was a big fat lie, nobody had called me (or my brother). They told the cop they weren't staffed to take care of a high maintenance patient, that they couldn't handle her. They said they couldn't give a patient any medication unless the patient agreed, and my mom didn't want to take anything (this despite my having told the nurse and the administration that I held the power of attorney for health care and that they should give my mom all the drugs on the discharge orders). After a long talk with the very nice and sympathetic cop, who told me that she would note that if the police were called again the police should call me, I called back to the Manor.
I asked to speak with the Administrator in charge. I was told there wasn't one since it was evening. I then asked to speak to whoever was in charge for the evening. I was given the phone number of an offsite nursing supervisor. I told the operator I wanted to speak to whoever currently in the facility was in charge and was connected with the LVN who had called me earlier regarding my mom.
She told me that they didn't have anyone in charge, that the staff knew what they were supposed to do and just did it. I was openly incredulous but she wouldn't put me through to anyone else. I asked why she hadn't called the family when the police were first called, or why she hadn't called the family before it got to that point. She said that she was busy following my mom as she walked around outside and she didn't have a phone with her, "we're not a hospital you know and we're not equipped like a hospital." I asked who had called 911 and she said someone inside. She had no answer as to why that person couldn't have called me.
I asked what had happened to the sitter and was told both "she's scared" and that the sitter had been replaced by another sitter. This was the person who I thought would be the front line of care for my mom. Apparently I paid over $1,100 for 3 days of someone whose only job was to stare at my mom, and call someone if my mom moved. Quite helpful.
I told the LVN to call me if anything else happened, preferably before she called 911 again. So about a hour later she called again to tell me that my mom had never settled, that my mom had twisted her arm and pushed her when the LVN tried to give her some more medication. I asked her to hold the line and called my mom's doctor again. He called the nurse, called different facilities, made a couple of other calls.
At that point it was determined that the Manor would call for transport and have my mom transported to a hospital. Preferably it would be to Concord where there is a hospital with psych intake and triage, where they could provide for my mom and figure out where to go. Unfortunately the closest hospital was where they would probably take her and that was back to Muir, the hospital that broke her in the first place.
Then came calls back and forth; to my brother (being yelled at didn't help me too much), brother to doctor, doctor to hospital, doctor to Manor, doctor to brother, brother to me. At this point my mom was sound asleep and transport was deferred to the morning. Hope were high she'd sleep all night, but I'll be sitting by my phone in case that doesn't happen.
That's where it stands. In the morning my mom will probably be sent to a psychiatric facility, either one specializing in geriatric patients if they have a bed or a general one otherwise. All my mom wants is to go home, she's fixated on going home, and she's going to be locked up because she's incapable of caring for herself and doesn't understand that she's currently mentally incapacitated.
I'm told that's the best solution, that they'll be able to care for her, be able to find medications that will clear up her mind, give her physical and mental therapy that will make her more like herself. I will never be able to forgive myself that it's gotten that far since she trusted me to help her and make any decisions if she was incapable. But that's ok. I know my mom and even if she is fixed, even if she begins thinking straighter than she's thought for years, she will never, ever forgive me either.
With those lovely words my mother greeted me a couple of days ago. "I can't believe that you, of all people, would do this" she continued. Since I hadn't taken her home, had let the hospital keep her in custody and care, I had become the enemy.
As a runner, "downhill" has always been a good thing to me. It means my path is easy, better, smoother. But "downhill" for the rest of life isn't as good. My mom's condition has has continued to go downhill quickly. Mentally, physically, emotionally. Despite our hopes and the actions of the medical staff my mom is almost certainly about to be put in a mental hospital.
A week ago it looked like changing her medications would calm her down, clear up the mental confusion, steady her moods. Even while giving her some of the most toxic drugs available she has only gotten worse. Suspicious, paranoid, still unable to string together any type of coherent conversation. Her only focus was going home, being by herself. She said she was in prison, locked up, out of her own control and being held against her will.
Unfortunately her physical strength continued to build as her mental state continued to deteriorate. She's able to get up and walk, almost run, even though she's still bent over and stumbling and unsteady. Her anger built day by day.
The hospital decided she was stable and healthy enough to be released. We found what seemed like the perfect, peaceful rehabilitation facility (aka rest home aka nursing home). Since she really couldn't be left alone we hired a sitter, someone who would watch her and make sure she didn't hurt herself.
