My mother fell and broke her shoulder in mid-January of this year. Receiving the news about four days after the fall occurred, (a family member did not want to alarm us!) my mother was now resting in the hospital, albeit in a lot of pain, stabilizing her shoulder with round-the-clock bed rest. That bed rest led her to an episode of pneumonia, followed by congestive heart failure, pneumonia in the other lung, and a long rehabilitative process.
As a Financial Advisor licensed in insurance, and certified in Long Term Care in particular, I knew, intellectually, that her situation was the one I had most feared, having heard dozens of horror stories from clients about their own family members and their lengthy illnesses. But it was one that, at the same time, I had covered, by protecting her through a good long term care hybrid product that would provide her the medical benefits should her condition warrant them.
What I was not prepared for, however, were the physical, emotional and spiritual impacts of my mother's injury on myself and the rest of our family. Everything I need to know about Long Term Care I did not learn by studying the manual. I learned it by taking care of my mother, along with my brother and sister, both of whom live considerably further away that I did.
This is Part One of a five-part series on Long Term Care from an insider's perspective. For one can obtain the intellectual "book smarts" of understanding Long Term Care by sitting through the hours long mandatory training session, studying the manual and taking the exam. But one simply cannot learn the necessary lessons of long term care until you have witnessed it and dealt with it on a first-hand level. Until you care for a loved one of your own, none of the training material settles into one's mind, heart and spirit. Here is our story.
Receiving the News
During laundry chores, my weekend early morning tennis ritual already enjoyed and over, I got a phone call with the news that my mom was in the hospital with a fractured shoulder. My aunt's voice was weak, but she was calm. Younger by just one year than my mom, they had a pact of secrecy, trying to protect us adult children from the inconvenience that any bad news, ever, might bring. The accident, an early morning fall, occurred several days prior without any of us, other than my aunt, knowing about it. A trip for me to visit my mom was not even in question; I would leave that night, given that I already had plans to be in New York City, which was directly on my path to Allentown, Pennsylvania where my mom lived and was now hospitalized.
It was late into the night by the time I got to her room. Sleeping amidst heavy medications to keep both pain and insomnia at bay, she did not even know that I was there. It was not until the next day that she responded to me. Her state of confusion and sedation was bothersome to me, but I was assured that she was simply medicated in order to rest comfortably.
Multiple trips to Allentown during the course of the next few months ensued. For her bed rest led to pneumonia in one and then the second lung; congestive heart failure, blood pressure issues and breathing complications all took hold on my weakened, bed-ridden eighty-one year old mother.
By the time April rolled around, she had recovered from anything life-threatening or permanently disabling. Now in physical therapy to strengthen her shoulder, we were assured that she would soon be back home and to her normal self again.
Things are Not Always as They Seem to Be
The practical implications of long term care require that family members and friends step in to deal with the very real, daily issues resulting from someone being unable to perform activities of daily living. Long term care looks at the commonly accepted activities of daily living (ADL's) when assessing how able one is to live quite normally. They include: eating, dressing, grooming, bathing, getting to and from places or things, ambulation or being able to walk or move in a wheelchair, and maintaining bladder and bowel control. Once a loved one is unable to perform and two of these ADL's, long term care is generally required.
For elderly people in particular, falls are extremely common, and they can lead to serious complications as a result. Elderly people do not usually face mortality from a fall per se; they die from complications from the fall. Once a family member or friend has a serious fall, you must consider the practical implications. How often can you travel to visit and provide care for this loved one? What will this frequent travel require? Hotel accommodations, meals eaten out and time away from your job or career all exact a toll. If you are the only family member or friend available to help, how are you going to manage the additional responsibility of care? For how long can you maintain this responsibility?
In our own situation, since I was the adult child in closest physical proximity to my mother, I was the one who volunteered to make these initial frequent visits to the hospital. I wanted to make regular visits to check on her progress, and she greatly appreciated the company. A hospital is a very lonely place; your loved ones deserve your time and attention when they are temporarily placed there.
What we could not foresee were the very real issues of an extended stay in the hospital. Most of the time we had cared for our mother during other periods of illness or injury involved short stints; one or two weeks in the hospital followed by a brief stay in a rehabilitation center were commonly accepted modes of care. Perhaps requiring an out-of-state visit from one of her children, but perhaps not, these short treatments become part of most adult children's range of vision. Moving into care for our parents once they reach their eighties practically requires us to start thinking in terms of how real these medical treatments are or will become.
Longer treatments at the hospital, in rehab centers or assisted living centers are another story entirely. Out of their routines, our older parents get discombobulated, irritable, off-balance and unsure of what their future holds. Add to that the lonely and isolating experience of a medical institution, and the picture becomes even bleaker.
These practical issues must be addressed by all family caregivers. Trying to put yourself into your parent's shoes will perhaps yield a different picture than the one you might have drawn for their golden years. In our own mother's case, since we could not imagine ourselves being stuck in a hospital room or assisted living facility and enjoying it, we started talking about how one of us might take our mother into our own homes. What that would involve, practically, as we thought through the necessary re-alignment of our own lives and those of our own children? Whose career could best take the "hit" of this newfound caregiver responsibility? What were the implications of our mother leaving the varied medical practices she had entered into dozens of years ago, with her family physician and specialists viewed by her as her trusted advisors?
My mother's story continues. Parts two through five provide details of the rest of her journey, including financial, physical, emotional and spiritual setbacks and opportunities for growth. I imagine your story does as well.
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