The Visit

René Cantwell, advocated for her father after his stroke the night of the millennium and for the ten years that followed. After forming a Family Council in her father’s nursing home, Cantwell put her skills to use as she published the caregiver resource Families of Loved Ones (FOLO). FOLO, no longer in print continues to be available online at www.familiesoflovedones.com.

We all know those weeks that just sap all of your strength. Well, it was Saturday I had had a long week, and I was whipped. Maybe it was because I was acclimating to my typical schedule after an unprecedented week long vacation. Perhaps that dastardly thyroid was off again. After all, travel, weight fluctuation, eating too much fiber, the wind blowing in a different direction, almost anything could trigger an uncomfortable level change with the thyroid. Perhaps I was just bone tired, but going home to take a break was really not an option. Continue reading

Why? On this day, just like every Saturday for the past ten years (unless there was an extraordinary exception) I knew that someone special was waiting for me. It was the same on Tuesday and Wednesday too.  I was obligated, but not in a bad way, more like the commitment a new mother feels to care for her infant. Three days each week were reserved for my visit with Dad. He set his clock by it, and so did I.

As a family, we had come together in crisis on many occasions. By the time Mom was 49, she had endured over 20 major surgeries, leukemia, heart and lung disease, kidney failure, throat cancer, and most devastating of all, neurological impairment that brought about a type of personality disorder and dementia that was as debilitating as it was devastating. Dad’s compassion and devotion to his soul mate, in the most difficult of times, was often the topic of conversation among family and strangers alike. My Dad, it was often said, was a saint.

There are many stories on how their lives became an accumulation of sorrow and hardship. Job loss, no insurance, loosing their home—they were no stranger to life’s challenges. But as long as they had each other, they were able to move on. As adult children, we worried. We helped and supported as we could, our distance from the epicenter of their lives allowed us to become marvelous critics.  Conversations between the siblings would often contain phrases such as enabler and denial, but mostly the tone of the dialogue was that of concern. Our worries were real; the toll that Mom’s care was taking on Dad was measurable. He already had open-heart surgery, he was diabetic, and at 69, still had to find work in order to make ends meet.

On the night of the millennium, when most were celebrating a new era and worrying about Y2K, the family was about to learn how our worst fears were materializing.  A quick visit for the New Year revealed that Dad had a stroke. We think it happened sometime during the night before. Mom had made her way to his side, but once she sat on the couch, she was unable to get up.  She could not reach the phone, and didn’t quite comprehend that something was amiss. We don’t know how many hours passed, but she assured us that Dad was just napping, probably not feeling well today.  In that moment, life as we knew it had changed.

As tears flooded my eyes, my thoughts ran in a million directions. Call 911. Oh my God. I had Matt (my 12 year old), and my mother in law Dolores with me. Stay calm. Oh sweet Jesus!  My mind was racing, I’ve got to get them out of here. This is too much for them to see. Why am I crying?! Dammit, shit, (Mom always professed that nothing relieved stress like cursing.) I preferred deep breathing. Breath. Ok, I’m good. It’s not working! I decided to pray instead of curse.

My family has often marveled at my ability to delegate. In fact, my brother John nicknamed me “The Delegator,” and delegate I did. In the moments before the ambulance arrived, I was able to summon help to gather up the kids, get a friend in the house for Mom, and have someone contact family. My husband, a musician, was playing a gig and not reachable. For a fleeting moment, I felt utterly on my own. Waiting for the ambulance was the longest 5 minutes of my life.

On the way to the hospital I sobbed. It was the only thing I could do, and I so appreciated the ambulance driver just allowing that to happen.  I rang in the New Year in the emergency room, along with my brother and sister-in-law. At midnight, we could hear the staff wishing each other well, but not one of us could muster the strength to stand. Our reality, as if in sympathy with my father, was momentarily paralyzing us.

The next few months were horrific. There were so many decisions to make because Dad was not going home.  Within days of his stroke we had Mom in respite, and I began to learn the language of long-term care.  As the weeks and months progressed, the family settled into our new normal.