Early this afternoon she was transported to the place I'll just call "Manor." She didn't want to get in the transport, was rude and vile to the ambulance attendants, ignored me when she saw me waiting at the door. She arrived at her room, continued ignoring me. I introduced the sitter and mom was quite clear in telling her to go away. I was just as clear in telling mom that the sitter was staying.
I had brought clothing and some personal possessions so she could feel more comfortable. I don't know if she didn't recognize them, or just didn't care. She was very cold to me, outright rude to the sitter and ignored the nurse who was trying to do intake. My mom kept asking for my sister's phone number so she could call "the daughter I love" and finally I told her that if she allowed the nurse to do a short exam, the nurse would call my sis for her. My mom cursed, told me to get out of there, so I left.
We had told the Administration, the admitting people and the nursing staff we met that she was not compliant and was very angry and could be very loud and horrible and mean with what she said. We also told the sitter and the sitter's boss the exact condition of my mom. We made it clear, and the hospital discharge papers made it clear, that giving her Haldol would calm her down. Either none of them listened, or they just didn't believe us, because it turned out to be more than they wanted to handle.
I got a call from the sitter about an hour after I left (while I was in the middle of Safeway, shopping). She was in tears and told me my mom had pulled her hair and yelled at her and threw her purse at her. I called the doc, he called the Manor and told them to give her the drug, they told him they would, I called the sitter back, she sounded relieved.
Five hours later I got a call from the Manor telling me that they had called the police twice because they couldn't handle my mom. I was shocked. The nurse told me that while a cop was standing there my mom finally agreed to let them give her the Haldol - 5 hours after I thought she had gotten it. Since my mom was a little quieter after that, it seemed everything would be ok.
I then received a call from a wonderful Walnut Creek Police Officer. She was the one who responded to the second call and was sitting outside the Manor waiting to make sure everything was ok. She just wanted to get the full story about what was going on. I explained the whole over-medicating, dementia/psychosis thing, told her the Manor was well aware of what they were getting. She said that they had called 911 wanting to get an ambulance to take away my mom.
The staff had told the cop that they had spoken with the family, but were unable to produce the staff member who had made the call. Probably since that was a big fat lie, nobody had called me (or my brother). They told the cop they weren't staffed to take care of a high maintenance patient, that they couldn't handle her. They said they couldn't give a patient any medication unless the patient agreed, and my mom didn't want to take anything (this despite my having told the nurse and the administration that I held the power of attorney for health care and that they should give my mom all the drugs on the discharge orders). After a long talk with the very nice and sympathetic cop, who told me that she would note that if the police were called again the police should call me, I called back to the Manor.
I asked to speak with the Administrator in charge. I was told there wasn't one since it was evening. I then asked to speak to whoever was in charge for the evening. I was given the phone number of an offsite nursing supervisor. I told the operator I wanted to speak to whoever currently in the facility was in charge and was connected with the LVN who had called me earlier regarding my mom.
She told me that they didn't have anyone in charge, that the staff knew what they were supposed to do and just did it. I was openly incredulous but she wouldn't put me through to anyone else. I asked why she hadn't called the family when the police were first called, or why she hadn't called the family before it got to that point. She said that she was busy following my mom as she walked around outside and she didn't have a phone with her, "we're not a hospital you know and we're not equipped like a hospital." I asked who had called 911 and she said someone inside. She had no answer as to why that person couldn't have called me.
I asked what had happened to the sitter and was told both "she's scared" and that the sitter had been replaced by another sitter. This was the person who I thought would be the front line of care for my mom. Apparently I paid over $1,100 for 3 days of someone whose only job was to stare at my mom, and call someone if my mom moved. Quite helpful.
I told the LVN to call me if anything else happened, preferably before she called 911 again. So about a hour later she called again to tell me that my mom had never settled, that my mom had twisted her arm and pushed her when the LVN tried to give her some more medication. I asked her to hold the line and called my mom's doctor again. He called the nurse, called different facilities, made a couple of other calls.
At that point it was determined that the Manor would call for transport and have my mom transported to a hospital. Preferably it would be to Concord where there is a hospital with psych intake and triage, where they could provide for my mom and figure out where to go. Unfortunately the closest hospital was where they would probably take her and that was back to Muir, the hospital that broke her in the first place.
Then came calls back and forth; to my brother (being yelled at didn't help me too much), brother to doctor, doctor to hospital, doctor to Manor, doctor to brother, brother to me. At this point my mom was sound asleep and transport was deferred to the morning. Hope were high she'd sleep all night, but I'll be sitting by my phone in case that doesn't happen.
