Fall after fall after fall

South side of the building,
where people who can walk live.

Wednesday, Thursday, Saturday, Sunday. I got one ride in, and not even an hour of writing. I don't know if it's really need, or my own compulsion that keeps me going there -- my desire to come through this and have no regrets, no wishes that I'd done more.

I reserve the right, though, to be cranky.

She's had three fairly mild falls in the last three or four days. She doesn't understand -- and who would -- that the way she gets places is by sitting, not standing and walking. So she stands and falls. When I push her in the chair and we stop for a moment, she moves as if to get up, and if there's a railing nearby, as in church, she pulls on it to stand.

Her efforts to get up, and her falls, have forced the aides to put her in the penalty box -- right out in the hall by the elevators where they can watch her. It's a more social venue anyway than in her room, more people passing and saying hi.

She was good yesterday and today, her color good, her mind working pretty well. I took her down to the bistro yesterday in an after-dinner visit, where we ate Dove bars. Mom spied a woman sitting alone, crooked her finger at her and gestured for her to come over -- ordered it, almost -- but the woman declined, and Mom went back to her Dove bar. It's interesting that, even in her dire state, she doesn't really mope, but seeks connection. Any random stranger will do.

So I went back to take her to chapel today. (Going to the regular church, which necessitates a drive, is just too complicated.) I love the services in the chapel. Religion works best in times and places of trying circumstance, and Mom's time and place fits the definition.

Today there were maybe three dozen people, and only about about three-quarters of them could stand. The hymns are sung with gusto and affirmation, the prayers, oh dear, the prayers, are beyond touching. They start with calling on blessings for the world, then the country, the state, the city and right on down to the place and the congregation.

Then the reader names those with birthdays this week, and then those, invariably absent, who have asked for intercession -- "Georgie, Ted, Fred, Maureen, Bob, Marie Christina," 12 or 15 names -- and the reader says, "and those we name, either silently or aloud," and quiet calls rise up from the pews, "Sister Ann, Roger, Jim." The first time I heard it, I cried.

*

Julie and I and Mom made a post-church visit to Mom's room, and coming back, an older, shaking woman named Judy got on the elevator. She said, "Well, M___. Do you remember, the first day you came here, the very first day, you were down by the entry and you said, 'Can you sit with me? Can you talk to me?' So I sat down and we talked."

She was confused that day, scared, in a whole new place. I'm only sorry I wasn't there myself.

*

Young son E, on his way to making something of himself, has published a piece on the trendy website N+1, about growing up next door to Scott Walker. It's a lotta fun. Check it out here. 

Night ride

A changing landscape

Calatrava in full flight

It's hard to know what to think. I saw her Wednesday for dinner and she looked awful -- pale and cadaverous. After we ate she wanted to lie down, so we went to the room and she got in bed, then wanted her nightie on, so we got her up, but before we finished that, she said she had to go to the bathroom, and in the middle of that two aides came and said it was time for her shower. She was exhausted and wanted to beg off, but they went ahead, which I thought was good, and I left.

Then yesterday I went in the morning, and she was great. Having breakfast with G and B. Good energy, talked -- a nice morning. Everybody confirmed that both days she had gotten therapy, which the first week, only thanks to Sister K, did it happen at all.

So today I went again, and again, she struggled in the afternoon. Julie had been there midday and was told by an aide that she had hardly slept all night. So when I got there, she didn't know where she was, where she lived, where I lived, where she ate, did she have to pay, and on and on. Even after little sleep, she'd had a big day -- watched Al's Run, which comes right by the front door, and, when I found her, had just finished a snack while an opera singer entertained.

She was exhausted, and I took her to her room, tried to get her into bed, but she complained as to method and final arrangement, so I called in an aide, who did it just right. And finally I left, promising to take her to chapel tomorrow.

This move to rehab has been an upheaval for her, and she complains more than usual about her loneliness, though between Sister K (last week) and Julie and I, she's been visited at least once a day.  Next week, there'll be a staff meeting on her situation, and then on Thursday, she and I will meet with a social worker about getting her regular visits with a private aide -- three hours of companionship, basically, on weekday afternoons.

She never has been able to entertain herself, and now, unless someone puts something in front of her, she just lays there.

The time, the care, the effort, and the push-pull with the staff has just about doubled in the week since she returned from the hospital.

TosaFest
You know, it's not such a bad look. 

What if one of us wasn't there?