Mom’s condition was confusing to the nursing home staff; her often-caustic behavior required soothing interventions for her and those around her.  Dad was progressing a bit, but he was completely paralyzed on his right side. No more walking, ever. He was also aphasic. After years of being the voice of reason, the voice for my mother, he now uttered unrecognizable gibberish. The aphasia was termed “expressive.” Which meant he had thoughts, he was still “in there.” His inability to express himself was excruciating for everyone, but most especially for him.  You would think that he could just write letters to form those precious words and thoughts; but any attempt was as garbled as his speech. I became his voice.

We finally settled them both into the “honeymoon” corner suite of the nursing home. Mom asked to go home every day. We never told her that the apartment was no longer there. What purpose would it have served? At least she could dream and imagine the day they could go back. But that would not be, Mom only lasted until August that year. It was her time. Although she was relatively young, only 65, she appeared as you would imagine a 98 year old would look. In her final days she was granted the blessing of hospice and finally, sufficient pain control. Blessed morphine allowed her moments of clarity that we had not seen in years. She closed her life with dignity and peace, for which my family and I will be forever grateful.

After mom’s passing, we moved into a new phase for Dad. No longer tethered to her bedside, he slowly came into what would constitute his new life for the next decade. Thinking back, I’ve often commented on how those ten years were the most stress free of his life. It’s a very sad commentary, but true.  Living in a large facility afforded him plenty of room to move around in his wheelchair and when a neighbor gifted him a motorized chair his world really opened up. The principle would call me in; um… I mean an administrator would call me in to tell me he was in trouble, again, for going off property. He would beam with delight as I listened to the manager, concerned about his adventures. I loved that. While I was professing my alarm, I was secretly thinking, You go, Dad. Go!

I became Dad’s voice, his advocate. The one he knew would be there, without fail every Saturday, Tuesday and Wednesday. I could have never done this without support. My husband stepped up to the plate from day one. I curtailed my work hours, and even the kids knew that Grandpa was a priority, just like them. My siblings, God bless them, knew I would be the one calling the shots. My sister became my greatest partner in Dad’s care. The others did the best they could, but their circumstances were all different. The one promise that they made to me was the greatest gift I could have asked for. They never hassled me. I’m sure there were decisions that I made that they would have done differently, but they always supported my decisions because it was the kind thing to do. The last thing I would have needed would to have been arguing with them.

So back to that Saturday I first mentioned. It was now over ten years after Dad’s stroke. How could I not go see him, even if it was just a quick visit? Knowing that he would very well be waiting for me in the lobby made it impossible to not go.

When I got there I was surprised to find him in bed. I came to learn that he had been up, but had a colossal “accident” while up in his chair. He sheepishly giggled and motioned, clearly letting me know that “Geeze, you can’t believe what happened!”  The room was not so fresh. Well, at least I wasn’t hungry any more. I set about to reassure him and help the aide (also a saint) clean up. Every time she came in he was embarrassed all over again. I’ll never forget what she said to him. “Philip, someday I will need help. I want that person to treat me kindly. Why wouldn’t I do that for you?” Spending time at the nursing home was often fraught with life lessons. Another thing that developed as I spent time at the nursing home was an increasing dialogue with God.  My conversation with Him typically went something like “Alright, I think I get the compassion thing already. Can we slow down on the lessons?” But yet, here was another day, and another lesson.

As the hour stretched into two I realized I was now very hungry and excruciatingly tired—I needed to leave. I hurried to washed up and set about to say goodbye. He was tired too, but I could tell he did not want me to go, not yet. I hated it when that happened. I shushed him from his last minute question, kissed him on the forehead and intended to leave. Instead I realized that although he had been thoroughly cleaned, he was clammy, he looked sad. I could not leave him like that, so I put down my stuff and got him a washbasin and we spent a few minutes reorganizing. We washed his face, neck and back, powdered him up, got a new pillowcase, some cold fresh water, and wa-la—a new man. Now he was comfortable and sleepy and he was chasing me to go. That is how I liked to make my exit.