That's where it stands. In the morning my mom will probably be sent to a psychiatric facility, either one specializing in geriatric patients if they have a bed or a general one otherwise. All my mom wants is to go home, she's fixated on going home, and she's going to be locked up because she's incapable of caring for herself and doesn't understand that she's currently mentally incapacitated.
I'm told that's the best solution, that they'll be able to care for her, be able to find medications that will clear up her mind, give her physical and mental therapy that will make her more like herself. I will never be able to forgive myself that it's gotten that far since she trusted me to help her and make any decisions if she was incapable. But that's ok. I know my mom and even if she is fixed, even if she begins thinking straighter than she's thought for years, she will never, ever forgive me either.
Wednesday, July 8, 2009
The nightmare worsens
Warning: what follows is a hard look at illness and dementia. It isn't my normal carefree whining about my daily life and is full of pain and sadness. Please don't read this if you think it will upset you. I'm writing it down in the hopes that looking at it in hard print will help me understand what is going on.
When even the doctors are flailing around looking for a solution you know it isn't good. Instead of any improvement my mom is getting worse. She is a fragile shell of confusion and hate and anger.
What started as just another trip to the emergency room by a lonely hypochondriac looking for reassurance has probably turned into the final rational moments my mom will ever have. The first night in the hospital she was given Librium and Ativan. The Librium was because she normally has a drink at night and the doctors were afraid that she might go through withdrawal and have a seizure. The Ativan was given so that she would fall asleep. Both drugs should alleviate any anxiety and help her to relax. Unfortunately a side effect of both sedating drugs is the opposite; agitation resulted almost immediately.
The Librium is also not recommended for elderly patients or patients with dementia. My mother has at the very least mild dementia and she's 81 years old; elderly in anyone's book. Librium was a very bad drug choice. Mixing in the Ativan was a mistake, possibly a fatal one.
Because of the drugs, the morning after she arrived at the hospital she was more confused and uncoordinated than usual. She continued to receive regular doses of Librium twice a day. She saw many doctors/therapists/nurses/aides throughout the day and night and they determined that they should do even more tests.
Another night, more drugs, more confusion. With each change of shift a new set of caretakers would evaluate her, thinking that what they saw was her normal baseline. They didn't realize that she was acting drugged and I didn't know that they were drugging her. I thought she was just uncomfortable in the hospital or that maybe she had even had a stroke or something.
Thursday morning they were almost ready to release her, but the hospital doctor and her shift nurse were convinced she could not leave, since she lives alone. She was evaluated by a physical therapist who agreed that she couldn't be alone. It was determined that what she really needed was some rehabilitation, a short time in a rehab facility (or nursing home). Because of Medicare and insurance rules she would need to spend 3 additional nights at the hospital. She reluctantly agreed to this and was moved to a different floor.
At dinner time she was given some pills and while she was eating she got more and more confused and agitated. She forgot the conversations we had had with the doctors and with the case workers and insisted she wanted to leave. I repeated all the information we had gotten, repeated it a couple of times, but she was very unhappy.
After I left she got even more agitated so they gave her yet more Ativan. She slept, or was semi-conscious, for most of Friday. I spent the day looking at nursing homes and found what I thought would be a lovely rehab facility, near where she lives. Returning to her bedside I found her even more agitated than previously, although she was still focusing and making some sense. Once again at dinner she was given those same pills and once again she got more confused and quarrelsome. To get her to quiet down she was given the last dose of Ativan that put her over the top.
Finally on Saturday morning she was checked out by a new doctor who realized that plain and simple, she was over-medicated and over-sedated. She was mostly asleep for a good part of the day and when she awoke she was angry, confused, hostile. She insisted on leaving, yelled and screamed. The docs realized that she couldn't be given more anti-anxiety meds and decided to just wait until they were all out of her system. The hope was that she'd return to normal.
That hasn't happened. If she's awake she's, for lack of a better term, completely nuts. She's the crazy lady down the hall who keeps yelling, screaming, cursing. A geriatric psychologist was brought in to handle her case and for a while he just observed and also waited to see if she would regain her wits when the drugs wore off. She was given a 24 hour sitter so that they wouldn't have to physically restrain her but to her, the sitter is a jailer. She's physically weak, sometimes able to get out of bed with two people helping her, sometimes able to walk a couple of aided steps to the toilet, often unable to even sit up in bed or feed herself. She has strength in her grip but no coordination.
