There's no substitute for being there.
Parking lot, circa 1961 (Justin Cozart, flickr)
A few years ago, I bought a book at a yard sale with the title: Raise Kids in Your Spare Time. The book was printed in the 1960s and had a cheesy cover. I bought it because most people who have raised/are raising children realize that the concept of "raising children in your spare time," is laugh-out-loud funny. The same thing can be true of aging parents. Calling to check in when they are in a medical facility rarely works. This faith in the power of the phone reminds me of the French woman who used to live down the street from us. She would give her kids - two boys ages 10 and 12 - a cell phone and send them out to play, thinking that she could phone them to check in. That system worked to a point. However, one day when she phoned her boys, they were with some other children in the nearby woods starting a fire, even though they told that everything was fine. About an hour after that conversation, her boys and several other kids - including my 8 year old son - were driven home in a police car. "But, they told me everything was fine," the woman said, as she wept in embarrassment, when the officers knocked on her door.
In the case of aging parents, it's not that they would purposefully lie to us - although they might do that - it's that things adult children would be concerned about might not cross their minds. A friend of mine who has a mother in the early stages of dementia, told me that recently her mother spent three days without power before thinking to tell anyone. Luckily for her, she lives somewhere warm and no real harm was done. Nonetheless, staying with parents in a medical situation can mean the difference between life and death - at one extreme - and discomfort and confusion at the other. So, as I often like to say, you can't just park your aging parent(s) somewhere like a car. Aging parents are human beings with complex needs that are also unpredictable. You don't have to be by their side 24/7 in most cases, but BEING THERE as much as possible is important. When they are left alone, too many things can fall through the cracks. I speak from experience. In the hospital stays that my mom has had in the past two years, there was rarely a space of more than a few days when there wasn't an oversight that could have affected her health, her happiness, or both. None of these oversights were intentional and in hindsight it is easy to see how they happened. The truth is that my mom is often confused when in the hospital: she was delirious when she had pneumonia, she is in pain and confused from pain medication and mild dementia now. My dad also has limitations and, more importantly, both of my parents come from the generation where you don't question the doctor or worry about what is happening in a medical facility. Trust, not careful observation, is the rule of thumb for them. And, given the fact that when my mother is in the hospital or another facility, both of my parents are anxious and tired, it's no surprise that they can't be the ones on the front line making sure that everything is OK. That's not to say that nurses and other staff aren't doing the best they can. In my experience, they do the best they can, but - if no one tells them otherwise - they may assume that my parents can make complex decisions that they can't or assume that they will bring problems to their attention that they don't.
Late last week, for example, I accidently discovered that my mom hadn't been given one of her medications for several days. The oversight wasn't immediately life-threatening; however, if she had been without the medication for much longer she might have become confused enough to forget that she couldn't walk: a disastrous possibilityfor her hip fracture. Once back on this medication, she gradually became less anxious and, within several days, was back to "normal."
Early this week, I noticed a large drop in her blood pressure that didn't make sense and brought it to the attention of my mom's nurse. The nurse retook it and it was actually high, not low, and she called the doctor and he authorized her to give my mother another blood pressure pill and within an hour her blood pressure had returned to normal.
Yesterday morning I had just sat down to breakfast when my cell rang. I picked it up and my sister was on the other end. "Surprise," she said. "Surprise?" I repeated, with a frown. She was with Mom at the Rehab Center and surprises are rarely good ones when it comes to Mom. Guess what, she continued, Mom's going for her x-ray this morning. Mom had been scheduled for her next x-ray on February 26 - or so we thought - but when my sister looked at the date and looked at her calendar, she discovered that there was no February 26 on a weekday and that Mom's x-ray was in fact that morning - January 26. So Dad and I quickly finished breakfast and then he dropped me off at the doctor's office because he had physical therapy and he joined us later.
Meanwhile, Mom was having a mini-meltdown because, as with most elderly people, surprises alarming. But she was calmed down by the time she got to the doctor's office and it turned out for the best that the x-ray was sooner rather than later. The doctor said that there hadn't been much change since the last x-ray two weeks earlier and he said that my Mom should still be non-weight bearing and he would see her again in a month and he recommended that she stay in the Rehab Center until then.
And so, when I finish writing this post, I'll be headed back to the Rehab Center in time to hear what the facility doctor has to say and help Mom with the little things that can make the difference between a bare-bones stay at a facility and a little more comfort and - hopefully - a sense of safety.