The events of that day could have been any number of days with Dad. What makes this one different is that it was the last time I saw him before his final days. My sister spent an equally beautiful Sunday with him and on that Monday night I received a call that he had a heart attack. While he lingered for a few days, he was not aware. He was just giving us time to adjust to the fact that he was leaving. As always, he continued to be a perfect gentleman.

It’s now been two years since my dad passed and the life lessons are still being lovingly delivered. I think that the greatest gift I’ve received is the ability to reflect on my experience and have no regrets. Not that I believe for one second that I did everything perfectly, far from it. But I do know that I did the very best I could, and it made a difference in someone’s life—and was appreciated. In the end, who could ask for more?

Share on FacebookShare on Google+Share on LinkedInPin on PinterestTweet about this on TwitterEmail this to someone

Doing the Right Thing; It Can Come Naturally

by David Sprowl: Executive Director at Lutheran Towers, Atlanta; Director CCAL.

A recent and very personal experience put the concept of person-centered care in the forefront of my mind.  Last month, my 90-year old grandmother, Mama Dora, fell and broke her hip.  Until that time, she had lived independently in her own home and until her car was wrecked by her great-grandson, she was still driving.  Being the dutiful grandson, I immediately took the one and a half hour car trip to be by her side.  Continue reading

In less than a two week span, she underwent successful hip surgery, a short hospital stay, rehab in another city, and was suddenly returned to the hospital with renal failure before peacefully dying.  As someone who is particularly sensitive to how individuals treat Elders, I was struck at how well the hospital staff interacted with Mama Dora.

From the aids to the nurses, to the doctors, everyone without exception focused on her.  They did not exclude my family in their  interactions, but it was clear that my grandmother held their primary interest.  They spoke directly to her, asked her personal questions about her family, about how she was feeling, etc.  Now, I must acknowledge that Mama Dora has never met a stranger, so she exerted her own personality in the exchange.

I suspected that each staff member providing care was not especially trained to be sensitive to the needs of Elders, but it was simply a natural part of who they were.  Upon asking one of the nurses, I  learned that they had not received any special training related to  eldercare.  It turns out that she and the others had only received basic patient care training delivered via educational videos.  She had never heard of culture change, patient-directed care, or person-centered care.

Often, we only hear the horror stories, but we have to acknowledge that there are those who are doing the right things for the right reasons, but lack the awareness and formal training that provides them a common language from which to speak and a platform for working at a higher level.

Although what I observed seemed to happen naturally, how much more meaningful would the experience have been if the individuals providing the care were given tools to enable them to create a culture of caring that would last beyond the current group of employees?

Share on FacebookShare on Google+Share on LinkedInPin on PinterestTweet about this on TwitterEmail this to someone

A Challenging Parent in a Challenging System: What Would Person-Centered Care Look Like?

by: Penny Anderson: Secretary  CCAL.

At the risk of sounding selfish or self-pitying, when I hear stories of adults who have lost patient, loving, and caring parents, I often feel a twinge of jealousy.  My family, like many others, was challenging; and my parents’ behaviors, including alcoholism and a variety of mental health issues, continued throughout their lifetimes.  This made attempts to ensure appropriate care for them extremely difficult.  My mother died many years ago at a relatively young age (68), so  I am going to focus on my experience with my father who lived to be almost 84.   Continue reading

My father was a demanding (including of himself), obsessive-compulsive man throughout his life, with the focus of his obsessions being primarily on things, processes and routines. After he retired and my mother passed away my father developed a rare and debilitating disease called Primary Lateral Sclerosis (PLS), which meant he would gradually lose limb and likely some speech function, however his cognitive abilities would remain intact.  For my father, the PLS first resulted in the gradual loss of the use of one leg and the eventual need for a wheelchair.   This was one of the worst possible diseases for an obsessive-compulsive person such as my father to endure.  His need for assistance coupled with his uncompromising rules and routines was unbearable both for him and for those who cared for/about him.   While quite a few of his routines and demands could easily be considered bizarre, they were extremely important to him; they were his ways and it was his life that was  eroding.

