What a difference a day makes…

The day before yesterday, Richard and I  headed over the mountains to visit my folks, planning to fulfill our “service” on Monday, Martin Luther King, Jr Day of Service, by helping with my mom’s hospice care. Little did we know just how much help that would entail.

We brought Sunday dinner featuring a corn-winter squash-potato chowder I had cooked at home. While Richard and my dad ate in the dining nook, I fed my mom in the bedroom. In between spoonfuls, I embarked on my newest project: helping her conjure up happy memories to soothe her Alzheimer’s-affected brain. I started by asking about her childhood camping trips in the California’s Sierra Nevada in the late 1930s and early 1940s. (The photo below is my mom’s parents in Yosemite National Park in 1934. According to my mother, my grandmother rarely joined in these camping trips. This must have been a special occasion!)

MilnerJanet

Mom mentioned the old army tent they used, how they often camped in Tuolome Meadows and how my granddad loved to hike to high places (“I think he climbed Half Dome”). A smile crept across her face.

We left that night feeling good about thing even though I was surprised at how much more frail Mom seemed than our visit ten days before. Just how frail, I learned the next morning as we were finishing breakfast at our motel and my phone buzzed: It was my dad, calling with the news that Mom had fallen out of bed early that morning. They were at the Emergency Room, waiting to see if she had broken her hip. 

She had, and how. Over the course of consults with the ER doc, the orthopedic surgeon, and the palliative care doc, we learned that the fracture was not only “nasty,” it was beyond repair. Mom’s bones are so spongy from decades of taking steriods for  rheumatoid arthritis, her skin is so thin and so prone to eroding into ulcerated sores, and her overall health so frail, that surgery would likely make her condition worse. Mom listened and agreed; she was quite clear that she didn’t want surgery. The decision about treatment: Arrange for round-the-clock care and manage her pain with good meds.

So late yesterday afternoon, the hospital released Mom to a care center. The idea: her regular hospice nurses would come in every day to oversee her care; she’d be comfortable. “I just want to go home,” she said over and over. We weren’t sure that was possible with her now-severely limited mobility, but we promised to work on it. The care center seemed like a reasonable interim step.

Mom

But didn’t work that way. The staff was very nice, but the facility was more like a nursing home than my image of a homey, safe place I expect from hospice. (As I understand it, the point of hospice care is to make the patient as comfortable and safe as possible, and support their family, allowing the patient to end their days with comfort and dignity. Mom was anxious; Dad spent the night in an easy chair next to her bed.

And I woke at two this morning worrying. So first thing this morning, I called the hospice staff and expressed my concerns. They agreed to evaluate the situation.

Which is why after Richard’s his brain MRI at the VA Hospital this morning (we won’t have results on that until next week), we drove to the care center and met the hospice nursing team and social worker in my mom’s room. After that consultation and many, many phone calls, we left Denver this afternoon on what has become our accustomed race over the mountains in the face of worsening weather.

Elk
By the time we were slithering on icy roads across South Park–and counting elk pawing for grass through the wind-crusted snow–almost everything was set. An ambulance would arrive to transport Mom (and Dad, who had stayed with her) home to their cozy apartment. For the first 48 hours, they would have round-the-clock caregivers on 12-hour shifts; we’ll re-evaluate their needs after that.

As Richard drove down the last mountain pass into our own valley, I pulled the final details into place. After I hung up my cell phone, I looked across our valley. The full moon swam out of the clouds, round and luminous, whole and wholly beautiful, as if to bless this very long day, my parents’ continuing journey, and our homecoming.

Tonight, I’ll sleep well knowing my parents are home, and safe.

Fullmoon

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