Posts Tagged: eldercare

Staying busy part 1: eldercare

Ever since I was laid off from my job in February, life has been exceptionally hectic. This seems completely counter-intuitive. This is because I obviously have much more free time than I did when I was working full time. Nonetheless, the free time seems to fill up fast with things that I either wish to do or that come up that I must do.

One huge thing that has come up is caring for my mother. This started the very day I was laid off when she fell and broke her wrist. About three weeks later, her left hip, which had been painful for months as the prosthesis from a much earlier hip replacement was rattling around loose in her femur, finally just broke. That is, her femur just started disintegrating. It was time to attempt a total revision of the hip replacement. This was a major undertaking that just a couple months before was seen as not worth the risks by an orthopedist at Kaiser Richmond. But now the risk of a failed surgery, becoming wheelchair bound, was already a reality.

The first orthopedic surgeon to look at her new situation, basically thought he could not do anything for her, but offered to refer us for a second opinion. The referral was to Dr. Bini, director of orthopedics for Kaiser East Bay. Dr. Bini was very confident he could fix her. “I can cut this and replace that; and if that doesn’t work, I have some other toys I can play with.” But he was very upfront about the risks: “For a 91-year-old, the anesthesia is dangerous. Or afterwards, she gets a clot and it goes to her lungs, that’s it. Or she gets pneumonia, which it’s unlikely she’ll recover from.”

We decide to move forward with it, and he schedules her for April 29th, at the end of an already full day of surgery for him. He just adds her in. So, there were three days of appointments for tests, including blood, urine, ekg, and biggest of all, a heart stress test with nuclear imaging.

Finally, she has the surgery. Dr. Bini calls me 5 or 6 hours after I left her with the pre-surgery team to say that the surgery went great, and that she came through it well. By Friday, she was recovering really well and they were planning on discharge to a rehab home the next day.

But the next day, Saturday, she started having terrible trouble breathing, and a chest x-ray showed patchy fluid throughout her lungs. It looked like pneumonia. By Sunday, she was moved to ICU, on an oxygen machine that helped keep her lungs inflated (bipapp?) and the doctors there were mostly talking to me about her health directive and “do not resuscitate” (DNR) status. We were all preparing for the end game. But I know these old Greeks, and her in particular. She’s too stubborn. Monday morning, the doc on watch suggested that she could be on the breathing machine indefinitely and that if she goes a couple days without change it might be time to think about pulling tubes out of her and just keeping her comfortable till the end. I said let’s see what we can pull back in terms of intervention and see how she does. So, over the course of a couple hours, we took her off the back-pressure oxygen, and got her down to just a little oxygen through a nose tube, not even a mask. And there started the big rally. The ICU docs were surprised.

She continued to improve through the week in terms of her infection and ability to breathe. However, she refused to eat, take her meds or otherwise cooperate in any way. Her lack of English, baseline dementia, and combination of lack of sleep and regular morphine all had her totally delusional. I was having to come in everyday to try to get her to eat and take some meds. By Friday, the ICU docs were again concerned that this was going to send her into decline again. And they felt like the hospital environment was a big factor in her disposition. They wanted to discharge her to a skilled nursing facility for rehab and focus on getting her on a normal routine. Saturday they did that, and sent her to Kaiser Post-Acute.  Of course, that didn’t change her attitude much. They called me this morning to talk to her about eating, letting them take her vitals, and starting physical therapy on her hip. I tried. Later in the morning, we (Sarah, Theo, and my friend David) all went there for a mother’s day visit, and to see what the situation is. I actually got her to eat several bites of pureed food (can’t blame her for not liking it), and let them get her vitals. It looks like that is going to be the drill for the coming days, until she gets oriented. Assuming she ever does.

Leaving Home For Good – Family Snapshot

The Grocery Cart #2

The Grocery Cart #2, originally uploaded by neocles.

My mother, Efrosini Serafimidis, will be 90 years old this month. For the last five years she has been living down the street from us in a little one bedroom apartment. We moved her up here to Albany from Fresno and the home in which she had lived for over 30 years. I was resistant to moving her at the time, but my cousins insisted it was necessary. It is not easy for a person in their 80’s to switch gears like that. She still complains bitterly everyday about this place, and I think she still is a little resentful towards me on that count. But she did okay for two or three years.

The last couple years have been increasingly challenging. She has had a hip replacement and big surgery on a broken elbow. Also, she has been pretty lonely during the days when we are at work, and the lack of interaction and stimulation has taken a toll on her.

The next move is now necessary. This month, Effie will be going to a board and care facility somewhere nearby. It is going to be hard to do, and the transition is going to be a struggle, I’m sure. But her hips are not holding her up very well, and she is suffering from some dementia. She has wandered off a couple times, but her incredible luck with coming across non-Greek-speaking people who are charmed by her old-country, head-scarved, four-foot-ten-inch figure has held up. Each time we got her back none the worse for the wear.

Of course, Sarah and I both work full time, and have a five-year-old to attend to. And living in the Bay Area has its own challenges. So, I would not say I have been an overly conscientious caregiver, but nonetheless, I see her and give her her meds almost every day, try to keep her reasonably safe and fed, bring her back and forth to my home, clean her apartment, pay her bills, take care of her legal and financial matters, manage the renting of the family home in Fresno, and so on.

Chief among the challenges of moving her to a care facility is going to be the dissolving of her apartment home and figuring out what to do with all the things in it. We got rid of a lot of stuff when we moved her to Albany. But a lot of stuff is still packed away in her apartment. I am very nostalgic about these things and have a tough time just trashing them even though they are otherwise pretty worthless.

In response to all this I am planning a photo series. Right now the idea is simple snapshot-like photos of, basically, every object in her apartment. Where possible, descriptions will accompany the photos. Eventually, the series will include photos of each and every object I still have from my parents. I may be an old man myself by the time I finish.