Yesterday I was there at lunch time while her personal doctor came to see her. She was hostile and dishonest to him, yelled at me, didn't focus on anything other than she had to get out of there and go home. The aide started to feed her lunch and I left to go back to work. My mom had been given her first cup of coffee since she arrived in the hospital; despite asking for it continually they didn't want to give caffeine to a cardiac patient. The aide handed her the cup, warned her that it was hot, and my mom threw it in her face. Right in her eyes. Luckily the poor woman was able to jump back and avoid most of it and wasn't hurt. My mom was proud that she had done this.
Never, and I mean never, in her 81 years has my mom physically abused someone. Verbally yes, rarely she's called someone a fucking bitch and yelled other obscenities. But then she'll quickly hightail it away since she really doesn't like confrontation or fighting or anger. Now she's reveling in it. If she were in her right mind she would be as horrified as I am.
Last night she was so out of control they again had to give her Ativan. This time it didn't even knock her out completely and only made her angrier and more agitated. Today they started her on a new regimen. The doc is trying out Depakote Sprinkles. Yes, they're putting magic fairy dust on her food. This was originally a seizure medication but is being used as a mood stabilizer. This stuff, according to the warnings, is heavy duty toxic and very dangerous. In addition, they're giving her Haldol injections every 8 hours as needed for agitation. Cripes, this stuff is even worse. The warnings clearly says "HALDOL Injection is not approved for the treatment of patients with dementia-related psychosis" and yet the doctor thinks it's the best choice.
When I arrived to see her today she was completely wild. The aide was tying padding on the bed rails to keep her from injuring herself. She demanded to be dressed and taken home. I tried being sweet and loving, she swore at me. As I bent over her bed, she reached up as if to lovingly cradle my face in her hands. As she touched my face her fingers curled up and she tried to claw my face; I backed up in shock. I tried being stern and told her she couldn't talk to people the way she was doing. She cursed. I tried yelling and she yelled back. She continued raving and tears came to my eyes. She smiled an evil smile and said she was glad I was crying. She varied from knowing who I was and then demanding that someone find Amy. Since she was just working herself up I left.
I'm crushed. Seeing your mother this way is something that nobody should ever have to go through. I close my eyes and can see her satisfaction that she was able to inflict damage, can see her wild eyes, hear her hate-filled voice. The doctors have no answers. They don't know if she is suffering permanent brain damage, if the dementia will return to the previous low level or if she'll even come out of this cycle of drugging and agitation.
I'm not an optimistic person by nature, but I need to hope that this isn't the end. I have to believe that sometime soon, within a couple of days, some combination of medications will make my mom calm and reasonable. But even then we need to somehow convince her that she can no longer live alone and certainly won't be able to drive again. There are decisions to make that don't have right answers. It won't be easy or quick or pretty or easy. I don't know what to do.
When even the doctors are flailing around looking for a solution you know it isn't good. Instead of any improvement my mom is getting worse. She is a fragile shell of confusion and hate and anger.
What started as just another trip to the emergency room by a lonely hypochondriac looking for reassurance has probably turned into the final rational moments my mom will ever have. The first night in the hospital she was given Librium and Ativan. The Librium was because she normally has a drink at night and the doctors were afraid that she might go through withdrawal and have a seizure. The Ativan was given so that she would fall asleep. Both drugs should alleviate any anxiety and help her to relax. Unfortunately a side effect of both sedating drugs is the opposite; agitation resulted almost immediately.
The Librium is also not recommended for elderly patients or patients with dementia. My mother has at the very least mild dementia and she's 81 years old; elderly in anyone's book. Librium was a very bad drug choice. Mixing in the Ativan was a mistake, possibly a fatal one.
Because of the drugs, the morning after she arrived at the hospital she was more confused and uncoordinated than usual. She continued to receive regular doses of Librium twice a day. She saw many doctors/therapists/nurses/aides throughout the day and night and they determined that they should do even more tests.
Another night, more drugs, more confusion. With each change of shift a new set of caretakers would evaluate her, thinking that what they saw was her normal baseline. They didn't realize that she was acting drugged and I didn't know that they were drugging her. I thought she was just uncomfortable in the hospital or that maybe she had even had a stroke or something.
Thursday morning they were almost ready to release her, but the hospital doctor and her shift nurse were convinced she could not leave, since she lives alone. She was evaluated by a physical therapist who agreed that she couldn't be alone. It was determined that what she really needed was some rehabilitation, a short time in a rehab facility (or nursing home). Because of Medicare and insurance rules she would need to spend 3 additional nights at the hospital. She reluctantly agreed to this and was moved to a different floor.
