Making healthcare choices for a parent: a sad example

“Get me out of here.”

“Please take me home.”

“I don’t understand why I have to be here. Other people fall and aren’t sent away.”

It is agonizing to listen to a parent say such things. It is impossible not to feel guilty for putting her in a rehab facility.

My 94-year-old mother fell in her assisted living apartment at American House in Plainfield nine days ago. An ambulance took her to a hospital, where she stayed three nights. No bones were broken, but she was unable to walk, even with a walker. My three siblings and I wanted her sent back home, using a wheelchair while getting physical therapy there. The hospital PTs, however, insisted she needed to go to a nursing home for “aggressive” rehab, and the American House head nurse agreed. 

When she is able to walk with a walker again, she can go home. When will that be? If the medical professionals have an estimate, they’re unwilling to disclose it.

Worst of all, we can’t see her. Illinois’s latest guidance for nursing homes during COVID requires new residents, vaccinated or unvaccinated, to quarantine for 14 days. Mom coped with the hospital stay when we could be with her. Judging from phone conversations, she’s coping poorly now.

We’re especially saddened because Mom was doing so well at American House once COVID restrictions were lifted. Two new residents had befriended her. They came to get her for every meal and morning and afternoon activity. One spent more awake hours in Mom’s apartment than her own. Though Mom forgets their names, she is missing them at least as much as she misses us. In the hospital she kept asking, “Did you let my friends know what happened to me?” And, more heart-wrenching,  “They’re going to forget about me.”

We try to make Mom understand that the better therapy goes, the sooner she can leave, but how much can you push an old woman who is in pain? The PTs want her to have a Norco pain pill before therapy because she does better medicated. Since Norco makes her loopy, we worry that dementia will be noted in the report to American House, which doesn’t have a memory care unit.

Are we doing the right thing? We don’t feel as certain as the PTs and nurses. One of my sisters commented that she fears that we are ruining Mom’s mental health to improve her physical health. I said that I’d never agree to make her go through this again. 

I wish we knew where to turn for an unbiased opinion. A friend who is a retired nurse said that rehabilitation professionals will never say that they can’t make someone better. Since Mom’s been falling every few months, I fear she is in a cycle of falling, hospitalization, rehab, back home for a while, repeat. She had finished weeks of home PT shortly before the fall, with the therapist concluding that she had made as much progress as she was going to make. 

As part of the hypothetical conversation with an adviser, I’d ask how much Mom’s wishes should be considered when her decision-making skills are limited and my brother has healthcare power of attorney. Painfully aware of her desire to go home, we’ve still deferred to the pros. For how long?

The first “care meeting” over the telephone with Mom’s nurses and PTs and two of us is scheduled for Wednesday, her eighth day in rehab. I hope we get some definite answers about how long rehab is likely to go on. If we don’t, perhaps we’ll seriously consider saying, “Enough already.”

Filed under: Life lessons

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  • I feel for you, Marianne. You've stated the problems very well. If your mom is doing better at therapy when she's medicated, that doesn't seem to me to be a clear picture of what she can do in therapy. I don't think the loopiness is worth it, either. When I had PT for my knees, I was told to report when something hurt, and we (!!) would do something else. Just a thought... maybe PT at home and from someone else?

  • Thanks for your sympathy, Margaret. American House doesn't want her to return until she can walk -- that's why she didn't go back home. We will have to see whether the advice changes after Wednesday's meeting.

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