We were unable to locate an assisted living facility that met my father’s requirements (including a willingness to allow residents to drink at will) or that would accept him given his physical needs.  Another issue was that he refused to wheel himself in his wheelchair, insisting on being pushed at all times (strength was not an issue — at the time, he was still able to do an amazing 60 pushups).  The residences we visited were also reluctant to accept an individual who needed assistance with transfers from a wheelchair.  Some would have accepted him until he reached the point where two individuals would be needed to assist, but then he would have had to leave.  He ended up hiring an agency to provide him with a 24-hour in-home care provider.

My father refused to provide an actual bed or bedroom for his caregiver – a sleep sofa was used, which had to be folded up each morning and taken down each night.  The sofa was in a room that was actually my father’s office.  Each provider tried to comply with his many rules and demands, but it was extremely difficult for them and frustrating for him.   An example of one of his somewhat unusual requirements was that his caregiver had to put on my father’s shoes (with rubber soles) and socks prior to pulling on his trousers (the reverse was true as well – trousers off before shoes).  He would not budge on this routine, even though it made getting the pants on and off  very difficult.

Some caregivers were much better with my father than others, in terms of patience, tolerance, and even knowledge of how to provide the most basic physical care e.g., transfers.   However, most of the providers sent by the agency spoke little to no English, which for someone as precise as my father was extremely frustrating and upsetting, again for both him and the caregivers, and often resulted in my father becoming extremely angry, shouting and name-calling.  Particularly for someone with limited English, it can be difficult to understand the exacting routines my father demanded:there must be exactly 15 bitesize shredded wheats in the cereal bowl; the cereal box must be opened in a certain way; the juice glass must be exactly half full; the bathroom fan cannot be turned on for any reason; a certain pen must always be in a certain place, etc.  Needless to say, he went through many caregivers.  The home care agency never suggested that we meet to discuss his needs or issues.  My father would not suggest such a meeting, and he was adamant that I not contact them myself.

Towards the end, my father lost the use of his other leg.  He had also begun to lose the use of his hands and his clarity of speech was diminishing.  With neither leg functioning, he required two caregivers for transfers. He decided he needed to move immediately into  a nursing home.   His selection was one that I recommended he avoid after speaking with the county ombudsman.  But his chosen facility allowed him at least one drink before dinner, and he considered the place “classy” as well.  The experience was a nightmare.  His first day there, three staff members came to prepare him for bed and were in such a rush that they would not even take the time to listen to his routine, much less abide by it.  His items were randomly tossed out of his trouser pockets, rather than removed in the careful order in which they had always been removed and placed just so on the bureau.  Of course his shoes were taken off before his trousers.  He felt manhandled, disrespected, and abused.

My father lasted two nights in the nursing home, and then suffered a massive stroke.  When it became clear at the hospital that he needed to be removed from life support, he was returned to the nursing home.  We contacted hospice, who came regularly to ensure that he was receiving enough morphine (often he was not).  One early morning when I arrived in his room, the television was on.  Nighttime staff had taken advantage of his stroke to watch some TV.

I am a staunch believer in person-centered care/living.  But in some cases, such as my father’s, given the murky mix of issues affecting everyone involved, I struggle to conceptualize what it would actually look like. How could someone like my father mesh with person-centeredness and vice versa?   I would love to hear from others who have experienced, or are experiencing, similar convoluted and conflicting physical, mental, and emotional experiences/anguishes with an aging parent.

 

Share on FacebookShare on Google+Share on LinkedInPin on PinterestTweet about this on TwitterEmail this to someone

Person-Centered Care: Is It Actually Happening

by: Karen Love, Founder CCAL

Recent experiences have me wondering if our country does a
better job caring for and about people when they are dying in a hospice program than when they are living.  My mother passed away earlier this  year in a hospice.  The last several months of her life included numerous hospitalizations, several ambulance trips to the Emergency Department, a 10-day stay at a nursing home for rehab services, and many doctor and therapy appointments. Continue reading

During this time she received care from the spectrum of health care settings including primary, ambulatory, acute, rehabilitation, sub-acute, nursing home, and hospice.  The clinical care she experienced in all of the settings – except the nursing home – was excellent.  Yet it was only in the hospice setting that she and our family experienced humane care.