At dinner time she was given some pills and while she was eating she got more and more confused and agitated. She forgot the conversations we had had with the doctors and with the case workers and insisted she wanted to leave. I repeated all the information we had gotten, repeated it a couple of times, but she was very unhappy.
After I left she got even more agitated so they gave her yet more Ativan. She slept, or was semi-conscious, for most of Friday. I spent the day looking at nursing homes and found what I thought would be a lovely rehab facility, near where she lives. Returning to her bedside I found her even more agitated than previously, although she was still focusing and making some sense. Once again at dinner she was given those same pills and once again she got more confused and quarrelsome. To get her to quiet down she was given the last dose of Ativan that put her over the top.
Finally on Saturday morning she was checked out by a new doctor who realized that plain and simple, she was over-medicated and over-sedated. She was mostly asleep for a good part of the day and when she awoke she was angry, confused, hostile. She insisted on leaving, yelled and screamed. The docs realized that she couldn't be given more anti-anxiety meds and decided to just wait until they were all out of her system. The hope was that she'd return to normal.
That hasn't happened. If she's awake she's, for lack of a better term, completely nuts. She's the crazy lady down the hall who keeps yelling, screaming, cursing. A geriatric psychologist was brought in to handle her case and for a while he just observed and also waited to see if she would regain her wits when the drugs wore off. She was given a 24 hour sitter so that they wouldn't have to physically restrain her but to her, the sitter is a jailer. She's physically weak, sometimes able to get out of bed with two people helping her, sometimes able to walk a couple of aided steps to the toilet, often unable to even sit up in bed or feed herself. She has strength in her grip but no coordination.
Yesterday I was there at lunch time while her personal doctor came to see her. She was hostile and dishonest to him, yelled at me, didn't focus on anything other than she had to get out of there and go home. The aide started to feed her lunch and I left to go back to work. My mom had been given her first cup of coffee since she arrived in the hospital; despite asking for it continually they didn't want to give caffeine to a cardiac patient. The aide handed her the cup, warned her that it was hot, and my mom threw it in her face. Right in her eyes. Luckily the poor woman was able to jump back and avoid most of it and wasn't hurt. My mom was proud that she had done this.
Never, and I mean never, in her 81 years has my mom physically abused someone. Verbally yes, rarely she's called someone a fucking bitch and yelled other obscenities. But then she'll quickly hightail it away since she really doesn't like confrontation or fighting or anger. Now she's reveling in it. If she were in her right mind she would be as horrified as I am.
Last night she was so out of control they again had to give her Ativan. This time it didn't even knock her out completely and only made her angrier and more agitated. Today they started her on a new regimen. The doc is trying out Depakote Sprinkles. Yes, they're putting magic fairy dust on her food. This was originally a seizure medication but is being used as a mood stabilizer. This stuff, according to the warnings, is heavy duty toxic and very dangerous. In addition, they're giving her Haldol injections every 8 hours as needed for agitation. Cripes, this stuff is even worse. The warnings clearly says "HALDOL Injection is not approved for the treatment of patients with dementia-related psychosis" and yet the doctor thinks it's the best choice.
When I arrived to see her today she was completely wild. The aide was tying padding on the bed rails to keep her from injuring herself. She demanded to be dressed and taken home. I tried being sweet and loving, she swore at me. As I bent over her bed, she reached up as if to lovingly cradle my face in her hands. As she touched my face her fingers curled up and she tried to claw my face; I backed up in shock. I tried being stern and told her she couldn't talk to people the way she was doing. She cursed. I tried yelling and she yelled back. She continued raving and tears came to my eyes. She smiled an evil smile and said she was glad I was crying. She varied from knowing who I was and then demanding that someone find Amy. Since she was just working herself up I left.
I'm crushed. Seeing your mother this way is something that nobody should ever have to go through. I close my eyes and can see her satisfaction that she was able to inflict damage, can see her wild eyes, hear her hate-filled voice. The doctors have no answers. They don't know if she is suffering permanent brain damage, if the dementia will return to the previous low level or if she'll even come out of this cycle of drugging and agitation.
I'm not an optimistic person by nature, but I need to hope that this isn't the end. I have to believe that sometime soon, within a couple of days, some combination of medications will make my mom calm and reasonable. But even then we need to somehow convince her that she can no longer live alone and certainly won't be able to drive again. There are decisions to make that don't have right answers. It won't be easy or quick or pretty or easy. I don't know what to do.