Kites on the lakefront

Sister K has been here all weekend, working virtually 24/7 on settling Mom in to the rehab wing. It's been hard to get Mom the care she needs from the aides, who seem indolent, and to get her to her therapy sessions. It's not clear even if she's supposed to be brought to therapy, or if the therapist is supposed to come and get her.

Time and again, when K shows up, Mom hasn't been tended to in one way or another, or in several ways. She's not been dressed, or not been brought to breakfast, or not been taken to therapy, or she has to go to the bathroom, or she tries to stand when she shouldn't. Today at breakfast, K said, Mom stood and her wheelchair rolled away from her. It stopped at a nearby wall, but there might not always be a wall there.

K asked an aide, Why not put the brake on? "Because that would be a restraint, and we're not allowed to restrain them."

Such crap. It really makes me angry. If you're not going to put the brake on, YOU GOTTA BE THERE WHEN SHE STANDS.

Julie had a friend who said Mom's elderly housing place is great -- until you get to rehab. And that's where we're at right now.

Still, I've seen Mom walk since her surgery -- with a walker, with someone holding her firmly -- and it is cheering. But it doesn't solve any real problem. She'll always be unsteady on her feet; she'll still freeze and jitter in place. She'll need a wheelchair for most movement, and that means she'll need a pusher. Kari's taken her out several times -- to Walgreens and around -- but that won't happen if the aides are all she has. I'll take her out when I can, but I'm not there all the time, and she'll spend a lot of time alone, in bed.

K says she's begun to fret when she's alone; she's full of anxiety. After all the attention at the hospital, the reality of her situation has hit home.

K thinks we should hire private help -- somebody to come in the afternoons, make sure she gets therapy, stays up and about, and provides company. So K and I will look into that.

I think Mom's decline is kind of like global warming. You have a cold day and you think, no, it's not really happening. But it doesn't change the science. Mom has a good day and you think, maybe she's improving. But it doesn't change the science.

The Fellowship of the Strings
TosaFest

Guest post

Update from Sister K, who is in town:

I arrived yesterday at 1pm and found Mom dozing in her bed. Two minutes later D and C showed up for a visit, and there was a steady stream of caregivers and guests all afternoon, including Al and An from upstairs. 

At 5 we went to dinner and ate near Pat and Grace, both 94 and 100% present, and the meal was silent but not unpleasant. Be arrived but in an unsociable mood due to leg pain so she sat alone in the private dining room. A mild-mannered married couple sat at their own private table next to the group table and spoke a mixture of English and German. 

This was part their conversation during the dinner of what was called "pork marsala":

M: Wiener schnitzel!

W: Well, it isn't advertised as such so it can't be held accountable for what it doesn't pretend to be.

M: There is recognition in the audience!

(Later)

W: The pork is good if you take off the breading and dip it in the sauce.

M: Well, mine is completely breaded -- it wouldn't be wiener schnitzel if it wasn't.

W: It isn't wiener schnitzel, breaded or not.

After dinner Mom had a thorough "bed bath" with wonderful aide Ay. Jon came and we all chatted for awhile and then Mom was ready to sleep and Jon and I went out for a drink.

This morning we ate breakfast with Be, who was in a much better mood, and the gracious Grace. They reminisced about time spent in NYC. Mom could not really follow but her comments were somehow melded in and she seemed to feel a part of things. The social time wore her out and she zonked for about a half hour. 

At 10 she was taken to PT in the basement for an hour and 15 minutes! When I left her there she was doing an arm workout like pedaling. She can walk with her walker for short distances and with lots of support. Tomorrow I'm going to stay and watch the whole thing so I have a better sense of what they do with her.

She took a huge nap after PT and then I dropped her off for a late lunch at 12:30 (everyone was still there and a bevy of student nurses were chatting them up). I went for a run and returned at 2 to find her asking after me. 

She couldn't really sleep much in the afternoon so at about 4:30 I took her upstairs where we visited her old room and sat in on trivia for a little while. None of it seemed to stir her memory too much, but she happily greeted the staff members and they hugged her. Julie came by for dinner and we ate with Ja and Be. Mom was exhausted after dinner and went to bed before 7. 

Mom is pretty confused about what's what and where she is and where she's been and what's happened to her. When she visited Mom, An kept saying "Mary, I'm soooo sorry about what's happened!" Finally Mom said, "I'm getting pretty sorry about it too the more I hear about it!" She has no memory of her hospital stay or the surgery, or that she used to live upstairs.

That's the news. I'm sitting near the bistro as I write this since I have no wifi in the guest room. During her naptimes I'm keeping busy with my homework since classes have started.

