My mom had fallen and as a precaution her memory care community suggests we send her to the Emergency Room because she is complaining of leg pain. When I arrive, I immediately understand that everything for mom has just changed. Her leg is propped up but she looks uncomfortable. Any attempt to move her leg results in “wait, wait, wait.”
When they take her for the X-ray, I use the time to unravel. I know that she has broken her hip and know that the next 24 hours is going to result in some difficult decisions. Mom is 84 years old, described by her doctor’s as “frail” and well into a moderate stage of multi-infarct dementia. When the doctor comes in to confirm a broken hip, she gives me two options: Surgery or No Surgery.
Because I already experienced the consequences of a broken hip with my father who was in excellent physical condition, but never really cognitively bounced back after anesthesia, I cringe at the idea of what would happen to my mom.
The doctor explains that we would be doing surgery for pain management, but the Do Not Resuscitate (DNR) order in place would have to be lifted if this option is pursued. Now it’s mine turn to say ”wait, wait, wait.”
I realize it’s time for me to call in an Aging Life Care™ Professional. I need help navigating the choices for my mom and making sure I follow her wishes for end of life care.
I called Caring Considerations and by morning Debbie Aggen, RN, CSA® meets me in the hospital room. I explain to her that for pain management they suggest surgery, but are telling me I have to lift the DNR in place for my mom. My mom was very clear that should she lose her cognitive abilities, I should put a pillow over her head. While that isn’t really an option, when the doctor and I discussed it two years ago, the doctor put into place the DNR. Should mom have a critical medical emergency, she did not want extra measures taken to sustain her life. I don’t understand why the doctor is insisting that if mom has an issue during surgery that they be allowed to resuscitate her. I can only imagine a weaker and battered mom coming out.
Debbie listens to me and reviews my moms charts. She recognizes what I could not, my mom was most likely not even going to be able to qualify for surgery. She gives me some language to use and suggests that I ask for a geriatric consult. When the geriatric doctor arrives, I get to have a real conversation about my choices and my moms wishes. Eventually mom is discharged into hospice after it is determined that she has too many other health issues to withstand surgery.
Debbie visits my mom when she returns to her memory care community, She counseled me as I watched my mother lie in pain in her bed and felt helpless to soothe her. Debbie helped me understand the choices, and use the right language to help convey to her hospice team my mother’s wishes and ensure she was comfortable during this last stretch of her life.
It wasn’t easy and I had a host of engaged siblings. However, none of us knew how to best navigate mom’s condition and having Debbie by my side and a phone call away was a lifeline for me as I struggled to help mom. I hope more families will begin to understand the value of professionals certified in aging life care / geriatric care management, which is a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges.To learn more about Aging Life Care, you can visit the website for the association of dedicated to supporting these professionals. Benefited.
9 thoughts on “Understanding My Choices When Mom Ends Up in the Emergency Room”
Your services for people with dementia (and their families) is way ahead of anything we have here.
Thanks for this post Kay as Mary says we a seem to be way behind you approach to care.
Our doctor’s are typically only given 15 minutes per patient, so there is a reason so many other services are cropping up to help navigate our healthcare system.
Our doctors have scarcely 7 minutes per patient! There are other services but it is very patchy and staff are not properly trained in dementia.
That is crazy!
Good advice. I hope the field of aging life care professionals grows, so more people can take advantage of the valuable services they provide.
Agree — most people don’t even know about it.