Sunday, July 5, 2009
Habit
This blog has been an outlet for me, a catharsis of sorts, where I can say whatever I want and pretend that I'm talking to myself (while other people may or may not listen). The only times I've censored myself were last summer when I was so depressed (and even then I was blabbing on my alternate blog) and about family matters.
I've talked about my sis a lot, once in a while about my bro, but when it comes to my mom I only put in that I've spent mom time. I have such conflicted feelings for my mom that I have trouble expressing them to myself, let alone writing about them.
I'm the youngest of three kids, raised by a young single divorced mother in the days when there weren't many divorced parents. I was always mommy's girl and in some ways still am. But by the time I got to college my mom could never decide whether she wanted to be my friend or my parent and that caused conflict and friction. We developed a very stereotypical mother-daughter relationship of too much love and too much disagreement and too much time together.
My mom has always had a mean side, a caustic tongue, an anger at the world that things weren't working out how she planned. While younger she mostly hid that away because she avoided open conflict; she would just cut you off permanently if you crossed her. As she got older though, that internal filter ceased working. She started yelling, then cursing, then just being cantankerous and grouchy and mean.
She was also charming and funny and clever and intellectual and talented. Little bits of that still peek through, but mostly now she's just unhappy and angry. Her health is suffering, her body is betraying her and she refuses to believe she's slowing down and getting old. While she wants sympathy, she also rejects any offer of help unless it's from me (or from my brother). We don't help her nearly as much as she thinks we should. We'd have to move next door to her and become her personal slaves for her to think we help her enough. But since we won't, she continues to be independent and lives alone.
Last week, for the third time in a couple of months, she had chest pains and went to the hospital. The last time that happened they ran some tests, couldn't find anything wrong except for some gastric problems, and sent her home. This time it was a different medical staff and they decided that it could be serious so they wanted to keep her overnight for observation and more tests in the morning. She didn't like that, but went along with it.
You know how they say that hospitals are the worst place to be if you're sick? It came true this time. If you've been following my tweets you'll know that from the night she got there things have gone wrong. What started as overnight observation turned into over-medicating and discontinuity of care, causing her physical and mental harm.
The sedation is wearing off but it has resulted in confusion. My mom is acting exactly like a habitual drunk in the middle of a three day bender. She is under the impression that she is fine but she also has no strength, no coordination and no rational thought processes. She's agitated, loud, confused and angry. She's yelling and cursing at everyone, thinks she's in jail, can't understand a thing. It doesn't help that she keeps taking out her hearing aids and then can't even hear. She has regained just enough physical mobility to be a danger to herself.
We're told that by tomorrow she'll be better, her mental processes should be nearing what they were when she first got to the hospital and within days it will be like it never happened. We've also been told that she's on the way down the slippery slope of dementia and this same behavior could be her future. She will become physically weaker, more confused and unhappier with life. It probably won't be quick and probably will be drawn out and ugly.
It makes me ache to see my strong, beautiful, talented, funny, independent mother come to this. It's horrifying to think of how long she could be aware of her own decline and how much she'll deny its occurrence. She'll have good days, flashes of her old self. But meanwhile I'm left with knowing that even though she's still here, I've lost my mommy. All that remains to her is habit and instinct. It will have to be enough.
I've talked about my sis a lot, once in a while about my bro, but when it comes to my mom I only put in that I've spent mom time. I have such conflicted feelings for my mom that I have trouble expressing them to myself, let alone writing about them.
I'm the youngest of three kids, raised by a young single divorced mother in the days when there weren't many divorced parents. I was always mommy's girl and in some ways still am. But by the time I got to college my mom could never decide whether she wanted to be my friend or my parent and that caused conflict and friction. We developed a very stereotypical mother-daughter relationship of too much love and too much disagreement and too much time together.
My mom has always had a mean side, a caustic tongue, an anger at the world that things weren't working out how she planned. While younger she mostly hid that away because she avoided open conflict; she would just cut you off permanently if you crossed her. As she got older though, that internal filter ceased working. She started yelling, then cursing, then just being cantankerous and grouchy and mean.
She was also charming and funny and clever and intellectual and talented. Little bits of that still peek through, but mostly now she's just unhappy and angry. Her health is suffering, her body is betraying her and she refuses to believe she's slowing down and getting old. While she wants sympathy, she also rejects any offer of help unless it's from me (or from my brother). We don't help her nearly as much as she thinks we should. We'd have to move next door to her and become her personal slaves for her to think we help her enough. But since we won't, she continues to be independent and lives alone.
