Episode 63 - Transition - Part 2

Grandma wasn't sure why she was at the hospital.  Some of the time, she wasn't sure she was at the hospital or where it was.  She got the same questions from various people.  What year is this?  Where are we?  Who is the president?  After spending what didn't seem a very long time with her, the doctor took DH and I outside her room to say he was going to run some tests but she was mostly showing signs of dementia.  They would do x-rays to be sure she hadn't broken any bones in her recent fall.  She'd be meeting with physical and occupational therapists.  If all went well, she'd be released Tuesday.  Grandma wasn't too keen on spending the night but perked up when they brought her supper.  DH and I left a short while later.  I would be back tomorrow.

My plan for Tuesday included a stop at the bank and the assisted living/nursing home located a couple blocks from our home.  My bank business was swift, allowing more time at Cherry Ridge.  I spoke with the manager, got to see a room and was disappointed to learn that there were no openings and in fact, a wait list of 25 people for the 12 units.  The nursing home side didn't even have an opening for a female, but a wait list of 7 or 8 women.  Maybe this was a sign I had been praying for.  There is no room, because Grandma is supposed to stay with us.  I drove on to the hospital.

Grandma lit up like a Christmas tree when I walked into her room.  "There she is!!  There's my daughter!"  She told me she'd slept well, had taken a walk, had breakfast and answered some questions, though she really needed me to help with some of them.  Her nurse came in and said the doctor would be in later, but she would probably be released that afternoon.  A bit later, another staff member entered, identifying herself as an occupational therapist.  She had been the one who posed the questions to Grandma earlier.  We chatted with her for a few minutes, before the physical therapists came to work with Grandma.  Then we moved to a lounge to discuss the results of the morning's tests.

I felt a throwback to the elementary school parent-teacher conferences.  Looking at "my child's" papers, I could see clearly she was not at the top of the class.  She could pick out the triangle... and she knew what year it was (she should know by now... everyone keeps asking and correcting her if she's wrong).  Her comprehension and memory skills were below average if not failing.  She scored 7/30 which ranked in the "Dementia" category.  The OT was sweet.  I shared some stories and tips on how we've kept afloat the past fifty and one half weeks while Grandma lived with us.  As we parted, she told me we were doing a good job and the social worker would work with us to come up with a plan to best keep Grandma safe.

It was probably just past noon when the social worker came into Grandma's room.  The three of us talked about our house, schedule, what Grandma's routine was and so on.   Grandma was still picking at her lunch when the social worker said it had been determined that Grandma needed supervision all the time.  It was not safe for her to be alone.  "We work, but I'm only a few blocks away."  The SW asked me if I thought Grandma knew enough to push her lifeline button if she needed help.  I hesitated.  "No."  Her balance is poor.  She is subject to falls.  She could lie unconscious, bleeding or with broken bones until someone found her.  It was unacceptable and Grandma would not be released until a we had "a plan."

The SW gave me a list of agencies that provide in home assistance.  There were four pages, but none in our community.  No senior daycare where we live either.  I know from experience that Grandma does best with consistent routine and surroundings.  Having someone come into our home would likely be best - but the average cost of unskilled in-home care was $20 an hour.  That would be $160 a day with no provision for evening or weekend activities or respite.  I was numb.  "We need to have a plan," the SW said gently.

Dr. B's (the doctor from the previous night) nurse came in to talk about Grandma's release.  "Do you have a plan?" 

     "We're working on it," the SW responded.

     "I'll be back in a few minutes then," said the nurse.

A few minutes to come up with a plan. A plan that could alter the course of my mother's life forever.

     "I need to use the restroom."  I grabbed a tissue from the box and left the room.  I called DH and Belle's Daddy.  I had one on my cell phone and the other on the lounge's landline.

Me:  They won't left her go until I have a plan.

BD:  We can get a second opinion.  If Grandma was in her own environment, she'd get a lot more answers right.

DH:  There's no room at Cherry Ridge?

Me:  They don't offer 24/7 supervision in assisted living.  She needs more.

BD:  I can come down and have lunch with her everyday.

DH:  Is there any other care centers you'd want to check out?

Me:  I have to have a plan....

Two of the most important men in my life, trying to help me find a solution.  I'm crying.  Another visitor brings me tissues.  Why am I an only child?  I was barely allowed to make decisions growing up... I hate restaurants with menus... I can't decide what to wear and now I have to come up with a plan for my mother's well being.  What happened to my signs?  They have been reduced to a dollar sign and the fact that we cannot afford to bring someone into our house while we work, go to church, volleyball and live life.  We've likely left Grandma in harm's way the past many months when she had been home alone.  It has been a burden I've wanted to carry... but as in the words of my friend a couple episodes ago... I'm in over my head.

DH texted me the phone number to a reputable care center in McVille, a town 8 miles from where we live.  I called and was told they had a room for a female resident. I gave them my name and said I'd be back in touch.

I returned to Grandma's room where she is finishing her lunch.  I quietly tell the SW(through tears)  that I can get my mother into a care center in McVille.  She tells me in that case, Grandma can spend another night in the hospital and be released to go to the nursing home the next day.  This would give me time to get things ready for her move. 

The SW left and over the next hour, I went back and forth from the hospital room to the lounge.  Belle's Daddy checked the care center out online.  He gave approval on behalf of himself and his out of state brothers.  I went through multiple tissues each trip, returning puffy eyed to sit with Grandma while she watched TV and dozed.  Eventually, I sucked it up and spoke the words I had never wanted to have to say to her.

Me:  Mom, they won't let you leave here until I have a plan to take care of you.

G:  You need to make one.

Me:  They are telling me that you have to have someone with you all the time. Whenever we aren't home.  We'd have to hire someone to come into stay with you.

G:  Who's it going to be?

I cried the entire time I explained to her that as much as I wanted to, I couldn't keep her safe any longer.  She asked me why I was crying and I said because I wanted to take care of you. 

Grandma's response was similar to what any of us (as mothers) would have, seeing our child obviously distraught.

G:  It doesn't sound like you have any choice.  This is best.  I think your Dad would agree.

She was gracious, understanding and empathetic.  I probably could have told her I had to put her in a cardboard box and she would have said OK.  So although I had broken the news to her ... I would later learn her comprehension score had truly been 7/30.

DH came to the hospital when he got off work.  He made arrangements to take the next day off for the "move."  We told Grandma she was staying another night in the hospital, which was met with no opposition as soon as her supper arrived.  Since I hadn't eaten since breakfast, DH and I left at 6:00 to get dinner ourselves. 

The next day (Wednesday) would be hard - though I couldn't imagine any more difficult than this day had been. 

So ends Episode 63