Escalation

Well, things have changed suddenly and dramatically. Saturday evening my mother and I talked about the fact that I could not keep doing what I was doing. I know that I am burned out, because I’m starting to want to run away and that’s one of the things listed in articles about caregiver burn out. I’m also starting to have problems processing everything. I’m also beginning to realize that some of my mother’s demands — ones I was automatically catering to — might be somewhat unrealistic.

Anyway, she continued to assert that we didn’t need any outside help and I really didn’t need to stay there. She suggested that I could go home at night, that she would be all right and that she thought she might even be able to make her own breakfast. Thinking she meant her usual of toast and chai from a box, I agreed she might want to try.

So Sunday morning she got up and got right to it. But instead of toast and chai she decided to make toaster waffles which she had never made before. So she had to open the box, and read the instructions, put them into the toaster, heat up syrup and butter in a small pan, get out the dinner plate, get the large glass jar of pecans out of the refrigerator, try to lift the plates out of the cupboard… suddenly I saw all sorts of difficulties. Her dishes are a heavy pottery type, and it was difficult for her to lift more than two at a time. Since she has about six smaller plates stacked on six larger plates… she struggled.  With her shaky hands and weak grip I began to see all manner of potential problems. Even her storage containers are glass and heavy. And breakable.

I began to understand why my 90 year old stepmother habitually transfers things from their orignal glass or large heavy plastic containers into smaller ones…

Anyway, once the waffles were cooked in the possessed toaster oven, she cut up a banana to put on it, then the pecans. She also poured OJ.  All of it she did accomplish, but barely. I did have to bring the plate to her at the table.

Well, then it was time to go, my husband was at a race and knew he might barely make it, so had arranged to call me as soon as he arrived home.  When a half hour had passed after he’d said he’d call, I decided to just go. Mother had eaten a big breakfast and was settled on the couch. I was pretty sure with all that activity and food she’d be sleeping for most of the time I was gone, and felt confident she could get down the hall to the bathroom on her own if need be.

So I called home and left a message for my hubby not to come after all, and left. He never got the message. Instead, knowing he was late, he came straight to the house, had no key, rang the doorbell, Mother got up and hurried to open the door and in the process of figuring out which key to put in the lock, got tangled up in her walker and fell.

She did manage to get the key into the lock and let Stu in, but couldn’t get off the floor. He lifted her to the couch, and she had bruised knuckle, hurt her back on the walker and had a couple of abrasions on her head. She seemed to be functioning okay, but… we really, really, really didn’t want to go to ER on Sunday, for what might be nothing. (Been there, done that) She’d already fallen two times without injury and she was pretty set against going, herself.

Monday, she was having even more trouble standing from a sitting position, but that was something which had been going on for days on account of her feet. On Monday, however, she said it was not because of pain but because she seemed to have forgotten what to do. When the physical therapist came to give her her infrared treatment and we told her what had happened, she agreed about the hours in ER being very difficult for mother and suggested we call her primary care doctor and get an order for an x-ray at one of the radiology places. Great idea!

 Unfortunately, when I called the PCP, I found out he was out of town til the 18th. Because I had mentioned as an aside that I thought Mother might have fallen in part because of a drop in blood pressure when she jumped up off the couch, the PCP”S colleague who was covering for him refused to give us an order for x-ray and said we had to go to ER to get xray along with having the blood pressure sorted out.

Huh? I thought it was sorted out. But in the end we went. We waited two hours, sitting amongst people who were moaning, one guy who kept going to the bathroom to throw up, others who were hacking and coughing horribly. It was cold. Mother wouldn’t drink anything because she couldn’t go to the bathroom there. She still didn’t feel bad, except her feet had begun to really hurt. So I went to ask the receptionist what kind of wait we were looking at I was told 4 to 6 hours. That seemed way too long for the circumstances, so we decided to go home.

Perhaps that was a mistake… but in the end I don’t think so.

I left the light on all night and noted that she got up only once to go to the bathroom, which she accomplished without problem. But when I went into her room later to get her up, I found her sprawled across the bed, where she’d apparently sat/lay after the bathroom, unable to move herself out of that position. I used the sheet to pull her around so she was lying along the edge of the bed but even then she just couldn’t get up. Finally I could think of nothing to do but call 911.

The paramedics came, transferred her to a gurney and whisked her away. Even though their leader warned me the wait might be as long as the day before, and she might even be put out in the waiting room as before, it didn’t turn out so. I think the fact she couldn’t move or stand up contributed. When I arrived she’d not only been given a bed and a room, but they were wheeling her off to x-ray.  We did have to stay in ER almost all day, but at least she was lying down on a bed with a blanket and people came in with a bedpan if she had to go the bathroom.

The x-ray showed she had a break in a bone in her hand, and two compression fractures in her spine. They did an MRI to determine if either of them was new. One was, and could therefore be “casted” from the inside with an injection of bone cement.  Compression fractures typically heal on their own over time, but this procedure commonly reduces the pain almost immediately, allowing the patient to get back to daily activity far more rapidly than otherwise. When we agreed to pursue that line of treatment, Mother was admitted to the hospital.

This morning, they did the vertebroplasty, and I think it helped a little, though not as much as I’d hoped. When I saw her this evening, she was still having trouble even moving for the nurses to insert her bedpan.  Tomorrow the physical therapists will evaluate her and decide what should happen next. Might be in-patient rehabilitation, or she might have to be moved to a skilled nursing center with a rehab unit, if she’s not strong enough to do the three hours of daily rehab required for in-patient. The doctor even suggested she might go home, but I don’t think I could handle that. It was hard enough when she didn’t have a fractured hand, and apparently there are cancer lesions in other vertebrae to an extent the doctor was amazed she wasn’t on powerful pain meds at home.

And besides all that, her blood pressure, instead of being low, and gone back up again and they’re wanting to treat her for high blood pressure rather than low… I don’t think any of this could get any more complicated… Then again, sure as I say something like that, it will.

Anyway, right now I’m hoping for the in-patient rehab option at the hospital where she already is, since they actually have food she can eat and have done much to accomodate her dietary demands.

To be continued…

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3 Responses to “Escalation”


  1. 1 Gayle Coble February 10, 2011 at 1:56 pm

    You both are in my prayers.

  2. 2 KC Frantzen February 10, 2011 at 5:09 pm

    Karen,
    Just prayed for you and the entire situation…
    kc

  3. 3 Loren Warnemuende February 10, 2011 at 6:50 pm

    Dear Karen,

    Thanks for the continued updates. I’m praying for you and yours. Your mom’s situation reminds me so much of Kraig’s grandmother in her last few years (her situation was a chronic disease, so there was no long term chance of recovery). She *did* have in-home full time care her last couple years which eased the burden for the family, but it was still hard to see her struggle so!

    Anyway, all that to say I’m hearing your struggle and I’m praying!

    ~Loren


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