Last week, for the third time in a couple of months, she had chest pains and went to the hospital. The last time that happened they ran some tests, couldn't find anything wrong except for some gastric problems, and sent her home. This time it was a different medical staff and they decided that it could be serious so they wanted to keep her overnight for observation and more tests in the morning. She didn't like that, but went along with it.
You know how they say that hospitals are the worst place to be if you're sick? It came true this time. If you've been following my tweets you'll know that from the night she got there things have gone wrong. What started as overnight observation turned into over-medicating and discontinuity of care, causing her physical and mental harm.
The sedation is wearing off but it has resulted in confusion. My mom is acting exactly like a habitual drunk in the middle of a three day bender. She is under the impression that she is fine but she also has no strength, no coordination and no rational thought processes. She's agitated, loud, confused and angry. She's yelling and cursing at everyone, thinks she's in jail, can't understand a thing. It doesn't help that she keeps taking out her hearing aids and then can't even hear. She has regained just enough physical mobility to be a danger to herself.
We're told that by tomorrow she'll be better, her mental processes should be nearing what they were when she first got to the hospital and within days it will be like it never happened. We've also been told that she's on the way down the slippery slope of dementia and this same behavior could be her future. She will become physically weaker, more confused and unhappier with life. It probably won't be quick and probably will be drawn out and ugly.
It makes me ache to see my strong, beautiful, talented, funny, independent mother come to this. It's horrifying to think of how long she could be aware of her own decline and how much she'll deny its occurrence. She'll have good days, flashes of her old self. But meanwhile I'm left with knowing that even though she's still here, I've lost my mommy. All that remains to her is habit and instinct. It will have to be enough.
Tuesday, June 30, 2009
Good intentions pave the road to where?
Because of the extreme heat and crappy air quality, my plan this week was to get up very early and either run or cross train before work. I was successful on Monday; I wasn't sleeping anyway so I got up and did a lower body toning tape. I was unsuccessful today; I wasn't sleeping anyway and still reset my alarm for the regular time. Sigh. Before I left home I packed a bag so I'll be running after work. In the heat. And the smog.
It's definitely cooling though. In theory the air quality will be much better today than it's been, there's a good strong breeze through the trees. The horizon looks blue instead of sickly brown (but it's still a bit hazy) and that's a good sign too.
Chicago seems so far away, but it'll be here before I know it. In training-for-a-marathon terms, it's just a few long runs away. Well, several long runs away. But in order to do the long runs I need to keep up with the weekday training.
After my exhausting run on Saturday I was at my mom's house. She noticed how crappy and worn down I looked and asked me why I bothered with all of this. My answer was simply that there is nothing I love more than running marathons, and to do that I need to train. Regardless of weather or air quality or health or injuries, I need to have consistent mileage on my feet (preferably running) and regular toning and core work. My brain is well aware of this. Now I just have to convince the rest of me.
It's definitely cooling though. In theory the air quality will be much better today than it's been, there's a good strong breeze through the trees. The horizon looks blue instead of sickly brown (but it's still a bit hazy) and that's a good sign too.
Chicago seems so far away, but it'll be here before I know it. In training-for-a-marathon terms, it's just a few long runs away. Well, several long runs away. But in order to do the long runs I need to keep up with the weekday training.
After my exhausting run on Saturday I was at my mom's house. She noticed how crappy and worn down I looked and asked me why I bothered with all of this. My answer was simply that there is nothing I love more than running marathons, and to do that I need to train. Regardless of weather or air quality or health or injuries, I need to have consistent mileage on my feet (preferably running) and regular toning and core work. My brain is well aware of this. Now I just have to convince the rest of me.
Sunday, June 28, 2009
I didn't inhale ...
... when I was outside today since the air was so polluted. It's another Spare the Air Day in the Bay Area; unlike yesterday when the air was merely "Unhealthy for Sensitive Groups," today the air in the inland East Bay is plain old "Unhealthy." Yesterday I should have limited my outdoor exertions, today I should avoid them completely. Okey dokey, I'll stay inside with my air conditioning on. Come to think of it though, doesn't my excessive use of energy for said air conditioner contribute to the unhealthy air?
Despite the inability to breathe deeply I ran 13 miles yesterday. Fine, I "ran" 13 miles yesterday. Anita and I started our run on the Lafayette-Moraga Trail at 7:00 am hoping to beat the worst of the heat. We were only partially successful; by the time we finished it was only 80 degrees instead of the 100+ that came later. The early part of the run went pretty decently except for the stretch where I aspirated an insect. It was pretty gross, trying to cough up some gnat out of my lungs.