While my mother was only in the hospice for five days, the staff and volunteers all took the time to get to know us, made us feel welcome and at home, were attentive to our comfort needs, went out of their way to answer questions, and even made sure we knew when food was set out.  Everyone we encountered at the hospice was kind, caring, sensitive, and thoughtful.  They were as focused on my mother’s clinical needs as her human needs.  As a result, the sad and difficult experience of dying for my mom and losing a parent -grandparent for our family was special and memorable.

In contrast, my mother’s 10-day stay at the nursing home was barely humane and mostly unpleasant.  Not one staff member took time to get to know anything about her other than her medications. Despite the fact that she was very ill and scared, the staff bathed and toileted her as if she was an object.  The environment was noisy and intrusive at night making sleep difficult.

The other care settings at least provided good quality clinical care, but ranked low in humanism.  Staff generally were hurried and only focused on her clinical care: taking her temperature; drawing blood; and delivering medications.  Occasionally someone would mention how cold a room was, but make no effort to do something about it or to get a blanket.  It was as if they had blinders on about the fact that they were caring for human beings with emotional, physical, mental and social needs.

In our family’s experience, all the talk about person/patient-centeredness was just that…talk.  It’s hard to understand why.  Not only was the time at hospice good for our family; it was the only setting where the staff seemed to actually enjoy being there.  Maybe person-centered and humane care is good for staff too.

Share on FacebookShare on Google+Share on LinkedInPin on PinterestTweet about this on TwitterEmail this to someone

The Eye of the Beholder

by: Sheryl Zimmerman, PhD., Kenan Flagler Bingham Distinguished Professor of Social Work and Public Health and Co-Director of the Program on Aging, Disability, and Long-Term Care of the Cecil G. Sheps Center for Health Services Research

My father, who was suffering from dementia, needed to move to a nursing home.  The assisted living community in which he had been living couldn’t provide the medical care he needed, a fact that became abundantly clear when he was hospitalized.  My mother and I worked with the hospital social worker to select the nursing home that best met our primary need:  location, location, location.  We wanted to visit my father — often — and distance mattered.  We knew the closest nursing home wasn’t the “best” nursing home in terms of its quality rating, but it was the best in terms of what mattered to us.  The social worker made the necessary arrangements, and he was to be transferred the next day. Continue reading

Later that same day, a well-intentioned physician who valued quality, quality, quality, changed the discharge plans so that my father would be discharged to a “better” nursing home.  What I found rather remarkable about this experience was that (1) the physician made a decision about discharge location without talking with my father, mother, me, or the social worker, and (2) the physician expressly changed the discharge plan, without inquiring as to how it had been determined.  My indignation as to how this unfolded made it easy for me to take action to over-ride the physician’s discharge plan …
without talking with her about it, since that was a style with which she was obviously familiar.

I reflect on what would have happened had my mother and I not considered in advance what mattered to us, and had we not felt empowered to guide my father’s care.  We would have spent much less time with him during the three months he lived in the nursing home before he died.  Restated: We would have lost cherished time, time when it was most important to be a family.

Share on FacebookShare on Google+Share on LinkedInPin on PinterestTweet about this on TwitterEmail this to someone

From Person to Condition & Back Again

by: Michele Ochsner, Ph.D., Co-director Occupational Training & Education Consortium, Rutgers Univ. –

About a dozen years ago I realized that my parents’ confusion and forgetfulness was probably the beginning of dementia. The realization was delayed by the long distance that separated us and my relatively brief visits home to the Mississippi Gulf Coast.  After a period of hiring caregivers that might allow them to stay in their home, I realized it simply wasn’t possible to keep them safe.  My still strong, independent eighty year old father would decide to pay a bill on foot—undertaking a five mile walk into town in 98 degree weather–followed by my much frailer, nearly blind mother and their small dog Minnie.  Neighbors would find this sadly comic trio walking along busy roads and with no small amount of difficulty, persuade them into their cars for the ride home. Caregivers were fired or simply unable to keep up.  Miraculously my parents survived half a dozen or more misadventures that could have led to tragedy. Continue reading

Recently divorced with two pre-adolescents and working full-time, I knew that I could not provide the care they needed. I wasn’t familiar with the term person-centered care at that point—but I knew I wanted to find a place near my home where my parents could make friends, find and offer affection and make a new home. My parents were simply the kindest people I’ve ever known—and I was sure that we would forge a new family that included caregivers who could keep my parents safe.

