Therapist FINALLY gets it but it's too late to help Mom

After finally getting Mom's therapist on the phone, some changes are made but I'm wondering if it's too late to do good for Mom.   I learned a lot from talking with Mom's therapist.  Mom's supposed to go to therapy for an hour a day.  The doctor ordered 30 days of it then a review to see if it's doing any good.  The therapist is frustrated with Mom because she thinks Mom's not trying to get stronger. The therapist spent 10 minutes complaining to me about how uncooperative Mom was.  "She'd rather have a Pepsi with a friend than go to therapy." She seemed pretty upset over the whole situation.  The therapist didn't realize Mom is 89 nor that she's grown increasingly weaker over the last year.   She didn't know Mom was successfully using a lift pole in assisted living.  She didn't know Mom was complaining about her wheelchair, that she couldn't work the phone or TV, or that she was willing to try using the bathroom by herself.   I was ASTOUNDED and mad as hell because this information wasn't transfered at the time Mom was transferred to this joint! (One that her physician INSISTS is the best in town.) This time it was MY turn to get mad and frustrated.   I had conversations about her history, abilities and such with the Executive Directior and with Social Services staff, and, a few days later, the nurse on mom's floor.  All of them said they'd "spread the word". None of them suggested that I speak with the therapist.  They all knew she was there for 30 days of therapy!!  It's quite logical to me that the therapist would need to know a LOT about Mom to judge her improvement.   Unfortunately, I didn't realize they would not communicate.  I never expected that I would have to DO THEIR DAMNED JOB!! 

Unfortunately, this seems all too common.   No one seems to have the time to do more than the immediate task in the moment.  Being a process person, and one who's made a living moving data around into usable information - I am VERY frustrated by this and wonder how much harm has been done to my Mom because of their inability to see that they need more understanding.  They need processes to look at a patients WHOLE condition and history when they arrive.  They need to orient the patient/resident to their surroundings VERY well and spend some extra time for a few days to get the resident/patient out of their shell and involved.  They need to ask lots of questions of the patient/resident and family. They need to LISTEN to what each says.    The therapist didn't realize how old my Mom was for crying out loud!!!  How can she provide good therapy if she didn't think to look at her age.   It doesn't give me much confidence in the ability of this place. I'll finally get to visit next week so they'd better get ready - the inquisition is about to begin!

Mom's settled in nursing home but still wondering...

Mom moved into a nursing home Monday afternoon and shows some improvement each day.   I've called her daily and with each conversation she sounds perkier.  She is happier with the food, her table mates and the proximity of people in the hallway.  She misses her recliner, can't quite figure out the telephone and hates the view of a broken down wooden fence but overall seems content.  She's gone to physical therapy a couple of times and is very appreciative of their support to get her to the bathroom more often.

She arrived at the nursing home with a urinary tract infection so has to go often and hates to ask for their help.   Urinary tract infections seem to be common among the elderly - both my in laws had them often.   Such infections can be hard on an older body because it weakens the patient making it harder to manage other conditions like blood pressure.   I wonder which happened first the seizure or the urinary tract infection? She is responding to treatment so I'm hopeful that she'll continue to feel better.  She had a catheter for 3 days during her hospital stay so I wonder if the UI resulted from that or eased her pain and suffering?  I'm not there so I can't ask these questions - which I HATE but must deal with it. I can only trust that she is getting the good care she deserves.  My brother, sister-in-law and niece ( a nursing student) seem confident so I trust them as well.  I'm facing my inner control freak and have to let it go.

In each conversation she says "I don't know how long I'll be here or where I'll go after therapy." As she improves I hope she has no desire to return to assisted living because it will be up to me to tell her no. Upon learning she'd go to a "rehab center" (code for nursing home) she was upset and mad but realized it was necessary.  If it becomes an on-going question, I plan to blame it on her doctor.  It's not a lie; he says "absolutely NOT, she stays put."   We've moved her things from her apartment to her garage and told the ALF that she will stay at the nursing home.   I hope I'm not repeating my reply several months from now but I suspect I will.   It frustrates me to tell her the same things over and over, I'm not ashamed to admit that.   But - a frustrated me is better than an upset mom so I'll learn to deal with my frustration and try VERY VERY hard not to let that show to her.    As long as I can be loving and supportive WITH her, I figure I can be frustrated in private later.

Dealing with visits

Once I got Mom to move, I had a deliberate plan to get her settled, ensure the facility understood her needs then leave town to force her to get acquainted. Leaving her there and leaving town was harder than I expected. I didn't want her to feel dumped, isolated, lonely and despondent - I still don't. But, she HAD to get used to it and I needed a break from the emotional and physical demands of the whole situation.

In mid-April I got mom settled into a studio apartment at an Assisted Living Facility (ALF). I saw her daily for 3 weeks and the time was filled with hanging pictures, labeling clothes, sheets and towels; doctor visits; nail clipping; permanents and visits from other family and friends. Then I left town and promised to return in 4 weeks. While I was away, I called Mom every other day, some days she was fine others she cried and wanted to go home.

As promised I returned to see her and saw her daily for a seven days. It was really rough at first; each visit left me frustrated and in tears because she insisted she can live at home just fine. After 3 days I was a wreck and realized that I was feeling physically ill from the stress. To cope I came up with some ideas that enabled me to visit Mom, spend quality time with her and enjoy her company. I still have to be firm about the reasons she's moved - it is safer, she will get her meds as needed and she will eat better. It's become my internal mantra around mom - safety, meds, food - safety, meds, food - safety, meds, food..... To keep my sanity and be good company for Mom, here's what I try to do:

• Keep visits short but go often; stay 30-45 minutes, but go visit twice a day if possible
  
• Get funny: find a funny story, joke or something like that to share during your visit
• Read the paper together, helps keep parent current and give you some common ground
• Go sit outside: often it's the only time they'll get outside is with assistance and some sunshine is good for creating vitamin D
  
• Share a crossword puzzle
• Watch a special program: our favorite are Red Skelton videos and Turner Classic Movies
  
• Do projects: re-organize photo albums; I bought a cheap scanner and left it at Mom's apartment. On our next visits we will scan photos; it will give use time to talk about the subjects and people in pictures, capture interesting family histories, names, dates and relationships.
  
• Go "out" into common rooms for a soda or coffee and speak with other residents, then introduce your parent
• Attend events at the ALF like bingo, concerts or other outings
• Play games; play scrabble, cards, use the facilities Wii for bowling or golf
  

Think of things that would be meaningful and fun for your parent. Ensure that they are engaged WITH you not watching you. Don't forget to take your parent out to family gatherings, most ALFs will loan wheel chairs for easy transport.