Sunday, April 29, 2012

Sunday, April 29, 2012


I have been emotionally battered and I am sore all over.  Mom is now in rehab in Omaha and brother dearest is flying to dad today to help him drive home.

LESSON #6 when a family is stressed, every form of dysfunction comes out to play.  DETACH.

Dad, mom’s physical therapist and I decided that when mom was able to be a “one-person” assist, I would fly down and bring her home to rehab in Omaha.  Next thing I get a call from the Social Services gal who informs me that “they” want to call in an outside wound specialist for mom’s burn and since her insurance will not cover her in FL it might be best for me to bring her home now.

I fly to Fort Myer’s on Tuesday.  Dad pulls up in mom’s red Miata, wearing his Santa Claus beard and a Hawaiian shirt.  SO daddy.   I monitor his driving to determine if his macular is impeding his abilities or if he has just been drinking.  Neither.  (My brother tells me daddy has always stopped inches from the car ahead of him.  Correction – INCH.)

LESSON #7 you are never prepared to see a parent in a hospital or rehab facility. 

Mom is wrapped like a mummy – not because of her burn but because she is freezing in bed at the rehab facility.  The TV is blaring (where are your hearing aids?)  She has a grayish pallor, her hair is horrendous, and she appears quite pathetic.  OMG.  My mother has aged 100 years since I last saw her.  My mother is an old lady.

With emotions in my throat, I take charge and investigate mom’s body, taking pictures and ping them to my sister.  Mom’s tongue looks like she has been sucking on black licorice.  This is the THRUSH from the antibiotics.  Mom’s right wrist is wider than her forearm and her fingers are curled up with paralysis.  WE ARE TOLD THERE IS NOTHING WRONG WITH IT. And what I could never be prepared for…her leg burn.  I nearly threw up.  Serious.  Think large fish scales, really bad road rash, hamburger meat, and a five inch, crater-like, divot above her inner ankle.  Reds, purples, greens and yellows.  Seepage.  No blood.  Gooey yellow pus-like paste fills the crater - the wound doc slowly scrapes it out.  Mom doesn’t feel it because she has likely burned her nerves.  Me being me, I ask the doc if MAGGOTS would do a better job?   Yep, he says.  If that wound would have smelled like a garbage dump I would have passed out.  The doc assured me it is MUCH better than it was.  I cannot even imagine.

I make arrangements for the next day to work with the physical therapist and mom to learn how to best help mom maneuver for the flight home.  Dad and I go out for lunch.

Dad.  Where to start?  I really don’t know him well.  Growing up he was busy growing his company.  He was my softball coach for a few summers before I discovered boys and quit. Next thing seems like I was married and moving to Kansas City.  Dad is a man of very few words.  Ask him a question and it seems an eternity before he verbalizes a reply.  Talking on the phone with him can be agonizing.  You wonder if he’s on the other end of the line or fell asleep.

When dad wants to make a point and/or be heard, he raises his voice.  It sort of feels like he is yelling at you.  My brother and I learned this from him and it has periodically caused us problems in our own relationships.  Being with dad again is a good reminder for me to watch my tone.  His puts me on edge, on the defense and my “listening” ability is tainted. 

Loudly and with emphasis dad proceeds to tell me that my mother has no relationship with effort and never has.  He said he first noticed it when they were in college and mom made no effort to study.  He proclaimed her entire life with him to be self centered with minimal effort toward anything or anyone else.  I realize I am in the middle of my dad’s STORY.  I just listen.

He goes on to blast the rehab facility for bilking them of money since they are private pay.  Insisting that they are not helping mom, merely placating her lack of effort and enabling her addiction to ease.  I didn’t totally disagree and we both consented that it was time for them to get home.

We hop into the Miata after lunch and dad takes me to the rental house where they have been living since January.  Once again, I wasn’t prepared.  In my own house I live a certain way – and when I live somewhere that isn’t mine I live a different way – usually on my best behavior.  Not so for dad.  I try to tell myself his poor eyesight is the culprit yet what I witness is….wait for it……lack of effort (or care).