Full credit

Mom with her walker,
surveying Julie's garden in early August.

It has all happened so fast, this decline. She fell a third time last night, after the ambulance had brought her back to the elderly housing place. She has been moved to the skilled nursing unit -- nurses always present -- and in trying to get out of a wheelchair, she fell down on her knees. No injury, but what is skilled care about except for preventing falls like this? Any transition from bed to wheelchair to table or whatever MUST BE ASSISTED. 

Her new room is small, I would say less than half the size of her room upstairs. It's got a single bed, not the queen she had before, a small closet, a dresser, a TV, and a bathroom. We are slowly moving clothes, toiletries and everything she needs down from the assisted living room. They're holding it for her for now, but she may not move back. 

She has lived through a lot of upheaval in the last year and a half -- moving to a new place in a new city, moving from independent living to assisted living, breaking her hip, spending days in the hospital, and now moving to a whole new room on a whole new floor. All of this, of course, after my dad died, after her heart surgery, after falling and breaking her elbow, after breaking her kneecap, and after Parkinson's set in. I don't know that I could have lived through any of that without falling into despair, but she has handled it with a kind of grace and sense of acceptance that is remarkable. I give her full credit. 

We've made visits daily since this happened, Julie making as many as I have. The church sent flowers Sunday, and she's had a couple of visits from the pastors. She naps often and thinks that anything that happened before the most recent nap happened yesterday, which I've stopped trying to talk her out of. 

I talked to a nurse yesterday, and will meet with a social worker maybe this week, to plan ahead in case there are decisions to be made that she may not be able to make at some point in the future. It was sobering.

I didn't think this would be this hard.

Humbug

Door County

Mom's going to be in the hospital another day or two, getting out maybe tomorrow or maybe Monday. 

I saw her today and she looked pale and wan and wanted to leave. I felt bad for her. It's dull there when they're not tending to her, and she doesn't read or watch TV or do anything to entertain herself. I read her her mail -- Dot, MM -- and she liked that, and we discussed her junk mail piece by piece and threw it all out. It was something to do. 

I stopped at her place and met the rehab nurse and went upstairs and checked Mom's email. That room will stay hers until they know what's what. 

I think, soon, she'll need constant care. I can't see her bouncing back from this very well. The nurses say she'll get her strength back with therapy, but she didn't walk well before she fell, and to risk the other hip? It's not worth it. 

This property for sale -- seriously!

The broken hip

Hospital room view

Mom fell in her room Tuesday afternoon and broke her hip. Scraped her arm and knee pretty good, and said she waited "an hour" for the aides to find her writhing on the floor. But 10 minutes to Mom feels like an hour, and it might not have even been 10 minutes.

She had surgery Wednesday evening, and it helped moderate her pain, but if she walks again, I will be surprised. She fell using her walker, and before and after her fall of a week and half ago, she has had regular near-falls with her walker, and has gotten less and less steady on her feet.

It's been a difficult week, trying to finish my work, running to the hospital and back, sitting with her, she and I both bored, and waiting in the waiting room, me just as bored. Her thoughts and speech have been jumbled, and today when the case manager at the hospital called and said that, "because of her confusion," they would invoke my power of attorney in her move back to her place (to the rehab unit there), it shocked me a little. Not that I haven't been doing that work, taking that responsibility, right along -- but to hear from an outside professional what we privately observe as her wild state of mind threw into stark terms the depth of her decline.

Laying in bed, she has rambled intricately and impossibly between her old home, her summer place, the hospital, her elderly care place, and between people present and gone, bringing up her mother, her childhood, me, my dad, her children, somehow confusing them with Julie. When the nurses ask her a question, she'll answer in a reasonable tone, and with proper head-nods of emphasis, such a pastiche of utter nonsense that they are forced to answer "OK, OK," and look to me for an answer.

If I'm there.

I'm not going today. It took a broken hip to get her the constant care and attention she so craves, and she is well occupied. When they leave the room, she gets somebody to call me and when I answer she complains to me bitterly that the hospital staff is "not doing anything. I'm just lying here and they're not doing anything." It makes me want to scream.

The care, the need, the time she requires will only grow when she leaves the hospital -- likely tomorrow -- and settles into some unsatisfactory new state of life.

My friend Tom, and others I know, have said their elderly parents never recovered from a broken hip, and some died right there at the hospital. I don't wish for that -- and yet she is leaving bit by bit.

That same orchid