Elderly Insults

August 20, 2011
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I open my mother’s bedroom door.

“Good morning, Mom,” I chirp, as I part the drapes. The chirp is a feeble bluff. I already know it isn’t going to be a good morning. I know she had a rough night. She was coughing like a ’57 Mercury on a steady diet of low-test.

At about midnight, I had to give her medicine. It was either that, or drive her to the Al’s Gas & Garage.

I retreated to the living room with John Steinbeck. I sat in the recliner until dawn, in a sleeve of yellow light… listening. I keep an eye on her with my ears.

Even with the drapes pulled, this cold Sunday morning in early March offers more gloom than light. I put my hand to her forehead, a slight fever. She is wan, and looks tired. Still, she tries to greet me with a smile of recognition. Recognition would have meant a lot to me. But she coughs instead. I’m not insulted. She’s ill.

I leave her in bed and, as per our practiced morning routine, I tell her I’ll be right back to help her bathe. Another bluff. I call for an ambulance instead.

Mom will turn 87-years-old in a few weeks. She and I both suffer from Alzheimer’s. That is the way with this disease. Nobody is allowed to suffer alone.

Mom has also succumbed to many of the other physical insults that get blithely piled on the hapless, helpless folks who have the effrontery to live beyond their ability to care for themselves. For the most part, though, I can handle all that crap. I have been handling it on a daily basis for nearly five years.

But today is one of those different days. Today, she needs an ambulance. Again.

The neighbors are getting used to seeing the ambulance in my driveway. Maybe they think it lives here. This is the fourth ambulance sighting in the last seven months.

Mom has become prone to UTIs—Urinary Tract Infections. Nasty buggers, and very high on my list of DEIs—Dreaded Elderly Insults. UTIs rob Mom of her balance, produce fevers, and scramble her eggs even more than usual. What’s more, they’re not good for her. Though I can recognize these insults, I cannot handle them all. Sometimes a son isn’t enough. Sometimes the sun and the moon aren’t enough. Sometimes she needs professional care.

“A few days on IV antibiotics will do it,” the doctors always assure me. And, of course, I am always thoroughly assured. Has anybody seen the turnip truck I just fell off of?

So, every time I bring her back home, she’s as good as new. Until I have to call the ambulance again. Have you ever seen Ground Hog Day?

The doctors and nurses tell me there is no way to prevent Mom’s UTIs.

“She’s incontinent,” they explain.

Incontinence: Dreaded Elderly Insult Number One. And, sometimes, Number Two, too.

The lead EMT has been to my house before, and recognizes me as soon as I open the front door.

“Fever?” he says, as he and his buddy wrestle the gurney round the narrow, cluttered spaces.

“Just 99.1,” I answer. “But she’s weak. Disoriented. No vomiting, though. She’s alert and breathing easily. But she does have a pretty ragged cough.”

He grins and nods at my practiced report.

Hell, I know the routine. I even have all of her insurance cards ready.

“Probably another UTI,” he suggests. “But the cough could be something else.”

I like this guy. His says what he thinks. Doctors be damned. Of course he says what I already know. Maybe that’s why I like him.

“That’s my guess, too. UTI. But the cough is unusual. Maybe something she picked up at daycare?”

He shrugs. “All women your mother’s age are pretty susceptible…to everything.”

He doesn’t have to say it, I know what he’s thinking, ‘Dreaded Elderly Insults.’ I can tell that he is insulted, too. Now I know why I like him.

He takes Mom’s temperature. “101.4.”

He has trumped me. “But I just took it ten minutes ago… it was only…”

“It’s good that you called. These things can get out of hand pretty quick.”

It’s good that I called. I’m proud of myself. I’m getting good at this. Mom is in good hands. So why is she so sick? And why do I want to throw up?

Mom is confused by the strange men in her bedroom, and shoots me an accusing look. She even sticks her tongue out. It’s okay, I’m used to it. I chalk it up. Alzheimer’s insult.

Even though she doesn’t know what’s going on, she’s quite cordial and cooperative with the EMTs. I’ve learned that the Alzheimer’s Imp reserves her insults only for the primary caregiver. After all, Mom still loves my brother. She hasn’t seen him since Christmas. And she doesn’t even remember Christmas. But she remembers me. Sometimes I think she wishes she could forget. How’s that for Alzheimer’s irony?

Just before they slide my mother, like a loaf of bread dough, into the ambulance-oven, I assure her that I’ll gather up her essentials, and meet her at the Emergency Room.

“Bring the cake,” she says.

“What?”

“Bring the cake.”

“Oh, okay.” I have no idea.

I am right on the money with my UTI diagnosis. But I come up craps on the pneumonia and the heart attack.

Heart attack? Where the hell was I?