From 2001 – 2004, my parents lived in what was generally believed to be the best dementia care unit within a 30 mile radius of my home in Princeton NJ.  I loved the non-profit facility’s principles of dignity, autonomy, and respect—my parents were free to walk anywhere and would be gently guided back into the building.  But the facility provided little in the way of meaningful activities. Nor did the staff seem to engage with the residents.  My father used his autonomy to pack his pillowcase daily for return walk home to Mississippi—and my mother was equally determined to leave.  In numerous conversations, the unit director and nursing staff explained that my parents’ unhappiness and troubled behavior –to me the result of loneliness and a lack of engagement–was simply a symptom of their dementia.

In 2004 a continuing care retirement community with a dementia unit opened a few miles from my house, and my parents were among the first to move in—for a few weeks at least the staff may have outnumbered the residents.  The staff were excited about the new facility and unit and determined to create a good environment for the residents. For the first time since I had moved my parents from their own home, my parents became Doris and Bob, people with dementia—but more importantly, people, who could be enjoyed and known.  My dad rediscovered his sense of humor—words were beginning to fail him—but a wink, a military salute or a quick hug connected him to the aides and nurses.  The staff loved my mom’s southern accent and the mixture of affection, irony  and pride she exhibited toward her husband of more than 50 years.  My parents were no longer able to tell their own stories, so I told the stories of my parents’ lives —and helped build the web of connections among nurses and caregivers.  When I eventually remarried, the ceremony was held in the dementia unit decorated for the occasion with white satin bows and flowers—among new family and friends. In the face of many losses—we had all found new connections, hope and humor.

My dad was lucky to make this small, caring place his home for four years.  A little more than a year after the move, my mom fell and broke her hip.  Facility policy required that she move upstairs to the nursing home.  But until she was very frail—she would come down to sit in the common room near my dad.  At this point she had to share him with nearly half a dozen nurses and aides and activities staff who he loved, helped, and sometimes tried to protect when a frustrated resident became aggressive.  And he developed relationships with other residents—with whom he sometimes strolled the halls hand-in-hand—having conversations whose words were hard to interpret but whose affection was unmistakable.

Given the freedom to be themselves, many of the residents seemed to decline slowly here.  Problems arose on a fairly regular basis—residents became frustrated, families shared annoyances, staff were often spread too thin and not all staff engaged with residents; formal activities were sometimes uninspired…but there was still a sense of community forged by shared jokes, arguments, and small victories.

My mother had a series of strokes that left her paralyzed on one side–but upstairs in the nursing home she developed a close relationship with an aide who cared for her tenderly.  Downstairs, my father continued to heal—leaving his room in the morning with arms outspread to embrace the aides who had become like daughters.

In the face of recurrent bacterial pneumonia due to a weakened swallowing reflex, my father who had struggled so hard against a loss of control, relaxed even in the strange environs of the hospital, lighting up when I visited and taking me in his arms to croon a melody.  He was discharged from the hospital and spent his final 72 hours at home in his unit—eventually unaware of the procession of aides and nurses who entered his room to touch him lightly and say good bye and who comforted me and my husband.

My parents are gone now, and I know that we were lucky to find a place in which people with dementia are seen as more than their illness and that has managed to recruit and retain such caring staff.  My family’s experiences taught me a great deal about the human capacity for growth and healing in the face of illness. I believe that environments in which staff have the time, training and desire to see and engage with the person—not just the illness—are a crucial foundation for person-centered care and a source of life and hope even in the midst of loss and decline.  “Customer service,” a term I hear batted around in nursing homes and assisted living these days, is a pallid shadow of the kind of engagement and connection I sought for my parents and if I live long enough, may someday seek for myself.

