Adjusting Hope When The Options Are Bleak

When the doctor confirmed mom’s hip was broken, she gave me two options. No surgery, or surgery, but we would have to remove the Do Not Resuscitate (DNR) order in place. Mom has been using a walker while assisted and in a wheelchair for months. She wasn’t interested in working to walk again so the surgery would be for pain management. My guideposts for mom’s care have been how does she feel and how does she look. She should feel as comfortable as possible and maintain as much of her personal style as her health allows.

Of course surgery seemed like the right course, but would they return mom with broken ribs as well after surgery because her heart stopped? As I sit in the E.R. waiting room, I review the hundreds of times my mom said “If I’m like my mother … don’t have my wits about me … am in a wheelchair … put a pillow over my head and take me out.” Yeah, she said this to me in varied forms for more than 20 years. I am glad my mom made sure I knew what she wanted. I’ve been trying to balance her wishes with the real choices we face. We put in the DNR as recommended by her community after she moved into assisted living with dad and was well into a moderate stage of her dementia.

Two years ago we faced many of these decisions for dad who had cancer and was in a moderate stage of Alzheimer’s. Thank you to Kathy S. for reminding me what a gift of love my dad offered by going first. I am so much better prepared to help my mom, but it doesn’t make the choices any easier.

We followed the recommendation for surgery, but learn after a day of tests that mom has both a lung and heart issue that would have to be treated most likely without success before we could again consider surgery. The medical, ortho, and geriatric doctor all recommend against surgery now. The significance of that to mom’s comfort is devastating.

We have moved my mom back to her community and she is in hospice care once again. Through this she has been frightened and tense. My mom never closed her eyes for more than a short blink through 4 courses of morphine the first day. She was so tense, movement was more painful than it should have been.

Now back in her community, we realize she may have had another stroke during the process. One side of her face is drooping and she is unable to really communicate with us now. I am blessed with a personal care assistant who has been with her for nearly a year that knows her well.

For now, I have to adjust my hope to keeping mom pain-free, and that she will join dad after a short visit with her children who all want the best for our mom. Hoped.