As a child uber-klutz, I spent more than my fair share of time bleeding and moaning in ‘50’s and ‘60’s Emergency Rooms. And I can attest that things have gotten better. I’m not the one bleeding anymore.

By the time I get past the armed guard (my mother is safe, now), and into the ER, Mom is in a comfortable bed, in a cozy, private nook, and some sort of chicken soup is being pumped into her veins. I hold her hand.

“Oh, Don, what are you doing here?” Don is my absentee brother. Mom can be such a kidder.

Mom seems totally comfortable, and settles in for a nap. I squirm in a hard chair. I pretend to read James Lee Burke’s Two For Texas, but I’m really more fascinated by the clock.

Two hours and fourteen minutes later a very harried doctor introduces himself. He is Indian, and his name includes several vowels I have never heard before. He sees the look on my face and smiles with less humor than an anvil.

“Just call me Dr. Almi.”

My plan had been to just stick with Doctor, but, hell, this is an emergency. I can, and will adjust.

“Your mother is a very sick woman.” And this from a guy who hardly knows her. “She has had a coronary event, or heart attack. She also has pneumonia, and a UTI. We will have to admit her.”

“Really?”

He looks at me sharply. “She is a very sick woman.”

I guess sarcasm isn’t his specialty. I guess he doesn’t watch House.

It turns out that Mom has a hole in one of her heart valves. And it’s getting bigger. Surgery is out of the question. She would probably die on the operating table. Wouldn’t want that. I have a perfectly good TV table. She takes most of her meals there. As good a place as any to keel over, right? Mom, get your face out of the spaghetti!

Six hours and seventeen minutes and thirty-two seconds later, they finally find a bed for Mom. I have already finished Two For Texas. Can anybody tell me what the hell it’s about?

After six days in a hospital bed with nothing to do but watch Cream of Chicken drip into her arm, Mom is in no shape to come home. She’s weak and disoriented. Naturally, the hospital boots her out.

The doctors and the Social Services Director recommend I send her for a couple of weeks of nursing care.

“But, she’s already in a hospital,” I observe. “This place is crawling with nurses.”

The doctors appear to be confused.

“We were thinking a rehab facility,” says the SS Director. Funny, I hadn’t noticed her German accent before.

“Rehab? From what, you’ve got her hooked on Chicken Noodle?”

The doctors all get busy consulting their charts.

“Herr Hill, your mother vill need a lot of care for a few veeks.”

I almost heil. “Ja, then, let’s get her the hell out of the hospital.”

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Lee Allen Hill

I'm just a leftover hippie with a penchant for word-slinging and a desire to live off royalty checks in sunny Zihuatenajo, Mexico.I spent twenty years as Creative Director for my own ad agency.For the last four years I have been the sole caregiver for my Alzheimer's-afflicted mother.I'm told I 'write good.'Well, we'll see.

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22 Responses to Elderly Insults

  1. ChicagoGuy on August 20, 2011 at 12:45 pm

    Anybody wondering why “Do No Harm” is a doctors first rule should read this. “Medical Nemesis” —which came out in the 70′s is a book I know well. Superimposing real life, vivid narrative on medicalization isn’t just good writing. It’s a service. You might even have a book a publisher (if there are any of those left) would buy here. This is compelling stuff.

  2. Lee Allen Hill on August 20, 2011 at 1:15 pm

    Thanks, ChicagoGuy. I’m not familiar with ‘Medical Nemesis’ but it is now on my to-read list. This is the second leg of a stool I’m writing. It writes itself, my friend. I appreciate your kind thoughts. Lee

  3. Frank Scarangello on August 20, 2011 at 2:26 pm

    Good luck and all the best Lee. The only consolation is that after all of this is over you will have no regrets over what you should have done. You did everything possible.

    Regards.

  4. Lee Allen Hill on August 20, 2011 at 2:55 pm

    You know, Frank, you are right. But in the back of my mind, I wonder if I’m not doing it all for me. I know I’m nuts. You understand. Lee

  5. AtHome Pilgrim on August 21, 2011 at 8:07 am

    We took care of my wife’s mother her last 15 months of life. Her mind was sharp, thank God, so we didn’t have to go through all the forgetfulness and confusion, but the emotional drain was there. I really understand your need for humor (“Sometimes I think she wishes she could forget. How’s that for Alzheimer’s irony?”)–and the desire to care for her, even though it’s an awful grind. Yes, you’re doing it for yourself–and for her, too. The key is to accept, as Frank said, that you did everything you could.

    To strength through humor!

    • Lee Allen Hill on August 21, 2011 at 4:07 pm

      Strength through humor—I’ll drink to that!
      It has been five years now, and it’s coming to an end.
      This is the second installment of a trilogy.
      She’s well, and well-cared for, but now I have to write about the part where I had to let go.
      Thanks, Pilgrim. Lee

  6. Maureen Andrade on August 21, 2011 at 11:59 am

    This tugged and tugged at me. I had to come back today to comment on it. Watching someone we love struggle and have their body fail,after all the care they gave us, is difficult to endure.