The tile floors were covered with grass, twigs, wrappers, dirt, dead bugs and what not.  Seems he kept all doors open so the dogs could let themselves out.  Every flat counter surface was piled with mail, packaged food, wrappers, papers, books and stuff.  The counters, floors and rugs where decorated with all sorts of dried spills and stains.  The kitchen appeared to have been sprayed with….I’m not sure…but it was sticky and covered the dishwasher, fridge and stove fronts.  A soup pot on the stove contained rice that wiggled.  There was dried diarrhea on the front of the leather couch, on the floor and rug.  The toilets were caked with shit spray.  I was stunned into silence and while dad busied himself trimming the dogs I started to clean.  When I felt it was clean “enough” I went to bed.   Still incredulous.

Next day, Wednesday, we are back at the rehab facility and mom and I are working with the PT.  Not so bad considering mom can’t use her right hand and has no conditioned muscle in her legs.  There are a few momentum moves where mom and I work together to get her standing.  Once she equalizes, I support her, she shuffles herself around and we lower her onto a seat.  A few rounds of this and we have it down.  No worries.  Flying home should not be a problem.

Mom.  Where to start?  I don’t really know her well.  Growing up she was busy watching TV.  She was my Camp Fire Leader a couple of years before I decided it was uncool.  Mom is a woman of independence.  Ask her a question and she tells you to figure it out for yourself.  Talking with her can be very lonely.  You wonder if she’s practicing tough love or just doesn’t want to be bothered.

Our flights from Florida to Nebraska were, for the most part, easy.  First class does have its perks.  Airline wheelchair people are worthless….or I am as stubbornly independent as my mom and we can do it better ourselves, thank you very much.   My mom is embarrassed to be so dependent.  My embarrassment of her inability to care for herself is slowly turning to compassion.  She is safe in rehab in Omaha.  She is now physically available for support and encouragement from friends and loved ones.  Monday she and I meet with all the “Heads” at rehab and together we will plan her recovery.

Today I dropped my brother at the airport.  He is flying to FL to help dad drive back home.  When dad is back here at the house with me, we are going to meet.  Together we will make a list of all he and mom’s business, money, house, health, etc . affairs so I can now better help them with this transition. 

I have finally accepted the fact: My parents are old.  They need help.  And I need to stop railing at reality and step it up.  My internal mêlée with these people is turning to a palliative conversation.   The battle against the dark side of aging (and my war with myself) is waning.  The acceptance of the inevitable course of life is no doubt going to illuminate some magnificent transformation.  I can’t wait.  Really.

LESSON #8 get out of your own way.

Friday, April 6, 2012

April 5, 2012


So……..the inevitable has arrived.  All this minor frustration and poking fun at mom and dad has paled in comparison to our current situation.  Mom, while on “vacation” in Florida, is in the process of being transferred from the hospital to a rehab facility.

Saturday a couple of weeks ago I called to see how things were going and mom tells me she just got out of the hospital.

“WHAT?!?! “ I shriek!

“I fell a couple of times so they wanted to check me for strokes,” mom casually explains.  “I’m ok, just black and blue, swollen and I hurt all over.”

Under my breath I am screaming that if one of us kids was in the hospital and we didn’t call to tell her we would have hell to pay.

“So,” mom continues, “I’m taking pain meds and hope the pain goes away soon.”  Typical mom – nothing in her vocabulary about healing…just wanting pain to go away.  We kids are amazed she gave birth to us.  Her pain threshold is measured with a minus sign. 

I told her to take good care of herself and hung up the phone to immediately call my sister and brother with the news.  It should have been a three-way call as we all said and thought out loud the same things – it would have served as a cathartic family therapy session.

A week later I get a call from Dad.  “She’s in the hospital again.”   This is where the blur begins.  Dad didn’t have answers to all my questions (or even his questions).  I called my nurse practitioner sister to step in and run interference. 

