Monday, October 31, 2011

Dealing with Mom

My mother is 81 years old and not in great condition. To hear her, she is as good as when she was 30 or even 25, just not able to do as much housework, and this from a woman who has two leaky valves in her heart (tricuspid and mitral), one remaining kidney full of tumors and hemangiomata (blood tumors), liver riddled with hemangiomata (more blood tumors), reflux, a hiatal hernia (hole in esophagus), needs frequent blood transfusions (don't know where the blood is going -- probably to the expanding hemangiomata), iron infusions, monthly B12 shots (her body no longer makes its own B12), protein-calorie malnutrition (body does not absorb nutrients or vitamins), a raging sweet tooth and she eats constantly, weighing in at 105 pounds (usually less), wrecked intestinal tract from decades of laxative abuse with resultant constipation and need for disimpaction (don't ask), truncated small bowel (15 inches because of strictures and adhesions from previous surgeries), incompetent bladder, and I could go on with hypertension, arrhythmias and more. Yeah, she's in great condition.

The above litany of problems means she is as healthy as a horse -- that has needs to be put out to pasture -- and then there are the balance problems and constant falling, one time taking a close-up look at a sidewalk from a prone position resulting in enough bruises to qualify her for going one-on-one with Muhammad Ali in his prime and then letting George Foreman use her face as a punching bag. She also has TIAs (transient ischemic attacks that leave her cold and barely consciously of her surroundings or actions for longer and longer periods of time) and vomits for days at a time.

I had THE TALK with her this evening after she got home from a 5-day stay in the hospital about her options. None of my siblings is willing to discuss this, although they have talked about it among themselves. I wasn't included. I live in Colorado and nothing I say is germane to the issue since they live in Ohio and are dealing with the issues, except they are not dealing.

I told my mother that she has three options: a daily caregiver while Hoity-Toity is at work, adult day care while she is at work, or an assisted living facility. You can imagine her response. She is great. (She just had an iron infusion and a blood transfusion today, the vampire after a feeding all full of blood and warmth. How long will that last?) She doesn't need any help. She said that after she picked herself up from yet another fall. I told her having two canes, a motorized wheelchair, and a walker do no good if you don't use them.

She is adamant about not needing help and she isn't going to pay for it either. She doesn't want to waste her money, and yet she will waste money on jewelry she carries around in Ziploc bags and seldom wears. She's failing. She's 81 years old. She is no longer the best judge of her own situation or her needs.

"I'm healthy. Nothing wrong with me," she said. "No one can believe I'm 81."

No, I think. That's because they're sure you're 101 or even 120.

I broached the subject of going to court to have a guardian appointed, probably Hoity-Toity or The Mushroom, to make these decisions for her and her response was a threat to commit passive suicide by no longer eating or drinking. I don't take that seriously. She'd never give up the bags of peppermint patties she goes through every day or the Bit-o-Honey, Tootsie pops, or circus peanuts she devoured by the bagful. Besides, we'd just wait for her to pass out from her sugar coma and take care of business.

It's difficult dealing with an intransigent parent bent on destruction and unmindful of her own safety and needs. She still thinks she is able to make these decisions and I can see that is not the case. I know she's terrified of being bed-bound and left to die in a nursing home like she did with her mother, not that there was much choice since repeated strokes had destroyed half of Gram's brain and she was a vegetable -- a vegetable in pain with no access to speech or language or reasoning functions in her brain. Mom kept her in the nursing home so she would get the care she needed and kept her alive by begging Gram not to leave her alone. Mom doesn't believe in karma, but I can see that she knows a great big old free-for-all is coming and she doesn't want to face the music.

I understand my mother's need to direct her own care and her own fate. I also understand that she can no longer do so with any reliability and needs someone to take care of her or to be taken care of during the day. Hoity-Toity's house is out in the country far from the city. It's picturesque with its surrounding farm land and semi-built-up housing development, but it's still the country. There are no services that far out of town. As lovely as it is, it's not longer safe for Mom to be there along for 10-12 hours a day, not with her falling and the TIAs.

My siblings are not willing to make the hard decisions, which is why I had THE TALK with Mom tonight. She needs to be aware of what is coming, and so do my siblings. They're going to have to put on their big kid panties and deal with this. They can no longer wait until some day. That day is now.

It's never easy telling Mom anything and even less so now that I have to hit her with the bad news. She's not safe. She says she has her cell phone, but cannot grasp the reality that if she is hurt and not able to reach her cell phone, she could die or be hurt badly and no one would know until Hoity-Toity made it home.

I don't relish this moment. I know that in not too many years it will be my turn to face these realities and I hope someone love me enough to make the hard decisions. Someone has to.

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