We had a surprise visitor during the run. As I was standing on the side of the trail trying to hack up the bug, Mary Ann caught up to us. We hadn't know she was coming so we didn't wait for her at the start. Since she didn't want to run more than 8 miles we only had a short time with her before she headed back, but it's good to run with her again.
At about 6 miles out we ran past the back of my nephew's school. I was pointing it out to Anita and didn't notice the very large lump on the pavement right in front of me. My toes jammed into it, I think I went just a little airborne, my face came within about a foot of the ground and somehow miraculously I caught my balance and kept running. But I had such a huge rush of adrenaline that I felt high. Within a very short time that surge was gone and I was left with trembling legs and little energy. But at least I wasn't wiping blood off my chin!
The return run wasn't nearly as pleasant as the outbound leg. I was feeling the effects of the air, the heat, the distance and my little trip. We did more walking than I would have liked but I continued to try to push it as fast as I could. We finished hot and tired and dehydrated but feeling quite pleased with ourselves for getting it done. I guess 13 miles is still 13 miles, no matter how ugly!
Despite the inability to breathe deeply I ran 13 miles yesterday. Fine, I "ran" 13 miles yesterday. Anita and I started our run on the Lafayette-Moraga Trail at 7:00 am hoping to beat the worst of the heat. We were only partially successful; by the time we finished it was only 80 degrees instead of the 100+ that came later. The early part of the run went pretty decently except for the stretch where I aspirated an insect. It was pretty gross, trying to cough up some gnat out of my lungs.
We had a surprise visitor during the run. As I was standing on the side of the trail trying to hack up the bug, Mary Ann caught up to us. We hadn't know she was coming so we didn't wait for her at the start. Since she didn't want to run more than 8 miles we only had a short time with her before she headed back, but it's good to run with her again.
At about 6 miles out we ran past the back of my nephew's school. I was pointing it out to Anita and didn't notice the very large lump on the pavement right in front of me. My toes jammed into it, I think I went just a little airborne, my face came within about a foot of the ground and somehow miraculously I caught my balance and kept running. But I had such a huge rush of adrenaline that I felt high. Within a very short time that surge was gone and I was left with trembling legs and little energy. But at least I wasn't wiping blood off my chin!
The return run wasn't nearly as pleasant as the outbound leg. I was feeling the effects of the air, the heat, the distance and my little trip. We did more walking than I would have liked but I continued to try to push it as fast as I could. We finished hot and tired and dehydrated but feeling quite pleased with ourselves for getting it done. I guess 13 miles is still 13 miles, no matter how ugly!
Friday, June 26, 2009
Now that it's summer
The Bay Area finally noticed that summer has officially started and presented us with glorious weather. The sky right now is about as blue as you'll ever see when you're staring wistfully out of your office window. While I'm not a big fan of running or cycling in it, the wind is fascinating to watch as it blows bits of the overgrown Eucalyptus trees all over the place. I see that the temp is currently 68 degrees, although I'm shivering in my over-air conditioned office. I'd love to be outside.
I'm pretty sure that back when I was about 30 I thought that by 55 I'd be seriously considering retirement, that I could do whatever I'd want because I'd be so financially secure that I wouldn't have to work. Uh, right. Although I'm feeling much older than then, I'm still thinking it will be at least another 10 years before the retirement bug bites me hard enough to get out of here.
All of which comes down to this. Why can't we be like civilized nations where hard-working people get several (or many) weeks of consecutive vacation time in the summer? Why do we feel guilty leaving work for longer than a week, why do we feel indispensable, why do we think things would fall apart without us? Or why do we feel that in this economy we're lucky to have a job at all, and if we take any vacation time the job might not be waiting for us when we return?
[edited to add: I thought I posted this yesterday after I wrote it. Whoops!]
I'm pretty sure that back when I was about 30 I thought that by 55 I'd be seriously considering retirement, that I could do whatever I'd want because I'd be so financially secure that I wouldn't have to work. Uh, right. Although I'm feeling much older than then, I'm still thinking it will be at least another 10 years before the retirement bug bites me hard enough to get out of here.
All of which comes down to this. Why can't we be like civilized nations where hard-working people get several (or many) weeks of consecutive vacation time in the summer? Why do we feel guilty leaving work for longer than a week, why do we feel indispensable, why do we think things would fall apart without us? Or why do we feel that in this economy we're lucky to have a job at all, and if we take any vacation time the job might not be waiting for us when we return?
[edited to add: I thought I posted this yesterday after I wrote it. Whoops!]
Subscribe to:
Posts (Atom)