LESSON #1 – Have a trained medical professional as a family member.  While avenues of communication are still difficult, they can at least translate medical-ese, ask the right questions and basically manage the situation. (Entrepreneurs – big business idea here.)

Here is my interpretation of the blur:

Mom is in hospital with acute renal failure due to too many pain pills (Motrin) and not enough hydration. (Quite possibly meaning her self medication put her in la-la land and she didn’t think to eat or drink.)

While in hospital, a burn is discovered on her leg. WT??  Seems she fell asleep (passed out) on top of a heating pad and over time the heat was trapped and slowly cooked her leg.

LESSON #2 – heating pads are to be placed on top of, not underneath body parts – also not to be used while incoherent, drugged or tired.  Heating pad manufacturers – perhaps inserting something bumpy into the pad would create a level of discomfort to then deter an underneath placement.  Just thinking out loud here.

First we were told third degree, possible skin grafts.  Then we were told 2nd degree, just needed to heal.  We STILL don’t know the real story.

Next we were told that her right hand and thumb were broken.  Then we were told they were not.  Mom refuses to move, bend or flex her right hand and arm.  WT??

An exam of some sort showed spots on one of mom’s kidneys.  They performed an MRI.  We never got the results.  Sister reports “Renal” signed off and no news is good news.  We’re going with that.

During all of this my sister was wondering why no one was getting mom out of bed and moving around.  She decided to call the hospital’s Social Services department and got them involved.

LESSON #3 – when feeling under informed, lost, overlooked in a hospital environment, contact Social Services and they will act as your healthcare advocate.

Now all of this happened over six days.  Mom went into the hospital on a Friday.  Evidently all hospital business operations shut down over the weekend so we had to wait until Monday to begin to learn anything.  And yes, one of us kids should have flown down there to manage all of this but we are all experiencing a divine intervention of some sort and are unable to.  Maybe this is to be an experience of a certain meaning for our dad??

On Wednesday it was determined that mom no longer needed hospitalization yet she would require rehab.  She is referred to as a two-person assist which means it takes two people to get her up out of bed.  Further she refuses to walk; her knees are wobbly and she is afraid she will fall again.  Further she refuses to use her right hand; it hurts.  Further, we are all frustrated and want to hurt her more.

This is an emotional area I really want to unpack.  Why do we believe our mother is being such a baby about this?  Why are we getting frustrated instead of enacting compassion?  Intellectually we realize how unfair we are thinking yet we cannot for longer than 30 seconds muster any kind of empathy for her.  And then we feel bad about it on top of it all.  This in turns makes us mad again.  Insight, anyone??

In a mad dash to find an Omaha rehab facility with an open room, it was recommended by the hospital Social Worker to place mom locally because it would be very difficult to move her a long distance at this time.  She needs to get stronger.  Whew.  We all agree a good idea.

LESSONS #4 – make sure your health insurance will cover you out of state/on vacation.
LESSON #5 – make sure your parents, your spouse, your kids,  complete all consent forms for other family members to intervene in their healthcare, health insurance, financial, etc. affairs.

Mom is going to have to pay $3,500 a week for rehab in Florida, her hospital stay may not be covered, her health insurance company will only speak with those at the hospital, and her personal Dr. here in Omaha won’t even take our calls for medical records. 

Dad has a bit more authority yet he is not one to take direction well. He has many questions that we cannot answer and does not quite understand that he is the one that has to ask on mom’s behalf as her husband.  He’s sort of stuck in WHY?  And then slides to forgetfulness or overwhelm, i.e. minor shut down.

I repeat LESSON #5 with emphasis on a family member far enough removed to remain coherent, lucid, actionable and able to make a decision.

This is another emotional area I really want to unpack.  Why do we believe our father is behaving ineffective in all this?  Why are we getting frustrated instead of enacting compassion?  Intellectually we realize how unfair we are thinking yet we cannot for longer than 30 seconds muster any kind of empathy for him.  And then we feel bad about it on top of it all.  This in turns makes us mad again.  Insight, anyone??