Observations 20 JAN 2010

I have not posted for some time. There's a good reason for this. Mom is now in Room 305 of the Bethesda-Dilworth Skilled Rehab Facility.

How she got there is the story of the last month-plus.

When I moved in to take care of her, she was still mobile. She appeared to need only minimal assistance (driving, shopping, some fetching and carrying). Her spirits had improved. The dog was now her well-loved buddy, not a rival. She now had a live person to talk to.

But after the holidays, and after the severe cold set in, she began to physically deteriorate, rapidly. I discovered problem after problem that had been concealed. Numbness in the limbs. Extremely poor sleep patterns. Depression. She was showing signs of pulmonary distress when getting up and down.

More and more, I was being turned into a full-time LPN. Bathing. Clothing. Y'all know the details.

Last week, she had three falls. She refused to see a doctor, or seek care for the first two. On last Thursday night, it took an hour to get her out of her living room chair. A half-hour for the bathroom. Then, I put her in bed with instructions to call me for anything, and not to get out of bed.

0550 Friday morning, a gigantic crash was heard through the re-enforced concrete ceiling. I ran upstairs, and found her between her bed, and the side table, with her head (left side) on the open door of the side table. Both of us knew the game was over. Her gamble to die at home had failed.

911 was called, and the STL City FD responded rapidly and professionally. She was immediately taken to St. Mary's Hospital ER. Her BP at one point was 90/49. Her blood sugar count was 55 (!!). She had been deliberately reducing her food and fluid intake to reduce the need to relieve herself- and starving herself in the process. Her O2 saturation's were dangerously low. Every sign was there that her congestive heart failure was worse. Her right leg was infected, and inflamed. No cranial bleeds were shown in the scans, but there was a lesion on the front temporal lobe. She was disoriented, and in pain.

By noon Friday, she was stabilized, and taken to Room 367, on the med-surgical/oncology wing. That's when the generational war of nursing began. Mom could not understand the rigid, by-the-numbers style of modern medicine. EVERYTHING was scanned, and entered into the computer. Every vital sign, every action taken recorded. The staff had no choice. The nursing staff were facing a three-day weekend, reduced staffing, and a rush of critical patients.

Mom, of course, wanted to direct her own care, and had managed to make herself PNG by openly degrading the staff. "We never treated patients this way! This hospital is a Gulag!"

The Silent Generation Uber-RN was having a collision with a Boomer/X'r managed healthcare system, staffed mostly by Millies.

Enter Wally the Peacemaker (Generation Jones, 1959). For five days, I acted as liaison for Mom. The Charge Nurse was openly relieved whenever I showed up- I stopped the call button from being pressed every 13 seconds, and managed to pull off some diplomatic miracles. I fended off at least one coronary (on both sides).

My sister was doing her part by scouting long-term care facilities. I pity the administrators subjected to her not-so-tender mercies.

Both my sister and I have Power-Of-Attorney. We split the duties- she would handle the medical hassles, I the financial and legal ones. Again, do not have an emergency on a federal holiday weekend. Tuesday and Wednesday were burned off, because Monday was MLK day. The same applied to the high and mighty specialist departments. Tuesday is usually spent getting the backlog cleared. Wednesday, the work got done.

Tonight, Mom is much happier in the better staffed rehab facility. "They didn't say goodbye to me!" she complained about leaving the hospital. I will leave it as an exercise for the student why that would be so.... :)

Did I mention the paperwork?

I no longer needed an alarm clock. My sister would wake me up by cell phone with the first demands of the day. Then Mom would call, demanding that the entire contents of her house be brought to her.

My dog misses Mom. He can tell something is wrong. He loved the firefighters and the paramedics, and they liked him. But afterwards, Mom's absence was felt.

I am now convinced, more than ever, that we are going to have a breakdown of the medical system. The political system is equally compromised (as shown by the legislative antics of both sides). At some point, the Millies and the Artists now being born will simply not put up with the mess we have created. Be nice to them- you would not believe the difference treating them decently can make. I found that out first hand. They couldn't believe I was a late Baby Boomer, because I was both nice, respectful and understanding of them, and politely assertive. And funny.

I doubt my debate board opponents would have pulled this off, from their online demeanor's. The staff was shocked at how much I knew about medicine. They were greatly amused when I explained my military background, and why we got buried for our mistakes, while doctors buried theirs. Take *that*, Your Majesty. The staff also liked the old joke that we didn't think we were doctors, but the doctors thought they could be pilots... :)

Mom is much happier (and healthier) now, in the rehab center. She has now a goal to work for. Much depends on how badly her heart and lungs were damaged. She's still on O2. The weakness and numbness in the right limbs is also a major concern. If she returns home, she will need to be supervised, since she will go off-leash, given the chance. The car is being sold, since we now know she will not be driving again.

Many thanks to my employers, for understanding, and allowing me the time off to deal with this situation. Thank God I get to go back to work. That will be a vacation.

Wally.