Prepare now

The quiet life of my 86-year-old parents was shattered when Dad fell at home on Jan. 2 and was hospitalized. Three days later, Mom went bonkers and tried to pull out Dad’s IV tubes so she could take him home, striking a nurse and screaming at the policemen. She was sent to a geriatric psychiatric unit where they managed her medical issues, diagnosed mild to moderate dementia, and declared her incompetent. After two weeks, Mom was transferred to a skilled nursing facility with a dementia unit and “wander guard” to keep her from leaving the building.

Meanwhile Dad spent four weeks in a skilled nursing facility. He had good days and bad days, quiet days and angry days, with lots of confusion, forgetfulness and pacing the halls trying to figure out why this had happened to him and how he could get their life back the way it was.

At a patient-care conference in mid-January, Dad, my partner, my son and I met with the discharge planner and social worker to discuss Dad’s progress and plan for his discharge. The choices included round-the-clock home health care or an assisted-living facility. After a long conversation with my brother and sister, who live 500 miles away, we decided to take Dad home for a month. We thought it was worth the $18 per hour to see how much Dad could regain of what he’d lost.

At this writing, Mom has been in her skilled nursing facility for five weeks. She has periods of mental clarity interspersed with moments of believing she is shopping in Rochester, N.Y.—which she hasn’t done in 40 years—or that her husband has run off with a younger woman. She also gets very angry and yells at her professional caregivers, at me and at other family members. Dad has been home with round-the-clock care for two weeks. We all see some improvement due to his being in familiar surroundings, eating good-quality food, getting better rest, having quality vitamin-and-mineral supplements, and taking regular walks outside.

Although the physical demands of having two parents in different facilities have been very difficult, the really overwhelming part for me has been the emotional roller coaster. Growing up as the oldest of three kids, I felt a constant tension between my parents—a subtle, ongoing, unspoken discontent. Over their 64 years of marriage, it gradually transformed into regular angry exchanges. The first time we took Dad to see Mom at the hospital, their conversation was initially pleasant, until Mom began asking questions that Dad couldn’t answer. He hung his head and said: “I don’t know. I wish I hadn’t come.” Mom then lashed out at both me and my partner. Fleeing to the nurses’ station, I asked the social worker to join us. What a relief to have an experienced, neutral person help Mom and Dad navigate those long-standing emotional rapids!

Before the next visit, we arranged for the social worker to be present. This time Mom said she didn’t want to see Dad; he was devastated and crying. Mom wanted money; Dad gave her some, and she gave it back. I could feel both parents’ anger, fear and hurt, as well as my own. I felt like a 10-year-old child again, trying to make my parents happy. I couldn’t do it back then, and I still can’t.

Another time I spent more than an hour registering Mom into the skilled nursing facility, including 17 signatures and 10 initialings. I returned to her bed and told her that I loved her. She replied, “No, you don’t.” At that moment, I had a huge awareness: If I looked at my mother and saw a 2-year-old, I could keep my heart open to her and not feel hurt. Wow! That insight has saved my heart—and my sanity—several times. A wise person advised me that the best place for me now emotionally is what he called “detached compassion.” And I’ve decided to see a therapist to deal with my surfacing anger issues.

For several years before his fall, Dad had complained of a growing inability to remember things. The huge stress of the current major life changes has exacerbated the problem, and he constantly voices his frustration. I want to change that too, regaining the father I remember—the one with the amazing mind and memory.

I’ve found many valuable resources on this journey; here are just two. I began attending a wonderful group, the Caring for Aging Parents Education and Support Program, which meets at Mission Hospitals’ Women’s Resource Center. For information, contact Nancy Smith-Hunnicutt in Senior Services (213-4542) or Kate Zurich at the Buncombe County Council on Aging (277-8288). Another great help is the “Licensed Nursing Homes & Adult Care Homes Guide in Buncombe, Henderson, Madison and Transylvania Counties” prepared by the Land-of-Sky Regional Council (251-6622 or www.landofsky.org).

Finally, if you haven’t already done so, please, please, please find a lawyer who specializes in elder-care law to help you prepare two essential documents: a durable power of attorney specifying who will handle financial affairs and other aspects of life if the person is unable to, and a health-care power of attorney.

Many of us are in denial about our parents’ aging and ultimate death, but it will happen. Talk with everyone involved, and start preparing now.

[Holistic nutritionist Elizabeth Pavka provides nutritional counseling, teaches classes, consults with organizations about wellness, and speaks to professional and lay audiences. Contact her at 252-1406 or epavka@main.nc.us.]