2010-04-25

Where to start?

Life is being interesting these days. On Monday, March 8th my mother didn't wake up when it was time for her morning medications. I was a little concerned, but thought that she might just be really deeply asleep, so I decided to wait an hour and see if she woke up, and then waited another hour until I decided that this was just too long for her to be unresponsive to my shaking her shoulders, etc., and called 911, whose response in regard to my saying my mother wasn't waking up was to send paramedics and an ambulance right away. That would have been around 10:00AM, I guess, well, just a bit later as I got dressed before calling. I let the paramedics in, and provided answers to their questions while they checked mom out, and finding her still not responding, and her muscles being pretty rigid, pull on her arm and it would resist and move back to the same position, and apparently she had some slight vomit that I hadn't seen due to the positioning of her head, they packed her up and took her out to the ambulance once it arrived. I tried to track down our copy of her advanced directive, but couldn't find it at the time, she'd been thinking of redoing it and it wasn't in any of the locations I could think of, and I decided that getting her to the hospital was a bit more important than looking for the advanced directive. I rode in with them, taking the perspective that I could catch a bus home if need be but wanted to be there with mom and if I rode with them I'd get to the right place. Instead of going to Kaiser, mom being a Kaiser patient, we went to OHSU [Oregon Health Sciences University] Emergency Services, guess it was closer and they were not sure what was going on. Got checked in at Emergency, they cut mom out of her clothes which she hadn't taken off from the day before, discussed with me inserting an airway to keep here breathing clear in case she were to vomit or have problems swallowing, and while I know that mom didn't want tube feeding and various other forms of life prolonging treatment, this struck me as a reasonable preventive precaution, the idea of giving her a fighting chance. I'm not sure when they installed the catheter, but when they did there was a lot and nasty looking. They got her on an IV, and took her in for a CAT scan and had me wait in the waiting room at that time. That's when I called Beth, my older sister, to let her know what was going on, got her voicemail and left a message; Beth lives in Olympia, WA, and is a self-employed Piano teacher. Beth had been down jsut a few days earlier, on Thursday, to go to a meeting with mom's doctor, who was of the opinion that it was time to start looking at some variety of long term care, that mom shouldn't be living at home any longer, her dementia and incontinence, specifically the problems keeping clean, were such that she should have assistance greater than she could have at home, that we were past the help I could give with my own problems which were why I was on disability. Anyway I left a message on Beth's voicemail, and waited. After a while, long enough to read through the only interesting magazine and then some, they came out to let me know they were moving mom to ICU, that she didn't seem to have had a stroke or anything, but she was dehydrated and still hadn't woken up. So I went with them as they transported mom to another section of the complex, up to the 12th floor of another wing, possibly another building it's hard to tell, and had me wait in a waiting room while they got mom set up. This is the one section where I'm not happy with them, it wasn't made clear to me how I could get in touch with them when I was left in an unattended waiting room, I was there for hours without any contact. During that time Beth called me, her phone was out because of construction work cutting through the trunk line to her subdivision, the phone wouldn't have the physical connection repaired until the 13th, but voicemail worked since it was voicemail and not an answering machine, they'd borrowed a cell phone from a neighbor and had finally gotten a chance to check their voicemail and found out that mom was i8n the hospital, and that they were going to come down, they'd contacted her students and rescheduled the rest of the day, and Beth had a copy of the advanced directive and would bring it. About that time I said enough was enough, I was done waiting for someone to come talk to me and was going to go looking for mom. Turns out there was a phone on the wall next to the door which could be used to contact the nurses station, I called and told them I was looking for my mother [with her name] and they checked and said I could come back, so I did and found the nurses station and they then directed me on to the room mom was in. No, wait, they had come out while I was in the waiting room, three doctors, to ask me questions about mom, but no one had said how I'd be able to go back to see her. And being in a waiting room didn't do mom any good, but if I could be back with her I could at least hold her hand and let her know someone who cared about her was there. Which was what I did, held her hand and petted her head like she was a cat, to let her know someone cared and was there, she still hadn't woken up and it was late afternoon, but they were pretty sure now that it was a bad urinary tract infection, and it had started to go systemic, so they had her on antibiotics and saline, she'd gotten very dehydrated and her kidneys weren't happy with her. Oh, and I'd also called my uncle Richard earlier, to let him know something was up. I don't remember precisely when in all this I called Richard, but I think it was before I went on mom search. Beth and Karen [Beth's partner] arrived after visiting hours were over, and had a fun time getting into the building, but snazzy staff members helped them find their way to the proper area. They sent me off to get food, I hadn't eaten since breakfast, and we were now into late evening, and they talked with doctors whilst I was off. 10:00PM or so we decided that it would serve no purpose to stay the night with mom, so they ran me home and went to stay with Allison, a friend of ours who they normally stay with when they come to town. I think they'd already started calling students to clear Tuesday, the neighbor who'd let them use a cell phone had a spare cell phone that he'd sent with them so they could do phone stuff [good neighbor, yes].

