Thursday, November 13, 2008
One wrong step and....
By Claudia Ricci
A couple weeks back, my 82-year old mom was just about to get into a taxicab on Lexington Ave., right outside Grand Central Station in New York, when she stepped into a pothole. She collapsed in a heap, fracturing one ankle and seriously spraining the other. In minutes my sister had whisked her over to the ER at NYU hospital, where Mom spent an excruciatingly long seven hours having her ankle positioned (think pulling and tugging the bone). The young orthopedic resident set the bone, placed the cast, and then Xrayed the leg. Nope, it wasn't straight enough. The doctor repeated this painful procedure five times, yes, FIVE times, before she was satisfied that she'd gotten my mom's leg "right."
The next day, my sister and my Dad and my mother took a six or seven hour ride in a very bumpy cabulance, in a snowstorm, to reach their home in Massachusetts. My mother's leg, cradled in my sister's lap, bounced the whole way.
It is difficult to put into words how much pain and trauma and suffering this accident has caused my poor mother, and how much angst and stress and up-in-the-middle-of-the night worry it has caused the rest of the family.
But let me just say that today I am lying here in bed. I think all the stress of the last two and a half weeks has finally caught up to me. Oh, I suppose I could say it was that bad bowl of cream of spinach soup I ate yesterday afternoon that caused my stomach to turn volcanic last night. But honestly, I think the volcano that erupted really has a far wider core.
I know I've never worried more about my mom than I did on Monday night. Monday was the day she was discharged from the hospital where she had surgery a week ago to pin her ankle, which had four breaks. The doctor, in discharging her, insisted that she needed to go to a nursing home, so we selected the one we had been told by a trusted friend, had the best reputation.
Well, OK, I guess that reputation must have been earned one way or another. But when I got to the nursing home Monday afternoon, I had all I could do not to turn around and run out the door. The smell was overpowering. The lines of wheelchairs and reclining chairs, occupied by semi-comatose white-haired old folks, staring idly into walls and ceilings, gave me a feeling of dread I can hardly describe. I steeled myself and headed quickly for Mom's room, where I found her in tears.
The air in her room was so hot she could hardly breathe (and she's asthmatic.) Her bed was covered by a three-inch air mattress into which Mom had sunk like a hotdog in a roll. The lighting overhead was so dim you could't possibly read. There was no telephone in the room, and no TV or radio, and the woman in the next bed, a three-and-a-half year resident of the nursing home, was hardly able to communicate.
Mom told me she had repeatedly pushed the buzzer for the nurse, but nobody responded. So I got her up to go to the bathroom, using the walker. It was so frigging hot in the bathroom that I felt dizzy. Mom broke down crying, and I had all I could do not to join her. Here was my mother, a perfectly healthy woman just two weeks before, imprisoned in a nursing home where she couldn't even catch her breath.
Shortly afterward, I asked the nurse to check my mom's blood oxygen level. It was below 90 percent, which isn't good at all. I told the nurse my mom had been on oxygen in the hospital, and that the air there in the nursing home was making it hard for her to breathe.
The nurse replied, saying that my mom had no order for oxygen, which shocked me. (As it turned out my mom DID have an order, but the nurse either didn't know that or didn't CHOOSE to know that.)
What shocked me even more was what the nurse said next. "I know the air quality in here is awful, it's really stagnant." The male aide joined in to say how bad the air was.
Shudders passed through me. The nurse then left the room and came back with a fan. They set up that damn fan on my mother's nighttable and proceeded to blow the dusty stagnant hot air at the back of my mom's head. Wonderful therapy for an asthmatic!
Leaving my mother in that nursing home that night was one of the most difficult things I have ever done. But what could I do? She had a huge cast on her leg, and she could not even negotiate her way into my car, let alone the long walk up the leaf-covered sidewalk to the door of my old farmhouse.
So I had no choice. I worried about her all night, and as it turned out, I had reason to worry. An aide came in to give Mom a bedpan in the middle of the night and because of that ridiculous air mattress, the bedpan spilled. My mom woke up to find herself and her bedsheets soaked in pee. She bawled for who knows how long, until some kind young aide discovered her in the morning and cleaned her up.
Yesterday, I got on the phone and started making calls. I found a rehab center, checked on it with some contacts in the area, and discovered it had an excellent reputation. Miraculously, they had a bed. Within a few hours, my dad and I had transferred Mom out of the nursing home, and into what appears to be a top-notch rehab center.
I spent six or seven hours there yesterday and I am delighted to say the air is good, and the nurses and aides very attentive. The other patients in my mom's wing are all, like her, short-term residents anxious to get back home and into their lives (before her accident, mom was attending an exercise class three times a week.) They have phones and a TV. But even more importantly, they have a fabulous occupational and physical therapist and they do four hours of each therapy every day!The physician who checked in on mom last night was so compassionate, so insightful, so sharp, that I just sat there smiling, and thinking, ah here at last we have an all around bright light.
So there is good reason for hope.
About four o'clock yesterday, I took a break from my mom's bedside and went out to get some food with my cousin, who was kind enough to help give me moral support as I made my mom's transfer.
"You can relax now," Pat said over our bowls of soup. "Your mom is in a good place. She even smiled and joked this afternoon."
Yes, my cousin was right. Things seemed so much better. And yet, my stomach was still very literally in knots. My heart was still in such turmoil.
"It's hard to let go of worrying," I said. "I just so much want to fix everything for her."
And of course, I can't. It's going to take time.
So like I said, it might have been that bowl of cream of spinach soup that brought me to my knees in the middle of the night. But I'm thinking that there is a better, but scarier, explanation. The last couple of weeks have brought me to my knees in worry. They have brought me to the totally terrifying reality that life can go screwy at a moment's notice. Just take one wrong step. Just make the unfortunate mistake of placing your foot down three or four inches in the wrong direction on a city street, and you may face weeks, months, or even more of agony and distress.
And there is an even scarier reality too: all of us face the real possibility of landing our parents, or ourselves, in a nursing home that is horrific. I've told my sisters and my husband that if that happens to me, I want a way out, as in, a bottle of pills. Will I feel differently at some point in the future? I'm not sure, but right now, I don't know how to wrap my head around the things I saw this week.
Mom's ankle will heal. We will weather this storm. But there is such terror in seeing a beloved parent drop precipitously into an invalid condition, and have to face such pain and indignity, indignity visited routinely on elderly people in nursing homes.
I sit here and my stomach feels shredded. It rumbles and aches and I take a moment to breathe and I think, life is just so incredibly fragile. And the thought of that, honestly, is so overwhelming today that I will just stop writing now, and take a nap.