    • Lee Allen Hill on August 21, 2011 at 4:11 pm

      From a writer’s standpoint, I have to appreciate the ‘tug’. Writing about it brings me balance. Thank you, Lee

  7. Naomi de Plume on August 21, 2011 at 12:06 pm

    “So, every time I bring her back home, she’s as good as new. Until I have to call the ambulance again.” This line is so appropriate when it comes to caring for the ill. I like the different emotions you infuse in this. I am sorry to hear about your mother’s pain – and yours. I wish you both some kind of peace in all of this.
    I also love that you waited with John Steinbeck. he seems like a nice companion in times like this.

  8. Lee Allen Hill on August 21, 2011 at 4:18 pm

    Thank you, Naomi (cool name, by the way.) Thanks for understanding how I can jump from anger to humor to frustration and have it all feel appropriate.
    Steinbeck is the ghost I would most like to be haunted by. You understand, right? Lee

  9. Jill Reese on August 21, 2011 at 5:04 pm

    Lee, this is an honest look at the stress and frustration of being a caregiver. You tell it like it is. I’m sure so many people can relate to your account. You give those of us who are not yet taking care of elderly parents something to think about. You are amazing.

    Jill

    • Lee Allen Hill on August 24, 2011 at 1:10 pm

      Thanks, Jill. So many people respond to my stories with stories of their own. I think is as much a rite of passage as acne. We grow out of it, but we loose something in the process, too. Lee

  10. Marlene Dunham on August 21, 2011 at 5:06 pm

    “She and I both suffer from Alzheimer’s”
    So sorry about this but i do love your writing and your sense of humor, which is (I’m sure)what gets you through.

    • Lee Allen Hill on August 24, 2011 at 1:14 pm

      Marlene, life is funny, even when it’s kicking your butt. Sometimes I don’t see the humor until I write down. Thank, friend. Lee

  11. greenheron on August 24, 2011 at 1:00 pm

    I completed a six year tour of AD duty with my own mom in July. As difficult as these days are for you both, once she has passed, there will be relief, as well as a profound yearning to hold the juice straw to her mouth one more time.

  12. Lee Allen Hill on August 24, 2011 at 1:19 pm

    Six years! I would have had five in July, but by May I had to wave the white flag. The heart attack and subsequent infections took to much out of her. She’s in a nice facility. Every morning I help her eat her breakfast, and help her with her straw. She’s content, and I’m reasonably comfortable that I did as much as I could. That’s what the third installment of my trilogy with discuss—a clear conscience. Lee

  13. greenheron on August 24, 2011 at 1:54 pm

    Mine was finally placed in a nursing facility as well for her last year, just too dangerous to continue in home care. I live a distance and could not be with her daily, but went home ten times in the last twelve months. Yes. You figure out how to provide love and care with generosity and without falling on the sword. Then when she passes, your sorrow feels clean and right and without regret.

    My heart goes out to you. Folks who have not been through this cannot fully understand the horror that is Alzheimer’s. Lefty anarchist liberal that I have always been, there is soft place in my heart for the Reagan family. While hardly one of his fans, I have deep empathy for what he and they went through.

  14. greenheron on August 24, 2011 at 2:06 pm

    P.S. I blogged about my mom over at Open Salon a few times. Here’s one I like: http://open.salon.com/blog/greenheron/2011/01/20/crossing

    Reading about Alzheimer’s can be draining and painful when you’re living it, so please know that I would not feel in the least bit slighted if you choose not to check it out.

    • Lee Allen Hill on August 25, 2011 at 12:30 pm

      greenheron, I haven’t been able to get to open salon yet, but I am interested in what you have experienced, and how you have written about it. The Community of the Caregiver grows with the Community of the Suffering. Lee

  15. N.K. Wagner on August 25, 2011 at 12:13 pm

    I know. And I still cried. You’re a hero, Lee, as is everyone who takes on eldercare. The role reversal is enough to send most screaming into the night. Written honestly, with the full range of emotions. The only one you don’t deserve is guilt. You’ve done it all exactly right. N.K.

  16. Lee Allen Hill on August 25, 2011 at 12:33 pm

    Then the world is full of heroes. Without a dash of guilt, we would all become complacent. My aren’t I philosophical today! Thanks, Nancy. Lee

    • N.K. Wagner on August 25, 2011 at 3:59 pm

      Guilt for other things, then. Not for this. N.K.

Talk to the writer!

SideNotes

Chain Lightning

Chain Lightning

Women, and I can’t have been the first to notice, are different in crisis. Women of a certain age and life experience are magical beings flying, all too often, under the radar and beyond the sonar of man, until they fold their wings and descend or surface to save their slice of the world.

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