Tuesday mom started to be somewhat responsive, but only somewhat, we weren't really sure how aware she was of things, if she was really responding to us or not, as the whole time she'd been having twitches, I'd forgotten about that until now, she'd been twitching a bit the whole time this was going on, from when I first saw her Monday morning, so the whole asking her to squeeze your hand or move a foot or whatever was totally bogus because she was having these twitches and you couldn't presume any meaning to them. Her eyes being somewhat open didn't mean anything. But once or twice it seemed that she was turning slightly towards the voice of someone talking to her, but we couldn't be sure she was really responding. Partway through the day they determined she had stabalized enough to be transported to Kaiser, and I again rode over with her, Beth and Karen bringing their car, and around this time B&K decided they'd probably be here the rest of the week and to start clearing her schedule of students, because they weren't heading back to Olympia until they had some idea about where to move mom after she was released, but it sure looked like it wasn't going to be back home. And boy were they glad we'd gotten mom to sign a Power of Attorney on the previous Friday before Beth had to go back to Olympia. We'd drawn up a PoA that named me as the Agent, and Beth as an alternate, but real quick we realized that I just wasn't up to what was going to need to be done, so Beth was going to have to become the primary. If we'd started out as Beth as the primary mom might not have signed it, which is part of mom being a bit weird, but she'd signed it and we could now shift it to where the person capable of dealing with stuff would be the agent. Things have blurred together in regards to what day and precise order, but we got Beth all the information on the various life insurance policies, IRAs, etc., which could help with funding, she already had the long term care insurance policies; I might not have been up to dealing with the various people and entities, but I was able to lay my hands on the information needed for Beth to do so. I do know that Wednesday mom started being clearly responsive, they'd taken the tubes out late Tuesday before we headed out for the night, Wednesday when I drove over she was in a chair, not doing well in regard to talking, but clearly someone was home. I honestly can't remember how many days she was at Kaiser, B&K had to head back up to Olympia and see about finding a facility to transfer her to upon her discharge from Kaiser, because they really had to handle things and that meant it would be best to find a place in their neck of the woods. I was in what I refer to as "deal with it" mode, with jsut enough adrenaline permeating my system that I was functioning well, so I was making it out to see mom each day while she was at Kaiser, staying until I could feel my edge start to fade and then get home while still safe to drive. Part of my problem is that I don't seem to produce adrenaline and various other neurotransmitters properly, so I can't be relied upon, too much day to day what will I be up to, and getting myself started on things, meh, totally undependable, the gradual decline from what I used to be able to do has me totally depressed when I allow myself to think about it. Anyway, B&K found a Nursing home/rehab facility in Olympia to shift mom over to, which they did, not cheap but very good, and she was there for the better part of a month, she's gotten back pretty much to where she had been before the infection, so it's been determined that an Adult Foster Care situation is what would be best, and Thursday I think they transferred her over.

The long term care insurance may not cover this, but it's more appropriate at this time. We're going to have to sell the Portland property to fund things long term. But that requires that we have someplace for me to move to. Due to my being on disability Medicaid will allow mom to set monies aside to help me, and my IRA is enough for a good sized down payment, but the order in which monies are made available is going to be crucial, if uncle Richard or my cousin Glenn can buy out mom's interest in the family farm in Grand Ronde that will cover getting me re-situated which will then allow for disposing of this property where I'm currently living, which has been "home" since 1976, even when I lived in Chicago for six years this was home. So as funds are made available there will be a search for a place near Olympia, in one of the lumber towns most likely, where the economy is really depressed and home values are down, for me to move to so I'll be close to mom and sis. And I have to start getting my stuff organized for a move, and this is something that is difficult for me, which is a problem for precisely the reasons they approved my disability claim. I've got to sort stuff, throw stuff away, recycle stuff, dispose of things to worthy homes, sell some stuff, whatever, drastically reduce what I have and determine what things I actually might use again.

One of the things I've always identified myself as being is an Oregonian, a fourth generation native born Oregonian, and that will become a thing of the past, I'll be moving and never coming back. Of course, another thing I always believed was that I'd marry and have children, at 48 that doesn't seem so likely anymore, so looking at keeping things to pass onto further generations doesn't seem to be a consideration at this time. Beth and Karen have raised Karen's niece, Caillie [or however it is spelled, Gaelic for dance or some such thing], and look to be passing things down to her, so the family stuff is being funneled to Beth for preservation and distribution.

Well, that's three hours plus of writing, and crying at times. Maybe I won't take so long before my next entry.

2 comments:

Peg said...

Oh Ian. I'm so sorry that you are having to make these changes. I hope your mom is better and that you have help. I wish we were closer.

Eri said...

Ian,
I, too, wish I were closer. Starting to do some of the same things you are.
This is a terrible blow. I hope and pray you all will have all the help and energy to do everything.
I wish I could help.
-Ferdinand, Darryl, Eri, etc.