During the 3 months that I was near mom and dad’s winter home, I endeavored to establish a complete support system around them. Using suggestions from the Area Agency on Aging and from the private Case Manager’s assessment, I obtained a number of services for them. These services included the emergency call system, meals on wheels, a homemaker 4 hours per week, a visiting nurse who came monthly to give dad his shots, a case manager who came out periodically to assess dad’s needs, a plumber to repair the bathroom floor and toilet and a number to call for emergencies (for additional services as the needs became apparent).
I went home confident that I had done my best. I had not accomplished my primary goal (which was to convince them to move to an independent care facility where there were 3 meals a day provided and 24 hour nurses if needed.) However, I felt relieved that at least they had someone coming every day to bring the meals on wheels, weekly to do light housekeeping and shopping as needed, and the nurse would be checking both mom and dad monthly.
In addition during my 3 months there I had accompanied mom and dad to all their medical appointments. Dad had emergency surgery in February and an emergency tooth extraction just the day before I left, but otherwise seemed to be in good physical health (other than the Alzheimer’s). Mom, on the other hand, had several chronic problems. I had accompanied her to about 2 to 3 medical appointments per week including pre and post testing for some procedures as well as regular appointments with her eye doctor, medical specialist and general physician. I scheduled all these appointments with the goal of finishing as many medical appointments as possible before I left. Mom and dad planned to go to their summer home in the north just over a month later.
Less than 2 weeks after I got home, mom cancelled all the support services I had scheduled for them! She told them all they would be leaving soon for the north. However, she still had one important medical appointment that had been postponed. The doctor’s office called to say he was going to be out-of-town and to reschedule her appointment. She was supposed to have follow up-blood tests after the medical procedure and they didn’t get done. May turned to June and still no follow-up tests and appointment were scheduled.
In the meantime, over the phone, mom was starting to sound more and more agitated. She was easily upset and sometimes rambled on about things that didn’t make sense. Mom had always been the rational one who handled all the financial and medical needs for both dad and herself. Now it seemed she might be unable to follow-up on her own blood tests. I called her doctor and told them my concern that the blood tests should be done and she should be seen because of the increasing dementia. Finally in mid-June she had the tests and the doctor wanted to adjust her medications and see her again in 2 weeks.
Around the same time, mom started to worry about issues that had been taken care of decades ago. She was worried about bankbooks and property owned by her siblings and parents who were now deceased. Somehow she concluded they had forgotten about it and the property was sitting uncared for and the money would revert to the government if she didn’t contact them. I couldn’t convince her that these issues had been settled up to 50 years before. She started telephoning me 3 or even 4 times a day with her worries. She was calling my brother as well.
I found it worked best to just tell her not to worry, that I would take care of it. My brother tried to argue with her and convince her she was wrong which just got her more agitated.
One Friday in early July she called me for about the 3rd time after dinner to tell me she was afraid. Things were happening around her and she wasn’t sure what was real and what was just a dream. “I feel like I am living in my own nightmare and I can’t tell if I already had my pain appointment or if I am still supposed to go for it. I don’t know when I’m dreaming and when I’m awake.” She was clearly hallucinating! What could I do from 1000 miles away?
I telephoned her doctor’s after-hours line. I finally reached one of his colleagues who told me to take her to the emergency room. I had to turn to her friend, Essie, for help. Essie was very ready to help as it turned out mom had been calling her from early morning to late at night with questions like: “What day is it? What time is it? I think I have a doctor’s appointment” (when she didn’t).
Essie took mom to the emergency room. They determined her blood pressure was extremely high and her blood tests were abnormal. She was medicated and observed for hours and then sent home with instructions to follow-up with her physician on Monday. Fortunately her friend, Essie would be able to drive her to see her Monday office visit.
The aftermath of this emergency room visit would change everything…