The Bite of Reality....

Clinical objectivity can really only take you so far in your personal life.

I had a meeting with the nursing home staff yesterday afternoon.  Mom is supposed to be there for a quick rehab stint - recover her physical strength and scoot back home to her beloved kitties so she can continue to sit and watch the jewelry channel (not sure what the attraction is, but it's what she watches). 

The nursing home staff do not feel this is going to happen.  Physical and occupational therapy feel that although she is not TERRIBLY weak, she isn't really very strong either.  She has no ambition or drive to become stronger. She doesn't really make any spontaneous attempts to get moving on her own.  She doesn't want to get up and get dressed, and personal hygiene is poor. 

(Um, well, none of this is a particular surprise to me.  Even when my mom was working, if she had a day off, she stayed in her nightgown all day.  Remind me not to get in this habit - it apparently makes nursing home staff think badly of you.  And I've known for two years that getting my mom into the shower is torture, and don't talk to me about her nails.)

Furthermore, they are concerned about her level of confusion.  Her overall in-and-out orientation is a risk.  Although she's never been a wanderer, and she's never ever turned her stove on (the benefits of being ambition-less, I guess), what if that changes?  And she remains, in their opinion, a fall risk.  A fall is what got her in there, and another could happen.

So they suggested three things:  1) Keep her permanently placed there.  Her insurance will cover six months and then we apply for Medicaid.  2) Take her home and send her to Granny Day Care at $70/day (not covered by her insurance, that's $350/week, $1400/month+ when her entire Social Security check is less than $1300) and keep her in sight at all times when we are home with her, including at night.  3) Hire full-time aides to watch her ($13 - $25/hour, also not covered by insurance, making Granny Daycare a bargain by any standard).

And the bottom line on all of this:  Mom is dying.  She doesn't really understand that she is dying, but she is, and she wants to come home to her kitties.

The reality of that brutal, dark truth hit me right between the eyes in the middle of that meeting.   

I have to say that my response earned the respect of my younger brother when I told him about it:  "Stop bringing her meals into her room.  Food is her biggest motivator.  Make her walk to the dining room to get her meals and you will see her get stronger pretty fast.  Work with PT to get her to be able to go up and down four steps - that's what I'll need to get her into the house. Meanwhile I'll call her doctor and see whether she qualifies for hospice services or not, and I'll see what we can set up in terms of family, friends and monitors to keep her safe at home."

She's no more confused now than she was three weeks ago.  If she falls, she falls.  She needs to be home.

DeeDee