The “critical incident” decisions are always difficult

I’m back in the emergency room with mom. She had a fall and they expect to find a broken hip. As I await the X-ray results, I’m worried about the coming choice I will face.

I’ve been here before with dad. He was in good health but a little forgetful before he fell on the racquetball court. He returned physically but his cognitive issues were undeniable after surgery.

Mom at least recognizes me most days. The waiting has me imagining the worst. Last year pain medication landed mom in hospice. How will she fare with the morphine? What if she needs surgery? It’s these moments and choices we all fear. Dreaded.

The Caregiving Roller Coaster Twist No. 267

OLYMPUS DIGITAL CAMERAFor those of you who blog, there is a feature that lets you schedule posts. I love it because I know if I have something to say, but already posted for the day, I can push the story forward a few days. I’m hesitant to barrage you with more than one post a day. I’m breaking that rule today … and might not follow it again.

I did that last week with These Sneaks Are Made for Walking! In the morning I posted the story about Palliative vs. Hospice Care and went to visit my mom to find her using a walker to move around her community. I came back, wrote about it, and then scheduled to post. I didn’t think about at all as the weekend unfolded. So now the story is a little out-of-order. I’m sorry for that. I also realize I posted twice on Sunday … but I did sleep between posts so they felt like two different days. ; >

Unfortunately, on my visit today (Tuesday, 3/31), I find mom isn’t doing well. The hospice social worker told me on Monday they were not going to discharge mom after the fall and that she was not interested in getting out of bed.

The PDA I see most texts me this morning to check in after she arrives and reports the same this morning. Just last week she had mom walking all over the community and today, she is unable to even transfer herself. I know she is bummed to see my mom in such a state after she was doing so well. We all are.

My mom still has a very pronounced lump on her forehead and now has a black eye. The discoloration can be seen all the way down to her neck. My mom asks me to repeat almost everything today which is very unusual. After my visit I call back the social worker to ask her when the doctor is going to visit next. She tells me he’s going to see mom tomorrow.

After I’m done reporting what I saw, she tells me point blank “most people don’t recover from a fall like your moms.” I supposed we have all heard how devastating falls are to frail elderly patients, but it just didn’t seem that bad as we sat in the hospital. I was more worried about a concussion given that two of my daughters good friends have just suffered one. Mom didn’t even have a concussion, but the lingering effects are very noticeable and real.

We’ve been to this place before. If this is the beginning of the end, I only pray for it to be swift. However, I have watched my mom fight back from a lot worse. Told.


We found your Mom on the floor

ambulanceThe issues are starting to snowball now. I got a call from the community to let me know that they found my Mom on the floor and have called 911. I let them know I’m on my way.

Before I can leave, I get a call from the EMT asking me some questions about my Mom. She doesn’t want them to touch her. The EMT asks for permission to assess my Mom. After I say “yes” she asks if I could get to my Mom’s apartment. I let her know I was planning on coming after I got the call and hope that it will only take me 30 minutes to get there.

After 40 minutes, they call again as I’m finally walking into my Mom’s apartment. She is laying on the bed now. My Mom is now asleep. I find out that when they found her she was asleep on the floor. She thought she was asleep in her bed. We assume she fell, but it’s another mystery.

I try to get my Mom to wake up and get out of bed. They tell me she was complaining of her back hurting when they moved her. I explain that she has been complaining of a back ache for more than a year on and off. When we have seen the doctor, she denies having back pain.

The EMT offers to take my Mom to get an MRI to make sure there is no injury. I recall how they did this for my Dad when he fell in the bathroom a week before he died. I suppose it’s standard operating procedure, but I would think you would first find out if she has pain.

I hesitate to go down this path because I feel like we are checking the boxes, not really following up on an issue. I also know the new environment will only bring out mean Mom (the lion). I work to get my Mom out of bed which takes time. She just wants to sleep and asks me to come back later. The EMTs have already been her for 50 minutes now, so I can’t let her finish her nap. I ask if she will get up and help me. She tells me to “buzz off and come back later.” I try to convince her that I need her help making sure it’s her clothes in the laundry and she tells me she doesn’t care. I finally get her up. We all watch as she slowly sits up with trembling arms.

The biggest concern for me is that my Mom can’t verbalize her pain. I tried and failed to find why my Dad was slurring for months before he was finally diagnosed with a tumor on his tongue.

The only way to really tell is to have my Mom get up and walk around. After she’s up, she walks across the room and out the door. She seems to be her same frail and stiff self and says nothing hurts.

I decline to send my Mom off for an MRI. She crawls back into bed and goes back to sleep. Eye-witnessed.