I hope that many of us will take up the challenge to create and strengthen environments in which life can unfold.

Share on FacebookShare on Google+Share on LinkedInPin on PinterestTweet about this on TwitterEmail this to someone

Transitions: A Rocky Road of Reality

by: Joanne Kaldy, President Cooper Communications –

A year ago, my 86-year-old mother was living a life of contentment. She was independent and mentally alert. While she had health problems, she basically was comfortable and happy.  She spent the days watching TV—Judge Judy was her favorite—with her cat sitting on her lap and purring contently while she pet him. Or she would read—Nora Roberts was a favorite author, and she had a framed picture of herself with the author taken a few years earlier. Then one day everything changed. Continue reading

I received a call from my mother’s neighbor telling me that my mom had been in a car accident and was in the local hospital. I reached her on the phone, and she had a few broken ribs and a lacerated liver; but she was resting comfortably. At the hospital, I was relieved to see that she was alert and talking. She was frustrated and annoyed about the accident, and she just wanted to go home. I thought that the worst was over. I was wrong.

Two days later, my mom’s lungs filled with blood, she was airlifted to a Shock Trauma Center 90-minutes away. They performed emergency surgery; and while she almost died on the table, she survived. When I got to the hospital, I was shocked. She had a tube down her throat, and she looked pale and frail. As I entered her room, she reached out and grabbed my hand. She pulled me close to her face and locked eyes with me intently. Her message was clear to me: “Don’t let me die here.”  I told her, “You will get out of here. I promise.” I sat and held her hand, I brushed her hair, and I told her how much I loved her. And I cried all the way home.

The next several weeks were rough. She was recovering, but she hated the hospital. It was noisy, and the food was awful. I would bring her goodies—mashed potatoes, lasagna, chocolate, and coffee drinks—that I knew she’d like. I balanced work with my long drives to the hospital and visits with my mother, but I was exhausted. And I felt so guilty. My mom was depressed and unhappy, and none of my cheerful visits, gifts of a fuzzy purple robe and a stuffed dog, or comfort foods seemed to help much.

When she was finally well enough to be released to a nursing home for rehab, my mom went to a facility in North Carolina—near my sister, who is a physician. My sister and I agreed that this was the best place for her, even though it was hundreds of miles away from my mother’s home…and from me.

At first, my mother was still depressed. She was too weak to walk or do anything for herself. As a stubbornly independent woman myself, I could well understand her pain. Nonetheless, she slowly gained strength.  We talked on the phone daily, and she spoke
of her doctor—although she never mentioned his name—and the staff glowingly. But she still complained about the food!

Two months ago, I was covering Long Term Care Medicine—2011,
the annual meeting of AMDA—Dedicated to Long Term Care Medicine (the national association for long term care physicians) for Caring for the Ages magazine. I was at a reception where I started talking with a couple of physicians. We were making small talk, and I asked them where they practiced. The one doctor said that he worked at a nursing home in Concord, NC. I told him that my mother had been a resident at a nursing home in Concord. He looked closely at me and asked her name. I told him, and he said, “I was her doctor.” I resisted the urge to hug him (I was there as a professional, after all). But I shook his hand and said, “Thank you so much.” There were over 1,600 people at that meeting. What were the chances that I would meet the man who cared for my mother?

I’ve been working with long term care physicians as a writer, editor, and communications professional for many years. I’ve admired these people and their dedication, passion, and seemingly infinite knowledge. But now I saw the impact of their work on someone I love. A caring, skilled physician makes all the difference in the world. I’ve said that for years. And now I say it from experience.

Oh, and my mother? She left the nursing home and entered an assisted living facility. Now, several months after her accident, she is back to where she was before—watching TV with the cat, reading Nora Roberts books, and living contently.

Share on FacebookShare on Google+Share on LinkedInPin on PinterestTweet about this on TwitterEmail this to someone