DON’T BE TOO IMPRESSED with the magnificent chandelier hanging from the ceiling or the tastefully furnished lobby. A nursing home is a nursing home. It’s not the best answer, but sometimes it’s the only answer.
Mom grew very frail when she entered her 90s. She’d already been diagnosed with late onset Alzheimer’s. At age 91, she fell and broke her right hip and shoulder. At 93, she broke her left hip and, at 95, she fractured her pelvis. Surgery was out of the question for the pelvis. Her bones were now porous and brittle. From that point on, she was wheelchair bound. Mom was taken to the hospital, and then transferred to its rehabilitation and residential skilled nursing-care facility. She was placed in the Alzheimer’s wing.
I was spared having to formally admit her. I don’t think I could have. But as providence would have it, the timing of her admittance was beneficial—because shortly after she required major surgery on her liver. This came to light because I noticed she was becoming jaundiced, and I immediately reported her condition to the head nurse.
Fearful because of her age, I asked the doctor if surgery was a necessity. He replied that she would die in terrible pain without it. That settled the question. But the doctor also told me if there were complications with the surgery, he wasn’t going to do anything “heroic.” Somehow, at 95, she survived and lived another three years, but with worsening dementia and more medical problems.
A nursing home patient needs a strong advocate—something that’s imperative for those who aren’t able to speak for themselves. The care of your loved one depends on the health care workers, who are often understaffed. Problems can be overlooked or, worse still, dismissed. The nurses do their best, but are harried and under pressure.
The majority of hands-on care boils down to the aides, who handle the everyday routine tasks and have the most frequent contact with patients. Some are caring angels who go the extra mile. Others do the minimum that’s required of them in a desultory manner, while still others seem totally unsuited to their vocation. Staff turnover is high. In reviewing my concerns with Mom’s doctor, he did say the facility had good ratings but that all facilities have their problems.
I entered a state of mind known as anticipatory grief. This is the distress a caretaker feels for months or even years when loved ones have a serious and often lengthy illness, such as advanced cancer or Alzheimer’s. Watching your loved one deteriorate is a disconcerting, numbing, unreal condition which becomes more palpable as time passes. It’s the loss you feel before the final loss. You long for the person you once knew—the friendship, the intimacy.
My health suffered and I had no personal life. I became preoccupied with Mom. With each visit, there was some issue to deal with. Her hearing aids went missing. Her dentures were broken. Sometimes, she was dressed in another patient’s clothing. Each day, I’d help her with the noon meal. On one occasion, when they were short of aides, they allowed me to give her a shower. I still don’t know how that one passed muster.
On nice days, I’d take her to the adjoining garden. She liked me to paint her nails. It seemed to calm her, and ease her constant fidgeting and repetitive movements. There were days she was agitated, and had hallucinations and paranoia. One day, as I gathered her laundry, she accused me of stealing her clothing—but to the end she retained her sweetness.
I may have been part of the problem at the nursing home. I was so accustomed to caring for Mom that I never wanted anyone else to touch her. She was my treasure, my mom. I scrutinized and checked on everything. I stayed too long. I think the staff was relieved when I left to go home.
I would get to the secured doors of the wing and something would restrain me from leaving. I was gripped with anxiety. Had I checked the hearing aid batteries, made sure she had a little snack, freshened her water pitcher? I would then walk back to her room—any excuse for one last check. My reluctance to leave her was so great. Because of her severe hearing loss and mental confusion, I constantly worried about her ability to communicate with the nursing staff.
When Mom died at age 98, she was in a coma-like state. She had succumbed to pneumonia, as many Alzheimer’s patients do. We were unable to communicate. But while holding her hand, I felt three quick spasms from her fingers. I knew at that point she had passed. These were probably electrical impulses, but I like to think it was her way of saying goodbye and that she loved me—always.
Mom’s favorite song was Always, written by Irving Berlin. It’s a song of enduring love. The last words of the song echo my feelings for Mom.
“Days may not be fair always
That’s when I’ll be there always
Not for just an hour
Not for just a day
Not for just a year