update on my mother

I tried to post this update from work a couple of days ago and wasn’t able to finish. And of course there it sits on my work computer, which for some reason I’m not able to get into.

So again from scratch.

I’ve posted fragments about my mother’s decline. In short, she’s 80, has severe emphysema from a lifetime of smoking (she stopped ten years ago but the harm was done), and is showing signs of dementia (memory loss, confusion, anxiety).

This was a slow steady decline until about the last month, when it suddenly changed. Over two weeks she went from grouchy and forgetful to completely unable to cope, so paralyzed by anxiety and so forgetful she can no longer even use her asthma inhalers.

It became clear her time living by herself was over; but we have no options there (my house is small, with no room for mom, let alone mom + nurse), and her house is in such a state of sorry disrepair that no nurse would be willing to come in. So a nursing home is the only reasonable option, at least for the short term

Of course there’s no coverage for that. She owns a home, has some investemnt income, and a pension. She has full health from Kaiser but care-taking isn’t covered.

Meanwhile, we were advised to get her in for testing so the nursing homes would know what they were getting.

Last week, they did a CAT scan (which was actually really cool, I got to see brain), took blood, and did some other testing. This week, when we went in for the results, her doctor finally decided to practice medicine, rather than business, and admit her. The excuse was blood chemistry (her long time habit of eating low sodium foods and drinking a lot of water turned against her when her over-all food intake went to near zero; her blood sodium level was dangerously low).

So monday, with Mom screaming and begging, I admitted her to the hospital.

We expect this to be just one night; but surprisingly, there is room for compassion in the Kaiser system after all, though it’s buried deep. The doctor who has her case knew he had a case that was MUCH worse than mom’s regular doctor recognized. The CAT scan shows what looks like a series of very small strokes, worsened by the terrible state of her veins from years of emphysema. Her legs are so poorly supplied with blood that it’s amazing she still has feet. And of course the sodium problem isn’t responding. It’s also, finally, clear to Kaiser that my mother is profoundly mentally ill, depressed, anxious to the point of incoherence, and completely confused. So instead of booting her after one token night, they’re keeping her for a bit, looking for anything they can do to help, and, for the first time in her life, putting her on the right meds to control her depression and anxiety.

My mother is a brilliant woman, with a genius level IQ. But one of her greatest gifts is in her ability to fool people. She’s done it for years, convincing doctors she’s fine. But she couldn’t do it any more, finally snapping, in a constant state of fear and anger with anyone she deals with at Kaiser.

I sat with her last night for several hours while she alternately dozed and then woke, convinced she was at home, or that she had to do something. I reminded her every fifteen minutes that she was in the hospital and that nurses were there, she wasn’t all alone.

This morning (Thursday), I’m waiting to hear if she’s being released, or if they’re keeping her another day; I pray for another day. The stress and lack of sleep caught up with me monday night, and I have a horrible cold, and am at low ebb with my coping skills. So if I have to get my mother out of kaiser today and move her to a nursing home, the word ‘ordeal’ doesn’t describe it. She does not yet know about the nursing home, though on some level she’s aware (in between thinking she’s home, she will say ‘i’m never going home, am i’). But I do not look forward to the conversation where I tell her she’s leaving one hospital and going to another.

I’ve been very clear with the doctors; all I want for her now is as little pain and as much comfort as possible. DNR, do not take any special efforts to prolong her life. She has nothing to look forward to other than decline. They understand, but sadly, there’s no solution for a woman whose brain is dying, but whose body fights on. So comfort is our singular goal.